PARLIAMENTARY DEBATE
Covid-19 - 22 October 2020 (Commons/Commons Chamber)

I beg to move,

That this house has considered covid-19.

The House meets today to debate the coronavirus pandemic once more. The peril of the pandemic has no short-term quick fix, but calls for ingenuity, commitment and resolve from us all. We have responded with one of the greatest collective efforts that this nation has seen in peacetime, but the fight is not over: the virus continues to spread, and cases, hospitalisations and, tragically, deaths are all rising. Yesterday we learned that Liverpool University Hospitals NHS Foundation Trust is now treating more patients than it was at the peak in April, and across the UK the number of deaths has doubled in under a fortnight. And yet, just as the situation we face is grave, so the hope of a solution is growing. With every day, my confidence in the ingenuity of science to bring resolution grows. But until that moment, we must have resolve. We are focused on finding a long-term solution, and we reject political point scoring. I call on the House to work together in the interests of our whole nation—and, indeed, the whole world.

I just wonder whether one problem we have at the moment is that we do not have enough capacity in the whole of the NHS to take on covid in a long-term way, as the Secretary of State suggests, and still be able to do all the things that we really need to do. How can we ramp up that capacity so that we are still treating people for cancer, for brain injury and for all the other things that we all care about?

The hon. Gentleman is absolutely right. He represents a seat in Wales, and this is a challenge for the NHS in all four nations of the United Kingdom. I was going to come on to this, but one thing that we have learned in the first phase is how we can do better in keeping the other services running that the NHS must and should provide, for instance for brain injuries, for cancer treatment and for heart patients. There are also those things that are not life-threatening, but that harm people’s lives—a painful hip or a cataract that needs treatment. In the first wave, as we knew so much less about this virus, many of those treatments were stopped altogether.

In the second wave, we have two advantages. The first is that this is a much more regional wave, which puts more pressure on areas such as Liverpool and Lancashire than elsewhere in the country, but that does mean that elsewhere the elective and the urgent operations can continue. The second difference is that we know much more about the virus and how it spreads, so we have separated the NHS into green sites and blue sites. Green sites are for where we have a high degree of confidence that there is no covid, using testing and asking people to isolate before going in for an operation, so that people can have more confidence. The central message across all parts of the UK is that the NHS remains open. Finally on this point, the best way we can keep the sorts of treatments that we all want to see going is to keep the virus under control.

The Secretary of State has answered my question in part with his reference to the importance of green and red. One of the big problems in the first wave is that people were frightened, even if they feared that they had cancer or some other condition, to go into the hospitals, and we have to reassure them that they can go there and they can be safe.

The right hon. Gentleman is absolutely right. We have an advertising campaign, “Help us to help you”, to make the simple point to people that, if they are asked to go to hospital by a clinician, then it is safer to go to hospital than not to do so. In fact, we call them green sites and blue sites. Green means free from covid—we are as confident as we can be that they are. It is blue, not red, which means that we still want people to come to hospital, even if they have to come to A&E, because there is only likely to be, at worst, as much covid as there is in the general population, unless, of course, a person is in a covid ward treating only covid patients. The NHS has learned a huge amount both about the microbiology of the disease and about how to run health services in a world when covid is at large.

Of course this is a dangerous disease and of course cases are rising, including in my own area, so it is with some humility that I have a look at the daily excess all-cause deaths in all ages in England, which show that there has been no significant excess all-cause mortality observed in week 40 overall. Is it not the case that the good news in this second wave is that the disease is not progressing as it did in the first?

I want to keep it that way. It is true that the all-cause mortality rates are at around the typical levels for this time of year, and that is partly because non-covid deaths are actually lower at the moment than in most years, and because, thus far, we have worked to keep this virus under control. We know from the basic mathematics of compounding growth and the exponential nature of the growth of any virus that the number of deaths will increase if the number of cases increase, exponentially, hence the need for the actions that we in this House have voted for.

Many of my constituents were frightened to go to hospital because they thought that they might get infected with covid. With that in mind—I am quite sure my right hon. Friend has thought of this—would it not be an idea to separate hospitals so that we have a covid centre of excellence, say using the Nightingale hospitals, where everyone goes, and then the normal hospitals that deal with everything else? Forgive me for raising this point, because I am quite sure that the Secretary of State has a very good answer.

It is a brilliant idea—so brilliant that the NHS has spent the summer working on that concept. We cannot do it as perfectly as my hon. Friend suggests, and the reason is the practicalities of the treatment of covid—for instance, if someone has covid and something else, they need a normal intensive care unit. But the Nightingale hospitals are there—in fact today, sadly, the Nightingale hospital in Manchester is reopening. In all the rest of the hospitals, we are making sure that different parts are deemed either blue or green—essentially covid-free or at risk of covid. Some of the different buildings are covid-free or non-covid, or, in some cases, whole hospitals are covid green sites and people cannot go to them unless they have tested negative. That means we can have a high degree of confidence because, for instance, if we are treating cancer patients, we want to ensure that there is not any covid in there.

We need these long-term solutions and, like other liberal democracies around the world, we are wrestling with this question—as we have wrestled with it in the last few minutes—of how to keep people safe from the virus while protecting other important things in life: our liberties, our livelihoods and the things that we love. That is what leads us to the strategy of suppressing the virus and supporting the economy, education and the NHS. The NHS needs to be supported to do all the other things that it needs to do until a vaccine is available.

I reject the false choice that says we must pick a side and choose between a healthy economy and a healthy nation, because the two are intrinsically linked. If, God forbid, we were to let the virus unleash its full force, the damage to not just the NHS and the hundreds of thousands of lives, but our livelihoods would be catastrophic. We can only get our economy and our society going gangbusters again if we drive this virus down, so that people have the confidence that they need to live their lives to the full—and drive it down we must.

This is a deadly virus, and, yes, it reserves its biggest impact for the oldest in society, which means that the rise in the number of cases among the over-60s gives me a lot of cause for concern. We also just heard compellingly from the Minister for Equalities about the impact on people from ethnic minority backgrounds, but the impact is not confined to these groups. The virus can affect anyone of any age and any background, and we have already seen worrying numbers of young, fit, healthy people suffering debilitating symptoms months after contracting covid. Yesterday, a study by King’s College London showed that one in 20 people with coronavirus is likely to have virus symptoms, such as fatigue, breathlessness, muscle pain and neurological problems, for eight weeks or more. Yesterday, I visited the cutting-edge long covid clinic at University College London hospital. I have met people in their 20s and 30s unable to work, sapped of all their energy, living with the long-term effects of a virus that has completely changed their lives. Therefore, to anyone of any age, catching covid can be very grave indeed. Long covid underpins, again, our strategy for suppressing the virus until a vaccine arrives.

When my right hon. Friend came to the Health and Social Care Committee a few weeks ago, he talked about long covid and the fact that clinics were being set up to deal with it. Will he give the House an update on where that has got to?

These clinics are being set up—the London clinic is now open—but we need to see them right across the country. The NHS now has a programme of rolling out clinics to be able to support people and, of course to communicate with GPs. That is important because primary care is often where people arrive with long covid, because there appears to be no correlation between the seriousness of someone’s initial illness and how long they can have these debilitating consequences. In some cases, people have no symptoms of the coronavirus initially, but then find that they have months and months of fatigue, a brain fog and muscle pain, and they do not know where it came from until they are diagnosed with long covid. It is a very serious complication.

To enable us to get a picture, could the Secretary of State tell us what percentage of people up to 25 suffer from the condition?

Yes. We have two points of evidence; one is the evidence from King’s College London that shows that approximately one in 20 people with coronavirus is likely to have long-term symptoms, but the other evidence implies that in adults under 50, the proportion is more like one in 10. There seems to be some correlation that implies that it is more of a problem among younger people, but the understanding of long covid is still in its early stages and an awful lot more research is needed.

I am sorry to press the point, but it is a question of roughly what percentage is affected not of those who contract the disease, but of the overall cohort.

It is very difficult to know. We estimate that approximately 8% of the population have had covid and that one in 20 people who has had it has symptoms for longer than eight weeks. Of course, the fewer people get covid, the fewer people get long covid, which reinforces the overall strategy of suppressing the virus until we get a vaccine. Let me turn to how we do that.

We cannot reiterate enough the importance of the basics: social distancing and “hands, face, space”. The next area is following rules on local action, which are at the core of how we and an increasing number of other countries around the world are tackling the crisis at the moment. Through our local covid alert levels, we have been able to take a balanced approach; I would like to update the House today on some further changes that we are making.

Unfortunately, we are seeing rising rates of infection in Stoke-on-Trent, in Coventry and in Slough. In all those areas, there are more than 100 positive cases per 100,000 people, cases are doubling approximately every fortnight and we are seeing a concerning increase in cases among the over-60s. We have agreed, in partnership with local leaders, to move those areas to the high local alert level, which will come into force at one minute past midnight on Saturday.

The central change is that people will not be able to meet other households socially indoors. This applies in any setting—at home, in a restaurant or in any other venue. The rule of six still applies in any outdoor setting, and although people may continue to travel to open venues, they should reduce the number of journeys where possible. I thank local leaders in the areas for the work they have done and for their co-operation. I can assure the people of Stoke-on-Trent, of Coventry and of Slough that we will support them all the way through, including with the business support that the Chancellor announced earlier today for all areas with a high local alert level.

We are also formally beginning discussions with Warrington about moving it to the very high alert level, owing to a continuing rise in cases there.

I thank the Secretary of State for the ongoing dialogue with me as a Warrington MP and with my colleagues in Warrington. I was particularly concerned this morning after having seen Public Health England data about the rapid rise in the infection rate among the over-60s in Warrington. Could he say a little more about that information?

I am worried about the rise in cases, especially among the over-60s in Warrington. We have seen that case rate continuing to rise, despite the hard work of people locally, since Warrington was moved to local alert level 2. There is an excellent local hospital in Warrington, but it is dealing with a very high number of cases and is working with other local hospitals to ensure that everybody gets the treatment they need. I pay tribute to my hon. Friend, who has provided great leadership in his local community. I hope that with everybody supporting these measures and taking the actions necessary, we can keep these restrictions in place for as little time as possible, but I am absolutely convinced that we need to make progress. I have announced today that we will formally start the talks; I hope that we can reach an agreement and resolution soon.

The virus moves quickly, so we must respond quickly and in a targeted way like this to keep it under control. As part of local discussions, local authorities including the Local Government Association have asked for stronger enforcement powers, and I agree. To support businesses who are doing the right thing it is fair that we take action against those business who are doing the wrong thing. Firm enforcement helps make these restrictions fairer for all. We want to put in place stronger regulations to give local authorities further powers to take further action in their area. The proposals that we will bring forward will mean that councils can act without delay and use closure notices to shut premises on public health grounds to help suppress the virus. We will work with local authorities in the coming days on the details of these proposals so that we can act in a firm and fast way against the minority who are breaching these life-saving rules.

These changes will help us fight the virus in the here and now, but we are also making progress on long-term solutions. The long-term solution is not to give up, as some would have us do, or wish the virus away; it is to harness the science and the ingenuity of innovation while supporting people through this.

First, on testing, thanks to exceptional work from so many people, we have built a critical national infrastructure of diagnostic testing. Today’s testing capacity is now over 370,000. Alongside this expansion of the current technology, I want to update the House on mass testing. I know there have been many questions about this project. Last week, we began rolling out new testing technologies to hospitals based on the point-of-care LAMP—loop-mediated isothermal amplification—test. That will allow the regular repeat testing of NHS staff and patients. I am delighted to be able to tell the House that yesterday we began the roll-out of lateral flow tests to schools and universities. Lateral flow tests do not require a lab or a machine; the kit gives a result within minutes. We have successfully purchased many millions of these tests, and they will allow us both to find the virus where it spreads and to reduce the disruption that virus control measures inevitably create.

If we can deliver a mass-testing solution so that pupils in a bubble do not have to isolate for a fortnight when one in the bubble tests positive, we will not only help control the spread of the virus, but protect education better and help schools, teachers and parents to live their lives much closer to normal. These tests will also allow directors of public health to have more rapid access to testing capacity and we are starting the roll-out to councils, including, today, the council in Stoke-on-Trent.

