PARLIAMENTARY DEBATE
Covid-19 Response - 2 June 2020 (Commons/Commons Chamber)

With permission, I would like to make a statement on coronavirus.

Thanks to the collective determination and resolve of the nation, we are winning this battle. We have flattened the curve, we have protected the NHS, and together we have come through the peak. Yesterday, I was able to announce that the level of daily deaths is lower than at any time since lockdown began on 23 March. Today’s Office for National Statistics data show that the level of excess mortality is also lower than at any time since the start of lockdown, falling on a downward trend. The ONS reports 12,288 all-cause deaths in England and Wales in the week ending 22 May. That is down from 14,573 in the previous week. That latest figure is still above the average for this time of year and we must not relent in our work to drive it down, but it is now broadly in line with what we might typically see during the winter. We never forget that each of those deaths represents a family that will never be the same again. This House mourns each one.

We are moving in the right direction, but this crisis is very far from being over and we are now at a particularly sensitive moment in the course of the pandemic. We must proceed carefully and cautiously as we work to restore freedom in this country, taking small steps forward and monitoring the result, being prepared to pause in our progress if that is what public safety requires. So today I would like to update the House on two important aspects of the action we are taking.

First, NHS Test and Trace is now operational. That means we have updated our public health advice. Since the start of the crisis, we have said to people that you must wash your hands, self-isolate if you have symptoms, and follow the social distancing rules. All those remain incredibly important, but there is a new duty—and it is a duty—that we now ask and expect of people. If you have one of these symptoms—that is: a fever; a new, continuous cough; a change in your sense of taste or smell—you must get a test. We have more than enough capacity to provide a test for anyone who needs one and we have more than enough capacity to trace all your contacts. So, to repeat: if you have symptoms get a test. That is how we locate, isolate and control the virus. By the way, I make no apology for this overcapacity. The fact that we have thousands of NHS contact tracers on standby reflects the fact that transmission of the virus is currently low. If we were in a position where we needed to use all that capacity, it would mean that the virus was running at a higher rate—something that no one wants to see.

Secondly, I want to update the House on the work we are doing to understand the unequal and disproportionate way that this disease targets people, including those who are from black or minority ethnic backgrounds. This is very timely work. People are understandably angry about injustices, and as Health Secretary, I feel a deep responsibility, because this pandemic has exposed huge disparities in the health of our nation. It is very clear that some people are significantly more vulnerable to covid-19, and that is something I am determined to understand in full and take action to address.

Today, I can announce that Public Health England has completed work on disparities in the risks and outcomes of covid-19, and we have published its findings. PHE has found the following. First, as we are all aware, age is the biggest risk factor. Among those diagnosed with covid-19, people who are 80 or older are 70 times more likely to die than those under 40. Being male is also a significant risk factor. Working-age men are twice as likely to die as working-age women. Occupation is a risk factor, with professions that involve dealing with the public in an enclosed space, such as taxi driving, at higher risk. Importantly, the data show that people working in hospitals are not more likely to catch or die from covid-19.

Diagnosis rates are higher in deprived or densely populated urban areas, and we know that our great cities have been hardest hit by this virus. This work underlines that being black or from a minority ethnic background is a major risk factor. That racial disparity holds even after accounting for the effects of age, deprivation, region and sex. The PHE ethnicity analysis did not adjust for factors such as comorbidities and obesity, so there is much more work to do to understand the key drivers of these disparities, the relationships between the different risk factors and what we can do to close the gap.

I want to thank Public Health England for this work. I am determined that we continue to develop our understanding and shape our response. I am pleased to announce that my right hon. Friend the Equalities Minister will be leading on this work and taking it forward, working with PHE and others to further understand the impacts. We need everyone to play their part by staying alert, following the social distancing rules, isolating and getting a test if they have symptoms. We must not relax our guard but continue to fight this virus together. That is how we will get through this and keep driving the infection down. I commend this statement to the House.

There have now been 56,308 excess deaths since the beginning of March, 12,500 of which are not related to covid, but we do have one of the worst excess death rates in the world—why does the Secretary of State think that is? What does he believe is the cause of the non-covid excess death rate?

With respect to the PHE’s findings, which I am pleased to see published today, we have always known that there is a social gradient in health. The poorest and most deprived have inequality in access to healthcare and inequality in health outcomes. What the Secretary of State has confirmed today is that covid thrives on inequalities. Yes, indeed, black lives matter, but it is surely a call to action that black, Asian and minority ethnic people are more likely to die from covid and more likely to be admitted to intensive care with covid. He has seen the findings. I note that the Equalities Minister is taking work forward, but what action will be taken to minimise risk for black, Asian and minority ethnic people?

There are other vulnerable groups who are highly at risk. I am sure the Secretary of State will have seen today the Care Quality Commission report which shows a 134% increase in deaths of people with learning disabilities. Surely it is now time to expand testing to those under 65 in receipt of adult social care.



On the easing of restrictions, the Secretary of State said that this was a sensitive moment—well, quite, Mr Speaker. Our constituents have concerns and are looking for reassurance, particularly those in the shielding group. They really should not have had to wake up on Sunday morning to find out that they could now leave the house once a day. They need clarity and details. And why were GPs not informed in advance?

