Coronavirus

Matt Hancock Excerpts

Thursday 25th March 2021 Commons Chamber

[The Secretary of State for Health and Social Care (Matt Hancock)]

I beg to move,

That the Health Protection (Coronavirus, Restrictions) (Steps) (England) Regulations 2021 (S.I., 2021, No. 364), dated 22 March 2021, a copy of which was laid before this House on 22 March, be approved.

[Madam Deputy Speaker]

With this we shall discuss the following:

Motion 3—Coronavirus Act 2020 (Review of Temporary Provisions) (No. 2)—

That the temporary provisions of the Coronavirus Act 2020 should not yet expire.

Motion 4—Coronavirus Act 2020 (One-year Status Report)—

That this House has considered the one-year report on the status on the non-devolved provisions of the Coronavirus Act 2020.

Motion 5—Proceedings during the Pandemic (No. 6)—

That the Order of 2 June 2020 (Proceedings during the pandemic (No. 2)), as amended on 1 July and 22 October 2020, the Order of 4 June 2020 (Virtual participation in proceedings during the pandemic), as amended on 1 July, 2 September, 22 October and 30 December 2020, the Order of 3 November 2020 (Proxy voting during the pandemic (No. 2)) and the Order of 25 February (Sittings in Westminster Hall during the pandemic) shall have effect until 21 June.

[Matt Hancock]

Over the past year, we have all been engaged in a monumental national effort to fight coronavirus, which has required the House to take extraordinary measures in response to this extraordinary threat. Today, we debate our road map to recovery and what is legally needed to take the cautious but irreversible path out of this pandemic. We propose to remove some of the emergency powers that the House put in place a year ago and set the steps of the road map that my right hon. Friend the Prime Minister has set out into law, replacing the existing national lockdown. We are able to take this action and propose these measures thanks to the perseverance of the British people in following the rules and the success story that is our UK vaccination programme, which has now vaccinated more than 28.6 million people—55% of all adults in the United Kingdom.

Hospitalisations are now at their lowest point since September and are down 90% since the peak. To put this into context, there are today just over 5,000 people in hospital with covid. At the peak, just two months ago, there were just under 5,000 new admissions with covid each day. Deaths are now at their lowest point since October and they are down 94% since the peak. The research published today shows that our vaccination programme has already saved the lives of more than 6,000 people across the UK, up to the end of February.

The success of the vaccination programme means that we are now able to carefully replace the short-term protection of the restrictions that we have all endured, with the long-term protection provided by the vaccine. Our goal is to be cautious yet irreversible. I must tell the House, Madam Deputy Speaker, that while I am still, by nature, an optimist, there remain causes for caution. Cases are rising in some areas and they are rising among those under 18. There are early signs of cases flattening among the working-age population, too.

I am delighted that uptake of the vaccine is now 95% among over-60s and that protection against dying from the vaccine is around 85%. Both of those figures, 95% uptake and 85% protection, are higher than we could have hoped for, but while we are confident that we have broken the link between the number of cases and the hospitalisations and deaths that previously inevitably followed, no vaccine is perfect and take-up is not 100%, so that link, while broken, is not yet severed.

New variants also remain a risk because we do not yet know with confidence the impact of the vaccine against the new variants. We all want these next few months to be a one-way route to freedom, so as we restore the freedoms that we all cherish, we must do so in a way that does not put our NHS at risk.

[Mr Mark Harper (Forest of Dean) (Con)]

On that point about the take-up and the efficacy, one thing that the chief medical officer said was that the timings in the road map were driven by some of the modelling that the Government had seen. The assumptions behind that modelling I think came from February and are much more pessimistic than what we now know about take-up and efficacy. Can the Secretary of State ensure that that modelling is redone with the new assumptions to see whether that would justify a faster unlocking of the country, which is important to save jobs, save businesses and maximise the economic future of our young people?

[Matt Hancock]

While modelling is obviously something that is looked at, the observation of the actual data is I think the best guide. The good news is that the number of deaths has fallen very sharply and continues to fall sharply, and the number of hospitalisations has fallen sharply—not quite as sharply as deaths, but nevertheless sharply. Critically, the link has broken, so the weight that we place on the number of cases as an indicator is not nearly as great as it was before, because it used to be inevitable that that led to hospitalisations and deaths.

The reason for the timings in the road map is so that, after each step, we can see its impact before being able, carefully, to take the next step. That is the core reason for the timings in the road map—four weeks to see the impact of a step, and then one week to give warning of the next step. It is that, rather than the modelling, that I put the stress on for the timings in the road map.

[Mr Harper]

To come back very briefly on that final point, if deaths and hospitalisations are what is important, is the Secretary of State able to confirm the information that was published in The Times this morning on the modelling by SPI-M—the Scientific Pandemic Influenza Group on Modelling, the Government’s advisory committee —showing a dramatic reduction in hospitalisations and deaths taking place over the next week and throughout April? That really drives my assumption that we could go a bit faster. Is he able to confirm that for the House?

[Matt Hancock]

I have not seen that article in The Times—I have read parts of The Times, but not that bit—so I cannot confirm, but I can write to my right hon. Friend with details on this point. However, I would stress that the focus only on modelling is not really where the ultimate judgment on the timings of the road map is; it is about being able to observe progress and then take the next step with confidence. The central point here is that cases may well rise. In fact, I would say cases are likely to rise, not least with schools going back. The critical thing is that the automaticity—cases going up having an impact on hospitalisations—is no longer there. However, if cases got extremely high, even with a much weaker link from cases to hospitalisations, that is something we clearly have to guard against and it is set out in test 3 of the Prime Minister’s four tests.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

The Health Secretary has talked of protections for the over-60s. Can he appreciate why, for some of our constituents who crave a foreign holiday, it looks very odd that a Stanley Johnson loophole seems to have been negotiated, so that someone over 60 with their own property abroad can get around that? Can he also appreciate that a lot of our constituents think that these measures—the Prime Minister used to talk about women who look like bank robbers—have now mandated us all to wear these masks?

[Matt Hancock]

I am not quite sure what point the hon. Member is making, but this is what I was going on to say. The critical point where I ended the exchange with my right hon. Friend the Member for Forest of Dean (Mr Harper) is that we must restore the freedoms that we all cherish, but in a way that does not put the NHS at risk. Throughout the crisis, we have successfully protected the NHS, and I am delighted to be able to inform the House that there are now record numbers of NHS doctors and NHS nurses in England. New data published this morning show that there are over 300,000 nurses in the NHS in England for the first time in its history. So we have protected our NHS and we are delivering our commitments to it. Nobody wants to have to reimpose measures, as we have sadly seen elsewhere in Europe only this week, so we must follow this cautious and, we hope, irreversible road map.

[Mr William Wragg (Hazel Grove) (Con)]

My right hon. Friend mentions data on occurrences within the NHS. Does the NHS have data to suggest how many people have, sadly, died from covid in NHS hospitals three weeks after receiving their first dose of a covid vaccine?

[Matt Hancock]

Yes, the data on the impact of the vaccine—including side effects from the vaccine and the rare occasions when, sadly, people die after having had the vaccine—are published by the Medicines and Healthcare products Regulatory Agency. If there are any data in this area that are not published but my hon. Friend would like to be published, he can write to me and I would be very happy to look into publishing them. Essentially, we take an attitude of being as transparent as possible, because there are side effects to the vaccine as there are to all pharmaceutical drugs and we want to be completely open and transparent about those side effects—essentially to reassure people that the risks are extremely low.

[Sir Christopher Chope (Christchurch) (Con)]

My right hon. Friend answered a question from me on this very subject by saying that the data was not available. I cannot understand why crucial data—such as the number of people who have been vaccinated for more than three weeks, who are then admitted to hospital and subsequently die—is not collected. Why is that?

[Matt Hancock]

This data has been collated recently; it is in the so-called SIREN study from Public Health England. I am very happy to look into exactly the data that my hon. Friends are looking for and, if we have it, to publish it. I think we have what has been asked for, but let us try to do this by correspondence to ensure that we get exactly what is being looked for. On the face of it, my hon. Friend is absolutely right; it is exactly the sort of thing that we are looking at, but I want to make sure that we get the details right.

As I was just saying, each step of the road map is guided by the data and the progress against the four tests. We were able to take the first step on 8 March, when we allowed the return of face-to-face education in schools, relaxed the rules on two people gathering outside for recreation and allowed care home residents to nominate a single regular visitor, supported by regular testing and personal protective equipment.

The regulations before the House today ease restrictions further—again, in a careful and controlled way. First, they allow us to put in place the remaining measures of step 1, which will come into force on Monday. That means that the “stay at home” rule will end and six people or two households will be able to meet outdoors, and outdoor sports can resume. The regulations also commit the remaining steps of our road map into law, so that we can gradually ease restrictions at the right time before eventually removing them all together, which we hope to be able to do on 21 June.

[Mr Richard Holden (North West Durham) (Con)]

My constituents have been in touch to raise concerns about these measures being in place for longer than absolutely necessary, but they have also been raising concerns about long covid. Will the Secretary of State respond to my constituents on both issues, and explain to the House what he and his Department are looking into to better understand the effects of long covid on the population?

--- Later in debate ---

[Matt Hancock]

We clearly want to lift these measures as soon as is reasonably possible. My goal is that we will eventually see covid as something that has to be managed rather like flu. We do not put in place restrictions on normal life to tackle flu, but we do have a regular vaccination programme. With vaccines, that is where I hope we will be able to get to.

[Several hon. Members rose—]

[Matt Hancock]

I just want to answer my hon. Friend’s second point before taking further interventions. His point about long covid is important. In fact, the National Institute for Health Research, which has done a brilliant job during the pandemic, has today put out a £20 million call for further research and diagnostics, including patient and public involvement, so that long covid can be properly understood, and people who catch covid and have symptoms over a long time—which I know can be deeply debilitating for some people—can get the support they need on the NHS.

[Greg Clark (Tunbridge Wells) (Con)]

My right hon. Friend mentions the fact that we live with flu every winter and act against it. Has he made an assessment of what level of hospital admissions would be consistent with protecting the NHS?

[Matt Hancock]

It is very difficult to know in advance. At the peak of this pandemic, we had 38,000 patients in hospital across the UK at any one time with covid, but of course that meant that other non-urgent treatments had to be delayed. There is a question of the trade-off and how much treatment is delayed. In a bad flu season, elective operations and non-urgent treatments are delayed. That is one way in which the NHS manages through a difficult flu season in winter. Measures like that will be necessary if we have an increase in covid cases.

If we have learned anything in the last year, we have learned that we have to live with risk as a society. That is a reality, so the goal and the strategy are to invest in the NHS so that it has more capacity, make sure that it can expand capacity and make sure that we have the vaccine effort and the continued efforts that people will no doubt take personal responsibility for, such as mask-wearing—and people will be highly likely do that to protect themselves and others, after the experience we have just had. I want to get to a point of personal responsibility plus the vaccine plus the test and trace programme, so that people can be regularly tested and we can use that to break the chains of transmission. I want to manage covid in that way, while restoring our freedoms. That is the best way, once we have made our way carefully down this road.

[Mr Steve Baker (Wycombe) (Con)]

What my right hon. Friend has just said is extremely encouraging, and I am very grateful. Will he confirm that the reason that step 4 is not in the regulations is that it does not need any regulations? It is freedom from these regulations.

[Matt Hancock]

Yes—that is a very good way of putting it; in fact, it was on the next page of my script. It is a pleasure to be as one with my hon. Friend after all this time, and I hope very much that he joins us in the Lobby later.

[Mr Baker]

No comment.

--- Later in debate ---

[Matt Hancock]

I am an optimist, as I just said.

Let me carry on detailing the purpose of these measures. Step 2 allows non-essential retail and personal care services to reopen. We have said that that will happen not before 12 April. It will also allow the reopening of leisure services, indoor leisure such as gyms, and self-contained accommodation. Step 2 also sees the reopening—outdoors—of our pubs and restaurants, which I know so many of us are looking forward to.

Step 3 will lift restrictions on meetings outdoors, subject to a limit of 30, and up to six people, or two households, will be able to meet inside. Indoor hospitality, indoor entertainment and all other types of accommodation will be able to open their doors once again. Step 4 will begin no earlier than 21 June. This is the final stage in the road map, because, bolstered by a mammoth testing effort and capacity and by the protection of the vaccination, that is when we aim to remove all legal limits on social contact and restore our freedoms once again.

I know how hard these restrictions have been. I know they have meant missing out on special moments with loved ones and putting important events on hold, and they have also taken a significant economic toll, so we do not want to keep them in place any longer than we judge we have to. I am therefore pleased to say that these road map regulations will expire at the end of June.

Let me turn now to the renewal of the temporary provisions in the Coronavirus Act 2020, which are also before the House today. The Act has been a crucial part of our response to this virus. It helped us to protect the NHS in its hour of need, to keep public services, courts and local democracy running and to offer the financial assistance that has been a lifeline to so many people.

Some provisions in the Act require renewal every six months. If we were to remove the temporary provisions in the Act altogether, we would lose, for instance, measures protecting commercial tenants and renters from eviction, we would not be able to run virtual court hearings, which are an integral part of maintaining the rule of law, and people would not be able to receive statutory sick pay for the full period for which they are required to self-isolate. So there are some important technical provisions that allow for the running of public services, given the social distancing we have at the moment.

[Dawn Butler (Brent Central) (Lab)]

The word “crucial” has been doing a lot of heavy lifting in the Minister’s speech. Is it not correct that if these measures are voted down today, the Government would have 21 days to bring a new Bill to Parliament? Is it not also correct that a lot of what we are relying on comes from other legislation and not actually the Coronavirus Act?

[Matt Hancock]

Absolutely. The main provisions under which we put in place the lockdown come from the Public Health (Control of Disease) Act 1984, not the Coronavirus Act. The mainstay in terms of the Coronavirus Act is to allow us to support people and public services. For instance, furlough is in the Coronavirus Act; that is not up for renewal, because it is a permanent part—it is for the full period of the Act. Nevertheless, in terms of being able to pay statutory sick pay to people when they are self-isolating, I am asking the House today to renew that provision, and I think that we must.

I want to stress this point to those who are understandably concerned about the extent of powers in the Coronavirus Act. Although the Act remains essential and we are seeking the renewal of elements of it, we have always said that we will only retain powers as long as they are necessary. They are exceptional powers. They are approved by the House for use in the most extreme of situations and they must be seen in that light. Because of the progress we have made, we are now able to expire and suspend a whole raft of measures in the Act, just as we expired provisions after the previous review six months ago.

We propose to expire 12 provisions in the Act: section 15, which allowed local authorities to ease some responsibilities around social care; section 24, which allowed biometric data held for national security purposes to be retained for an extra six months; five provisions that required information for businesses and people involved in the food supply chain; section 71, which allowed a single Treasury Minister to sign on behalf of all Treasury Commissioners—I know the Whips Office is looking forward to getting its signatures out again. There are two provisions that created a new form of emergency volunteering leave, which we have not needed and are retiring. Section 79 extended arrangements for business improvement districts and section 84 allowed for the postponement of General Synod elections. Those are not needed anymore and we are therefore not seeking to extend them. We only extend that which we think is necessary.

[Munira Wilson (Twickenham) (LD)]

I welcome the expiry of some measures, particularly the social care easements, which were discriminatory against the most vulnerable in our society. Will the Secretary of State accept that under the Coronavirus Act we have had 250 people wrongfully charged? The Act is full of far-reaching powers that are not needed. The practical measures he talked about can be brought forward in the next 21 days. As he suggested, the fake news that furlough cannot go on without renewing the Act is just untrue, because that is a permanent provision.

[Matt Hancock]

Furlough is provided for under the Act. As I just said, it is a permanent provision of the Act, but the statutory sick pay is not and I think we should be giving people statutory sick pay to help them to self-isolate.

[Steve Brine (Winchester) (Con)]

The Secretary of State is asking for a further six months under the Act, which is all that we can do. The Prime Minister has been talking in the last few days about the need for section 2, for instance, on the emergency registration of nurses, to help us to deal with the backlog. The same is true of sections 53, 54, 55 and 56 with respect to the courts. In six months’ time, will we need that? Will we have dealt with the backlog in the health service and the courts, or will he need to renew this again in six months?

[Matt Hancock]

That is a good question. The truth is that we have a record number of nurses in the NHS, over 300,000, in part because the Act allowed for their emergency registration much more swiftly than previously. Parts of the Act have allowed us to do good things like that, which everybody would like to see. When we come to retire the Act, which we must within one year and preferably within six months, we will need to make sure we can continue to do that sort of thing to ensure that nurses can be enrolled into the NHS as easily as possible. I cannot answer whether we will be retiring it in six months. My preference would be yes, but given the last year I think a prediction would be hasty.

[Steve Brine]

Further to that point, may I make a suggestion to my right hon. Friend? The expansion of the availability of live links for criminal proceedings will be put into the Police, Crime, Sentencing and Courts Bill, so that will not be needed. The Secretary of State is bringing forward a new health Bill during the new Session. Would that be an opportunity to update that?

[Matt Hancock]

Yes, that is an important point. We have just started the process of working on that. If measures have worked well and we want to keep them because they are good, can we put them permanently on the statute book? That should, properly, take the process of normal primary legislation. My hon. Friend mentions a forthcoming health and care Bill. I look to the Leader of the House and I can see that he is smiling, although I cannot, of course, say whether that Bill will be brought forward until we have a proper sign-off—it is nice to see him looking so handsome there. [Laughter.]Our aim would be to get that on to the statute book, should we bring it forward, in the middle of next year, so there is a shorter-term question of the handling from here to there. We need to do that with the best administrative efficiency that we can, but I am talking here about the less controversial elements of the Act.

[Mr Harper]

I am grateful for the Secretary of State’s judgment and I will try not to test his patience again. He mentioned that there are some very valuable administrative measures. If they were the only things being rolled forward, I do not think people would mind, although my reading of the Act is that the registration provisions for medical staff are in section 89, in the permanent part of the Act rather than the temporary part. The controversial parts include the police powers to detain potentially infectious persons, which the hon. Member for Twickenham (Munira Wilson) referred to, and which have been used unlawfully on a number of occasions. It says in the one-year review of the Act that those are intended to be long-term powers and my right hon. Friend has just suggested that those provisions might be rolled forward a further six months. That is why so many of us are worried. These are extraordinary provisions, not for normal times, and they should be expired at the earliest possible opportunity.

[Matt Hancock]

I actually agree with my right hon. Friend that they should be expired at the earliest possible opportunity. The challenge, especially as we lift measures on all of us, is if there are, for instance, new variants that we need to pin down absolutely—in the same way that a new variant came about in Liverpool and we tackled it. We have not seen any new cases of it, not only because of fantastic local work, but because in lockdown that is easier. Having these very targeted interventions for now is important. Therefore, we have made the judgment that we should propose that they are necessary for now. I know that we disagree on that point, but I suggest that by voting against all these renewals, a whole load of valuable things that he and I would agree on would not be renewed, were that vote to go through.

[Mr Steve Baker]

Will the Secretary of State give way?

[Matt Hancock]

I will just make a little more progress.

We are also suspending three further provisions, although they may need to be restored and called on if required. As well as that, we have completed the six-month statutory review on covid-secure regulations for businesses, the collection of contact details and self-isolation, and concluded that they remain necessary at this time. The Coronavirus Act is temporary, time-limited and proportionate to the threat we face, and we are keeping measures only where they are necessary as we exit this pandemic, and then we can do away with this Act for good.

Throughout the pandemic, this House has also found a way to meet. I cannot wait for the time when this Chamber will be full and rowdy once again as the cockpit of our democracy, where we can almost literally take the temperature of the nation. I may pay for that when I say something particularly unfortunate, but I prefer it, and I think everybody in this House does. After widespread consultation and on the basis of detailed public health advice, my right hon. Friend the Leader of the House has tabled a motion to extend virtual participation and the current proxy voting arrangements until 21 June, the proposed date for the removal of all legal restrictions on social contact. We thank you, Madam Deputy Speaker, and through you the other Deputy Speakers, Mr Speaker and the House authorities for the work that has been done in these unprecedented times to keep people safe here.

The measures before the House today show how we will put the pandemic behind us and restore life to normal. We are on the road to recovery, but we are not at the finish line yet, and by passing these measures, we can keep protecting lives and livelihoods while we get our nation back on its feet once more.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

On a specific point, which I rather hoped the Secretary of State would cover but I anticipate will not, we are obviously very concerned about variants in Europe and the surge that we are seeing there. Is it the Government’s intention to impose restrictions on those coming in from France or Germany—to add either France or other European countries to the red list—or to impose testing on hauliers coming into the country?

[Matt Hancock]

All these questions will be answered as part of the work of the global travel taskforce, which the Prime Minister has announced will be published on 5 April, so I recommend that the right hon. Gentleman waits until then. In answering that final question, I commend the motions to the House.

UK Health Security Agency

Matt Hancock Excerpts

Wednesday 24th March 2021 Written Statements

[The Secretary of State for Health and Social Care (Matt Hancock)]

I wish to inform the House of progress in establishing the UK health security agency and the appointment of its leadership.

In August 2020, the Government announced its intention to create a new body, bringing together the at-scale operational response capability of NHS Test and Trace, the joint biosecurity centre’s intelligence and analytical capability and the public health science and health protection expertise of Public Health England into an organisation focused wholly on protecting people from external threats to this country’s health.

From 1 April, we will formally establish the new UK Health Security Agency (UKHSA). The UKHSA will be this country’s permanent standing capacity to prepare for, prevent and respond to threats to health.

The UKHSA will plan for the risk of future infectious disease pandemics and other major health threats, maintaining this focus both during a crisis and in better times. It will work with partners around the world and lead the UK’s global contribution to global health protection research. The new agency will prevent threats by deploying the full weight of our analytic and genomic capability, on infectious diseases and beyond, and will hold responsibility for our health security scientific capabilities including those at Porton Down and Colindale.. It will respond to the threats we face with speed and scale, including terrorist threats to health, another pandemic or environmental hazards.

The agency will operate with local and national partners to deliver its brief, including building a strong partnership with local government and directors of public health. It will work with the national public health bodies for Scotland, Wales and Northern Ireland, continuing strong collaborative work such as the joint biosecurity centre to support health security for the whole of the UK.

UKHSA will be empowered to hire the very best team possible from around the world. Its chief executive will be Dr Jenny Harries, who has performed brilliantly during this crisis. Dr Harries previously led the public health response to the Novichok poisonings, she played a critical part in the UK’s Ebola response, and last year, as deputy chief medical officer, she delivered the shielding programme which is both incredibly sensitive and has been superbly delivered. Dr Harries’ distinguished career as both a public health physician, and crucially, as a public health leader, make her impeccably qualified for this role.

Ian Peters will be UKHSA’s Chair. Under Ian’s leadership as chairman of Barts Health NHS Trust, the trust has built an impressive track record in life sciences with the combination of private sector, academic and Government capability that is so important to delivering excellence at scale. Ian brings his extensive experience of leadership in the public and private sector to this task, including several years as managing director of British Gas. Both Dr Harries and Mr Peters will be appointed from 1 April.

To protect operational continuity and provide for necessary staff consultations, the transition of responsibilities and capabilities from Public Health England and NHS Test and Trace into the new agency will take place over the coming months, with the UKHSA fully operational from October 2021. Until this date, PHE and NHS Test and Trace will continue to deliver their existing functions.

I will provide a further update in due course on the Government’s wider plans for public health reform, including on arrangements for promoting and improving health.

[HCWS884]

Independent Review into Do Not Attempt Cardiopulmonary Resuscitation Orders

Matt Hancock Excerpts

Thursday 18th March 2021 Written Statements

[The Secretary of State for Health and Social Care (Matt Hancock)]

The Government are announcing today the publication of the Care Quality Commission’s (CQC) report into the use of do not attempt cardiopulmonary resuscitation (DNACPR) decisions taken during the covid-19 pandemic. We would like first to thank the CQC for their swift work on the review, as well as the people, their families, representatives and staff who shared their experiences on such an important and complex issue. A copy of the report is available at: https://www.cqc.org.uk/.

The report follows concerns raised at the beginning of the pandemic around the use of “blanket” DNACPR decisions across groups of people, particularly our most vulnerable. The Care Quality Commission has investigated these concerns.

Sensitive and well communicated DNACPR decisions can be an important part of patient care and end of life experience. It is essential, therefore, that good practice is embedded across the health and care system to build understanding of the role good DNACPR decisions play in high-quality personalised care.

We are pleased to see the numerous examples of good practice, across both health and social care settings, highlighted by the report. We heard about experiences of people and their families seeing health and care providers go above and beyond to overcome the challenges posed by the pandemic.

However, such good practice was not true everywhere. The report tells the stories of people who were denied the opportunity to discuss their DNACPR decisions, as well as of families and carers feeling unable to support their loved ones or challenge DNACPR decisions. This is completely unacceptable.

Inappropriate or “blanket” application of DNACPRs decisions are wholly unacceptable, even in pressurised circumstances. All decisions about DNACPR must, in all circumstances, be made on an individual basis according to need.

We must be able to ensure that people feel equal partners in their care and that staff across all care settings feel well equipped to hold these difficult conversations. We must have processes to ensure that people feel supported to speak up when they have concerns. We support the recommendations of the CQC, including ensuring that staff have the training needed to be able to support people with DNACPR decisions; that there is national guidance and system level oversight; and that people are well informed of what good practice looks like, what their rights are and for DNACPR decisions to be considered as part of good end of life care.

The Government are determined to tackle bad practice and welcome the report’s recommendation for a ministerial oversight group to drive progress on this important issue. We are committed to driving forward the delivery of these recommendations and ultimately ensure everyone experiences the compassionate care they deserve.

[HCWS859]

Health and Social Care Update

Matt Hancock Excerpts

Thursday 18th March 2021 Commons Chamber

[The Secretary of State for Health and Social Care (Matt Hancock)]

With permission, Madam Deputy Speaker, I would like to make a statement on the support that we are giving to the NHS and social care to help recover from the pandemic.

Before turning to that, I want to update the House on vaccine supply and the roll-out, and set out the facts, given some of the speculation that we have seen overnight.

Let me set out the position absolutely straightforwardly. Throughout the vaccination programme, the pace of roll-out has always been determined by the availability of supply. As I have said in the House many times, supply is the rate-limiting factor. The process of manufacturing vaccines is complicated and subject to unpredictability. Because we get supplies out into the field so fast, and run a highly lean delivery system, changes in future supply schedules impact on the weekly availability of vaccine. This has been true throughout. We make public commitments to the goals we can reach according to our best estimates of future supply. That supply goes up and down. We are currently, right now, in the middle of some bumper weeks of supply.

We have now reached the milestone of 25 million vaccinations, within the first 100 days of roll-out, and we have therefore been able to open up invitations to all people aged 50 and above. Yesterday, for example, we delivered over half a million vaccines, and we will do so again today. In April, supply is tighter than it is this month, and we have a huge number of second doses to deliver. During April, around 12 million people, including many colleagues in this House, will receive their second dose. These second doses cannot be delayed, as they have to be delivered within 12 weeks of the first dose. In the last week, we have had a batch of 1.7 million doses delayed because of the need to re-test its stability. Events like this are to be expected in a manufacturing endeavour of this complexity, and this shows the rigour of our safety checks.

We also have a delay in a scheduled arrival from the Serum Institute of India. I want to put on the record my gratitude to the Serum Institute of India for the incredible work that it is doing producing vaccine, not just for us in the UK but for the whole world. Its technology and its capability, which has been approved by the Medicines and Healthcare products Regulatory Agency, is remarkable. The Serum Institute of India is producing a billion doses of the Oxford AstraZeneca vaccine this year. It truly is a partnership that we can be proud of. I also want to put on the record my thanks to both AstraZeneca and Pfizer, who have been remarkable partners in this historic endeavour.

We have committed to targets, it is vital to say, to offer the vaccine to everyone aged 50 and over by 15 April and to all adults by the end of July. I can confirm that we are on track to meet both those targets. I also want to clear up some rumours that have been circulating and give people reassurance. There will be no weeks in April with no first doses. There will be no cancelled appointments as a result of supply issues. Second doses will go ahead as planned. Most importantly, the vaccine data published yesterday show the life-saving impact of this vaccine. It is not just that the vaccines are safe; it is that they make you safe. You are much safer having had one. Shortly, the MHRA will be saying more on this matter, which of course it keeps under constant review.

I know the House will also want to hear some good news from Gibraltar. Throughout the crisis, we have provided Gibraltar with personal protective equipment, testing and a sovereign guarantee for its covid spending. We have also provided Gibraltar with vaccines, as we have all other British overseas territories. I am delighted to be able to tell the House that yesterday Gibraltar became the first nation in the world to complete its entire adult vaccination programme. I want to pay tribute to all Gibraltarians for their fortitude during this crisis, and the kind words of Chief Minister Fabian Picardo, who said yesterday:

“The United Kingdom has played a blinder on vaccinations and we have been among the beneficiaries in the British family of nations.”

I agree.

The vaccination programme has been a success thanks to a team spirit across the British family of nations. It has not always been easy; of course there are challenges thrown at us in what is the biggest civilian undertaking in history, which affects every single one of us. The whole House pays tribute to those who have helped make it happen, including Emily Lawson, Kate Bingham, Maddy McTernan, Ruth Todd, Nikki Kanani, Professor Jonathan Van-Tam, Professor Chris Whitty, Sir Patrick Vallance, Wei Shen Lim, Sarah Gilbert, Andy Pollard, Pascal Soriot, my officials in the Department, colleagues across the House, and so many others who have made this a success.

With 25 million people vaccinated and a clear road map out of lockdown, we are taking careful steps out of this pandemic. Now, there are 7,218 people in hospital with covid across the UK, down from a peak of almost 40,000 just seven weeks ago, the rate of hospitalisations has halved in just the past 16 days, and thankfully, the rate at which people are dying has fallen by a third in the last week.

As a result, I can tell the House that we are, from today, writing to all clinically extremely vulnerable people to let them know that shielding will come to an end on 31 March. I thank all those who have shown such fortitude, and all those who have done so much to look after the most vulnerable. The shielding programme truly has been Britain at its best—pulling together to help those most in need.

I know that colleagues in the NHS and social care are beginning, cautiously, to look to the recovery ahead. I know that everyone in this House is proud of the life-saving work we have seen in hospitals across the country. Yet we also know that our battles against covid-19 have meant that there are things that we have not been able to do, such as routine treatments and operations. The challenges of covid are still with us. We must continue to treat patients with the disease and bolster our vital mission of infection control, while also laying the groundwork for a recovery that gets us back to where we need to be.

We have backed the NHS at every point in this pandemic so that it can treat patients, stay safe and save lives, and I am delighted to inform the House that we are backing it again today with a further £6.6 billion of funding for the first half of this coming financial year. This money is in addition to the £3 billion committed at the spending review last November to help the NHS meet the additional costs of covid while, critically, starting the work on the elective recovery ahead.

Due to the pandemic, the waiting list for elective treatment in January was almost 4.6 million, and 304,000 people are waiting more than a year for an operation or diagnostic. Before the pandemic, we had reduced the number of 52-week waits—people waiting more than a year—from 20,000 in 2010 to 1,600. We were in fact on track to get that number to zero before the pandemic hit. This backlog of elective work is an inevitable consequence of the pandemic, and I know that NHS colleagues are as determined as I am to put it right.

We are also putting £594 million towards safe hospital discharge. Over the last year, the NHS’s existing discharge programme freed up over 6,000 beds and, with them, the valuable time of 11,000 NHS staff. We can be grateful that we are seeing so many people leave hospital and that our discharge programme has shown the way forward, ensuring that people can get the very best of care outside of our hospitals, helping them off the wards and into the right settings, with the right support at the right time.

Our £500 million mental health recovery package will help tackle the challenges that the pandemic has wrought in access to mental health services. I can also confirm that we will be extending enhanced discharge arrangements for mental health patients, getting patients safely from hospital into healthy community settings, providing better care and freeing up thousands of beds.

The challenge of mental ill health is so important. We all need to keep looking out for each other and doing all we can to strengthen our mental health. Tackling mental ill health is a core objective of our NHS long-term plan, and this Government are committed to seeing mental health treated on a par with physical health and to delivering on the long-needed reforms that we have set out.

I am equally committed to supporting the vital work of our colleagues in adult social care. Last Monday, we reopened care homes to visitors, with a careful policy of a single regular visitor, who will be tested and wear PPE. I know how important this is, and I know that colleagues will be cheered by the stories we hear each day of more and more residents safely reunited with people they love. It means everything to them.