The second area to touch on is vaccines. Progress continues on the development and the deployment of vaccines, and we are determined to give those developing vaccines all the support they need. I can inform the House that we are initiating human challenge trials to speed up the development of the coronavirus vaccine and to improve further its safety. We are contributing £33 million to back these trials, joining forces with academia and industry. A human challenge trial involves taking a vaccine candidate that has been proven to be safe in trials and giving it to a small number of carefully selected, healthy adult volunteers who are then exposed to the virus in a safe and controlled environment closely monitored by medics and scientists. That gives us the chance to accelerate the understanding of promising vaccines that have been through the clinical trials so that we can improve their safe development. The UK is one of the only countries in the world with the capability to run that kind of programme, and we should all be proud that, once again, we are leading on this global effort.

Our response to this lethal virus has been one of the greatest collective endeavours that this nation has seen. Thanks to those efforts, we are better prepared this time round. As a nation, we built the Nightingale hospitals in just nine days. As a nation, we came together as one to protect the NHS, and it was not overwhelmed. Now the NHS is better prepared still. As a nation, we built the biggest testing capability of all our peers, and we have made huge and historic advances in vaccines and treatments. We understand this virus infinitely more than at the start of this pandemic, but we are not there yet—not when the virus is spreading at pace. So we must each of us look at what we can do, the role we can play and what actions we can take. We have seen throughout this pandemic that we are at our best when we come together. We know that with science on our side, ultimately we will prevail.

Order. Colleagues will see that there are many who wish to contribute to this debate. Therefore, I will impose an immediate five-minute time limit on Back-Bench contributions. I call the shadow Secretary of State.

Given the numbers who are interested in the debate and given that I have enjoyed the indulgence of the House now for four days in a row—I am not sure what I will do next week; I might just come here and make a speech for the sake of it—I will try to be brief. I also apologise to the House, because I have a long-standing commitment and so I will not be here for the wind-ups. I apologise to the House for that discourtesy on this occasion. I have spoken to Mr Speaker about it, and he understands the particular circumstances.

I noticed that the Secretary of State updated the House on Slough, Stoke-on-Trent and Coventry, but he did not mention anything about Nottinghamshire and West Yorkshire, and he will know that they are candidates that are widely speculated as the next to go into the tier 3 lockdown restrictions. For example, in parts of Nottinghamshire, localised infection rates are 370 per 100,000 in Gedling and 362 per 100,000 in Rushcliffe. In West Yorkshire, the rate is 307 per 100,000 in Wakefield and in Calderdale. Given that, he must be considering the future of West Yorkshire and Nottinghamshire.

I am aware that we are going into the parliamentary recess. I do not know whether I can invite the Secretary of State to say anything now, because Members from those areas will be concerned that with Parliament not sitting next week, they might not have an opportunity to put their points to him or get their points on the record. If he does not want to say anything now, it would be important if the Minister of State could offer some reassurance to people in those parts of the world as to what might be happening.

As previously announced, discussions are under way. We want to proceed in consultation with and working with the local areas. With the parliamentary recess next week, we will find a way to ensure that colleagues are apprised of the situation, preferably in advance of any announcement.

I am truly grateful for that reassurance, because the Secretary of State will understand that many people in those areas will be concerned and Members will want to get their points of view on the record on that front.

The virus has caused a pandemic because it exploits ambivalence and takes advantage of our human vulnerabilities. It undermines our biological defences and spreads through human social behaviour and clustering. We know that people with long-term chronic conditions in particular are vulnerable, and we know that there is a greater burden of illness in our more disadvantaged areas, which covid cruelly exaggerates. We know that as we entered this crisis, we had less resilience as a society. We entered with life expectancy falling for some of the poorest and stalling nationwide, and life expectancy is a summary of our overall health.

In the past 10 years, the amount of life in good health has decreased for both men and women. Our child mortality rates are some of the worst in Europe, and poor health and chronic illness leave communities acutely vulnerable to disease, so it should come as no surprise to any of us that some of the boroughs currently fighting the most virulent fires are some of the very poorest in our country, with the very worst life expectancy.

I welcome the progress being made on diagnostics, therapeutics and vaccinations, on which the Secretary of State has updated us today. We welcome the expanding of mass testing, including the saliva testing and the lateral flow testing. I hope, by the way, that the Secretary of State will invest in our great universities, which are developing some of this saliva-based testing, because they will need the equipment and the labs to process it. He will probably need to invest in robotics and artificial intelligence to do some of that, because there are not enough staff to do it at the moment, and I hope that is part of his agenda. As well as all that, because the virus is now endemic, we will need a health inequalities strategy to get on top of it for the long term.

In the immediate term, we also need to adjust our behaviours to bring infection rates down, which is why I have supported the difficult restrictions that the Secretary of State has had to impose, and why we are saying we need clarity all the time from Government. But people also want to know that there is light at the end of the tunnel, because it is still not clear to families in Bury, Heywood and Penistone and all those other places that have been put under lockdown in recent days how they will escape it.

We still do not know whether the restrictions across the north will be lifted when the national R falls below 1 or when local regionalised R values fall below 1. We still do not know whether restrictions will be lifted across the north when hospital admissions stabilise. Yesterday, the Prime Minister said that decisions are

“based on a number of things including the R—also, of course, rates of infection, rates of admission to hospital and other data.”—[Official Report, 21 October 2020; Vol. 682, c. 1053.]

He did not tell us what that other data is. Perhaps the Minister responding to the debate can outline how an area in the north in tier 3 gets out of those restrictions. I know that the areas will be reviewed every four weeks, but what are the criteria to inform those reviews?

I represent Leicester, where we are in tier 2, but we have been in a version of restrictions for 114 days. We went directly from national lockdown to local lockdown. In fact, we endured tougher restrictions than those currently designated for tier 3. Our hospitality closed, our non-essential retail closed and—I did not agree with this—our schools closed as well. All those measures together did help to bring infections down in Leicester to about 55 per 100,000—to be frank, many Members would bite your hand off for 55 per 100,000 now—and even at 55 per 100,000 we remained in a version of lockdown.

Now, months later, after all the sacrifice we made in Leicester—after months with our businesses closed, with the mental health impact of people not being able to see their loved ones and families denied the opportunity to visit a care home to see their grandmother or mother—our infection rates in Leicester are 219 per 100,000. The Secretary of State will therefore have to forgive me when I express some scepticism that his approach will work and suppress the virus to the levels sufficient to bring the R value down, because although the early restrictions in Leicester did have an impact, after months we are still under restrictions with infection rates over 200 per 100,000.

The Secretary of State updated us on the situation we are in. He has been good at updating the House repeatedly; I have no criticism of him at all on that front. The growth rate in the virus is slower than in March—it is more muted, thanks to the great sacrifices of the British people, with hand hygiene, social distancing and everything we are doing—but it is not plateauing. We are dealing with an autumn resurgence, and for all the heat and fallout we have had across the House this week, the truth is that the virus is at worrying levels everywhere. The national R is between 1.3 and 1.5. The R across the south-east is between 1.3 and 1.5, across the south-west between 1.3 and 1.6, and across the east of England between 1.3 and 1.5.

Of course, admissions to critical care are currently concentrated in the north and the midlands, but while at this stage in the first wave those admissions to critical care were beginning to come down, they are continuing to go up. It is right that improvements in care mean that people are less likely to die. That is a good thing, and we all celebrate that, but general and acute beds are filling up with covid patients across the north and across the midlands.

We know that the Prime Minister has rejected a circuit break for now—he does not rule it out indefinitely. We think he should have taken advantage of next week’s half term. He decided not to do that. But we should remind ourselves that SAGE advised the circuit break on 21 September. A month later, on 21 October, we had these grim statistics: 191 deaths; 996 hospital admissions; 6,431 in hospital; 629 on ventilation; 26,688 tested positive; and 249,978 cases in the past 14 days. Many will ask how much of that could have been avoided, had the Prime Minister gone along with SAGE’s advice a month ago.

Today, the Chancellor said in his statement that we have to find a balance between saving lives and protecting livelihoods, but I do not believe that the two are in conflict. It is not a trade-off. Actually, I do not believe the Secretary of State thinks it is a trade-off—the tone of his remarks was very different from that of the Chancellor earlier. Saving lives and protecting livelihoods go hand in hand. I worry that the approach the Government are currently taking—while understandable, because nobody wants to be in a lockdown, and none of these decisions are easy or do not have negative consequences; I think we are all mature enough across the House to appreciate and understand that—means that there will, of necessity, have to be tougher, deeper action in the weeks to come, not only in autumn. Winter has not hit us yet.

Professor John Edmunds of the London School of Hygiene said yesterday in one of the Select Committees that

“there’s no way we come out of this wave now without counting our deaths in the tens of thousands…I think we are looking at quite a bleak situation unless we take action…I don’t think we should be taking action just specifically in the highest risk areas, but I think we need to take action everywhere”.

A similar sentiment was expressed by Sir Jeremy Farrar, who is also on SAGE. For balance, Professor Van-Tam said at the press conference this week that he disagreed, but also that

“we may have to push on the pedal a little harder”

to get it under control.

I know the Secretary of State is a decent man. He has been very good throughout this crisis in talking to me privately; one would expect a Secretary of State and a shadow Secretary of State to have those discussions. Whenever I have asked for briefings, all the way back to January, he has ensured that the chief medical officer will give me confidential briefings, as I am sure that every Member across the House would understand and appreciate. So I know he is a decent man. I know he is not playing games or anything like that. I know that these are difficult judgment calls of extraordinary gravity. I know there is no easy solution. Everything has trade-offs; everything has negative consequences. But we also know that unless we take decisive action, the consequences could be even worse. No one should pretend to the House that that is not the case. There is a worry that by not taking action now, we will, in the words of Professor David Hunter, an epidemiologist at Oxford,

“all wind up in tier 3 eventually.”

According to Times Radio yesterday, Government sources were telling it that the Government are now planning a three-week circuit break next month across all tier 2 and tier 3 areas. If that is the case, then the Government should probably level with us so that we can all start preparing for it.

This is not just about minimising harm and deaths from covid. As the Secretary of State said in responding to questions from my hon. Friends, we have a huge responsibility and duty to minimise harm and deaths from non-covid conditions as well. We have to avoid the situation that we were in in the spring, when the immense lockdown, which was actually a number of different interventions all at once, meant that to build surge capacity in the national health service, we had to cancel elective operations to free up general and acute beds, and much important diagnostics work and treatment got delayed. That has left us with a situation today where 110,000 people are waiting beyond 12 months for treatment, compared with just 1,600 in January; 3 million people are waiting for breast, bowel or cervical screening, and more people are waiting for treatment.

My worry is that we will end up building a greater backlog in treatment if we do not act. General and acute beds are filling up. We have a number of hospitals cancelling electives already. Bradford has just suspended non-urgent surgery. Birmingham is talking about suspending non-urgent surgery. It is happening in Nottingham. We know that Merseyside is under considerable pressure; the Secretary of State outlined it. It has just been revealed in the Health Service Journal that we are heading into this winter with 2,000 fewer beds than we had last winter. Today the Royal College of Emergency Medicine has warned that over half of A&Es across the country are caring for patients in corridors due to the lack of beds—and we are not even in winter yet. Our overcrowded A&Es are not ideal at the best of times, but during a covid pandemic it is obviously highly dangerous to be treating patients in corridors of A&Es. The president of the royal college, Katherine Henderson, has pointed out that this situation

“will put more lives at risk than it ever did before.”

If the Government really want to drive down infections, suppress the virus and ensure that general and acute beds are not overwhelmed and more operations are not cancelled, they have to seriously consider what steps they need to take to go further. Unless the Secretary of State or the Minister is going to get up at the end of this debate and say, “Actually, we’re going to do a circuit breaker over half-term next week”, I accept that the Government have probably missed that window of opportunity now, but at some point they will have to take further action.

We could have avoided much of this if test and trace had been more effective. The Secretary of State is spending £12 billion on this programme. Twelve billion pounds is a colossal amount of money. Some of it is going on consultants who earn £7,000 a day, but where on earth is the rest going? We are throwing around figures in this covid debate, and we are becoming quite complacent and relaxed about them, but £12 billion is an extraordinary amount of money; we could probably run the NHS for a month or so on that. We learn today that the system is reaching only 59.6% of contacts, which is the equivalent of failing to contact 101,000 people. That is not world beating; it is a world-beating shambles. I really hope that the Government look at stripping all the failing private outsourcing firms, such as Serco, of these contracts and putting local public health teams in charge. That would be much more effective.

I want to pick up a point about the app. It is telling people to self-isolate, but it does not give them the code that they need for the process, so they cannot claim their £500. That is creating chaos across local authorities. Does my hon. Friend agree that the Government need to get on top of this quickly?