We are still at around 50,000 infections a week, so may I press the Secretary of State a bit further on the easing of restrictions? The biosecurity level remains at 4, but his own Command Paper from 11 May said that changes to lockdown

“must be warranted by the current alert level”.

At the Sunday news conference, the Secretary of State for Housing, Communities and Local Government said that all the proposed easing of restrictions had been modelled and showed that the R value remained below 1. That is, of course, reassuring, but will he now publish that modelling so that it can be peer-reviewed?

The easing of restrictions was based on tests, so may I ask the Secretary of State a couple of questions? First, on NHS capacity, we know that the NHS has not been overwhelmed, but that has been on the back of cancelled planned surgery, delays to vital treatment, and the postponing of cancer screening. Arguably, it has been the biggest rationing exercise in the history of the NHS. Will he now publish the total number of planned operations that have been cancelled and detail them by procedure? As the lockdown is eased, is it his intention to step down some of that surge capacity so that this backlog of clinical need can start to be tackled?

On managing the virus, one of the tests is whether we can manage the virus, but, as the Secretary of State has said, that depends on testing and tracing. There is now capacity for more than 200,000 tests, but there is still a lack of clarity about how that figure is arrived at. The UK Statistics Authority has written to him today, saying that his figures are still

“far from complete and comprehensible”,

that the testing statistics still fall well short of standards in the code, and that it is not surprising that testing data is mistrusted. That is quite damning, I have to say to him. Will he start publishing again the actual numbers of people tested? Will he stop counting tests mailed to homes as completed? Will he detail what proportion of the 200,000 tests are diagnostic PCR, what proportion are antibody, and what proportion are surveillance? Can he tell us how many care home staff and residents have been tested? When will he start weekly testing of all NHS staff, as that is crucial for getting on top of infections in hospitals? Will he tell us what percentage of the Deloitte-run testing facilities have been sent to GPs?

On test and trace, which is absolutely vital to safe easing out of the lockdown, the Prime Minister told the House before the recess that it would be “world-beating” and operational by yesterday, but it is not actually fully operational at a local level, is it? Can the Secretary of State confirm that local directors of public health have been told to prepare strategies for tracing with a deadline of the end of June, that they will not actually start receiving local individual data until next week, and that many have still not been told their allocations of the extra £300 million or what they can spend it on? When will they get those allocations? Despite this, he said yesterday that test and trace is up and running. I am not sure how he can say that it is up and running when local directors of public health are still asking for that information. Will he publish the data and what percentage of infections have been contacted and how many contacts have been followed up? Will that data be published on a daily basis?

This is a crucial week, given the easing of restrictions, and our constituents want reassurance and clarity, but I am afraid that trust has been undermined by the Dominic Cummings scandal. Our constituents want to do the right thing for their loved ones and their neighbours. Can he give them those reassurances today?

I entirely agree with the hon. Gentleman that it is critical that people play their part in making sure that we continue the work of controlling this virus and driving down the number of new transmissions. I am glad that he recognises the work that has been done, not just by Government, but by all of us, to get this virus under control.

Let me answer the hon. Gentleman’s questions specifically. He asks about the inequalities in health outcomes. He is quite right to address that subject. It was important before we went into the coronavirus crisis, and it is even more important now. Black lives matter, as do those in the poorest areas of our country, which have the worst health outcomes. We need to ensure that all these considerations are taken into account and that action is taken to level up the health outcomes of people across this country, because there is no more important levelling up than the levelling up of a person’s life expectancy and the quality of health with which they live that life.

The hon. Gentleman asked specifically about those with learning disabilities and autism. That testing in care homes for those of working age has continued all the way through this crisis, and we are rolling it out further. He mentions the changes for those who are in the shielding category. I was very pleased that we were able to make these changes. We announced them at the weekend and they have been very well received, especially by those who are shielding, because they are now able, safely, to go outside. It is hard to overstate the impact of saying to people that the recommended medical advice was that they should not go outside for 10 weeks. I am glad we have been able to lift, just slightly, the restrictions on those in the shielding category.

The hon. Gentleman also asked about the restart of the NHS. It is vital that we get the rest of the NHS going again, and that work is under way. The expansion of cancer facilities is under way. The demand for accident and emergency and urgent care is not as high as it was, but I look forward to the full restoration of our A&E facilities across the country, including in central Lancashire.

The hon. Gentleman asks, rightly, about the NHS test and trace capability. That is up and running, and working well. He asks how I can say it is working well. It is working well because thousands of people have been contacted and their contacts are being traced. So the system is working. We absolutely will publish data on that, but, as the letter from the UK Statistics Authority this morning shows, it is very important that we get that data publication right. We will work with the UKSA to make sure it is happy with how we are publishing that data, to make sure we get the data published in a reasonable and sensible way, one that also supports the operation of NHS test and trace, which we agree is a critical part of the next stage. I commit to publishing that data and to working with the UKSA on how it is put together.

The final point to make in response is that the goal here is to have a more targeted approach to the lockdown, so that we can carefully and cautiously lift the broader lockdown. That is what we are working to achieve, and I am very grateful for the support from right across the House for our efforts to accomplish that.

Let me start by thanking the NHS and care workers in my constituency in the Scottish borders, who are working so hard to keep us healthy. The Health Secretary will be aware of the very low levels of testing taking place in Scotland, which is clearly a concern as we move into the test and isolate phase. Given the UK Government’s role in providing test facilities in Scotland, what further assistance can they provide to the Scottish Government to help push up the testing numbers?

