Local Contact Tracing

Luke Evans Excerpts

Wednesday 14th October 2020 Commons Chamber

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

I agree with everything my hon. Friend the Member for Wirral South (Alison McGovern) said.

NHS Test and Trace is not working. Billions of pounds have been poured into a system that has sidelined existing local expertise in primary care, public health and science. The resulting system is labelled NHS Test and Trace, but it has hardly anything to do with the NHS. Stop denigrating the NHS by associating it with this failing system.

We are stuck in this world of uncertainty, with a rising infection rate and the virus out of control, and we are without the ability to properly track it, as my hon. Friend has just described. It is like “Groundhog Day”. Until we have a vaccine, we will not get out of this without a functioning track and trace system.

We are the fifth richest economy in the world, and we have one of the best healthcare systems. We have leading science research universities, yet we have spent all this money contracting out the system to Serco. Now, on top of that, we are spending millions of pounds bringing in private contractors to try to sort out the mess. It costs more in one week than we pay an experienced nurse in a year. It is a disgrace, and it feels like a wasted opportunity to build on the existing expertise and experience to strengthen the local systems in primary care and local authorities. Doing that now is the only way out of this nightmare scenario.

The outbreaks we have seen in the universities in Newcastle, for example, were not identified by the national system—it seems incapable of doing that at present. The outbreaks were identified based on local intelligence and local knowledge, and by piecing the pieces together. We know that co-operation between local health services and authorities is the way to control infectious diseases. GPs, NHS and public health laboratories, and local public health officers all play a key role. Winter is approaching and GPs will be the people who can see the overlap in covid symptoms such as fever and a dry cough, and the classic flu symptoms of fatigue, sore throat and headaches. We need that integrated public health expertise to truly make this testing and tracking system work. We have 1,200 primary care networks in England. They will be best placed not only to run test, track and trace, but to deliver the vaccine when we finally have it—we will be ready for it.

[Dr Luke Evans (Bosworth) (Con)]

I hear time and again from this side of the House people talking about giving more to the primary care networks. As a GP, I worry that this could be a concern for my public health colleagues as well because they already serve a function—of non-covid health service. I would be interested to hear the thoughts of others on this concern: what happens if we keep putting more pressure on public health and GPs, who are already dealing with non-covid stuff? How do we deal with this? It makes a lot of sense to bring in a national service to try to do that; we did that with the Army to help with test, track and trace. What does the hon. Lady think about the possibility of extra pressure there?

[Catherine McKinnell]

Absolutely, spend the billions of pounds that we have wasted—spend it on bumping up the capacity and ability of our local GPs and health services, which can do a better job.

I wish to say a word about asymptomatic carriers. Research published by University College London last week found that 86% of those sampled who had tested positive for covid-19 between April and July had had no symptoms—that includes cough, fever or loss of taste and smell. So many people who are asymptomatic test positive, as we have seen at Northumbria University, and that is hugely concerning. It shows that we need a much more robust and expanded testing strategy to control the virus.

What are the Government doing to ensure that we can capture these silent spreaders? Is the system anywhere close to having the capacity to address this, given that we cannot even test those who have symptoms and have been instructed to take a test? The Government wasted the time we spent in national lockdown and failed to get the apparatus of proper track and trace system in place once those restrictions were finally relaxed. We are now living with the consequences of that decision. As we now appear to be entering another era of harsher restrictions across much of the country, the Government owe it to the people who continue to endure hardship, uncertainty, loneliness and bereavement not to waste this time again.

Public Health: Coronavirus Regulations

Luke Evans Excerpts

Tuesday 13th October 2020 Commons Chamber

[Matt Hancock]

Yes, absolutely, and I will go further than that: we look at this at sub-district level, if that is appropriate. In High Peak we put four wards into level 2 and the rest of the wards stayed in level 1. So we are prepared to look at the sub-district level if that is appropriate. Some districts within North Yorkshire have individual outbreaks in individual institutions that we are managing, and we should not mistake that for general community transmission and therefore put those areas into a higher level than is necessary. I am happy to go through the local epidemiology from near Thirsk that affects my hon. Friend’s constituency.