Absolutely. There have been problems with the app. When I am in Leicester, it tells me that I am in an area that is both medium and high alert. Leicester has been under lockdown for 100 days, so how can the app say that in the part of Leicester where I live?

I thought that the hon. Gentleman’s comments were very thoughtful until we got to the unnecessary political knockabout. I want to make a couple of factual points about the app. It only takes the first two segments of someone’s postcode, some of which spread over two different alert levels, so that is why it describes the situation in Leicester as it does. When it comes to making sure that people press the button on the app to access the £500 self-isolation payment for the low-paid, that button is there on the app.

I want to leap to the defence of Test and Trace, because in the past fortnight the number of contacts and cases that have been reached has doubled. In slightly more than the last month, the distance travelled to get a test has halved, and the turnaround time for tests that are sent to care homes—those tests are critical for saving lives—has come down. More than 50 statistics on test and trace are published every Thursday, and of course the hon. Gentleman can look through them, find a couple that are going in the wrong direction and complain about them, but I think it is better to have a balanced opinion.

That was a spirited defence, but the statistics have been bad every week. The Secretary of State knows that, because I have raised it with him every week.

What happens is that every week, the hon. Gentleman looks through the 50 statistics and finds the ones that are not going in the right direction. I am merely pointing out that the system is doing much more than it ever has. One place where the huge amounts of money that we are putting into test and trace go is into the record amount of testing capacity, which is now more than 370,000. I think he should stand up and thank all the people who are delivering on this colossal effort.

I am very happy to thank the people who are working in test and trace.

U-turn.

That is not a U-turn. Thanking the staff is not a U-turn. The Opposition are on the side of the workers; the Secretary of State is on the side of the bosses. Of course we are happy to thank the staff who are working in test and trace, but he cannot seriously look at the statistics and tell us that the system is effective. The Chancellor of the Duchy of Lancaster did not defend it. When he was asked about the statistics on “The Andrew Marr Show” on Sunday, he said that

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

when the virus is accelerating. If the Secretary of State thinks that there is a good set of statistics, perhaps he should send it to the Chancellor of the Duchy of Lancaster, who took a different line on Sunday.

Let me come to a conclusion, because I know that many people want to speak in this debate. [Interruption.] The Secretary of State tells me to leave out the knockabout, but he is the one who started it off. The problem is that we went into this pandemic with an underfunded NHS, public health cut back and less resilience as a society. This will not be the only pandemic that we have to deal with. Climate change, urbanisation and deforestation mean that we are likely to see more viruses jump from animals to humans. The big challenge for us as a society when we come through this pandemic, as we will, is that we have to start building the health security to protect us for the future, because unfortunately, all of us across the House will be dealing with more of these pandemics in the years to come.

I draw the House’s attention to my outside interests.

This is the first time I have sought to catch your eye, Madam Deputy Speaker, in any of the covid debates. I want to express strong support for my right hon. Friend the Secretary of State. He has an impossibly difficult job to do, which in my view he is doing very well indeed, and we should all support him. I also want to express my gratitude and admiration for the health facilities in my constituency, in particular Good Hope Hospital.

I want to encourage a few small changes—to use a nautical metaphor, an adjustment of the tiller—to be made when possible. I am pleased to see that my right hon. Friend is working far more with Members of Parliament. The wisdom from our constituencies, as we report back in the House from the frontline, is very important and should play a critical part in the Government reaching their conclusions. Working closely with local authorities and Mayors is not easy and not always elegant, but it is vital for my right hon. Friend successfully achieving what he wants to.

For many year, I have not had many nice things to say about Birmingham City Council, but the public health authorities under Justin Varney are doing an exceptional job under the regional Mayor, Andy Street, whose leadership we all admire. It should also be said that Birmingham City Council did a first-class job in dealing with the homeless at the start of the pandemic and ensuring that they all had somewhere to go off the streets. Politicians in the west midlands, who I think it is fair to say never agree on anything, have worked closely together since March and established a good working relationship. This is not a political crisis; it is a health crisis. We should all play our part in keeping the aggro levels down, and the Secretary of State and the shadow Secretary of State set a good example today.

In the trade-offs that Ministers inevitably must make between protecting our health and the health service and protecting jobs, livelihoods and investment, I would push the tiller a bit more towards the economy and economic activities. I am lost in admiration at the ingenuity, impressive optimism and vitality of those in the private sector in Sutton Coldfield as I visit their businesses and hear their determination but also their anxiety.

I wish to mention two sectors. The first is the events and exhibitions sector, which employs 600,000 people and has a turnover of about £80 billion each year, which is roughly the same as the automotive industry. A couple of weeks ago, I visited Solutions2 in Minworth in my constituency, which previously had a £6 million turnover but since March has had a turnover of precisely £8,000. It has 36 staff, 35 of whom are furloughed. They showed me a map of Europe, which showed that there was activity in their sector across Europe and in the middle east and far east but not, alas, in this country. They pointed out that an exhibition had taken place in Dusseldorf for the caravan show, which 107,000 people had visited.

The second sector that I wish briefly to mention is the weddings and marriage industry, which is flat on its back in Sutton Coldfield. More could be done to relax the tight restrictions in favour of covid-sensible arrangements, and I hope that the Government can show some flexibility. Venues such as Moor Hall and the wedding car industry, for example, are being badly affected.

I think I know the Prime Minister well enough to say that he is a social liberal at heart who dislikes the massive extension of the state as much as I do—the framework of restrictions and ways of living; the language of authority, with curfews, lockdowns, compliance and bans; and the machinery of coercion, with informing, policing, snitching and fining. I was horrified to hear this morning that four students in Nottingham have been fined £10,000 each—more than a year’s fees—for breaching the rules. The lives and opportunities of young people in particular have been blighted by this dreadful pandemic. We probably need to protect the elderly and vulnerable a little more and shield and curtail the young a little less. It is about a touch on the tiller, being a little less didactic and a little more trusting in the good sense of social solidarity of the vast majority.

Finally, I am a former member of the all-party parliamentary group on mental health, along with Alastair Campbell and Norman Lamb—probably one of the best public health Ministers we have had since the war. We are facing a mental ill health epidemic. People who are, inevitably, not being seen really should be seen. We must keep this issue at the front of all our minds as this crisis continues.

I would like to start by acknowledging that the Government are in an unenviable position. This is a tough gig.

Hear, hear!

I see that the Health Secretary agrees with me somewhat. Everybody on these islands is tired at the moment, but those making the tough decisions do not have the option to give in to the tiredness. I might not always agree with everything they are doing—I do not generally agree with most of what they do—but I understand that everybody is an expert these days.

Some of what the Government did in response to the pandemic was good. Furloughing was not just good; it was fantastic. I am not going to qualify that. These islands were not alone in having the idea, but it was a great idea. When I sat and watched the Chancellor’s initial response, I thought he was fast, flexible and responsive. I felt at that point that ideology had gone, that politics had been taken out of the situation and that the Government were simply doing what they could to support people as best they could. In fact, I remember thinking that when the Chancellor appeared on “Spitting Image” he would be wrapped in the red flag, so socialist were some of the furloughing policies.

We also heard about people slipping through the net. As everybody keeps saying, we are in unprecedented times. We had those Paymaster General calls every day, and much of what we reported was acted on initially. It was a terrible time, but it was a good time for politicians to work together in the interests of the four countries of these islands.

Not everything was acted on, however, and not everyone was supported. Some of those gaps were never filled. I want to mention two things in particular. First, my constituency has many wholesalers who chose not to furlough their staff because they wanted to play their part in responding to the pandemic. They wanted to ensure the flow of food and drink, particularly to hospitals. I know something was said in the statement earlier today, which I have not yet seen, but they have felt for a long time that they did not receive a response.

I wrote to the Chancellor to ask about that, and I want to say something about the responses I have been getting. The hon. Member for Blaenau Gwent (Nick Smith) made a point of order about this earlier. Some of the responses have no reference—when we have put in a reference, they do not include it: One of the complaints made in the point of order was about a six-word response to a question. I got an eight-page response to something, but I have no idea what the question had been because, as I said, it did not give a reference. In addition, it seemed to be eight pages of “Isn’t the Government great?” which is just not acceptable. I do not know why the replies are like this. I wonder if it is an attempt to stop us asking questions in the first place, because I am certainly giving up sometimes.

The people who formed the campaign organisation ExcludedUK have not given up—I am part of the all-party parliamentary group Excluded UK. They have been incredible, but they are in a really difficult position and I, too, would have been in their position had I not won my seat in December. I was self-employed but I had not been self-employed for long enough. I will not go into the details, but I know that if I were one of them right now, I would not be living in the home that I have lived in for 10 years. I do not know what would have happened to me, so I identify with them and want to keep supporting them.

It was really good that the Government added £1,000 a year to universal credit, although it had been cut to the extent that that simply brought it back up to 2011 levels. On the other hand, I did not expect a Conservative Government to do that, so I am glad that they did. However, they need to extend it and they need to add it to legacy benefits. I implore them to do that and to extend the furlough scheme. Whenever that is mentioned in this place, Government Members shout, “For how long can we do that? We can’t sustain it forever!” But it would not be forever, and even though we do not know exactly how long it would last, we can estimate and reasonably suppose that by next summer there will be some kind of normality, so why not extend it until then, if need be?

In the past few months I have noticed some terrible situations with employers, and I have many examples. I gave some when I spoke in the debate on whistleblowers a while back, but I want to raise another today, because I am hoping that Government Members will do something about it. It is a very serious matter. The employer is the Government. Whoever took the decision that I am going to tell the House about should be ashamed of themselves.

There are three DWP service centres in Glasgow, and this example concerns people working in those service centres who do not have to do face-to-face interviews. I am telling the House what is happening in Glasgow, but I am sure this will not just be the case in Glasgow; I imagine that it is widespread across these islands. Workers were on a work-from-home pilot scheme. Some teams were allowed to work four days a week at home and one day in the office, while others worked three weeks at home and one week in the office.

On 23 September, the Prime Minister and the First Minister both gave the instruction that anybody who could work from home should work from home. Naturally, those workers expected that they would be allowed to work from home full time, but they were refused permission to do that. Some of the workers, who are all kitted out at home, are having to bring their equipment into the office on that one day of the week or that one week of the month, despite what the Government were saying people should do. They were constantly being told that it was fine, it was safe and there was no danger to them. Well, that was not what the Government were saying.

In the week ending 9 October, it was announced that two members of staff in that building had tested positive. On 12 October, another three members of staff were reported to have tested positive. On 15 October, a further two members of staff tested positive—seven cases in less than a week. On 19 October, Monday of this week, there was another case and on 20 October, Tuesday, there were another two. So that is 10 cases.

I am sure that Members can understand the fears that those workers were experiencing, but I will tell them who did not understand—or maybe they did and just did not care. Last Friday, a senior manager at the DWP held a Skype meeting with the teams to reassure them that the office was safe and to remind them that the pilot could not be changed and there could be no flexibility, despite what the Prime Minister and the First Minister were telling employers to do. I understand that the tone was more threatening than reassuring. The senior manager warned that if workers continued to raise concerns, the pilot might be cancelled and they would all be forced to work in the office full time. She “hoped” that that would not have to happen. That is workplace bullying and I hope the Secretary of State will raise it with the Secretary of State for Work and Pensions. I certainly will be raising it.

Yesterday, just to bring everyone up to date, staff were told that the pilot had been suspended. That is good in the short term, because all those who can work from home are now doing so full time, but there is no information and no answer to their questions about how this situation will progress. Given threats that speaking out might mean that the pilot is cancelled and everyone will be forced to work in the office, one can be forgiven for thinking that that is what is going to happen. So I just want to ask a few questions. Why, if staff could work from home and are equipped to work from home, were they forced to work in the office? Of the 10 testing positive so far, how many were part of the work-from-home pilot? How can a Government agency be given permission to ignore the restrictions that everyone else is rightly following? Will the management punish the “unruly dissenters” who complained about it by forcing them all to work in the office, as was suggested by the senior manager? Do the Government understand the message that the workers are getting, which is “You don’t matter, you have no power”?

Well, not only do they have no power, but their MP seems to have no influence. My attempts to represent my constituents started on 4 October, when I had a meeting with DWP senior managers. I had just been made aware of the situation—the meeting was about something else—so I said I urgently needed to know who to contact to raise the issue on behalf of the employees. They got back to me yesterday, 21 October, after being prompted three times. I waited 17 days and their response was, “You might need to give us some more information.” If I cannot represent those employees as an MP and make any difference to their lives, and they cannot as workers, who else can?