We have supported and helped the Scottish Government throughout this, because although they have missed their targets in the roll-out on tests delivered in Scotland, the UK programme of the drive-through centres and the home-test kits has also been operational in Scotland. I work closely with my Scottish counterparts to try to make sure that testing is as available in Scotland as it is in England, and that work is ongoing.

I call Ian Blackford to speak on behalf of the Scottish National party—you have four minutes.

I am standing in today for my hon. Friend the Member for Central Ayrshire (Dr Whitford), who is excluded from taking part, given the removal of the hybrid Parliament— for now.

There are growing concerns that this Tory Government are taking a cavalier approach on coronavirus, by rushing to ease lockdown measures despite warnings from public health experts. There are serious questions to answer on the political decisions the Prime Minister and the Health Secretary have taken, which could increase the rate of infection and put lives at risk—or even cause a second wave of covid-19. The Government claim to follow the science, so why have they ignored the experts who have advised against opening schools or easing lockdown further, without pausing to evaluate each step? On what basis were the decisions made to allow groups of people from six different houses to meet in England, to tell 2.2 million people in the shielded group that they can go outside and to send people back to work in England on 11 May without a functioning test, trace and isolate system in place? The results from the Deloitte regional test centres are still not being reported to local public health teams. How does the Secretary of State plan to fix this, and by when? What financial support will be put in place for those called on to isolate as asymptomatic contacts, especially as this could happen more than once?

With test and trace depending on people being willing to isolate if told to do so by a contact tracer, does the Secretary of State not regret that he and his Cabinet colleagues have completely shredded their own lockdown rules to protect a man who thought he was above the rules? In refusing to sack Dominic Cummings for travelling 260 miles with his wife, who was symptomatic, the Prime Minister has destroyed his own “Stay home and save lives” message. We know that the Dominic Cummings scandal has undermined efforts to tackle the virus by eroding trust in the UK Government and its public health guidelines, and we have seen that people are breaking the rules as a result. Does the Secretary of State not recognise that the scandal has already undermined lockdown and could lead to more infections and even more deaths in the future? This is about leadership and responsibility. Dominic Cummings should go, and he should go now.

I look forward to my SNP opposite number returning and to being able to have a constructive discussion about how we might together tackle the virus; how we might together protect those who are shielding and for whom, thankfully, it is safe to go outside, based on the clinical advice; how we can ensure that the test and trace system is rolled out across the whole of the UK; how the systems can interact and work together to protect people, especially in border areas, where people may need to make cross-border journeys; how we can work together, as a whole country, to keep the number of new infections going down; and how we can work together to protect people and protect our NHS. Those are the conversations that I have with the Scottish Government and with my SNP opposite number here in Westminster, and those are the things that really matter.

I am expecting to run this session until 2 o’clock. I call Harriett Baldwin.

Will the Secretary of State join me in thanking the teachers in Worcestershire, who managed to get 77% of reception classes open yesterday? I am told by these teachers that their schools are not large enough for them to welcome all pupils back and observe the 2 metre rule, so could he update the House on why the UK is continuing to maintain a distance that is double that recommended by the World Health Organisation?

We have reviewed the science on the 2 metre rule. The challenge is that the further apart people are, the less likely is transmission of the virus, so the rules we have in place are to slow the transmission of this virus. It is not really the rule that presents the challenge in schools; it is about trying to make sure that all places are as safe as possible. We keep this under review, as the Prime Minister has said. I congratulate schools across Worcestershire on reopening 77% of reception classes. It is a very important step forward. Making sure that we have the guidelines in place so that we can live with the virus while bringing the rate of transmission right down is very important.

In view of the Secretary of State’s statement confirming PHE’s findings that being black or minority ethnic is a high-risk factor, what guidance is he providing to the NHS and social care sectors on the rostering of BAME staff in high-risk covid areas? Will his Department be investigating whistleblower claims that BAME locums were disproportionately placed on the rota at Weston General Hospital, which has recently experienced a major outbreak?

The hon. Lady is right to raise the case of Weston hospital. We have been working hard to ensure that the local outbreak is brought under control, and we are making progress. She is also right, of course, to raise the PHE report that we published today.

The critical next step is to ensure that we understand the drivers of the disparities that are seen in the data and, in particular, that we address the question of the impact, taking into account co-morbidities such as obesity and the impact of occupation, which are not taken into account in the PHE work thus far. That is the work that the Minister for Women and Equalities, my right hon. Friend the Member for South West Norfolk (Elizabeth Truss), will be taking forward.

I know the worry that has been felt by the BME community during this period. I have personally felt it, as have many of my family members working on the frontline in the NHS, so I sincerely thank the Secretary of State for commissioning the review and continuing its work. Can he confirm that its publication was not delayed due to the sensitivity of its findings?

I can absolutely confirm that. I know my hon. Friend understands this, not least because I think that both her parents are doctors who are absolutely in the heat of this. In terms of the data publication, when I asked PHE to undertake this piece of work, I asked it to produce it by the end of May, which it did. It delivered it to me on Sunday, and we have published it and brought it to the House at the earliest opportunity.

