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

With permission, Mr Speaker, I would like to make a statement on coronavirus and about our plans to put us in the strongest possible position for this winter. Like many other countries around the world, we are continuing to see a concerning rise in cases, with 3,991 new cases recorded yesterday, and this week the number of patients in mechanical ventilator beds has risen above 100 for the first time since July. The battle against coronavirus is not over, and while we strain every sinew to spring free of its clutches, with winter on the horizon we must prepare, bolster our defences and come together once again against this common foe.

One of our vital lines of defence has been taking targeted action at a local level. We have seen local action work well in some parts of the country, and now we must take further action. We have seen concerning rates of infection in parts of the north-east. Sunderland, for example, now has an incidence rate of 103 positive cases per 100,000 of population, and in South Tyneside, Gateshead and Newcastle the figures are all above 70 per 100,000. As a result, local authorities wrote to me earlier this week asking for tighter restrictions, and we have taken swift action to put them into place. From tomorrow, in Northumberland, North Tyneside, South Tyneside, Newcastle-upon-Tyne, Gateshead, Sunderland and County Durham, residents should not socialise with other people outside their own households or support bubble; hospitality for food and drink will be restricted to table service only; and late-night restrictions of operating hours will be introduced, so leisure and entertainment venues must close between 10 pm and 5 am.

I know, as the whole House does, that these decisions have a real impact on families, on businesses and on local communities. I can tell everyone affected that we do not take these decisions lightly. We agree with the local councils that we must follow the data and act, and the data says that we must act now so that we can control this deadly virus and keep people safe. I know that the people of the north-east will come together to defeat this virus, as defeat it we must.

We are working to bolster our health and care system too. Winter is always a stretching time for health and for care, but this winter presents particular challenges. People will be spending more time indoors than they did in summer, where we know the virus is more likely to spread, and we know that we will need to deal with coronavirus along with the usual pressures that the season will bring. So today I want to set out our plans to support the NHS and social care this winter.

Turning first to the NHS, I can tell the House that we have allocated a further £2.7 billion to the NHS to support it during the winter months. This funding, in addition to the extra funding for personal protective equipment and testing, will help the NHS with the vital task of operating safely in a world in which covid is still at large and the critical task of working through the backlog of elective work that was inevitably caused by the first peak.

Our emergency departments are on the frontline of the fight for life in the NHS. Today, I am delighted to announce a series of measures to support our urgent and emergency care system this winter and beyond. I want to thank and pay tribute to Katherine Henderson, the president of the Royal College of Emergency Medicine, with whom I have worked closely to develop these proposals. I want to thank her, and, through her, all those who work in emergency care for their service in the face of adversity. I saw this again this morning at the St Thomas’ Hospital accident and emergency department, and I know that all of us support the work of those who work in our emergency facilities, right across the country. I very much hope that yours, Mr Speaker, will be opening soon in Chorley.

We will make our emergency departments bigger. Many are simply too small—that was true even before the pandemic, but it is even more acute now. So we are investing to expand capacity in urgent and emergency care, so that hospitals have the space to continue treating patients safely in the coming months. In August, we confirmed £300 million for emergency upgrades across 117 trusts, and I can today announce a further £150 million to expand 25 more emergency departments, including some of the most constrained in the country, such as those in Worcester and at the Royal Shrewsbury. This extra funding will put us in the strongest possible position for this winter, and boost the crucial work to accelerate non-covid care.

It is not just about the space, but about the service, so we are working to get patients the right care in the right place, by expanding the role of NHS 111. During the peak of this pandemic, we saw millions of people using NHS 111, on the phone or online, to get the best possible advice on coronavirus, helping them to stay safe and, where possible, to stay out of hospital, where they could have unknowingly spread the virus. It is crucial that, ahead of winter, we use this window of opportunity to seek out what worked and build on it, so we provide a better service for patients and protect the NHS. Of course, no one will ever be turned away from our emergency departments in the most serious of cases; however, we have worked with the royal colleges, the NHS and others to develop a better, quicker and more clinically appropriate service for patients by using NHS 111 first.

This is how it works. We will invest £24 million to increase call-handling capacity and to make sure there are more clinicians on hand to provide expert advice and guidance, and we will build on our trials to make NHS 111 a gateway to the emergency care system, providing a first port of call for patients. In future, rather than having to queue in an emergency ward, we are testing that people should call NHS 111 first to book an appointment with whoever can give them the most appropriate care, whether it is a GP, a specialist consultant, a pharmacist, a nurse or community services. Of course if they need to go to the emergency department, NHS 111 will be able to book them into an appropriate time slot. We want to see this approach lead to shorter waiting times and better availability of appointments for patients. We will consult on how its performance is best measured, and, with successful pilots, we will roll out NHS 111 First to all trusts from December.

Finally, I want briefly to update the House on our work to protect care homes. One of the worst things that we know about this virus is that it reserves its greatest impact for those who are physically weakest, especially the elderly, so we must do everything in our power to protect residents in social care. In May, we introduced the adult social care infection control fund, which has helped adult social care providers reduce the rate of transmission. This was used to fund important measures such as improving infection prevention and paying staff to self-isolate. I can now inform the House that we will extend this fund for six months and provide over £540 million of extra funding for providers. That brings our total funding for infection control measures in social care to over £1 billion. We will also shortly be bringing forward our adult social care winter plan, because we will do whatever is humanly possible to protect our care homes from this virus so that they are a place of sanctuary this winter.

We will soon be facing winter in this fight and, whether on our NHS emergency care wards or in our care homes, we will strain every sinew to give them what they need, so they are well equipped for this pandemic and, indeed, for the years ahead. I commend this statement to the House.

I thank the Secretary of State for advance sight of his remarks.

The capital investment for 25 A&Es will be welcome. On the piloting of the 111 triage ahead of A&E, given inequalities in accessing healthcare for the poorest and disadvantaged, how will the Secretary of State ensure that it does not worsen health inequalities? If it leads to greater demands on primary care, will GPs be given extra resources as a consequence?