Madam Deputy Speaker, you are looking at me as if you want me to stop—[Interruption.] No? Oh, that’s excellent.

I am sure the hon. Lady is aware that there are a great number of speakers, but I am quite happy for her to finish her remarks.

I have had less than half the time that the hon. Member for Leicester South (Jonathan Ashworth) had, but I thought his speech was great anyway.

I want to talk about some other people who have been prevented from working from home—namely, MPs. We can participate virtually in question sessions, and when it comes to voting we can nominate a proxy, but we cannot participate virtually in debates such as these. I heard the Leader of the House confirm this morning that the virtual Parliament would be extended to Easter, so we will be able to speak in question sessions and nominate a proxy vote, but we will not be able to take part in the debates that are the lifeblood of our democracy.

I was interested in the so-called reasoning behind that decision in response, this morning, to my hon. Friend the Member for Edinburgh East (Tommy Sheppard), who again questioned why MPs who cannot be here in person cannot participate in debates virtually. His microphone was muted and there was a 10-second gap while that was resolved. The Leader of the House then used that as a justification for not allowing virtual debates, but he had just said that it was fine to participate virtually in question sessions. The question session that they were taking part in had a glitch of 10 seconds, but the question got asked and it got answered, and the roof did not cave in and nobody came to any harm. No catastrophe would befall us if there were such a glitch in a debate like this, so why does this place, which many like to think of as the mother of all Parliaments and a great bastion of democracy, silence the voices of MPs who, through no fault of their own, cannot be here in person? Worse, why does it silence the voices of their constituents?

Madam Deputy Speaker, I will stop there, even though I have a good eight minutes more, because I know lots of people want to get in.

I am very grateful to the hon. Lady for being so understanding. I am going to reduce the time limit to four minutes, but Members will need to brace themselves for the fact that not everyone will get in. However, there is a whole day’s debate on covid-19 on Monday 2 November, the day we come back from recess.

It is a pleasure to speak in the general covid update debate. Last time I spoke, I welcomed the tiered approach the Government had put in place to deal with the covid virus, and today I am pleased to welcome the support the Government have put in place as a further measure that is more nuanced and more targeted to help those in most need.

I have been asking questions today about road maps and plans for the future. If we start with the economic side, these questions are key. I met representatives of the Hinckley business improvement district last night, and one of the biggest questions they had was about what would happen if we moved from tier 1 to tier 2. I was pleased to be able to tell them that the Treasury and the Chancellor were listening. That message was heard, and new support was put in place. That security will be greatly welcomed in Bosworth and up and down the country.

The other thing that businesses need is some form of certainty and a road map of where they are going. We are lucky in this House to have a learned friend in my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell), who is no longer in his place. He has highlighted areas about which I also have concerns after meeting constituents and businesses last Friday.

The wedding industry, the events and conference industry and the travel industry are all going to face difficulties because of the very nature of their business: the people business. The virus thrives on people’s interactions, and those industries feel as though they are now zombie businesses, because they are not officially closed, but they cannot open fully because there is no trade for them. I think it is reasonable to argue that, because of that, they need some certainty over what the future may hold for them, with a road map of how to get there and what the support might look like after we have made choices in the hospitality sector.

Equally, there are non-fiscal measures we can take. We can relook at the levers that we may be able to pull to allow a change of use or the extension of licensing, so that businesses like those in the wedding sector can use their facilities in a different way. After all, they are keen to be open and keen to innovate. The Government need to give them the chance to do so.

I was also pleased to hear today about a further road map relating to health. I mentioned a couple of weeks ago to the Health Secretary and to the House the importance of knowing where we are going and how we can innovate to make our way out. It is fantastic news that laminar flow testing is being rolled out, because until we have a vaccine, this is the way to enable people to take responsibility for their own testing in organisations and hopefully even in their personal situation. When people go to school, when they go to the hospital or when they come to Westminster, they will be able to test themselves, find that they are negative and carry on with their daily life. Of course, if they are positive, they will be followed up and isolated in the correct way. It is really important and will be a stalwart step until we get the vaccine.

In the Health Committee, I was pleased to hear from Professor Edmunds that SAGE feels that a vaccine is coming. That is important to factor in when we think about what lockdown measures to take, because there is a big difference between waiting for months and waiting for years. That comes with a word of caution. From the very start, Chris Whitty—both in private and public announcements—has said that there are a range of measures that are easy to take and each of which has a differently weighted impact. If we are getting a vaccine and improved testing, we cannot lose sight of the simple basics that must be in place: hands, face, space. Without doing those things, it will be very hard to control the virus, even with the testing and when we start to roll out a mass vaccination. I am therefore keen that the Government are clear in articulating, and continue to push, the message of hands, face, space, because the virus has opened Pandora’s box, and what we really need to see is the guarded hope left.

There is an increasing weight of evidence showing that covid-19 and the response to the pandemic—however necessary to contain and slow the spread of the virus—is having a significant impact on and leading to a growing epidemic in mental ill health. As we are forced to contend with the fear, stress and worry of contagion for ourselves and our loved ones, these feelings are compounded by anxieties about the monumental changes to everyday life.

Working from home, shielding, furlough, self-isolation, home schooling, face coverings, and a lack of physical contact with family and friends have become the new normal. Faced with these new realities and a growing sense of uncertainty, we are already beginning to see the impact of the pandemic on people’s mental health. Social isolation, loneliness, bereavement, health anxieties, loss of income and jobs, poor or unaffordable housing, a lack of access to outdoor space, and working in frontline services are triggering mental health conditions or exacerbating existing ones.

Covid-19 has undoubtedly increased the drivers of worsening mental health, but at the same time it has reduced access to and interrupted the provision of essential mental health services, just when they are needed most. To compound the problem further, the pandemic has diminished many of the coping mechanisms that people typically use to deal with stress, worry and anxiety, such as meeting up with family and friends, exercising or going out to work. As a result, there is a real fear that we are building up considerable mental health problems for the future, and could see a wave of acute and untreated mental illness after the pandemic.

To avert a mental health crisis, we must ensure that mental health needs are treated as a central component of our response to and recovery from the covid-19 outbreak. We need to increase significantly investment and capacity in services during the pandemic and beyond, to ensure that all people living with mental ill health have continued access to treatment to prevent their conditions from worsening and becoming more acute. In Coventry, there are some excellent community groups delivering tailored local support to tackle these growing problems. I recently visited one such group, the Moat House Community Trust. I saw the fantastic work that it is doing in conjunction with our health services to combat loneliness, and deliver positive health and wellbeing outcomes.

From tomorrow, at just past midnight, Coventry is due to move to tier 2 of the local covid alert system. Although there was a sad inevitability about this decision, given the rising number of coronavirus cases in the city, the new tighter restrictions such as those imposed on other towns and cities in tiers 2 and 3 will simply add fuel to the fire of the mental health epidemic, unless we can ensure that the right support is in place. I sincerely hope that Ministers will confirm that mental health services and social prescribing schemes will be given the requisite support to tackle the growing mental health epidemic before we reach crisis point. After all, failing to recognise the importance of good mental health and invest appropriately in services now risks storing up significant mental health and physical wellbeing problems for the future. That would come at an unacceptable human, social and economic cost.

If we were to ask a scientist, “How do you stop a virus that spreads through human contact?”, we should not be surprised if he answered by telling us that we must stop human contact as far as is possible. It falls to us, however, to decide whether the price is worth paying in terms of the misery and unemployment it generates. We are talking about a generation marred in their life chances; and mind-boggling borrowing that we will have to pay off over years, which will diminish proper investment in public services and industry. All that, and for what? The Secretary of State has told us this week that the average number of deaths is consistent with the long-term average for this time of year. Some 1,600 people die every day, but covid is by no means chief among their killers. It is no good to say, “Well, every other jurisdiction in the world is following basically the same policy”. That would strike me as herd stupidity.

Speaking of herds, I understand that a number of Ministers have questioned the existence of herd immunity, which is odd, given that a successful vaccine programme relies on herd immunity and that is the basket in which the Government have placed all their eggs.

We can throw into this mix the fact that we appear determined to claim every possible death as a covid death, as though we were in some sort of international league and competition; the failure to be absolutely up front on the limitations of the PCR—polymerase chain reaction—test as a means of tracking the disease; and the way we use large numbers to terrify people. We have been told that intensive care units are at 80% of their capacity, but of course at this time of year that is exactly what we would expect them to be. No wonder our constituents are writing to us with ever greater conspiracy theories—it is because our actions defy rational explanation.

Hallelujah—the consensus has been broken; the Prime Minister has finally resisted the advice he has been given by the scientists, just at a time when the Opposition have embraced it with enthusiasm. Now at least an argument can be had, and proper scrutiny and freedom from groupthink will arise. The danger is that if we do not change the way in which we respond to this disease, in years to come historians will pick over how a prosperous society entered into such a devastating act of self-harm.

In business questions today, the Leader of the House brushed off my suggestion of a specific debate in which the Government could present their evidence that the closures in and restrictions on the hospitality, sport and leisure industries would have a significant impact on the course of the pandemic. I was trying to be helpful. Two weeks ago, the Prime Minister was asked:

“is there a scientific basis for the 10 pm rule?...If there is a basis, why do the Government not do themselves a favour and publish it?”—[Official Report, 7 October 2020; Vol. 681, c. 897.]

The industry would not necessarily have been happy with that, but it would at least have been comprehensible. Indeed, had it been published earlier, things might have been even better because those in the industry would not have had to spend considerable sums on changing their premises, only to have that disregarded. They may have the slightest suspicion that the evidence is non-existent or at best very thin, and that the policy has been driven more by the desire to be seen to be doing something, but at huge cost to this industry, which is not only a huge part of the economy, but part of what makes our country stand out in the world.

What a vast industry we are talking about: pubs and clubs; restaurants and cafés; betting shops; bingo halls and casinos; cinemas and theatres; gyms; music venues; wedding venues; football and rugby clubs and racecourses —the list goes on—as well as the myriad suppliers and transport companies that service them. There are hundreds of thousands of businesses, some international brands, but most small businesses whose owners have invested their life’s work, dreams and savings in them. They have been hanging on, hoping for better times. The Government’s response is depriving them of that hope. Of course they need relief and the belated help that was announced today, but they also need customers and trade.

That is another reason why the Chancellor’s contribution today was disappointing. There seemed to be no recognition of the Government as a customer—a major purchaser of goods and services. The Government could have a big impact on employment and economic revival. There was no indication of any sense of urgency in Whitehall for that.

For example, the order for fleet solid support ships has been hanging around with the Ministry of Defence for years, and they are needed. This week, the Defence Secretary announced that the MOD will be inviting bids for a British-based contract, but it will not issue the invitation until the spring. Why further dither and delay? Get a move on. Get industry gearing up. The same goes for buses, trains, cars, trucks, hospitals, schools, road and rail fares—the list is endless. What that means in the end is jobs, jobs, jobs. Earlier in the year, the Prime Minister claimed to be channelling his inner Franklin Roosevelt. Well, let him take a lesson from the Works Progress Administration in the US and get real projects—the output but also the work—rolling fast.

The Secretary of State talked about suppressing the virus until we get a vaccine, but let us be clear: we have only ever eliminated one virus—smallpox—and that after many decades. We face significant harm, here and around the world, from viruses, bacteria and fungal conditions, but even with a vaccine, thousands die of flu every year. We all acknowledge the incredible efforts of the scientific community here and around the world to create a vaccine, but they rightly warn that they cannot be sure of success. As the PM himself acknowledged, after 18 years, we still have not found an effective vaccine against severe acute respiratory syndrome. Furthermore, if we do get an effective vaccine, it will not be effective for all—no vaccine is—and that is before we consider the constraints of production and the need to overcome resistance from anti-vaxxers. As I have said before, we probably will have to learn to co-exist with the virus while maintaining the economy and society. The sooner we face up to that, the better.

We face a difficult winter. Many areas of England are under heightened restrictions, including Elmbridge, part of which forms part of my constituency. We face the national challenge of a new disease, with a population that is largely unexposed to it and has built no immunity to it through either prior infection or other means, such as vaccination. It spreads easily and quickly, and can make people in high-risk groups, particularly the elderly, seriously ill. It can spiral out of control and overwhelm our health service.