Further to the previous question, is the Secretary of State saying that the publication of the report by Public Health England on the wildly disproportionate level of deaths among ethnic minority communities was delayed purely because further work was needed on elements of it? In that case, at what point will it be published?

No, I am not saying that. I asked Public Health England to produce this work because I was very worried by the evidence of the increased morbidity and mortality among black and minority ethnic communities. I gave a deadline of the end of May. The work was delivered to me on Sunday, at the end of May. I considered it yesterday and brought it to the House at the first chance.

Will my right hon. Friend join me in thanking the British Ceramic Confederation for its work advising the Government on safety in the hospitality industry? A chipped plate is not covid-safe, so will he encourage the hospitality industry to buy high-quality chip-resistant tableware from our world-class manufacturers in Stoke-on-Trent?

Yes, I will. The manufacturing of pottery and chinaware in Stoke-on-Trent has long been one of the finest things in this country. My hon. Friend is an inesteemable representative, along with her two colleagues, for Stoke-on-Trent—[Interruption.] Inestimable. Exactly. I think that is what I said. She rightly makes that case, but there is a broader point, which is that coming out of this, we are going to need many industries that work differently. The economy will not be the same on the way out as it was on the way in, and in many cases we can make changes for the better. She is absolutely sticking up for the pottery industry.

I very much welcome what the Secretary of State has said about the PHE report and the need to get to the bottom of why these racial disparities seem to be a thing, but it is not enough to work out after the event why there have been so many more deaths among the BAME community. What is he doing to support the public health function in local authorities so that they can work with local community groups to try to identify people who are more likely to be at risk, to prevent the illnesses and deaths from occurring in the first place?

We have put extra funding into those functions, obviously, because this is a significant crisis that demands massively more of our local public health capabilities in councils and in the devolved Administrations as they deliver local public health services on the ground. It is absolutely critical to look at these risks, but we have to look at them in the round. We have to look at all the different risks. For instance, there is growing evidence of the impact of obesity on the morbidity—that is, the impact of covid—and on people’s chances of dying, and that has to be taken into account as well.

I know my right hon. Friend feels a deep sense of responsibility for health outcomes across the United Kingdom, and not just health outcomes but how healthcare services are delivered. Will he provide an update on what the Government are doing to support social care in Dudley, the Black Country and the rest of the country?

I am delighted to say that the statistics published by the Office for National Statistics this morning show that the proportion of covid deaths in social care is falling, and that is very good news. I am very grateful to all those working in social care, and those working in local authorities to support those in social care, in Dudley and throughout the country. We have put in billions of pounds of extra funding, including £600 million just 10 days ago. We have to make sure that we support those working in social care, who look after some of the most vulnerable.

A growing number of constituents are getting in touch with me to express their concerns about the Public Health England report and the impact of coronavirus on ethnic minorities. The death rates of black and minority ethnic people are in many ways connected to people who have no recourse to public funds; people who are forced out to work when it is less safe for them to do so, because they are not entitled to statutory sick pay; and people who are in lower-paid jobs and, as in the case of Belly Mujinga, are less able to complain to their employers about their circumstances. Does the Secretary of State agree that it is one thing to say that black lives matter but quite another when he forces them out to work with no alternative?

It is very important that we look all the risk factors, including ethnicity, that have an impact. Indeed, that is what our broad approach has been, led by our shielding programme, whereby we have said that those who are most vulnerable should not leave the house at all until we were able to say this weekend—I am pleased to say—that it is safe for them to go, as long as they stay 2 metres apart from others.

Russells Hall Hospital in Dudley serves my constituency of Stourbridge well but, as we start to admit and treat those who require surgery and cancer therapy, the hospital urgently requires capital investment to create additional wards in a free-standing facility to maintain social distancing. Will my right hon. Friend join me in visiting Russells Hall Hospital to discuss this much-needed investment and, of course, to thank the staff there personally for their continued, compassionate and heroic efforts to protect patients and staff from covid-19?

The Dudley-Stourbridge massive are out in force today. I am delighted to thank everybody at Russells Hall for the work that they are doing. I am pleased to be able to confirm to my hon. Friend that we are working hard to restore cancer services. Many cancer treatment services have continued, but many were not able to continue because taking somebody’s defences down to close to zero, which is needed in much modern cancer therapy, is not the right thing to do when a killer virus is about. We are able to restore those services and I would love to visit my hon. Friend’s local hospital, whether virtually or physically.

Wales has 130,000 people who are considered most at risk from covid-19, and they deserve to be treated better than being caught up in a game of cross-border political brinkmanship. The Secretary of State’s Government’s changes to the status of shielded people in England were announced in the English media on Sunday. What procedure is in place to co-agree such announcements in good time with the Government responsible for health in Wales?

I work with my Welsh opposite number, Vaughan Gething, very closely. He and I have worked very closely indeed and the approach that the Welsh Government have taken has been to work through the four chief medical officers to try to do this in the best possible way.

Scotland has a daily testing capacity of 15,500 tests, but the Scottish Government’s own figures suggest that the most recent daily testing total was just 2,729. Does the Secretary of State agree that that is a woeful and alarming figure for many people in Scotland? What further support can the UK Government give to the SNP Administration at Holyrood to ensure that we are not left behind as the rest of the country moves to the recovery phase?

My hon. Friend is right to raise that issue. All I can say is that we give all the support that we possibly can to the Scottish Government to help them to get their testing numbers up.

