Covid-19 Vaccine

Jo Churchill Excerpts

Tuesday 10th November 2020 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

Thank you, Mr Dowd. I will try to be concise. We have covered an awful lot of ground, and to give my hon. Friend the Member for North Herefordshire (Bill Wiggin) his two minutes—

[Bill Wiggin]

I don’t need two minutes; just tell us everything.

[Jo Churchill]

Right—bless you!

It is a pleasure to serve under your chairmanship, Mr Dowd. I congratulate my hon. Friend the Member for North Herefordshire on securing this debate—and on such a timely day, as the hon. Member for Nottingham North (Alex Norris) said. It is almost as if my hon. Friend had planned it. I agree wholeheartedly with his comment that we must continue to protect the vulnerable as a priority. I also agree with much of what he said about making sure that we are moving at pace, while never sacrificing safety or efficacy, to drive forward and make sure, in therapeutics and particularly in vaccines, that we are delivering as fast as we can.

Many of those doing the work are involved not only in vaccine development but in vaccine manufacture. That means that they are ready to deploy once regulatory approval has been received. But the process has to be properly and ethically done, and people have to be secure in the knowledge that the vaccine is safe.

As everybody has mentioned, yesterday’s news excited us. However, as my hon. Friend the Member for Henley (John Howell) mentioned, there is not a golden bullet. We need to carry on with the non-pharmaceutical interventions and with driving down the R number, as we are doing. But we have had good news, and we can all afford a little moderated optimism to give ourselves a little bit of cheer. It is promising progress that takes us one step closer to finding a vaccine and, as has been much mentioned in this debate, to helping protect millions of people across the world as well as in the UK.

We need to make the vaccine clinically safe. We know that it will not by itself bring the pandemic to an end, but an assured vaccine would be a huge step forward towards resuming a normal way of life. After clean water, vaccination is the single most effective public health intervention. As my hon. Friend the Member for North Herefordshire said, the benefits are enormous. Working with the Department for Digital, Culture, Media and Sport and social media platforms, we are making sure that the message of vaccination hesitancy is worked on. We are doing that across Government and, more broadly, across companies. This is a national effort, and we have to work together to make sure that we give the right message that gives people confidence.

There is enormous collaboration across science, medicine, industry and government, here and internationally, to find a safe vaccine. Our aim of rapidly developing a mass-produced vaccine means that we are striving to do something that has never been done before. Progress is being made at an extraordinary pace.

My hon. Friend the Member for North Herefordshire took me back to my degrees by mentioning p-numbers and statistical significance, and as he said, although access to the vaccine should be given as quickly as possible, we must ensure that it is safe. I congratulate the vaccine taskforce, which has been mentioned, on its hard work leading the UK’s effort to find and manufacture a vaccine. It has successfully secured early access to 350 million doses through agreements with six separate vaccine developers.

My hon. Friend spoke of several of the vaccines, but not all of them. We have four different types: the Oxford-AstraZeneca vaccine, which is in phase 3 trials; the BioNTech-Pfizer mNRA vaccine, about which we had the excellent phase 3 trials news yesterday; and inactivated whole virus vaccines and protein adjuvant vaccines, which are all in phase 1, 2 or pre-clinical trials. The vaccine taskforce makes a call on those most likely to be effective, because we need a rational approach. The vaccine candidates are all in different stages, and extraordinary progress is being made with the phase 3 clinical trials underway in the UK, the USA, India, Brazil and South Africa. I reassure all hon. Members that the Government are prioritising developing, acquiring and deploying vaccines as soon as they are safely available.

The NHS covid-19 vaccine research registry has been developed in partnership with NHS Digital to help facilitate the rapid recruitment of large numbers of people into further trials over the coming months, so that an effective vaccine for coronavirus could potentially be found. It is important that we spread the net and encourage as many people of both genders and from as many different backgrounds as possible to take part, because we know that there is often a degree of over-representation in clinical trials in certain areas. I know that my hon. Friend is particularly interested in ensuring that we do not dismiss any potential vaccines, but he also said that he is very interested in seeing things sped up, so that bench to patient is much quicker. I could not agree more.

Experts from the NHS, academia and the private sector have worked closely with us to explore and establish human challenge trials in the UK, backed by more than £33 million-worth of investment. The studies offer a chance to accelerate the development of promising covid-19 vaccines in a safe and controlled environment. They are being considered by regulators and ethics committees and, if approved, would start in January with results expected by May 2021. Almost £20 million more is being made available to scale up capabilities to process blood samples from clinical trials.

We have invested significantly through UK Research and Innovation to provide unique capability for process, development and scale up. Once an effective vaccine is ready, we must be able to manufacture it at an unmatched and hitherto unseen speed. We will then move on to deployment. I am running out of time, but I am sure that the usual routes will give us a chance to talk about that deployment and other pertinent issues at another date.

The global co-operation was mentioned by several hon. Members. Globally accessible vaccines, treatments and tests are needed for all of us. No single country holds the key; it is a worldwide pandemic, and we are stronger when working together. The UK has taken a strong role in global leadership and in collaborating with other countries. Our commitment to international collaboration is clear, and we were proud to work through multilaterals—such as the G7 and G20, and with the WHO and other international partners, including industry —to agree collaborative approaches to supporting vaccine development, manufacturing scale-up and future distribution to meet domestic and international needs, including for the world’s poorest countries, which touches on points that were made earlier.

I thank scientists and clinicians around the world for their remarkable efforts in working at pace to develop covid-19 vaccines. I thank my hon. Friend for securing this debate. The vaccine will not be a silver bullet—we have to keep trying—but it will be one of the several tools that help our fight against the virus and allow us to have a more normal way of life.

Question put and agreed to.

Resolved,

That this House has considered covid-19 vaccine.

Draft Reciprocal and Cross-Border Healthcare (Amendment etc.) (EU Exit) Regulations 2020

Jo Churchill Excerpts

Wednesday 4th November 2020 General Committees

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I beg to move,

That the Committee has considered the draft Reciprocal and Cross-Border Healthcare (Amendment etc.) (EU Exit) Regulations 2020.

It is a pleasure to see you in the Chair, Mrs Miller, and to serve under you. My right hon. Friend the Secretary of State for Health and Social Care has laid before the House this statutory instrument, which concerns reciprocal and cross-border healthcare. In summary, it is a technical instrument that updates the 2019 legislation, taking into account the withdrawal agreement, which was not in place when the legislation was made in 2019 and offers significant healthcare protections for those relying on reciprocal healthcare arrangements in the EU. The aim is to ensure that the statute book is ready for the end of the transition period.

The Government are introducing the statutory instrument under section 8 of the European Union (Withdrawal) Act 2018 and under the Healthcare (European Economic Area and Switzerland Arrangements) Act 2019. On 31 December 2020, the transition period will end and the EU withdrawal Act will automatically retain the relevant EU law, and the domestic implementing legislation, in UK law. If we did not legislate further, the retained law would be incoherent and unworkable. There would also be uncertainty and a lack of clarity about patients’ rights to have UK-funded healthcare in EEA countries and Switzerland.

In April 2019, the Government made three statutory instruments to correct the deficiencies in retained EU law relating to reciprocal healthcare, as part of the UK’s preparations for leaving the EU without a deal. The UK has since agreed with the EU reciprocal healthcare arrangements under the withdrawal Act and entered a transition period. The purpose of this instrument is basically to fix this issue—first, to reflect the transition period and the withdrawal agreement by making consequential and technical amendments to four EU exit instruments, which will come into force on 31 December. Those are the Social Security Coordination (Reciprocal Healthcare) (Amendment etc) (EU Exit) Regulations 2019, the National Health Service (Cross-Border Healthcare and Miscellaneous Amendments etc.) (EU) Exit) Regulations 2019, the Healthcare (European Economic Area and Switzerland Arrangements) (EU Exit) Regulations 2019 and the Health Services (Cross-Border Health Care and Miscellaneous Amendments) (Northern Ireland) (EU Exit) Regulations 2019. I will refer to those, for ease, as the 2019 EU exit regulations.

The purpose of this instrument is, secondly, to update references in NHS legislation to EU forms, to entitlements under EU treaties and to concepts such as “EU rights” that will no longer be appropriate after the end of the year; and, thirdly, to set out clearly the rights of patients in a transitional situation who will access pre-authorised or ongoing treatment in the EEA under the cross-border healthcare directive following the end of the transition period. This instrument will allow the Government to complete the funding of those patients who are in the middle of treatment at the end of the year, or if they have already applied for authorisation.

As the instrument is quite technical, I am sure that members of the Committee will welcome a summary of the 2019 EU exit regulations. As Committee members all know, those regulations were made in preparation for our exit from the EU and will come into force at the end of the transition period. They revoked the EU reciprocal healthcare legislation and social security co-ordination regulations, as well as the domestic legislation implementing the cross-border healthcare directive, in relation to England, Wales and Northern Ireland. As the arrangements are inherently reciprocal, it would not be possible to operate them without reciprocity from the member states.

The regulations enabled the continuation of reciprocal healthcare arrangements until 31 December 2020, to the extent that that was agreed with member states through bilateral reciprocal healthcare arrangements. They made provision for the UK to protect patients in a transitional situation accessing reciprocal healthcare on exit day in the event that the UK left the EU without a deal, in so far as that was possible unilaterally. The regulations conferred functions on the NHS Business Services Authority and on health bodies—that is, NHS England and devolved Administrations’ health boards—to implement aspects of reciprocal healthcare arrangements. That includes the administering of healthcare payments.

In addition, in March 2019 the House passed primary legislation—the Healthcare (European Economic Area and Switzerland Arrangements) Act 2019— providing the legal basis for funding and implementing future reciprocal healthcare arrangements.

I will now outline the reciprocal healthcare arrangements that have been agreed with the EU under the withdrawal agreement since the 2019 EU exit regulations were made. In practice, the agreement that we have reached with the EU means that there are no changes to the reciprocal healthcare access for state pensioners, workers, students, tourists and other visitors, the European healthcare insurance card scheme, or planned treatment before 31 December 2020.

From 1 January 2021, reciprocal healthcare arrangements will not change for those individuals who are in scope of the withdrawal agreement. This means that, regardless of any future healthcare arrangements, state pensioners and workers who have moved to the UK or the EU and are resident there before 31 December 2020 will continue to have lifelong reciprocal healthcare rights for as long as they live in that country and are covered by the agreement.

The agreement also protects UK and EU nationals who find themselves in a cross-border situation over the end of the transition period. For example, somebody whose holiday begins before 31 December 2020 but ends afterwards can continue to use their EHIC to access any treatment they need until they leave that country by travelling to another EU member state or returning to the UK.

A student who habitually resides in the UK but is studying in the EEA or Switzerland before 31 December 2020 can continue to use their EHIC to access immediate and necessary healthcare in the country of study for the duration of their course. People receiving planned medical treatment in the UK or through the EU S2 route will be able to commence or complete their treatment, provided that authorisation was requested by 31 December 2020. This provides certainty to patients, as it guarantees that they will be able to complete their course of treatment.

I will now address the amendments made by the instrument and the reasons for making the changes now. As I have just set out, the withdrawal agreement protections mean that several transitional measures under the 2019 EU exit regulations have now been superseded by the withdrawal agreement protections. Therefore, they are being revoked through this instrument.