The NHS is facing a likely second spike, winter pressures and a monumental backlog in non-covid care. The Chancellor promised to give the NHS “whatever it needs”. Does that promise still stand, and will the NHS get the funding it now needs to tackle the growing backlog in non-covid care?

On social care, can the Secretary of State guarantee that care homes will not face the same personal protective equipment shortages they faced at the start of the pandemic? Does he also accept that restrictions on family visits cause huge harm to residents? Does he rule out re-imposing nationwide restrictions on family visits?

The Secretary of State said little about testing this afternoon. Back in May he stood at the Dispatch Box and told the House that

“everyone aged five and over with symptoms is now eligible for a test. That applies right across the UK, in all four nations, from now. Anyone with a new continuous cough, a high temperature or a loss of, or change in, their sense of taste or smell can book a test”—[Official Report, 18 May 2020; Vol. 676, c. 380.]

“We have”, in his words, “now got testing for all”.

Yet, four months later, for the British people, it has become not so much “test and trace” as “trace a test”. Just when many fear we are on the cusp of a second deadly spike, the Prime Minister admits we do not have enough capacity. Rather than fixing the testing, the Secretary of State is restricting it. In the exchanges on Tuesday, 33 Members from across the House raised issues around testing in their constituencies. He responded with the local figures—it was a very good debating trick, and well done to the specialist adviser for producing the briefing—but that will have been no comfort to constituents advised to travel hundreds of miles for a test when ill. It will have been no comfort to parents with a poorly child and themselves sick with worry and unable to get a test. It will have been no comfort to those turned away from walk-in centres and now presenting at A&E asking for a test. It will have been no comfort to the 25,000 teaching staff not in schools teaching our children because they cannot get a test. People want to know when the Secretary of State will fix testing and deliver on his promise to make testing available to everyone.

The Minister in the media this morning said there would be priorities for testing, so can the Secretary of State outline what his rationing plans are? Care England says that weekly testing of all care home staff is still not happening. Will care home staff get testing under his imminent rationing plan? What about people living in areas of restrictions, including the north-east? Will the north-east get all the mobile testing sites it requests? What is happening in university towns, with thousands of students set to come to universities across the country in the next two weeks? Will there be extra testing in those areas? In July, he pledged 150,000 asymptomatic tests per day by September. Has that commitment now been abandoned?

We should not be in this mess. We warned the Secretary of State that without fixing testing and isolation, infections would rise. Rather than capacity being increased over the summer, pillar 1 and 2 lab capacity remained broadly flat. He is now setting up more commercial Lighthouse labs. Why not invest in the 44 NHS labs instead? There are still problems in these commercial labs, aren’t there? There are huge numbers of voided tests across the commercial labs. Randox had 35,000 voided tests across August. Today’s stats show test turnaround times for testing in these labs getting longer. Serco is still failing to trace 80% of contacts. At what point will the Secretary of State step in and strip poor-performing outsourcing firms of their lucrative public sector contracts?

When testing breaks down, case finding breaks down, isolation breaks down, and we lose control of this virus. The British people made great sacrifices—they missed family celebrations, they could not say their final goodbyes to loved ones at funerals—and honoured their side of the bargain. In return, the Government were supposed to deliver effective testing and tracing. The Government failed. Now we have vast swathes of the country under restrictions. Where do we go next? The Prime Minister yesterday said a second lockdown would be disastrous. Obviously, we all want to avoid a second lockdown, but the British public deserve some clarity. Is the Secretary of State completely ruling out a second short national lockdown in all circumstances? Infections are rising at pace, but it is not clear what the actual strategy of the Government now is. It is all very well talking about camel humps and moonshots, but we need a plan to fully suppress the virus. It is urgent that he fixes testing and tracing and gives people isolation support to avoid further restrictions. Otherwise we face a very bleak winter indeed.

To respond to the constructive questions that the hon. Gentleman raised, I welcome his comments on the use of 111 First. The purpose of 111 First is to improve access, including in terms of inequalities in the NHS, by ensuring that people get the right treatment in the right place and easier access if they do need to go to an emergency department, because the emergency department will know that they are coming. It is commonplace now in almost every part of our life to let people know that we are coming. If we are going to do something as important as visit an emergency department, it will help both the patient seeking treatment and the NHS to let them know that they are coming first. That is the principle behind 111 First. It sits alongside 999, which anybody should call in a serious incident.

The hon. Gentleman asked about the need for extra funding for the NHS, both for winter and for testing. I have just announced £2.7 billion of extra funding for the NHS, and he might have done better to welcome it. He talked about tackling the backlog of cases that inevitably built up in the first peak. The good news is that we are making progress on tackling that backlog and reducing it. Of course, there is an awful lot of work to do, and part of this extra funding will go towards that, alongside the funding to expand our emergency departments, the funding for PPE and the funding for testing that I mentioned in my statement.

The hon. Gentleman asked about PPE for care homes. We have a huge plan to ensure that care homes can get PPE, and the details will be set out shortly in the social care winter plan. He asked about family visits. The challenge of visits to those living in care homes is incredibly difficult, because nobody wants to spread coronavirus, but we also need to ensure that those who live in care homes get the support that they need and deserve.

The hon. Gentleman asked about testing. Of course there is a challenge in testing. The central point is that, contrary to what he said, capacity is at record levels and has increased week on week. The challenge is that demand has gone up faster—[Hon. Members: “No, it’s not.”] Those on the Opposition Benches can say, “No, it’s not,” but they cannot defy the facts. The most important thing for everybody across the country to hear from their elected representatives, if they are interested in helping the country get through this pandemic, is: if you have symptoms, get a test, and if you do not have symptoms, please do not come forward to get a test unless you are specifically asked to. That is what colleagues on both sides of the House need to be repeating to their constituents.