I can today announce a further £341 million to support adult social care with the costs of infection prevention, control and testing that will make sure that visits are safe for everyone. That takes the total infection control fund and testing support to more than £1.6 billion, alongside the free PPE that care homes receive.

The pandemic has tested our NHS and our social care system like never before. That they have risen to meet the challenges of the past year is down to the incredible dedication and hard work of colleagues—they have our thanks. We will deliver on our commitments. We will build 40 new hospitals. We will hire 50,000 more nurses. We will vaccinate this country ahead of almost all others. We will back our NHS and social care as we build back better for everyone. I commend this statement to the House.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

As always, I thank the Secretary of State for advance sight of his statement.

Our constituents will be worried, anxious and disappointed at the news on vaccination last night. It has been an unspeakably horrific year. We have one of the worst death rates in the world and our economy has taken a massive hit. Many key workers under the age of 50, such as teachers and police officers, who through the nature of their work are not at home, are going out and are more exposed to risk, had been hoping that vaccination for them was not far away. Of course, we understand why there will be delays in supply, but this is not fantastic news and nor, frankly, is it expected news.

On Saturday, the Government, or Government sources at least, were briefing The Daily Telegraph about a “bumper boost” and that everyone over 40 would be offered their first vaccine by Easter. Last week, the Business Secretary was hinting that all adults could be vaccinated by June, saying:

“There is no reason why we can’t be optimistic.”

On Monday, Nottingham and Nottinghamshire clinical commissioning group began inviting those in their 40s for vaccination, and a similar invitation went out from Bury CCG. We are grateful for the Secretary of State’s update today, but it will be a surprise to many.

The Secretary of State did not mention Moderna supplies today. I understand that supplies from Moderna will start in April. Is there any prospect that, if Moderna supplies come on stream, new appointments can be offered in the light of that?

About 11 million people received their first dose between January and February. I listened carefully to what the Secretary of State said. Can he clarify for the House and our constituents: is he offering them an absolute guarantee that all those will get their second dose within the 12 weeks throughout April? Our constituents will be keen to get that absolutely clarified.

The vaccination programme will need to ramp up to about 3.5 million doses a week from May to ensure that everyone under 50 is vaccinated by mid-July. Is the Secretary of State confident that these supply issues will be fixed by May? Is there any prospect of doing more than 3.5 million jabs a week from May? We heard today from Adam Finn of the Joint Committee on Vaccination and Immunisation that infection rates may rise as a result of the delays. Does the Secretary of State anticipate that any of the stages, any of the dates, in the road map for easing out of lockdown will be pushed back, given that we are rightly judging the road map by data, not dates?

On behalf of the official Opposition, I take this opportunity to support the AstraZeneca vaccine. Of course, where people are worried and have concerns, those worries and concerns must be addressed, not dismissed. But this is a concern at the moment. Yesterday, for example, I was told that hundreds of people failed to show for appointments at the ExCeL centre and we think that is because of concerns and misinformation circulating online.

There are parts of the country where infection rates remain relatively high and vaccination rates are relatively low. I see that in my Leicester South constituency. Will the Secretary of State pull together a cross-party taskforce of community and local leaders to look at tackling these vaccine hesitancy issues? I again offer to work with him on that on a cross-party basis.

Children make up about 21% of the population. That is a large segment of the population that will be lacking immunity. Obviously, research and trials are ongoing, but does the Secretary of State have a timeline for when he hopes to vaccinate children? Does he anticipate, for example, being able to vaccinate children this autumn, as Anthony Fauci in the US has suggested could well happen over there? Even as vaccination rolls out, the virus continues to circulate, and new vaccine-evading variants could emerge. We may need booster jabs in the autumn, and the winter will be challenging, which is why driving up vaccinations across the whole of the population is so important.

On the Budget allocations that the Secretary of State has announced for the next six months, I welcome the extra funding, of course, but can he guarantee that the NHS will continue to get additional funding after the six months if it is needed for covid care? As he has said, people are waiting longer for treatment, with more than 300,000 people waiting over a year, risking permanent disability or loss of livelihood, and with thousands waiting too long for cancer treatment, risking loss of life. We should not have to choose between cancer care and covid care. We are also facing a mental health epidemic as a consequence of this crisis. Crucially, because of years of underfunding, bed cuts and understaffing, when we entered the pandemic we already had growing waiting lists, our A&Es were in crisis and we were missing cancer targets. Can he tell us when he expects to bring down those waiting lists and meet the various cancer targets again?

Finally, the Secretary of State did not mention NHS pay today. He claps NHS workers and nurses, but he is introducing a real-terms pay cut for our NHS staff. Can he tell us whether he will implement any recommendations of the independent pay review body? If it recommends an increase above 1%, can he assure us that the funding will be additional to what he has announced today? In truth, if he really wants to value NHS staff, he should withdraw that pay cut now.

[Matt Hancock]

I welcome the right hon. Gentleman’s support for the vaccines, the vaccine roll-out and the clinically-led approach that we have taken in this country, and I mean that as more than simply a polite gesture. It is vital in this country that we have such a strong cross-party consensus, which includes all parties represented in this House, behind the vaccine programme and behind the science. The science means, of course, that we should and we do publish any side-effects, and we are open and transparent about that, but also that we make an assessment as to the benefits and how those benefits weigh against any side-effects. It is absolutely clear from the data we have seen so far that the vaccines are safe and that they make us safer than not getting vaccinated. That is an absolutely critical fact, and the MHRA will shortly set out more details; it is properly for the independent regulator to set out those details.

The right hon. Gentleman asked about supplies from Moderna. We expect supplies from Moderna in the coming weeks, and I am grateful to Moderna for the work that it has done. Of course, we have always been cautious about setting out future supply details, and the experience of the last 24 hours makes me even clearer that it is far better for us to set out clear commitments to the public in terms of when people can be vaccinated. This means that all over-50s now can come forward and that we are committed to and on target to offer to all over-50s and groups 1 to 9 by 15 April.

However, we know that supply figures move up and down. We have seen that throughout the roll-out, and it is part of the normal management of this roll-out. The commitment I can give the right hon. Gentleman is that, for those who are coming forward for second doses, those appointments will not be delayed because of these supply issues. Also, appointments that are already made will not be cancelled because of supply issues. I therefore say clearly to any member of the public who is watching: the vaccination programme is on track to meet the targets we have set out, and if you get the call from the NHS—whether you get it through a letter, a text, a telephone call or even, these days, an email—take up the offer and get the jab.

The right hon. Gentleman rightly asked about the road map. We are on track for the dates in the road map, and there is no impact on the road map from the changes to vaccine supply that we have been detailing in the last 24 hours.

The right hon. Gentleman asks about the vaccination of children and the autumn vaccination programme. Neither of these is certain. The vaccination of children is currently being assessed in a number of different clinical trials and it is very important that we consider the results of those before making any decision. It is likely that we will need a vaccination booster programme in the autumn, not least to deal with new variants, but that is again not yet certain.

Finally, I am very glad that the right hon. Gentleman welcomed the extra funding that we are putting into the NHS. He asks whether, after six months, there will be more funding if needed for covid purposes. The Chancellor has been absolutely clear from the start of this crisis that the NHS will get what it needs to deal with covid. That is very important, as is the work to restart the NHS in areas where it has had to be paused and, critically, the work that colleagues across the NHS will be doing to recover the backlog of elective work and make sure that everybody can get their appointments and operations in a timely way on the NHS once more. That is the work of the months ahead and I look forward to supporting NHS colleagues in delivering on it.

[Jeremy Hunt (South West Surrey) (Con) [V]]

Was the Health Secretary as concerned as I was by the comments by former Finnish Prime Minister, Alexander Stubb, on the “Today” programme this morning about the threat by the EU Commission President to block exports to countries that were ahead in their vaccination programme? He said that that was a “political reality”, irrespective of any breach of legal contracts that it might involve. Does my right hon. Friend not agree that it is incredibly dangerous to make threats to the supplies of vaccines and components, alongside casting aspersions on their safety at the very moment when vaccines are the only way the world is going to get out of our covid straitjacket?

[Matt Hancock]

I agree with every word that my right hon. Friend said. It is vital that we all work together. The supply chains for the manufacture of these vaccines cross borders. They are often global supply chains and it is vital that we work together to deliver them. There is a need for that co-operation and there is, of course, a need for all countries to respect contract law. That is the basis of international trade, and I am sure that the European Union will live up to the commitments and statements that it has made, including President von der Leyen herself, who has said that there should not be restrictions on companies when they are fulfilling contractual responsibilities. Of course there should not, and we fully expect those contracts to be delivered on, because there are very significant consequences to breaking contract law.

One further point is that the Oxford-AstraZeneca vaccine was developed because of UK taxpayers putting the funding into the science, development and clinical trials and because of AstraZeneca, with an incredibly bold and generous decision, which we fully support—but it was their decision—to offer this vaccine around the world at cost. Working with institutes such as the Serum Institute of India, Oxford and AstraZeneca are providing a vaccine for the whole world. They are not taking a profit from it. We are very proud of that fact, and that makes this materially different from other vaccines that have been developed for commercial advantage. I am not against that at all, but let us celebrate what AstraZeneca has done, and it only underlines how important it is for everybody to work together to keep their populations safe.

[Martyn Day (Linlithgow and East Falkirk) (SNP) [V]]

I am grateful to the Secretary of State for advance sight of his statement, and, of course, any additional funding for health is always welcome, especially during the pandemic. However, we must ensure that it delivers results. A Public Accounts Committee report has found that the £22 billion UK Government test and trace system has had “no clear impact” on coronavirus infection rates in England. Does the Secretary of State accept that the NHS-led track and trace was the correct option, not privatising public health? And will he tell us whether he believes that Serco track and trace did not have a clear impact on coronavirus infection rates because of the failings of the system, or was it because the UK’s pitiful statutory sick pay is not sufficient to support people in self-isolation to stay safe and save lives?

[Matt Hancock]

People across Scotland who were listening to that will recognise that political point scoring is the opposite of what is needed right now and that instead the UK Government are delivering for people across Scotland the benefits of this United Kingdom working together. Instead of making arguments for constitutional meddling and separation, we are delivering for people. We are delivering vaccines into arms. We are delivering a testing system that works for people across the whole of the UK. Crucially, we are also delivering that enormous economic support package to businesses and individuals alike. All of this is possible only because of our great United Kingdom, and I am glad that the people of Scotland increasingly recognise that.

[Robert Halfon (Harlow) (Con) [V]]

I welcome my right hon. Friend’s statement and pay tribute to him for the vaccine programme, along with everyone else in the NHS. Given the £200 million already spent on the move of Public Health England to Harlow, first announced by the Government in 2015, and the additional £120 million given this year to facilitate the move, will he set out the progress on and timings of the move of Public Health England or its successor body to Harlow and the next steps on the completion of the Harlow campus, as part of our country’s programme to modernise our public health science?

[Madam Deputy Speaker (Dame Rosie Winterton)]

Before I call the Secretary of State, I wish to reiterate that there is a dress code for people participating by video link. We expect them to be dressed in the same way as they would be if they were in the Chamber—with a jacket.

[Matt Hancock]

If I may say so, Madam Deputy Speaker, I think my right hon. Friend would wear that tie if he were in the Chamber as well. He makes an important point about the future of investment of public health. He is a great champion for Harlow, and he and I have spoken about the Harlow project many times. As he knows, we are reforming the way we deliver public health, to make sure that the delivery of health security, especially against contagious diseases, gets its own special focus, and the vital work of health improvement, to improve public health in non-contagious diseases, such as by tackling obesity. The Harlow project has been worked on for some time and I look forward to working with him on the next steps in that programme.

[Munira Wilson (Twickenham) (LD) [V]]

The Secretary of State rightly paid tribute to the service and sacrifice of NHS staff over the past year. Several Conservative Members joined me in speaking to nurses and Royal College of Nursing representatives from across south-west London last week. The message to us was clear: they are traumatised and exhausted after treating thousands of severely ill covid patients, and they are insulted by the proposed 1% pay rise. Will he therefore follow the example of the Welsh Government and offer NHS workers a £500 tax-free bonus as well as a real-terms pay increase?

[Matt Hancock]

As the hon. Lady knows, we are in a difficult economic situation due to the pandemic, and about 700,000 people have lost their jobs. As a result, we have implemented a pay freeze across the public sector, for all but the lowest-paid workers and NHS staff. As she knows, the independent pay review body is looking at this point, but, like her, I bow to no one in my admiration for the work of staff across the NHS. They have worked incredibly hard and have done a huge amount to help people through this pandemic. She is absolutely right to say that we must support them, especially in getting rest and recuperation after this latest peak, because we also have work ahead of us to make sure we can deal with the consequences of covid, including the backlogs for which I announced the financial support to crack through today.

[Stephen Hammond (Wimbledon) (Con) [V]]

I thank my right hon. Friend for his statement. The roll-out of the vaccine has been truly impressive and undoubtedly led to some heightened expectations. From experience, I recognise that the supply letter from NHS England to the system was not actually unusual. Does my right hon. Friend agree that there is a possibility that an equally appropriate phrase for the current supply fluctuation might be “expected level” rather than “constrained”? May I ask him to allay the fears of the people of Wimbledon and the UK and confirm that he expects supply levels to be in line with expectations over the next few months and that no target dates for vaccinations will be missed?

[Matt Hancock]

I can absolutely give that assurance. My hon. Friend is quite right, and he brings his experience as an incredibly impressive Health Minister to bear. It is absolutely standard to tell the system what our future expectations are, but they are expectations, and we are always clear that supply is lumpy. We have set out clear commitments to the public, and those commitments that come either from me or the Prime Minister are the ones that we will meet, and we manage this enormous programme in order to deliver them as best we can.

[Jim Shannon (Strangford) (DUP)]

I, too, thank the Secretary of State for his continued updates on these issues in the Chamber. As a type 2 diabetic who lost four stone when I was diagnosed with diabetes some 13 years ago, I have come to understand the importance of a healthy weight. My specific concern on reported vaccine supply is that the overweight, who are ostensibly more vulnerable to coronavirus, must have access to the vaccine. Can the Minister confirm that shipments to Northern Ireland will continue as scheduled and, further, that clinical priority will continue to be given to those with a high body mass index, despite the alleged shortage?

[Matt Hancock]

Yes. People listening to the news over the past 24 hours might be surprised to hear this, but there are no changes to the prioritisation and no changes to planned appointments. People will be called forward as previously proposed and in the order previously proposed, including with the addition of opening up invitations to those who are 50 and above. The vaccines will be delivered by the NHS across the whole of the United Kingdom, including in Northern Ireland, where I work extremely closely with my counterpart.

[Jacob Young (Redcar) (Con)]

The vaccine roll-out has been a tremendous success. Just 100 days after the first jab, we have vaccinated 25 million people. In front of the Science and Technology Committee yesterday, Dominic Cummings made reference to the vaccine roll-out and criticised civil servants in the Department of Health and Social Care. Will the Secretary of State outline the decision-making process that led to the vaccine taskforce and the most successful vaccine roll-out in the world?

[Matt Hancock]

Absolutely. The thing about the vaccine roll-out, the vaccine delivery, the purchase of vaccines and the scientific research into vaccines is that the whole thing has been a massive team effort, and I thanked some people in my opening statement who have been involved. They have worked incredibly hard together as one big team. That is the attitude that we take, and that is one of the reasons why this programme has been successful. In particular, I emphasise my gratitude to officials in the Department of Health and Social Care, who have worked incredibly hard and very, very effectively at making this happen.

--- Later in debate ---

[Mick Whitley (Birkenhead) (Lab) [V]]

Care home workers have made enormous sacrifices over the past year to keep their residents safe, and they continue to work on the frontlines of the pandemic. Will the Secretary of State inform the House of what he is doing to increase uptake of the covid vaccine among care home staff and whether high-risk care home staff who have come forward for vaccination in April will be able to get their first dose?

[Matt Hancock]

Yes, absolutely. The hon. Gentleman is quite right and I totally agree with him. Anybody who works in an elderly care home should come forward now for a vaccine if they have not had it. We are working incredibly hard to try to make those vaccines as accessible as possible.

[Chris Grayling (Epsom and Ewell) (Con) [V]]

Thanks to the work of the Secretary of State and his team, I represent a constituency where most over-50s have had their first jab, where there are now very few covid patients in local hospitals, and where the rate of infections is very low and still falling. But I also represent a constituency where hospitality businesses are going bust right now, because they cannot hang on any longer. Given that the Secretary of State says that outdoor settings are very low risk, why do covid-secure hospitality businesses with table service in outdoor settings still have to wait another month to reopen, when the data shows pretty clearly that it would be pretty fine for them to reopen now?

[Matt Hancock]

We have set out the road map based on clinical advice. I am delighted to say that, because of the success of the vaccination programme so far, we are able to proceed down that road map.

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

I start by giving my unreserved support to the NHS for the massively successful roll-out of the vaccine programme, but can the Secretary of State assure the House today that, given the unpredictability of supply, all of those due their second dose will receive it within the specified 12-week time period?

[Matt Hancock]

Yes.

[John Redwood (Wokingham) (Con) [V]]

Many congratulations to the Secretary of State and his team on the vaccine roll-out. It shows the success of collaboration between Government, business and universities, and the beneficial side effect of more high-quality jobs and more self-reliant and productive capacity in the UK, which I hope we will follow in other areas. Can he give us a brief update on progress with finding new treatments for covid-19 and applying existing drugs?

[Matt Hancock]

I highly, 100%, wholeheartedly agree with my right hon. Friend. The model that we established in the vaccines taskforce—of the holy trinity of business, academia and civil service colleagues working together as one team—was learned from reforms from his time in government. It has worked incredibly well, and I think will do as well in the future.

We also apply that approach to therapeutics, and one of the reasons, alongside the NHS, why we are the only country in the world that has participated in the discovery of all the current therapeutics is our use of that approach. Obviously we are driving it further, and I would be very happy to discuss it with my right hon. Friend.

[Dan Jarvis (Barnsley Central) (Lab) [V]]

One of the gravest threats posed by covid is its potential to create a cancer epidemic. I recently co-ordinated a cross-party letter to the Secretary of State in support of an urgently needed £50 million refurbishment plan for Sheffield’s Weston Park cancer centre. I urge the Secretary of State to give serious consideration to the proposal, which would ensure that patients across South Yorkshire and Bassetlaw received the best possible treatment.

[Matt Hancock]

I have seen the letter and I am looking into what we can do. Because of the crisis the need to tackle cancer is more urgent but there is also more hope, and the hope is that the underlying technology behind some of the vaccine—the so-called mRNA technology—also has the potential to improve cancer-fighting technology radically. So we propose and plan to support very significantly work on that, in order to find further breakthroughs in cancer treatment. I would be very happy to talk to the hon. Gentleman—and indeed you, Madam Deputy Speaker—about the proposal for South Yorkshire.

[Duncan Baker (North Norfolk) (Con) [V]]

Given the sterling success of the vaccination roll-out in North Norfolk, where on recent numbers we had vaccinated the second-highest number of people by constituency population in the whole country, can my right hon. Friend assure my constituents that despite the recent supply news, the vast majority of them will see no interruption to their being given their first and second doses in the roll-out programme?

[Matt Hancock]

Yes.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op) [V]]

The Secretary of State knows that I sometimes criticise him but I sometimes pat him on the back. I want to pat him on the back for much of what he has done. Yesterday’s evidence from a Select Committee just shows that he did not always get the support that he needed from No. 10, and from Dominic Cummings in particular.

I want to see a level playing field—whether it is in Harlow, Richmond or Huddersfield. There is some resistance to getting the vaccine in some of our urban centres. I can assure him that I will work with him, and we all will work across the House, to make sure that people know it is so vital to get the vaccine, wherever they live. I hope we can have a good PR effort, working together to do that.

[Matt Hancock]

I am a pretty collegiate kind of guy and I generally see the best in people, and I see the best in the hon. Gentleman. One thing that I have really enjoyed about the vaccine roll-out is that it has been a totally cross-party effort and people have really leaned into getting the message out. I look forward to working with the hon. Gentleman—my hon. Friend, certainly today—on his suggestion.

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

The Secretary of State will know from his appearances before the Health and Social Care Committee that we are concerned about how the backlog is dealt with, so it is great that he is taking such a proactive stance to deal with it. He set out in his statement just how big the backlog for elective surgeries is going to be. The question from Bosworth is: how long does he estimate it will take to clear the elective-surgeries backlog that has built up?

[Matt Hancock]

I am currently working with the NHS to answer that question, which is a characteristically acute one from my hon. Friend. We are not yet able to answer it simply because the pace at which we can return activity to full, normal levels is not yet clear because the main barrier to that recovery is a combination of infection, prevention and control and the need for staff to get some R and R. We will know more in the coming weeks and months.

[Tim Farron (Westmorland and Lonsdale) (LD) [V]]

There was no mention of cancer in the Secretary of State’s statement, nor a single penny in the Budget to boost cancer services, despite the fact that Macmillan Cancer Support’s figures show the need to increase all cancer services by 10% for a solid 15 months, starting now, to clear the cancer backlog.

Macmillan also says that there are 37,000 people with cancer who are not even in the system yet. Given the scale of this crisis, will the Secretary of State agree to set out an urgent, ambitious and funded plan to catch up with cancer, so that tens of thousands of people do not unnecessarily lose their lives?

[Matt Hancock]

The need to catch up on the backlog is there across all elective operations and of course that includes those for cancer. The good news is that the NHS has worked incredibly hard, especially in this second peak, to make sure that cancer services have remained working and effective as much as possible. Some cancer services have in fact delivered more than their normal pre-pandemic levels of care. The hon. Gentleman is absolutely right that we have to make sure that any backlog is reduced—that is a critical part of what I have been talking about today.

[Mrs Pauline Latham (Mid Derbyshire) (Con) [V]]

The vaccine roll-out has been incredibly successful, but we have now come up against a bit of a hiccup with the AstraZeneca vaccine. Europe does not seem to be too keen on using that vaccine; could we not use its vaccines? Will my right hon. Friend assure me that the Pfizer vaccine will be available for not just second jabs but first jabs in April?

[Matt Hancock]

My hon. Friend has put her finger on a certain irony in two different positions that our European friends are taking at the same time. The best thing to say is that I hope that, following the MHRA’s statement later today and consideration by the European Medicines Agency, we can get the vaccine going everywhere, because the data are really very clear that it saves lives, as the European Medicines Agency itself has said throughout past couple of weeks. It is important to follow the science on this one.

[Charlotte Nichols (Warrington North) (Lab) [V]]

I thank all those in Warrington involved in the vaccine roll-out, including our NHS and community vaccine centres, GPs and primary care networks, pharmacists and volunteers. While I patiently await my jab as a 29-year-old, I have been heartened by the progress made so far in getting our community vaccinated.

Can the Secretary of State reassure the House that if high-risk people in the top categories come forward for their first dose of the vaccine, they will not be prevented from receiving it as a result of anticipated delays to delivery?

[Matt Hancock]

That is absolutely our goal. The hon. Member is 29; I am 42. The fact is that we have to vaccinate an awful lot of people of our age to save the same amount of lives as vaccinating just one octogenarian. We will take this time to loop back and find as many people in the most vulnerable cohorts as possible. That is the way to save as many lives as possible and reduce pressure on hospitals as much as possible. I hope that she will bear with, in the same way that I am having to bear with, until we are able then to open up vaccinations—first for those in their 40s, then those in their 30s, and finally the youngsters.

[Mr Philip Hollobone (Kettering) (Con)]

Kettering-born Professor Sarah Gilbert of Oxford University, who has led the team that developed the Oxford-AstraZeneca vaccine, attended Kettering High School for Girls, which is now Southfield School, in the 1970s. It was at that school that she first decided she wanted to work in medical research.

As Sarah is a heroine of the town, her name is today being added in a mayoral ceremony to Kettering’s historic timeline in the marketplace, which commemorates key milestones, achievements and famous local people. Will the Secretary of State join me in congratulating Sarah on that thoroughly well-deserved accolade from her home town, praising her outstanding work and recognising her as a role model for young people everywhere who want to enter a worthwhile career in science?

[Matt Hancock]

I am sure the whole House will agree with every single word that my hon. Friend said. They say that success has many fathers, and Kettering has discovered another extraordinary daughter in the vaccine roll-out. Sarah Gilbert worked on the Ebola vaccine before this one and has played a role in saving many, many thousands of lives over her career in medical research. I have no doubt that she will save many, many more in the future. We all salute her work, and we salute her attitude and her team work too, because that is one of the characteristics that has made it possible to deliver these vaccines so fast.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP) [V]]

As chair of the all-party parliamentary group on disability, I have been hearing heartbreaking accounts of the disproportionate effect that the pandemic has had on disabled people across the United Kingdom. According to a survey conducted by the Family Fund, 93% of families said that coronavirus had negatively affected disabled or seriously ill children’s mental health. What crucial steps are the Government taking to support the mental health and wellbeing of children and adults with disabilities?

--- Later in debate ---

[Matt Hancock]

The hon. Member is quite right to raise that; it is an incredibly important subject. Of course, those with disabilities have been recognised where they have clinical priority for a vaccine, as have their carers, according to clinical advice. Part of the £500 million of mental health funding that I mentioned in my statement will go towards further strengthening children’s mental health services, with the goal that mental and physical health are treated with parity, as of course they should be.

[Theresa Villiers (Chipping Barnet) (Con)]

The United Kingdom’s vaccination programme has been among the most successful in the world right from the point at which the Government took the decision to fund the scientists who made it all possible. With these constraints on supply, is the Secretary of State still confident that we can follow our road map to release, which is so important to so many families and businesses across the country?

[Matt Hancock]

Yes. We did fund the science from the start, and we worked collegiately to make that happen. I can confirm that there is no impact on the road map timetable from the news on supply, because we remain on track in terms of the targets that we have set out.

[Mary Kelly Foy (City of Durham) (Lab) [V]]

If there are indeed issues with vaccine supply, it does not make sense that countless manufacturers across the world are unable to produce covid-19 vaccines, treatments, diagnostics and other health technologies because of intellectual property restrictions and pharmaceutical monopolies that prevent open technology sharing. Will the Government now commit to supporting a waiver of covid-19-related patents at the World Trade Organisation, or is artificially limiting vaccine supply official Government policy?

[Matt Hancock]

I am very happy to provide the hon. Lady with a briefing, because she should be very proud of her country. AstraZeneca is providing the Oxford vaccine free of charge—it is not charging for any intellectual property rights—right around the world. That is not true, as she implies, for all the vaccine companies, but she should be really, really proud of ours.

[Simon Fell (Barrow and Furness) (Con) [V]]

I was listening to the excellent “Covid Confidential” podcast on the BBC and was surprised and delighted to find out that when the various vaccines were nearing production they were named after submarines built in my constituency, so may I first thank my right hon. Friend for his choice of names? Secondly, not to labour this analogy, a good defence rests on having a good range of options, and Kate Bingham recently said that not having monoclonal antibodies as part of our defence is the gap in our armour, so can my right hon. Friend give an update on where his Department is on this?

[Matt Hancock]

Yes, this is an incredibly important subject and we are working very hard on it with clinical leads and external experts. I said earlier that success has many fathers, and I am sure that the people of Barrow are very proud of their role in making sure that we could keep what needed to be kept confidential confidential. We have now had to change all those names, because everybody knows about it.

[Tulip Siddiq (Hampstead and Kilburn) (Lab) [V]]

GP surgeries have been crucial to the roll-out of the vaccine, and I pay tribute to all those involved. However, many of my constituents are concerned that the Centene Corporation, a massive American health insurance firm, has just taken over dozens of GP surgeries in London, including Brondesbury and Swiss Cottage GP hubs in Hampstead and Kilburn and others in Camden. Does the Secretary of State share their concern that this appears to have taken place with no meaningful public scrutiny, and their concerns about the increasing involvement of US healthcare corporations in our health system?

[Matt Hancock]

No.

[Andrew Selous (South West Bedfordshire) (Con) [V]]

Given the link between covid deaths and obesity, does the Secretary of State share my concern that children from the poorest constituencies are being the most heavily targeted by social media junk food adverts, and that over half of the top UK child influencers on Instagram have promoted junk food in the last year? Will he meet some of the young people from Bite Back 2030, who are concerned about this?

[Matt Hancock]

I would be very happy to ensure that the children of Bite Back 2030 meet the Minister for public health, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who leads on these matters, and my hon. Friend is right to raise that incredibly important point.

[Liz Twist (Blaydon) (Lab)]

Almost as soon as the Secretary of State sat down yesterday after his statement, I was contacted by a constituent who is shielding and is very concerned that shielding will now end on 31 March, but he has not had his second jab. Will the Secretary of State be issuing guidelines on what those people should do, as my constituent is asking?

[Matt Hancock]

Yes, absolutely, and we will be writing to all those who are shielding to set out the details so that they get a personal copy of those guidelines. What I would say is that the rates of covid now are much lower than when we paused shielding in the past, so this is not just because of the vaccination programme—which of course has benefited many people who are shielding, and we know that the first dose brings huge safety and benefit already—but is also because the rates of covid are so much lower.

[Aaron Bell (Newcastle-under-Lyme) (Con) [V]]

On behalf of their citizens, who need to be vaccinated and who need to see their economies reopened, I have to say I am personally in despair at the short-sighted decisions taken by many European countries and what seems to be their absurd misapplication of the precautionary principle. I am sure my right hon. Friend would wish to be diplomatic, so will he join me in praising what we are doing, and the MHRA and the JCVI for their sensible and proportionate decision making, which has always prioritised public health here in the UK both in respect of the approvals given for vaccines and the dosing regimens they subsequently recommended?

[Matt Hancock]

Yes, my hon. Friend puts it characteristically well. It is very important to take all considerations into account when making decisions like these. Of course, the precautionary principle is important, but when there are such huge benefits to vaccination, over-precaution is a mistake. We have to take overall public health into account.

[Rebecca Long Bailey (Salford and Eccles) (Lab) [V]]

The Salford system has delivered the covid vaccine in an unprecedented way. Everyone from cohorts 1 to 9 has been invited at least once—some three or four times—and I understand that, even with the vaccine shortage and guaranteed second doses factored in, we will run out of people in cohorts 1 to 9 to give our current vaccine supply to. Will the Secretary of State authorise Salford to proceed to cohorts 10, 11 and 12 and begin to prioritise the vulnerable members in those age groups, so that we can maximise the doses we have?

[Matt Hancock]

No. What everybody in Salford and around the country needs to do is make sure that every last effort is made to reach every last person in groups 1 to 9, because they are the most vulnerable. Only in exceptional circumstances should people under the age of 50 who are not in groups 1 to 9 be invited for vaccination. The message is incredibly clear and I speak very directly to the whole team, including in Salford: please put all your efforts in the forthcoming weeks into delivering vaccines for groups 1 to 9.

[Jason McCartney (Colne Valley) (Con) [V]]

As I am over 50, I will get my Oxford-AstraZeneca jab later today at my local Honley village vaccination centre, which has now delivered over 10,000 vaccinations. Will the Health and Social Care Secretary join me in thanking our wonderful local NHS, the pharmacy involved and all the volunteers there, and confirm once again that we are still on track to vaccinate all over-50s and deliver the second doses as planned?

[Matt Hancock]

Yes, absolutely. It is wonderful to see the joy on my hon. Friend’s face in anticipation of his jab. I hope that he gets the opportunity to change into a short-sleeved shirt, because some colleagues have inadvertently had to undo an awful lot of buttons in order to be vaccinated. Although I imagine that some of their more enthusiastic constituents may have enjoyed the sight, I think it is best if we gents wear a short-sleeved shirt so that we do not have to bear our hairy chests.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I thank the Secretary of State for his statement. I will suspend the House for approximately three minutes to make the necessary arrangements for the next business.

Covid-19 Update

Matt Hancock Excerpts

Tuesday 2nd March 2021 Commons Chamber

[The Secretary of State for Health and Social Care (Matt Hancock)]

Today marks 12 weeks since Margaret Keenan became the first person in the world to receive a clinically approved vaccine for covid-19. She has since been joined by over 20 million other citizens of this country in the biggest and fastest vaccination effort the world has ever seen.

This is a phenomenal achievement. Our vaccination programme is a national success story for the whole United Kingdom, and the reason it matters is that it allows us to replace the protection currently given by restrictions on our freedoms with the protection from science.

The data confirms that this strategy is working because the vaccines work. The number of hospital admissions is falling faster than the number of new cases, whereas in the first peak it fell more slowly, and the fall in hospitalisations is faster among the age groups vaccinated first than in younger age groups yet to get a jab.