One element, namely cross-border healthcare under the cross-border healthcare directive, was not included in the withdrawal agreement. It will no longer apply as a matter of EU law from 31 December 2020. The cross-border healthcare directive is separate from the reciprocal healthcare rights under the social security co-ordination regulations, for example for pensioners, students, tourists and workers, which relate to the free movement of people. The directive is linked with the single market and the free movement of services, which is ending with the UK’s departure from the EU. The directive facilitated patients’ rights to travel to another EEA country and to receive qualifying healthcare and reimbursement, capped at the cost of state-provided treatment in their own country.

As the cross-border directive is ending, this instrument will ensure that the Government can finish funding those who have received or applied for treatment through this route, and those who are in the middle of treatment at the end of the year. This will provide reassurance for patients, as people will not face an abrupt change in their access to healthcare at the end of the year, and it ensures that their reimbursement rights are protected.

The withdrawal agreement also means that the 2019 provisions that allowed the UK to maintain current reciprocal healthcare arrangements until the end of 2020 are no longer required. These provisions were subject to bilateral agreements with EEA countries and Switzerland. The withdrawal agreement automatically continued current agreements with those countries during the transition period and therefore the 2019 provisions are being revoked as redundant.

As many hon. Members will know, the Healthcare (European Economic Area and Switzerland Arrangements) Act 2019 provides powers to give effect to healthcare arrangements, including those that may be comprehensive, bespoke or different from the current arrangements provided by the EU framework. The Act also provides the legislative framework to implement long-term complex reciprocal healthcare arrangements with the EU.

Finally, other technical amendments made by the instrument include updating EU references that will no longer be appropriate following the end of the transition period. The devolved Administrations have been consulted in the drafting of this instrument at every stage and they have provided consent for the Government to proceed. The instrument also makes provision in relation to and on behalf of Northern Ireland and Wales.

I am grateful for the continued collaborative approach in this area. Indeed, the Department and the devolved Administrations have had excellent engagement and clear arrangements in place to ensure the implementation of reciprocal healthcare arrangements after the end of the transition period. I am pleased to say we have worked openly and collaboratively with operational partners in NHS England, NHS Improvement and the NHS Business Services Authority, ensuring that reciprocal healthcare arrangements will be successfully implemented.

Looking to the future, reciprocal healthcare arrangements with the EU are subject to ongoing negotiations. The UK has been clear that it wishes to establish arrangements that provide healthcare cover for tourists, short-term business visitors and service providers.

I am also pleased to report good progress with Ireland on agreeing a specific healthcare arrangement between the UK and Ireland, under the auspices of the common travel area. That will seek to ensure that the residents of the UK and Ireland continue to be able to access necessary healthcare when visiting the other country, as well as benefiting from co-operation between UK and Irish healthcare providers, regardless of the outcome of negotiations with the EU.

Finally, as this instrument proposes no significant changes to the current regulatory regime, we estimate there will be no significant impact on industry or the public sector. As this instrument makes technical amendments, and does not introduce new policy, we have not conducted an impact assessment.

In summary, the overarching aim of the instrument is to ensure that the UK statute book is functional, reflecting the withdrawal agreement and EU exit. It also ensures that reimbursement rights are provided for people accessing healthcare at the end of the transition.

--- Later in debate ---

[Jo Churchill]

There was quite a lot there, and I will try to canter through what I can. As the hon. Lady knows, my door is always open. The majority of what she alluded to is the subject of ongoing negotiations, which are currently being handled with the Foreign, Commonwealth and Development Office. We are working hard to ensure that people can enjoy the travel that they have enjoyed thus far.

I fully recognise that it is challenging for those with pre-existing conditions. I know how difficult it is to secure travel insurance in the current environment when travelling outside the EU. However, the Money Advice Service has recently launched an insurance directory for people with serious medical conditions, which brings together specialist firms with the aim of making it easier to find travel insurance that provides the right health cover. Working with the FCDO, the DHSC stands ready to support UK nationals who might find themselves in difficulty.

On cost recovery, identified income from NHS costs for overseas visitors has increased significantly over the past five years, rising to £760 million in 2019-20. NHS Improvement is working closely with NHS trusts to improve cost recovery. As I said, we have been most grateful for the work that the NHS Business Services Authority has done with us to enable that work to go forward. As the hon. Lady well knows, many of these things will become clearer in the next few weeks, but there have already been good conversations with some member countries. It is hoped that we will shortly be able to have more clarity on the matter.

I want to assure members of the Committee that the overarching aim of the SI is to ensure that the UK’s statute book is functional by reflecting the withdrawal agreement and EU exit, and to ensure that reimbursement rights are provided for people accessing healthcare at the end of the transition period, when the directive will no longer apply to the UK. The withdrawal agreement provides a robust framework for reciprocal healthcare, which includes significant transitional and longer-term protections, as the hon. Lady mentioned. To support people in understanding their entitlements, the Government have published guidance on people’s rights under the withdrawal agreement on gov.uk, and we are keeping the information updated regularly so that people are clear about the reciprocal health rights, their rights and the actions they might need to take as they prepare for the end of the year.

Looking ahead, reciprocal healthcare arrangements with the EU are subject to ongoing negotiations, as I said earlier. Finally, I thank again the devolved Administrations and our operational partners in the NHS, who are working extremely hard. Their collaborative and constructive engagement means that we have clear arrangements in place and assurance for patients’ healthcare at the end of the year. I commend the regulations to the Committee.

Question put and agreed to.

Human Medicines (Coronavirus and Influenza) (Amendment) Regulations 2020

Jo Churchill Excerpts

Friday 16th October 2020 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

The primary objective of our policy is to support the expansion of the annual seasonal flu vaccination campaign and to support the successful roll-out of a safe and effective covid-19 vaccine. Throughout the coronavirus outbreak, the Government have brought in the right measures at the right time, based on the most relevant and up-to-date scientific advancements and advice. As the UK enters the “flu season” where domestic transmission is rising, it is important that the Government can respond swiftly and effectively to the current situation.

The independent Commission on Human Medicines (CHM) will advise the UK Government on the safety, quality and efficacy of any vaccine; no vaccine will be deployed unless stringent standards have been met through a comprehensive clinical trial programme. The preferred route to enable deployment of any vaccine, including new vaccines for covid-19, remains through the usual marketing authorisation (product licensing) processes.

In the interests of patient safety and bringing the pandemic to an end, which will allow life to restore to normality, the Human Medicines (Coronavirus and Influenza) (Amendment) (England) Regulations 2020 will come into force, for the most part, on 3 November 2020, although some provisions need to be brought into force on the day after they are laid before Parliament. Our plan is to bolster the safeguards to product authorisation and to improve access to necessary vaccines in order to protect the public ahead of the winter and beyond, and ultimately reduce mortality.

The regulations introduce measures to support the safe future mass roll-out of a covid-19 vaccine, and the expansion of the annual seasonal flu vaccination programme, and include bringing the five main changes into effect:

Reinforcing temporary authorisation measures to provide for the attaching of conditions, a technical change in order to make sure that any unlicensed products that the Government recommends for deployment in response to certain public health threats must meet required safety and quality standards;

Expanding the workforce able to administer covid-19 and flu vaccines to improve access and protect the public, including by new immunisation protocols for covid-19 and flu vaccines;

Rationalising the scope of the pre-existing partial immunity from civil liability for the pharmaceutical companies whose unlicensed products are recommended for use by the Government in response to certain public health threats, and also extending that partial immunity to all members of the additional workforce that could be allowed to administer temporarily authorised vaccinations under the new immunisation protocols;

Ensuring that treatments used in response to certain specific types of public health threat can be promoted by advertisements to the public as part of national campaigns;

The provision of an exemption from the need for a wholesale dealer’s licence to allow the swift and safe transfer of covid-19 and flu vaccines, and other medicines for treatment of pandemic disease, in response to patient need, by NHS and armed services providers at the end of the supply chain.

If a covid-19 vaccine is ready for deployment prior to 1 January 2021, these measures will bolster existing temporary authorisation powers that allow the Medicines and Healthcare Products Regulatory Agency to consider approving its use, before a full product licence is granted, provided it is proven to be safe and effective during the extensive clinical trials. The measures are especially necessary in the context of the transition period because until its end any full product licence for a potential covid-19 vaccine must be granted by the European Medicines Agency (EMA).

The UK Government have sought views on proposals to make changes, in conjunction with the Minister of Health in Northern Ireland, to the Human Medicine Regulations 2012. The Department has further welcomed views from any interested individual or organisation through a public consultation which ran from 28 August and closed on 18 September, also holding discussions about the proposals with specialists and key stakeholders in tandem. We welcome the participation of all individuals and organisations who contributed to the consultation and received over 188,000 responses. We analysed these responses and based on feedback made three key changes to the content of the legislation, which are explained in the explanatory memorandum published alongside the instrument.

The explanatory memorandum published with the instrument also explains why some of the provisions of this instrument breach the rule that provisions of statutory instruments subject to the negative procedure should normally be laid 21 days before the instrument comes into force. The measures that are being brought into force in breach of the 21-day rule are essentially permissive and enabling. The priority action is to support the annual flu vaccination roll-out; delaying their implementation could increase the incidence of influenza in the UK. Currently a safe effective vaccine for covid-19 to deploy is subject to the outcome of clinical trials. However, any delay to the annual vaccination roll-out would hamper an important aspect of the covid-19 fightback.

The independent Joint Committee on Vaccination and Immunisation (JCVI) will advise the UK Government on which covid-19 vaccine/s the UK should use, and on the priority groups to receive the vaccine based on the best available clinical, modelling and epidemiological data. This will depend on the properties of the vaccine, those most at need—including health and care “frontline” workers—and the medical circumstances of individuals. Updated JCVI advice can be found at https://www.gov.uk/government/publications/priority-groups-for-coronavirus-covid-19-vaccination-advice-from-the-jcvi-25-september-2020/jcvi-updated-interim-advice-on-priority-groups-for-covid-19-vaccination

[HCWS520]

Local Contact Tracing

Jo Churchill Excerpts

Wednesday 14th October 2020 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I beg to move an amendment, to leave out from “when” to end and insert

“working in conjunction with NHS Test and Trace; welcomes the huge expansion of testing to a capacity of over 340,000 tests a day; applauds the efforts of all involved in testing and contact tracing both at a national and local level; recognises that 650,000 people have now been asked to isolate thanks to the work of NHS Test and Trace, and supports the Government’s efforts to expand testing and tracing yet further.”.

I agree with the final sentence of the hon. Member for Leeds West (Rachel Reeves) that this is about protecting people. The entire focus of the Government from day one has been on driving a system that can protect people. It is not a zero-sum game, and it is not an either/or.

This pandemic is the most unprecedented public health emergency we have faced in a generation. We knew that our response would require a phenomenal national effort and that we would need to work closely with others. Local authorities and directors of public health have played an enormous part thus far, including in the delivery of test and trace. They have worked exceptionally hard to prepare and support their communities throughout the coronavirus outbreak, protecting the most vulnerable and saving lives.

I take this opportunity to say thank you to all the public health teams and local authority staff for their hard work thus far, and I know I speak for everyone in this place, irrespective of where we sit, and beyond when I say how grateful we are that they have been there.