I supported the first lockdown and I support the current restrictions. As an NHS doctor, I say with all my body and soul that we cannot let the NHS be overwhelmed. But lockdowns and restrictions are deeply harmful in themselves. The long-term effects will be profound—a higher burden of disease from poverty, with associated costs in lives; loss of livelihoods; misery and damage from isolation, and reduction in liberties. We need a way out.

My constituents are feeling it—especially those who are now in tier 2 restrictions in Elmbridge—and I pay tribute to them for their resolve. They rightly ask me, “What’s the way out? How does this end? How do we escape the cycle of lockdown?” The current strategy is to suppress until there is a vaccine, but what if there is never a vaccine? As people start to tire of lockdown, increasing coercion and punitive measures are being put in place. On my commute from Runnymede and Weybridge, I travel to Waterloo station, and I have seen the signs there change—from a £100 fine for not wearing a face mask, to £3,000, to £6,000—in the course of a few months. It is inevitable that greater coercion will be needed. When does that stop?

Coercion is illusory. It works briefly, but after a while it fails, unless we take people with us and they own the decision. Of course, in a public health response to an infectious disease, we cannot have a free-for-all, but at the same time, in my constituency, I see people at low risk from covid who ignore the guidance because it will not directly affect them and all they see is harm from restrictions. I see people at high risk ignoring guidance because life is short and they want to see their grandkids. I see people terrified of covid hiding away from the world. Day in, day out, people make decisions about their health risks, such as to smoke or not to smoke—indeed, given that 76,000 people die every year from smoking, probably more people have already died this year from smoking than from covid. People decide whether to put salt on their chips, or not to eat chips. We all make compromises and trade-offs, but rather than the state deciding those trade-offs, we must find a way to let people decide their own.

Is not the problem that whether I choose to have salt on my chips is a matter for my health, but when I take risks with covid, I take them not just for myself but for everybody else with whom I interact, and for the whole of society?

I thank the hon. Gentleman for his intervention, and I will come to precisely that point in due course.

I supported the first lockdown, and I support the current restrictions, but we need a way out that works, irrespective of the invention of a vaccine. We need a way out that supports people to take their own decisions and respects free choice, but, as the hon. Gentleman said, we must also protect society from an infectious disease. Such a system needs to be sustained for a long time, and those measures will need to be in place for a long time.

It is easy to criticise, but it is more difficult to put forward other options. We therefore need a debate about what a plan B could look like. We started with a national lockdown, but that was too blunt. We rightly moved to targeted measures, which are better, but still not great. The geographical area is too large, and people do not live their lives by local authority boundaries. The next logical step is to shrink the geography further—to the household or individual—and to have a system that allows people to make decisions for themselves regarding their own risks and the people they come across socially or at work.

We must use our testing capabilities in a targeted, risk-based manner, so that those at high risk, should they choose to, can shield and have support to do that. Those at low risk would be able to live their lives more freely, should they choose to do so. At the same time, we must ensure that things do not spiral out of control, with broader measures and restrictions available in reserve if needed. We must invest in our NHS surge capacity, and carry out research into vaccines and treatments.

The challenge, of course, is how we support those at medium risk, or those who live or work with high-risk individuals, and we need to have that debate. Lockdowns are not a cure for covid. They only regulate the pressure on the health service and, important as that is, in time they can, and will, be worse than the disease itself. We need to have that difficult debate and there is no easy solution. While I suggest that we wait for the phase 3 trials of vaccines, which are we imminently, we must start putting flesh on the bones of a plan B, based on individual choice, and consider a pilot in the UK. To get through this pandemic, whatever we do will be difficult. Difficult decisions have to be made, and more difficult decisions remain to be made.

In his statement earlier today, the Chancellor claimed to be targeting support where it is most needed, but one early and obvious lesson from the covid pandemic was the disinvestment and chronic underfunding of social care, which led to a system that was ill-prepared for that pandemic. The 2018 report on social care from the other place, following an inquiry led by Lord Forsyth, found that the social care system needed around £8 billion, just to return quality and access to the sub-optimal levels of 2009-10. According to Age UK, councils now say that they need an additional £6 billion on top of that to meet the extra costs of covid-19. Therefore, a minimum investment of £14 billion is urgently required to return social care in England to a pre-austerity position.

The social care system entered the pandemic underfunded, understaffed, undervalued, and at risk of collapse. Any response to covid-19, however vast or comprehensive, would have needed to contend with that legacy of political neglect. It is telling in respect of this Government’s approach to social care that a recent Health Foundation report found evidence that

“the government acted too slowly and did not do enough to support social care users and staff”.

As has become all too clear throughout the recent crisis, in England protecting social care has been given far more priority than the NHS. As we have all witnessed, the Government’s handling of the covid crisis has left much to be desired, as we have seen with most clarity in the major and widespread problems that have been experienced in social care in England. In the most extreme cases, councils are now meeting a person’s needs only if not doing so would breach their human rights.

The right hon. Member for South West Surrey (Jeremy Hunt) is on the record as claiming that he wanted to produce a 10-year plan for social care to match the one drawn up for the NHS two years ago, but that that was blocked by the Treasury. He said:

“The political pressure is never as great for social care funding but the reality is additional NHS funding will be wasted if we don’t sort out social care.”

He is right: the crisis in social care cannot be ignored. Just as the numbers of people going without care will continue to rise, in particular with respect to long covid sufferers, so will the pressure on the NHS and the public purse. We are a year on from the statement on the steps of No. 10 in which the Prime Minister claimed that he would “fix” social care, but like so many of the Prime Minister’s promises, that claim was without substance.

When the Minister for Care appeared before the Health and Social Care Committee last week, I asked why the Government’s professed dedication to the reform of social care was not reflected in policy. I received a terse response:

“Clearly, the Department has been dealing with a pandemic.”

But that is precisely why reform must push ahead. I echoed the words of the right hon. Member for Kingston and Surbiton (Ed Davey):

“The Covid crisis makes the need to fix social care more urgent, not less.”

Despite all that, the Minister was completely unable to provide any response beyond a vague, non-committal commitment. If that is a measure of the Government’s commitment to target support where it is most needed, they have failed to learn the most vital lesson of the pandemic.

The Government and the whole of British society have made an amazing response to covid and to the challenge that we have faced. We knew very little about it at the beginning, but we have evolved and adapted with time. Society now is so different—who would have believed at the beginning that we would be in this position now, sanitising our hands every time we went into a shop, wearing masks and socially distancing?

We know far more today than we did then, and we understand the impact and cost of covid, but we are also in an increasingly good position to understand the cost of the lockdown. We hear figures about millions of cancer screening appointments and tens of millions of GP appointments not being taken up, and we understand far better that in the weeks, months and years ahead there will be a huge cost from the lockdown, but the details have not been adequately explained to the British people as a whole or to right hon. and hon. Members of Parliament. We heard moments ago about colleagues asking questions—quite reasonable, quite straightforward questions—and getting a six-word answer.

I have written to the Secretary of State to raise concerns about Bolton, which has been in a particularly difficult position with a rather severe lockdown. Constituents tell me about the impact on their mental health, their physical health and their ability to get treatment—it has a cost. I wrote to the Secretary of State on 29 September to raise concerns that in Bolton borough 20,000 fewer people than last year have had a referral from a GP to hospital. Important treatments have not been taken up as a result. This is serious—it is life and death—for my constituents, and I think it is replicated around the country.

I have yet to receive a response to my letter, but I do have an answer to my written question about what action has been taken in relation to the 20,000 fewer referrals from GPs to hospitals this year than last. The answer that came back was:

“No specific assessment has been made.”

That is 20,000 people in Bolton as a whole whom GPs think should have a hospital appointment of one form or another. I do not know how many of that 20,000 would be in the category of life or death, but I suspect it is a very significant number, and I suspect that this would be replicated right across the country. To receive a six-word answer —“No specific assessment has been made”—to cover that 20,000 is disappointing, to say the least. It is also covering a health time bomb that will explode. That is already happening at the moment. Far more needs to be done so will my hon. Friend commit to delivering a covid lockdown health impact assessment for every constituency around the country?

In West Ham, we had the highest number of people furloughed in the country—almost 30,000. All those people, and so many more who are self-employed, are potentially at risk of real economic hardship, and we simply do not know how many more will lose their work over the coming winter. The scope for damage to our already deprived and very vulnerable communities in Newham is vast.

As we know, there are differences in economies across the country. In my constituency, many parents work two or three jobs to pay their rent and their living costs. Let me tell Members quickly what it is like in Newham. The lowest quartile of private rent is higher than the lowest quartile of earnings. A month’s wages do not even cover the rent on its own. In many cases, if parents lose one source of income they will be under threat of homelessness and it will immediately mean cutting back on the things that children need and that parents want to provide, such as food, clothes, shoes for the winter, internet access and books. In this wealthy country of ours, losing that second or third job will leave parents with no choice but to cut back on food—first for themselves and then for their children. We know that when parents are pushed into poverty, the impacts can be lifelong on their children’s health, education and opportunity.

Last week, the End Child Poverty coalition estimated that almost 20,000 children were in poverty in West Ham alone—20,000 children! That is more than half the children in our local schools, and those numbers are from before the pandemic began. We have 20,000 children living in poverty in just one constituency. I worry about how bad this is going to get even if the Chancellor does not follow through with his threat to cut universal credit next year, and I hope to God he does not.

Around 575 school days have been lost since March. Only 8% of children with special educational needs and disabilities or under the protection of a social worker attended school during lockdown—8%! How can schools or local authorities identify the children who are at risk of abuse or neglect when they are not being seen? Self-isolation for covid is a really quick excuse that can be used for everything. Our services need to find new ways to proactively check children at risk, and they need the resources to enable them to do that.

In my area, county lines see gangs grooming children with life-destroying consequences. This problem is now even more acute, because, normally, extended absences from schools are one of the clear signs that a child is being exploited to run drugs and put at risk of seeing and doing things that no young person should see or do. If preventive support is not given, it will create more damage in our communities and more costs for the public purse in the future, but most of all it will kill the hopes and the dreams of the children and the parents in deprived communities, cause much pain and waste so, so much potential.

May I place on record my thanks to the residents of Blackpool for the tremendous sacrifices they have made over the last seven months? The way in which my community has risen to the challenges we have faced has been fantastic to see, and I would like to extend my gratitude to our amazing key workers and all of those volunteers who continue to keep Blackpool going. There are too many fantastic individuals for me to mention them all, but it would be remiss of me not to highlight the fantastic contributions that Linda Mcevilly, Ryan Smith and Mark Butcher have made over the last few months.

Infection rates in Blackpool have been consistently below the Lancashire average, and as such, I had hoped that Blackpool would remain in tier 2 in the short term so that hospitality businesses could stay open during the upcoming half-term period, which is a most important time of year for my tourism-based local economy. There is no doubt whatsoever that the increased restrictions will financially hurt businesses in my constituency. Most work is seasonal, and businesses are now staring at a bleak winter, following a heavily disrupted summer. I have been contacted by a significant number of businesses in the sector, including hoteliers, all of whom have exactly the same concerns: how can the Government impose restrictions and advise holidaymakers not to travel to Blackpool, but not order them to close so that they can access the local restrictions support grant and the extended job support scheme?

I welcome the additional measures outlined by the Chancellor today, and the hundreds of billions of pounds that this Conservative Government have already spent to protect people’s jobs and businesses since March. An additional £30 million for businesses across Lancashire and the £4.6 million un-ring-fenced grants given to Blackpool Council only today are also to be welcomed. However, such are the challenges in my constituency that we will continue to require additional support. It may be pointing out the obvious, but our small hotels cannot survive on local bookings alone. Winter is coming, and the tourism industry will not survive without further support. I would urge the Treasury to allow small hotels and B&Bs that voluntarily close to access the grants and the extended job support scheme available to businesses that have already been mandated to close.

I appreciate that health considerations have meant that Blackpool must be included with Lancashire in the highest tier of restrictions, and I was grateful that local leaders put politics aside to work together and agree a sensible solution. However, we are obviously seeing contrasting levels of virus across the UK, so a full national lockdown or a circuit breaker would be a blunt instrument affecting businesses and jobs in places with low infection rates. The tiered system is much more precise and targets additional measures exactly where they are required, and for this reason it has my full support.