I can tell the House about some further analysis that backs up this excellent news. The halving time of hospital admissions is now every 18 days. Over the past fortnight, it has fallen for those aged over 85 from 18 days to 15. This morning, the Office for National Statistics published data showing the number of deaths falling by over a quarter a week in mid-February. More than that, the number of deaths each day is not only falling faster than after the first peak, but it is falling faster in the over-80s, who got the jab first, compared with the under-80s. The number of daily deaths is halving every 12 days, but among the over-80s it is now halving every 10, so while the fall in cases is decelerating, the fall in the number of deaths is accelerating. What all this shows is that the vaccine is working, reducing the number of deaths among those who were vaccinated first and preventing hospital admissions. This is real-world evidence that the vaccine is protecting the NHS and saving lives, that the 12-week dosing regime is saving lives, and that this country’s strategy is working.

As well as this real-world data, I would like to update the House on two new pieces of analytical research published over the last 24 hours. First, this morning the Office for National Statistics published new data on the levels of protection people have. They show that up to 11 February, one in four people are estimated to have antibodies against coronavirus in England, up from one in five. The levels are highest in the over-80s, the first group to be vaccinated, showing again the protection from the vaccine across the country. The second piece of research, published last night, shows that a single dose of either the Oxford or the Pfizer vaccine delivers protection against severe infection in the over-70s, with a more than 80% reduction in hospitalisations. It is great news that both vaccines work so effectively. In fact, the protection from catching covid 35 days after the first jab is even slightly better for the Oxford jab than for the Pfizer, so people can have confidence that they will get protection, whichever jab they are offered.

I am grateful for the work of colleagues across the House in promoting vaccine take-up, which has helped to deliver some of the highest levels of enthusiasm for vaccination in the whole world, and I am pleased to inform the House that we are now inviting over-60s to be vaccinated too. Although the day-to-day figures for supply are lumpy, we have some bumper weeks ahead later this month. Given that our vaccination programme began 12 weeks ago today, from now we begin in earnest our programme of second vaccinations, which ramps up over the month of March. I can assure the House that we have factored these second jabs into our supply projections, and we are on track to meet our target of offering a vaccine to all priority groups 1 to 9 by 15 April and to all adults by the end of July.

Our vaccination programme means that we can set out our road map to freedom and put this pandemic behind us, but we must stay vigilant because covid-19, like all viruses, mutates over time. Part of controlling any virus is responding to new variants as they arise, just as we do with flu each year. Knowing this, we invested in genomic sequencing right at the start of the pandemic, giving the UK one of the biggest genomic sequencing capabilities in the world. Thanks to that, we have been able to spot variants here at home and support others to detect variants in other parts of the world.

I would like to update the House on the six cases of the variant of concern that was first identified in Manaus in Brazil and that we have now identified here in the UK. We know that five of those six people quarantined at home, as they were legally required to do. We have been in contact with them, and I would like to put on record my gratitude to them for doing their duty and following the rules. Whenever we identify cases of a new variant, we respond fast and come down hard by bringing in enhanced sequencing and testing, so we are stepping up our testing and sequencing in south Gloucestershire as a precaution. We have no information to suggest that the variant has spread further.

Unfortunately, one of the six cases completed a test but did not successfully complete the contact details. Incidents like this are rare and occur only in around 0.1% of tests. I can update the House with the latest information on identifying this case. We have identified the batch of home test kits in question, and our search has narrowed from the whole country down to 379 households in the south-east of England. We are contacting each one. We are grateful that a number of potential cases have come forward following the call that we put out over the weekend, and I would like to thank colleagues from across the House who have helped us to get the message out there.

Our current vaccines have not yet been studied against this variant. We are working to understand what impact it might have, but we do know that the variant has caused significant challenges in Brazil, so we are doing all we can to stop the spread of this new variant in the UK, to analyse its effects, to develop an updated vaccine that works on all these variants of concern, and to protect the progress that we have made as a nation. This country is on the road to recovery and we have freedom on the horizon. We must proceed with caution because although we are moving quickly, the virus moves quickly too. Let us not waver; let us do whatever it takes to keep this virus under control.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

As always, I thank the Secretary of State for advance sight of his statement. On the Brazilian variant, in January and February cases here were running at tens of thousands a day and we were in lockdown—we are still in lockdown—because of our own home-grown new infectious variant, yet people were allowed to fly in from abroad, bringing the P1 Brazilian mutation with them. Throughout history, epidemic after epidemic has exploited international travel. Surely it is obvious that tougher border controls should have been in place sooner.

I welcome the progress that the Secretary of State has made on identifying the batch, but how on earth can a test be processed that does not collect the contact details? What mechanisms will be put in place to fix that in the future? Twenty-two billion pounds has been allocated to this system, and it feels as though someone has vanished into thin air. Can he assure us that it will not happen again?

I note that the Secretary of State said that there is no information to suggest wider spread of this variant, but he will recall that John Edmunds from SAGE told the Home Affairs Committee in January that for every identified South African variant, there were probably another 30 unidentified. Can the Secretary of State tell us whether he has received any estimates of the number of unidentified cases in the wider community?

I welcome the tremendous progress that has been made on vaccination and driving infection rates down. It is a testament to the NHS and everybody involved in the vaccination programme, and to everybody who is playing their part in this lockdown. We also know that the virus can quickly rebound and that mutations could evade vaccination. We are in a race against evolution, so we have a long way to go. To be frank, nowhere is covid-safe until everywhere is covid-safe. None of us wants to yo-yo in and out of lockdowns, so will the Secretary of State guarantee that the lockdown easing will, as promised, absolutely be based on data, not dates, and that the assessment time between each step is not compromised? I welcome the extra surge testing, but what is the current timeframe for genetic sequencing? How can it be sped up?

Overall trends are coming down, and that is welcome, but infections in some areas remain stubbornly high. The national average is 100 cases per 100,000, but in Leicester, my city, the infection rate is one of the highest in the country at 222 per 100,000. In Ashfield, the infection rate is 246 per 100,000. In Hyndburn, the infection rate has increased to 162 per 100,000. In Oadby and Wigston, it has gone up. In Watford, it has gone up. In Worthing, it has gone up. What steps will be taken to ensure that areas such as Ashfield, Leicester, Watford, Worthing, Hyndburn and so on are not left behind when the national lockdown restrictions begin to lift, or will those places remain in localised lockdowns? Will the local authorities be given extra resources to do more door-to-door testing and retrospective tracing? Will workplaces in those areas be inspected by the Health and Safety Executive to ensure they are covid-secure? And of course, will people finally be given decent sick pay and isolation support?

Many areas such as Leicester are facing a double whammy of relatively high infection rates and relatively low vaccination rates. What further action will now be taken to drive up vaccination rates among hesitant communities? Will the Secretary of State fund faith groups, community groups and local public health teams to develop more targeted and tailored local vaccination campaigns?

Tomorrow’s Budget cannot be about the Chancellor’s Instagram account; it has to be about the NHS and social care accounts. Can the Secretary of State guarantee that tomorrow we will get an increase in public health allocations to help public health teams plan their local covid response over the next year? Will our NHS heroes get the pay rise they deserve? With 224,000 patients waiting more than 12 months for treatment, will our NHS get the resources it needs to deliver the patient care that patients and our constituents deserve?

[Matt Hancock]

The right hon. Gentleman is quite right to thank all those who are responsible for the vaccine roll-out. It has been an absolutely remarkable effort. He is right to say that the NHS has played its part—it has played a central part—but it has been more than the NHS. It has been the brilliance of the logistics, in particular, of our armed services. It has been the volunteers who have come forward in their droves. It has been the regulator and the partnership with private industry, and I think that this model of a combination of academic excellence and partnership between Government, regulator and private industry is one on which we can build. I know it is a model that they do not like much on the Opposition side of the House—

[Jonathan Ashworth]

I like it.

[Matt Hancock]

The right hon. Gentleman says he likes it. We always knew that he was misplaced over there. His problem is that sometimes his rhetoric is aimed more at his Back Benchers than what he thinks is right. I urge him to listen to his conscience and to back us and the businesses that are making this vaccination roll-out happen, and to put that support into practice.

The right hon. Gentleman asked about sequencing—again, done by a brilliant combination of academics, Government and private businesses. We are now sequencing a third of the positive tests in this country. That is not yet a full survey of all the positives, although we are working towards that, but it does mean that we are able to spot the variants much more than anywhere else in the world. We currently provide around 40% of the total global sequences of this disease—this virus—and we are driving up that sequencing capacity.

The right hon. Gentleman asked about increasing the uptake of vaccination. He was quite right to, and we are working with faith groups and local directors of public health and others. Councils have a very important role to play alongside pharmacists and, of course, GPs in increasing the vaccination uptake. However, the vaccination uptake has been very, very high—higher than I expected—and I am really thrilled about that.

Finally, the right hon. Gentleman asked about making sure that the road map follows data, not dates. We have rigorously set out the gap between the steps to ensure that we can see the effect of one step before we take the other. That is with the goal of having this road map as a one-way route out of restrictions so that we can all get back to the freedom that we crave.

[Jeremy Hunt (South West Surrey) (Con) [V]]

I congratulate the Health Secretary on the brilliant progress of the vaccine roll-out, which is a personal achievement for him as well as a collective achievement for the Government. I also thank him for transparency in that programme and the transparency on the risks of the new Brazilian variant.

I would like to ask about transparency in another area, which is the new integrated care systems that he is planning in his White Paper and the concerns expressed by the Nuffield Trust, the King’s Fund, the Health Foundation and NHS providers at this morning’s Health and Social Care Committee about the lack of detail on how the public will know how well their local ICS is doing. Sir Robert Francis told the Committee that he favoured asking the CQC to Ofsted-rate the new ICSs and I wonder whether my right hon. Friend thinks that that might be a solution to the accountability issue.

[Matt Hancock]

Transparency has played a vital role in our approach to responding to this virus, and I think that is an important lesson from it that should be heeded globally. In terms of the future of the NHS arranged around the ICSs, that transparency will be important, too. There will be a crucial role for the Care Quality Commission, which currently rates hospitals according to, as my right hon. Friend put it, an Ofsted-style rating. It is vital that the CQC has a similar role when it comes to ICSs, and I look forward to working with him and other members of his Committee to make sure that we get the details of that right.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

Although the number of cases of the Brazilian variant is thankfully small, it is a warning that being tested in advance does not rule out travellers carrying covid. The South African variant is resistant to antibodies in previous covid patients, and there is concern that both variants may be resistant to vaccine-induced immunity and could therefore undermine the success of the vaccination programme.

The Brazilian variant has already been identified outside South America, and the South African strain is present in 35 countries not on the red list. The arrival of the Brazilian strain via both Switzerland and Paris demonstrates the various routes to the UK from high-risk countries and shows how a traveller can avoid the current hotel quarantine system by separating the legs of their journey. Those infected spent several hours in close quarters with other travellers, who would not be subject to hotel quarantine even now.

I assume that the Government are tracing the passengers from the flights, but with genomics taking some time, the window for worrying variants to get a foothold in the UK before they are discovered is significant. The situation would not have arisen with comprehensive hotel quarantine, as advised by SAGE, so why did the Secretary of State agree to such an inadequate system? Can he tell us the view of the Joint Biosecurity Centre? Does he recognise that quarantining just 1% of international arrivals does not protect the UK from these variants, or protect it from those that may evolve in other parts of the world? Will the Government now review their hotel quarantine policy and make it fit for purpose?

[Matt Hancock]

The hon. Lady is completely wrong, and she knows it. Quarantine is in place for 100% of passenger arrivals in this country. In fact, this episode, in which all those we have successfully contacted—all five—have fully isolated and quarantined at home as required, demonstrates that the policy is working. We have further strengthened it and introduced hotel quarantine, and that will no doubt give further reassurance. The hon. Lady’s characterisation is wrong, and some of the descriptions of the organisations involved are wrong as well. I am happy to ensure that she gets a private briefing so that she can understand the situation in future.

[Mrs Pauline Latham (Mid Derbyshire) (Con) [V]]

I congratulate my right hon. Friend on the vaccine roll-out and on the use of the SureScreen tests, which were bought local to me. The pressure on the NHS due to coronavirus has caused the cancellation of thousands of elective operations. What plans does my right hon. Friend have to ensure that hospitals catch up on cancer diagnosis and care and cardiothoracic diagnosis and surgery? How fast does he expect to progress that?

[Matt Hancock]

My hon. Friend makes two critical points. The first is that the manufacture and purchasing of British-made tests is an incredibly important project. I thank SureScreen in her constituency for working closely with us over several months. We now have a product that we can all be proud of and that will test people in Britain to help break chains of transmission and control this virus. I am grateful for her work in that regard.

I also agree with her second point. The spending review put aside £1 billion for the recovery of elective operations, as well as half a billion pounds for the recovery of mental health services. That is crucial for cancer and all the other elective areas, including cardiothoracic, and we will publish further details of the recovery programme soon. The NHS is just exiting a stage of significant pressure—more than 10,000 people are still in hospitals with covid—and we need to ensure that staff get some rest and recuperation, but next year will be all about the recovery my hon. Friend talks about. The money has been allocated, and we will need to get on with it.

[Yvette Cooper (Normanton, Pontefract and Castleford) (Lab) [V]]

The Brazil variant cases arrived a month after I raised this issue with the Prime Minister, and they show not only the problems of delays, but the limitations of the pre-travel tests that did not catch those cases. Even now, 99% of the 15,000 daily arrivals are not covered by hotel quarantine, and most people can still travel home from the airport by tube, train or even plane, mixing with others—as some of these travellers did—without being tested on arrival in the UK. Why are the Government still refusing to introduce additional tests on arrival, and still allowing international passengers to travel onwards on UK public transport? Does the Secretary of State recognise that those gaps in the system will let more new variant cases spread?

[Matt Hancock]

These cases would be caught by the new hotel quarantine policy. The right hon. Lady talks about the need for more testing, and we have introduced tests on day 2 and day 8, to ensure that we keep everybody who arrives as a passenger in the UK under the necessary level of surveillance.

[Bob Blackman (Harrow East) (Con) [V]]

My right hon. Friend will be aware that my constituency is extremely diverse in its racial and religious makeup, and our national health service staff have done a brilliant job in keeping up the fantastic vaccination rate during this period. However, we are still having to combat the anti-vaxx propaganda that is going out. How will my right hon. Friend ensure that people get the truth about the wisdom of taking the vaccine, regardless of what race, religion, and cultural background they come from?

[Matt Hancock]

That is an incredibly important question, and I pay tribute to the work that my hon. Friend has done in getting that message out. In Harrow we are vaccinating in mosques, temples, and GP surgeries. A critical part of the roll-out is to ensure that the message gets to everybody that this vaccine is safe and it works. It is no good just my saying that. We want to, and we are, engaging with leaders of all communities—faith leaders, and people who have strong voices in their community. Critically, we must ensure that people feel as much as possible that the vaccination effort is accessible to them. It is on us to ensure that the vaccines are easy to get hold of, and that people get answers to any reasonable questions they may have. I look forward to working further with my hon. Friend on delivering that across Harrow and the whole of the country.

[Munira Wilson (Twickenham) (LD) [V]]

I am sure the Secretary of State will agree that every hour is vital in tracking down new positive cases, particularly new cases of new variants. Will he explain why the eye-watering £22 billion that has been spent on the test and trace system does not track each and every test that is sent out, based on a unique code for every test? Surely that would help close the net on positive tests much quicker than the public calls for help that we have seen over the past few days, when that vital information is missing when each test is returned.

[Matt Hancock]

I am not sure you were in the Chair, Madam Deputy Speaker, when I addressed that precise question in my statement. Not having the contact details happens in about 0.1% of tests. In this case, we think the test was done as part of a home test kit, when it is incumbent on the individual to set out those details. Home test kits can be sent to someone’s home, in which case of course we have the details of where it was sent. Alternatively, in response to surges, tests can be taken round by local authority teams and dropped off. We therefore need to find out exactly where this test was dropped off. What the hon. Lady omitted to say is that the team has done a good job of narrowing down where that may be to 379 households. The call-out at the weekend was answered with a number of leads, and we are working hard to make sure we find the individual concerned.

[Aaron Bell (Newcastle-under-Lyme) (Con) [V]]

I welcome my right hon. Friend’s statement. Both the scientific news and the progress of our vaccine roll-out suggest that we are well on the way to getting back to normal. In particular, I was delighted to learn about the fantastic new data showing that both the Oxford and Pfizer vaccines are effective in hugely reducing hospitalisations and deaths from covid and, indeed, that the Oxford jab, which is being manufactured here in Newcastle-under-Lyme, may even be the more effective of the two. Will he join me in welcoming the fact that our European neighbours, such as France, have recognised that fact and are moving to allow this terrific vaccine to protect the lives of older people there, just as it has done in the UK?

--- Later in debate ---

[Matt Hancock]

I am delighted to see any country recognise the life-saving value of the Oxford-AstraZeneca vaccine, as we recognise the life-saving value of all that have passed assessment by our regulator, the Medicines and Healthcare Products Regulatory Agency. We know that this vaccine is not only safe but is saving lives and stopping hospitalisations right across this country right now. I pay tribute to the scientists behind it, who have done so much work to get it to this place, and it is simply fantastic to see in the data with the naked eye that these vaccines are saving lives.

[Ian Paisley (North Antrim) (DUP) [V]]

I congratulate the Secretary of State on having the temerity and leadership to identify early on that vaccination and getting a good vaccine was the way ahead. Here we are, leading the way for not only Europe but the world. Indeed, a few weeks ago, the Irish Government and Europe tried to steal vaccines out of the arms of people in Northern Ireland because they were so jealous of how well the United Kingdom was doing. With that in mind, what will the Secretary of State do in late summer, given the fact that we have eight times the amount of vaccine that the United Kingdom will need? Is a list being compiled of needy countries where the United Kingdom can help people with vaccination?

[Matt Hancock]

Yes, absolutely. While I am so proud of the work that we have done in this United Kingdom to develop the Oxford-AstraZeneca vaccine and to buy vaccines from around the world that are safe and effective, so that we are able to vaccinate everybody here at home, I am also cognisant of the fact that vaccination around the world will be necessary. I was very pleased to see that COVAX started vaccinating in Ghana last week. It currently looks as if we may have excess vaccines in the future, and we have clearly committed that we will make them available around the world.

We know for sure that we seek to vaccinate with two doses every adult in the UK. There may well be a need for a third vaccination over the autumn against variants, and there is currently a clinical trial considering the vaccination of under-18s. So the exact number of vaccines that we will need for the UK population is not yet known, but we are keen to ensure that we then go on to support, with vaccines and with the money that we have already pledged, the vaccination of the most underdeveloped parts of the world.

[Mark Pawsey (Rugby) (Con) [V]]

The Secretary of State knows how well the vaccination programme is going here in Warwickshire, and his remarks at Friday’s national briefing were greatly appreciated here. Many of the residents being vaccinated at Locke House in Rugby have asked me about the road back to normality, and some have asked about getting some sun on a foreign holiday. Could he say something about any plans the Government are considering for people wishing to travel both at home and abroad to be able to demonstrate that they have received their vaccination through some form of certification?

[Matt Hancock]

Coventry and Warwickshire have done an amazing job, and I was very pleased to see them top the ranks published on Thursday of the areas of England that have vaccinated the most. I congratulate my hon. Friend and his team.

On foreign holidays, we said in the road map that international holidays will not be allowed before 17 May. We are working with the global travel taskforce, which met this lunchtime, just before I came to the House. It is chaired by my right hon. Friend the Transport Secretary. I am on it, along with Home Office and Foreign Office colleagues and representatives from the travel industry—from the airlines, cruise ships and others. That will report by 12 April. Last year, international travel restrictions were about restricting the number of cases due to high prevalence elsewhere when the prevalence here was low. The challenge now is that we have to take into consideration the risks from variants of concern, which means that more understanding about the impact of vaccines on variants of concern, such as the one first discovered in Manaus in Brazil that we were talking about earlier, is critical to answering the question of when we will be able safely to reopen international travel.

[Florence Eshalomi (Vauxhall) (Lab/Co-op) [V]]

I received some welcome news this morning that Lambeth’s local covid vaccination team is one of the highest performing teams in the country. Our local clinical commissioning group reports that 85% of people over 75 and 89% of residents in care homes have now been vaccinated. Here in Vauxhall, we have had to implement the surge testing operation in the past few days because a case of the South African variant was discovered locally. This is all down to the tireless efforts of our primary care workers, nurses, GPs, pharmacies and an army of volunteers. I am concerned, though, that despite this heroic effort, there is still some misinformation and vaccine hesitancy. Does the Secretary of State agree that more needs to be done to counter this misinformation and to support the vaccine roll-out and take-up among our black, Asian and ethnic minority communities?

[Matt Hancock]

Yes, I do. I want to add one more person to the long list of people whom the hon. Lady rightly thanked for their incredible work of getting take-up in Lambeth to as high as 85% among the over-75s, and that is her. She has played a personal leadership role, and I thank her and pay tribute to her for that. There is still much more work to do, and I hope that we can keep working together on it.

[Jane Stevenson (Wolverhampton North East) (Con) [V]]

The pace and scale of the vaccination programme has been incredible, and we owe a debt of thanks to everyone involved. In Wolverhampton, we have kept pace by using a variety of locations, including our leisure and community centres. As we all look forward to restrictions ending, I hope that these public buildings will be returned for leisure and community use. For how long does the Secretary of State predict that we will need a mass vaccination programme? With the potential need for a rolling programme of booster injections or vaccination against new variants, what infrastructure is being planned so that we can protect our entire population for as long as is necessary without overburdening our NHS?

[Matt Hancock]

My hon. Friend raises a very important point: free the leisure centres! Many are being used as vaccination centres now, but, like her, I look forward to the day when they can be used for the purpose for which they were built—as leisure centres. It is important that, should we need a continued vaccination programme, for instance, over the summer and into the autumn, as seems likely, we will have to move to more permanent places or places that are free to be used as vaccination centres over that period. In fact, that has already started to happen. We have already started to move some of our testing and vaccination centres to more semi-permanent sites to free up the original sites that we started with, because we needed things to move incredibly quickly. That is an important consideration. Frankly, it is best done as close to the local area as possible, so it is right that I do not get involved in each individual one. I am absolutely certain that the NHS in Wolverhampton is far better placed to make those sorts of decisions than I am from this Dispatch Box, but I hope that it will keep my hon. Friend informed.

[Daniel Zeichner (Cambridge) (Lab) [V]]

I am afraid that “data not dates” clearly has not worked, because people have quite understandably just focused on the dates. The spring sunshine at the weekend meant that in lovely places such as Cambridge it was very busy. Are the Government now going to make a precautionary adjustment or, with hospital numbers still so high, take a chance and risk running the NHS into the ground?

[Matt Hancock]

No.

[Dr Julian Lewis (New Forest East) (Con)]

Given that we believe in people taking responsibility for their own actions, will my right hon. Friend confirm that the refusal of a minority to accept vaccination is no reason to delay the lifting of restrictions on society as a whole?

[Matt Hancock]

That is an important point. We do not have mandatory vaccinations in this country. We do encourage as much uptake is possible, but with the percentages for uptake well into the 90s among the groups who have been offered the vaccine, it is clear that we will be able to get very high levels of coverage and therefore lift restrictions. I hope will be able to lift restrictions on the basis of the dates in the timetable set out but, as per my answer earlier, we will also monitor the data on the impact between each one.

[Mohammad Yasin (Bedford) (Lab) [V]]

Anita Barker, the headteacher of Scott Primary School in Bedford, is doing all she can to keep her school safe and open, but she knows that more can be done and wants her staff to be vaccinated. I understand the JCVI’s reasoning on priority, but we have already made a special case for schools. The success of the road map hinges on schools going back safely, so does the Secretary of State have the political will to do all that he can to prevent further school closures and recognise that that means vaccinating school staff as soon as possible?

[Matt Hancock]

I am very happy to ensure that, as much as possible, school staff are vaccinated whenever they possibly can be within the JCVI categorisations, but we have to follow the clinical advice on this, because there is no evidence of teachers being worse affected by covid than other professions. It is incumbent on us all to ensure that the message gets across that the prioritisation—the order of the queue, so to speak—is based on the best clinical advice as to how to save the most lives most quickly. I am sure that is something in which everybody wants to share.

[Chris Grayling (Epsom and Ewell) (Con)]

I again congratulate my right hon. Friend on the 20 million milestone, which is fantastic achievement for everybody involved. May I probe him on the question of outdoor transmission? It has been quite clear in the past few days that the level of adherence to the rules has dropped in outdoor settings; has my right hon. Friend’s research shown that there is genuinely an issue around the transmission of the virus outdoors? Have we actually seen any significant incidents of widespread transmission in outdoor settings?

[Matt Hancock]

The clinical advice is that outdoors is safer than indoors—the likelihood of transmission outdoors is much lower—but that in crowded outdoor areas in particular it is not nil. Hence, the road map is based on opening up outdoors sooner, but people should still follow social distancing and, of course, follow the rules, which should mean that come the 29th of this month we are able to open up outdoors first.

[Martyn Day (Linlithgow and East Falkirk) (SNP) [V]]

Scottish health protection teams are having to trace all the people who travelled on the plane to Aberdeen, and there must be similar risks and concerns in England, given the travel through London. Of course, there are no passenger lists for anyone who travelled on by train. Does the Secretary of State not therefore agree that it is a matter of urgency that his Government change policy to reduce the risk of importing further and more dangerous variants?

[Matt Hancock]

Since the six people under discussion with the variant of concern first found in Brazil travelled here, we have introduced further strengthening at the border—the hotel quarantine. I think the best approach would be a UK-wide one. I discussed that with my colleagues in the devolved Administrations and I look forward to a time when we are able to have an aligned policy.

[Andrew Jones (Harrogate and Knaresborough) (Con)]

The constituency data released by Public Health England last Friday showed that more than 30,000 people in Harrogate and Knaresborough had had their first dose of the vaccine. This fantastic local performance, alongside the stunning national performance, reflects the expertise, determination and teamwork of many people, and I put on record my gratitude to them. Will my right hon. Friend confirm that we are on track to give everyone their second dose of the vaccine within 12 weeks of the first?

[Matt Hancock]

Yes; we have the vaccines available, and local areas need to know that the vaccines will be delivered to them in order for them to meet their schedule commitments for those second jabs. The logistics of the second jab are slightly more complicated than the first, because we need to make sure that the right person gets the right vaccine on the right date. There is a huge amount of work under way as that programme starts—today being 12 weeks to the day since the vaccination programme as a whole started. May I put on the record my thanks to the team in Harrogate, who have done an amazing job vaccinating over 30,000 people—more than the national average, if my memory serves me correctly? I thank my hon. Friend for his leadership in Harrogate and for supporting the team there to make this happen.

[Clive Efford (Eltham) (Lab) [V]]

The roll-out of the vaccines by the NHS and the efficacy of the vaccines are to be celebrated, and I congratulate everybody involved. However, the UK has the highest mortality rate per capita of any major country. Given that the Government maintain that they have consistently followed expert scientific advice, how soon does the Secretary of State think we should review that scientific advice and the decisions of the Government that were based on it so that we can learn the lessons of the past year as soon as possible?

[Matt Hancock]

We are constantly learning—about the asymptomatic transmission of the virus, the way in which it mutates and what works effectively against it; and we update policy according to what we learn. That is the nature of science; it is about constantly learning as new facts come to bear. We do not wait until after a pandemic to learn; we learn all the way through it.

[Ruth Edwards (Rushcliffe) (Con) [V]]

I congratulate my right hon. Friend on the pace of the vaccine roll-out, and welcome the good news about the sharp decline in hospital admissions and deaths among vaccinated groups. Does he agree that this provides real hope that we will be able to end social distancing, along with other restrictions, from 21 June?

[Matt Hancock]

Yes.

[Stella Creasy (Walthamstow) (Lab/Co-op) [V]]

I know that the Secretary of State shares my concern that not every community is as confident as others about taking up the vaccine. That is why I know he will want to congratulate my local doctors, primary care networks and local church leaders in Walthamstow, who led a vaccine clinic last week in our community to help support the black and ethnic minority residents to take up the vaccine. He will also want to congratulate my doctors on being some of the highest performers in the country in terms of getting people to have their vaccine. Will he meet me to discuss what we can learn about this community-led approach to vaccination and how we can do more to help that outreach work bridge the gap between different communities in our country, so that nobody is left behind in this health challenge?

[Matt Hancock]

Yes; this is one of the hon. Lady’s campaigns that we can all get behind. She is quite right to raise the work that is being done in Walthamstow, which is very impressive. I will arrange a meeting between her and the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), to see what we can learn and what we can replicate.

[Sir Edward Leigh (Gainsborough) (Con)]

This morning I received an email from a lady who is extremely clinically vulnerable. For perfectly good medical reasons, she cannot receive a flu jab or a covid jab, so she is very concerned that she will not be able to leave her front door if we bring in covid passports. For reasons of civil liberties, will the Secretary of State make it absolutely clear that we are not interested in bringing in covid passports internally, but that they are useful for foreign travel? I say to the shadow Secretary of State that, with the benefit of hindsight, perhaps we should have introduced a hotel quarantine system much sooner. Will the Secretary of State make it clear that he will resist the travel lobby? Will he be absolutely up-front and honest with people, and say that it is unwise to book summer holidays now because there may be these mutants and it is better to hold off? I think that people accept the Government being tough, as long as they are consistent, particularly on foreign travel.

[Matt Hancock]

I will address each of my right hon. Friend’s questions in turn. The point about certification is important. While decisions on certification are being reviewed in a review led by my right hon. Friend the Chancellor of the Duchy of Lancaster, it is clear that we will need to provide people with the ability to certify whether they have had the jab, and we will absolutely need to consider those who have a certified clinical reason why they cannot have the jab. That applies to a relatively small number of people, but it is an important consideration that will be taken forward as part of that work.

I am grateful to my right hon. Friend for expressing his views on the approach to international travel. Quarantine is required for everybody who arrives as a passenger to this country, as well as testing on day 2 and day 8. That means we have a robust procedure to ensure that cases cannot be brought into this country and then spread in the community.

[Mr Ben Bradshaw (Exeter) (Lab) [V]]

With covid rates in Devon now down to just 31 per 100,000 and with all the vulnerable groups due to have been vaccinated by the end of this month, what will be the justification for keeping my constituents locked down and local businesses closed through Easter and beyond because rates happen to be higher somewhere else?

[Matt Hancock]

We obviously had a tiered system over the autumn and one of the challenges we found was of people travelling from a part of the country where rates are higher to those where rates are lower. Therefore, while we do not rule out a localised approach to outbreaks, we will move down the road map as a nation across England.

[Sir Christopher Chope (Christchurch) (Con)]

People understand figures more than percentages, so I ask my right hon. Friend: how many people in England have been admitted to hospital having already had a vaccine for at least three weeks? That figure will illustrate the risk assessments that people would like to be able to make in respect of this set of vaccines. In the same way that I have been told that flu vaccines are only 40% efficient, these seem to be at least 80% efficient, which is really good news.

[Matt Hancock]

I do not have those specific figures to hand, but the MHRA—the regulator—regularly publishes what are called adverse events when somebody still has a problem with coronavirus having had the vaccine or has a response to the vaccine, and I will ensure that the appropriate body, whether it is MHRA or Public Health England, publishes both the number and the percentage.

[Hywel Williams (Arfon) (PC) [V]]

The covid testing package reservation form for international travellers from red list countries into England requires proof of purchase of two covid-19 tests before they can travel on to England and Scotland. However, there is no reference to Wales on the form. Will the Secretary of State assure me that that is an oversight that will be remedied immediately and that international travellers from England continuing on to Wales are indeed required to comply with the testing and quarantine rules?

[Matt Hancock]

Yes, all international passengers are required to comply with the rules. It is the first time I have heard of that particular issue. I will write to the hon. Gentleman to set out either why the system is done in that way or that it has been rectified, if that is what is needed.

[Steve Brine (Winchester) (Con)]

The road map contains a chapter on building resilience to future pandemics, which I think we must be honest and say will not leave us alone for another 100 years. Therefore, with respect to the global network of zoonotic research hubs, as the Prime Minister wisely set out in his five-point plan at the UN last September, can we ensure that they build on the work of experienced virus hunters already out there such as the Global Health Network who have years of experience searching for unseen viruses that leap from animals to humans?

[Matt Hancock]

Yes. The proposed work, as set out by the Prime Minister at the UN General Assembly, which we are working on with our presidency of the G7, aims precisely to build on and strengthen the existing work that is under way. However, clearly we need to ensure that all the future risks, whether they are from zoonotic diseases or are due to environmental changes that lead to risks to human health, are taken into account and we need to have an early warning system that is as effective as possible.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD) [V]]

This very afternoon, I am going to get a jag—a “jag” is a Scottish term for a vaccination, not a posh car. Getting the maximum number of people in the highlands vaccinated as fast as possible is crucial to the reopening of businesses in my constituency, including those in hospitality and tourism. Will the Secretary of State give the maximum encouragement to the Scottish Government to make sure that that happens?