Local partnerships have been at the heart of both covid and of the NHS Test and Trace response. As this House knows, Test and Trace was stood up at incredible speed and has developed at scale and pace. As would be expected, the Government responded at pace.

The hon. Lady mentioned Serco on more than one occasion but, as she well knows, having reacted to the changing situation at pace, Serco and Sitel went through a full tendering process to became one of the suppliers to the Government, and they can be drawn down at short notice. They gained their place through fair and open competition via an OJEU procurement process. Value for money and capability are part of those assessment criteria.

On 8 May, the Prime Minister announced that we were bringing Test and Trace into a single service, listening to those people who were asking us to respond, and it was formally launched on 28 May. We have brought together a huge range of people and organisations into the system, from the Department of Health and Social Care, the NHS, Public Health England, local authorities, academia, epidemiologists, the private and even the not-for-profit sector. I think my hon. Friend the Member for Milton Keynes North (Ben Everitt) will be speaking. Milton Keynes is just the most glowing example of using people’s skills.

[Andy Slaughter]

The Minister mentioned the private sector. Three weeks ago in named day questions, I asked her Department for details of the private consultants working at the Joint Biosecurity Centre, but she still has not answered, even though some of the information has been published in the press since. What have they got to hide about the employment of consultants and their cost? Will she now answer those questions and publish that information?

[Jo Churchill]

As the hon. Gentleman can imagine, in the current circumstances the Department has a vast amount of correspondence. I will chase his inquiry personally when I return.

As I said at the start, it is not a case of either/or, as the Opposition motion makes out. The pandemic requires us all to work towards that common goal of beating the virus. Contact tracing is an excellent example of partnership in action. We have Public Health England’s epidemiology expertise to ensure that the operationalisation of the tracing model is built on a strong scientific base. Through NHS Test and Trace and its partner organisations, we can do it at scale. The national framework enables us to reach tens of thousands of people a day. It would not have been possible to do that on the existing infrastructure without placing an unbearable burden and strain on the system. To support this, we have local health teams who know their local areas and can provide expert management locally. Probably one of the finest examples of that was the response in Leicester, where local teams responded phenomenally to the challenge presented to them earlier in the summer, with the national oversight identifying that there was a problem and then the local response. We know we need people on the ground locally who can reach the most vulnerable and those who are disengaged from local services.

The local health protection teams form the first tier of the NHS Test and Trace contact tracing service, consisting of public health specialists. NHS Test and Trace and Public Health England work with local government colleagues, including the Association of Directors of Public Health, the Society of Local Authority Chief Executives and Senior Managers, the Local Government Association and UK chief environmental health officers, on part of this programme. It is, therefore, simply untrue that contact tracing does not include those experts front and centre, helping us deliver.

[Mr Betts]

I very much welcome the plan in the Liverpool city region, where the local authorities have been given £8 per head to take over responsibility for tracking and tracing. It recognises the most serious problem in the country, the Liverpool city region, and the funds have been given to local authorities. If that is the case, why does the scheme not extend to at least tier 2 regions, such as Sheffield, so we can avoid becoming a tier 3 region in due course?

[Jo Churchill]

The hon. Gentleman is correct to say we have provided £8 per head, giving Liverpool some £14 million to assist with its local public health attack on the virus and to help drive down the rates. Tier 3 local authorities get that help. The Government will work with local areas to accelerate local roll-out and to allow conversations to be ongoing, with additional money to protect vital services. Further details, I am sure, will come from the Ministry of Housing, Communities and Local Government in time.

As I said, it is untrue that public health experts are not there front and centre. There are about 1,000 tier 1 contact tracers working within the core contact tracing system in health protection teams and field services across the country. More local recruitment is under way. We have more than doubled the size of local health protection teams since the pandemic began. The next layer of the test and trace contact tracing services is NHS clinicians, who signed up to contact people who have tested positive and talk them through the process to find out where individuals have been and who they may have been in contact with. Those clinicians do the most phenomenal job every day, stepping forward with their wealth of expertise to assist.

Today’s motion refers to local contact tracing and that has, in fact, been getting rolled out to local authorities across the country since August of this year. Has it always gone seamlessly? Has it always been perfect? I am always the first at this Dispatch Box to say that nothing ever does, much as we may want it to. Nothing ever does. We put the best efforts into making sure that individuals at a local level are supported in this difficult work every day.

[Dawn Butler (Brent Central) (Lab)]

The Minister is right to say that we want everything to go well, but what we can do is learn the lessons. In my constituency in Brent, people were trying to get access to the NHS database—the Contract Tracing and Advisory Service—and they were met with just “No, no, no” so many times. Will the Minister tell the House the average wait time for local authorities to get access to CTAS? That is vital if they are going to do local test and trace.

[Jo Churchill]

I thank the hon. Lady for her question, and I will be coming on to access. As she rightly points out, it is hugely important that local and national systems are in lockstep so we get a better picture of the virus and how it is affecting our local communities.

[Alexander Stafford (Rother Valley) (Con)]

Will my Hon. Friend give way?

[Jo Churchill]

I will push on a little and then I will give way to my hon. Friend.

Today’s motion talks about local contact tracing, which has been rolled out since August and is something that NHS Test and Trace is actively driving forward in its commitment to local systems. Since August, NHS Test and Trace has provided local authorities with dedicated teams of contact tracers working alongside local public health officials to assist and give a more specialist service. Local public health officials can access and use the data shared by the NHS on a daily basis. Together we can increase the number of people contacted. We have more than 95 lower-tier local authorities across the country that have gone live with local tracing partnerships. There are more going live in the coming weeks, and any local authority that wants to be involved can be. The national programme is doing an unbelievable job of helping people who might unknowingly be putting their loved ones at risk, but so is the local programme.

In England we have reached more than 650,000 people who have tested positive and their contacts and advised them to self-isolate. Every person who tests positive is contacted by NHS Test and Trace, which consistently reaches more than 80% of contacts when details are given. Because everybody, whether national or local, is locked on to the same system—this is vital—we can see how the virus is spreading. It gives us important knowledge. All the data that we publish on NHS Test and Trace include data on local performance. At this point, I recommend to everyone the coronavirus dashboard, which has been improved and updated, and gone live only this morning. It gives fantastic information about what is happening locally. As local testing partnerships are rolled out, we expect to see performance improving further.

[Rachael Maskell (York Central) (Lab/Co-op)]

As my hon. Friend the Member for Leeds West (Rachel Reeves) set out, the system is not working. The statistics speak for themselves and, while the system in Wales is delivering, it is not in England. Will the Minister say why the private companies do not just hand the test and trace system over to local directors of public health? Are there any financial penalties or anything in their contracts that preclude them from doing so?

[Jo Churchill]

We are better together. It is as simple as that. It is about a national programme. Let us imagine that the national programme is the spine and the local authorities are the ribs that wrap around us. The combination of the rigid spine and those solid ribs protects the organs, and this is what test and trace will do. We need both elements of the system.

[Alexander Stafford]

Clearly, this spine is very important, and one of the key elements is the app, which 17 million people have downloaded—that is a great success. Does my hon. Friend agree that that is in stark contrast to other systems, such as the StopCovid app in France, which has been an abject failure, as only 2.6 million people downloaded it? When we compare that with the figure of 17 million people in the UK, we see that we are getting it right compared with other countries.

[Jo Churchill]

I thank my hon. Friend for making that point and highlighting that 17 million individuals have downloaded the app. I am sure many in this House are using it frequently, because that helps us to test and trace. He also raises the point about talking to other countries, which we do in order to learn. When we have spoken to other countries, they, too, have reinforced the fact that this is not only about local systems and it is important to have an overarching national system and local systems as well.

As the Secretary of State said to the House yesterday:

“Local action has proved to be one of our most important lines of defence.”—[Official Report, 13 October 2020; Vol. 682, c. 198.]

Beating this virus is about a series of building blocks. Every day, week in, week out, we are in constant dialogue with local areas to make sure there is support on the ground for extra measures and that the local perspective is combined with the wealth of data we now have, and share, on the spread of this virus. The next evolution of this, thanks in large part to the wealth of data and the insight of Test and Trace, which we did not have at the early stage of the pandemic, is introducing the three covid alert levels that the House voted to approve last night, demonstrating our commitment to respond on a much more targeted and local basis, working closely with community leaders and communities.

Over the past few months, we have built a massive national infrastructure for testing. That work has involved local authorities identifying and setting up testing sites that work for their local areas, and deploying mobile testing where it is most needed. I wish to place on record my thanks to the Army, as we know that its deployment and mobility around the country has given us another tool in the toolbox in order to be able to fight. It is with great thanks to the local authorities that we now have more than 500 testing sites; many more are local walk-in sites to make it easier and quicker for people living in urban areas. The median distance travelled in person to a test is just 3.7 miles.

[Mr Betts]

rose—

[Matt Rodda]

rose—

[Jo Churchill]

I have already given way to the hon. Member for Sheffield South East (Mr Betts), so I will give way to the hon. Member for Reading East (Matt Rodda).

[Matt Rodda]

I am grateful to the Minister for giving way on that point, as I wish to ask her to investigate something for me. In Reading, we have been waiting for some time for a new testing centre, and this is in a university town that is currently in the bottom tier but which could rapidly progress to the second tier or even the top tier if the spread is not arrested now. Students have been told that they will have to travel only 1.5 miles to the nearest testing centre, but in fact the nearest testing centre is in Newbury, which is more than 15 miles away. I know of residents of Reading who have had to go as far away as the Welsh valleys and Tewkesbury to get a test. Will she now investigate the need for speeding up the provision of a testing centre at the University of Reading?

[Jo Churchill]

I believe that the Minister for Universities answered an urgent question in this House last week, and I am sure that if the hon. Gentleman refers the challenges he has on the university to her, she would be more than happy to work with him. I just refer him back to the fact that we are working with all local authorities.

While talking about testing, I would like to take the opportunity to remind the House about the scale of testing. It was 2,000 people a day when the pandemic began in March, and when NHS Test and Trace began our capacity was over 128,000. The capacity is now over 340,000. We have processed over 25 million tests, and one in eight people in England have been tested for the virus. I am really keen that we understand the size of this challenge. We have built the largest diagnostic network in British history, including five major labs, 96 NHS labs and Public Health England labs, and we are expanding further. We have pilots going with some of our greatest universities. We are working with hospitals, with the addition of new Lighthouse laboratories in Charnwood, Newcastle and Bracknell, as well as new partnerships only last week with Birmingham University and Health Service Laboratories in London, so we are expanding.

Right at the start of NHS Test and Trace, we worked with all 152 local authorities to help them develop their local outbreak plans. We have ensured access to data, and when it was highlighted that there was a need for better data flow, we worked on it to provide them with additional support to respond to outbreaks, such as with enhanced testing. We have also published the covid-19 contain framework—the blueprint for how Test and Trace is working in partnership with local authorities, the NHS, local businesses, community partners and the wider public so that we can target outbreaks. We introduced new regulations to give local authorities additional powers when they ask for them to stop the transmission of the virus, giving them the ability to restrict local public gatherings and events, and the power to close local business premises and outdoor spaces if it is deemed necessary. This includes more support for local test and trace, more funding for local enforcement and the offer of the armed services in areas of very high alert.