The hon. Gentleman rightly raised prioritisation—I like him, and he raised exactly the right point, which is that we choose to prioritise care home staff and care home residents. Over 100,000 tests a day of the 260,000 capacity are sent to care homes. We could solve other problems by not doing that, but we prioritise those who live in care homes because that is the right thing to do. He asked about areas where there are restrictions. We prioritise putting tests into areas of restrictions, such as Leicester, where there were over 1,000 tests yesterday. This is the core point: when something is provided for free and demand is therefore high, we have to prioritise where we put our national resources. His tone on prioritisation was almost at the point of welcoming it, and welcome it he should. He also asked about universities, and it is important to prioritise testing, where that is clinically appropriate, for universities too.

Finally, the hon. Gentleman asked about today’s contact tracing figures. Again, he played this divisive card that does not suit him at all, talking about the difference between the NHS and the private contractors. What I care about is a good service for the people we serve. The figures announced today are that 83.9% of contacts where communication details were given have been reached and told to self-isolate. That is the contact tracing working—even as the number of cases goes up—to help to control this virus. As we approach winter, I look forward to the two sides of this House coming together in the national interest, not playing these divisive cards that will simply play against the interests of those we serve, who elect us here in order to take our country through difficult times.

Today is World Patient Safety Day, which I had the privilege of launching virtually with Dr Tedros of the World Health Organisation this morning. The changes that the Health Secretary is announcing to A&Es are about patient safety. As Dr Katherine Henderson told the Health Committee, if we go back to crowded A&E waiting rooms, patients will die, so I welcome these changes. May I ask my right hon. Friend specifically about sepsis? Our A&Es have made huge progress in testing people who need to be tested quickly for sepsis when they arrive at A&E. If that is now to be done on the phone—if that is the first point of contact—it is absolutely vital that 111 call handlers are properly trained and their algorithms adjusted to ensure that we ask the right questions on sepsis. Will he undertake to do that?

I wholeheartedly support the points that my right hon. Friend has made. I pay tribute to him for his work in establishing World Patient Safety Day and thank him for his ongoing work in the international arena, both representing our country and driving forward this agenda globally. I entirely agree with his comments about 111 First. It is absolutely critical that both the online and phone systems act to ensure that sepsis is recognised, wherever that is feasible, to ensure that people get the best and safest route to care. I will ensure that that point is registered. We have put in the extra funding, which I have just announced, for 111 to ensure more clinical support for people accessing the service through NHS 111 First. Indeed, I pay tribute to him for introducing 111 in the first place. There is an awful lot of work to do here, but it will undoubtedly help patients to get a better service and help the NHS to deal with the multitude of cases that come its way.

While personal behaviour and local measures are critical, so is a functioning test, trace and isolate system. Last week the Prime Minister claimed that there was capacity for 350,000 covid tests a day, but I am sure the Secretary of State is well aware that a third of that capacity is antibody testing, which becomes positive only after the infection and is therefore of little use in diagnosing cases or managing outbreaks. Why have the Government not published the daily diagnostic testing capacity since last Thursday? The Secretary of State has promised that there will be 500,000 diagnostic tests a day by the end of next month. Can he confirm that that definitely refers to diagnostic antigen testing, and is he confident that it will be delivered on time?

The current problem appears to be a shortage of laboratory capacity, with the Government now cutting test appointments in many parts of the UK. Does the Secretary of State accept that that causes a danger of new outbreaks not being detected at an early enough stage? With the rationing of test slots, there are multiple reports of people being advised to enter an Aberdeen postcode to obtain authorisation for a test, even though the test will be carried out in the south of England. Does he accept that that will undermine Scotland’s contact tracing system and that incorrect data could give the false impression of a local outbreak in Scotland that does not exist? How does he plan to stop that practice?

Finally, the Secretary of State has previously talked about his moonshot testing project, based on millions of people testing themselves for covid every morning. Can he clarify whether he is planning for such tests to be provided on the NHS, or would individuals be paying for them? If they are on the NHS, given the enormous price tag and the fact that the technology does not even exist yet, should he not focus funding and efforts on getting the current diagnostic testing system working in the here and now?

Taking those points in reverse order, of course investing in the next generation of technologies is important here and now, because if we do not push forward those technologies that allow us to expand testing, we will always be stuck with the current one. The idea that there is a dichotomy between the two is completely wrong.

On the hon. Lady’s point about an Aberdeen postcode, we already have in place a system to ensure that if someone puts in one postcode but then turns up at the wrong drive-through centre, that will be indicated to the people there, so that problem has been resolved—indeed, it had been resolved before it was first raised in the House.

I hope that, like the Scottish Government, the hon. Lady will reiterate the point that people should come forward for a test when they have symptoms or have been told to do so by a public health professional, and they should not come forward if they do not have symptoms. Working together across the UK is undoubtedly the only way to solve this crisis, to the benefit of all our constituents.

That brings me to the point about testing in Scotland. More tests are being done in Scotland—through drive-through centres, local testing sites and mobile testing centres—than across the rest of the UK per head of population. We over-index the number of tests through those routes that we put into Scotland. Indeed, in the Scottish NHS there is spare capacity that needs to be used. I am working closely with the Scottish Government to ensure that that spare capacity is used, given the enormous demand for tests right across this country. I think that tone of working together is what we need to hear.

Earlier this month, Tameside and Glossop clinical commissioning group was reporting the highest rate of covid death of anywhere in the country. I want to put on the record my thanks to Ministers, Public Health England and NHS staff for working so hard to try to tackle this worrying situation, but it is very concerning that my constituents are still sometimes being asked to travel over 150 miles to get a test. Can the Secretary of State reassure me that the Government are doing everything they can to ramp up testing and laboratory capacity as a matter of urgency?

Yes, of course. There are of course challenges, which we are working incredibly hard to address, both in Derbyshire and nearby in Greater Manchester. Across Derbyshire as a whole, in the past week almost 4,000 tests have been done, so the testing capacity is there The challenge is that there is also this increase in demand. We have to ensure that the people getting the tests that are available are the people who need them most. That is the principle behind prioritisation, and it is a principle that everyone here should support.

A constituent wrote to me yesterday:

“My child started at primary school last week. Inevitably, she’s picked up a cold. That cold includes a slight temperature. She’s not allowed back to school until she’s had a negative Covid test result. Nor are my wife and I allowed to go to work. No tests are available.”