[Matt Hancock]

The vaccination programme is a successful UK-wide programme. We work very closely with the Scottish NHS and indeed the Scottish Government to make sure that right across all these islands we have the vaccination available fairly, according to clinical need, as fast as we possibly can. We can deliver this because we are one United Kingdom, with the buying power and scientific capability that comes from being one United Kingdom, all working together; this simply would not be possible if there were the separation that some propose. I will do everything I can to ensure that businesses and residents in Scotland get the protection from the jab that they deserve at an equal pace to everywhere else in this country. It is a crucial part of getting all of us on the road to recovery.

[Sir Desmond Swayne (New Forest West) (Con)]

In order that we get and keep herd immunity, is my right hon. Friend planning any hard-hitting public information campaigns to ensure that younger adults take up the vaccine with the level of enthusiasm that my relatively elderly constituents have done?

--- Later in debate ---

[Matt Hancock]

Yes, we are absolutely planning to instil as much enthusiasm as we can muster among younger people, as we have seen among older people. The message to anybody who is younger is that getting a jab helps to set us all free and back on the road to recovery. It helps protect them, including from long covid, which can be a debilitating condition, and all of us. It is the right thing to do.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for an incredible, record-breaking vaccine roll-out, with which we are all incredibly impressed. Given the wonderful results showing that even one vaccination dose reduces the chance of hospital admission by 80%, will he outline the rationale for not vaccinating all workers in frontline services? At present, a 61-year-old writer who is able to work from home will receive a vaccination before a 59-year-old shop worker who is face to face with hundreds of different people each day. Should the Secretary of State and the Government not consider those thousands of frontline workers, who have made the continuation of life possible during these difficult times?

[Matt Hancock]

We did consider this question and asked our clinical advisers, the JCVI, to look into it. It found that notwithstanding the different risks that different occupations face, the overriding determinant of risk is age. Therefore, we are proceeding on the basis of that advice across the UK.

[Jason McCartney (Colne Valley) (Con) [V]]

More than 40% of the adult population of my constituency have now received a vaccination, which is a truly magnificent effort, but across Kirklees there was an uptick in covid cases last week. What message can the Health Secretary send to my constituents so that we can stay on track with the road map out of lockdown?

[Matt Hancock]

I am very grateful to my hon. Friend for asking that question because we have seen, in a minority of areas, a small increase in the number of cases and that does include Kirklees. We have seen this in just under one in five local authority areas. My message to everybody in Kirklees is that this is not over yet. We have a road map out but it is not a road map for Government alone; it is a road map for all of us to walk down together. That means following the rules, and that means, for now, staying at home, but by doing that, we can all then move on the dates that are set out, and instead of “not before” dates they will become the dates that we can make the next step. But it is on all of us, and so I would urge everybody to continue. I know it has been a difficult winter and the sun is starting to shine a bit brighter, but we must all stick at this. We can see the way out and I hope that we can get there together.

[Ms Marie Rimmer (St Helens South and Whiston) (Lab) [V]]

Over 3,000 clinically vulnerable people in cohort 6 are going to have their vaccinations cancelled in St Helens at the end of this week, unless the required supplies are delivered by Thursday lunchtime. The vaccine site is serving four primary care networks, yet the national supply team is only recognising and supplying one network. The mutual aid gathered to cover this shortfall in the past is no longer available. Will the Secretary of State please urgently intervene to address this misunderstanding so that no vaccinations are cancelled?

--- Later in debate ---

[Matt Hancock]

I will absolutely ensure that the Minister for Vaccine Roll-out gets in contact directly with the hon. Lady. This is a massive effort, so there may be logistical challenges. We will look at and understand what the situation is in St Helens. As I have some family in St Helens, I am pretty keen to make sure this gets sorted ASAP. But it just shows that it is not easy to do this. The team are working incredibly hard all the time to resolve issues like the one that she rightly raised to make sure that this can go as smoothly as possible.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I thank the Secretary of State for his statement and suspend the House for three minutes to make the necessary arrangements for the next business.

Oral Answers to Questions

Matt Hancock Excerpts

Tuesday 23rd February 2021 Commons Chamber

[The Secretary of State for Health and Social Care (Matt Hancock)]

I am delighted that on 14 February we hit our target of vaccinating 15 million people across the UK and now more than 17.7 million people—one in three adults in the country—have been vaccinated. The NHS is delivering more than 250 vaccinations every minute, on average, and we are vaccinating at a greater weekly rate than anywhere else in Europe.

[Mr Holden]

The Government’s vaccine programme, procurement and roll-out has been described as “world-beating”. Those are not my words, but those of the Public Accounts Committee, which has Scottish National party, Labour and Lib Dem Members on it. Will the Secretary of State just clarify the link between the vaccine programme and the road map, because it is the return to normality, as far as is possible, that we want to see as soon as possible?

[Matt Hancock]

My hon. Friend is absolutely right to make this link, because not only are the vaccines important to keep each individual safe—we saw wonderful data yesterday about how effective they are at reducing hospitalisations and deaths—but the vaccination programme is crucial to the road map out of this pandemic. It is only because of the success of the vaccine programme that we are able to set out the road map in this way. The vaccine is good for the individual, but it is also good for all of us, because by taking a vaccine people are helping to protect themselves and helping all of us to get out of this pandemic situation.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

The provision of insufficient doses for care home staff to be vaccinated at the same time as elderly residents may have contributed to the fact that only two thirds have been immunised. As well as the convenience, the solidarity of being vaccinated with colleagues has helped to encourage uptake of 94% in Scotland. Will the Secretary of State ensure that staff can get vaccinated when second doses are delivered to care homes?

[Matt Hancock]

Yes, when the vaccination programme goes to a care home, vaccines are offered both to residents and to staff, of course. We want to support the ability of more and more people to access the vaccine, and that includes care home staff. People who work in a care home can now go on to the national vaccination site and book themselves an appointment. Alternatively, when we go to give the second dose to residents, any staff who have not yet taken up the opportunity of a vaccine will have the offer of getting going on the programme. I hope that care home staff and NHS staff across the board will listen to the words of the chief medical officer, who said that it is the “professional responsibility” of people who work in care settings to get vaccinated. It is the right thing to do.

[Dr Whitford]

More vaccine-resistant strains, such as the South African variant, could risk undermining the UK’s vaccine programme. As they could come via any country, does the Secretary of State not agree that all travellers should undergo strict quarantine?

[Matt Hancock]

Yes, I do. All those who arrive in this country as passengers need to undergo quarantine, and we have both the hotel quarantine and home quarantine; all need to be tested; and all the positive test results are sent for sequencing so that we can spot any new variants. This is a critical part of our national defences. The good news is that we can see from the data that the number of new variants in the country is falling and is much lower than it was last month. We obviously keep a very close eye on that, because making sure that we do not have a new variant that cannot be beaten by the vaccine is a critical part of the road map, as set out by the Prime Minister yesterday.

[Liz Kendall (Leicester West) (Lab)]

The Prime Minister promised that all staff in elderly care homes would be vaccinated by the end of January. Will the Secretary of State confirm that more than 30% of those staff in England have not been vaccinated, and that the proportion rises to almost half of all staff in elderly care homes in London? Will he urgently set out precisely how the Government will increase uptake and tackle lies and misinformation about the vaccine among this vital group of workers, as we have been urging the Minister for Care to do since before Christmas?

[Matt Hancock]

Yes. We are absolutely all on the same side on this issue. To be totally clear for the hon. Lady, and all those listening, the Prime Minister set out that we would offer the vaccine to all residents of care homes by the end of January and to all staff by 15 February, and we achieved that. The challenge is uptake. Rather than having a political ding-dong about it, what we all need to do is get out the positive messages about the vaccination programme. I am delighted that the Minister for Care and the Minister for Covid Vaccine Deployment have both been working incredibly hard on this issue, and we published an uptake plan last weekend. I am sure the hon. Lady will want to join the efforts to try to encourage everybody to get the jab.

[John Mc Nally (Falkirk) (SNP)]

What steps his Department is taking to support dental services during the covid-19 pandemic.

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[Liz Twist (Blaydon) (Lab)]

If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Matt Hancock)]

Yesterday, the Government published the road map that will put us cautiously but, we hope, irreversibly on the path towards reclaiming our freedoms once more. We are able to take these steps because of the resolve of people across the UK and the extraordinary success in vaccinating more than 17.7 million people—one in every three adults across the UK—and I would like to pay tribute to everyone who has played their part.

[Liz Twist [V]]

This coming Sunday is Rare Disease Day 2021. One in 17 people in the UK will be affected by a rare disease, and today people with PKU—phenylketonuria—are awaiting the outcome of a NICE appraisal of Kuvan, but 12 years waiting for Kuvan or other treatments is too long. Does the Secretary of State agree that our rare disease community deserves access to early diagnosis and treatment, and what will he do to make sure that this happens?

[Matt Hancock]

The hon. Lady is a long-standing and passionate campaigner for Kuvan, and I pay tribute to the work that she has done. The NICE methods review looks at the question she raises. It is important that we have a clinically-led process for approval of medicines, and I know she agrees with that. The question is ensuring that the details live up to that principle. The methods review will make sure that we take advantage of advances in medical technology, which will, I hope, allow us to bring drugs and treatments to patients of rare diseases who need them more quickly than in the past.

[Jeremy Hunt (South West Surrey) (Con) [V]]

Can I add my support to the previous question about the urgent need to sort out the issue of Kuvan, because I too have constituents suffering very badly from the long wait that they have had?

I wanted to talk to the Secretary of State about support for NHS frontline staff, who have done such a magnificent job this year but worry that, even now, we are not training enough doctors and nurses for the long-term needs of the NHS, and that is the crucial way that we will reduce the pressure on them. So could I ask him: will he be publishing a workforce plan this year, will that have independent projections as to the number of doctors and nurses the NHS will need in every specialty over the next couple of decades and will he commit to funding the number of training places that we need to make sure that we meet those needs of the future?

[Matt Hancock]

The good news is that, thanks in part to the work that my right hon. Friend did when he was in my shoes, we now have a record number of doctors in the NHS and he will have been as pleased as I was to see the record number of applicants to nursing places as well, because we need both more doctors and more nurses. I am delighted that, during the pandemic, we have increased numbers very substantially. On nurses, we are on track to meet our manifesto commitment to 50,000 more nurses, and we have seen a significant increase—just under 10,000—in the number of doctors too, so there is significant progress. Of course there is more to be done, and of course we will need to set out the route to that, as he suggests. The time is not quite right now, because right now there are still very urgent needs and pressures, thanks to the pandemic—I am sure that he and the Select Committee understand that—but this is undoubtedly a question that we will return to.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

Everybody knows—apart from the Secretary of State, it seems, from this morning’s media—that there were PPE shortages. The National Audit Office reported on it, we saw nurses resorting to bin bags and curtains for makeshift PPE, hundreds of NHS staff died, and his response was to pay a pest control firm £59 million for 25 million masks that could not be used, to pay a hedge fund based in Mauritius £252 million, again for facemasks that were inadequate and to pay a jeweller in Florida £70 million for gowns that could not be used. So will he take this opportunity to apologise, and will he commit to recovering every penny piece of taxpayers’ money from those companies that provided us with duff PPE?

[Matt Hancock]

Well, I am going to start by congratulating the hon. Gentleman—the right hon. Gentleman—on his appointment to the Privy Council. I appreciate the work that he has done in support of the Government and in support of the nation during this pandemic. Although occasionally he turns to rhetoric and narrow questions that he knows there are perfectly adequate answers to, he has generally during this pandemic, in the face of temptation—I mean this very genuinely—done the right thing and supported the right messages to people where they need to be made across party lines. So I congratulate him and thank him for that.

On the specifics of the question the right hon. Gentleman raised, of course, where a contract is not delivered against, we do not intend to pay taxpayers’ money, but of course, also, we wanted to make sure that we got as much PPE as we could into the country. While of course there were individual instances that we all know about and that highlight how important it was to buy PPE, there was, as the National Audit Office has confirmed, no national level shortage, and that was because of the incredible work of my team and the amount of effort they put into securing the PPE and doing the right thing.

[Jonathan Ashworth]

I dare say the Secretary of State has just finished off my political career with that fulsome praise but, on the substance of the point, I think he confirmed that he will—[Interruption.] When did it start? [Laughter.] I think he was saying in that answer that he will not be trying to recover money that he has paid out for duff PPE, but can I ask him about a different issue, which again comes down to public scrutiny and accountability? In London, a week or a week and a half ago, GP services with 375,000 patients were taken over by the US health insurance corporation Centene. There was no patient consultation; there was no public scrutiny. This is arguably a stealth privatisation, with huge implications for patient care. Will he step in, halt the transfer, ensure it is fully scrutinised and prevent takeovers like this happening in the future?

[Matt Hancock]

On the right hon. Gentleman’s first point, such a reasonable and sensible man is, of course, always welcome on these Benches, and I might ask, since his wife is taking the Labour party to court: why doesn’t the whole Ashworth family come and join us on this side?

On the substantive point the right hon. Gentleman raises, of course what matters for patients is the quality of patient care. We have seen again and again, especially throughout the pandemic, that what matters to people is the quality of care. That is what we should look out for, and that is, I know, what doctors, nurses and other staff, in primary care and right across the board, are working so hard to deliver on.

[Robbie Moore (Keighley) (Con)]

My right hon. Friend will be aware that the Airedale hospital in my constituency is now over 50 years old and 83% of the building is constructed from aerated concrete, which is known for its structural deficiencies. It is great news that this Conservative Government will commit to funding eight new hospitals in addition to the 40, but may I make an urgent plea to my right hon. Friend that the Airedale hospital, given its high-risk profile, is considered as one of the final eight?

[Matt Hancock]

I think my hon. Friend has just made his heartfelt plea and it has certainly landed with me, but I am not surprised because he has made this case to me on behalf of his constituents over and over again and he is quite right to. We are in the process of considering which hospitals will be in the eight additional, on top of the 40 that we committed to in our manifesto. I am grateful for his representations and we will certainly consider Airedale and its full needs for the local community.

[Chris Bryant (Rhondda) (Lab) [V]]

I wonder whether the Health Secretary would agree with me that coronavirus has not only changed many of the ways that we have to do our lives, but it is fundamentally going to have to change the whole structure of the NHS re. That means we are going to have to recruit more pathologists in this country for ourselves; we are going to have to have far more intensive care unit capacity; we are going to have to have UK manufacture not only of PPE but of vaccines if we are to be able to be self-reliant; we are going to have to have much better long-term rehabilitation for people with brain injuries; and we are going to have a complete review of our care homes, aren’t we?

[Matt Hancock]

We will need to draw many lessons from the pandemic. For instance, my brilliant team who have done all this procurement of PPE have also built an onshore PPE manufacturing capability. With regard to almost all items of PPE, 70% of it is now made onshore in the UK, up from about 2% before the pandemic—likewise for vaccines, where we did not have large-scale vaccine manufacture and we now do, and for a host of other areas, including some of those that the hon. Gentleman mentioned.

[Joy Morrissey (Beaconsfield) (Con) [V]]

With regard to the recent court ruling on the issuing of PPE contracts, will my right hon. Friend confirm that, as a result of the action taken by Health Department officials, NHS trusts did receive vital PPE, despite there being a global shortage?

[Matt Hancock]

My hon. Friend is absolutely right. The court ruling in question found that we were on average 17 days late with the paperwork, but it did not find against any of the individual contracts. My team worked so hard to deliver the PPE that was needed and so, as the National Audit Office has confirmed and as my hon. Friend set out, there was never a point at which there was a national shortage. There were, of course, localised challenges and we were in the situation of a huge increase in global demand, but I think that we should all thank the civil servants who did such a good job.

[Daisy Cooper (St Albans) (LD) [V]]

The Prime Minister’s first test for easing restrictions is that the vaccine deployment continues successfully, yet GPs and pharmacists have been telling me for weeks and weeks and weeks in St Albans that they cannot get the vaccine supply that they desperately need. They could be vaccinating 14,000 people a week, but they are only getting the supplies for 1,000. Why is that and when will it be fixed?

[Matt Hancock]

As we have repeatedly explained, supply is the rate-limiting factor. The hon. Member will no doubt have seen that there have been international discussions on the rate of supply, and countries around the world are finding supply the rate-limiting factor. Thankfully, thanks to the decisions that this Government took early, we have some of the best access to the supply of vaccine in the world. That is why we have one of the best vaccine delivery programmes in the world.

[Chris Grayling (Epsom and Ewell) (Con) [V]]

I congratulate my right hon. Friend again on the progress of the vaccination process. He should be proud of what he has achieved. The documents published yesterday about the road map did not appear to contain any assessment of the infection risk in individual settings, which could have demonstrated that there had been carefully informed decisions about the reasons for each individual restriction. Has that work been carried out? If so, will my right hon. Friend commit to publishing those assessments immediately?

[Matt Hancock]

Of course we assess this, but it is challenging to get to a statistical answer to the question that my right hon. Friend raises. When we have taken action to restrict access to areas where there is evidence of significant transmission, such as the hospitality industry, that confounds the statistical analysis because people cannot go into that environment and therefore the passing on of infection there reduces. This is a matter of evidence and judgment. It is a significant challenge, but the road map is based on our best assessment of the situation, which is based on clinical advice, including the focus on the fact that we know that outdoors is safer than indoors. Hence the early steps, after schools, are focused on opening things up outdoors.

[Carol Monaghan (Glasgow North West) (SNP) [V]]

Opening up by date and not data, as described by the Prime Minister yesterday, will allow prevalence in the general population to continue, unfortunately increasing the number of people affected by long covid. What discussions has the Secretary of State had with the Secretary of State for Work and Pensions to ensure that proper financial support is available for those afflicted by long covid, including a continued £20 a week uplift of universal credit?

[Matt Hancock]

Of course long covid is an incredibly serious condition for some and is part of our considerations and deliberations, but I want to correct something the hon. Member said. The road map sets out indicative dates before which we will not move, but we will be guided by the data, hence the five-week gaps between each step to make sure we have four weeks to see the impact of the step and one week of advance notice for the go/no-go decision. That is based on clinical advice, which I know is shared across the UK.

[Duncan Baker (North Norfolk) (Con) [V]]

I am delighted that many carers are in priority group 6 given the enormous and vital role they are playing during the pandemic. Recently, I led an initiative to help my local county council identify carers—and unpaid carers—around Norfolk as many are not on official registers. Will my right hon. Friend tell me how he is working with Norfolk County Council and all local authorities to ensure that those difficult-to-find carers are not missed in the call to be vaccinated?

[Matt Hancock]

I pay tribute to my hon. Friend’s work in making sure that all carers, who are properly in priority group 6, get the opportunity to be vaccinated, including those who may be unregistered with the system, but nevertheless are carers. It is very important and I pay tribute to the work of Norfolk County Council. I know that my hon. Friend the Care Minister will be happy to meet my hon. Friend and the county council to discuss what further can be done.

[Mr Speaker]

Let us head to Dr Rupa Huq for our final question. I am sorry about this, but we have taken a long time to get to this stage.

[Dr Rupa Huq (Ealing Central and Acton) (Lab) [V]]

It is pleasing that anti-vax propagandising has been clamped down on, but long predating covid, on a daily basis, women seeking to access abortion clinics have faced anti-choicers. At the moment they are on a 40-day running Lent protest. Will the Secretary of State work with Ministers across Government to ensure that no woman ever feels harassed or intimidated when obtaining medical care that she is legally entitled to?

[Matt Hancock]

I am very happy to take up that proposal. Nobody should be harassed when accessing any medical treatment. There are agreed rules around abortion and people should be able to access abortion properly, according to those rules.

[Mr Speaker]

I am suspending the House for three minutes to enable the necessary arrangements to be made for the next business.

Future of Health and Care

Matt Hancock Excerpts

Thursday 11th February 2021 Commons Chamber

[The Secretary of State for Health and Social Care (Matt Hancock)]

Mr Speaker, I come to the House today to set out our White Paper on the future of health and care. The past year has been the most challenging in the NHS’s proud 72-year history. The health and care system as a whole has risen in the face of great difficulties. Throughout, people have done incredible things and worked in novel and remarkable ways to deliver for patients, and we in this House salute them all—not just the nurse who may have had to care for two, three or four times as many patients as he would in normal times, and not just the surgeon who may have been called to treat patients beyond her normal specialism, but the managers across health and care who have come together in teams, as part of a health family, at local and national level; the public health experts, who have been needed more than ever before; and the local authority staff who have embraced change to deliver for their residents—and from all, a sense of teamwork that has been inspiring to see.

As a citizen, I care deeply for the whole health and care family, the values they stand for and the security they represent. They are there for us at the best of times, and they are there for us at the worst of times. As Health Secretary, I see it as my role sometimes to challenge but most of all to support the health and care family in their defining mission of improving the health of the nation and caring for those most in need.

I come before the House to present a White Paper based firmly on those values, which I believe are values that our whole nation holds dear. The White Paper is built on more than two years of work with the NHS, local councils and the public. At its heart, this White Paper enables greater integration, reduces bureaucracy and supports the way that the NHS and social care work when they work at their best—together. It strengthens accountability to this House and, crucially, it takes the lessons we have learned in this pandemic about how the system can rise to meet huge challenges and frames a legislative basis to support that effort. My job as Health Secretary is to make the system work for those who work in the system—to free up, to empower and to harness the mission-driven capability of team health and care. The goal of this White Paper is to allow that to happen.

Before turning to the core measures, I want to answer two questions that I know have been on people’s minds. First, are these changes needed? Even before the pandemic, it was clear that reform was needed to update the law, to improve how the NHS operates and to reduce bureaucracy. Local government and the NHS have told us that they want to work together to improve health outcomes for residents. Clinicians have told us that they want to do more than just treat conditions; they want to address the factors that determine people’s health and prevent illness in the first place. All parts of the system told us that they want to embrace modern technology, to innovate, to join up, to share data, to serve people and, ultimately, to be trusted to get on and do all that so that they can improve patient care and save lives. We have listened, and these changes reflect what our health and care family have been asking for, building on the NHS’s own long-term plan.

The second question is, why now, as we tackle the biggest public health emergency in modern history? The response to covid-19 has accelerated the pace of collaboration across health and social care, showing what we can do when we work together flexibly, adopting new technology focused on the needs of the patient and setting aside bureaucratic rules. The pandemic has also brought home the importance of preventing ill health in the first place by tackling obesity and taking steps such as fluoridation that will improve the health of the nation. The pandemic has made the changes in this White Paper more, not less, urgent, and it is our role in Parliament to make the legislative changes that are needed. There is no better time than now.

I turn to the measures in detail. The first set of measures promote integration between different parts of the health and care system and put the focus of health funding on the health of the population, not just the health of patients. Health and care have always been part of the same ecosystem. Given an ageing population with more complex needs, that has never been more true, and these proposals will make it easier for clinicians, carers and public health experts to achieve what they already work hard to do: operate seamlessly across health and care, without being split into artificial silos that keep them apart.

The new approach is based on the concept of population health. A statutory integrated care system will be responsible in each part of England for the funding to support the health of their area. They will not just provide for the treatments that are needed, but support people to stay healthy in the first place. In some parts of the country, ICSs are already showing the way, and they will be accountable for outcomes of the health of the population and be held to account by the Care Quality Commission. Our goal is to integrate decision-making at a local level between the NHS and local authorities as much as is practically possible, and ensure decisions about local health can be taken as locally as possible.

Next, we will use legislation to remove bureaucracy that makes sensible decision making harder, freeing up the system to innovate and to embrace technology as a better platform to support staff and patient care. Our proposals preserve the division between funding decisions and provision of care, which has been the cornerstone of efforts to ensure the best value for taxpayers for more than 30 years. However, we are setting out a more joined-up approach built on collaborative relationships, so that more strategic decisions can be taken to shape health and care for decades to come. At its heart, it is about population health, using the collective resources of the local system, the NHS, local authorities, the voluntary sector and others to improve the health of the area.

Finally, the White Paper will ensure a system that is accountable. Ministers have rightly always been accountable to this House for the performance of the NHS, and always will be. Clinical decisions should always be independent, but when the NHS is the public’s top domestic priority—over £140 billion of taxpayers’ money is spent on it each year—and when the quality of our healthcare matters to every single citizen and every one of our constituents, the NHS must be accountable to Ministers; Ministers accountable to Parliament; and Parliament accountable to the people we all serve. Medical matters are matters for Ministers. The White Paper provides a statutory basis for unified national leadership of the NHS, merging three bodies that legally oversee the NHS into one as NHS England. NHS England will have clinical and day-to-day operational independence, but the Secretary of State will be empowered to set direction for the NHS and intervene where necessary. This White Paper can give the public confidence that the system will truly work together to respond to their needs.

These legislative measures support reforms already under way in the NHS, and should be seen in the context of those broader reforms. They are by no means the full extent of our ambition for the nation’s health. As we continue to tackle this pandemic, we will also bring forward changes in social care, public health, and mental health services. We are committed to the reform of adult social care, and will bring forward proposals this year. The public health interventions outlined in this White Paper sit alongside our proposals to strengthen the public health system, including the creation of the National Institute for Health Protection, and last month we committed in our mental health White Paper to bringing forward legislation to update the Mental Health Act 1983 for the 21st century.

This landmark White Paper builds on what colleagues in health and care have told us, and we will continue that engagement in the weeks ahead, but it builds on more than that: it builds on this party’s commitment to the NHS from the very beginning. Eagle-eyed visitors to my office in Victoria Street will have noticed the portrait of Sir Henry Willink, who published from this Dispatch Box in 1944 the White Paper that set out plans for a National Health Service, which was later implemented by post-war Governments.

Throughout its proud 72-year history, successive Governments have believed in our health and social care system and strengthened it for their times. I believe the NHS is the finest health service in the world. I believe in the values that underpin it: that we all share responsibility for the health of one another. Its extraordinary feats this past year are unsurpassed even in its own proud history. Once again, we must support the NHS and the whole health and care system with a legislative framework that is fit for our times and fit for the future. We need a more integrated, more innovative and more responsive system, harnessing the best of modern technology and supporting the vocation and dedication of those who work in it. This White Paper is the next step in that noble endeavour, and I commend this statement to the House.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for advance sight of his statement. I suppose we should also thank Andy Cowper for advance sight of the White Paper.

We are in the middle of the biggest public health crisis that our NHS has ever faced: staff on the frontline are exhausted and underpaid; the Royal College of Nursing says that the NHS is on its knees; primary care and CCG staff are vaccinating and will be doing so for months ahead, including, possibly, delivering booster jabs in the autumn; and today, we learn that 224,000 people are waiting more than 12 months for treatment. This Secretary of State thinks that now is the right moment for a structural reorganisation of the NHS.

We will study the legislation carefully when it is published, but the test of the reorganisation will be whether it brings down waiting lists and times, widens access, especially for mental health care, drives up cancer survival rates, and improves population health. We are not surprised that the Secretary of State has ended up here. We warned Ministers not to go ahead with the Cameron-Lansley changes 10 years ago. It was a reorganisation so big that we could see it from space. It cost millions. It demoralised staff. It ushered in a decade of wasted opportunity and, of course, he voted for those changes and defended them in this Chamber, so, when he stands up, I hope that he will tell us that he was wrong to support them.

We have long argued for more integrated care, but how will these new structures be governed, how will they be accountable to local people, and how will financial priorities be set, because when something goes wrong, as tragically sometimes it does in the delivery of care, or when there are financial problems, such as the ones that we have seen at Leicester’s trust, where does the buck stop?

The Secretary of State is proposing an integrated care board tasked with commissioning, but without powers to direct foundation trusts, which spend around £80 billion and employ around 800,000 staff. He is suggesting a joint committee of the ICS and providers as well, but who controls the money, because it is from there that power flows? Both of those committees will overlap with a new third additional committee, the integrated care system health and care partnership, which includes local authorities, Healthwatch and even permits the private sector to sit on it. All these committees must have regard for the local health and wellbeing board plans as well. How will he avoid clashing agendas and lack of trust between partners, as we have seen at the ICS in Bedfordshire and Luton, for example? Nobody wants to see integrated care structures that cannot even integrate themselves. Legislation alone is not the answer to integration. We need a long-term funded workforce plan; we do not have one. We need a long-term, cross-governmental health inequalities plan; we do not have one. We need a sustainable social care plan; we were promised one on the steps of Downing Street and we still do not have one.

When the Secretary of State voted for the Cameron reorganisation 10 years ago, it was presumably because he wanted, in the words of the White Paper at the time, “to liberate the NHS”. Now he is proposing a power grab that was never consulted on by the NHS. It seems that he wants every dropped bedpan to reverberate around Whitehall again. He is announcing this just at the very moment when the NHS is successfully delivering vaccination, which is in striking contrast to the delivery of test and trace and of PPE early on where he was responsible. Again, we will look carefully at the legislation, but why is he so keen for these new powers? Why is he repealing his responsibility to set an annual mandate and bring it to Parliament?

The Secretary of State wants to intervene now in hospital reconfiguration plans, but why is he stripping local authorities of their power to refer controversial plans to him? With his new powers, will he reverse outsourcing? Will he end the transfer of staff to subcos? Will he bring contracts back in-house and block more outsourcing in the future? He is ditching the competition framework for the tendering of local services, while potentially replacing it with institutionalised cronyism at the top instead.

Fundamentally, how will this reorganisation and power grab improve patient care? The Secretary of State did not mention waiting times in his statement. It is mentioned once in the leaked White Paper. How will he bring waiting lists down? How will he improve cancer survival rates and widen access to mental healthcare, and by when? How will this reorganisation narrow widening health inequalities, and by when? Given that the Prime Minister insists that lessons cannot be learned from this pandemic until the crisis is over, why does the Secretary of State disagree with that and consider this reorganisation so urgent now?

[Matt Hancock]

I will take that as cautious support. I know that the hon. Gentleman sometimes has to say these things, but I am very glad that he leaves the door open for yet more enthusiastic support in the future, not least because of all the questions that he just asked. The proposals on the table—the proposals in the White Paper—are addressed directly to make the improvements that he calls for.

The hon. Gentleman raised an important point about the vaccination programme. The vaccination programme is one of the largest and also one of the most successful civilian operations that has happened in this country, and that is because of the teamwork among the NHS, local authorities, the Department and the brilliant civil servants who work in the vaccine taskforce. It is that combination, that teamwork and that integration which is making the programme the great success that it is.

The hon. Gentleman asked about timing, and I say to him: why argue for delay? Why stop work to integrate? Why stop work to ensure the NHS is more accountable? When people are working so hard in the NHS for us, why should we not work hard in this Parliament to give them the legislative support that they need and have asked for? That is the question he needs to answer if he wants to continue an argument for delay. If not now, when? There is no better time than immediately, so I hope that he will, on reflection and on reading the White Paper, come forward with enthusiastic support.

I absolutely look forward to debates about the details and the implementation. I look forward to the parliamentary passage of a significant piece of legislation in the future, and I look forward to the hon. Gentleman’s engagement on that, but the removal of bureaucratic barriers cannot wait. The increase in the integration of the system should not have to wait, and accountability for this enormous amount of taxpayers’ money to this House, and through this House to the citizens whom we serve, is something that should be welcomed right across this Parliament, and I hope that it will be.

[Jeremy Hunt (South West Surrey) (Con) [V]]

May I start my comments by thanking the brilliant staff at the Royal Surrey County Hospital for the wonderful care they gave me—this morning, as it happens, when I unfortunately slipped over and broke my arm on a morning run. I have just come from the hospital.

It is a very big deal to do a structural reorganisation of the NHS, and I know from my time as Health Secretary how distracting it can be, but it is none the less the right thing to do and a brave thing to do, because NHS staff want nothing more than to be able to give joined-up care—joined up between hospitals, GP surgeries, the social care system and community care—and the current structures make that more difficult than it should be.

I also welcome the public health measures, particularly on obesity, given the high mortality rates that obese people have had during the pandemic. However, these integrated care systems are going to be very powerful, so my question to the Health Secretary is this: how will the public know in their area about the quality and safety of care, and whether waiting lists are being properly managed? How will they know how good all that is? Is he planning to ask the CQC to do Ofsted ratings, as it successfully does for hospitals and GP surgeries?

[Matt Hancock]

I pay tribute to my predecessor’s work setting up integrated care systems in the first place. In a way, this legislation builds on the foundations that he laid when he was in my job, and I look forward to working with the Health and Social Care Committee on the legislation as it proceeds. We have already had discussions, and I am grateful for the Select Committee’s work so far and the insights it has provided.