In the London Borough of Brent, which covers part of my constituency, two thirds of communities are from a BAME background, so it comes as no surprise that some areas in Brent have the third highest rate of covid-related deaths in the whole of London. The Secretary of State has said that he recognises the disproportionate impact that covid-19 has on BAME communities, and he has said that black lives matter, but BAME communities are not interested in slogans or empty rhetoric from us politicians; BAME communities want to know what concrete and practical steps the Secretary of State is taking right now to ensure that BAME communities are protected when the lockdown is eased, so that the lives of no more people from my communities are lost.

The hon. Lady is quite right to raise this issue and to discuss it in the way she does. Working with the council in Brent, where this disease had one of the highest impacts at the start, we have managed to bring the incidence of disease right down. For instance, ensuring the protection of those living in care homes in Brent has led to the outbreak there coming right under control. Brent is a very good example of where, when we saw a focused outbreak at the start, we put extra resources in; we have put support into Brent Council, and together we have managed to get this disease under control.

Along with many of my constituents, I am very concerned that the number of covid cases identified in Ashford has been one of the highest in the country. I recognise that there are complex reasons for this, but in these circumstances may I ask my right hon. Friend to fill the gap that exists in the regional testing centre network—in east Kent—by placing one in Ashford?

I’m on it.

I am glad that the Secretary of State has announced the publication today of the report on how covid-19 has disproportionately affected black and minority ethnic communities, but it has taken far too long. It is because black lives matter that the Government must do all they can to address this disproportionality right across the UK, so will the Secretary of State update the House on what specific discussions he has had with the devolved Administrations about the impact on those from black and minority ethnic backgrounds across the UK?

The report was delivered to me on Sunday—on deadline—and I have published it two days later, so we have been moving at pace in this space. It is a Public Health England report and therefore focuses on public health in England. I am sure that Public Health Wales will want to look at the same questions.

I congratulate the Secretary of State on hitting both the 100,000 and the 200,000 targets for testing. It is indeed correct that the capacity needs to be there; we do not use the Army every day but it is important that we have it there as a resource. We have had some issues in County Durham regarding some of the drive-through testing sites. Will the Secretary of State look at that to ensure that we do not have those problems in the future?

My hon. Friend is absolutely right to raise the importance of having the testing capacity, but I would tell all his constituents in Durham and people right across the country to get a test if they have symptoms. The tests are available, and it is so important for tracing the disease.

Does my right hon. Friend agree that as the virus increasingly comes under control, it is vital that we begin to plan for the swift resumption in full of local and urgent healthcare such as the minor injuries unit at Deal’s Victoria Hospital, and other important services provided there and at Dover’s Buckland Hospital?

Yes. The restoration of services across the NHS is critical, and it is important that it is done in a covid-secure way. It is critical that people know that the NHS is there for them; if they need the NHS or if they are told by a clinician to go to hospital, I ask them please to go.

Since being caught double-counting tests for 11 days straight now, the British Government have refused to disclose how many people have been tested for coronavirus. Can the Secretary of State therefore explain how his test, trace and isolate system is world beating if he does not know how many people are being tested?

Ensuring that we get these statistics accurate is incredibly important. We are working on that with the UK Statistics Authority. It is a big piece of the work to ensure that we get the publications right.

I welcome my right hon. Friend’s announcement about his focus on the vital research into the risk factors of serious illness from covid, especially the impacts of age, sex and ethnicity. I look forward to future research that takes into account comorbidities, which are a crucial part of the puzzle. Does my right hon. Friend agree that we are now reaping the benefits of long-term investment in research in the NHS so that we can do these studies, but in going forward and understanding better the impact of comorbidities, can he give me an idea of when that may report back so that we can make policy decisions based on it?

This is clearly urgent work to disentangle the different factors that cause the disparities evident in the data in the report published today. The Equalities Minister will be leading that work, working with Public Health England and others, to get to the bottom of that as quickly as possible.

My constituency of Luton South is super-diverse, with a large BAME population, and it has significant pockets of deprivation. Given those risks, what do I say to my constituents who tell me they simply do not believe that it is safe to relax shielding, given the Government’s confused messages and apparent endorsement of breaches of public health guidance, with the lack of action taken over Dominic Cummings?

That is not an appropriate way to characterise the approach we are taking, because when it comes to people who are shielding, we have recommended that people shield for their own protection, but the clinical advice says that it is safe for people to go outside, because the incidence of disease is now lower than when we brought in the shielding policy, and I think—well, I know—that many of the shielded are so pleased to be able just to go outside. It has had a huge impact on them, when they have given up a great sacrifice.

I thank my right hon. Friend for ensuring that Redcar and Cleveland is at the forefront of the Government’s new test, track and trace programme. What assessment has he made of how test, track and trace will allow us to reduce social distancing in the weeks ahead from 2 metres to 1 metre, as per the guidance?

The success of test, track and trace is a critical part of making sure that we have a more targeted approach to lockdown, so that we can reduce the broader lockdown safely. That is what building the system is about—having more targeted interventions so we can reduce, when it is safe to do so, the broader interventions that everybody has been having to live under.