That scenario is being repeated in thousands of households across the country, with children who have already been out of school for six months facing further weeks at home because they cannot get a test. The heroic efforts of teachers to enable the full reopening of schools are being undermined by the chaos of the testing system. When will schoolchildren, teachers and support staff have reliable and rapid access to testing and results so that covid cases can be swiftly identified and isolated, and disruption to education minimised?

Those are the challenges that we are working so hard to address. The message to the hon. Lady’s constituent and others is that there are thousands of tests available in her part of London, and it is incredibly important that those with symptoms come forward and those without symptoms—[Interruption.] I know that her constituent had symptoms. The critical thing is that all of us have the same message: those with symptoms do come forward, but those without do not. That huge spike in demand is the challenge. It is as simple as that.

Testing capacity is a finite resource, and it is right to consider prioritising care homes, hospitals and key workers. Will my right hon. Friend ask his Department also to consider the issue of testing very young children, who frequently experience raised temperatures, coughs and colds? Some parents are taking very young children for multiple tests, but those in that age group are unlikely to be out in the community spreading the virus. People want to do the right thing and nobody wants to overwhelm the system, so will he continue to do all he can to ensure that the testing system is operating efficiently?

Yes. I thank my hon. Friend for that question, which captures the challenges we face. It is absolutely true that children under the age of 16 are very unlikely to get ill with coronavirus; indeed, the proportion of under-16s testing positive is extremely low and is flat, whereas it is rising in many other age groups. She raises a clear point: the prioritisation we have is about getting the tests that we have—record capacity—to the people who need them most. That is why it is an important principle.

Over the next few days, tens of thousands of students will be arriving in Nottingham. Our universities have spent months planning for a safe return, but there is a real danger that their hard work will be undermined, as Nottingham schools’ incredible efforts have been undermined, by the inability to get tests and results promptly. The University of Nottingham has repeatedly requested access to a small stock of pre-distributed pillar 2 swab test kits, which would enable faster and safer testing for symptomatic students and take the pressure off local community testing facilities. Will the Secretary of State work with and listen to universities such as the University of Nottingham to help to improve the efficiency of the national testing programme, and will he authorise the allocation of those kits to the university and others who request them?

I will absolutely look into that. That is exactly the approach we have taken with schools, and many universities’ labs are an important part of getting test results back. I am very happy to work with all of the 106 universities that are doing so much to ensure that the return of university is covid-secure, and I will look into the precise point the hon. Lady raises.

I have also had a number of Carshalton and Wallington residents get in touch with me about testing, some of whom are being sent down to the south coast to places such as Portsmouth and Southampton. May I ask my right hon. Friend what more the Government are doing not only to ensure that drive-through centres such as those in Chessington, which is nearby, are able to continue to process those tests, but to bring in more testing capacity into boroughs such as Sutton?

We are looking to get more testing capacity right across the board, as my hon. Friend well knows. The Chessington drive-through centre, which was one of the first that we put in place, has done an amazing job over the entirety of this pandemic. The good news is that, as I mentioned to the House on Tuesday, the average distance, as the crow flies, that people have to go to get a test has fallen from more than 6 miles to less than 6 miles. The message is that there are thousands of tests available and the average distance is low. The critical thing is that the people who come forward to get a test are the people who are eligible for a test, not people who do not have symptoms.

There are multiple private companies involved in running the track and test system: Serco, McKinsey & Company, Deloitte and Randox, to name but a few. Can the Secretary of State tell us whether there is a financial penalty written into their contracts for when citizens cannot get tests, and what that penalty is? Or is it only our constituents who will pay the price for this mess?

It is the task of the companies that the hon. Lady mentions and many more, and of the British Armed Forces, the NHS, the Department, Public Health England and many local councils, including her own, to get as much capacity as possible. That is what their job is, and they are doing that at record levels.

The feedback I am receiving from local schools is that the problems that staff and pupils are experiencing in getting tests could make it very difficult for some schools to remain open. To prevent this, can my right hon. Friend first liaise with the Secretary of State for Education to ensure that clear guidance is provided to schools about when to request a test? Secondly, can he do all he can to ensure that local testing programmes, such as that provided by the Norfolk and Waveney clinical commissioning group, continue to operate, as they do provide much-needed additional capacity?

Yes, I agree with both points made by my hon. Friend.

The Secretary of State has announced some £2.7 billion extra for the NHS. Can I seek confirmation: under the Barnett consequentials, how much of that will come to Northern Ireland? The news of the progress on a vaccine is a very positive step. Will he again confirm that no vaccine will be available on the NHS that has not been rigorously and completely tested? With that assurance, will he outline whether he considers children and education as a priority for the vaccine?

On the NHS funding, the Barnett consequentials will operate in the normal way for the hon. Gentleman’s constituents in Northern Ireland and right across the country. When it comes to the question of the vaccine, of course, we will allow a vaccine to be put in place across the board only when it is safe. The Medicines and Healthcare products Regulatory Agency is one of the most respected and high-quality regulators in the entire world. It is that body that will make the decision on whether it is safe to license. Of course, the question of who should be vaccinated and in what order is again a clinical decision, on which we will take advice from the Joint Committee on Vaccination and Immunisation.

I thank the Secretary of State on behalf of myself and my colleagues in Aylesbury and Buckingham for the extra A&E funding for Stoke Mandeville. It will make a great difference to patients and our valued NHS personnel in the Buckinghamshire health trust. But, in my constituency, in common with other Members, I am having a problem with the education system. A headteacher has written to me saying that we now have teachers and teachers’ children with covid symptoms, which means that they are off in isolation, and they are being told that there no tests available for 21 days. She writes,

“This is very tricky, as we have to pay a lot for supply teachers to cover classes. Would it not be sensible to prioritise testing for teachers if it is a priority to keep schools open, as once too many teachers are off waiting for tests, schools will have to close, and then people won’t be able to return to work?”

What can I tell my headteacher, and how can we get those tests into schools more rapidly to mitigate the problems that are coming down the line?