The question my right hon. Friend raises about the accountability of ICSs is absolutely central, not just to accountability for the use of taxpayers’ money, but to driving up both the quality of care for patients and the health of the population the ICSs serve. It is critical that we ensure the correct combination of high levels of transparency, the role of the CQC as inspector, and accountability up from the ICS, through NHS England, to Ministers and therefore Parliament, and through our democratic processes to taxpayers. The White Paper sets out at high levels how that accountability will work. The details will be a matter for the Bill. The combination of transparency and clear lines of accountability are vital to make sure that while we use the integration provided for in the Bill to empower frontline staff to deliver care better, they are held to account for the delivery of that care and, critically, the outcomes for the population as a whole whom we serve.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

Health and social care staff always do their best for their patients and residents, regardless of legislative systems, but I welcome the Government’s recognition of the damage caused to the NHS in England by the Health and Social Care Act 2012, and the proposal to reverse some of its most obstructive and expensive aspects, particularly section 75, which forced the outsourcing of services, promoted competition instead of collaboration, and made pathways more disjointed and confusing for patients, especially those with complex conditions. The devil, however, will indeed be in the detail.

Which model of integrated care is the Secretary of State proposing? Will he merge organisations, including commissioning groups, or, as the NHS would prefer, create new public NHS bodies, similar to the health boards we have in Scotland? When sustainability and transformation partnerships were created, their transformation budgets were quickly used up in covering debts caused by the bureaucracy of the healthcare market, so what additional funding is he committing to bring about this reorganisation? Given the pressure of covid, the backlog of urgent cases, and extensive staff vacancies, how does he plan to create the capacity for staff to carry out such service change? Covid has highlighted the vulnerability of the care system, so what plans are there to integrate health and social care?

Finally, the Secretary of State has highlighted health inequalities, but poverty is the biggest driver of ill health. What discussions has he had with the Secretary of State for Work and Pensions and other Cabinet colleagues about promoting the prioritisation of health in all policy decisions?

[Matt Hancock]

Of course health is an important consideration in all policy decisions. The overall response to the pandemic has demonstrated that.

The hon. Lady is right to raise the issue of integration and to ask what plans there are for the integration of health and social care. Indeed, that is at the core of the proposals, as I set out clearly in my statement, and at the core of the White Paper. The integration of health and social care has improved significantly this year as a result of people having to work together in the pandemic. Fundamentally, social care is accountable to local authorities, which pay for it, and therefore to the local taxpayer, whereas the NHS is accountable to Ministers and central Government. The combination of these two vital public services is a challenge that I think can be addressed through the integrated care systems. We have been working very closely with the Local Government Association in England and the NHS to try to effect that integration as much as possible.

The hon. Lady raises the issue of funding. Of course, the NHS has record funding right now, and rightly so, but these reforms are about spending that money better to improve the health of the population, to allow new technology to be embraced, and to remove bureaucracy. It is not about having to spend more money on a reform; it is about reforming in order to spend money as well as possible.

[Bob Stewart (Beckenham) (Con)]

When I was in the Army, I was badly hurt, and I was put under the care of the NHS. In turn, it sent me to a private practitioner, in Harley Street actually, who did me the world of good, and I paid nothing. Now, as an MP, I am frequently asked, “Are the Government intending to privatise the NHS?”. My reply is, “No, of course they aren’t, and very little of the NHS is privatised.” Could I ask my right hon. Friend to inform me how much of the NHS is privatised as a percentage and whether the plans are to increase it or not?

[Matt Hancock]

The NHS is not privatised at all. The NHS is delivered free at the point of care, or free at the point of use, according to need, not ability to pay. Of course, the NHS buys all sorts of things—it buys goods, technology, scalpels and services of different scales and sizes—and it employs people, and this combination is essentially what the NHS is made up of. It matters not the name of the provision; what matters is the care for the patients, and the quality of support for the population’s health. The pandemic has demonstrated that what matters is the outcomes, and the coming together of different types of provision has always contributed to the delivery of care for patients, as my hon. Friend set out. That will no doubt happen for the entire future of the NHS, which I have absolutely no doubt will go from strength to strength, not just now, after the last 72 years, but for the next 72 years, and after that.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op) [V]]

I am fully in favour of a review of the NHS that brings it up to date and makes it the best healthcare centre in the world, but if he wants to make this a milestone, surely he should slow down a bit. Why not consult cross-party? At this unique time, when we have all been in this together, why can he not consult more? Why does he not to listen to the people, and consult those who work in the NHS, as well as the people who have benefited from it? Why rush this? Why not talk about it and get cross-party support? Politicians of all kinds have never ever got the NHS absolutely right. Why not work together across party lines, and consult the people who work in the NHS, and those who benefit from it? Slow down, Secretary of State, and you will get me on your side.

[Matt Hancock]

I very much hope to get the hon. Gentleman on side and supporting these reforms, not least because many of them were in not just the Conservative party manifesto, but the Labour party manifesto on which he stood. We have consulted extensively on the measures in this set of reforms over two years. I look forward to further work, consultation and discussions with parliamentarians on all sides before, during and no doubt after the passage of the Bill. It is an incredibly important piece of work. What I do not want to do is delay the improvements that people on the frontline have called for. The core measures of this Bill have been built on the asks of the NHS, working with local government, and I think we should get on and deliver that.

[Antony Higginbotham (Burnley) (Con)]

I give my overwhelming support to these proposals, particularly the drive for innovation and technology, which will improve not only access to care but care outcomes for patients. The Secretary of State will be aware that in Burnley General Hospital, we already have some advanced surgical robots that provide incredible care. Could I urge him to look, as part of these reforms, at how we can make sites such as Burnley Hospital regional centres of excellence in areas such as surgical robotics?

[Matt Hancock]

Yes. We care about technology in the NHS because we care about people and the improvements to people’s lives that it can generate. Surgical robots are just one example. I am very glad to hear that they are being used in such an innovative way in Burnley Hospital. I would love to come and see that for myself some time. This is exactly the sort of progress that the NHS should be making to free up the time of dedicated and highly skilled clinicians, and to enable the delivery of more high-quality surgery because of, for instance, the higher magnification that one can get in using a robot for surgery. That is just one example of the sort of thing that we can push further as a result of the measures in this White Paper.

[Mr Deputy Speaker (Mr Nigel Evans)]

When you go to Burnley, Secretary of State, I know you will also put Ribble Valley, Chorley and a few other places on your list.

[Tony Lloyd (Rochdale) (Lab) [V]]

The Secretary of State may be aware that before I returned to Parliament, I had some involvement with the establishment of the Greater Manchester model of health and social care. Can I offer him two insights from that? First, social care is clearly not yet funded in the way that is needed if we are to have proper integration. Secondly, it was possible to have a Greater Manchester strategic level for the nearly 3 million people of the conurbation, but to have integration and delivery at the district level. On the integrated care systems, will he guarantee that there will be nothing that prevents the very successful model that Greater Manchester is already pioneering?

[Matt Hancock]

Yes. The changes in Greater Manchester, in which the hon. Gentleman had an important role, are a good example of where we can drive this sort of integration. I can confirm that nothing I am proposing would get in the way of that. In fact, I hope that the changes in the White Paper will help areas that, like Greater Manchester, are already some way along this journey to go further, and will support them by ensuring there are fewer legislative barriers to the sorts of actions that they want to take. That includes both the measures across the NHS and the integration between health and social care.

[Danny Kruger (Devizes) (Con) [V]]

Frontline health and social care providers have shown enormous flexibility, innovation and collaboration in dealing with this crisis. I welcome the Secretary of State’s proposals. I am particularly pleased that he suggests the need both for clear political accountability and strong local autonomy for the frontline. Will he assure me that, unlike Nye Bevan, the Secretary of State does not want to hear the sound of dropped bedpans in his office in Whitehall, and that, rather, we need a more local, more collaborative and more community-led approach to health and social care, as proposed by the Conservative Henry Willink—as he says, the original designer of the NHS?

[Matt Hancock]

Yes, that is absolutely right. In fact, my hon. Friend put it rather better than I did. Perhaps I will take up his rhetorical suggestions for how to make this case. Accountability is important, but the more local the decision making, the better. There should be local decision making across a whole range of partners—not just in the core NHS, but by providers of services, from whatever sector they come, including the voluntary sector, which, during this pandemic, has been embraced more. We need to build on that to make sure that we have a system that can truly serve local needs. Ultimately, all healthcare is locally delivered, because it is delivered to an individual to improve or save their life. Essentially, we need to make sure that the appropriate decisions are taken as locally as reasonably possible.

[Feryal Clark (Enfield North) (Lab) [V]]

The pandemic has shone a light on massive health inequalities across the country. The Secretary of State announced the abolition of Public Health England in September, but there is still no clarity on where the vital health improvement function will sit in the future. Why are we hearing about new structures for the NHS today without also getting clarity on the arrangements for vital elements of public health and prevention?

[Matt Hancock]

There is a simple, clear reason for that, and I am very glad that the hon. Lady asks that question, because it is an incredibly important function. We will set out more details on the arrangements for health improvement functions, but the population health approach that is embedded within the integrated care systems set out in the White Paper will itself be at the fulcrum of delivery of health improvement and of narrowing health inequalities. If we think about it, around 20% of the impact on someone’s health is what happens in hospital; the rest is what happens outside hospital, the extra support that people can get and, of course, the choices that people make. Integrated care systems will be supported and funded in such a way that their goal is to improve the health of the local population, not just of the patient.

Health improvement is embedded in the structure and the design of the future of the NHS embedded in the White Paper, and the wider health improvement responsibilities will flow from that. We will set out the precise organisational structure of those shortly, but I needed to get the White Paper out first, because it is off this population health approach that the future of health improvement will be built.

[Anne Marie Morris (Newton Abbot) (Con) [V]]

I welcome the commitment to more joined-up care, which must include mental health. The Health and Social Care Act 2012 committed to parity of esteem between physical and mental health. Will the Secretary of State set out how, specifically, the White Paper builds on that? Will it require and measure parity of esteem in output, and particularly outcomes, for mental health? If not, why not?

[Matt Hancock]

I am grateful for my hon. Friend’s support. Parity of esteem between mental and physical health is critical, and of course it is embedded in a population health approach. It is critical that the new integrated care systems will of course have responsibilities for provision of mental health services as well as physical health services. The historical silos in the provision of mental health and physical health services need to be brought together; so often, the provision of both is critical in a world in which many people have multi-morbidities, including challenges with both their physical and their mental health.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement and for announcing a progressive strategy, which we all welcome. Does he not agree that this pandemic has opened our eyes to the gaps in frontline service provision and that, if nothing else, we must ensure that nothing is able to prevent basic cancer treatment from taking place as we go forward? I spoke recently to someone in the midst of a cancer battle who said that they had been trying to fight with one hand tied behind their back. How will the Secretary of State ensure that patients awaiting scans and treatment plans are able to safely access them?

[Matt Hancock]

Yes, of course. The figures out today demonstrate the scale of the challenge when it comes to cancer treatment. Of course the pandemic has had a challenging impact on cancer treatment. We are supporting cancer alliances to improve outcomes as much as possible, and to work through the backlog that has inevitably built up because of the pandemic. Cancer alliances are a very important part of the future of the delivery of care. In many cases, they will be bigger geographically than an ICS. For them and for other specialist treatments, of course some cases will have to be at a larger scale than an ICS. Alongside putting these reforms in place, we are absolutely determined to do everything we can to ensure that people get the treatment for cancer that they need as soon as possible.

[Steve Brine (Winchester) (Con) [V]]

I very much welcome the White Paper. I urge my right hon. Friend to “think workforce” at every stage, but to ensure that prevention is the golden thread that runs through all future legislation and plans. Given that the last 12 months has very much laid bare the impact of inequalities on our public health outcomes, will we be truly bold and return to our prevention Green Paper, which the Secretary of State knows well, when it comes to facing the obesity crisis, smoking prevalence, alcoholism, diabetes and stroke prevention, to name just a few?

[Matt Hancock]

Yes. There are measures in this White Paper that precisely pick up the work of the prevention Green Paper that my hon. Friend did so much to shape when he was in the Department with me. In fact, many of the proposals in the White Paper are built from conversations that he and I shared. I want to put on the record my gratitude for the work that he did in shaping this agenda, because ultimately a population health agenda is an agenda about the prevention of ill health. Of course we must—and we will—treat those who become ill, but it is far better for everybody to support people to take a shared responsibility, including their own personal responsibility to stay healthy in the first place. The population health agenda that will be at the heart of the integrated care systems is ultimately a preventive agenda, and one that I am very glad to hear that he supports so wholeheartedly.

[Munira Wilson (Twickenham) (LD) [V]]

On this day eight years ago, the Government announced and then legislated for a new funding model for social care, which the Tories then scrapped two years later. Eight years on, we have yet another NHS reform announcement, but only yet another promise to reform social care. With 25,000 care home deaths during the pandemic, what will it take for the Prime Minister to make good on his promise to fix social care, and when will the Secretary of State start the long-promised cross-party talks to find a solution?

[Matt Hancock]

On the contrary—this White Paper covers health and care. It covers the integration of the NHS and social care at a local level. Of course there is further work on funding, as we have committed to in our manifesto, but the integration of those services, which has been so important during the pandemic, is one of the critical pieces of the forthcoming health and care Bill.

[Bob Seely (Isle of Wight) (Con) [V]]

I congratulate the Secretary of State on this very important plan and announcement. As he knows, the Island is already piloting some ideas, so I thank his team of excellent advisers and the Secretary of State himself. May we have more pilot schemes to support his work? As he knows, the benefit of his approach may be felt more strongly on the Isle of Wight than anywhere else in Britain, due to our excellent but unavoidably small hospital at St Mary’s, the smallest county council in England, and our age profile. We want to help him and we want to be at the front of the queue. Will he also please consider the position of the 12 unavoidably small hospitals in England as part of the programme, of which St Mary’s is the most unique because it is on an island? I thank the Secretary of State and his team for their great work.

[Matt Hancock]

With an ask like that, it is hard to say anything other than yes, enthusiastically. I am keen to work with my hon. Friend, who is such an incredible voice for the Isle of Wight. The services on the Isle of Wight, by its island nature, are more closely aligned together than in many other parts of the country, but nevertheless suffer from some of the bureaucratic silo requirements in current legislation. I hope that these proposals will be received enthusiastically by all those involved in the provision of health, social care and public health on the Isle of Wight because they will remove the legislative barriers to closer integration and allow them to continue in the direction in which I know they are enthusiastically working with my hon. Friend’s support.

[Derek Twigg (Halton) (Lab) [V]]

In the middle of a pandemic, when its implications for future healthcare are still not fully understood and when NHS staff are exhausted, with no respite on the horizon, there are real concerns that the Secretary of State is embarking on this reorganisation now. So how will these plans specifically address the lengthening backlog in cancer treatments in Halton and the north-west? How will replacing local decision making with large sub-regional health bodies allow greater local accountability and encourage local innovation?

[Matt Hancock]

The devolution of decision making to integrated care systems will help to join up care and deliver it more effectively. That is one reason why these proposals have been received so enthusiastically by the NHS itself and by NHS colleagues, including from local government, not least because the proposals originated from proposals from the NHS. I look forward to working with the hon. Gentleman and suggest that he works with his local NHS to make sure that this legislation goes through in the most high-quality way possible and that we have a high-quality debate on it, so that it can serve his constituents in exactly the way he sets out.

[Ben Bradley (Mansfield) (Con) [V]]

I know from conversations I have had with the Health Secretary in Mansfield that much of this change will be widely welcomed, and joining up our services is vital if we are to have the best possible healthcare system. I just have one concern: the announcement also talks about new public health measures, and there is an obesity strategy that I fear risks increasing inequality by raising the cost of the weekly shop. Surely education is the key to public health, by, for example, teaching people to cook fresh meals, as people need the skills to make healthier choices or they just end up paying more. So will the Health Secretary ensure that the public health elements of these reforms focus on that education and do not just end up hitting people in their pockets?

[Matt Hancock]

Yes, of course I am alive to that concern, and I look forward to further discussing these measures with my hon. Friend. The crisis has demonstrated how helping people achieve a healthy weight is important, and the Prime Minister has shown personal leadership on that in policy terms. Of course more information and education is an incredibly important part of this because it is about shared responsibility, including personal responsibility, to improve public health. I look forward to working with my hon. Friend on the details of it and making sure that we can get this into such a shape that it genuinely supports the tackling of obesity in a way that supports people, as he sets out.

[Lilian Greenwood (Nottingham South) (Lab) [V]]

A decade ago the Minister and his Conservative colleagues pushed through the Lansley reforms, even though NHS staff warned us that they would lead to fragmentation and waste. Why should we trust him now, given that he and his party got it so wrong then? How will he gain the trust and confidence of all NHS workers for his plans, and for the timing of these reforms?

[Matt Hancock]

The reforms that we have set out were themselves initiated and generated from the NHS, which may be one reason why I am so pleased to have seen such a strong, positive reaction from the NHS to these proposals. They are about what happens over the decade to come. Of course we always need to be improving the NHS, and each reform is a matter of the context of its times. These reforms are about more innovation, more integration and more accountability for the NHS, all with the goal of supporting those who work on the frontline to deliver better care.

[Lee Anderson (Ashfield) (Con) [V]]

Covid has changed the way we live and work. We have all had to adapt, and our NHS has been forced to find better ways of working. Can my right hon. Friend reassure me that our NHS will learn from our covid days, adopt some of the new measures in place and improve its performance over the coming years, while delivering on our commitment to recruit 50,000 more nurses and build 40 new hospitals?

[Matt Hancock]

Absolutely. We are on track to hire 50,000 more nurses over this Parliament and build 40 new hospitals over the decade. Those were core commitments in the manifesto that my hon. Friend and I both stood on with great enthusiasm, and I look forward to delivering on them. The White Paper will help towards that, but that is on track and under way already. He is quite right about learning from what has gone well in the pandemic, during which the NHS has had to work so incredibly hard, and the White Paper will help to do that.

Some of the culture and some of the ways of working have been more flexible, more dynamic and more joined-up within the NHS over the past year, embracing more modern technology than ever before. It is critical that we keep pushing that culture forward and supporting people in driving that culture forward and do not fall back to old ways of working. The White Paper will help us to do that, but it is only one part, because it is everybody working as a team and working together that is at the core of where things have gone well over the pandemic.

[Imran Hussain (Bradford East) (Lab) [V]]

A year and a half ago, we halted the dangerous back-door privatisation of key services in Bradford’s hospitals while Ministers sat on their hands and ignored the outcry of NHS staff and local people. The proposals in the press confirm what I and many others have long said about the disaster and waste of privatisation in our NHS—[Inaudible.]

[Mr Deputy Speaker (Mr Nigel Evans)]

Imran, it is a very bad line, even on audio-only, but the Secretary of State is going to have a go at answering.

[Matt Hancock]

The irony is that the proposed changes that the hon. Gentleman was concerned about, which were halted, were ones that it is currently legally impossible for a Minister to stop without going through a whole process, which he knows about. The proposals in the White Paper will make it easier for us to work together collaboratively on the right outcome and remove some of the bureaucracy that, frankly, stops Ministers getting involved when a project is not going in the right direction. On that basis, I hope that he welcomes the White Paper.

[Mr Deputy Speaker]

Sorry about the gremlins, Imran, but the Secretary of State did very well in answering your question.

[Gareth Davies (Grantham and Stamford) (Con) [V]]

Can my right hon. Friend assure my constituents that bringing health and social care much closer together will help to provide a more efficient, higher-quality service? Can he specifically outline how an integrated care model may help to reduce demand for emergency services in Lincolnshire?

[Matt Hancock]

I very much hope so. This is about being able to deliver services according to local need and, crucially, not just looking at the patients who turn up—whether that is to an emergency service or through their GP for treatment in secondary care—but trying to get ahead of that and support people to stay healthy, bringing the budget of the NHS to bear on keeping people healthy in the first place. That preventive agenda is critical and can ensure not only that people stay more healthy but that we spend money more wisely.

[Dame Diana Johnson (Kingston upon Hull North) (Lab) [V]]

Having been in Parliament in 2010, I voted against the Tory-Lib Dem coalition’s flawed reorganisation, the failure of which has led us to today’s announcement. As well as sharing concerns about having another reorganisation during a pandemic, what guarantees can the Secretary of State give that these changes will improve the health of my constituents when, under his plans, Hull will be lumped into an artificial hotch-potch of the Humber Coast and Vale ICS: an area of 1,500 square miles with cities, market towns and remote rural and coastal communities, with little transparency and no clear lines of accountability to local people in Hull, with our stark health inequalities?

[Matt Hancock]

Improving the accountability of ICSs is absolutely at the heart of the White Paper. I set out the three sections, and one of them is accountability to ensure that as ICSs get stronger powers and a statutory footing, there is the accountability that necessarily goes with that.

There is a perfectly reasonable debate to have about the geography of ICSs, making sure that they cover the right scale to be able to deliver services effectively and yet are local enough to deliver for local people. That has been an ongoing discussion. The aim is to implement the measures set out in the White Paper by April 2022 and by that time we will need to ensure that those geographies are right. In very large part they are already, but if there is further work to do in any area, I am happy to have a discussion about that.

[Mary Robinson (Cheadle) (Con) [V]]

The demands of the pandemic on Stockport Council, GP services and my constituency hospital, Stepping Hill, have shown the benefits of joint working and data sharing to improve care and health outcomes. I therefore welcome today’s announcement. We know that when bodies work together, people receive better care.

Stockport Together’s previous journey on this path highlighted the huge benefits of health and care working together as well as the challenges of addressing silo working and the pressures of pooled budgets. Will my right hon. Friend confirm that the proposals will deliver a more streamlined system that will give seamless care and healthier outcomes for my Cheadle residents?.

[Matt Hancock]

That is the goal, exactly as my hon. Friend sets out. In particular, I am glad that she raised data sharing as part of the integration. It is critical that we have high-quality data sharing, with data protected for the individual but shared among those who need it for the purpose of joining up care. If someone goes to hospital, they will not have to give all their details over and over again, and their GP will know about it. Care homes, GPs and hospitals, for instance, will be able to care better for an individual without having repeatedly to diagnose. This is a very important agenda for the NHS, which it should approach with confidence as a core part of joining up care.

[Mohammad Yasin (Bedford) (Lab) [V]]

In my constituency of Bedford and Kempston, patients are being left in unimaginable pain as they struggle to access even emergency dental treatment. Dental practices are struggling to stay open with the impact of covid on their businesses, and those who have survived are struggling to cope with the backlog. Imposing targets is not working, so will the Secretary of State include oral health in his future plans and agree a sustainable funding solution with NHS dentists to end the crisis in oral healthcare?

[Matt Hancock]

The crisis has been very tough on dentistry. By the nature of dentistry, the infection prevention and control systems in place are a challenge. I look forward to working with dentists to ensure that this sort of integration can help them appropriately. I am happy to arrange a meeting between the hon. Gentleman and the Minister responsible for dentistry to discuss these concerns.

[Robert Largan (High Peak) (Con)]

I welcome the proposals for more integration and collaboration between the NHS and social care. However, it is vital that these important reforms do not get in the way of investment in NHS capacity and the commitment to recruit 50,000 more nurses. Will the Health Secretary assure the House that they will not and that the Government remain committed to the badly needed new urgent care centres at Stepping Hill Hospital and Tameside Hospital?

[Matt Hancock]

Yes, absolutely. Stepping Hill Hospital is obviously vital to my hon. Friend’s constituents. The urgent care centres are important too, especially in ensuring that people can have access to treatment closer to home for smaller, yet urgent problems. We have also introduced 111 First and people should call 111 before going to an urgent treatment centre or an A&E to let them know they are coming and to check that that is the right setting for them. That is an important part of our wider considerations, which the measures in the White Paper will help.

[Dan Jarvis (Barnsley Central) (Lab) [V]]

Shamefully, the poorer people are, the younger they will die. That link between economic deprivation and health outcomes means that Barnsley is suffering one of the highest covid mortality rates in England. Health inequality is an incredibly complex problem, but it is avoidable. Does the Secretary of State agree that a key test of the reforms is whether they will tackle that injustice?

[Matt Hancock]

I do. Tackling health inequalities is incredibly important and is a vital part of our levelling-up agenda. The hon. Gentleman is right to point out the gaps in life expectancy across the country. I hope that a move to a population health approach, whereby the focus of the whole local system is on improving the health of the population, not just those who ship up needing support, can help us as a society to tackle health inequalities.

[Tom Hunt (Ipswich) (Con)]

A key element of the statement today is that it strengthens accountability to this House, which I very much welcome. Will my right hon. Friend confirm that this will mean that, as local Members of Parliament, we are better placed to represent our constituents in this place when it comes to communicating any concerns that they might have about unpopular local reorganisation of key services at their local hospital?

[Matt Hancock]

Yes, absolutely. It is important that, while the NHS continues to evolve and must evolve, it is there to serve our constituents. For a reform to take place, it needs to make the argument for why that is better for our constituents. Ultimately, when such a large amount of taxpayers’ money is spent on a public service, it is right that there is accountability to Ministers, and through Ministers to the House, for the services that are provided—that is the essence of a democracy—while preserving clinical independence, for instance, for individual decisions, and for the National Institute for Health and Care Excellence and decisions about appropriate advice on drugs. That is the settlement that the White Paper proposes and that I hope garners widespread support.

[Margaret Greenwood (Wirral West) (Lab) [V]]

Integrated care systems have their roots in accountable care organisations, such as those used in America, in which individuals take out private health insurance. It is therefore hardly surprising that there is a great deal of concern about the introduction of integrated care systems here. Will the Secretary of State give a cast-iron guarantee that he will legislate to ensure that NHS patient data cannot be used to promote or sell private health insurance or services to patients?

[Matt Hancock]

I do not understand the logic of the hon. Lady’s question. I have not seen the sorts of concerns that she raises about integrated care systems, which, in the UK, have provided the joined-up care that people have been looking for for so long. I am happy to look at the details she raises on the provision of data, but the White Paper is about NHS provision, not the provision of healthcare through insurance, other than the national insurance that we come together as a society to pay in order to provide healthcare free at the point of use. That is a belief that I hold dear and is shared by the vast majority in the House and the country. I am happy to reaffirm that and reassure the hon. Lady.

[Dr James Davies (Vale of Clwyd) (Con) [V]]

As an officer of the all-party parliamentary group on obesity, I welcome this statement, particularly its promises relating to obesity policy, including limitations on unhealthy food advertising and new requirements for calorie information on food packaging. Will my right hon. Friend outline the likely timescales for the associated legislation and, in the interests of fairness and efficacy, will he ensure that there is a level playing field between advertising via British television broadcasters and advertising on often overseas online services, in terms of statutory extent and date of commencement?

[Matt Hancock]

Yes, these are very important measures and I am glad that they have my hon. Friend’s support, not least because of his extensive knowledge as a practising GP who has done so much during the crisis—the whole House is grateful for his commitment and work. On the timing of legislation, unfortunately I am not permitted to go into any further detail ahead of Her Majesty’s next visit to the other place, but the White Paper sets out the reforms that we hope to have in place by April 2022, and I hope that he can take from that some indication of our sense of pace.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

With one of the highest covid death rates in the world, and with NHS workers under such incredible pressure, this is hardly the best time to be talking about yet another NHS reorganisation. In his response to me two weeks ago, the Prime Minister committed to addressing the key underlying causes of the high and unequal covid death toll: primarily, socioeconomic inequalities driven by 10 years of austerity. He said that he would be implementing Professor Sir Michael Marmot’s recommendations, to “build back fairer.” How do the White Paper proposals address those inequalities and their impact on our declining life expectancy and on the highest excess mortality rate in Europe?

[Matt Hancock]

I gently say that I disagree entirely with the hon. Lady’s pessimism about the ability of improvements in the health service to assist in the closing of health inequalities and the provision of care. As a Greater Manchester MP, she will understand better than most the benefits that come from that sort of integration. The idea that we should fail to act on what the NHS has itself asked for because of the challenges it is facing is completely the wrong way round. I see it entirely the other way round; it is incumbent on us to act in order to deliver the improvements that the NHS is calling for.

[Andrew Lewer (Northampton South) (Con) [V]]

During the last Parliament, I sat on a joint Health and Housing, Communities and Local Government Committee, and I am pleased to be re-joining the latter Committee. That Committee commissioned a report on the future of adult care, which left open care insurance-type options to spread the financial burden, so as not to create an ever-larger NHS versus the critical local government role, and, crucially, with enhanced choice and flexibility for a 21st century care system. How will those aspirations fit into the plans that my right hon. Friend has described today?

[Matt Hancock]

The White Paper takes forward parts of those proposals relating to the integration between health and social care, and ensuring that it is those on the ground delivering health and social care who can decide the best way to provide that for their population. We are committed to taking forward funding reforms, as set out in our manifesto. Those funding reforms are not part of this Bill, but the Prime Minister has committed to bring those forward this calendar year.

[Mr Deputy Speaker (Mr Nigel Evans)]

I thank the Secretary of State for his statement, and for answering 30 questions in just under one hour and 10 minutes.

Covid-19 Update

Matt Hancock Excerpts

Tuesday 9th February 2021 Commons Chamber

[The Secretary of State for Health and Social Care (Matt Hancock)]

With permission, I would like to make a statement on new measures to keep this country safe from coronavirus. Thanks to our collective efforts, we are turning a corner. Cases of coronavirus have fallen 47% in the last two weeks, and they are falling in all parts of the UK, but we are not there yet. Hospitalisations are falling, but there are still many more people in hospital than at the April or November peaks, and the number of deaths, while falling, is still far too high.

Our vaccination programme is growing every day. We have now vaccinated over 12.2 million people—almost one in four adults in the United Kingdom—including 91.4% of people aged 80 and above, 95.9% of those aged between 75 and 79, and 77.2% of those aged between 70 and 74, who were the most recent groups to have been invited. We have also vaccinated 93.5% of eligible care home residents. We have made such progress in protecting the most vulnerable that we are now asking people who live in England who are aged 70 and over and have not yet had an appointment, to come forward and contact the NHS. You can do that by going online to nhs.uk, or dialling 119, or contacting your local GP practice, so that we can make sure that we reach the remaining people in those groups, even as we expand the offer of a vaccine to younger ages.

These are huge steps forward for us all, and we must protect this hard-fought-for progress by making sure we stay vigilant and secure the nation against new variants of coronavirus that put at risk the great advances that we have made. Coronavirus, just like flu and all other viruses, mutates over time, so responding to new variants as soon as they arise is mission critical to protect ourselves for the long term. We have already built firm foundations, like our genomic sequencing, which allows us to identify new variants, our testing capacity, which allows us to bring in enhanced testing wherever and whenever we find a new variant of concern, and our work to secure vaccines that can be quickly adapted as new strains are identified.

Our strategy to tackle new variants has four parts. First, the lower the case numbers here, the fewer new variants we get, so the work to lower case numbers domestically is crucial. Secondly, as I set out to the House last week, there is enhanced contact tracing, surge testing and genomic sequencing. We are putting that in place wherever a new variant of concern is found in the community, like in Bristol, Liverpool and, as of today, Manchester. Thirdly, there is the work on vaccines to tackle variants, as set out yesterday by Professor Van-Tam. Fourthly, there is health protection at the border, to increase our security against new variants of concern arriving from abroad.

I should like to set out to the House the new system of health measures at the border that will come into force on Monday. The new measures build on the tough action that we have already taken. It is of course illegal to travel abroad without a legally permitted reason to do so, so it is illegal to travel abroad for holidays and other leisure purposes. The minority who are travelling for exceptional purposes will be subject to a specific compliance regime and end-to-end checks throughout the journey here. Every passenger must demonstrate a negative test result 72 hours before they travel to the UK, and every passenger must quarantine for 10 days. Arriving in this country involves a two-week process for all. We have already banned travellers altogether from the 33 most concerning countries on our red list, where the risk of a new variant is greatest, unless they are resident here. But even with those tough measures in place, we must strengthen our defences yet further.

I appreciate what a significant challenge this is. We have been working to get this right across Government and with airport operators, passenger carriers and operational partners, including Border Force and the police—I thank them all for their work so far—and we have been taking advice from our Australian colleagues, both at ministerial level and from their leading authorities on quarantine. The message is, “Everyone has a part to play in making our borders safe.” I know this is a very difficult time for both airlines and ports, and I am grateful to them for working so closely with us. They have such an important role to play in protecting this country and putting in place a system so that we can securely restart travel when the time is right—the whole team at the borders working together.

