PARLIAMENTARY DEBATE
Covid-19 Response - 2 June 2020 (Commons/Commons Chamber)
Debate Detail
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.
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?
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.
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.
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 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.
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?
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