[Steve Brine]

I feel sorry for the Minister and her colleagues now that constructive opposition has ended, but let me ask her about the local tracing partnerships she mentioned. She will remember the thousands of volunteers who signed up to help during this pandemic. Have Ministers given any thought to using that army of volunteers for the local tracing partnerships?

[Jo Churchill]

I thank my hon. Friend. Those local volunteers were in some cases employed in other jobs and have returned to those jobs, but where they have indicated they are available, obviously they have been used.

[Mr Betts]

Will the Minister give way?

[Jo Churchill]

No. I am just coming to a conclusion, and I did give way to the hon. Gentleman.

In a few short months, we have made huge strides forward to tackle this deadly virus. It has been a collective commitment. It is not about us or them; it is about all of us—one team, working day and night together in the different areas, and using expertise to bring the virus under control. We will keep working side by side with our important local partners in the months ahead.

Some quotes from directors of public health have been bandied about, and the hon. Member for Leeds West said they supported the motion. I would merely like to say that the Association of Directors of Public Health

“supports the need to implement, at scale, a contact tracing programme. No single organisation or agency, whether national or local, can design and oversee this operation alone. The success of contact tracing will depend on a truly integrated approach between national and local government and a range of other partners across the UK.”

That is from its press release. On that note—I think it very firmly puts the Opposition motion where it needs to be today, which is to be defeated—I commend our amendment to the House.

Oral Answers to Questions

Jo Churchill Excerpts

Tuesday 6th October 2020 Commons Chamber

[Kim Johnson (Liverpool, Riverside) (Lab)]

What steps he has taken to ensure the continuation of breast screening during the covid-19 outbreak.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

Women at greatest risk of breast cancer continue to be prioritised for screening. The NHS has worked hard and has significantly reduced the backlog of delayed breast screening appointments from over 468,000 in June to under 52,000 in September. All services have now been restarted and, in Breast Cancer Awareness Month, the message is clear: when you get a screening invite, please attend; if you are worried about anything, contact your general practitioner.

[Kim Johnson]

Breast screening appointments were paused during the height of the pandemic. Breast Cancer Now has estimated that 986,000 women across the UK missed their mammograms, and it estimates that, as a result, there could be 8,600 women living with undetected breast cancer. With this being Breast Cancer Awareness Month, what steps is the Secretary of State taking to address the gaps in specialist breast cancer nurses recently highlighted by Macmillan Cancer Support?

[Jo Churchill]

I thank the hon. Lady for her question. Cancer nurse specialists are a particular interest of mine, and the long-term plan identifies that everybody deserves to have personalised care from a cancer nurse specialist. We did see the rate decline from 91% in 2018 to about 89% in 2019, and we are focused on making sure that everybody has a cancer nurse specialist. We promised it in the long-term plan and it is our ambition to deliver that personalised care to every woman. As I have outlined, the backlog of breast cancer screening has gone down but, again, I urge women who are called for screening to come forward. It is safe and, as with me, it could make all the difference.

[Bill Esterson (Sefton Central) (Lab)]

What assessment he has made of the effectiveness of local restrictions on reducing the rate of transmission of covid-19.

--- Later in debate ---

[Mr Alistair Carmichael (Orkney and Shetland) (LD)]

What steps he is taking to support people with long covid.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I am sure that the right hon. Gentleman would welcome yesterday’s announcement that the National Institute for Health and Care Excellence and the Scottish Intercollegiate Guidelines Network will work with the Royal College of General Practitioners to develop guidelines to support patients and practitioners in the treatment of and recovery from the disease. This follows on from the NHS launch in July of the Your COVID Recovery service, which provides personalised support for individuals. In addition, we are funding research into covid-19, including a study of 10,000 patients who were admitted to hospital with covid, building our understanding of the long-term effects and helping direct those improved treatments that are needed.

[Mr Carmichael]

I thank the Minister for that helpful and comprehensive answer. If she has not already read it, may I commend to her the most recent edition of The Doctor, the British Medical Association magazine, which outlines several compelling case studies of GPs who are still suffering, some up to six months, after they first contracted covid? There is a growing body of evidence that a number of people continue to suffer with this months after it has been contracted, in a quite debilitating way. Will she build on the work that she is already doing and make the case to the Treasury and the Department for Work and Pensions in particular to ensure that all those who suffer from long covid get the support that is necessary for them?

[Jo Churchill]

I thank the right hon. Gentleman for that statement and I will read the document that he mentions with interest. It is a new disease on which we are still gathering evidence and data, so that we know how we can best support the individual in their recovery and, arguably, in their new covid-tinged life. I assure him that that is precisely what I shall be doing—looking at the evidence base and making sure we work with the colleges and general practitioners to ensure that we get the right answers.

[Miss Sarah Dines (Derbyshire Dales) (Con)]

What steps his Department is taking to support the adult care sector during the covid-19 outbreak.

Health Protection (Coronavirus, Restrictions) (Birmingham, Sandwell and Solihull) Regulations 2020

Jo Churchill Excerpts

Monday 5th October 2020 General Committees

[The Chair]

Before we start, may I remind the Committee of two things? First, you are well separated by social distance, so please do not change that during the course of the debate. Secondly, if you say anything, will you kindly send your remarks by email to Hansard? Hansard would take your papers, but I think it would be more courteous by email. Thirdly, those sitting in Strangers’ Gallery may do so, and may vote from there, were we to vote, but if they wish to speak, they need to come within the main area. With that, I call the Minister to move the motion.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I beg to move,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (Birmingham, Sandwell and Solihull) Regulations 2020 (S.I. 2020, No. 988).

It is a pleasure to serve under your chairmanship, Mr Gray.

The regulations came into force on 15 September, following an announcement by my right hon. Friend the Secretary of State for Health and Social Care that the latest epidemiological data and local insights supported the action being taken. The data showed that for Birmingham, Sandwell and Solihull, targeted measures needed to be taken to tackle the outbreak of coronavirus. The incident rate in Birmingham had increased to 139.1 per 100,000 people over a seven-day period from 23 to 29 September, in Sandwell to 108.1 per 100,000 and in Solihull to 98.2 per 100,000.

The director of public health considered household transmission to be the primary driver of spread. Therefore, the regulations’ aim was to mitigate the risk of household transmission. The regulations prevent gatherings involving more than one household in private dwellings. That includes outside spaces that are part of those dwellings. The regulations mirror the provisions already in place in parts of the north of England, namely Greater Manchester and Leicester. Since the measures were introduced, the number of positive cases in Birmingham, Sandwell and Solihull has unfortunately increased, although not at the exponential rate seen in other parts of the country.

The co-ordinated local and national effort, in particular by the people living in those local authority areas, is having an impact on reducing the rate of growth. Household transmission is understood still to be the main driver of the current case levels, so it is crucial that the regulations remain in force and for the people in Birmingham, Sandwell and Solihull to continue observing hands, face and space practices.

I hope that the summary just provided will provide the context for the regulations that we are debating. Given the urgency of the situation in Birmingham, Sandwell and Solihull, we used the emergency procedure to make the present set of regulations as soon as we could. They gave effect to the decisions set out by my right hon. Friend in response to that latest epidemiological evidence and local insight. Before the implementation of the Health Protection (Coronavirus, Restrictions) (Birmingham, Sandwell and Solihull) Regulations 2020, the area was not subjected to or under any other restriction.

The measures prevent gatherings involving more than one household in private dwellings and their gardens in the protected area. There are some exemptions from the restrictions, including where all the people in the gathering are members of the same household or part of a support bubble, birth partners for mothers, end-of-life visits, education and training purposes, professional and informal childcare, emergency assistance, to facilitate house moves, to provide care to those who are vulnerable and to enable shared custody arrangements for children.

The definition of a private dwelling does not include specific businesses such as B&Bs, which should follow the covid-secure guidance. Not only do the regulations prevent people who live in a protected area from gathering in a private dwelling or garden with any other household in any location, they also prevent people living outside the protected area from gathering with another household in a private dwelling or garden within the protected area.

We revised the guidance for owners and operators of other settings, including places of worship, in the protected area. It states that they should not intentionally facilitate indoor gatherings between households, or they may be fined or closed by local authorities using new powers. Care homes have also been advised to allow visits only in exceptional circumstances to protect their vulnerable residents. No restrictions have been placed on travel, but people have been advised not to travel with people from other households.

The regulations include provisions making it a criminal offence to breach any of the restrictions or requirements, and as with the national regulations, those who breach the provisions may be issued a fixed penalty notice to fine them the amended rate of £200—or £100 if paid within 14 days—which increases for repeated breaches, up to a sum of £6,400. Offenders can also be fined following conviction.

The concern about the outbreak in Birmingham, Sandwell and Solihull has been significant, and engagement with local leaders has been extensive and productive throughout this period. I thank the local authority and resilience forum, Public Health England, the Joint Biosecurity Centre, local council leaders and, specifically, the local director of public health, Justin Varney, for all their action and hard work.

The decision to take action was not driven by one number; it was a judgment about the overall situation. The local councils have taken political, strategic and operational decisions in their response to the rising number of cases. They have all engaged extensively, from chief executive level to resilience partners, to increase testing in both targeted and generalised ways. They have focused on increasing compliance with social distancing measures to prevent the spread of covid-19. They are prioritising the protection of the most vulnerable in their communities. Guidance has been published for people living in Birmingham, Sandwell and Solihull to help them to understand what they can and cannot do under the restrictions.

We always knew that the path out of lockdown would not be entirely smooth; it was always likely that infections would rise in particular areas or workplaces, and that we would need to be able to respond quickly and flexibly to those outbreaks. As with other local regulations that we have already debated, the regulations demonstrate our willingness and ability to take action where needed and to assist the local community in so doing. By mirroring restrictions that have been successfully used in other parts of the country, we have shown that we are learning from experience. We will, of course, use the experience of the measures in Birmingham, Sandwell and Solihull to inform and help us to develop our responses to any future outbreaks. As I said earlier, there has been a review of the Health Protection (Coronavirus, Restrictions) (Birmingham, Sandwell and Solihull) Regulations 2020. The next review is due on or before 9 October. We will, of course, make public the outcome of that review.

I am grateful to all hon. Members for their continued engagement in this challenging process and in the scrutiny of regulations. I particularly thank the people in the protected area in Birmingham, Sandwell and Solihull, who have responded so well to the measures that have been put in place. Thanks to their continued effort, we can see the rate of infection coming under control, and we hope to ease the measures as soon as we are assured that the high transmission rates have been suppressed. I commend the regulations to the Committee.

--- Later in debate ---

[Jo Churchill]

I thank hon. Members for contributing to this important debate. The restrictions that we have debated in part today are necessary and important for three reasons.

First, it is important to protect the people of Birmingham, Sandwell, Solihull and the surrounding area from this terrible virus. The restrictions we have had to impose have been difficult, but I think that people in protected areas across the country recognise that these measures have been vital to stopping the spread of the virus, and those in Birmingham, Sandwell and Solihull are no different.