I have been sitting here desperately trying to give the benefit of the doubt to the Government, because we are in a national crisis, but I have to reflect the fury that my constituents have reflected to me on Facebook and in emails about the Dominic Cummings situation. I know the Secretary of State will want to shrug it off and will want to move on, but I have to say to him that it has been absolute fury. People think that there is one rule for the Government and their friends and another rule for everybody else. They have made massive sacrifices, and they feel that the Government are not standing by them. Please, please will he reflect that back to the Government?

I think the most important thing as we go forward in trying to tackle this together is that the social distancing guidelines we have set out are critical for the safety of the nation. We are able, safely, to make small changes, which will improve health because of the negative impact on people’s physical and mental health of being solely shut indoors. Therefore, it is crucial that people follow the social distancing guidelines, and that will in turn help us to lift these measures more broadly.

As my right hon. Friend is aware, my constituency of Kensington has some of the most extreme health inequalities in the country. The difference in average life expectancy for men is more than 16 years between the richest ward and the poorest ward. Will my right hon. Friend assure me that practical, concrete steps will be taken to alleviate these inequalities?

Yes, absolutely. As my hon. Friend eloquently puts it, there is levelling up to do not just between different parts of the country and different regions of the country, but even within individual constituencies. Hers is of course one of the greatest examples of this, as are some of the other inner-city constituencies in boroughs. I think the levelling up of health inequalities across the country is going to be an even more important part of the agenda after coronavirus than it was before.

The number of cases and deaths is falling, but several health officials, including the Association of Directors of Public Health, say they are not convinced that all five of the Government’s tests have been met sufficiently to ease lockdown restrictions. As of this morning, we hear that test and trace is up and running, but no figures are available. Given that easing the restrictions is risky—one could argue that having us all here discussing it is risky—and there has been, according to my mailbox, an undermining of public confidence in the Government’s approach by the Dominic Cummings scandal, what additional metrics will the Government use to monitor and contain transmission, and how do they suggest we reassure the public that they are effective and being followed by everyone?

The hon. Lady is quite right about the devices that we need for monitoring. Through the public health authorities, extensive operations are already in place to monitor outbreaks, and we have spotted some outbreaks, as per the hon. Member for Twickenham (Munira Wilson), who discussed the outbreak in Weston-super-Mare. She is also right to say that more is needed. The new joint biosecurity centre will be an important part of that operation.

It is deeply distressing to see the toll that the disease has taken on people from black and minority ethnic backgrounds. It is also worrying that so many transport workers have fallen foul of the disease. In London, many of them come from black and minority ethnic backgrounds. Will my right hon. Friend urgently engage with transport companies and authorities across the country to keep our transport workers safe, especially those from BAME communities?

That is an incredibly important point, because there has been a disproportionate impact on transport workers, particularly those who, by the nature of their work, have to be in close contact with others, for example taxi drivers. That factor was not taken into account in the Public Health England analysis. It is exactly what we mean when we say that we must understand the different causes of the disparities in the data on the impacts according to people’s ethnic background. Disentangling how much is due to occupation and how much is due to other factors is an important part of the analysis that we need to undertake to be able to take action such as protecting those who work in the transport sector.

Public health professionals I have spoken to tell me that the success of the Government’s track and trace system is limited by the turnaround of up to five days for coronavirus test results. That delay severely impacts the ability of public health teams to prevent onward transmission and protect the population from the virus. Does the Secretary of State recognise that problem? If so, how does he plan to achieve a 24-hour turnaround for every test? When will that be achieved?

The hon. Lady is quite right to report the views of local public health staff, who are right to raise the question. I am pleased to say that the turnaround speed has significantly improved in the past couple of weeks, and now 83% of tests are returned from the drive-through centres within 24 hours. There is continued work to speed that up and get the proportion even higher, and the Prime Minister has very kindly set me a goal of ensuring that all tests from the drive-through centres are returned within 24 hours.

My right hon. Friend will be aware of the excellent work taking place at Colchester and Ipswich hospitals in partnership with local independent providers to increase capacity for dealing with non-covid cases such as cancer. What more can we do to increase capacity in the independent sector so that we bear down on the backlog in elective surgery?

That is an incredibly important point, because the backlog has of course built up as we had to protect the NHS in the heat of the crisis. The independent sector has played a critical role in helping us get through the crisis and will play a critical role in future. That has put to bed any lingering, outdated arguments about a split between public and private in healthcare. What matters is the healthcare that people get. We could not have got through the crisis without the combined teamwork of the public and private sectors.

Professor Newton spoke today of the vital importance of increasing serology to tackle the virus. Capillary blood from fingerprick tests has long been used to test and control viruses, from measles to dengue fever. Will the Secretary of State therefore explain why the Medicines and Healthcare products Regulatory Agency guidance asks providers of fingerprick tests to stop offering the service? Can he point to any published scientific data that suggests a clinical difference between capillary and venous blood? If not, why is he blocking the serology roll-out that Professor Newton considers so important?

First, serology tests are very important, and I am glad we are now doing over 40,000 a day. Given that they first got approval only two weeks ago, that has been a fantastic effort by the NHS and social care to get the roll-out going out so quickly. Secondly, fingerprick tests would be a big step forward. We are currently assessing the clinical validity of a number of fingerprick tests, because a bad test is worse than no test at all. I am sure the hon. Gentleman will agree with that.