In a sense, that brings us to the point of these local covid alert levels. These are the first statutory instruments to be debated under our commitment to consult Parliament on significant national measures that have effect in the whole of England or are UK-wide and, wherever possible, to hold votes before the regulations come into force. That is what we are doing today.

Local action has proved to be one of our most important lines of defence. Where firm action has been taken—for instance in Leicester, or in Bolton, where we flattened the curve—our local approach has inevitably produced different sets of rules in different parts of the country, as my right hon. Friend the Member for Sutton Coldfield (Mr Mitchell) set out. We have already moved towards simpler national rules that are centred on the rule of six, and we are now acting to simplify and standardise the rules at a local level.

The regulations set out three levels of alert: medium, high and very high. The medium alert level, which will cover most of the country, will consist of the current national measures. This includes the rule of six and the closure of hospitality at 10 pm. The high alert level reflects the interventions in many local areas at the moment and that aims to reduce household-to-household transmission by preventing social mixing between different households indoors, with the rule of six outdoors. That is super-simple: no household mixing socially indoors and the rule of six outdoors.

The very high alert level will apply where transmission rates are rising most rapidly and where the NHS will soon be under unbearable pressure without further restrictions. In those areas the Government will set a baseline of prohibiting social mixing, while allowing households to mix in public outdoor spaces, because that is where the risk of transmission is lowest, as long as the rule of six is followed. That baseline is set out in the very high alert level regulations being considered today. Pubs and bars will be closed, and we will advise against travel into and out of very high-risk areas.

We also offer a package of support for individuals, businesses and councils. That includes more support for local test and trace, which many have asked for, more funding for local enforcement and the offer of help from the armed services, as well as the job support scheme announced by the Chancellor. That is best done as a team effort and, wherever possible, we want to build local support on the ground before we introduce these measures. So in each area we will work with local government leaders on the extra measures that need to be taken. We do not rule out further restrictions in the hospitality, leisure, entertainment, or personal care sectors, but retail, schools and universities will remain open.

[Dr Luke Evans (Bosworth) (Con)]

On buying-in the local community, would the Secretary of State consider having a Government postcode checker so that people know exactly where they should be, in having the three tiers?

[Justin Madders (Ellesmere Port and Neston) (Lab)]

That was my idea.

--- Later in debate ---

[Dr Luke Evans (Bosworth) (Con)]

I take this opportunity to thank all those in my constituency who followed the rules when Leicestershire was being threatened with a lockdown. Through their dedication and their following of the rules, we have managed to avoid it for now.

During that threat of lockdown, one of the key messages I brought to this House was the importance of making sure that two key messages get through: where the affected area is and the measures that come into place. I am therefore pleased to hear today that we have a simplification and a tier-based system that will allow our constituents to understand the measures in place. With a postcode checker as well, it is even better. That was built, and I fed into the review led by Dame Mary Ney. She has produced a document on good practice for areas going into lockdown. I suggest that Members have a look at that document, because they can hold the Government to account by the very nature of what is written in it.

I was pleased to hear yesterday—it was repeated again today—that the Government acknowledge the difficulties of balancing health and the economy. It is a simple temptation to say, “Let’s just do it by generations and protect the shielded”, but the evidence shows that we cannot do that. Generational spread does happen, and that is when the threat comes to our elderly and our shielded.

What has happened this time is that we have a more nuanced response from the Government, and I welcome that. It is good medicine to change as things progress, but I want to focus on the future. I have some short-term suggestions for the Government, such as making sure we are clear with our signage about indicative dates, changes and accountability. We need to be clear about the principles behind the decisions we take, so that when someone asks, “Why can’t I sing?”, they can be told, “Well, singing transmits the virus four times further.” When those principles are clear, it becomes obvious how to interpret the guidelines.