We simply have to give the tiered approach enough time to prove effective. Arbitrary decisions to close specific industries in the highest tier cannot be made by Ministers without clear and transparent evidence. For example, we need better communication to explain decisions such as closing pubs at 10 pm and the enforced closure of betting shops in tier 3. The latter seems to be a particularly unjustified decision, which will cost jobs and cost the Exchequer a substantial tax revenue, and for which there is apparently no scientific basis.

I want to take this opportunity to recognise some of the work being done in my own constituency, but also to highlight some of the challenges that these various sectors continue to face as we deal with a big pandemic.

Let me start with the health and social care sector. As a former NHS worker, I know how dedicated the health and social care staff in the United Kingdom are. St Helier Hospital in my constituency was one of the first hospitals to have to deal with a case of coronavirus and sadly also had one of the first confirmed deaths from the virus, which has taken far too many of our loved ones from us too soon. The hospital’s incredible efforts in caring for patients, consoling grieving families and looking out for the mental health of staff, not to mention keeping other hospital services going, is to be applauded.

The hospital is being supported by the fantastic teams working in our local care homes, and I want to thank providers such as Churchill and MHA, which have engaged constructively with me throughout the pandemic. The care sector plays a vital role, and the pandemic has shone a clear light on the challenges that the sector faces. I look forward to seeing the Government’s proposals for a long-term, sustainable social care plan.

When we talk about the health response to the pandemic, I want to ensure that we do not overlook the fantastic work of our local community pharmacists. I was privileged to have a call with some of our pharmacists earlier in the week. They told me how extremely busy they have been and how they have had to work exceptionally long hours to catch up on dispensing, after seeing hundreds more patients in need of advice on minor ailments. I believe that pharmacists can play an even more vital role in the future by making better use of their advisory capacity and ability to deliver vaccines, taking pressure off GPs, and using their community links to improve the health of local people. I hope that the Minister, in winding up the debate, will say something about the recently published EY report on pharmacy funding and how we can further support community pharmacists.

The coronavirus response has not only been about the health and social care sector. It has brought out the best of the entire community in Carshalton and Wallington, and I particularly want to pay tribute to the voluntary sector. Community Action Sutton, Volunteer Centre Sutton and Age UK Sutton have harnessed the good will and the power of hundreds of volunteers. I have met some truly inspirational people as I have joined them to deliver PPE. I thank them for everything that they have done to keep the community going and look after others during the pandemic.

I launched an “unsung heroes” scheme, as many other Members did, to recognise those who have gone above and beyond to help others during the pandemic. I wish I could list the hundreds of amazing stories I heard—about people like Connal Donovan and the team at the Duke’s Head pub, who have used their kitchens to cook for elderly people; Su Robertson, the housing manager at Laurel Lodge Retirement Living; and Carshalton High School for Girls, which created over 200 items of PPE for the local hospital. There are so many examples that I could give.

Residents have worked hard to keep the virus down and, understandably, they are quite concerned about being moved into tier 2 restrictions, but I am encouraged that four further testing facilities will open up in the borough, and I was pleased to hear the Chancellor announce further financial support packages today for tier 2 areas such as Carshalton and Wallington. This has been an incredibly tough time for businesses and particularly the self-employed, so I am grateful that the Chancellor has heard those calls and taken appropriate action. As we continue to fight this virus, we need to find a balance between protecting the economy and protecting health, and I am hopeful that, as we continue to tackle this virus over the coming weeks and months, we can strike that balance and come through this together.

Sometimes it feels like we are living in a parallel dimension. When we think of our lives a year ago, it feels like another galaxy far, far away. For many of my constituents —particularly those isolating on their own—it is the impression of being stuck in a parallel life, subject to confusing and inconsistent communications, battling alone through a long tunnel with no light at the end that is so dispiriting, undermining mental wellbeing and the success of public health measures. That is why we need a circuit breaker now and a road map to control the virus.

I imagine another parallel universe—one where the Government got a grip on the virus back in March and did not let go, and where the Secretary of State did not decide to stop tracking community infections in March but instead took up the offer of local environmental health officers and gave local authority public health teams, such as the one in Newcastle led by the excellent Eugene Milne, the responsibility and resources to set up local community tracking and tracing. As Allyson Pollock, professor of public health at Newcastle University, said in April,

“You need people on old-fashioned things like telephones or going door to door and they need to be local teams because they need to understand the local communities.”

The fact is that without the Government’s Health and Social Care Act 2012, which led to the decimation of public health disease control and both its centralisation and fragmentation; without 10 years of austerity, which slashed the capacity of the state and our public services and drove up inequality, on which the virus feeds; without a Secretary of State who put his faith in technology, when, as an engineer, I know that it is only ever people who are the solution; without a Prime Minister who is scared of difficult decisions and unable to grasp detail; and without a Government steeped in the ideology of the free market knows best, we could be in that world.

Instead, we find today that only 60% of Test and Trace contacts are reached by the £10 billion Serco test and trace. We should be in a position where we know where the disease is, so that while coronavirus remains a deadly threat, we feel confident that we know where it is and how to avoid it. In Newcastle, we are battling to stay in tier 2, and I urge everyone to follow the coronavirus measures—the security measures—but I also say that without a proper track and trace, we are working blind, and the failure to control the disease is a failure of the Government and not my constituents.

Finally, I want to talk about jobs and the re-emergence of mass unemployment on Tyneside, which would be another failure of this Government. Two weeks ago, I held a business roundtable in Newcastle and I was struck by how hard so many businesses are working to do the right thing, investing thousands in covid security, keeping their customers safe, keeping their employees safe and protecting jobs. I really want to urge the Government to work with local authorities, to work with Newcastle City Council, to communicate effectively with businesses that feel betrayed and to ensure that the support is there for businesses as well as a plan that they can follow, but also to make sure that no one is excluded. We have seen mass unemployment in Newcastle under a previous Conservative Government. If our viable sectors—and our sectors are viable—and our viable jobs are destroyed during this pandemic, it will be another failure of a Conservative Government.

The current crisis is difficult for so many reasons, but overwhelmingly, I have seen it bring out the best in the people of High Peak. Back in April, I launched the High Peak hero awards to recognise those who have gone above and beyond to help others during the pandemic. I have received a huge number of nominations and it has been wonderful to learn about the efforts of some truly extraordinary local people. I wish I had time to name them all, but let me give a few examples.

Leon Haynes, at the Surrey Arms in Glossop, tirelessly delivered essential shopping and meals to those unable to leave their homes. Hayley Roebuck, a care worker at Goyt Valley House care home in New Mills left her family to live in at the care home to minimise the risk of infecting vulnerable residents. Helen and Phil Flanagan, landlords at the Peels Arms, paid out of their own pocket to supply meals to the elderly and vulnerable in and around Padfield. Lia Roos from the Residents of Fairfield Association has been running a foodshare scheme in Buxton, delivering food to the vulnerable, those self-isolating and key workers having to work longer hours—I could go on. Needless to say, I am incredibly proud to represent the people of High Peak.

Turning to the challenge that we now face, I welcome the Chancellor’s additional measures to protect jobs and businesses in areas such as Glossopdale that have been under tier 2 restrictions. Those measures are vital, though I hope that we can continue to consider the impact on businesses in the supply chain and in the events industry, which have also been very badly affected and will need to play a vital role in the economic recovery.

Thinking ahead to this winter and where we go next, I want to talk about restrictions and the impact that they have on people’s lives. It is essential that we do all we can to prevent the NHS from being overwhelmed to help to save lives, and that needs a multifaceted approach. As we learn more and more about coronavirus, we need to follow the evidence and make the difficult decisions about restrictions and public health guidance. We also need to pull out all the stops when it comes to researching a vaccine, something on which the UK is currently leading the world.

However, we also need to recognise that there is a huge cost to these restrictions, and there is a difficult balancing act between fighting coronavirus and other public health challenges. I am increasingly concerned about the long-term impact on our nation’s mental health and other serious health issues. How many illnesses have got worse because people have not felt able to get the treatment they need? How many serious conditions have not been diagnosed in time because screening and scans have not been possible? A good example in my constituency is the recent commissioning decision by NHS England to withdraw the breast cancer screening units from New Mills, Buxton and Chapel-en-le-Frith, citing covid as the reason. Instead, women in the High Peak are being asked to travel to Bakewell. Given the state of the roads and public transport in the Peak District, especially during winter, I am worried that many will not be able to get to appointments. A huge number of local people signed my petition calling for the reinstatement of the screening units, and I will meet Health Ministers shortly to discuss how we can do that. I desperately hope that we can get the right outcome.

I absolutely support the necessary measures that the Government are taking, but I also believe that we need to start a national conversation about how we can live with covid in the long term. We must not get ourselves locked into a never-ending cycle of constantly tightening and easing restrictions with no end in sight. To do that, we need further to increase capacity in the NHS, especially in intensive care. Since the start of the crisis, the Government have achieved a lot in that area, but there is a lot more to do. I have been campaigning for new urgent care centres at Tameside Hospital and Stepping Hill Hospital as well as a major new health centre in Buxton. We need them now more than ever.

The road ahead is uncertain. It is challenging, but I am confident that High Peak and the rest of the country will get through this together.

I want to talk about a dangerous bit of fake science that is doing the rounds—the so-called Great Barrington declaration which calls for focused protection for the vulnerable and ending all lockdowns and restrictions so that everyone else should immediately be allowed to resume life as normal. It sounds wonderful, doesn’t it? Idyllic. Some 6,300 people have signed the declaration. That sounds impressive, but it is a tiny, tiny proportion of all the medical professionals in the world, the vast majority of whom dismiss that approach out of hand.

Many of the signatories to the declaration are not world-leading epidemiologists and virologists. Many of them are homeopaths and self-certified therapists. They include the famous Dr Johnny Bananas, the Rev. Booker Clownn, Dr Person Fakename and Mr Matt Hancock, although not the one of this parish. I remember what fake science did over the MMR vaccine when lots of journalists paid court to one man, Dr Andrew Wakefield, simply because he had the title Doctor in front of his name. That caused immeasurable harm to a very important vaccine programme.

Some of the people who signed the declaration told us earlier this year that the virus would just melt away by the summer and others guaranteed that there would not be a second wave. Yet some people still support them. None of the declaration’s assertions is supported by evidence. They do not even pretend to be. There are no references to peer-reviewed research; they are simply assertions.

It is completely wrong to call people who believe all this stuff “nutcases”. I did earlier this week and I wish that I had not used that word the other day. I have worked long enough in acquired brain injury and as a personal counsellor to others to know that that is wrong. I apologise. But this really is a fringe opinion shared by conspiracy theorists, funded by hard-right economic libertarian extremists in the United States of America and advocated entirely by fake scientists. Ignorance is one thing. Deliberate ignorance really is stupidity.

At the heart of the declaration is the belief that we need to acquire herd immunity by letting everybody get infected. The facts—and there are no alternative facts here—are that there is no evidence that contracting covid-19 grants long-term immunity to future infection. We already know that one can catch it twice and it is not yet a year old. Other coronaviruses only grant temporary immunity. Fact.

To support the hon. Gentleman’s case, may I point out that if we could achieve herd immunity, we would not contract diseases like measles? We still get them, so herd immunity is impossible to achieve.

In this case, the point is that we will not achieve herd immunity just by trying to let everyone get the disease. That is an immoral proposition. We have all heard the line that this virus is not that dangerous and is less dangerous than flu. I am sure that we have all had emails about it. The facts—and again there are no alternative facts here—are that covid is more easily transmitted than flu and has more complications for more people. Between January and August 2020, there were 48,168 deaths due to covid-19—not associated with it—compared with 13,619 deaths due to pneumonia and 394 deaths due to influenza. The number of deaths due to covid up to 31 August this year was higher than the number of those due to influenza and pneumonia in every single year since 1959, including years when we did not have a vaccine for flu.

The other theme of the declaration is supposed to be focused protection. Again, that sounds great—“let’s protect the most vulnerable”—but we cannot just shut the elderly and vulnerable away and throw away the key. They do not live in hermetically sealed units, funnily enough. They rely on nurses, carers, home helps and family members. All those people would presumably have to be locked away. Is somebody going to suggest that the most vulnerable communities—in fact, the BAME community—are en masse all going to be locked away, as well as the overweight, no doubt, and all the men? Of course, that is a complete and utter nonsense. By one estimate, we would be incarcerating a quarter of the whole UK population.

There is a cruelty at the heart of this proposal: it is basically survival of the fittest. Yes, it does make me angry when people propose it. It makes me angry for those who have lost loved ones this year, who seem to be ignored. It makes me angry for the NHS staff who have slogged their way through the misery on our behalf and need us all to realise that there is a much better creed than survival of the fittest, and it is that we are all in this together.