Does the Secretary of State agree that the outbreak has taught us the importance of investing in domestic PPE manufacturing to increase our supply chain, and that south Yorkshire towns and villages with a textile heritage, such as Thurcroft in Rother Valley, are prime locations for new PPE facilities?

Yes, absolutely. I congratulate my hon. Friend not only on his new beard but on his support for Rother Valley. He is absolutely right that the domestic manufacture of PPE is one of the most important things we could be doing right now. We are pushing that incredibly hard, with the support of Lord— Paul—Deighton.

I agree with the Secretary of State that retaining the public’s trust is absolutely crucial if we are to tackle the virus, but that trust needs to be earned and honoured. I want to put on record my constituents’ deep frustration at the Government’s response to Dominic Cummings breaking the rules. There are deeply felt fears among doctors, nurses and other frontline health professionals about coming out of lockdown too quickly and all the sacrifice that so many people have made going to waste. We know that some people are asymptomatic and could be spreading the virus unchecked, so how will test, track and trace work for those people if they are not being tested?

The hon. Lady is absolutely right to say that we must move cautiously and carefully. Those were not her exact words—I am putting them in her mouth—but she is nodding in agreement. We must not lose all the advantages and progress we have made. The number of people sadly dying from the disease is down to almost a tenth of what it was at the peak, but that is still far too high. Test and trace will be critical. The precise answer to the question she asks about testing is that if you are contacted by an NHS contact tracer and asked to self-isolate, you should do so. That period of two weeks of self-isolation is the time in which if you were going to get symptoms and pass on the disease, you would. Therefore, that is what breaks the chain. It is the isolation on instruction from the NHS that breaks the chain. That is the power of the NHS test and trace programme.

I start by thanking my right hon. Friend for moving so swiftly to make the bet365 stadium in Stoke-on-Trent a regional testing centre, after hearing the case for it from Councillor Abi Brown, the leader of Stoke-on-Trent City Council, and myself. It will allow many of my constituents in Stoke-on-Trent North, Kidsgrove and Talke rapid and easy access to vital tests to help to drive down R further still. Will he confirm to the House that regional test sites will remain in place for as long as they are needed to ensure we remain able to continue an effective test and trace strategy?

Yes, I can. The voice of Stoke-on-Trent is strong today.

I join all the tributes to the public health workers in my constituency who are helping to fight the virus. We hear the Secretary of State sing the praises of public and private partnership. I hope he will not be using the crisis as an opportunity to increase privatisation and profiteering in the NHS through the back door. If it is proving such a success, will he explain why the Deloitte regional test centre results are still not being provided to the local public health authorities?

The drive-through centres are a classic example of the public and private sectors working in a team spirit. I just wish that people would not try to drive teams apart, because this is a combination of the private diagnostics companies that provide the tests; Boots and Deloitte, which have provided the logistics; the armed forces, without whom we could not have made this happen right across Great Britain; and, of course, the NHS, Public Health England and the relevant Scottish authorities—they have made it happen. I will look into the specific data point that the hon. Gentleman raises, but I want to congratulate all those involved, no matter what their employment status, and I urge him and others to back the team.

With couples sat together one minute and one of them taken away in an ambulance the next, with people not being able to see their partner in hospital or in the chapel of rest—those living in Calderdale could not even pay their last respects at the crematorium either—and with grandparents not seeing newborns or their grandchildren for 10 weeks, on the whole, people have made huge sacrifices to maintain the lockdown and the Government’s public health message. Can my right hon. Friend advise whether an assessment has been made of what, if any, damage has been done to the Government’s public health message by the actions of the Prime Minister’s special adviser?

The critical thing is that, given the sacrifices that my hon. Friend lists and that are heartfelt, as a nation, we have the resolve to see this through. We can see that the number of cases is coming right down and the number of people dying is coming right down, and we have got to see the back of this disease. We are not there yet.

Given the disproportionately negative impact that covid-19 is having on BME men and women, has the Secretary of State given any consideration to the additional risk that the reopening of schools will pose to this community? What discussions has he had with the Department for Education about the concerns around BME children returning to school, particularly among parents, and what steps are being taken to mitigate those concerns directly?

The hon. Gentleman is right to ask that question in the sensitive manner in which he does. Of course, I have had discussions with my colleague the Secretary of State for Education, and both of us have taken clinical advice on the decisions around schools. I would not support the changes and the reopening of schools if I did not think they were safe. One of the reasons to bring in three years in the first instance in primary school is to ensure that there is the physical space that my hon. Friend the Member for West Worcestershire (Harriett Baldwin) spoke about earlier. We have got to be careful, cautious and sensitive, especially to the needs of those who might be disproportionately affected, and we have got to do the research to get to the bottom of why.

A great deal of work has been done by local policing teams in Richmond and Kingston to inform my elderly constituents about the risk of scams both online and over the telephone. What shall I tell my constituents to look for, if they are contacted by a contact tracer, before disclosing personal data?

The hon. Lady is absolutely right to raise that. It appals me that people would try to raise a scam in response to this mission-critical national project of NHS Test and Trace. NHS contact tracers will never ask for your personal financial information. They will never ask you to pay for anything, and they will never disclose your personal medical information. If any of those things start to happen on a call, it is not a call from NHS Test and Trace. We have worked closely with the National Cyber Security Centre to ensure that we get the scripts right and that we protect against these risks, and she is right to raise it.