We want certainty for sectors, whether that is the wedding industry, events, the aerospace industry or the travel industry. They need certainty on exactly what will happen for them with guided points. They welcome timetables and they understand if things move, but a clear direction at least is important.

I welcome the aim for a vaccine, but until we get there I agree that a plan B would be useful. We have talked about near patient testing, and I have raised those questions in this House. Could it be that, in the future, before we come to speak in the Chamber, we have 20-minute saliva test—it is bound to be negative—and then come in and carry on with our day-to-day life? Until we get there, I urge the Government to read the Health and Social Care Committee’s recommendations on dealing with non-covid sites. At the end of the day, experience teaches us to help those who cannot and to empower those who can. That should be the message that the Government take forward.

Covid-19 Update

Luke Evans Excerpts

Monday 5th October 2020 Commons Chamber

[Matt Hancock]

That is exactly what we are doing—absolutely. For instance, this morning I also spoke to Sadiq Khan, the Mayor of London, about how we continue to strengthen the join-up between the national and local approaches. I entirely agree with the hon. Lady that that is incredibly important.

[Dr Luke Evans (Bosworth) (Con)]

Until we get a vaccine, the House knows that it is about following the rules of hands, face, space and get a test, but my right hon. Friend will also know that there are different types of test out there. Can he comment on the plans for future testing and on what updates there might be? We have heard talk of saliva testing, finger-prick testing or, possibly, that we may be able to allow individuals to deal with covid themselves.

[Matt Hancock]

We are doing a huge amount of work to trial these next-generation tests at the same time as expanding the current testing capability. For instance, if we have to have a test, would it not be easier if we just needed some of our saliva rather than to having to put the swab all the way up our nose and down the back of our throat? These sorts of improvements in technology are in the pipeline and we are working incredibly hard to bring them to bear as soon as possible.

Covid-19

Luke Evans Excerpts

Tuesday 1st September 2020 Commons Chamber

[Matt Hancock]

We are working very closely with the Department for Education to have a successful and safe return of universities, just as, from today onwards, we are seeing a successful and safe return of schools.

[Dr Luke Evans (Bosworth) (Con)]

I am really pleased to hear my right hon. Friend talk about the largest flu vaccine programme ever being put in place, particularly for those over the age of 50. In normal times that would be a challenge and it is going to be even more difficult in the light of covid. I would be grateful if he would talk about the practical steps he is taking to make sure that things are simple and secure enough to deliver it, but not too prescriptive for those delivering the vaccine; whether or not adequate funding is in place to support the flu vaccine; and any other steps he has taken to make sure we have a successful flu vaccine campaign over the winter, given the covid situation.

[Matt Hancock]

We are putting enormous sums into the flu vaccine programme and have released extra funds to buy more vaccine. We are deregulating and making sure that we have a wider group of people—who will all be clinically qualified—who can administer the flu vaccine; those regulations will come before the House shortly. My hon. Friend is right to say how important it is to get the communications out that everybody should get a flu jab. We will start with the free jabs for the over-65s, the frontline healthcare workers and those who are clinically vulnerable, and we will then move on to the 50 to 64-year-olds. But everybody, of every age, can get one—it is just not free to others. I encourage everybody to get one. We must tackle these online rumours that spread the pernicious anti-vax lies.

Coronavirus Response

Luke Evans Excerpts

Monday 20th July 2020 Commons Chamber

[Matt Hancock]

I am pleased to congratulate all those working in Buckinghamshire—the council, the CCG and the other parts of the NHS—on their work to keep Buckinghamshire safe. The number of infections across Buckinghamshire is very low now, and we want to keep it that way.

I also take this opportunity to answer part of the question from my hon. Friend the Member for South Derbyshire (Mrs Wheeler) that I did not answer. More powers, as well more data, will be available to local areas to take more local action themselves, without having to refer up to the Secretary of State to use my powers. Of course, national Government hold further powers for significant action, which we have had to use just the once, but we will give local areas more powers, as well as more data, to be able to grip this issue locally.