Let me set out the three elements of the strengthened end-to-end system for international arrivals coming into force on 15 February. This new system is for England. We are working on similarly tough schemes with the devolved Administrations, and we are working with the Irish Government to put in place a system that works across the common travel area. The three parts are as follows: hotel quarantine, testing and enforcement.

First, we are setting up a new system of hotel quarantine for UK and Irish residents who have been in red list countries in the last 10 days. In short, this means that any returning residents from those countries will have to quarantine in an assigned hotel room for 10 days from the time of arrival. Before they travel, they will have to book through an online platform and pay for a quarantine package, costing £1,750 for an individual travelling alone, which includes the hotel, transport and testing. That booking system will go live on Thursday, when we will also publish the full detailed guidance.

Passengers will only be able to enter the UK through a small number of ports that currently account for the vast majority of passenger arrivals. When they arrive, they will be escorted to a designated hotel, which will be closed to guests who are not quarantining, for 10 days or longer if they test positive for covid-19 during their stay. We have contracted 16 hotels for an initial 4,600 rooms, and we will secure more as they are needed. People will need to remain in their rooms and, of course, will not be allowed to mix with other guests. There will be visible security in place to ensure compliance, alongside necessary support, so that even as we protect public health, we can look after the people in our care.

Secondly, we are strengthening testing. All passengers are already required to take a pre-departure test and cannot travel to this country if it is positive. From Monday, all international arrivals, whether under home quarantine or hotel quarantine, will be required by law to take further PCR tests on day two and day eight of that quarantine. Passengers will have to book those tests through our online portal before they travel. Anyone planning to travel to the UK from Monday needs to book these tests, and the online portal will go live on Thursday. If either of these post-arrival tests comes back positive, they will have to quarantine for a further 10 days from the date of the test and will, of course, be offered any NHS treatment that is necessary.

Any positive result will automatically undergo genomic sequencing to confirm whether they have a variant of concern. Under home quarantining, the existing test to release scheme, which my right hon. Friend the Transport Secretary has built so effectively, can still be used from day five, but that would be in addition to the two mandatory tests. The combination of enhanced testing and sequencing has been a powerful weapon throughout this pandemic, and we will be bringing it to bear so that we can find positive cases, break the chains of transmission and prevent new cases and new variants from putting us at risk.

Thirdly, we will be backing this new system with strong enforcement of both home quarantine and hotel quarantine. People who flout these rules are putting us all at risk. Passenger carriers will have a duty in law to make sure that passengers have signed up for these new arrangements before they travel and will be fined if they do not. We will be putting in place tough fines for people who do not comply. That includes a £1,000 penalty for any international arrival who fails to take a mandatory test; a £2,000 penalty for any international arrival who fails to take the second mandatory test, as well as automatically extending their quarantine period to 14 days; and a £5,000 fixed penalty notice, rising to £10,000, for arrivals who fail to quarantine in a designated hotel. We are also coming down hard on people who provide false information on the passenger locator form. Anyone who lies on a passenger locator form and tries to conceal that they have been in a country on the red list in the 10 days before arrival here will face a prison sentence of up to 10 years.

These measures will be put into law this week, and I have been working with the Home Secretary, Border Force and the police to make sure that more resources are being put into enforcing these measures. I make no apologies for the strength of these measures, because we are dealing with one of the strongest threats to our public health that we have faced as a nation. I know that most people have been doing their bit, making huge sacrifices as part of the national effort, and these new enforcement powers will make sure that their hard work and sacrifice is not undermined by a small minority who do not want to follow the rules.

In short, we are strengthening the health protection at the border in three crucial ways: hotel quarantine for UK and Irish residents who have visited a red list country in the past 10 days and home quarantine for all passengers from any other country; a three-test regime for all arrivals; and firm enforcement of pre-departure tests and the passenger locator form. Our fight against this virus has many fronts, and just as we are attacking this virus through our vaccination programme, which protects more people each day, we are buttressing our defences with these vital measures, to protect the progress that together we have worked so hard to accomplish. I commend this statement to the House.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary State for advance sight of his statement. I again start by congratulating all involved in the vaccination roll-out. Vaccination needs to reach everyone, and we need to drive up vaccination rates among the over-70s. There have been reports today that over-70s have been ringing up to get an appointment but NHS computer systems are not yet ready to accept appointments over the phone. Will he look into that for us?

What is the plan to drive up vaccination levels in minority ethnic communities? I am sure the Secretary of State is as worried as I am about vaccination rates among diverse communities. I know the Government announced some funding for local authorities to tackle vaccine hesitancy in minority ethnic communities, but a city such as Leicester—my city, and one of the most diverse in the country—was not on the list. Will he rectify that?

At last night’s press conference, the Secretary of State said that the way we deal with new variants is to respond to them as they arise, and that the first line of defence is to identify them and stop spread. However, our first line of defence is surely to do everything we can to stop new variants arising in the first place. That means securing our borders, to isolate new variants as they come in. He announced a detailed package today, but he has not announced comprehensive quarantine controls at the borders. Why are more than half of the countries where the South African variant has been identified not on the so-called red list? According to newspaper reports, he wanted to go further, with more extensive quarantine arrangements. I want that as well, and the British public want that as well, so I will work with him to make that happen, so that we can strengthen our borders and fix any holes in this nation’s defences.

The Secretary of State knows that mutations occur so long as the virus can replicate and transmit, and the greater the spread, the greater the opportunity. We have the South African variant and the so-called Eek—the E484K mutation—and the B.1.1.7 strain has been identified as well. Is it not the cold reality that the virus is now here for some time, and therefore that, for vaccines to succeed in protecting us, we need to do more to protect those vaccines by cutting transmission chains and spread, especially when lockdown eases? Last year the Secretary of State said, in launching Test and Trace, that it would

“help us keep this virus under control while carefully and safely lifting the lockdown nationally.”

But it did not keep the virus under control, did it? How will it be different this time? Will retrospective testing and tracing—the enhanced tracing he outlined for areas where there are variants—be routine everywhere?

Extra testing where there are new variants is of course welcome, but for many who cannot work from home on Zoom calls and laptops, who are poor or low paid, who live in overcrowded housing or who are perhaps care workers currently using up their holiday entitlement when sick so as not to lose wages, a positive test is not only a medical blow but a financial one. Last Tuesday, the Secretary of State boasted of the £500 payment, yet more than 70% of applications for financial support are rejected. By Wednesday, his own head of Test and Trace was pointing out that 20,000 sick people a day do not isolate. Indeed, two months earlier, Dido Harding had already said that people are not self-isolating because they find it very difficult, and that the need to keep earning and feed a family is fundamental, so is it any wonder that infections are falling at a slower rate in the most deprived communities? We need that financial support that his own scientific advisers have called for and that has been shown to work internationally. If he thinks I am wrong, will he tell us why he thinks Dido Harding is wrong?

We know that this virus can be transmitted through aerosols. Has the Secretary of State looked at installing air filtration systems in public buildings such as schools? Given concerns that the new Kent variant may shed more viral load through coughing and sneezing, will he update the guidance on face masks, as Germany has done, with FFP2 masks required on public transport and in shops? Will he ensure that higher-grade PPE for frontline NHS staff becomes the requirement, as the British Medical Association, the Royal College of Nursing and unions have called for?

Finally, next week is Children of Alcoholics Week, a cause very close to my heart. Indeed, I will be running the London marathon again to raise money for an alcoholics charity—[Interruption.] If it is on. I am looking forward to the Secretary of State assuring me that it is going to be on, and perhaps he can run it with me. The number of excess deaths from liver disease is up 11% in the pandemic—a huge increase—and many children are in lockdown in homes under the shadow of alcohol abuse. Will he look at providing more support for those organisations that are helping children through this difficult time of lockdown when dealing with parents with substance misuse problems?

[Matt Hancock]

I was listening very carefully to the hon. Gentleman, and I think I take that as support for the measures we are bringing in.

On the specific points the hon. Gentleman raises, he is absolutely right that further driving up vaccination rates is critical. I am delighted by the vaccination rates and the uptake of over 90% in all of the groups over the age of 75, and rapidly rising now—above 75% and rising fast—in the 70 to 74s. I agree with him very strongly on the need to keep driving up the uptake of the vaccine. The Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), is leading the efforts across the NHS and local authorities to try to make sure that we can increase vaccination rates further. Nevertheless, the take-up has been absolutely superb so far, and there is still more to do.

I will absolutely look into the points the hon. Gentleman made about Leicester. I know that it is close to his heart and a very important matter.

I will commit to the hon. Gentleman to keep the red list up to date. It is important that we take the measures that are necessary to protect this country. There are countries around the world on a so-called green list that have very low rates of infection and no known variants of concern. I am absolutely in favour of keeping the red list up to date, but I also think it is important that we are proportionate when there are countries that do not have a record of variants of concern. However, we will use the fact that we will sequence every positive test from somebody who comes through the border as a global system of vigilance to make sure that we are always looking for those variants of concern.

The hon. Gentleman raised the issue of financial support. I reiterate that the £500 support is available for anybody on low incomes, so people should come forward for testing in all circumstances. I am absolutely delighted at the level of testing as well. There is now an average of over 650,000 tests a day done in this country, which is obviously a very substantial number.

The hon. Gentleman raised the point about air filtration systems, which are important. I will point him to guidance from the Business Department on air filtration systems and on PPE—we have taken clinical advice and follow the clinical advice on the correct levels of PPE.

Finally, I know that the issue of children of alcoholics is very close to the hon. Gentleman’s heart and to those of many colleagues across the House, so I will absolutely look at how we can ensure that the extra funding we have provided in this space continues to support the vital work not just of those in the NHS, but especially of charities that do so much in this space. The invitation to run the marathon with him is a very interesting one. I am not sure I have enough time for training this year, but it is certainly something I would like to do at some point in the future.

[Jeremy Hunt (South West Surrey) (Con) [V]]

I strongly support the new measures. The higher the number of new daily cases, the more opportunities for variants and mutations to emerge, including ultimately some that may be immune to the vaccine. So does the Health Secretary agree that the central priority now must be to bring down the number of new daily cases, and as we do that, is he planning to introduce enhanced contact tracing for all new cases, including Japanese-style backward contact tracing and genomic sequencing of every new case?

[Matt Hancock]

We have the biggest genomic capacity in the world by some margin, and when the number of cases comes down, as our genomic capacity continues to expand—we plan to more than double it in the coming months—I hope to get to the position where we can genomically sequence every positive case, yes, but we are not there yet.

The strategy that I outlined to tackle new variants, of which the border measures are an important part, is itself one part of the four conditions that the Prime Minister set out for when we can lift measures. The other three are the successful roll-out of the vaccine, which is going very well, and the fall in the number of hospitalisations and the fall in the number of deaths, both of which, as I said, are moving in the right direction but are still too high. Therefore, this strategy to tackle new variants is crucial. The number of cases is a factor, because that itself determines the number of new variants. The conclusion of all that is that we must all stick to the rules now, and the more we stick to the rules now, the sooner we can get out of this.

[Martyn Day (Linlithgow and East Falkirk) (SNP) [V]]

The South African variant is a sure warning sign of the risk from other mutant strains that may be out there; combined with the question mark over vaccine efficacy with this variant, it is clear why we need effective border restrictions. Can the Secretary of State tell me why there are 35 countries where the South African and Brazilian variants are present that are not on the quarantine red list? Do the Government have a plan to redress that gap? From a Government obsessed with taking back control over their borders, that omission is surprising.

The Prime Minister has previously said that the UK cannot emulate other island countries, such as New Zealand and Australia, in preventing all unnecessary travel into the country due to the amount of food and medicine that it imports. Today’s change of heart is welcome. Can the Secretary of State confirm how these measures will keep the flow of goods and those transporting them open, while restricting travel not related to the import and export of goods?

[Matt Hancock]

The measures I have outlined today relate to passenger travel. There is, of course, a testing regime already in place for accompanied freight. There is a difference between this country and Australia and New Zealand, and that is that accompanied freight is a significant proportion of our daily imports, including just-in-time delivery, for instance, of food, whereas for islands that are further away from a continent, unaccompanied freight is a much more significant proportion of their international imports. We have to take these practical considerations into account. As I said, we keep the red list of countries under review, and the extra testing measures that I have outlined today will help us with that vigilance so that we can see where variants of concern are and to what degree they are present in other countries around the world.

[Peter Gibson (Darlington) (Con) [V]]

I thank my right hon. Friend for his announcement today. The people of Darlington and people right across the north- east have made incredible sacrifices to tackle this virus, and I know that they will welcome the tough measures that he has announced for those who seek to avoid quarantine. Does he agree that it is mass testing, vaccinations, following the rules and tough sanctions for those who break the rules that will help us to tackle this virus?

[Matt Hancock]

I agree with my hon. Friend that a combination of mass testing, vaccinations and tough enforcement is not only right to deal with this virus but, as he says, fair for people who are doing the right thing. This virus attacks us all as humans. It does not treat people differently just because they are better off and might be able to fly to Dubai for the weekend; it treats us all the same, so we should treat people the same. That is one of the reasons why it is important to bring these measures in with strong enforcement, so that they are both tough and fair on people who are working so hard and sacrificing so much to follow the rules.

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op) [V]]

I simply do not understand the logic being used for the red list. Countries where dangerous variants are present are not included, and multiple back doors are left open. Over the past few days, I have watched passenger flights, including a flight from Peru—on the red list—that is currently en route to the Netherlands, which is not on the red list but has substantial connections to the UK, and flights from southern African red-list countries en route to hubs in Addis Ababa, Nairobi and so on, which again have substantial onward connections to the UK but are not on the red list. We have even heard about UK troops in Kenya testing positive for covid today. Will the Secretary of State publish the epidemiological data that is being used to take decisions about which countries are included, and urgently review some of the very serious inconsistencies?

--- Later in debate ---

[Matt Hancock]

The hon. Gentleman raises important points, which are addressed in what I just announced in two ways. First, anybody who has been in a red-list country in the past 10 days must declare it on a passenger locator form. To fail to do so will be an imprisonable offence. Of course, nobody can come directly from a red-list country anyway because those flights have been stopped. That is a critical part of the enforcement of this system.

In addition, the second point that the hon. Gentleman raises is important. There are some countries where a variant of concern is the dominant variant, including in southern Africa and parts of Brazil. There are other countries where there are very small numbers of variants of concern, in the same way as in this country there are thankfully very small numbers of variants of concern. Absolutely, we publish information on a very broad scale. We have to make judgments about what is on the red list, and we will keep it under review.

Different countries have very different levels of genomic sequencing. There are some countries—even developed countries—that have very low levels of genomic sequencing. We have offered to support all countries around the world, so if they want a sample sequenced, we will do it for them to help with this vigilance. The mandated testing arrangements that we have introduced today will help ensure that we can strengthen the epidemiological data on which the judgments about the red list are taken.

[Selaine Saxby (North Devon) (Con) [V]]

Cases here in North Devon are now down to just 25 per 100,000. What reassurance can my right hon. Friend give me that when the time comes to unlock, the hard work of the people of North Devon will not be undone by an influx of visitors from either home or abroad with new variants? Are options being looked at for local unlocking to enable schools to reopen and some local businesses to restart, given the very low level of community transmission here?

[Matt Hancock]

I am delighted to see that there are some parts of the country where the case rate really has come down a long way—down to 25. It is important for us to make sure we get the levels down across the country. We have seen before that when there are areas that are low, there is spread from elsewhere in the country. The experience of last summer was that tourists travelling to go on holiday within the UK did not contribute to an increase in levels. It was when levels elsewhere got much higher that we saw the transmission to other parts of the country. It is those judgments that will inform the road map proposals that the Prime Minister will set out on 22 February. I wish I could say more in more detail to my hon. Friend, but it is for the Prime Minister to set that out later this month.

[Karin Smyth (Bristol South) (Lab) [V]]

The news of the new mutation is obviously of great concern to the people of Bristol, but local public health officials have rapidly set up new testing centres, including five new collect and drop testing centres today. It is a massive effort locally, and hundreds of people have come forward voluntarily since Sunday to be tested. Will the Secretary of State join me in thanking those local public health officials in Bristol and the people who have come forward? Will he join me in encouraging more people in those postcode areas that have been identified to come forward for surge testing to help us understand this virus better?

--- Later in debate ---

[Matt Hancock]

I agree with every word the hon. Lady has said. This is an incredibly important effort by the people of Bristol, especially those in the postcodes that were identified. I want to thank all the public health officials, at Bristol City Council and more broadly, including those in South Gloucestershire, for the work they are doing to tackle the variant of concern, where it is found. Even though the numbers are small, we want to tackle every case we find and really get this under control. As you can see from this exchange, Mr Speaker, and as everybody in Bristol can see, this is a cross-party, cross-community effort in which everybody has a part to play, and I thank the hon. Lady for her leadership.

[Suzanne Webb (Stourbridge) (Con) [V]]

I welcome today’s statement and I am very proud of all my constituents across Stourbridge, Cradley and Lye for the way in which they have fully understood and taken on board the fact that we all have our role to play in defeating this virus. Does my right hon. Friend agree that the constant flip-flopping and reliance on hindsight by the Labour party is nothing more than its seeking only to score political points, rather than reinforcing the Government’s message that we all have a part to play to defeat this virus? Those on the Opposition Benches would be well served by following the fine example set by my constituents.

[Matt Hancock]

What the public want to see, in Stourbridge and across the whole UK, is people working together to defeat this virus. Some of the measures have to be tough, and some are difficult, but it is all done with the goal of getting this country through this as well as we possibly can, so that we can lift as many of these measures as soon as we safely can. That balance between pace and safety is central to the judgments ahead. I want to thank everybody in Stourbridge and say to them that there is no politics in this; the only thing that is important is the safety of the people of Stourbridge.

[Rushanara Ali (Bethnal Green and Bow) (Lab) [V]]

I am grateful to all those working together—the GPs, Queen Mary University of London, the Royal London Hospital, Tower Hamlets Council, the London Muslim Centre and others—in my constituency to make sure that people get vaccinated. As Members have heard, vaccine take-up is lower among minority communities and some other vulnerable groups. Some 77% of white residents are getting vaccinated, which is great, whereas only just over half of Asian residents and under 46% of black residents in our borough are getting vaccinated. Will the Secretary of State commit to increasing the supply of vaccines to our GP surgeries, as they are saying that this is where they can make a big difference with vaccine take-up? This would make a big difference to the death rates and the dangers that these minority communities face, in my constituency and elsewhere in the country.

[Matt Hancock]

I want to praise the hon. Lady for the leadership she is showing locally in driving up those vaccination rates. The fewer people who are left unprotected by the jab, the safer we will all be, both individually and in communities in London and across the country. My hon. Friend the Minister for Covid Vaccine Deployment is leading the efforts in this space, and I will make sure he gets in contact so that we can work together to reassure everybody that the vaccine is the right thing for you and the right thing for your community.

[Huw Merriman (Bexhill and Battle) (Con)]

I welcome the roll-out of the vaccine programme, which has been a great success, and I congratulate the Secretary of State. May I ask for a bit of clarity on the statement? He states:

“Under home quarantining, the existing test to release scheme…can still be used from day five”.

Does that mean that somebody can successfully test negative on day five and is then free to interact in the community for three days, but will still have to take another test at day eight and if they fail that test they will have to quarantine again? Secondly, how long is this likely to last for? Obviously, summer travel is very important for the aviation industry. Is this just to last until we have vaccinated 99% of the mortality risk, which should be done by May? Or is it until we tweak the vaccination, in which case this could really have an impact on the aviation industry?

[Matt Hancock]

On the first point—the point of clarity—my hon. Friend has stated the position exactly correctly. On the second, we want of course to be able to exit from these arrangements into a system of safe international travel as soon as practicable and as soon as is safe, and Professor Van-Tam last night set out some of the details that we need to see in the effectiveness of the current vaccines on the variants of concern in order to have that assurance. If that is not forthcoming, we will need to vaccinate with a further booster jab in the autumn, on which we are working with the vaccine industry.

These are the uncertainties within which we are operating. Hence, for now, my judgment is that the package that we have announced today is the right one.

[Munira Wilson (Twickenham) (LD) [V]]

Many of us have been urging the Government for about 12 months now to take stronger action at our borders, so the measures announced today are very welcome, but Ministers have been consistently slow on this issue. With the ONS estimating today that, tragically, covid deaths in the UK have now surpassed 125,000, how many of those deaths does the Secretary of State believe could have been prevented by imposing much stricter public health measures at our borders since last March?

[Matt Hancock]

We have had significant measures at the border throughout. The new, stronger measures are necessary because of the arrival around the world of new variants of concern at the same time as the vaccine roll-out is progressing successfully. We do not want the very successful vaccine roll-out to be undermined, so it is reasonable to take a precautionary approach to international travel now, while we assess the effectiveness of the vaccines. We are clear that they have some effectiveness; the question is to what degree. That is being tested right now.

[Neil O’Brien (Harborough) (Con) [V]]

Given the incredible success of the UK vaccination programme, it would be terrible to put at risk our opening up by importing new variants like those seen in Brazil. Will my right hon. Friend stand ready to further tighten the measures at the border and the enforcement of quarantine, and does he agree that if we want to see rapid opening up, as we all do, we should be supporting strong measures at the border?

--- Later in debate ---

[Matt Hancock]

My hon. Friend is right, first, that we must keep the red list under review; and secondly, crucially, that strong protections at the border are part of defending and safely allowing the domestic opening up. For those of us who want to see that domestic opening up, ensuring that we have protection from variants that might arise from overseas is an important part, until we can get to a position where we can be confident in vaccine efficacy against all variants, not just against the current variants that are here in large numbers in the UK.

[Jim Shannon (Strangford) (DUP) [V]]

May I put on record my thanks to the Secretary of State for all that he and his team are doing on this issue? Northern Ireland is the only part of the United Kingdom with a land border. As the Secretary of State is aware, the Republic of Ireland is enforcing the very apparent border in Northern Ireland, for its safety, on its side. It seems, as I said, that there can be a border when it suits. However, I am eager to understand what steps are being taken to ensure, as I highlighted last week, that officials and Government have access to pertinent travel information for those coming to Dublin, to ensure that the United Kingdom, on the Northern Ireland side, is also safe.

[Matt Hancock]

I spoke to my Irish opposite number, Minister Donnelly, this morning and he has assured me that that data will be provided appropriately and securely; we have been working together to ensure that that happens for some time.

As I said in my statement, we have been working with the Irish Government to ensure that there are appropriate measures, both in the Republic of Ireland and in the United Kingdom, to ensure that the border on the island of Ireland can be kept completely open, as it must, yet we have adequate protection against arrivals of variants of concern internationally. It is the two countries working together, putting in place similar arrangements both in the Republic and in the United Kingdom, that will allow us to deliver that goal, which I am sure we all share.

[Felicity Buchan (Kensington) (Con)]

I am increasingly concerned about the effect of lockdown on the mental health of children; I am receiving so many emails from adolescents and teenagers. Will my right hon. Friend assure me that when he feeds into the 22 February road map, the mental health of children, and indeed their parents, is taken into account?

[Matt Hancock]

Yes, of course I will.

[Hywel Williams (Arfon) (PC) [V]]

Yesterday, the number of deaths from covid in Wales passed the grim total of 5,000. Our public health leaders say that the Welsh Government’s £500 self-isolation payment is not enough and is indeed an economic driver for people to go to work. Sick pay, on the other hand, is the responsibility of this Government, so will the Secretary of State now commit the Government to increasing the paltry level of sick pay, as suggested, from £96 per week, to enable working people to self-isolate safely?

[Matt Hancock]

We have put in place the extra £500 for those on low incomes to ensure that everybody can get the financial support that they may need while self-isolating.

[Peter Aldous (Waveney) (Con) [V]]

I commend my right hon. Friend on his statement. The Norfolk and Waveney clinical commissioning group, local NHS staff and volunteers are to be commended on rising to a challenge which on Sunday resulted in 1,000 people being vaccinated at Kirkley Mill in Lowestoft in very difficult weather conditions. There is a plan to significantly increase the number of daily vaccinations for more sites; so that this can be delivered can my right hon. Friend confirm that there will be a consistent and increased supply of vaccines and that the initial difficulties some have experienced with the national online booking system will be ironed out?

[Matt Hancock]

Yes, absolutely. I want to thank everybody across Norfolk and Waveney for the work they have been doing to roll out this vaccine. It is a critical part of the country in terms of the covid response, and the work done locally has been absolutely exemplary. I commend my hon. Friend on the part that he has played and the leadership he has shown in Lowestoft in making that happen; the uptake has been superb. I have seen some of the reports locally, and the emotional impact on people of getting vaccinated is absolutely fantastic. I will absolutely take away the points my hon. Friend has made.

[Judith Cummins (Bradford South) (Lab) [V]]

Despite assurances from the Secretary of State and Ministers, it is now clear that the newly imposed NHS dentistry targets are in fact actively undermining patient access to urgent treatment during the pandemic, as I warned they would. Last week, a whistleblower at the UK’s largest dental chain with over 600 practices, mydentist, sent me an internal memo that advised them to prioritise routine check-ups over treatments in order to meet the new targets. Will the Secretary of State look at this urgently and agree to revise these targets to ensure that they do not undermine patient care, as the system as it stands incentivises routine check-ups above those in severe pain?

[Matt Hancock]

I want to thank our nation’s dentists, who have worked incredibly hard to get dentistry services going again. It is very important that we support them and that the financial incentives underpin the need to restart as much as is possible.

It is of course challenging to deliver services given that there are so many aerosol-generating procedures, and I will ask the dentistry Minister, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), to speak to the hon. Lady and perhaps meet her to discuss these ongoing challenges.

[Henry Smith (Crawley) (Con) [V]]

I support the introduction of targeted quarantine for passengers coming from high-risk covid-19 variant countries. Will my right hon. Friend also commit to regular reviews and even a sunset clause on these regulations, as we seek later in the year to get our economy restarted and support our aviation sector?

[Matt Hancock]

I do not underestimate the impact that all these measures have had on Gatwick. My hon. Friend represents so many of those who work at Gatwick, and I understand the impact. I was at Gatwick airport on Friday, and the empty departure hall was really quite a sad sight. These measures are necessary, in my view, and I am glad that he supports them, difficult as they are. We are also acutely cognisant of the economic impact on airports and those who work in them, and I would be happy to keep talking to him about how quickly we can remove these measures safely.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab) [V]]

The whole House has welcomed what the Secretary of State has had to say about the progress in fighting coronavirus, but he will be aware that there is a very real danger that one cohort will be left behind: black and ethnic minority communities. We already know that black people are four times more likely to die from coronavirus, and currently the statistics show that black over-80s are half as likely to be vaccinated as white people. I am conscious that the Minister for Covid Vaccine Deployment is aware of this issue, but will the Secretary of State give the House an undertaking that he will drive forward a whole series of measures to increase vaccine take-up among black and minority ethnic persons? When black and minority ethnic people are on the frontline of the fight against coronavirus as health and social care workers, it would be a tragedy if there was an increased death toll because enough was not being done to encourage take-up of the vaccine.

[Matt Hancock]

I do not say this lightly, but I agree with every single word that the right hon. Lady said. I want to pay tribute to her, because I have not had the chance in the House to thank all the black MPs who took part in the incredibly moving video to persuade people, who may have understandable concerns, that taking the jab is the right thing to do. She played a pivotal role in that short video, and it is just one small part of the huge effort we need to make, because the fewer people who do not have the protection, the safer we will all be. I am very grateful for her work and her support, and I hope that we can continue to work together to drive uptake among black communities right across this country.

[Mr Mark Harper (Forest of Dean) (Con)]

Policies are often easy to announce and difficult to end. The chief scientific adviser says that covid is with us forever, and it will presumably continue to mutate into new variants forever. I listened carefully to the answer that the Secretary of State gave to my hon. Friend the Member for Bexhill and Battle (Huw Merriman), but I did not hear an answer to this: when is this policy going to end, if ever, because if the virus continues to mutate, surely the risk will be there forever?

[Matt Hancock]

The risk of mutations absolutely can and will be managed through the evolution of vaccines, in the way that the annual flu jab changes each year and allows us to protect ourselves. While necessary now, these are not measures that can be in place permanently. We need to replace them over time with a system of safe and free international travel; that is where we need to get to. The first task is to vaccinate the population. If we get good news on the impact of vaccination on hospitalisations and deaths for new mutations, we will be in a better place. If we do not get such good news, we will need to use the updated vaccines to protect against the variants of concern.

The scientists inform and advise me that there are, repeatedly and independently around the world, mutations of the same type in the E484K area of the virus, as mentioned by the hon. Member for Leicester South (Jonathan Ashworth). That gives the scientists a good start in where to target the new updated vaccine—if we have to wait until then—but it may be that we get from the existing vaccines enough efficacy against hospitalisation and death that they work perfectly well to hold this virus down. We just do not know that yet; hence, the precautionary principle applies.

[Rachel Hopkins (Luton South) (Lab) [V]]

It is hugely important that we keep making progress in tackling the virus and in vaccinations. However, last week I heard from the Catch Up With Cancer campaign, the research of which indicates that we would need cancer services to work at 120% capacity for two years to catch up with the existing backlog. I am concerned that the cancer recovery taskforce lacks sufficient resources and scope to achieve the restoration of services and tackle the backlog. Will the Government, in the March Budget, increase the resources available to the taskforce, to expand the overall capabilities of the UK’s cancer services to tackle the backlog?

[Matt Hancock]

We announced in the spending review significant extra funding to tackle the backlog. I am very proud of cancer services throughout the country, which have kept up the work during this second wave in a quite remarkable way, owing to tenacity, working together, flexibility and, of course, very strong infection prevention and control.

Last week I was at the Royal Marsden Hospital, where they are doing 100% of their normal-time operations. That is not true everywhere—the Royal Marsden has the advantage of being, in essence, a cancer-only site, which makes things easier. The thrust of the hon. Lady’s question is right—we absolutely must catch up on the cancer backlog—but I am optimistic because people have worked so hard in oncology to keep cancer services going. As the number of covid patients comes down, so we must ensure that the backlog is worked through.

[Mr William Wragg (Hazel Grove) (Con)]

I pay tribute to everybody in Stockport who is part of the massive vaccination effort that is going so well, as it is throughout the rest of country. The original purpose of lockdown was to reduce hospitalisations and keep hospitals from falling over; if that is achieved through a vaccination programme, is it now the Government’s intention to use the level of virus in circulation—the number of cases in the population—to determine when to ease lockdown?

[Matt Hancock]

No. The Prime Minister has set out the four conditions that need to be met and will be saying more about that on 22 February.

[Clive Efford (Eltham) (Lab) [V]]

I add my congratulations to all those involved in the roll-out of the vaccine, particularly those in my local area who have been working non-stop. Will the Secretary of State say something about international co-operation, particularly in respect of identifying new variants and assisting other countries to stop their transmission? What discussions are taking place with the World Health Organisation and others to ensure that we are keeping track of new variants as much as is practicably possible?

--- Later in debate ---

[Matt Hancock]

That is a critical question, on which I point to three things. First, we have put in place the new variant assessment platform, which uses our genomic capability to be of service to countries that do not have the capability to identify variants and sequence samples, if that is needed.

Secondly, we are working with the World Health Organisation to ensure that its library of variants is as up-to-date as possible. Of course, it is that work from which must flow the assessment of what appropriate updates to any vaccine are necessary, which is how it works with flu. The system is nascent but incredibly important, and I am grateful to the World Health Organisation for its work on that so far. We need to go further.

Thirdly, on the measures put in place today, by testing every international rival—given the nature of the UK, even in these tough times, as an international hub—we will, where we spot positives, be able to sequence them and therefore gather the sequences of coronavirus from around the world. The announcements made today will directly help us to address the question of where variants of concern are arising and therefore help the international efforts to tackle them.

[Aaron Bell (Newcastle-under-Lyme) (Con) [V]]

I thank the Secretary of State for his statement and join him in praising everyone involved in the vaccine roll-out. It is going incredibly well in Newcastle-under-Lyme; in Staffordshire, we have just passed 200,000 vaccinations given.

Brilliant scientists in the UK and around the world have delivered us these vaccines at an unprecedented pace, and I welcome the news that they are now working on new versions of them to fight variants. However, if we were to embrace even faster methods for evaluating the efficacy of vaccines, such as challenge trials, we could speed up the process even further.

Given the enormous economic cost of lockdowns, every month counts. That should prompt the whole world to re- evaluate our standard methodology for approving vaccines. Could my right hon. Friend set out what steps he is taking to allow new varieties of vaccines to be developed as quickly as possible, if they prove to be required?