My right hon. Friend raises several important points. First, Stoke Mandeville Hospital is a famous and excellent hospital and I am delighted that we are able to expand its emergency facilities in this way. She has done more than anyone to represent the needs of Stoke Mandeville Hospital and all those who serve in that great hospital, so I welcome her comments on that. On testing, absolutely, we have sent tests to all schools to make sure that they have tests available. But of course I also recognise the challenges in getting hold of tests. I do not accept at all that there is a delay of 21 days and nobody should accept that. That is not Government policy. I have just looked up the figures: across Buckinghamshire, just over 1,000 people a day are getting tests, so there are tests available. This is part of the challenge of having the record capacity but demand having gone up. I am working as hard as I can to ensure that all those who need a test—all those who have the symptoms—get a test. I understand that it is a very human instinct to think that if a close contact has symptoms the best thing to do is to get a test, but if people do not have symptoms please do not come forward and use a test that is needed for somebody who has symptoms, so that either they can get a negative result and get back to their normal lives such as teaching at a school, or, if they test positive, we can give them the treatment and support that they need.

I do want to be able to get everybody in, so I urge colleagues to make the questions fairly brief and, correspondingly, the answers.

While there are some welcome announcements in this statement, I am utterly astounded that there is only one reference to coronavirus testing when we see cases rising across the country, a system in meltdown, people unable to access tests, and turnaround times down. If the Secretary of State does not believe us, perhaps he should read his own constituency inbox. Will he finally admit that the system is broken and we risk losing control of the virus? Will he issue a public apology?

The hon. Lady, earlier in the week in a statement that was all about testing, raised an issue that turned out to be wrong. I think it is really important and incumbent on all of us as public servants to explain things fairly, straight and properly to our constituents, and that is what she should start to do.

I thank the Secretary of State for that statement. I was actually due to head to the north-east myself this weekend to celebrate my parents’ golden wedding anniversary, which obviously I cannot do now, but I take this opportunity to wish them a happy anniversary anyway.

On the subject of testing, I have been contacted by constituents who are struggling to get tested. I know that is something the Secretary of State really does grasp and appreciate, but I wonder what further reassurances he can give them that those who genuinely do need testing will be able to access that as soon as possible.

I am sure that my hon. Friend’s family will be disappointed he will not be there, but at least a mention in Hansard is something to make up for it. He rightly raises the challenges in getting tests. I assure him that we are working as hard as we possibly can to fix the problem, that tests are available, even though it is a challenge to get hold of them, and that those who do have symptoms should come forward and get a test.

First up, we absolutely support the pillar 2 testing, as it is called, which in Sheffield has delivered more than 10,000 tests in the past week. The hon. Gentleman, who is normally such a reasonable man, should welcome that and thank all those who work on that project. I absolutely support his proposal to further expand the NHS testing in Sheffield, and I look forward to working with the NHS in Sheffield to do just that.

It is absolutely right that we now put in provisions to prepare for winter, so will my right hon. Friend join me in welcoming the announcement of £6 million for expanding St Peter’s Hospital’s accident and emergency and urgent care centre, which will make a huge difference to patients and to staff working in our hospital?

Absolutely. This is one of the 25 projects that we are announcing today that are all about preparing for winter. There is nobody who stands up for Runnymede in this House more than my hon. Friend, and he has made a great case for his local hospital. I am very glad to be able to support it today.

A constituent of mine’s husband, who works in the NHS, came home on Friday with covid symptoms. She has been trying to get him a test ever since, getting up at 5 am in the morning to try to do so. She is being told that tests are available locally and then being told, “Actually, no, there aren’t”, and she cannot get one. She has since developed symptoms herself. Neither of them has been tested. Neither of them is therefore in the tracing system, so there is no follow-up to prevent other people getting the virus as well. This is not just chaotic; it is dangerous.

The Government knew there would be a huge increase in demand for testing when the schools went back and when they were encouraging people to go back to work, yet since mid-July testing capacity has only gone up by 10%, while the number of cases has gone up by 400%. Why did the Secretary of State set his target for the end of October and not the beginning of September, so we could get enough tests in place?

We are increasing that capacity and, as I said, it is at record levels. When it comes to the right hon. Lady’s constituents, first, those who work in the NHS are eligible to get tests through the NHS pillar 1 system, but for all those who have symptoms of coronavirus or think they may have symptoms of coronavirus, it is very important that they self-isolate—

She is doing that.

The right hon. Lady says she is doing that. I am very glad that she is, and I thank her for doing that. I am very happy to work with the right hon. Lady to ensure that her constituent who works in the NHS can get a test through the NHS, because that is the role of the NHS for provision for those who work within it.

I welcome the confirmation today that Leighton Hospital will receive £9 million extra to help it prepare for winter. That funding will make a huge difference. I think everyone in this House and in the whole country hopes that we manage to find a vaccine, so I would be grateful for an update on vaccine development. Can my right hon. Friend also confirm my understanding that Test and Trace has found that the virus is spreading in our own homes, when we mix with friends and family, and that, as much as it is difficult for us, that is why the lockdown is focusing on those types of interactions?

My hon. Friend is absolutely right. Of course, as an emergency doctor himself, he knows more than almost anyone in this House about the needs of emergency care, not least because he spent lockdown working on the frontline of our NHS. I know that everybody is grateful to him for that. I know that the £9 million expansion to Leighton Hospital, which he and I visited in November or December, is much needed, and I hope that it brings good benefits, but it is also critical that people listen to my hon. Friend’s wise words.

On 21 July, during this summer’s nadir of new covid cases, I pressed the Government’s chief medical officer on the need to expand testing capacity. In that meeting of the Health and Social Care Committee, he stated that he would not consider that until there was evidence of a new surge in cases. Now we are in the grip of a second wave, with mounting chaos in testing capacity. Who should resign? The Secretary of State? The chief medical officer? Or do Ministers in this Government resign only when they refuse to break international law?

There is record testing capacity, which we work across the whole UK to deliver.