I am grateful for the opportunity to speak in this debate. For many months, we have all been engaged in hand-to-hand, all-encompassing national combat with the coronavirus. We are deep, deep in the trenches. In our fear of the virus, we must not lose ourselves—our compassion, decency and humanity, our sense of right and wrong, our very values as a nation—and the progress we have made as a society.

We stand at a crossroads as we face down the next wave. In our mission to save lives from the virus, we are increasing the risk of physical and mental health harm, and no person is more at risk of such harm than the very poorest and most vulnerable in our society, including those who are most dependent on others: the homeless and destitute, the mentally ill, those in care homes and hospitals and in our prisons.

As Winston Churchill said, the test of a civilised society is how it treats its prisoners. Since the pandemic hit, prisons have been in severe lockdown. Just this week, the chief inspector of prisons, Peter Clarke, described the dangerous situation in very bleak terms. He has raised real concerns about long-term damage to prisoners’ mental and physical health, as prisoners are locked up for 23, 23 and a half or even 24 hours a day, day after day, in the name of covid.

To avoid any misunderstanding, I have researched the position in prisons from Swansea to Stafford and beyond. I have taken note of contributions from the other place, as well as speaking to many involved with prisoners, including current prison chaplains, prison charities and many others besides. In raising this national matter in this debate, I should say that my remarks should not be taken to refer to the situation of my son Thomas or his father’s prison.

There is no doubt that the report of the chief inspector of prisons should be considered with grave concern, because it also affects the lives of those outside prison, particularly the children of prisoners. The National Information Centre on Children of Offenders estimates that there are more than 300,000 children of prisoners. Of those, around 10,000 each week had prison visits before covid. That is 10,000 visits by children to a parent each and every week. For thousands of prisoners and their children, these vital visits in person and by video call have stopped or can be scheduled only during school hours during the week, so school-age children are cut off from their parent entirely.

Despite assurances that secure phones will be made available during covid for prisoners without access to phones in their cells, several thousand prisoners have no such access to a cell-based phone, so they are unable to speak to their children, sometimes for days on end. As covid continues, days turn into weeks and weeks turn into months. Now they look to turn into years. This is an inhumane, dangerous and unsustainable position.

In addition to the lack of family visits and calls, in many prisons there is no access to a library or a gym. There is no daily exercise hour of exercise, walking around that small yard in the drizzling rain. There are no skills courses, no education, no English language lessons—there is nothing at all to help prisoners in that situation. I hope that, by raising this matter today, we will take urgent steps to avoid long-term physical and mental health harm in our prison population.

There has been, quite rightly, much discussion of the mental health impact of covid during the pandemic. I have spoken about it on a number of occasions, largely with regard to children and young people and those working on our frontline in health and care, but today I will focus on two groups who have been largely forgotten and overlooked by the Government and are suffering the mental health impacts of the pandemic immensely: those excluded from financial support and unpaid carers.

We had a welcome statement from the Chancellor earlier, but those excluded from support since the start of the pandemic were yet again overlooked. We know well that those are largely self-employed freelancers and small business owners, especially in hard-hit industries such as the arts, the events industries and exhibitions, as well as many others. The financial struggle and anxiety is taking its toll on their mental health. They are struggling to put food on the table, support their families and keep a roof over their heads. ExcludedUK has already reported four suicides and large-scale insomnia and depression among those affected. My hon. Friend the Member for Caithness, Sutherland and Easter Ross (Jamie Stone), the chair of the gaps in support all-party parliamentary group, wrote to the Health Secretary and the Chancellor that on 16 July about but has yet to receive a response. We requested financial support for that group, a boost in mental health services and support for debt counselling charities.

The hon. Lady is right that mental health is one of the core issues, but there are many issues. Does she agree that one thing the Government could do is provide a phone service that people could contact to get guidance on what to do? People are left to their own devices and, if that continues, clearly we will have very serious times.

The hon. Gentleman, as ever, makes a valid point. That is why I have been calling for additional support, whether signposting or helplines. We actually need a cross-Government strategy on mental health going forward.

On those who have been excluded from financial support, as the Chancellor remains intransigent on that point, I urge the Minister first to speak to her Treasury colleagues and ask them yet again to think again. Will she also step up mental health support for those who have been excluded? The mental health impacts will cost us a lot down the line.

The other very important group is the more than 9 million unpaid carers who are the forgotten heroes in our society. I hope the Minister agrees when I say that our health and care systems would be overwhelmed if it were not for the work of unpaid carers in our society. The Exchequer saves billions thanks to their work. Four out of five unpaid carers have taken on more caring responsibilities during lockdown, and almost two thirds have seen their mental health worsen during the pandemic. Many have lost their access to respite care, which has affected their ability to earn money. The Minister will be aware that carer’s allowance is pitifully low, at £67 a week.

One thing that would help respite care and day care centres to reopen—Homelink in my constituency is taking all sorts of safety measures and is desperate to reopen—is access to regular testing. I raised that in the Chamber with the Secretary of State for Health and Social Care on 7 July. He told me that a plan was in place and he would write to me about it. He never wrote to me, but I did not chase him about it because I heard that testing had been made available to day centres—briefly; I have now heard that it is no longer available. My council has spoken to colleagues in the Department of Health and Social Care, who say that they cannot offer tests to respite care day centres. Those officials say that they are following SAGE priorities, and that suggests to me that there never was a plan. I would be grateful if the Minister could clarify that point. This is an issue for the Department, and I urge her to address it urgently, because respite care is a lifeline to so many unpaid carers. I also ask the Minister to speak to her colleagues in the Department for Work and Pensions about addressing the woeful level of carer’s allowance. How can anyone be expected to survive on the equivalent of £1.91 an hour?

The Chancellor previously said to the public,

“you will not face this alone”.

Can we say, hand on heart, that unpaid carers and those whom the Chancellor has excluded from financial support have not been left alone? They feel abandoned and their mental health is suffering, so I urge the Minister to address these injustices.

I have said it before and I say it again: lockdowns, whether they are partial or total, are the wrong strategy. They are oppressive and profoundly un-Conservative. As a Conservative, I have always believed that the role of the state is to provide a safety net for those who cannot help themselves. Now we have a Conservative Government who are preventing people from helping themselves by engaging in economic activity, and, having prevented those people from engaging in economic activity, the Government are not providing a safety net for all of them. As the hon. Member for Twickenham (Munira Wilson) has just said, people are missing out because they are not allowed to engage in economic activity. In my constituency, people who work on cruise ships, people who work in the events industry and people who run luxury coaches are but three examples of the terrible cases that have come to my notice in recent days.

In their actions, the Government are treating citizens not as individuals but as part of a collective, and that is depersonalising. It is most obvious in the Government’s refusal to differentiate between those who have had covid-19 and are therefore immune, whether in the short or long term, and those who have not. If the state wanted to maximise liberty, it would remove the restrictions on freedom wherever it was possible so to do. What threat is there to public health from allowing those who are immune to covid-19 to go about their normal business? That is what happens in Sweden.

I asked the Secretary of State about that in a written question, but I have not had a reply, even though I referred in the debate on 13 October to that failure to respond. I am afraid that that is indicative of the Government’s arrogance in this respect. In that debate, I also mentioned the number of deaths in Sweden. I have looked up the latest figures, and there have been two deaths in Sweden from covid-19 in the last five days. Sweden allows much more social activity than we in this country have done, and its Government rely on individual citizens to trust each other. Sweden’s citizens trust the Government, because the Government trust them. Why can we not do something similar?

We have heard the scaremongering, and the Department refuses to justify some of its most alarmist rhetoric. The Secretary of State for Health and Social Care said on 1 October that

“hundreds of thousands of deaths…would follow”

if the Government

“just let the virus rip”.—[Official Report, 1 October 2020; Vol. 681, c. 503.]

I asked if he would publish the evidence in support of that statement. He has failed to do so—because, I suspect, there is no evidence in support of that statement. That was gross scaremongering. Instead of trying to build people’s confidence to engage in economic and social activity, the Government are actively frightening them. All this talk about long covid is also designed to try to frighten people, rather than addressing the collateral damage that the Government’s oppressive measures are causing.

I pay tribute to the health and social care workers, education and childcare workers, those working in the food supply chain, local government, civil servants, utility workers, food bank workers and everyone in my constituency of Jarrow and across the country who is enjoyed day in, day out in the fight against this virus.

I am sorry to say, however, that it seems to me that, on just about every measure, the Government are losing control and, sadly, we are going backwards in this fight. This lack of control has seen the Government resort to treating the north of England as some sort of sick experiment this week. It is beyond belief that now, because London has moved into tier 2, the Chancellor has rejigged his support package and gone some way to addressing what we in the north have been asking for for weeks. Previously, it fell on deaf ears. Why did it take London going into tier 2 for this to happen, when areas like my constituency in the north-east have been in similar restrictions for many weeks? This has come far too late for some and is no consolation for those who have already been made redundant or for businesses that have already closed. Significant economic damage has already been done. The new support will help going forward, but we still need a bold strategy to level up our region to stop covid from further increasing existing inequalities.

Now let us have a look at the money wasted by this Government. We have seen £108 million for a PPE contract going to a firm that is best known for making sweets—it has certainly left a bitter taste in my mouth—and £12 billion for a private track-and-trace system that is now reaching fewer than 60% of close contacts. The only people benefiting are Dido Harding and her Tory mates. With the constant changes in guidelines and restrictions, we are going round in circles. The Government must listen to Labour’s call for a national two to three-week circuit breaker that will give us a chance to fix testing, protect our NHS, and save livelihoods.

Moreover, the Government’s new plans for the job support scheme are still not enough. People on low wages are already struggling, and today’s announcement still leaves many to fall through the cracks. It is still not as generous or as well targeted as others, like the German scheme, and other European countries extended their furlough schemes to next year months ago, giving certainty and clarity—and those schemes are not dependent on tiers. We must remember that the cost of living in England is much higher than in our European counterparts. We have the highest rents in Europe and pay some of the highest bills for our gas and electricity, so receiving a fraction of what is an already low wage is pushing many further into poverty. Renters who are struggling financially can now, of course, be evicted.

The Government need to stop jumping from one announcement to another. Businesses need to be able to plan in order to survive, and the Government need to stop their haphazard approach. If the Government had had a clear plan from the start, we would not be where we are now. The Government must change tack, as well as moving to a circuit breaker. They must ditch the proposed job support scheme and extend the 80% minimum furlough scheme across the country.

The confusion in the Minister’s eyes says it all. The Government have lost control of the virus and lost control of the message, and they are now completely ignoring the scientific advice from SAGE. My constituents and those across the country deserve better.

The last speaker from the Back Benches will be Greg Smith. I know that many Members who have waited to speak this afternoon will be disappointed, as quite a large number have not been called. I must point out that all the people who have not been called are those who have spoken many times in recent weeks. I am sure that a little arithmetic will show that with the number of Members there are, 650, and with the amount of time that we have to debate every day, which is eight hours, it is actually not possible for most Members of Parliament to make more than one speech in a week or several speeches in a month. It is not possible and it is not normal.

I rise to add my voice to those expressing the urgent need for the Government to develop a plan B in the event that the vaccine that we all hope and pray can be developed and come good does not in fact materialise. I am clear in my mind that if that vaccine is not forthcoming, and quickly, we simply cannot, as a country, go on much longer with the restrictions that we have.

Covid is of course an horrendous disease, and it is right that all reasonable steps are taken to quell its spread, but we must also look, as others have said, at the deprivation of liberty in all our daily lives. We must look at the impacts—despite the unprecedented and enormous support package the Chancellor has put in place—on jobs and livelihoods, particularly for those who have so far been unable to access support, on the health outcomes for those suffering with conditions other than covid, and on the long-term mental health challenges.

As I have reflected on this debate, I have read and reread many of the emails that I received from my constituents about the impact of the restrictions—real life stories. In my examples, I will maintain the privacy of my constituents by not naming them. Mr W writes:

“At that time I felt the argument being made to flatten the curve and protect the NHS and save lives made sense…and within a matter of perhaps 3 months or so could return to normal and recover. That did not happen and the lockdown cost me my business, it cost me my relationship and worse of all it cost me my health.”

To be clear, Mr W lost his health not to coronavirus, but to a misdiagnosis of a deep vein thrombosis.