Secondly, the restrictions in those places protect those of us who do not live in that area, and as a result of the ongoing restrictions, there is less risk of the high infection rates in the city and surrounding areas spreading elsewhere. We should appreciate that the restrictions and difficulties faced by those in Birmingham, Sandwell and Solihull will benefit the country as a whole, and I offer everyone who is under these restrictions my thanks.

Thirdly, the restrictions show our absolute determination to respond to outbreaks of the virus in a focused and effective way. We are learning from what has happened in Birmingham, Sandwell and Solihull as we work with local authorities and others, including local Mayors, to respond to future localised outbreaks. We have seen that recently in parts of the north-west and north-east, as well as the west midlands. While the impact of the regulations has not been as significant as we would have hoped, together with the national measures now in force, infection rates in areas of Birmingham, Sandwell and Solihull have not risen, as I said, as fast as in other countries. We hope to be able to ease the measures as soon as we are assured that the high transmission rates have been suppressed, to realign Birmingham, Sandwell and Solihull with the rest of England’s measures. The next review will take place on 9 October.

I gently say to the hon. Member for Leicester West that it would be wonderful to have a crystal ball, but we do not, so we have to take a measured approach. We know that as the cases rise, the next 10 days are important in understanding how those rises transmute through to people getting infected. Then it will be a further 10 days before we look at hospitalisation. The overarching aim is still to protect the NHS, and that must be our aim. As the hon. Lady said, so much hard work went into the first phase, and so many people helped to set up Nightingale hospitals and so on. That is the same aim that we are carrying on with. After the review on 9 October, when the figures will be understood, more information will come forward.

The hon. Lady mentioned a few things. As the Chair said, some were out of scope, but I will cover one or two of the areas. We consult local authorities, mayors and local directors of public health, and we will continue to do so. It is not purely about the rates: it is about the overall picture in the area, as the hon. Lady understands from her experience. As she said, there is not a constituency MP in this place who does not feel for business owners and constituents who might be subject to these events. We want our schools and businesses open, which is why we have made sure that we have ramped up testing.

The hon. Lady mentioned the pleas from the conference and hospitality sector. I understand that representatives have written to the Chancellor, who I am sure will respond. She would not expect me to comment on many of the specifics, but I would like to pick her up on the fact that the numbers of people who are being contact-traced are exponential by comparison with what was expected. That obviously means that contact tracing—test and trace is up and active—is working. As of 4 October, testing capacity was at 310,288 per day, whereas it was 2,000 in March. On that day, 264,979 tests were processed. If there are specific challenges with testing in specific areas, I would be happy to take those up.

[Liz Kendall]

The point was more that the local authority was getting a lot more contacts that it had to follow up. It is asking whether it will get the financial support to do that properly. That was my question to the Minister.

[Jo Churchill]

To move on to the finances, all councils, in producing their local outbreak plans, are being supported by £300 million of funding from the national Government. In particular, we have provided £84,278,494 to Birmingham City Council, over £25 million to Sandwell and over £13 million to Solihull. In addition, each council has received additional funding to provide small business grant funds and retail, hospitality and leisure funds. In Birmingham, that has equated to over £214 million, in Sandwell, it is over £56 million, and in Solihull, it is over £26 million.

The Government are supporting businesses and the population. The hon. Lady mentioned that people perhaps feel compelled to go out to work. The Government have provided further support in recent weeks, ensuring that people on low or restricted incomes can access funds to enable them to self-isolate as they are being asked to do.

I conclude by recording on behalf of the Government our thanks to the people of Birmingham, Sandwell and Solihull, particularly NHS and care workers—indeed, all key workers in the city—for their ongoing hard work to keep our vital services running and save lives. I commend the regulations to the Committee.

Question put and agreed to.

Health Protection (Coronavirus, Restrictions) (Bolton) Regulations 2020

Jo Churchill Excerpts

Tuesday 29th September 2020 General Committees

[The Chair]

Before we begin, I need to remind hon. Members about social distancing, so thank you all for sitting in appropriately marked spaces or at the back of the room. Hansard colleagues would be grateful if you could send any speaking notes to [e-mail].

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I beg to move,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (Bolton) Regulations 2020 (S.I. 2020, No. 974).

It is a pleasure to serve under your chairmanship, Ms Nokes. The regulations came into force on 10 September. On that date, my right hon. Friend the Secretary of State for Health and Social Care announced that the latest epidemiological data showed a dramatic increase in the incidence rates of covid-19 in the Bolton area, leaping from 18.6 per 100,000 people to more than 100 per 100,000 people within a week. Test positivity was also higher than the national average.

Given the rapid increases in cases, the local authority understood the seriousness of the situation and was proactive and willing to take more stringent action. It increased testing by bringing in mobile testing units and distributed 2,000 home testing kits throughout the community. The University of Bolton carried out a comprehensive risk assessment and made plans for the imminent start of term. The council engaged with the university and local businesses to discourage them from promoting large events to coincide with the start of term.

Learning from the outbreak in Leicester earlier in the summer, Bolton was one of the first areas to roll out its own locally supported contact tracing. The start date was brought forward by two days in response to the spike in cases. At that time, there was no clear understanding of what was driving transmission. The council, Public Health England and the Joint Biosecurity Centre analysed the available NHS Test and Trace data and other data to try to identify what was driving transmission.

The results were interesting. It was found that 93% of cases were among 18 to 49-year-olds, two thirds of cases were in the 20 to 39-year-old age group, the main ethnic group testing positive for the virus was white British, and the cases were understood not to come from the most deprived parts of the population. The cases were also geographically dispersed across the Bolton area, rather than being clustered in hotspots, as was the familiar pattern in other parts of the north of England at the time. There was anecdotal—I stress “anecdotal”—evidence that an outbreak was linked to a local pub and started from a visitor who had recently returned from overseas. There were also concerns that transmission was happening in workplaces, but that was not thought to be the main driver of the spike in cases.

It is important to remember that at this point Bolton was already subject to interventions as part of the protected area defined in the Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020. That meant that households in Bolton could not meet up with each other in private homes or gardens, and certain businesses remained closed despite being able to reopen elsewhere in England.

Given the urgency of the situation in Bolton, we used the emergency procedure to make the present set of regulations as soon as we could. They gave effect to the decision set out by the Secretary of State, responding to the latest epidemiological evidence and local insights. These regulations went further than just repeating the restriction on different households mixing in each other’s homes by requiring certain businesses to remain closed. They seek to address the increased risk of transmission associated with people’s reduced compliance with social distancing guidance when they are out socialising in and around hospitality venues. The new restrictions prohibit food and drink businesses from opening, other than to sell items to be collected or delivered and consumed away from the premises. They cannot operate at all between the hours of 10 pm and 5 am. Other non-essential businesses and services are also required to close between 10 pm and 5 am.

The restrictions are enforced by the same regime as the other health protection regulations, although there is the creation of new offences punishable by fixed penalty notices or fines following conviction.

We published guidance to help people living in Bolton understand what they can and cannot do under the restrictions, and it was updated every time there was a change. The local authority’s guidance went even further, given the exceptionally quick increase in the incidence rates. It advised residents to use public transport only for essential purposes and not to mix with other households, even when they were outside their homes. The local authority also decided to reissue previous national guidance on shielding for the clinically extremely vulnerable.

The concern about the outbreak in Bolton has been significant, and engagement with local leaders throughout this period has been extensive and productive. I thank the local authority, the local resilience forum, Public Health England, the Joint Biosecurity Centre and the local director of public health, Helen Lowey, for their engagement.

Action had already been taken to protect people in Bolton, including increases in testing and public health capacity. We had hoped that those interventions and the work of local public health teams would get the infection rate down without our having to take more drastic action, but that was not to be. As is required by the regulations, we have reviewed the situation at least once every 14 days and the incidence rates have dropped in the last few days to 205 per 100,000 people for the period of 12 September to 18 September, although I understand that they have risen again.

We always knew that the path out of lockdown would not be entirely smooth. It was always likely that infections would rise in particular areas or workplaces, and that we would need to be able to respond quickly and flexibly to those outbreaks. These regulations have demonstrated our willingness and ability to take action where we need to. Of course, we will use the experience of these measures in Bolton to inform and help us develop our responses to any future outbreaks. As I said earlier, there have been ongoing reviews of the Bolton regulations; the next review is due today and of course we will make public the outcome of that review shortly.

I am grateful to all Members for their continued engagement in this challenging process and in the scrutiny of the regulations. In particular, I thank all those people in the protected area in Bolton who have responded so well to the measures that have been put in place. None of this is easy.

I commend the regulations to the Committee.

--- Later in debate ---

[Jo Churchill]

I understand and recognise how, as the hon. Member for Nottingham North said and the hon. Members for Ellesmere Port and Neston (Justin Madders) and for Warwick and Leamington have said on many occasions, there is a willingness to work together. They want us to get ahead of the curve, as it were. I understand why that is, but we introduce such regulations under section 45R of the Public Health (Control of Disease) Act 1984 because we need to move at speed. These are public health emergencies rather than anything to do with the broader setting.

We recognise the impact of localised restrictions on local businesses. That is why we provided Bolton Metropolitan Borough Council with £57,980,000 of business support grant funding. Businesses have access to a large number of support schemes including discretionary grants and tax breaks because there is a need to protect both people and the economy. The measures we are taking in Bolton seek to find balance on that difficult tightrope. No one wants to put restrictions on people’s lives.

The hon. Member for Nottingham North alluded to yesterday’s debate. One thing I took from it is how the power of many of the speeches came from the impact on people’s lives from a human capital point of view and how that spins out. As I said on the Floor of the House yesterday, we are working hard to move things forward and have more dialogue. I appreciate the articulation of his willingness to work with us.

[Mrs Maria Miller (Basingstoke) (Con)]

It is a great pleasure to see you in the Chair, Ms Nokes. I am sure hon. Members do not need their attention drawn to the fact that the Minister was on her feet in the Chamber 12 hours ago. It is astonishing to see her here doing a great job of presenting the regulations to the Committee.

I want to press the Minister on working together. The hon. Member for Nottingham North raised an important point about the timeliness of consideration of legislation. There is obviously a huge amount of secondary legislation at the moment. Could the House of Commons and Parliament be doing more to support the Government to that end? Should we press the authorities to do more?

[Jo Churchill]

I thank my right hon. Friend for her intervention, which I am sure the Whip, my hon. Friend the Member for Erewash, will take away through the usual channels. Everyone wants to see these things succeed so that we get out of this covid-tinged world and into something more akin to what we are used to.

The hon. Member for Nottingham North asked me about the restrictions. It is too early to know whether they have bedded through. One of the challenges is that if we leave things as they are when we see the spike rising, the argument is that we are too late, but if we go too early, the argument is that we are impinging on people’s lives. One of the big problems with the disease is that, when we see the prevalence rise, there is a 10-day lag before we see the number of people entering hospital rise and then a further 10-day lag before we see the number of deaths rise.

I can report that, unfortunately, from this week, the positivity rate is 241.8 per 100,000. The next review is on 9 October.

These are challenging times. The information I read out was based on local intelligence from the University of Bolton, which knows its own community. In many debates I have been challenged about getting granular and getting local. This is a fine example of where the director of public health and other local bodies are helping us drive the right solutions locally. For my money, that is the right way to proceed.