[Dr Luke Evans (Bosworth) (Con)[V]]

I am grateful to my right hon. Friend for his announcement today and congratulate the scientists looking into the research that will hopefully solve this covid problem. On Friday, he announced a review into Public Health England deaths data, which is incredibly important. Does he have any indication of how inaccurate that data may be? If so, how is that impacting future planning for the covid response?

[Matt Hancock]

I do not have anything further to add yet. The problem was that anybody who had had covid at any point and then subsequently died, whether or not from covid, was being counted in this data. Right at the start of the crisis, that was a perfectly reasonable approach to take, but clearly it needs to be reviewed. It is likely that the number of deaths has been overestimated on this measure, hence the urgent review, and I hope to have more information this week.

Covid-19 Update

Luke Evans Excerpts

Thursday 16th July 2020 Commons Chamber

[Matt Hancock]

The report was incredibly important in making sure that we cast ahead and look at all the challenges facing us, but it took the assumption that there would be no action from the Government should the R go to 1.7 and it is our stated policy not to allow that to happen. So although the report showed a worse-case scenario based on a set of assumptions, we are constantly vigilant.

[Dr Luke Evans (Bosworth) (Con) [V]]

I appreciate the Secretary of State’s answer to several questions about the learning he has done, because 10 days ago I asked him about information for the people of Hinckley and Bosworth, in Leicestershire. They want to know where the boundary is and what the implication is of any changes. Would he be kind enough to point out exactly where the boundary is? For the people who are now out of lockdown, will he say what that means in terms of the measures they are taking, so that they have a clear message to take home tonight?

[Matt Hancock]

I am happy to give that answer, which is very clear. For those in the city of Leicester, and in Oadby and Wigston, the position is that of the measures that I have set out: releasing, on 24 July, the closure of non-essential retail and of schools and childcare facilities, but keeping all the other measures in place. Those not in those two specific areas return to the same measures that the rest of the country is living with, except of course that we will keep the higher vigilance, the higher level of testing and the communications in those areas. The decisions on this geography were taken on the advice of local council leaders. While I have been on my feet, I have seen that the Mayor of Leicester has made some comments on this. I did ask him whether he wanted to put forward a different geography within the city of Leicester and he declined to do so, but we work very hard and as closely we can with Leicester and especially with the public health officials there, who are doing a valiant job in difficult circumstances.

Coronavirus

Luke Evans Excerpts

Tuesday 7th July 2020 Commons Chamber

[Matt Hancock]

Yes, we have a project under way on this. It is something that the Chair of the Science and Technology Committee has been working on for weeks as well. Again, I will write to the hon. Member with the full details of the plan to make this happen.

[Dr Luke Evans (Bosworth) (Con) [V]]

May I take this chance to thank the people of Leicester and Leicestershire, the police and public health services for dealing with the local lockdown that has been implemented? When it comes to a local lockdown being announced, the people of Hinckley and Bosworth need two vital pieces of information: what the measures are, and where the boundary is. The Government were quick to put up on their website what those measures were, and they rightly allowed Public Health England and the councils to draw the boundary. What lessons has the Health Secretary learned from the Leicester lockdown, including about passing on information quickly, to be used in future lockdowns , which may well happen in the rest of the country?

[Matt Hancock]

My hon. Friend is right to praise the work that has been done by Leicestershire County Council, as well as by the city council, with which we are working hand in glove. We are looking at the way that the lockdown was brought in at pace in Leicester, to ensure that, should we need to do that again, it is a yet more effective process. One of the lessons is that the boundary for the action is a critical piece of information. We managed to publish that overnight, within about 12 hours of the decision being publicised. I pay tribute to the county council, which led on that decision. Ensuring that we have both the actions and the boundary ready as soon as possible is critical, because, naturally, local people immediately want to know whether they are in the lockdown area.

Coronavirus and Care Homes

Luke Evans Excerpts

Tuesday 19th May 2020 Commons Chamber

[Matt Hancock]

I am a massive supporter of the living wage and, of course, the increase in the living wage that we have seen since its introduction in 2015 has had a very positive impact on the pay of the lowest paid people in our country right across the board, including many in care homes. I think it is an excellent policy and I am delighted that we have brought it in.