I pay tribute to my hon. Friend the Member for Rutland and Melton (Alicia Kearns) on her work around maternity services during the pandemic—a cause highlighted by my constituent, Mrs S, whose husband has been denied access to join her at appointments, not least at the review meeting after an emergency scam following concerns of a heart complication in their unborn child. Mrs S writes:

“I can honestly say waiting for that review meeting with the consultant was the most agonising wait of my life. So much so, I entered the room in tears, unable to control my emotions…when all I needed was the support of my husband”.

What made it all the more complicated for Mrs S was that she could not understand why—in a room that contained a sonographer, the consultants, a midwife and herself—her husband could not be there, given that he works fully from home and does not even leave the house for a weekly shop. She concludes:

“I am sure there are multiple women who…have had to go through devastating news alone.”

I turn to Mrs K, whose son was so excited to go to Exeter University this year, but on arrival has been treated worse than a prisoner in his halls of residence, with sniffer dogs deployed on site to break up groups of students. The isolation of this experience has taken a serious toll on him, leading to him having to return home. I have not even got to the list of the many businesses that, if they have not already gone bust, face the prospect of doing so.

I seriously hope and pray that the vaccine comes good and we can get our lives back to normal. But if the vaccine does not come good, I urge the Minister to consider that serious plan B—thinking about how we learn to live with this virus, looking at work, including that of Dr Raghib Ali, and listening to other ways that we could move forward.

We have heard some superb speeches in this debate, but due to limited time, I cannot personally refer to them all. We have heard stories from every part of our nation, of the heroism of our NHS workers, of the stoicism and resolve of the British people, and of the tragedy and loss caused by this cruel disease. But there is something else too: a growing sense of frustration, a loss of confidence and a lack of trust in this Government; a feeling that decisions are guided by politics and public relations, not by science and evidence; and a sense that many sacrifices have been in vain, and that the current strategy has all the pain but so little gain.

We heard in Prime Minister’s questions yesterday that there is no clear route out of the tier 3 system if the R remains above 1. We have seen Ministers in broadcast studios squirm as they try to explain byzantine rules to an increasingly bewildered public. We have seen advisers flout the coronavirus rules while calling for stiffer penalties for the rest of us. We have heard the cries of anguish from hospitality and events, retail, the arts, aviation, small businesses, the wedding sector and 3 million freelancers excluded from any support. Job losses mounting; young people’s education in chaos; students treated like prisoners; a crisis in our care homes; people scared for their future; and, all the while, the number of infections rising, hospital admissions rising, the death toll rising.

The Government’s strategy is not working. Winter is coming and we all understand the pressure that winter places on our NHS. I know from serving on the NHS frontline that winter is the cruellest season, from slips to falls to flu to loneliness to hypothermia to respiratory diseases to depression and other mental health conditions triggered by these darkening days. Now we are piling on the huge pressures from covid-19. There is a real risk that, just as Ramadan as well as the Jewish high holidays were disrupted by covid restrictions, so too will Christmas be on the line. After this terrible year, people deserve to know whether they can spend Christmas with their families; whether they can hug their loved one in a care home for what may be their last Christmas. The Government have shown that they are willing to take free school meals from the mouths of children. Surely Ministers do not want to steal Christmas as well?

A harsh winter without respite will hit the nation’s mental health and it will hit it hard. I have heard from the Samaritans that many, many more young people are struggling. Self-harm among women has increased. Older people are isolated. University College London reported that after a month of lockdown, nearly a fifth of people had thoughts of self-harm and/or suicide. The charity Rethink says that 79% of people with an existing mental health condition have experienced it getting worse. Mind found that a quarter of people trying to access mental health services were simply unable to do so. Mental health services, especially child and adolescent mental health services, were stretched to the limit before covid. Now they are being pushed over the edge. I hear every day from teachers in schools and desperate parents crying out for help from CAMHS, but who are unable to get on the waiting list and unable to get help. A new report out today highlights that one in six children have been identified as having probable mental health illness, increasing from one in nine in 2017. One in six children—that is staggering.

We know that covid is having a marked impact on our children and young people. We know the impact on people in abusive relationships. We have heard about the impact on cancer patients, on people with addictions, on people in prison and their families, on people waiting for operations or diagnostic tests. We know the waiting times in A&E have increased nationally. The fact is that we are storing up a huge public health crisis that will last well beyond the last case of covid-19. NHS staff are exhausted. I have seen tears of desperation, of frustration, of rage, of exasperation and, now, of disappointment that the Government are not listening to frontline workers and their pleas.

Just today, the NHS absence rates for June were published. Alarmingly, 32% of all sickness absence in the NHS in June was for mental health reasons, up 3% from May. Mental health-related absences were three times higher than covid-related sickness at that time. Frontline workers have had to bury their colleagues. They have had to deliver the most painful of news and be the last point of call for so many of their patients. They are suffering immeasurably, so many of them, with post-traumatic stress disorder. All they are asking for is some timely help before it gets so unmanageable that they cannot manage their own lives and their families, and have to be off long-term sick. We owe them that at the very least. Every month, I highlight the growing absences and tell the Government that they should serve as a wake-up call, but clearly they just keep hitting snooze. We must ease the pressure, care for our carers and pay them properly.

The track and trace system is failing, so let us get rid of the private consultants and let the public health teams take over. The tier system is confusing, it is unfair and, seemingly, without a way out. It wrecks our national unity. The Government have been pitting Mayor against Mayor, business against business, region against region. It has to be fair. That is why the Labour party is calling for a national circuit breaker. As the Government’s own scientific advisers say, it would save up to 7,000 lives and halve admissions to hospital. We are talking about two to three weeks to curtail this disease, followed by the real prospect of a Christmas as close to normal as possible.

This House has heard many great clashes of ideology over the centuries, but this is not one of them. This is not the time to be playing politics with people’s lives or their livelihoods. This is the time to listen to science, reason and evidence, and to show humanity. There is no shame in the Government reversing their position, even at this late stage. There is no burn in a U-turn. I tell Ministers that the Opposition will support them, the nation will applaud them and history will judge them well if they announce a circuit breaker this afternoon. It is time to do the right thing.

As my right hon. Friend the Secretary of State and others have made clear during this debate, although so much has been done to get this virus under control, the fight is not over. I thank all the Members who have spoken today. It is clear that this pandemic has had a huge effect on everyone’s constituents, across the country.

I wish to start by paying tribute to all the hard work of NHS workers, social care staff and volunteers throughout the pandemic. I also pay tribute to the British public for the sacrifices they have made to help us combat coronavirus and for observing the essential social distancing measures that have kept us all safe. Thanks to that hard work, we are able to protect the NHS, just as it is always there to protect us. As my right hon. Friend said, this has been an incredible national effort, and we are seeing the increasing effects of it today in the compliance with social distancing, particularly among young people, which is helping us very much to slow down the progression of the virus.

I wish briefly to outline to the House a few further areas to those set out by the Secretary of State where we have strengthened our response. I will go through these quickly because I want to answer some of the points raised today. We know that we have delivered more than 4.2 billion items of PPE since last February, and our adult social care winter plan, published in September, sets out the actions for the Government and every local care provider.

I want to get straight on to some of the points that have been raised, because some really important issues have been discussed today. I cannot mention everybody and every point, but some people will definitely be receiving a letter from me, particularly the hon. Member for Twickenham (Munira Wilson). I will write to you and answer your points, because you are always very constructive in the way you ask for information and I will make sure you get that information. The hon. Member for Rhondda (Chris Bryant) made the best speech I have ever heard you make in this House—

Order. I am going to stop the Minister. I let her do it once; she called the hon. Member for Twickenham “you” and now she is calling the hon. Member for Rhondda “you”. Please call him “the hon. Gentleman”.

I do apologise, Madam Deputy Speaker, it is because I have not been here very often lately.

The hon. Gentleman made one of the best speeches I have heard him make in this House, probably because he agreed with every word I have been saying—indeed, I almost ripped up this speech. I applaud him for some of the comments he made.

I will have to resign now!

Possibly; the hon. Gentleman is in a very difficult position now. I say well done to him for taking apart the Great Barrington declaration. I will now not go into it, as he did an excellent job.

Without a vaccine, how do we attain herd immunity? With no knowledge of immunity from coronavirus, how do we obtain herd immunity? I will share with the House the fact that I was diagnosed with coronavirus on 7 March, I had a severe dose, and my antibodies had disappeared 12 weeks later. I am no longer immune to coronavirus. That is not just my story; it is the story of many, many people. Many people who were donating their plasma post-coronavirus for convalescent therapy were told quite quickly, “We no longer need your plasma because you do not have any antibodies left.” Work is being on one immunity, and we have not reached a conclusive position yet, but I can speak from my own experience and from the experiences that we are hearing about, and if people do not have long-term antibodies and we have no vaccine, there is no such thing as herd immunity. I say that again because it is the truth.

On the comments about the measures we are putting in place, how restrictive they are and social distancing, all I can say—and this relates to the number of deaths in hospitals—is that back in March no one was wearing face coverings and no social distancing was being complied with by the public, and the rate of infection was doubling every three to four days. Now it is doubling every seven to 14 days, because the public are wearing masks, they are hand-washing and they are socially distancing, and that means that when someone contracts coronavirus, they contract a smaller viral load, which is enabling doctors to treat those patients once they reach an intensive care unit. In ICUs, people are now living, not dying, but we still need the ICUs and we still need the ICU beds in which to treat those people in order that they can live. The fundamental purpose of every measure we take is to protect the NHS and to keep those beds in ICUs, so that they are there to treat people and to keep people alive.

I described this to someone today who argued with me that masks and face coverings are unnecessary. If people are in the space of someone with no mask—I will use a scale of one to 100—they will breathe in 100 droplets and a full viral load, but when someone has a mask on it is much less. This is not a scientific experiment; it is my own analogy, but the figure is probably 10. The hon. Member for Tooting (Dr Allin-Khan) knows this much better than I do, and can confirm or deny it. Therefore, with a mask, people’s viral load is lower and it is far easier to treat them once they arrive in hospital at A&E and are transferred to an ICU, and there is a huge chance of success. That is what we are seeing in action now in our hospitals. If we all abandon our face coverings, stop social distancing and stop hand washing, we will be back to where we were in March, when the virus was doubling every three to four days.

My hon. Friend the Member for Christchurch (Sir Christopher Chope) mentioned Sweden, but an article in The BMJ—a research study—concluded that Sweden and the US are the only two countries that are failing to reduce their numbers of deaths. In fact, it is far more accurate to compare Sweden with its Nordic neighbours. Sweden has 586 deaths per 1 million people, while its neighbour Norway has 279, so I am not quite sure why Sweden would be cited as a country of success.[Official Report, 24 November 2020, Vol. 684, c. 8MC.]

Will the Minister give way?

No, there is no time—I am sorry—because I want to go on to what other Members have said.

I want to talk about mental health and just correct a few points, particularly on frontline workers. On the evidence we have at the moment, the two groups of people who are suffering with their mental health as a result of this pandemic are people who had pre-existing mental health conditions and frontline workers who are suffering from post-traumatic stress disorder. For those frontline workers, a package was put in place straight away by the NHS, which provided each frontline worker with three counselling sessions, numerous apps and the ability to have a contact and to receive immediate counselling, as well as a website where they could go through the tools offered to work through their feelings. Almost every trust manager put in place a support package for frontline hospital workers, and yesterday the NHS announced a further £15 million to support the mental health of frontline workers.

For those with pre-existing mental health conditions—and I pay tribute to Claire Murdoch, who is responsible for mental health delivery in the NHS—trusts across the UK put in place 24-hour mental health crisis helplines in a matter of weeks, and they have had a huge impact. The Government have committed the £2.4 billion; we have accelerated the long-term plan; we have accelerated the trailblazer schemes in schools; we have introduced the wellbeing package in schools for children returning to school; and we have supported the third sector financially to deliver additional mental healthcare to almost every sector of society, including those with eating disorders. I always say that is one of the worst mental health conditions because it has a high rate of morbidity, and it too has received additional funding. We have put a huge amount of work into mental health, and I know that Claire Murdoch and others are proud of what the NHS has done in terms of the mental health services that it has delivered.

I cannot respond to anybody else, but I will write to Members. This has been an important debate in the middle of one of the greatest public health emergencies that this country has faced, and I would like to end by again thanking everyone across the country for playing their part to reduce the rate of transmission and to protect their loved ones and our local communities.

Question put and agreed to.

Resolved,

That this House has considered covid-19.