May I ask my right hon. Friend to set out the specific criteria that must be met for the rule of six to be lifted?

The judgment on how we lift the rule of six will be based on a whole series of measures: not least, of course, the case rate across the country, but also the impact of those cases in terms of hospitalisations. Sadly, we are seeing hospitalisations starting to rise, and therefore we have brought in measures to try to slow the spread of the virus. We also look at test positivity and the surveys of how many cases there are around the country, not just at the total number, because of course if you put more testing in, you get more positives. We look at all those indicators and, of course, take the clinical advice, and then make a judgment.

The last time I raised test and trace failures, the Secretary of State accused me of not being serious. Well, I am deadly serious. The Mildmay testing centre opposite my office in Ilford South has stopped accepting walk-in tests, despite the constituency being on the cusp of a local lockdown, with Redbridge now having the highest infection rate in London. The Secretary of States has repeatedly claimed to be following the science and data while ignoring the advice of leading scientists who have called for an expansion of our public health infrastructure. We now face further lockdowns across the country as a direct consequence of the lack of capacity in his test and trace system. It is hardly world beating. With the chief medical officer saying that there are 38,000 infections per day, can the Secretary of State give us an assurance that we will not need a second lockdown to mitigate his failing test and trace system?

I work very closely with the London leadership, cross-party, to tackle the problems and to ensure that there is testing available according to the clinical priority. In the hon. Gentleman’s area in the last week, there have been over 3,000 tests. I am sure that he welcomes those, but we absolutely work so that there are more, not least in the public health and NHS systems, as well as through the pillar 2 Lighthouse lab approach.

I have four asks for the Secretary of State. No. 1 is to fix the national portal. A constituent of mine failed to get a test in Bolton, but then she tried using a Wigan postcode and succeeded in getting a test for Bolton. No. 2 is to remove the backlog on testing results. People are having to wait too long before getting results. The third is to ramp up contact tracing. The senior leadership at my local authority inform me that they do not have the resource to deliver what is needed. Finally, what specific actions is his Department taking right now to help bring down the numbers in Bolton?

The situation in Bolton is very serious, and all four of the requests from my hon. Friend are rightly made. He is pressing the case, as he should, and perhaps I should meet him to see what progress we can make on all these cases.

Despite the likes of me warning last month about test lab capacity problems, the Government could not get a grip of their supposedly world-beating system and have now instructed our testing centre in Slough to become appointment-only. The only slight snag is that, instead of being able to use the Slough site, local people are being asked to travel for hundreds of miles, including getting a ferry to the Isle of Wight. This debacle is dangerous because Slough has already had too many fatalities and has only recently come off the Government’s covid watchlist. Given that we all know that test, track and trace is the best weapon to tackle coronavirus, how does the Secretary of State for Health expect local communities to continue their hard work in overcoming this virus if his Government are failing to provide vital resources?

On the contrary, the fact is that we are working hard with the local authority in Slough, where just in the last week over 1,900 tests have been done. I think it would be better to work together—don’t you?

On a visit to Trinity Academy in the town of Thorne in my constituency, the principal told me that increasing the number of testing kits given to each school from 10 to 30 will better ensure that children remain in the classroom, where they belong. Can my right hon. Friend therefore confirm to the House whether his Department is planning on increasing the number of testing kits distributed to educational settings?

Yes, we are looking at exactly that, and I am very happy to talk to my hon. Friend about it.

The Health Secretary has announced restrictions in the north-east. He will know that, in my community, we have been under those restrictions for quite some time now. This has impacted on beauty businesses, soft play centres, wedding companies and, particularly, coach companies. With my constituents doing the right thing and trying to beat this virus, but with furlough ending and winter looking like we might have continued lockdowns, does he agree with me that we now need a financial package to support the businesses that are suffering so that they do wither on the vine, and so that my constituents can do the right thing in having to choose between leaving work in order to keep people safe and putting food on the table?

I pay tribute to the hon. Lady, because in Kirklees it has been difficult in the last few weeks. Unfortunately, we are seeing continued cases in Kirklees. Last week, my right hon. Friend the Chief Secretary to the Treasury announced further support for businesses. She rightly argues for that in Batley and Spen, and I will see what I can do to further that.

I want to re-emphasise that we need brief questions, because we have two very well subscribed debates this afternoon on coronavirus support and it is important that we get to those fairly promptly.

Over the past few days, I and Kent colleagues have received a significant increase in the number of inquiries from constituents regarding testing arrangements in the county, which are leaving many frustrated by the online booking system and, ultimately, unable to arrange a test nearby. What steps is the Department taking to scale up testing and lab capacity in Kent, and could consideration be given to a more accessible and localised system to ensure that those in genuine need of a test are able to arrange one as close to their home as possible?

Yes, of course. My hon. Friend makes the point well. We are putting more localised testing in and making sure that it is as accessible as possible. Of course, the challenge is to ensure that those tests get to the right people, prioritised appropriately, and I look forward to working with my hon. Friend to deliver that across Kent.

At least six care homes in my borough of Enfield have seen the return of covid-19 cases. At the same time, they are experiencing delays in receiving pillar 1 and pillar 2 test kits, and results are taking more than a week to arrive, potentially leading to a rise in the spread of the virus. What steps is the Minister taking to ensure that testing is not taking as long? What does he intend to do to fix this mess?

Making sure that test kits get returned rapidly is incredibly important, including in social care. I am glad to say that the backlog has come down over the past week. At its core, our response to the problems in social care, because so many people who live in care homes are older and therefore vulnerable, is to protect the amount of test kits. The weekly testing of staff and the monthly testing of residents has been delivered and is being protected, even despite all the other pressures on testing capacity.

I thank my right hon. Friend for all the work he is doing in clearly challenging circumstances. My constituency, which is part of Solihull Borough, is under enhanced restrictions at the moment, restricting household-to-household mixing. That is absolutely the right thing to do. However, will my right hon. Friend give consideration to allowing informal childcare arrangements? Many parents who cannot afford to pay for childcare would welcome the opportunity to go to work within the guidelines and also have childcare in place.