[Matt Hancock]

Yes, we do not rule out challenge studies at all. We are working with Oxford University on such an approach. More broadly, I am up for considering anything that can ensure that a vaccine can safely be brought to bear and support this effort as fast as possible.

I would, though, caution against undue pessimism in this space because the Medicines and Healthcare products Regulatory Agency has done an amazing job of maintaining very strong safety and efficacy requirements while speeding up every process, constantly challenging the critical path to vaccine approval and asking how it can be sped up while maintaining the very high standards that it should expect. It is continuing that work with potential iterations of the vaccine to ensure that the level of assuredness is appropriate and the degree of checks that an iteration needs to go through is appropriate to the degree of difference from the original vaccine.

For instance, for flu, we do not need to go through the full clinical trials process because the underlying platform is known to be safe—we need to demonstrate clinical efficacy. It is that sort of flexible yet rigorous thinking that the MHRA should be very proud of.

[Stephanie Peacock (Barnsley East) (Lab)]

People are at home with the windows closed and the heating on: those are potential conditions for carbon monoxide poisoning, whose symptoms are very similar to those of covid-19. What are the Government doing to enforce legislation on that issue and make the public aware of that silent killer?

[Matt Hancock]

The hon. Lady raises an important point, which is taken into account in the work that we are doing to push forward high-quality ventilation, which is good for tackling carbon monoxide poisoning and for trying to reduce the risk of the spread of covid.

[Mr Peter Bone (Wellingborough) (Con) [V]]

I start by thanking the hard-working Secretary of State for yet again coming to the House and updating us on the covid situation.

In north Northamptonshire, we have a particular problem with covid infections—we just cannot get them down. In Wellingborough, we are 25% above the national average, in Kettering 50% above it and, in Corby, more than double the national average, with the highest infection rate in the country. Has the Secretary of State given any consideration to the mass testing of north Northamptonshire so that we can get infections down, rather as happened in Liverpool?

[Matt Hancock]

I am aware of and also worried about the continued high rates of infections in north Northants, which has not had a particularly bad pandemic thus far but now, at this point, seems to have a stubbornly high infection rate. I am absolutely up for all measures that might help to get it down, including mass testing. I will take that idea away, work on it with colleagues and return to my hon. Friend and his north Northants colleagues with a proposal.

[Jonathan Edwards (Carmarthen East and Dinefwr) (Ind) [V]]

The pandemic has been particularly difficult for those with a weak immune system; I therefore welcome the fact that UK Research and Innovation has provided funding to support research on vaccine responses in groups of immunosuppressed individuals, such as high-risk cancer patients. When does the Secretary of State expect the Joint Committee on Vaccination and Immunisation to have enough data to develop a vaccine-protective strategy for immunosuppressed individuals that details whether any specific vaccine is preferred for this cohort?

[Matt Hancock]

This is a very important consideration. For those for whom the vaccine is clinically inappropriate, clearly the single most important thing is that everybody else gets the vaccine because that is what can best keep them safe. When we say that the vaccine is “good for you and good for others”, that includes those who are clinically unable to take the vaccine to protect themselves, so everybody around them needs to take the vaccine in order to protect them. More broadly, that work is under way. I will ask the deputy chief medical officer to write to the hon. Gentleman to set out the precise clinical details.

[Mrs Heather Wheeler (South Derbyshire) (Con) [V]]

I thank my right hon. Friend for his statement. As I have so many constituents who work in the aviation industry, this is important information. I am thankful for the now ramped up provision of vaccine centres in South Derbyshire, but how will he ensure that housebound residents receive their jab? There seem to be gaps in communications between primary care networks, district health services and GP surgeries, leaving my constituents unsure.

[Matt Hancock]

I will look into the specifics of the situation in South Derbyshire and ask the Minister for Vaccine Deployment, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), to call my hon. Friend to try to understand precisely the situation in her area. It is absolutely the responsibility of PCNs to deliver vaccines to the housebound. That is working in most parts of the country. I had not heard of any concerns in South Derbyshire, but this is obviously incredibly important because we are talking about some of the most vulnerable people to covid in the country. We must make sure that everybody, including those who are housebound, has the offer of a jab, and that people can get out and make that happen.

[Patricia Gibson (North Ayrshire and Arran) (SNP) [V]]

New border restrictions to safeguard us from covid will mean a reduction in the amount of travel into the UK, which will of course cause further harm to aviation and travel firms. Will the Secretary of State update us on progress and give us more details about the ongoing Cabinet discussions regarding specific support for aviation and travel firms in the light of these additional measures?

[Matt Hancock]

Yes; we do not underestimate the impact of these measures on the travel and aviation industries. My right hon. Friend the Transport Secretary is leading the discussions, as he has done throughout, because it is incredibly important that people get the right level of support. It goes to the point made by my right hon. Friend the Member for Forest of Dean (Mr Harper), which is that we need to ensure that we go into these measures with a plan for how we come out of them into a set of secure international travel arrangements, so that people can get moving again.

[Jonathan Gullis (Stoke-on-Trent North) (Con)]

In Stoke-on-Trent, Kidsgrove and Talke I have seen at first hand, while volunteering at the mass vaccination centre in Tunstall, the incredible effort of our local NHS heroes in getting jabs into the arms of up to 1,000 people each day. This is important, as the Royal Stoke University Hospital has been under tremendous pressure in critical care, dealing with capacity 220% above its usual averages. Will my right hon. Friend thank the local health and care heroes across Stoke-on-Trent, Kidsgrove and Talke, and assure us that we will get increased vaccine doses as the supply increases?

[Matt Hancock]

Yes, absolutely. The effort in Stoke has been absolutely magnificent. I follow it particularly closely because every time I come to this Chamber—it is normally at least once a week—I am grilled by a colleague from Stoke about performance in Stoke. I have been looking at it recently; across Stoke, the hospital, the GPs and the pharmacies have been doing a magnificent job in the vaccination effort. I am grateful to my hon. Friend for his leadership locally in promoting uptake of the vaccine.

[Hilary Benn (Leeds Central) (Lab) [V]]

Given the evidence that some of the new variants of covid are much more transmissible, the Royal College of Nursing and the British Medical Association have raised concerns about whether current PPE guidance is adequate. It has been reported that some hospitals are offering staff high-grade PPE, for example FFP3 masks, while others are not, which means unequal levels of protection depending on where staff work. Can the Secretary of State tell us whether the NHS has reviewed the guidance about the standard of PPE to be provided to all staff when treating covid-19 pathway medium and high-risk patients?

[Matt Hancock]

Yes, I asked for specific advice on this when we saw the increased transmissibility of the B117 strain—the so-called Kent variant. Exactly this question was reviewed. As the right hon. Gentleman would expect of me, I follow clinical advice on PPE guidance and the clinical advice remains unchanged.

[Andrew Griffith (Arundel and South Downs) (Con)]

I thank my right hon. Friend for coming to the House with his statement today. Will he join me in congratulating the Henfield heroes at Henfield Medical Centre? They have already vaccinated more than 1,000 patients, who very much appreciated not having to travel 40 miles to the previous clinic in Storrington. I am grateful that artificial limits on the number of centres per primary care network have been relaxed in rural areas.

[Matt Hancock]

I pay tribute to everybody at the Henfield Medical Centre doing this incredible work. It is really uplifting being in a health centre. If Members have not been to a vaccination centre as a Member of this House, I would highly recommend it because it is such an uplifting experience. I am really glad that it is being carried out ever closer to home for people as we expand the number of vaccination sites, of which there are now more than 1,400 across England.

[Kevin Brennan (Cardiff West) (Lab) [V]]

The maximum sentence for a person lying on their locator form will be 10 years in prison. What will the minimum sanction be for that offence? The cost of the hotel, including testing and transport, will be £750 for 10 days. Can the Secretary of State give the House an absolute assurance that that represents good value for money to passengers and that there is no undue profiteering?

[Matt Hancock]

Yes, absolutely. One of the things that we have been doing in our discussions with hotel groups and others is ensuring value for money as much as possible for passengers. Hence we have managed to get the costs down to £1,750 for an individual traveller in a room alone.

[Sir Desmond Swayne (New Forest West) (Con)]

Will the Secretary of State maintain his war aim of protecting the NHS and eschew those siren voices calling for a desired level of infection in the community? If we depart from a level of hospitalisation with which the NHS can cope effectively, we will lose the proper sense of urgency to lift restrictions that are so devastating and costly to us all.

[Matt Hancock]

My right hon. Friend is right to raise the issue of the level of hospitalisations as one of the key factors and conditions for exit, as set out by the Prime Minister. The good news is that the number of people in hospital with covid is now falling. It is still higher than either at the April peak or at the November peak. The challenge in terms of the number of cases is that, when cases are very high, you are more likely to get a new variant, but, thankfully, cases are coming down very sharply, too.

[Yvette Cooper (Normanton, Pontefract and Castleford) (Lab) [V]]

Yesterday, the Home Secretary told me in Parliament that 100% compliance checks were now taking place at the border. Yet one passenger arriving at Heathrow yesterday from South Africa via Qatar has reported having no checks on her forms or tests and being just sent on her way through passport e-gates. This is a problem that I raised with the Prime Minister almost a month ago. Travellers have reported throughout that the reality is not matching the Government’s rhetoric, so why, when this is so important, does it appear that the most basic checks are still not happening?

[Matt Hancock]

The Home Secretary is looking into this individual case. The measures that we announced today further strengthen the enforcement to make sure that the rules that are currently in place are enforced more strongly, and indeed that we have brought in a new system of rules to strengthen the safeguards at our border yet further.

[Dr Jamie Wallis (Bridgend) (Con) [V]]

May I say a huge thank you to everyone on the frontline working hard on the vaccine roll-out in Bridgend and Porthcawl? When it comes to dealing with the transmission of the South African variant, could my right hon. Friend set out what steps he is taking on surge testing so that we can gather more information and effectively monitor any further community transmission?

[Matt Hancock]

Yes. When we see the community transmission of a variant of concern, we send in extra testing, and sequence all the positives to try to find any other variant of concern nearby. That means going door to door to offer testing, and enhancing contact tracing so that, for anybody who tests positive, we ensure that we test all those they have been in contact with and, in some cases, the contacts of those contacts in turn. That is currently under way in a number of locations, in targeted areas. Of course, I speak regularly with the Welsh Government to ensure that we take the same sort of approach over the border.

[Helen Hayes (Dulwich and West Norwood) (Lab) [V]]

Vaccine hesitancy is highest among black, Asian and minority ethnic residents, and tackling it is vital to stop the existing covid-19 health inequalities widening and deepening further. My constituency has one of the most ethnically diverse populations in the country yet neither of my local councils, Lambeth and Southwark, was included on the seemingly arbitrary list of councils invited to bid for additional funding to address vaccine hesitancy. Can the Secretary of State explain why, and will he commit to working with the Communities Secretary to look again urgently at that decision?

[Matt Hancock]

It is the Minister for the vaccine roll-out, my hon. Friend the Member for Stratford-on-Avon, who is leading those efforts. It is obviously an incredibly important subject, because it matters to us all.

[Steve Brine (Winchester) (Con)]

The Secretary of State said earlier that the virus treats us all the same, which is of course quite right. Sadly, it does not go easy on those who do not take up the offer of a vaccine, so can I ask my right hon. Friend what his thinking will be if, despite all the excellent work going on to support the vaccine hesitant, and there is lots of it, we have fellow citizens not protected? Will he confirm that such a personal decision cannot impact on the ultimate release of our society and our economy?

[Matt Hancock]

We are not proposing to mandate vaccination, partly for the reasons that my hon. Friend sets out. Anyway, vaccine take-up has been really very high—much higher than expected—which is terrific. In fact, in the latest international surveys that I have seen, the UK has the highest enthusiasm for taking the vaccine—up from about fifth highest a couple of months ago. Our attitude, tone and communications throughout have been purposefully entirely positive about why the vaccine is good for people and for their communities, and how people like them are taking the vaccine. I praise the Government Communication Service, NHS England and local councils, which have worked so hard to drive vaccine take-up as high as it has been.

[Vicky Foxcroft (Lewisham, Deptford) (Lab) [V]]

To date, Government communication with the 2.2 million people who have been shielding on and off for almost a year has been poor. On their behalf, I ask the Secretary of State a very simple question: will it be safe to stop shielding after they have received their second dose of the vaccine?

[Matt Hancock]

I am afraid I do not agree with the hon. Lady one bit. We write regularly to those who are shielding and we write to them individually, so I am not going to make a blanket announcement in the Chamber. We will communicate carefully and individually with people who are on the shielded patient list. It is too sensitive to play politics with.

[David Simmonds (Ruislip, Northwood and Pinner) (Con) [V]]

I commend my right hon. Friend’s decision to fund the local authorities of Harrow and Hillingdon, which serve my constituency, to reach out to people who may be reluctant to come forward and get their vaccine. In respect of those who are in our country with an uncertain immigration status, but for whom vaccination is vital for both humanitarian and medical reasons, will he consider a similar approach and fund local authorities, which know their communities best, to reach out to those people, to ensure that they are also part of this great British success story?

[Matt Hancock]

Yes. We are working with GPs, with community parts of the NHS and also with local authorities to do this. As my hon. Friend may have seen, the Home Office has stated that the most important thing is that we vaccinate everybody who is present here, whatever their status or paperwork.

[Patrick Grady (Glasgow North) (SNP)]

I am very glad to hear that exchange, because this is a considerable issue in Glasgow, with our large asylum-seeking population. Will the Secretary of State also tell us how his announcements about quarantining will be applied to people who arrive in this country seeking asylum and who probably do not have £1,750 in their back pocket? How will new arrivals be supported in the quarantine process?

[Matt Hancock]

A new arrival to the UK who has been in a red-list country in the past 10 days and who is not a resident of the United Kingdom or Ireland or a UK citizen will be denied entry and held in hotel quarantine until they can return to the country from which they arrived.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am endeavouring to ensure that everyone on the list gets a chance to ask a question, but they will not do so if we do not speed up a bit, because we have a lot more business to come—[Interruption.] No, I do not criticise the Secretary of State. If he is asked complicated questions, he has to give complicated answers, so let us have quick and simple questions, then we can have quick and simple answers.

[Jack Brereton (Stoke-on-Trent South) (Con) [V]]

May I join my neighbouring north Staffordshire colleagues in thanking our health workers for the amazing job they have been doing in rolling out the vaccine? Will my right hon. Friend join me in encouraging everyone in Stoke-on-Trent who is in priority groups 1 to 4 to get an appointment and get their jab before 15 February?

[Matt Hancock]

Yes. Stoke-on-Trent has been ably and effectively represented in this discussion, and everybody across Stoke deserves praise for the work that they are doing to drive up the vaccination rate. The higher the vaccination rate, the more quickly and safely we can all come out of this together.

[Chris Bryant (Rhondda) (Lab) [V]]

The roll-out of the vaccine programme has been absolutely commendable. Brilliant! Well done! Locally, it has been really encouraging to see the mass vaccination centres working alongside the GP surgeries, but I am really worried that from this Friday onwards all the local mass vaccination centres will have to close because there will not be any more Pfizer vaccine except for the delivery of second doses, which will not start for another fortnight. On top of that, the number of AstraZeneca doses available locally will fall from 24,000 a week to 8,000 a week, so I am really worried that the next cohort of people are not going to get their vaccinations soon. Is there anything the Secretary of State can do to ensure that we get more vaccines locally by this weekend?

[Matt Hancock]

I am not aware of the closure of any vaccination centres. Of course, it is a matter for the Welsh Government if they are going to close vaccination centres, but I speak to the Welsh Health Minister regularly and this has not been raised as an issue of concern. Supply is of course the rate-limiting factor, as it has been throughout the roll-out. Supply continues, but we have to start ensuring that we have those second jabs ready for people. I am not aware of the issue that the hon. Gentleman has raised. It is certainly not a problem across England, where I am directly responsible for the roll-out. So far, this programme has been going so well across the whole United Kingdom, and we have all been working so hard together to make it happen.

[Sir Edward Leigh (Gainsborough) (Con)]

In warmly welcoming what the Secretary of State has said today, the question that I have to ask, like many people, is why we did not do this over a year ago. After all, we are an island. If we had done what the Australians and New Zealanders have done, perhaps we would not have had to close our schools for all this time. I am saying this to support the Secretary of State when he is locked in Cabinet discussions with people who say that we have to protect the travel industry or the aircraft industry. I would say: let us have tough quarantine regimes, like Australia and New Zealand, and tough, enforced local lockdowns like China. Let us get a grip on this rather than just saying that it is more important to keep the travel industry open than our schools.

[Matt Hancock]

I am very grateful for my right hon. Friend’s support in the way that he puts it. I have been talking to my Australian counterparts about the approach that they take, not least because their hotel quarantine has now been in place for some time. The central point that he makes is that once we get cases down through both the measures now, and then the vaccine to keep them down, a tough borders policy can help to keep us free domestically. That is a very important part of this consideration.

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

I pay tribute to all organisations in Liverpool working on the frontline to manage this pandemic. Does the Secretary of State believe that the Government are following their own guidance in making over 2,000 Driver and Vehicle Licensing Agency workers physically attend the workplace for non-essential work processing provisional licence applications when driving lessons are not possible under current restrictions? Does he agree that no one is safe until we are all safe?

[Matt Hancock]

My right hon. Friend the Transport Secretary has looked into the issue about DVLA that the hon. Lady raises, and Public Health Wales has been involved in advising DVLA, which is of course based in Swansea.

[Stephen Hammond (Wimbledon) (Con) [V]]

I congratulate all those in the local health service and volunteers rolling out the successful vaccine programme in Wimbledon. I agree that we need effective border security. However, my right hon. Friend said earlier that new variants could emerge anywhere, so could he allay my concern that our efforts might be better spent on ensuring effective, rigorous and enforced home quarantine for all rather than setting up a hotel regime that will only protect against red-list countries?

[Matt Hancock]

The rigour and the security of both home quarantine and hotel quarantine are important. It is a matter of the degree of risk, and that is why we have attempted to strike the balance that we have. However, what is not in balance is the need for rigorous quarantine both for those coming from red-list countries and those coming from all other countries who quarantine at home. It is important that this takes place, whether it is at home or in a hotel, and hence the stronger enforcement measures.

[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

One of my constituents is a long-term in-patient in the spinal injuries unit at Southport Hospital. He is 70 years old and is tetraplegic. Despite there being covid cases on the ward, he has not yet received a vaccine, and staff tell his partner that they have no idea when they will be able to offer one to him. Vulnerable patients in units like this may be there for months or years. What is the Secretary of State doing to ensure that all long-term in-patients, including my constituent, get the vaccine at the same time as they would if they were an out-patient?

[Matt Hancock]

Yes, that is exactly the principle on which we are proceeding. I pay tribute to the work that the hon. Lady does in this area and in always speaking up for those who are in in-patient care. It is very important that we make sure that there is equal and fair support for all according to clinical need, and that will be addressed in the next phase of the roll-out, once we have ensured that the offer to all those in categories 1 to 4 is achieved by next Monday.

[Laura Farris (Newbury) (Con) [V]]

I put on record my thanks to everybody working at Newbury racecourse for leading a fantastic vaccination programme for my constituency. I welcome my right hon. Friend’s statement about very high rates of take-up of the vaccine. What has the take-up rate been among those under the age of 70 who have been offered it so far? What conversations has he had with the vaccine Minister about dispelling one of the most persistent myths that has been raised with me by young women—that the vaccine could negatively affect their fertility?

[Matt Hancock]

There is no evidence at all that the vaccine negatively affects fertility. There are many myths about vaccines, and I am very glad that they have largely been rightly ignored by the British public when they are inaccurate. The way we try to tackle such myths is by putting out as much positive, accurate, objective information from objective sources as possible, both on the NHS website and through the chief medical officer and deputy chief medical officers answering questions whenever possible. I am glad that my hon. Friend has raised that issue. I will ask one of the deputy chief medical officers to write to her, and we will publish that letter to provide the further reassurance that she asks for.

[Mr Ben Bradshaw (Exeter) (Lab) [V]]

What exactly is the Secretary of State’s exit strategy from this quarantine policy? Is he, for example, planning airport testing, GPS tracking and covid passports, like other European countries, to avoid the total collapse of our vital travel sector?

[Matt Hancock]

I refer to the answer I gave to my right hon. Friend the Member for Forest of Dean (Mr Harper). Absolutely, testing is a very important part of this, as I set out in the statement.

[Joy Morrissey (Beaconsfield) (Con) [V]]

I know that my right hon. Friend is committed to securing our borders. Will he therefore consider commissioning and funding airlines and airports directly to run these new Department of Health and Social Care passenger and border restrictions? Airlines and airports such as BA and Heathrow have the experience, market innovation and incentive to deliver safe travel for Britain. Will my right hon. Friend meet me and representatives from the airline industry so that together we can deliver secure borders but a global Britain?

[Matt Hancock]

That is exactly our goal, and we have been working very hard with the carriers and airport operators to put this new scheme in place. There is further work to do in the days ahead, and no doubt after its initial introduction on Monday. What I would say very directly to my hon. Friend, the airline industry and the airports is that I know this is very difficult and tough. It is absolutely vital that we all work together constructively, positively and with the spirit of innovation that she describes to put in place a robust system that uses all possible technology to ensure that we have the basis of a future safe global travel arrangement. It is about both securing the borders now and ensuring that we can get global travel going for the long term.

[Apsana Begum (Poplar and Limehouse) (Lab) [V]]

Last week, the London director of Public Health England, Professor Kevin Fenton, said that London’s Asian communities have been the hardest hit by the covid-19 second wave. It is being felt deeply in my constituency, and I pay tribute to those on the frontline in my constituency who have been helping to drive up the vaccine uptake, and those serving in our mortuary and funeral services. I am sure the Secretary of State agrees that the Government need to learn quickly from the impact of the first and second waves on minority communities, but that must be informed by evidence, especially to ensure the effectiveness of any strategy to deal with vaccine hesitancy. Will he and his colleagues ensure that data about the vaccine roll-out and mortalities in the second wave is published regularly in a meaningful format and disaggregated by ethnicity?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Before I call the Secretary of State to answer the question, I give notice that we ought to be stopping this statement now, but I have seven more people who wish to get in. Can you please just cut your bits of paper in half and ask a question? It is not fair to everybody else, and the people who are sitting at home are not getting the atmosphere. We have got to do this quickly. We do not need speeches, just questions. If people take more than 20 seconds, I will cut them off.

[Matt Hancock]

The answer is yes.

[Dr Rupa Huq (Ealing Central and Acton) (Lab)]

The jury is still out on whether every vaccine can eliminate every covid variant, but we know that vitamin D builds immunity to all viruses. The Secretary of State promises a four-month free supply for the vulnerable, but how come nobody has heard of it? Will he commit to widely advertising it and its benefit to all Brits?

[Matt Hancock]

Yes, indeed I have, and I have written to more than a million people about the availability of vitamin D. Indeed, I know that that offer is being taken up, because there are Members of this House who have received their free vitamin D, taken a photograph of it and sent me the photo.

[Paul Bristow (Peterborough) (Con) [V]]

The ministerial team and our NHS have done a phenomenal job of vaccinating our most vulnerable and our frontline health and social care workers, but my right hon. Friend—

[Paul Bristow]

My right hon. Friend will be aware that autistic people and those with learning disabilities are vulnerable to covid-19, with a death rate 4.1 times higher than the general population. Will the Secretary of State use his influence to make sure that the Joint Committee on Vaccination and Immunisation properly considers the right time for autistic people to be prioritised for vaccination?

[Matt Hancock]

Yes, I will. My hon. Friend rightly raises a very important subject. I will make sure that that is properly taken into account.

[Carla Lockhart (Upper Bann) (DUP) [V]]

I thank the Secretary of State for his statement. There will be significant concern among the population of Northern Ireland that entering into the UK could continue through Dublin, putting people in my constituency at additional risk of new variants. Does the Secretary of State agree that this is not behaviour becoming of a good neighbour? In fact, it is quite shameful and irresponsible for the Government of the Irish Republic to refuse to share arrivals data with the UK. Furthermore, if this continues, does he agree that the hard border currently being enforced by the Irish Republic, restricting travel from north to south, will have to be enforced by the Police Service of Northern Ireland to stop entrance into Northern Ireland from across the border, to protect the UK?

[Matt Hancock]

No, I do not agree with the hon. Lady. I reassure every one of her constituents and all citizens across Northern Ireland that we work closely with the Government in Dublin to ensure that data is shared properly and that both Governments have an appropriate system to safeguard our borders against the challenges that we face while allowing free travel within the common travel area.

[Chris Green (Bolton West) (Con)]

I welcome my right hon. Friend’s commitment to making a contribution to the roadmap on 22 February on the understanding of the impact on mental health of children and families. Will he commit to publish that in advance, to make sure that parents know that all of their concerns are being addressed and that they have an opportunity to make a contribution to it?

[Matt Hancock]

I will look into my hon. Friend’s suggestion.

[Daisy Cooper (St Albans) (LD) [V]]

The head of the Government’s own test and trace system admitted that up to 20,000 people per day who are asked to self-isolate are not doing so. Will the Secretary of State please confirm, after 10 months of being asked for it, when he will come up with a plan to fix the isolation system, so that those who need to self-isolate have the pastoral and financial support they need to do so?

[Matt Hancock]

We have put in place that support, including £500 for all those on low incomes. Everybody who is asked to self-isolate needs to self-isolate to break the chains of transmission.

[Mr Robert Goodwill (Scarborough and Whitby) (Con)]

What lessons can we learn from Israel which, uniquely, is ahead of us in this race to protect its people? For example, when we reach group 10—under-50s who have not already been injected—should we prioritise those who have not been exposed to the disease and who are not bursting with antibodies, so that we actually protect more people? Incidentally, the Israelis are also injecting 16 and 17-year-olds. Are there any lessons to be learned from that?

[Matt Hancock]

I talk to my Israeli counterpart regularly, and I am impressed by the effort that Israel has delivered on to vaccinate its population. I am very happy to look into the detailed points that my right hon. Friend raises.

[Caroline Lucas (Brighton, Pavilion) (Green) [V]]

Projections show that some countries in the global south will have to wait until 2023 to achieve widespread vaccination because pharmaceutical monopolies are creating artificial restrictions. Given that no one is safe until everyone is safe, will the Secretary of State use his influence with Cabinet colleagues to ensure that the Government change their position and back proposals from India and South Africa to address pharmaceutical monopolies and help ensure that the world can produce enough vaccines for every country as soon as possible?

[Matt Hancock]

The hon. Lady would get a better hearing if she started on this subject by congratulating AstraZeneca, the British player in this vaccine race, on the fact that it is rolling out its jab with no profit at all. It is doing that in order to be able to vaccinate as many people around the world as fast as possible, at an affordable cost. That should be our starting point. There would be no vaccines if it was not for the global pharmaceutical industry. I pay tribute to all those working in the pharmaceutical sector. There is no way that we would have these jabs were a policy followed that disparaged the pharmaceutical sector in the way she proposes or in the way the Labour manifesto proposed at last election. Instead, we should come together to support industry, scientists, the NHS and Government. It is a massive team effort.

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

For phase 2, will the Health Secretary commit to having mental health workers at national vaccine sites?

[Matt Hancock]

I will absolutely look into the suggestion that my hon. Friend makes, which is all about making sure that we reach out to people at a moment when everybody, or almost everybody, is going through a process together—and I hope it is everybody. It is very interesting proposal, which I will take away and hopefully speak to my hon. Friend about in the days to come.

Covid-19

Matt Hancock Excerpts

Thursday 4th February 2021 Written Statements

[The Secretary of State for Health and Social Care (Matt Hancock)]

On 5 January 2021, the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020 (All Tier Regulations) were amended. These amendments instructed people across England to stay at home and only to leave where they have a legally permitted reasonable excuse, as well as requiring the closure of many businesses and venues.

We are getting the virus under control, however the numbers of covid-19 cases, hospital and ICU admissions, and deaths remain extremely high nationally. As a result, our hospitals are still under significant pressure from covid-19.

As of 1 February, the weekly case rate in England has decreased to 294 per 100,000 for all ages, compared to a rate of 421 the week before and 233 per 100,000 in people aged 60 and over, in comparison to 332 per 100,000. There are seven local authorities with case rates greater than 500 per 100,000. Overall positivity for England is 11.9%, which is a 1.8% decrease over the last seven days.

Case rates for all ages have decreased but remain high or very high across all regions. Case rates also remain very high in the west midlands (350 per 100,000), the east of England (308 per 100,000) and the north-west (320 per 100,000). The lowest case rates are in the south-west (200 per 100,000)—a 30% decrease from last week. The highest positivity is in London (22%) and lowest in the south-west (6.9%).

The measures the Government have put in place are bringing down the number of cases/ However, these figures are significantly higher in comparison to early December, and there still remains considerable pressure on NHS systems nationwide as although hospitalisations are now decreasing, bed occupancy is still high and remains ~50% above the peak of the first wave. General and acute bed occupancy for covid-19 across England has decreased by 4,023 to 26,216 from 30,239 last week. Mechanical ventilation bed occupancy for covid-19 across England has similarly decreased to 3,366 from 3,736 in the previous week. Deaths within 28 days of a positive test remain high: there have been 7,898 covid-19 related deaths in England from 18 January to 24 January 2021.

In line with our commitments, I have kept the measures in place for the national lockdown under ongoing review. On 2 February I completed a review of the geographical allocations as required by the regulations and have determined that it is necessary for all areas in England to remain in tier 4 in order to tackle the threat posed by the covid-19. Whilst there are early indications that new infections may have started to decline in those areas which have been under stricter measures for the longest, scientific advice and the latest epidemiological data are clear that lifting restrictions now would be too early. We recognise the strain that these restrictions have placed on people across the country, but we must continue to take the necessary steps to slow the spread of the virus, protect the NHS and save lives. The restrictions are kept under continual review and will be lifted as soon as it is safe to do so.

[HCWS761]

Covid-19 Update

Matt Hancock Excerpts

Tuesday 2nd February 2021 Commons Chamber

[The Secretary of State for Health and Social Care (Matt Hancock)]

I rise to make a statement on the fightback against coronavirus.

Across the country, our vaccine roll-out continues at pace. With each vaccine we administer, we are one step closer to normal. As of today, we have vaccinated 9.2 million people. I thank everyone involved in this collective national effort that saw nearly 1 million people get vaccinated last weekend alone, or, to put it another way, one in 60 of all the adults in the UK. We have now protected almost nine out of every 10 people over 80 and half of people in their 70s. I am delighted that we have been able to visit every eligible care home, 10,307 in total. I want to thank everyone involved in that effort, including the NHS, our dedicated staff in social care, and the residents themselves, too, for coming forward. I pay tribute to the Minister for Care, who has worked so hard to help us meet this ambitious target.

I know that many of us in this House are playing our part in the national vaccination effort. Today, we published a new resource for the House that provides more information on the vaccine roll-out and how all colleagues can play an important part in increasing the take-up of the vaccine in their area, because the take-up will directly impact how effective the vaccines are and how fast we can safely get out of this.

We are confident we have the supplies to meet our target to offer the vaccine to the four most vulnerable groups by 15 February. We now have over 400 million doses of vaccine on order, including the additional 40 million doses from Valneva that we ordered yesterday. That we find ourselves in this position is no accident. Our strategy has been to invest early and invest at risk. We have backed many horses, no matter where they are from, and we have also built up our vaccine manufacturing capability here at home.

As a result, today we have the AstraZeneca jab being manufactured in Oxford, Staffordshire and Wrexham, the Novavax vaccine made in Teesside and the Valneva vaccine manufactured in Livingston in Scotland. It is a great example of what we can achieve together, working as one United Kingdom.

Despite this optimistic backdrop, we must continue to act with caution, not least because of the renewed challenges posed by new variants of the coronavirus. We have found here 105 cases of the variant first identified in South Africa, including 11 cases that do not appear to have any links to international travel. As with the variant first identified here in the UK, there is currently no evidence to suggest it is any more severe, but we have to come down on it hard. Our mission must be to stop its spread altogether and break those chains of transmission.

In those areas where this variant has been found—parts of Broxbourne, London, Maidstone, Southport, Walsall and Woking—we are putting in extra testing and sequencing every positive test. Working with local authorities, we are going door to door to test everyone in those areas. Mobile testing units will be deployed, offering polymerase chain reaction tests to people who have to leave their home for work or other essential reasons. We have also seen 11 cases of mutations of concern in Bristol and 32 in Liverpool and are taking the same approach. In all these areas, it is imperative that people stay at home and only leave home where it is absolutely essential.