My constituent Dr David Flavell, the scientific director of Leukaemia Busters, has sent a face mask to every Cabinet member, every shadow Cabinet member and, indeed, the entire Health and Social Care Committee. I hope my right hon. Friend has received his. Will the Government consider upgrading their advice on the use of face masks from recommended to mandatory?

I have not received mine, but I would like to. Let us try to find it, wherever it has got to in the system—it might be in the bowels of the Department of Health and Social Care somewhere. I will go and dig it out; that is an unfortunate image. The serious point is that face coverings are important, especially in areas where you might come into contact with people you would not otherwise frequently see, such as on public transport or in some shops. I will look into the issue that she raises.

If it’s sunny in Manchester, it really must be hot. [Interruption.] Coming from the north-west myself, I know how much it rains in that part of the world. The, the—I have completely lost my train of thought. The hon. Lady raises a very important point about test and trace. Subject to patient confidentiality, which I take very seriously, of course we will publish data on the test and trace system and will work with the UK Statistics Authority on the best way to do that. I spoke to David Norgrove earlier today about that and how our teams should work together to make sure we can publish it in the right and appropriate way.

I welcome the progress that has been made on testing, but I have a specific case of a care home in my constituency that caters for people with disabilities. Because the residents are typically under 65 and do not have dementia, they do not have access to testing in the same way those in other care homes do. Could the Secretary of State look into this case?

Yes, of course, and I will get back to my hon. Friend.

The Secretary of State will know of the exceptionally high rate of infection in the north-west and he will also be aware that local authorities such as mine say that the peak of demand for social care has not yet been reached and will actually hit later in the summer. In order to facilitate transparent information to the public and good capacity for local planning, will he commit to regular publication of the R value on a regional basis?

We regularly publish the R value on a national basis and are increasing the scope of our surveillance testing regime to be able to increase the detail around that—that is one of the key tasks for the weeks ahead.

With track and tracing now being rolled out, if there happen to be localised increases again in the rates of infection—localised second waves—at what level would the Secretary of State recommend bringing back localised restrictions? Would it be at a county level, a town level, a council level, a village level, or even a street level?

The answer is “needs must”: whatever is necessary to bring any local outbreak under control. We will take local action with local directors of public health using all the information we have, whether at a highly localised level, more broadly or on an institution basis—for instance, around a school, care home or hospital—if that is what it takes.

The pandemic has exacerbated mental health conditions and made it harder for people to access appropriate mental health services in many cases. This morning, I received an email from a constituent whose child has a severe psychiatric condition exacerbated by covid. The child has been in our local hospital for six weeks waiting for a specialist bed and is now hoping that there might be a bed in Birmingham—they are in north Paddington. What can the Secretary of State do to make sure that such urgent mental health conditions are responded to?

The hon. Lady is right to raise this issue. Mental health services, especially for less severe mental ill health, have in some ways been strengthened by the crisis, because of the extent of psychiatric support online, which in some cases, we have discovered, has been more effective than face-to-face support, especially in paediatrics. That said, of course that is not the case in all areas, especially with some of the more severe conditions, such as the one she outlines, and I am happy to look into that individual case. We are doing everything we can to restore services, in a way that is safe and covid secure, so that people can get access to the services they need.

I thank my right hon. Friend for the guidance as we move through the phases of lockdown, but can he reassure my constituents in North Devon that it is not too soon for our beaches to be used safely, provided that people are maintaining social distancing?

We have learned a lot about this virus over the past three or four months. We have learnt, for instance, that asymptomatic transmission is a very significant problem and a challenge, but one of the things that we have learned on the other side of the ledger is that transmission outside is much lower than indoors. It is not risk free, but it is much lower, and that means that we are able to do things like recommend that being on the beach is one of the lower-risk activities—but that people should still keep 2 metres apart, because that is what the guidelines say is safe.

I am delighted that the beautiful beaches of North Devon are once again providing pleasure to local families so that they can really enjoy the weather.

Secretary of State, Teagan Appleby has been in intensive care twice in the past 10 weeks because her family were unable to pay for the medical cannabis that they need to keep her alive.

The families of these epileptic children have been put on the back burner by Brexit, a general election and now covid. The sums of money we are talking about are tantamount to what the right hon. Gentleman’s Department spends on paper clips. Will the Secretary of State make a call to NHS England immediately and right this wrong?

As the hon. Lady knows, I have put significant effort into trying to resolve this matter. We have made some progress. I am sorry to hear about the conditions that she describes, and I will ask my hon. Friend the Minister for Health to take this forward immediately after this statement.

I congratulate my right hon. Friend on getting the track and trace system up and running. In Barrow and Furness our shipyard employs about 10,000 people, but we will struggle to gain the confidence of the community and the workers as they begin to bring their workforce back unless we can demonstrate that we are tracking and isolating infections. Can my right hon. Friend confirm that his Department will be working with large employers such as mine to ensure that confidence can be built back in the community and the workforce?

Absolutely. The work in Barrow and Furness is incredibly important, not least because at an earlier stage in the crisis a higher number of people tested positive. That is partly because there were so many tests in Barrow and Furness, and that itself is testament to the local health authorities that worked hard to make that happen. My hon. Friend has been an assiduous representative throughout this crisis, making sure that I am kept constantly informed of developments and the needs of Barrow and Furness.