We recognise that, for many, self-isolating for 10 to 14 days to avoid passing on the virus is a challenge. The Prime Minister announced that, from 28 September, we will be supporting those on low incomes by paying them £500 if they cannot work from home or have lost income as a result of the requirement to self-isolate. That needs to be fed through to see if it also has an effect. The requirement to self-isolate became law yesterday and there are penalties for those who breach the rules. There will also be penalties for employers who fail to support the requirement, for example, by threatening self-isolating staff with redundancy if they do not come to work. We hope that will send a clear message about the importance of self-isolating.

We take Public Health England’s report on BAME communities extremely seriously. However, there is still work to do in understanding how the disease affects different groups, including BAME communities, as well as the broader communities we are working with. Expecting a reliable result within a week or 10 days is difficult in this situation. Other factors, such as comorbidities and occupational risk, mean that every situation is more complex than it might seem at face value. We are investing a large amount in medical and clinical research to get a better understanding. In the meantime, we are making it a priority to safeguard BAME workers in the NHS who might be at risk and in need of specific treatment, while making sure that all workplaces have been risk-assessed.

The decision to impose even more stringent restrictions in Bolton is based on a number of factors and local intelligence. They include not just the positivity and incidence rates but the extent of high-risk behaviours. The next review will take place on 9 October.

I conclude by thanking the people of Bolton and particularly its NHS and care workers and all the city’s key workers for their ongoing hard work to keep our vital services running and save lives through this difficult time. I urge everyone to get behind hands, face and space, so we can eradicate the virus from our country as soon as possible.

Question put and agreed to.

Covid-19

Jo Churchill Excerpts

Monday 28th September 2020 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I start by adding my thanks to those of hon. and right hon. Members from across the House who have thanked frontline NHS staff and social care workers, key workers, businesses and communities from all their constituencies for how they have risen to the unprecedented challenge that has faced us. I particularly thank my hon. Friend the Member for Thurrock (Jackie Doyle-Price) for highlighting the good work that our pharmacists have done on the frontline so far, and how they have adapted in this covid-tinged world to keep us safe.

As my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) suggested, this is where we are now, and we have to learn to live with this disease. I am an optimist, but I am also a realist. As my right hon. Friend the Secretary of State said at the beginning of the debate, the recent steep rise in the number of cases is something that should concern us all. Our first priority is to preserve life, as my hon. Friend the Member for Hitchin and Harpenden (Bim Afolami) laid out. We have to adapt, and we have done.

The excellent speech by my hon. Friend the Member for North East Derbyshire (Lee Rowley) showed us that we have come a long way, and that was the theme running through the speech by my hon. Friend the Member for Runnymede and Weybridge. We are continuing with our plan to slow the spread of the virus and balance very tough decisions about health, the economy and protecting individual freedoms. I would like to park one suggestion immediately: there are no plans to keep students at university over Christmas.  I really do not think that it helps those young people, when they are launching into a new phase of their life, for right hon. and hon. Members to suggest that those things might happen. It is, to quote the hon. Member for Ellesmere Port and Neston (Justin Madders), better to deal with the facts.

Colleagues’ contributions to today’s debate were wide ranging and thoughtful, and they were most welcome. There were too many speakers to highlight each individually, so I shall address some of the key themes that were raised by hon. Members across the House.

On access to this place, what I have heard today is that this House wants to debate the challenges and that Members want to put forward their and their constituents’ views. I know that their words today will have been heard. As the Prime Minister said, the aim is to provide more opportunities to hon. and right hon. Members via statements. The Secretary of State has been here innumerable times—over 800 times answering questions—but we will have more debates, questioning of the Government’s scientific advisers and access to local data. We are looking at further ways to ensure that the House can be involved more fully, and there will be more details soon.

We have, as a Government, supported businesses in an unprecedented way, which many hon. Members mentioned, with furlough, the bounce back scheme and the self-employment income support scheme. I thank all hon. and right hon. Members for their kind words, but it is tough out there. We know we need to balance the needs of the economy and our health needs. This covid-tinged world is the one we are now trying to live in.

My hon. Friend the Member for Arundel and South Downs (Andrew Griffith) explained the challenges for his constituents, particularly in the wedding sector, and I heard my hon. Friend the Member for Southend West (Sir David Amess) somewhat gleefully suggesting that the delay of two weddings in his household was not the worst thing in the world. I know he did not mean that. As someone with a daughter who has delayed a wedding this year too, I think what came out from everybody’s speeches was that they were personal—about the pain of love and the difficulty of decisions that have had to be made throughout this crisis.

We have had to make choices. My hon. Friend the Member for West Aberdeenshire and Kincardine (Andrew Bowie) highlighted positive interventions by the Government, but the most essential point that I took from his comments was why we must keep education going—why we must keep it open and why we must give the next generation that hope.

As I take those themes, I want us to hold in our mind the critical thing that we started with: that we must stop the NHS being overwhelmed. That is still our key objective. Although we know that people’s lives have been disrupted, critical care has continued throughout, and I pay tribute to those in community care, primary care and the acute sector who have enabled that to happen. Our response to create surge capacity of over 2,000 beds through our Nightingale hospitals is the key to forward resilience, as are the more than 30,000 ventilators that are now available.

Many hon. Members spoke about cancer. I would like to mention in particular my hon. Friend the Member for Northampton South (Andrew Lewer) and my right hon. Friend the Member for Wokingham (John Redwood). I reassure them that the NHS’s recovery approach has looked to restore urgent cancer care immediately. The latest figures, from June, show that over 180,000 people have been seen, more than 90% of them in two weeks. We have formed a cancer recovery taskforce, which met on 22 September and will meet every month in this financial year. It involves charities, stakeholders and clinicians. The national recovery plan will be developed over the coming weeks and published.

We must carry on treating. Cancer hubs, where teams work together in covid-free environments, are up and running now. The message is clear: “Come forward still.” We still need to get people to have confidence that we are there and we are open. The hon. Member for Luton South (Rachel Hopkins) mentioned the situation in her area. Certain areas, such as gastrointestinal and bowel, are particularly difficult because of the diagnostic pathway, but we are working hard to make sure those patients are seen as quickly as possible.

Many hon. Members raised the curfew. Several countries have, like us, introduced curfews at 10 o’clock at night. The contact tracing data indicating patterns of behaviour shows that our inhibitions reduce as the evening goes on because we have usually drunk a little more. Having a curfew at 10 o’clock balances the need for businesses to operate against people’s ability to enjoy themselves, but we will, of course, keep the situation under review.

One or two Members said that we should have seen better—we should have been able to look into the future—while telling us how good they were at explaining the past to us. If only that were true. Several Members spoke about local challenges in testing, but it is important to remember that, when we started, all we did back in March was 2,000 tests a day. We passed the 20 millionth test today. It should be recognised that we have built the largest diagnostic network in British history. We have one of the best in Europe, and arguably one of the biggest in the world. I pay tribute to those who fought so hard to get us there. We have had mountains to climb, and every time we go up one side there is a dip on the other. None of this is easy. We have never said that we have all the answers, but we keep going because that is what makes us able to deliver for the people of this country. I welcome the support of the hon. Member for Ellesmere Port and Neston for what the Government are doing.

We have risen to the challenges on each occasion, and every week driving the system to be bigger than the week before. We have five major laboratories, backing up 258 mobile testing sites, 76 regional sites and 122 walk-through sites. In London, we had eight local testing centres in August; we now have 22. Yes, there have been challenges due to unprecedented demand, but the curve of returning tests to people is beginning to go in the right direction. We are seeing huge improvements in data flow, and we are we are making sure the directors of public health, health protection teams, Mayors and local authorities are involved in these conversations. It is right that we are challenged, but it is also right that we recognise what has been done.

[Mr Steve Baker]

Would the Minister allow me?

[Jo Churchill]

No, I am terribly sorry. I have only two minutes left.

I say to my hon. Friends the Members for Harrogate and Knaresborough (Andrew Jones) and for Wealden (Ms Ghani) that I understand the need to see loved ones, but there is a balance in protecting care homes. As I sat on the Bench, one of my care homes texted me and said, “All is well. I feel in control.” May that long continue. We are getting 100,000 tests out to care homes every week. The strategy for winter is about having national guidance and local systems, and enabling care homes, which know their individual residents, to do their best for them.

I thank my hon. Friend the Member for Wealden for acknowledging how far we have come. We have delivered more than 3.5 billion items of PPE. The strategy was put out today, and I pay tribute to Lord Deighton for all the work he has done. We are building supplies, and we have resilient supply lines that we did not have before. We started distributing to 226 NHS trusts, and we now send to 58,000 settings. The PPE portal is a blueprint for rapid mobilisation.

My hon. Friend the Member for Burnley (Antony Higginbotham) highlighted how we are using local factories in this country—in these four nations. That is where new business opportunities have arisen; it is not all doom and gloom. In treatment, we have secured good supplies of dexamethasone, which has helped mortality for the sickest patients. We also have the recovery programme, leading clinical trials, which has been called—not by us—the most impressive on the planet. By 2021, we will know more about the good and bad treatments. Once again, we are showing how the NHS, private business and academia work successfully together. I congratulate everybody involved in those. The global vaccine industry has responded with a speed never seen before. We are at the forefront of the science for finding a vaccine for this novel organism. There is a huge amount of planning going on to ensure we are ready to roll things out. We are walking a tightrope, as many Members have acknowledged. There are no easy decisions and there is no silver bullet, but we know that the thing is: hands, face, space. If even my hon. Friend the Member for Wycombe (Mr Baker) has downloaded the app, I urge everybody to download it. It is the fastest download in British history, and all these small measures will help us get the virus under control.

[Mr Deputy Speaker (Mr Nigel Evans)]

Order.

Health Protection (Coronavirus, Restrictions) (Greencore) Regulations 2020

Jo Churchill Excerpts

Tuesday 22nd September 2020 General Committees

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I beg to move,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (Greencore) Regulations 2020 (S.I. 2020, No. 921).

It is a pleasure to serve under your chairmanship, Mr Mundell. The regulations came into force on 29 August. On 21 August, my right hon. Friend the Secretary of State for Health and Social Care announced that, due to a significant covid-19 outbreak at Greencore Food to Go Ltd, regulations would be laid requiring the workforce and their households to self-isolate for a period of 14 days, to contain the outbreak and avoid the need to impose restrictions on the wider community.

The concern about the risk of transmission across the workforce at Greencore and out into the wider community of Northampton was significant. Engagement with local leaders and company directors was extensive, repeated and productive. To that end, I would like to thank Greencore, Public Health England, the joint biosecurity centre, the Department for Environment, Food and Rural Affairs, the Department of Health and Social Care, Northampton Borough Council, Northamptonshire County Council and, in particular, Lucy Wightman, the latter council’s director of public health, for their constructive engagement with one another.

The decision to act was not driven by numbers only; it was a judgment about the overall situation. It was necessary to make this change as quickly as practicable in recognition of the immediate risk of a continued increase in the incidence of covid-19 among the workforce at Greencore as the main cause of wider community transmission. During the period from 9 to 15 August, Northampton saw a sharp spike in its weekly incidence rate to 116.4 per 100,000 of population. NHS test and trace data showed that most of the covid-19 transmission appeared to occur within the household and community settings that were then traced back to the staff who were employed or had worked at the local Greencore site.