That is an important question. It is a very difficult balance, because often informal childcare is grandparents looking after children and older people are, of course, the most vulnerable to the disease. That is the balance that we need to strike. I always keep an open mind and I am very happy to talk to my hon. Friend about getting the balance exactly right in his area.

The Government’s plans for mass testing have been criticised for placing their faith in technologies that are yet to be fully validated scientifically. The Prime Minister himself acknowledged that we are some way off the widespread use of pregnancy-style covid-19 tests. Given the well documented issues with capacity in the UK testing system at the moment, does the Health Secretary accept that we need to focus on ensuring that the existing system works before trying to shoot for the moon?

We need to do both. I would just ask the hon. Lady to look at the work the SNP Scottish Government are doing. They are themselves employing and deploying some of the new technologies.

In Bolton, the national lockdown has been followed by the local lockdown and economic lockdown. Positive covid cases are rocketing up, and that is having a devastating impact on people’s physical and mental health, as well as people’s livelihoods and businesses. Many people are heading out of the borough to get beauty treatments, and to go to pubs and restaurants. At the same time, the testing system is failing to deliver, so people are increasingly going to accident and emergency departments in Bolton and Wigan in the hope of getting a covid test. What actions is my right hon. Friend taking to deal with that?

We have put huge amounts of testing into Bolton, with almost 7,000 tests over the past week. People should not go to A&E to access tests. I saw that that was being reported yesterday. My team have been working with the hospital, which is doing a very good job in difficult circumstances. It is seeing the number of hospital admissions with coronavirus starting to rise. I pay tribute to my hon. Friend. The situation in Bolton is very difficult, with over 200 cases per 100,000 of population. That is the highest in the country by a long, long way and we have a lot of work to do to get the situation under control in Bolton. All the people of Bolton should listen to the public health advice, which is unanimous among Members of Parliament, the council, which is doing an excellent job, and the national clinical advisers. The advice is this: “Do not socialise with those outside your household.” That way, we will be able to get this most localised of epidemics under control.

It is no good blaming the public. People want to know that they can get a test when they need to. Some 25% of new cases are in north-west England, but only 15% of testing capacity. My constituents who are showing symptoms cannot get a test. Children and staff in our schools need to be able to get a test, so schools can stay open safely. The care homes in my borough are worried that, as demand goes up, they will not be able to get a test. When will the extra capacity be available in my constituency? The British people know what is going to happen and who is responsible. Fix it!

We have been putting in the extra testing capacity in Sefton. More than 5,000 tests have been conducted in Sefton in the last week. People should hear loud and clear that if they are in Sefton, as anywhere else, and they have the symptoms, they should come forward. The hon. Gentleman’s question, by rightly raising the importance of people with symptoms and people in care homes being able to get a test, underlines how important it is to prioritise and that people who do not have symptoms should not come forward. I hope that he would repeat that message.

Having visited Chorley and South Ribble Hospital last Friday, I was delighted to see some of the Government’s £300 million grant in action, with teams on the ground building significant works to help to make the A&E unit more covid-secure and increase its capacity. Will my right hon. Friend join me in looking forward to its full reopening as soon as possible?

Yes, absolutely. As I mentioned in my statement, I want to see the A&E in Chorley reopen as soon as is safely possible. My hon. Friend is right that we have put in a huge amount of support, and we all want to see it reopening. I look forward to the day—I hope soon—when we can announce that that has happened.

As my constituency sees the introduction of the new local restrictions in the north-east, will the Government give extra thought to easing the restrictions on informal childcare? It is an important part of the north-east economy and an absolute necessity for those on the lowest incomes, particularly women. I understand it is something that the local authorities have also requested. Will the Secretary of State think about that again for the north-east?

Yes, I will happily work with the hon. Lady on that question. It is a challenge, because of the problem of intergenerational transmission of the virus—I am sure she understands that side of it—so it is an important balance that we need to strike.

I am absolutely delighted with the £9.7 million upgrade of Southend A&E, which is entirely appropriate as we move towards city status. Does my right hon. Friend agree that if Southend is to avoid a lockdown, we cannot have a repetition of the scenes at Short Street testing station yesterday where, apparently, someone in management said that people could turn up without an appointment?

I will happily look into the testing in Southend, but it is nice to have some good news for the people there today.

Luton was an area of concern earlier in the summer, but it came out of it because people were able to get tested whether they had symptoms or not. Now, however, with the prioritisation of only those with symptoms because of the abject failure of the Government to get the testing process right, residents in my constituency are worried that we will see the simple blunt tool of a national lockdown. Can the Secretary of State give some clarification?

The hon. Lady is absolutely right that Luton is an example of local action that worked to bring the case rate right down. The outbreak was specific to certain parts of Luton. The council worked with the national bodies brilliantly.

Over the last week in Luton, about 3,000 tests have been done, so those tests are available. I look forward to working with the hon. Lady to make sure that people who have symptoms are able to get the test.

I thank the Secretary of State for the extra money for the Luton and Dunstable Hospital that he announced today. Does he agree that it would help people with symptoms who need a test if those told to self-isolate without symptoms did not think that a test was a “get out of jail free” card? How can we help people to self-isolate properly, given that only one in five has been doing so?

This is the central point: if people do not have symptoms, but they have been close to somebody who has tested positive or has symptoms of coronavirus, unfortunately they have to self-isolate because of the biology of the virus, which can incubate for up to 14 days. Even a negative test does not release them from that obligation, because they may well get a false negative. That is at the core of how we control this virus. The more colleagues around the House explain that principle, the more we will relieve pressure on the testing system and break the chains of transmission of the virus. It is an incredibly important point for us to communicate to all those we serve.

Increasingly, we have a Health Secretary who is out of control of a virus that is out of control. Next weekend, 40,000 students will come to York. We were promised a testing centre next month. November is now the earliest that we will have a walk-in centre where people can have a test. What discussions has he had with his colleague the Secretary of State for Defence about strategic planning, because it seems that his Department is incapable of planning for this virus?