[Dr Luke Evans (Bosworth) (Con) [V]]

The £600 million presented by the Secretary of State for infection control is very welcome, and having a named clinician to help support care home staff is particularly important. That came out in the Health and Social Care Committee when Professor Lum talked about what happens in Hong Kong. One of the lessons they learned several years ago was to have a named person in a care home, but also to do yearly, effectively, virus drills, like a fire drill. Would the Secretary of State consider putting that in place to help to deal with the impact of possible second waves?

[Matt Hancock]

Yes, we are doing a huge amount of work now to ensure that there is protection in the future should there be a further increase, and in particular in advance of winter in case there is strong seasonality to this disease. As a clinician himself, my hon. Friend understands the importance of these areas and we will absolutely take the idea he put forward and run with it.

Covid-19

Luke Evans Excerpts

Tuesday 12th May 2020 Commons Chamber

[Dr Luke Evans (Bosworth) (Con) [V]]

It is nice to have the chance to put on record my thanks to constituents in Bosworth and the key workers. A couple of weeks ago, I wrote to the GPs, the pharmacies, indeed the police, the schools, the care homes, to congratulate them on the work they are doing, and continue to do. I am most grateful for all that they do.

It is fair to say that the virus reaches all areas of our lives, and in turn all areas of Government, and that brings pain—pain with the loss of businesses, pain with the loss of jobs, but, most importantly, pain with the loss of lives. However, out of crisis comes opportunity, and there are some positives. I would like the Government to take those forward. I envisage that in the form of a time-limited department called the “department of virus legacy”.

At the end of April, I wrote to the Cabinet Office and the Prime Minister, because I think it is so important, as we have heard in these debates, to encapsulate and draw on all the positive aspects that have come out of this crisis. We have had a revolution overnight, rather than the usual evolution. In my sector as a GP, literally overnight everyone has begun teleconferencing. That is something that the industry has tried to do for over a decade, and has not been able to achieve—and just like that, it has happened.

Pharmacies are now all digital, with electronic prescribing. In my role on the Health and Social Care Committee, I asked all the witnesses we have had what positive aspects had come out of this. Those in cancer care talked about how they were able to bring 10 teams into one hospital to deal with a patient, and maternity talked about the fact that they have actually had more contact because they can do remote teleconferencing. It is the same with mental health. There are positives out there, and that is just in the sector that I come from.

More widely, we have looked at remote working. We have looked at the societal benefits of now knowing your neighbour, caring for your neighbour and caring for your community. These are absolutely critical things, which we need to embed into our society. To do that, I urge the Government to consider establishing such a department.

Legacy planning, as we found in the Olympics, is absolutely critical. Now more than ever we have the time-limited opportunity to enshrine, post virus, the positive changes in the fabric of our policies and, in turn, our Government and society. To the Minister listening I say, “I hope you will take this on board when you hold discussions with the rest of Government.”

Covid-19 Update

Luke Evans Excerpts

Tuesday 5th May 2020 Commons Chamber

[Matt Hancock]

We now have one of the largest testing capabilities in the world; we are testing more people per day than Germany, and the whole country should be reassured by that fact. Of course there are individual examples of where the logistics go wrong; that is natural in any very large system. I would be very interested if the hon. Lady could send me the details of those specifics, and then we will look into them. But what I would say is that the availability of testing across the board is now huge. It is big enough to start the test, trace and track programme. We are piloting that, as the hon. Lady knows, in the Isle of Wight from today and then we will roll it out across the country.

[Dr Luke Evans (Bosworth) (Con) [V]]

In an earlier answer, the Secretary of State kindly went through the definitions of all the different vulnerable groups. Definitions are really important, especially as we start to consider releasing the lockdown. When that point comes, will he be crystal clear about exactly who is entitled to do what and when and ensure that everyone in the public knows that?

[Matt Hancock]

Yes.