Action had already been taken to protect Greencore employees. The whole workforce were tested. The factory layout was amended to make it more covid-secure than before, and deep cleaning was carried out. We had hoped that those interventions and the work of local public health teams would drive the infection rate down without our having to take further action. However, a large percentage of the workforce continued to test positive for the virus. It was likely that that was due to people socialising together outside work, for example by sharing accommodation or by car sharing to get to and from work.

At the local action gold committee meeting on 20 August, a decision was taken to require Greencore to close its food manufacturing site in Northampton and to require the workforce and their direct household contacts to self-isolate for 14 days. Those actions were supported by Greencore’s leaders. Current Government guidance advises that anyone who tests positive for the virus should self-isolate for 10 days from the date of the test. Anyone who has been in close contact with them is advised to self-isolate for 14 days. Requiring household members of Greencore workers to self-isolate went further than current Government guidance. However, that measure was necessary due to the scale of the outbreak and the risk posed to the wider community if further transmission was not prevented.

I now turn to the data provided that informed the decisions to which I have referred. Mass testing at Greencore started on 10 August. Following that first round of testing, nearly 300 members of staff tested positive for coronavirus. On 19 August, Greencore commenced retesting all staff who had previously tested negative, detecting further positive cases. In total, some 317 staff tested positive, giving a final positivity rate of over 20%. The weekly incidence rate for Northampton peaked at 125 per 100,000 people, and positivity rose to 9.2%. By comparison, the background incidence rate for Northampton, excluding positive tests from the Greencore workforce, was 38 per 100,000 for the same period.

The regulations required Greencore staff who have worked at the company’s designated production site since 7 August 2020 and members of their household to self-isolate for 14 days from 21 August, or for a shorter period in certain specified circumstances. Those dates were calculated to reflect the incubation period of covid-19. Although the regulations only came into force on 26 August, the workforce and their households were able to start their isolation from 21 August, when the site had closed temporarily.

The regulations specified exactly who was required to self-isolate and for how long, recognising that some workers had already started to self-isolate following their earlier positive tests. The regulations made provision to exclude household members if the Greencore worker had chosen to isolate separately. Provisions were also included to enable those self-isolating to access or provide emergency care and support, or to obtain basic necessities such as food and medical supplies.

Given the urgency of the Greencore situation, we used the emergency procedure provided for by the Public Health (Control of Disease) Act 1984 to make the present regulations as soon as possible. The regulations will expire this Friday, 25 September, 28 days after they came into force.

Regulations 7 to 11 set out how the provisions will be enforced. It is a criminal offence to breach the requirement to self-isolate. As with the national regulations, there is the possibility of a fixed penalty notice or a fine following conviction. We also published guidance on the gov.uk website for Greencore workers and their households, to help them understand what they can and cannot do under the regulations.

We always knew that the path out of lockdown would not be entirely smooth, that it was likely that infections would rise and that, in particular areas or workplaces, we would need to be able to respond quickly and flexibly to outbreaks. Greencore should be commended for acting so promptly and choosing voluntarily to go above and beyond its role as an employer to support the wider community in Northampton. Local rates have reduced to a weekly incident rate of 38 per 100,000 from 7 to 13 September.

The Greencore regulations have demonstrated our willingness and ability to act quickly, where we need to, to control specific outbreaks. We will of course use the experience of the Greencore restrictions to inform and develop our responses to future local outbreaks.

Finally, I thank those Greencore employees and members of their households who completed the required periods of self-isolation and who responded so positively and well to the measures put in place. It is thanks to their continued effort that we were able to contain the outbreak and avoid the need to impose restrictions on the wider community. I commend the regulations to the Committee.

--- Later in debate ---

[Jo Churchill]

I thank hon. Members for this important debate, and I thank the hon. Member for Ellesmere Port and Neston for his comments. If it has highlighted anything, it is that the regulations are of a timely nature and use the 1984 Act in a way that is defined and applicable. I am glad that the hon. Member sees that the Act has use for controlling the virus. We have often traded words: he would like more notice before, and I have often said, “Actually, we need to act at speed. We need this to be agile, which is why we are proceeding in this way.”

The Greencore sites were deep cleaned and inspected by the relevant agencies—the Health and Safety Executive and the Environmental Agency—before reopening. There are currently ongoing reviews, and I am sure that the hon. Member appreciates that we are very much in the time zone. The regulations do not expire until Friday, but reviews of the effectiveness of the regulations are happening now.

It is my understanding that guidance was given in different languages and made available by the local authority and employers in multiple languages. Greencore used the furlough scheme to support workers who were self-isolating, and it voluntarily paid up to 80% of salaries to staff who could not be furloughed.

The restrictions that we have debated are necessary and important for three reasons. First, and most importantly, they have helped to protect the Greencore workforce and the people of Northampton and the surrounding area from the transmission of this terrible virus. The restrictions we had to impose were difficult for those affected, but I hope the Greencore employees and their households recognise that letting the virus spread unchecked would have been worse. I once again place on the record my thanks for the way they approached the matter.

[Justin Madders]

I am grateful for the Minister’s answers. She is right that on this occasion we have no difficulty with the speed with which the regulations were introduced. However, there is the outstanding question of retrospective power to hand out fixed penalty notices for a period before the regulations came into force. Is that legally possible?

[Jo Churchill]

The regulations were unenforceable before coming into force, and therefore they do not operate retrospectively, which I think answers the hon. Gentleman’s question.

[Justin Madders]

Yes, thank you.

[Jo Churchill]

Secondly, the restrictions are important because they protect those of us who do not live in Northampton. As a result of the restrictions, the risk of transmission beyond Northampton was reduced, and high infection rates in the city did not spread elsewhere. We should recognise the restrictions and the difficulties faced by Greencore employees and their households. The sacrifices they made will have benefited the whole country.

Finally, the restrictions show our absolute determination to respond to outbreaks of the virus in a focused, locally effective way. We are learning from what has happened in Greencore as we work with local authorities, directors of public health and other businesses to respond to future localised outbreaks, one of which recently happened in Norfolk. I am pleased that as of 25 August Greencore was able to restart food production and that those affected were able to return to work once they completed the required period of self-isolation.

I am grateful to the hon. Gentleman for his contribution today, and want to conclude by recording, on behalf of the Government, my thanks to the people of Greencore in Northampton, and particularly to NHS and care workers, and all the key workers in the city, for their ongoing hard work to keep vital services running and save lives through the crisis.

Question put and agreed to.

Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020 Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) (Amendment) Regulations 2020 Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) (Amendment) (No. 2) Regulations 2020 Health Protection (Coronavirus, Restrictions) (North of England) (Amendment) Regulations 2020 Health Protection (Coronavirus, Restrictions) (North of England) (Amendment) (No. 2) Regulations 2020

Jo Churchill Excerpts

Monday 21st September 2020 General Committees

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I beg to move,

That the Committee has considered the Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020 (S.I. 2020, No. 828).

[The Chair]

With this it will be convenient to consider the Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) (Amendment) Regulations 2020 (S.I. 2020, No. 846), the Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) (Amendment) (No. 2) Regulations 2020 (S.I. 2020, No. 865), the Health Protection (Coronavirus, Restrictions) (North of England) (Amendment) Regulations 2020 (S.I. 2020, No. 897) and the Health Protection (Coronavirus, Restrictions) (North of England) (Amendment) (No. 2) Regulations 2020 (S.I. 2020, No. 931).

[Jo Churchill]

It is my pleasure to serve under your chairmanship, Mr Hollobone. The regulations came into force on 4 August to tackle the outbreak of coronavirus in parts of the north of England. My right hon. Friend the Secretary of State for Health and Social Care was made aware that the latest epidemiological data showed high transmission rates of covid-19 across Greater Manchester, areas of Lancashire and West Yorkshire. It was therefore necessary to impose restrictions to prevent further spread of the virus.

On 8 August, following concerns about the significant increase in local incidence rates of the virus, the regulations were amended to extend their remit to include Preston. On Wednesday 15 August, a further amendment to the regulations meant that the national restrictions that were lifted across England would not be applied to those areas covered by the regulations, due to the high incidence rates remaining across such areas. However, by Wednesday 26 August, on reviewing the up-to-date epidemiolocal data and information from local authorities, directors of public health, Public Health England, the Joint Biosecurity Centre and contain teams, the Secretary of State was able to remove Wigan Metropolitan Borough Council and Rossendale Borough Council from the protected area. This meant that the restrictions remaining in those areas aligned with the those on the rest of England. On 2 September, we were able to remove certain wards in Calderdale Metropolitan Borough Council and Kirklees Metropolitan Council from the regulations following another review.

The concerns about the outbreak of coronavirus in the north of England have been significant, and the engagement with local leaders has been extensive and productive. I want to thank all local authorities and local resilience forums, Public Health England and the Joint Biosecurity Centre—as well as local directors of public health, all council leaders and the Mayor of Greater Manchester, Andy Burnham—for their ongoing support. I also want to emphasise that the decision to take action on each occasion was not driven by numbers alone; it was a judgment about the overall situation, taking into account not only the epidemiological evidence, but local insights and views.

Action had already been taken to protect the people living in the affected areas in the weeks before the regulations came into force, such as increased testing and public health support. We also gave additional funding to all upper tier local authorities involved. That enabled them to enhance the various local interventions and to support measures that have been put in place. We hoped that those interventions and the work of local public health teams would get the infection rate down without our having to take more drastic action. When the regulations came into force, however, the incidence rates in almost all these geographic areas were significantly above the national average.

Pendle had the highest incidence rate in England between 31 July and 6 August, at 89.7 infections per 100,000 people. Oldham had the second highest rate, at 82.3, and nine other local authorities in the north had rates in excess of 30 per 100,000. The epidemiological data and local insights suggested that the most likely route for the increased transmission of covid-19 was as a result of people living in different households in the area meeting up with one another. Multigenerational households, households with several members and those from lower socioeconomic backgrounds have experienced a higher risk of transmission.

However, by the end of July, it was clear that rates of infection were continuing to increase to undesirable levels. The cross-Government covid-19 operations committee, chaired by the Prime Minister, decided on 30 July to take further measures to tackle the outbreak, and the Secretary of State set out the measures in his statement. In general, these regulations prohibited households in the relevant areas of the north of England mixing with each other in their homes or gardens, apart from those with support bubbles or in other limited circumstances, such as on compassionate grounds. Some exceptions include work purposes, education or training, emergency protection, to avoid injury or escape harm, to facilitate a house move, to provide care to vulnerable people or to visit family members who are dying.

These regulations also included a provision extending that restriction to the protected areas covered by the separate Health Protection (Coronavirus, Restrictions) (Blackburn with Darwen and Bradford) Regulations 2020. The regulations include provisions making it a criminal offence to breach any of the restrictions or requirements. As with the national regulations, those who breach these provisions can be issued with a fixed penalty notice, with increasingly larger fines for repeated breaches. Offenders can also be fined following conviction.