We of course have to ensure that the provision of testing centres is where the virus is most virulent. Actually, we do have military planners involved in that process, and it is very important to get it right.

I should also say that we have just had two speakers from Luton, and I forgot to mention the money to improve Luton Hospital, which is one of the best in the country. I am delighted that it has made the case successfully for the expansion of its A&E, which will serve all the people of Luton.

Some 1.4% of those 275,000 people who travelled and queued were positive. Will not even a modest number of false positives mislead us? Is the Office for National Statistics survey any less prone to false positives?

My right hon. Friend raises an important point about the mathematics and the science of testing. I am sure he would enjoy reading the annexes to the ONS report that comes out each Friday, which address directly the question how the ONS adjusts for potential false positives, due to the high but not perfect specificity of the polymerase chain reaction test. I am very happy for one of my academics to take him through the rigorous Bayesian mathematics, which I am sure will help to elucidate the debate on this matter still further.

Because of the testing shambles, I understand that covid tests now have to be rationed to high-risk areas, but that comes at a time of increasing case numbers in Brighton and Hove, where a yellow alert has just been issued amid record cases last week. How will new outbreaks in currently deprioritised areas be identified and contained if we are not testing properly in the community? How will contact tracing function? I am really worried about the impact of the rationing of tests on our chances of knowing about and containing new outbreaks in other regions.

While I have the floor, I ask the right hon. Gentleman to condemn the comments of the Leader of the House about an hour ago, when he told the public to stop their “endless carping” about the lack of access to tests. It is not endless carping; it is genuine concern about people’s health.

Given the hon. Lady’s understandable concerns for her constituents, she should welcome the record testing capacity that we have and the more than 3,000 tests that have been done in Brighton in the last week.

Given the speculation about new local restrictions in West Yorkshire, will the Secretary of State reassure me that he will continue to be driven by the data? Will he also deploy extra testing facilities and capacity, because entire families in my constituency are unable to go to work or school, as they sit at home repeatedly refreshing the testing portal to try to book a covid test for family members with symptoms?

My hon. Friend, who rightly raised this issue with me on Tuesday, knows that I will always be driven by the data in the local action that we take. Where we do take local action, I do so with a heavy heart. I was very pleased that we were able to take his constituency out of the local action in West Yorkshire. However, we have seen case rates go up, and we will be guided by that data. I look forward to talking to him and working with him on that basis.

Despite the disappointing news that the Health Secretary has delivered, the people of the north-east are committed to doing everything they can to get this virus under control—but the Government need to meet them halfway. In Scotland and Wales, children under 11 are exempt from the restrictions. That enables families who do not have an army of nannies and formal childcare to get to work. I appreciate the concerns that he has outlined today, but none of them explains why the people of Scotland and Wales are trusted to make these decisions, yet people in England are disproportionately put in the difficult position of not being able to rely on family and friends.

I pay tribute to the hon. Lady, who, in what she has been saying this morning and overnight about the restrictions that we have unfortunately had to put in place in her local area, has been speaking for her constituents, and with very clear public health messages that it is so important that people heed. I will absolutely look at the point that she raised and make sure, working with her local councils, that we get the details right of exactly the measures that are put in place in her area and, indeed, across the country.

As a north-east Tory MP, I am grateful to my right hon. Friend for engaging so effectively with our local authorities in the north-east as we try to tackle this really worrying rise in cases. However, I am concerned that residents across my constituency are facing these difficult, restrictive measures yet not seeing many rises in covid cases in our local communities. How will he review the situation in the north-east? Will he work with me to assess the figures at the most local level to ensure that residents from Spennymoor to Shildon to Barnard Castle can all get back to normal life as soon as possible?

Yes, of course. We take action at as local a level as possible, but unfortunately we do have to take action in this case. I was in the north-east on Monday. I would echo her comments that people will do what is necessary to control this virus and to look out for their communities. I pay tribute to the work that she has done in representing people from Bishop Auckland and her whole constituency in what are difficult times.

Many of my constituents cannot get tests, including people who work for the NHS. Others have been sent as far afield as Aberdeen for tests. At the same time, there has been spare testing capacity in the region. Last week, NHS Test and Trace moved all its mobile testing units out of County Durham. The measures that the Secretary of State has outlined today will be enacted by the people of the north-east—I agree with my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell)—but unless we have an effective local test and trace system, this will not work. Is it not time to just admit that the national system has failed and that the effort now has to go into directors of public health being given the finance locally to put in place effective test and trace systems that local people can have confidence in?

The test and trace system works in a combination of the national and the local. If we took away the national, we would not have the record testing capacity, but if we took away the local, we would not have the local knowledge and the boots on the ground to solve problems and to find people who need to self-isolate. It is the combination of the two that works. I urge the right hon. Gentleman to work with his local council and with the national teams to do everything we can to get the virus under control in his area.

On a point of order, Madam Deputy Speaker. During the Secretary of State’s response to me earlier in the statement, he said that I was wrong to raise the issue earlier this week of my constituents using Scottish postcodes to access tests and that I was not being fair or straight with my constituents. I would like to offer the Secretary of State the evidence that I have. I have emails from Sunday, from Monday and, indeed, from this morning of constituents using Aberdeen and Dundee postcodes to access tests at the Twickenham site. Will the Secretary of State withdraw his comment, or is he suggesting that my constituents are lying to me?

Further to that point of order, Madam Deputy Speaker. I am very happy to look at any evidence that is presented, but I did look into this issue when it was raised on Tuesday. If someone does as the hon. Lady suggests and then goes to a testing site that is not the one they booked into, an alarm comes up on the screen to say that the person is booked into the wrong testing centre, so there is a process in place to tackle the problem that she has mentioned. I am very happy to look at any evidence to solve any problems in the system, but I have looked into this one, and I am assured that that is the case.

I thank the hon. Lady for her point of order, and I thank the Secretary of State for responding to it. I suggest that if the hon. Lady still wishes to send the emails to the Secretary of State, perhaps she should do so. It feels as though we can perhaps get to the bottom of this if we do it that way. There will now be a three-minute suspension.