Due to the increasing incidence rate in Preston as the regulations came into force, my right hon. Friend the Secretary of State made the decision to add Preston to the restricted area covered by the regulations, extending the ban on households mixing with each other to residents of the city. Despite the restriction on inter-household mixing introduced on 5 August, the incidence rates continued to rise or remain undesirably high. Consequently, on 15 August, further restrictions were imposed requiring certain businesses and venues to remain closed, despite their being able to reopen elsewhere in England. The venues in each local authority area that had to remain closed for the time being included casinos, indoor skating rinks, indoor swimming pools and water parks, indoor play areas, indoor fitness and dance studios, indoor gyms and sports courts, bowling alleys, conference centres and exhibition halls.

By 26 August, rates had fallen or remained acceptably low in Rossendale and Wigan and by 2 September rates had also fallen much safer levels across Stockport, Burnley and Hyndburn, as well as across certain wards within Calderdale and Kirklees. In the light of the improving situation in all those areas at those dates, the Secretary of State removed them from the regulations, so the only restrictions remaining in force in each area were those applicable to the rest of England. The regulations must be reviewed every 14 days to consider the need for the restrictions to continue. The next review is due on or before 25 September. My right hon. Friend the Secretary of State committed to reviewing them weekly, which he continues to do.

Given the urgency of the situation in the north of England, we used the emergency procedure to make the present set of regulations as soon as we could. They give effect to the decisions set out by my right hon. Friend the Secretary of State in response to the up-to-date epidemiological data and situational awareness relevant to each local authority area. Alongside the regulations, we provided guidance on the www.gov.uk website explaining what people living in an affected area can and cannot do.

Since these regulations and their amendments were implemented, the Government have continued to review the ongoing situation. The incidence rates in most of these local authorities have increased and remain high. Although we are debating only these five statutory instruments, there have been regular reviews considering the positions in each local authority area, and we remain concerned about the continued high level of the virus in many of them, primarily driven by community transmission. People must follow the Government’s clear guidance to socially distance, wash hands frequently and wear face coverings in public indoor places.

We always knew that the path out of lockdown would not be entirely smooth. It was always likely that infections would rise in particular areas or workplaces, and that we would need to be able to respond quickly and flexibly to those outbreaks. The collective actions taken across the north of England have demonstrated a willingness and ability to take action where needed. We will, of course, use the experience of the restrictions in the north of England to help inform and develop our responses to any current local outbreaks.

As I said earlier, we will continue to make public the outcome of the reviews. I am very grateful to all Members for their continued engagement in this challenging process, and in the scrutiny of the regulations. I would particularly like to thank people in those parts of Lancashire, Greater Manchester and West Yorkshire who have, in general, responded well to the measures put in place. It is thanks to their continued efforts that the changes to the boundaries were made, and we hope to ease measures further if improvements continue. I commend the regulations to the Committee.

--- Later in debate ---

[Jo Churchill]

I place on the record my thanks for the hon. Gentleman’s tone; I am grateful for the support. As we know from this morning’s announcement by Professor Whitty and Patrick Vallance, this is a difficult, fluid situation that is changing. It is important, as I answer some of the questions that the hon. Gentleman put to me, that we keep that level of dynamism in mind, because that is the problem: we cannot see into the future. One of the challenges is that if we pre-empt where we are going, we are much more likely to be over-restrictive than under-restrictive.

The one thing we have not heard in the offer of support is how that support would work within the parliamentary framework. Do we sit for seven days, because these things are arguably coming at us hourly? Do we do it on a smaller basis? Do we go through usual channels? This is considerably more complex. I understand the point the hon. Gentleman makes, because often members of the public are not sure how this place works, and there is a challenge in helping them to understand why we do things in certain ways.

[Matt Western]

The Minister makes a valid point. As a constructive suggestion, we have Westminster Hall and we have spare capacity in this place. How about using Westminster Hall solely for the purpose of having these debates about everything related to the covid-19 pandemic and how we work our way through it, and we could do stuff in advance?

[Jo Churchill]

I thank the hon. Gentleman for his suggestion; I am sure my Whip will take that away and feed it up through the usual channels. The hon. Gentleman makes the point that there are other places on the estate but, as he will know, there are also restrictions on movement around the estate and what parts of if we can move to.

The restrictions we have debated today are necessary and important for three reasons. First, and most importantly, they are necessary to protect the people in the north of England and surrounding areas from this terrible virus. The restrictions imposed have been difficult, but I think the people of the north of England recognise that the measures have been paramount to try to stop the spread of the virus.

Secondly, the restrictions protect those of us outside the north of England. Containing was very much the strategy laid out on 10 May. These restrictions greatly reduce the risk of transmission within the protected area, which in turn reduces the risk of infection rates increasing elsewhere. We recognise and appreciate that in abiding by these restrictions, those in the north of England benefit the whole country, and I place on the record my thanks to them.

Thirdly, the restrictions show the absolute determination to respond to the outbreaks of the virus in a focused and effective way. We are learning from what happened in the north of England as we work with local authorities and others to respond to future localised outbreaks, such as those that one of my colleagues will be debating in the House in due course. Indeed, we were able to work down to a granular, ward-by-ward level, but we have found that it is probably not the best strategy to open up on that basis.

The next review of the regulations will take place on or before 25 September. I am grateful to hon. Members for their contributions to the date today. I would like to address the point that the hon. Member for Nottingham North made first about timeliness and speed. The Government are confident that the regulations were made lawfully under the emergency procedure of the Public Health (Control of Disease) Act 1984. They are receiving parliamentary scrutiny in accordance with the emergency procedure, and are being debated within 28 days.

The challenge with these regulations is that we caught the tail end of recess, which obviously pushed them out a little further. The procedure allows us to respond quickly to the serious and imminent threat to public health posed by coronavirus, first by imposing restrictions to break the transmission chain and to protect people, and secondly by removing those restrictions when it is safe to do so. The regulations we are debating show how fluidly and quickly we can make those adjustments and changes.

The Secretary of State considers that the requirements imposed by the regulations are a proportionate public health response to the threat of incidence and spread in England of severe acute respiratory syndrome coronavirus 2— SARS-CoV-2—or covid-19. The regulations set out that a review of those requirements must take place every 14 days to ensure that they continue to be necessary to

“prevent, protect against, control or provide a public health response to the incidence or spread of infection”.

It is also important that timely reviews are made so that restrictions are not overly imposed on any part of the population.

We have subsequently amended the regulations to ensure that we continue to take necessary steps to protect public health as national restrictions were lifted over the summer—amendments were accordingly made on 8, 15 and 26 August. The hon. Member for Nottingham North asked how decisions are made locally and what the system is. Public Health England, the Joint Biosecurity Centre and NHS Test and Trace are constantly monitoring the levels of infection across the country, and work with local authorities to implement additional control measures as appropriate. Those decisions will be taken on a case-by-case basis, which is why that local knowledge is so important, and advice may differ according to the specific circumstances of any given outbreak. Indeed, tomorrow we will be talking about an outbreak in and around a place of work, which is obviously quite different.

The watchlist is already publicly available in Public Health England’s weekly surveillance report, and the decision to place restrictions on local authorities in the north of England was based on a number of factors, including not just the positivity rate, but the incidence rate of the virus, the extent of high-risk behaviours and the rise in the increased risk of transmission between the population. The next review will take place on Friday 25th—this Friday—and we are debating the regulations before that review. My right hon. Friend the Secretary of State will consider all those factors when making his decision.

As I have just mentioned, we have increased the capacity of the test and trace system by more than 10% in the last few weeks, with the aim of reaching 500,000 tests per day by the end of October. I pay tribute to all those involved in the test and trace system because, initially, we could process some 2,000 per day. We are now well over 240,000 per day, and some capacity, including antibody tests, is well over 370,000 tests per day. We are on track to hit 500,000 tests per day by the end of October. There are four new Lighthouse labs coming on stream, including Newport, Newcastle, Charnwood and Brants Bridge. There are hundreds of additional staff and capacity is being bought up abroad. Test and trace has led to more than 420,000 people isolating who may otherwise have spread the virus. As we heard this morning, breaking that transmission chain is so important.

[Matt Western]

I thank the Minister for giving way—she is being very generous. I have an observation: I visited our testing centre at the Ricoh Arena in north Coventry, which serves the whole region of Warwickshire and Coventry. In the hour I spent there yesterday, only 16 cars went in. There was clearly a lot of capacity—a big facility has been established there—and very professional people on site, but there must be a disconnect between the capacity she describes, which I saw, and what is being fed through to those centres. The numbers that she describes are huge, but I am not seeing that on the ground.

[Jo Churchill]

I think what we are all seeing on the ground is that demand has become exponential in the past few weeks. It is therefore a question of the system catching up, but it is important that the Government assess the risk factors and continue to protect healthcare workers and members of the social care workforce first to ensure that we are protecting the most vulnerable in society with the capacity that we have, and then begin to move through to other key workers. We need to have a risk stratification approach as the numbers increase.

This country’s population is in the region of 67 million. Even with a testing rate at 500,000 per day, it would take some weeks to get through that. There has to be a marrying of the testing capacity within the testing facilities and the ability of the labs to have the throughput that backs up behind it. We are doing an enormous number of tests, and it has been noted that we actually have a larger throughput than Germany, Italy, Spain and France.

[Mr Ben Bradshaw (Exeter) (Lab)]

The Minister mentions Germany. I have just come back from Italy. Why is it that Germany and Italy have such lower numbers than the UK?

[Jo Churchill]

With the greatest of respect, I will move on, because we are somewhat going away from the regulations we are discussing. I was asked specifically about the test and trace figures in and around the north of England, rather than those stretching across Europe.

[Mr Bradshaw]

If the Minister will allow me—

[Jo Churchill]

No, I am sorry, but I will not give way.

The north of England regulations were also amended on 2 and 8 September. The amendments made on 2 September removed certain local authorities or specified wards from the protected area under the regulations, following the decrease in incidence rates of the virus in those areas. On 8 September, the regulations were amended to enable certain businesses and venues to reopen, in line with elsewhere in England. The remaining restrictions continue to prohibit people from different households meeting in each other’s homes or private gardens, and to stop a small number of businesses reopening—for example, nightclubs remain closed in the relevant parts of the north of England, as is the case across the rest of England, for quite sensible precautionary reasons.

Let me conclude by recording on behalf of the Government our thanks to the people of Lancashire, Greater Manchester and West Yorkshire, particularly the health and social care workers—indeed, all key workers in those areas—for their ongoing hard work and dedication in keeping our vital services running and for saving lives throughout these unprecedented times.

Question put and agreed to.

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) Regulations 2020 (S.I. 2020, No. 828).

Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) (Amendment) Regulations 2020

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) (Amendment) Regulations 2020 (S.I. 2020, No. 846).—(Jo Churchill.)

HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS ON GATHERINGS) (NORTH OF ENGLAND) (AMENDMENT) (NO. 2) REGULATIONS 2020

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Restrictions on Gatherings) (North of England) (Amendment) (No. 2) Regulations 2020 (S.I. 2020, No. 865).— (Jo Churchill.)

HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (NORTH OF ENGLAND) (AMENDMENT) REGULATIONS 2020

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (North of England) (Amendment) Regulations 2020 (S.I. 2020, No. 897).—(Jo Churchill.)

HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (NORTH OF ENGLAND) (AMENDMENT) (NO. 2) REGULATIONS 2020

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (North of England) (Amendment) (No. 2) Regulations 2020 (S.I. 2020, No. 931).—(Jo Churchill.)