When your local authority offers you a test, you should take up the offer, because we know that around one in three people with coronavirus has no symptoms, but can still pass it on. We are offering testing to everyone aged 16 and over, even if they have been vaccinated. If you live in one of those areas, but have not been contacted and are unsure whether you should have a test, I encourage you to visit your local authority website to find out.

Anyone who must leave home—to go to a workplace, for instance, because they cannot work from home—should get tested. All local employers should support and encourage their workers to get tested. The message is more important than ever: stay at home, maintain social distancing and get tested.

Across the whole country, we are expanding workplace testing, including here in Parliament. This morning, Mr Speaker, you and I together visited the new covid testing site in Parliament, which offers all those who work here—peers, MPs and staff—the chance to get tested. I took a test this morning—it was, thankfully, negative. It is quick and easy and you get the result back fast. I encourage colleagues who have to be here in person to sign up and do the same.

For all of us, no matter where we live, we need to continue to follow the rules, because while more scientific work is under way to learn more about new variants, we know with absolute certainty that social distancing works. It denies the virus the social contact it needs to spread. We must all keep at it. We have sacrificed too much—and come so far with the vaccine—to give up now. I know that we will not.

While we have been working night and day to fight coronavirus, I have often drawn inspiration from our fight against another killer pandemic, HIV, a disease that also took too many people before their time.

This is National HIV Testing Week. It is a reminder of how important it is to get your free HIV test, but it is also a reminder of the progress we have made in tackling that terrible pandemic that we can credibly commit to no new transmissions by the end of this decade. Today I am sure the whole House will join me in wishing Lord Norman Fowler a very happy 83rd birthday. He was an inspirational Health Secretary and a fearless advocate for tackling HIV and AIDS. Lord Fowler is someone who knows the importance of taking action early and the power of testing to turn the tide.

As we face these difficult weeks ahead, we can all draw inspiration from that great struggle and know that even when faced with a mountain of challenges, science, ingenuity and the sheer power of will can see us to better days ahead. I commend this statement to the House.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I am grateful, as always, to the Secretary of State for advance sight of his statement. I thank you, Mr Speaker, for putting in place the arrangements for testing on the estate. I am sure that Members and, crucially, staff on the estate are extremely grateful for that initiative. I also extend my best wishes to the Lord Speaker on his birthday today.

The news that the South African variant has been identified in eight different local authority areas is alarming and suggests significant community transmission. Can I just ask the Secretary of State to run through the timelines? When did these 11 cases test positive, and how long does the genetic sequencing take? When was he told of the cases? Can these processes be made speedier? I am told, for example, that the Ealing case tested positive in late December.

The variants bring into focus the importance of border controls. Times Radio reports that hotel quarantine arrangements will not be in place until 15 February. Why the delay? According to The Times, the Scientific Advisory Group for Emergencies warned two weeks ago that tougher quarantine restrictions for everyone entering the UK were needed. The Government dispute that interpretation, so will the Secretary of State publish the SAGE minutes from 21 January?

I welcome the extra testing, but may I suggest the Secretary of State goes further, because people move beyond their postcode boundaries? They go shopping and many still have to go to work. Will he therefore roll out testing in neighbouring postcodes? He wants to come down hard on this variant, but is not the lesson of mass testing, such as in Liverpool, that people are hesitant to take a test if they are not compensated for any loss of income associated with self-isolation? We are fighting this virus with one hand tied behind our back, asking the low paid to go hungry in order not to spread the virus. Transmission chains will not be broken without decent sick pay and isolation support.

We have seen the Kent B117 variant spread with speed. Public Health England’s latest technical briefing reports that B117 sequences with the E484K mutation seen in the South African variant have now been identified. That is very worrying, because this is the mutation thought to be behind the partial vaccine evasion. Surely that suggests that further action will be needed. For example, Germany, Austria and France are recommending FFP2 face masks on public transport and in shops. The Chair of the Select Committee, the right hon. Member for South West Surrey (Jeremy Hunt) has also suggested that. Will the Secretary of State now review the evidence and look at that measure?

On vaccination, I again congratulate the NHS. Not all care homes have been vaccinated—those with a covid outbreak have not, for understandable reasons—but will the Secretary of State tell us how many such care homes are outstanding? There have been reports of some care staff turning down vaccination, so can he tell us how many care staff have been vaccinated? Will he ensure that the NHS collects data on the numbers turning down vaccination, so that we can target and overcome the vaccine hesitancy more effectively?

Public health services have an important role in tackling vaccine hesitancy. When will public health directors know their allocations for the next financial year? UNICEF has warned:

“Children are not the face of this pandemic. But they risk being among its biggest victims”.

I accept it was inevitable that schools would close given community transmission levels, but that does not make it any less devastating. We are depriving young people of social interaction and of play with their friends. Learning is not the same and mental health problems are increasing. There will be children in homes where there is violence or where drink abuse or substance misuse is prevalent.

Children’s health must always be a priority. On current plans, how many teachers will be vaccinated as part of bands 5 to 9, and how many teachers and support staff will have to wait until the period between Easter and summer to be vaccinated? Last September, it was reported that 25,000 teachers had been off sick related to covid, further disrupting children’s learning, so how can the Secretary of State ensure that we do not see the same disruption again from March when it is hoped that schools will return?

Finally, this is indeed National HIV Testing Week. Over the weekend, I binge-watched “It’s a Sin”, and I was in tears. Thankfully, HIV is not a death sentence today. People living with HIV are in phase 6 for vaccination, but only if they have disclosed their HIV status to their GP. Many have not and still do not want to because of the stigma that we saw portrayed in “It’s a Sin”, so will the Secretary of State ensure that people living with HIV are able to access vaccination at their HIV clinic?

[Matt Hancock]

To answer the hon. Gentleman’s many questions, he is absolutely right to raise the importance of coming down hard on the cases of new variants that we have discovered here in the UK. These are cases that have been seen over the past two months. The action that we are putting into place is to make sure that we stop further spread, and further spread in the community, alongside the action taken to ensure that there is no spread from those who have a history of international travel. As he knows, we have brought in tougher action at the border and we stand ready to do more.

The hon. Gentleman asks for the SAGE minutes to be published. They are published regularly. He also asks about the neighbouring postcodes to those where a new variant case has been found, where it is a new variant of concern. We absolutely do that where it is epidemiologically sensible. For instance, if the case is found on the border of a postcode, obviously we go across that border. We also investigate linked premises—for instance, if somebody had a child at a school or is going to work in a particular workplace—and, working with the director of public health, we will ensure that testing is directed there as well.

The hon. Gentleman raises the issue of isolation payments. We have the £500 isolation payment in place, so nobody should, as he put it, go hungry because they have to isolate. What is critical in these areas is that people stay at home unless they absolutely have to go out. It is imperative that people follow the rules to get these new variants completely under control.

He asks about the care home success. I am delighted that we have been able to reach so many care homes. I said in my statement that we have reached 10,307 care homes in England. There are 110 care homes where the vaccination programme is still outstanding because they have had outbreaks and, for clinical reasons, the vaccination programme cannot start there, but it will as soon as it is clinically possible.

The hon. Gentleman also asks about the data being shared from the vaccination programme. That data is now routinely shared with local directors of public health, precisely for the reasons that he set out—so we can reach more parts.

Finally, he ends on the question of education. Of course we understand how challenging the impact of this lockdown is on those with children who have to be schooled at home. That is why the Prime Minister said that schools should be the first thing to open when it is safe and possible to do so. Sadly, that time is not yet, but the more that we all follow the rules that we have set out so clearly, the quicker that time will come.

[Jeremy Hunt (South West Surrey) (Con) [V]]

I thank the Health Secretary for liaising with me on the issues in Surrey over the weekend, where the actions taken by him and the outstanding leader of Surrey County Council, Tim Oliver, are absolutely right. My right hon. Friend mentioned that, at the weekend, we reached the milestone of offering the vaccine to everyone in care homes, except for where there has been an outbreak. Does he agree that we should crown that tremendous achievement by making 2021 a year as significant for the social care sector as 1948 was for the NHS—the year it was founded—with a long-term financial settlement implementing Dilnot and setting it up for the future with a 10-year plan?

[Matt Hancock]

My right hon. Friend knows that we set out in our manifesto, committed in the manifesto and were elected on a manifesto to resolve the long-standing problems in social care. The Prime Minister has set out to the Liaison Committee, of which my right hon. Friend is a member, the timetable on which he hopes that we are able to deliver that commitment. Alongside dealing with this pandemic, we are working to deliver our manifesto commitments, whether on social care or the 40 new hospitals or the 50,000 more nurses. I look forward to being held to account by the Select Committee on Health and Social Care on those commitments.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

I associate myself with the Secretary of State’s comments on HIV test week, but it is concerning to hear that over 100 cases of the South African variant have been detected in the UK, particularly as they do not represent a single outbreak, but are widely scattered across England. The concern, of course, is that while current vaccines will still give a significant degree of protection, this variant’s resistance to some covid antibodies could reduce their effectiveness, so does he plan to tighten internal travel restrictions to avoid it spreading across the UK as happened with the Kent variant?

Will there be increased random genomic testing of PCR specimens outwith those areas to identify just how widespread it already is? Unfortunately, this is shutting the barn door after the horse has bolted. The Government have been aware of the concern about this variant for some time, and the SAGE advisory group warned that limited travel bans would not be enough to keep out new covid variants and that the only way to stop them would be mandatory quarantine for all arrivals, so why did the Government choose not to follow that advice? This variant is already present in many countries and new, more resistant covid variants could evolve anywhere in the world, so will the Government reconsider their very minimal quarantine plan and extend it to all incoming travellers? As new strains brought in through holiday travel last year contributed to the second wave of covid, is the Prime Minister seriously suggesting that people should go abroad on holiday this summer?

--- Later in debate ---

[Matt Hancock]

What the SNP spokeswoman failed to mention is that it is only because we built the huge genomic surveillance capacity that we now have, which is available right across the UK, that we have been able to spot these variants of concern. This is a critical point, because those sorts of variation happen everywhere, but the challenge is to spot them as soon as we can and act on them.

The hon. Lady asked about travel. We already have in place rules against all non-essential travel, with clear “stay local” guidance. We also have mandatory isolation for new arrivals, so yes, we have tightened in response to the new evidence that she mentioned, but she did not also mention the fact that it is only because the vaccine programme is rolling out so rapidly across the whole UK that we are able to protect people against the old variant, which of course is the most widespread, in combination with the variant discovered in Kent. That is the way that we will get out of this situation. It is a UK programme, and we are enthusiastic and willing, from the UK Government point of view, to do everything we possibly can to support that roll-out, including all the way across Scotland, to make sure that people in Scotland and every other part of this United Kingdom can get their jab as soon as possible.

[Robert Halfon (Harlow) (Con) [V]]

I pay tribute to my right hon. Friend and to the vaccines Minister, my hon. Friend Member for Stratford-on-Avon (Nadhim Zahawi), for the work they have done on vaccines. Will my right hon. Friend thank Essex Council, NHS staff and volunteers in Harlow who have, so far, vaccinated many thousands of residents?

Public Health England has said that adults over 18 with learning disabilities are at greater risk of dying than most people aged 65 to 74. International studies show that if someone is learning disabled aged 55 to 64, death rates are comparable to those for people aged over 80. My right hon. Friend will have seen the parliamentary petition on this, signed by many thousands, so will he work with the Joint Committee on Vaccination and Immunisation to move the adult learning disabled high up the priority list for vaccinations?

[Matt Hancock]

I pay tribute to all those working in Harlow, including at the Harlow mass vaccination site, and also to the GPs and the pharmacists who are working so hard to vaccinate people right across Harlow.

On the question of the JCVI ordering and the prioritisation for vaccination, as my right hon. Friend knows, I think the best approach is to take the clinical advice and to follow that clinical advice. The sorts of considerations that he raises are an important part of the JCVI deliberations. I know it has looked very closely at the subject he raises. What matters now that it has made and published its decision is that we drive through the vaccination programme to get through as many of those groups as possible, and I am very pleased to see the hundreds of thousands of new vaccinations that are taking place every day.

[Dame Angela Eagle (Wallasey) (Lab) [V]]

SAGE warned about the dangers of the South Africa strain weeks ago, but the Prime Minister dragged his feet, and he has now decided on a partial quarantine arrangement that SAGE has already warned will be ineffective in preventing further introduction of this variant. Is it not the case that, once again, the Government have acted too little and too late to stop the spread of this new and dangerous variant in the UK?

[Matt Hancock]

No, on the contrary, we removed the travel corridors to ensure there is a self-isolation requirement that is mandatory for all those who are coming to this country. Protecting this country from new variants coming from abroad is important, hence we have taken the action swiftly, and we did that on the basis of the scientific evidence.

[Mr Philip Hollobone (Kettering) (Con)]

Could I commend the Health Secretary for the difficult and brave but correct decisions he made early on in the pandemic in relation to vaccines, which have led today to Britain having a world-leading vaccine roll-out? Could I also draw his attention to NHS Northamptonshire, which, thanks to the very hard work of all the local staff and volunteers, has one of the very best vaccine roll-out programmes in the whole country?

[Matt Hancock]

Yes, I have been watching the progress of those at NHS Northamptonshire, who are going great guns, and I know they are working incredibly hard. This does not happen by magic; it happens by hard graft, especially of the GPs and the pharmacists, and the support teams and the volunteers, who are doing such a great job in Northants.

I am very grateful for what my hon. Friend has said. We did take decisions at risk early, before we knew whether they were going to come off, and knowing that we would be criticised if it did not work out. However, that meant we could get those contracts signed ahead of many other places, and it means that we will be able to deliver vaccines for UK citizens and then, of course, play our part in ensuring that everybody across the world can have access to this life-saving vaccine, too.

[Zarah Sultana (Coventry South) (Lab) [V]]

The Government’s catastrophic mishandling of the virus has meant that, in the past month, there were over 32,000 covid deaths in the UK, an average of more than 1,000 a day. In New Zealand there were zero, in Vietnam zero, in Australia zero and in Taiwan one. The difference is that these countries pursued a zero-covid strategy—suppressing cases, saving lives and reopening economies. The vaccine offers hope, but so long as the virus circulates, there is a risk of thousands of more deaths and, now, of more dangerous new variants. Does the Secretary of State regret his Government’s decision not to pursue a zero-covid strategy, and will he now commit to this strategy?

[Matt Hancock]

All countries that have attempted a zero-covid strategy have found that this virus transmits and gets round the boundaries that have been put in place. There were parts of this country that tried a strategy of zero, and in fact we were urged to do so in this House, but what matters is making sure that we get the tools that are going to be used permanently for us to get through this, and that we get them deployed as fast as possible. That means testing, with the hundreds of testing sites that are now available and, crucially, it means getting this vaccine rolled out. The hon. Member said the vaccine offers hope, and I think that is where we should all focus—on getting this vaccine rolled out as quickly as we possibly can.

[Rob Roberts (Delyn) (Con)]

The Betsi Cadwaladr University Health Board in north Wales has had some difficulties over a number of years, and it was not surprising that there was a collective sharp intake of breath, and mutterings of “here we go again”, when the vaccine got off to a bit of a faltering start in north Wales. My colleagues and I have been in constant contact with the health board, and are pleased to report that things are now back on track. It is making good progress, and is very confident of being able to hit the target of vaccinating the first four groups by the middle of February. Will my right hon. Friend join me in paying tribute to the staff of the health board, and to the legions of volunteers, the armed forces, and all those involved in that process who are doing such a fantastic job in north Wales?

[Matt Hancock]

That is close to my heart, Madam Deputy Speaker, and across the UK people have done extraordinary things and worked incredibly hard to deliver this vaccine roll-out. We have been working as hard as we possibly can as a United Kingdom to support the NHS in Wales, including north Wales, and in Scotland and Northern Ireland, to ensure that the vaccine is delivered as safely and rapidly as possible to all parts of these islands.

[Dan Carden (Liverpool, Walton) (Lab)]

It is wonderful to see so many people being vaccinated so quickly, and it shows the value of investing in the right people, in the right place, at the right time, and of using our national health service GPs and local public health professionals. The vaccination is not the end of the story. Social distancing will continue to play its part, as will test, trace, isolate and support, and new variants threaten to take us back to square one. Will the Secretary of State learn the obvious lessons from this Government’s failures and successes, put local health teams in charge of test and trace with the proper funding they need, and fix the broken system of support, including the £500 payments and those not entitled to statutory sick pay, as quickly as possible?

[Matt Hancock]

I take all that as a compliment. The £500 payment is incredibly important in supporting people on low incomes, as is the huge roll-out of test and trace, with more than 90% of contacts now identified and contacted by NHS Test and Trace, which is doing a magnificent job. Of course, the roll-out of the vaccine is going rapidly, and this weekend, one in 60 of all adults in the country got a jab, which is testament to that. We are always looking to improve and learn lessons wherever we can, but I am glad that things are making the progress they are.

[Steve Brine (Winchester) (Con)]

I echo what the Secretary of State said about HIV. Binge-watching “It’s a Sin” is five hours well spent on a reminder of how close we are to that magic zero transmission. The Government’s acceptance last week that the release of our society, rightly starting with our schools, should move in lockstep with the success of the vaccine roll-out, was welcome. Will the Secretary of State assure parents that we will follow an increasing number of countries around Europe, and in the UK, and stick to that as the vulnerable groups, and those liable to overwhelm the NHS, are protected?

[Matt Hancock]

Yes, of course.

[Munira Wilson (Twickenham) (LD) [V]]

With the Prince’s Trust reporting a record high of more than half of young people often feeling anxious, and some A&Es reporting daily seeing children coming in after self-harming or overdosing, it is clear that the pandemic is taking an enormous toll on children and young people’s mental health and wellbeing due to school closures, family pressures, social isolation, and bereavement. Will the Secretary of State commit today, in children’s mental health week, urgently to form a cross-departmental plan for tackling the impact of the pandemic on the mental health of children and young people?

[Matt Hancock]

We have put a significant amount of extra funding into supporting children’s mental health alongside adult mental health. We know that one of the consequences of the lockdown, which is absolutely necessary, is that it puts significant pressure on mental health services. We have seen the increased burden on those services, and it is very important that people get the support they need.

[Mr Mark Harper (Forest of Dean) (Con)]

May I add my congratulations to those who have been rolling out the vaccine? I listened carefully to what my hon. Friend the Member for Kettering (Mr Hollobone) said, and I want to put on record my thanks to those in Gloucestershire, which, as of last Thursday, was the top performing part of the country. Hereford and Worcestershire next door was the second highest performing part, which kind of makes them the highest-performing roll-outs in the whole of the western world. I thank the Secretary of State for his help and that fantastic performance.

I want to take the Secretary of State back to his answer to my hon. Friend the Member for Winchester (Steve Brine). The whole point of the vaccine roll-out is to ensure that we protect the vulnerable, reduce the death toll and reduce hospitalisations and the pressure on the health service. Given that the vaccine roll-out is going so well and is, I suspect, ahead of where the Secretary of State thought it would be, will he confirm that when schools start going back on 8 March, it will be those two metrics falling—deaths and hospitalisations—that will guide the reopening of not just schools but the rest of the economy?

[Matt Hancock]

The Prime Minister has set out four metrics that we will follow. Deaths and hospitalisations are two of them, and they are both incredibly important. We expect deaths to fall faster than hospitalisations, because older people who are higher up in the JCVI cohorts are more likely to die by a greater degree than they are more likely to use hospital beds. The other two considerations are that we do not see further new variants that put all this at risk and, of course, that the vaccination programme rolls out well. I would not say that the vaccination programme is ahead of plans. I would say that it is on track; I make no further claim than that.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his and his Department’s wisdom and forethought in securing the vaccine for all of the United Kingdom of Great Britain and Northern Ireland—better together; I always say that, and it is the truth. As some Members will remember, the last smallpox outbreak in the UK was in the 1970s and was combated by health workers doing door-to-door testing. I understand the rationale behind that decision. What discussions has his Department had with the Treasury to secure additional financial support to enable each devolved Administration to carry out similar schemes if the need arises in every part of the United Kingdom of Great Britain and Northern Ireland?

[Matt Hancock]

We of course stand ready to put in place financial support for the devolved nations, should that be needed to tackle outbreaks such as this. We have a constant conversation with the devolved authorities. For instance, I speak to Robin Swann, the Health Minister in Northern Ireland, on a regular basis. I was talking to him on Saturday morning about the supply of vaccines, as the hon. Gentleman might imagine. It is something that we work very closely together on.

The fundamental point that the hon. Gentleman makes is absolutely right: it is by working together as one United Kingdom that we are managing to do this on vaccines. If we want a shining example of why this country performs so well when we work together, we just need to look to the vaccine programme being rolled out in every corner of the country, in every locality, with all nations working together in a single combined mission. It is a celebrated example of why this country works well when we are better together.

[Sir Graham Brady (Altrincham and Sale West) (Con)]

I thank my right hon. Friend for repeating his commitment to ensuring that schools can reopen as soon as it is safe to do so. As he reflects on that, will he keep in his mind the sobering words of Professor Russell Viner, the president of the Royal College of Paediatrics and Child Health, who said to the Education Committee that when we close schools, we close children’s lives, and went on to refer to 75 international studies that suggest significant mental health damage for children? Will he reiterate the huge importance of putting children’s mental health and wellbeing alongside the other onerous responsibilities that he bears?

[Matt Hancock]

I agree entirely with my hon. Friend. The Royal College of Psychiatrists has been clear in describing the negative impact of school closures and also the negative impact of the virus getting out of control. The challenge we have is to try to mitigate both those problems, and it is the vaccine that is the best way through.

[Ruth Jones (Newport West) (Lab)]

I start by thanking our amazing NHS staff, and especially those working in the Aneurin Bevan health board here in south-east Wales, for their amazing work throughout the pandemic. Will the Secretary of State update the House on any conversations he may have had with the pharmaceutical companies about the need to modify the vaccine in the light of the new variants?

[Matt Hancock]

We are working with pharmaceutical companies and the scientists to understand whether and where such modifications are needed and how they can be brought to use on the frontline as quickly as is safely possible. That is obviously an important consideration given the new variants that we have seen. We have confidence that, should modifications to vaccines be necessary in large scale, they will be available more quickly than the original vaccines and, just as the first time round, when we got in there early and bought at risk, we are having conversations right now with the pharmaceutical companies to ensure that we are right at the front.

[David Morris (Morecambe and Lunesdale) (Con) [V]]

There have been scare stories in Lancashire about vaccines being diverted to elsewhere in the country, causing a shortage and perpetuating further urban myths. Will the Secretary of State assure me and the House that my constituents will be covered, that vaccines are not being redirected to other regions of the UK, and that Lancashire will continue to receive the required proportions in the future, safeguarding my constituents?

[Matt Hancock]

Yes, I can give my hon. Friend that absolute assurance. Of course, the supply of vaccines is the rate-limiting step. We have seen the strain on vaccine supply from some of the things that have happened over the past week, and some weeks the supply is greater than in others. The website shows the daily move in the overall supply across the country as a whole. Lancashire will get its fair share and get enough to be able to deliver on the target of the offer to everybody in cohorts 1 to 4 by 15 February. I have looked closely specifically into the figures for the north-west, and it is getting its fair share. I can give my hon. Friend the assurance that the reports circulating on the internet do not come from credible sources.

[Clive Efford (Eltham) (Lab) [V]]

I add my congratulations to the workers in the NHS who are delivering the roll-out of the vaccine. Reopening schools will be a major step towards returning to some form of normality for young people in particular, but the presence of the new variant is likely to create some anxiety among staff. To minimise the disruption to education when we return and to create some confidence among staff when they are asked to go back into schools in large numbers, does the Secretary of State agree that we should plan to vaccinate school staff if at all possible before half-term, if not during it?

[Matt Hancock]

The challenge with the proposal the hon. Gentleman puts forward is that vaccinating those who are not as vulnerable to the disease before those who are more vulnerable would essentially increase the overall clinical vulnerability to the disease. I am glad that the hon. Member for Leicester South (Jonathan Ashworth) did not raise this issue as health spokesman on the Labour Front Bench, although I know others on the Labour Front Bench do so. We have to follow the clinical order of priority, because my priority is saving lives.

[Julian Sturdy (York Outer) (Con) [V]]

Further to the Prime Minister’s suggestion yesterday in Batley that we may not see a return to different regional tier restrictions due to the virus’s behaviour, how will the Government avoid unfairly disadvantaging areas with low covid rates? Or does the fantastic vaccination programme roll-out mean that the whole country can now make steady progress out of lockdown together?

[Matt Hancock]

That is our goal—that the whole country can make steady progress together. In fact, case rates across the UK are more similar in all parts of the UK than they have been for some time. There were significant regional variations over the autumn, but that is much less widespread now, hence the comments that the Prime Minister made yesterday.

[Julie Elliott (Sunderland Central) (Lab) [V]]

The Secretary of State will know that I have written to him several times recently on the subject of the gut microbiome, which the immune system heavily depends on, and its impact on covid-19. Will he meet me to discuss the emerging research, including on the use of prebiotics and probiotics, and positive mitigation of the impact of the worst effects of covid-19, helping people to suffer less and saving the NHS money?

[Matt Hancock]

I am very happy for either me or one of my team to meet the hon. Lady to discuss this issue and make sure that it is looked into properly.

[Dr James Davies (Vale of Clwyd) (Con) [V]]

The development, production and roll-out of vaccines in Britain is increasingly envied across the world, and the Wockhardt factory in north Wales is playing its part in that process. What plans does my right hon. Friend have to increase the production of vaccines in the UK further, both to meet our own needs and to allow us to assist our friends in the Republic of Ireland and elsewhere?

[Matt Hancock]

The onshoring of vaccine manufacturing is an incredibly important part of our strategy. We were previously very, very good at the research and at the regulation of vaccines, but onshore manufacturing was sparse. We have built that manufacturing capability, including at Wockhardt on the Wrexham industrial estate, as my hon. Friend mentioned, and also now with production in Scotland, Teesside and elsewhere, with more to come. It is a strategic choice that this country should make that we should bring onshore the manufacturing in critical industries and of critical products such as vaccines, not least because there is not going to be a global glut of vaccine manufacturing capability for a long time to come. We are at the forefront of the science, and we should be at the forefront of the manufacturing and production.

[Alison Thewliss (Glasgow Central) (SNP) [V]]

Dr Wendy Jones, who operates the drugs in breastmilk helpline, is continuing to get queries from people who have been told that they cannot get the vaccination if they are breastfeeding, so could I ask the Secretary of State to make it absolutely crystal clear that there is not a contraindication and that those who are breastfeeding should get the covid vaccination?

[Matt Hancock]

I will ensure that the chief medical officer writes to the hon. Lady setting out the precise clinical details of this point, because while she is right, I do not want to opine on the clinical points; I want to make sure that that comes from the top doctor in the land.

[Matt Vickers (Stockton South) (Con)]

A huge debt of gratitude is owed to all those involved in our incredible, world-leading vaccination programme, including Teesside’s hospital, our primary care network and the Fairfield pharmacy, which was one of the first pharmacy-based vaccination hubs around. Can my right hon. Friend confirm when Teesside will benefit from a mass vaccination site, so that we can get more jabs into the arms of Teessiders as soon as possible?

[Matt Hancock]

The performance of people on Teesside in getting the jab rolled out so fast has been absolutely magnificent—particularly, but not only, in Stockton-on-Tees, and I am not just saying that because it was my hon. Friend who asked me that question. It has been a really impressive performance and I am very happy to look into when we might be able to open a Teesside mass vaccination centre, but what I can say is that across Teesside the roll-out is going well and I am grateful to everybody who is coming forward so enthusiastically to get the jab.

[Tony Lloyd (Rochdale) (Lab) [V]]

May I join the Secretary of State in congratulating those in my constituency who have worked so hard on rolling out the vaccine? At the moment, in Rochdale, as in other areas, people are given roughly a week’s notice of the quantity and the type of vaccine that they will receive. As a way of working, that is fine for the first round of vaccinations. When we come to the second round, though, can flexibility be built in so that those responsible for delivering the vaccine know which vaccine and how many vaccinations they will get, so that they can ensure that those second vaccines are the ones that are needed?

[Matt Hancock]

I absolutely understand the point that the hon. Gentleman makes and I join him in what he says. I understand why people who are delivering the vaccine on the ground want to know those forecasts. The challenge is that the supply schedule is lumpy. We do not want to give certainty inaccurately: we do not want to imply that there is certainty where there is no certainty. There is certainty, though, in the fact that we have a high degree of confidence that the second doses will be available and, of course, will be distributed according to need, with the right vaccine for the right second dose going to the right place—we have a full record of that. The second dosing starts in earnest in a couple of months’ time—obviously, 12 weeks on from 4 January, when we shifted the dosing on to a 12-week schedule. We have the logistics under way to ensure that people get access to the right dose to match the first dose that they had. I am very happy to talk to him further if he has any more questions about the logistics of getting this sorted.

[Jason McCartney (Colne Valley) (Con) [V]]

More than 400 people were vaccinated at the new pharmacy-led vaccination centre at Honley village hall yesterday. The new vaccination centre at John Smith’s Stadium in Huddersfield is also open, as Yorkshire continues to lead the way with the vaccine roll-out. Will my right hon. Friend join me in thanking our NHS, the independent community pharmacy involved, and our wonderful community volunteers, who are all part of this great national effort?

--- Later in debate ---

[Matt Hancock]

Yes, I will. The vaccination effort right across Yorkshire has been absolutely fantastic, including in West Yorkshire, which my hon. Friend represents, and in South Yorkshire. Yorkshire has just pulled this one out of the bag. We will deliver on that offer to everybody in the top four vulnerable categories by 15 February—in just under two weeks’ time. Then we will get on and vaccinate all the others who are in the vulnerable cohorts. I know that it is hard work, but it is so uplifting. I am really glad to see that happening right across Yorkshire.

[Tonia Antoniazzi (Gower) (Lab) [V]]

In answer to my written question to the Home Office, I was informed that Border Force does not hold records of the number of staff who have tested positive for covid-19 in the past 12 months. We have seen the DVLA in Swansea unable to give the Transport Committee the correct number of staff who tested positive for covid-19 let alone a breakdown by Department. What conversations is the Secretary of State having with his Cabinet colleagues and Government agencies to ensure the safety of essential civil servants who are unable to work from home?

[Matt Hancock]

We are having those conversations all the time. In fact, I spoke to both the Home Secretary and the Transport Secretary about this issue yesterday, ensuring that we have widespread workplace testing available for all civil servants right across the UK.

[Ms Nusrat Ghani (Wealden) (Con)]

I come with good news from Wealden: the vaccination programme is working at a fantastic pace in my care homes and across the constituency. I come also with thanks to my right hon. Friend and to his leadership from lots of people across Wealden. So I thank him very much, but a Minister’s job is never done. Now I am being flooded by messages from parents, grandparents and teachers who want no further delays to school openings, so any assurances would be welcome. Furthermore, as we know that the lockdown has had an impact on our children’s mental health, health and educational attainment, is research being undertaken by the Department so that we can be ready to offer full wrap-around care for our young people when lockdown is over?

[Madam Deputy Speaker (Dame Rosie Winterton)]

Before the Secretary of State answers, I should gently remind the House that we still have almost 25 people to go, so brief questions and answers would be appreciated.

[Matt Hancock]

We want to provide as much support as possible. I am really glad that the vaccine roll-out is going well in Wealden and thank everybody who is playing their part in that.

[Mr Ben Bradshaw (Exeter) (Lab) [V]]

Why does it not make sense for teachers and other essential frontline workers to be vaccinated before perfectly fit and healthy people—like us, Madam Deputy Speaker—in their 60s?

[Matt Hancock]

Because people in their 60s are more likely to die from covid than people who are younger.

[Adam Afriyie (Windsor) (Con)]

Our world-leading vaccines programme will mean that deaths and hospitalisations for serious ill health will fall massively—probably to normal levels by around 8 March, when the top four priority groups will have been vaccinated. I am glad to hear the Secretary of State confirm that our top priority must be to open schools first and then move on, because parents are desperate to have schools opened, teachers want schools opened, businesses want schools opened and—God bless them—even our children are desperate to have schools opened. Will my right hon. Friend confirm that schools will be the first to reopen on or before 8 March?

[Matt Hancock]

I can confirm what the Prime Minister has set out: schools will be the first in the queue for reopening. We will consider the data in the middle of this month, my right hon. Friend the Prime Minister will set out a statement after that, and we will give two weeks’ notice. Schools will not open before 8 March, and of course we will look at the data, as I set out in a previous answer.

[Hywel Williams (Arfon) (PC) [V]]

The Health Minister in Wales has now admitted, at last, that many lives could have been saved had the Welsh Labour Government locked down sooner last year. Does the Secretary of State believe that an earlier general lockdown in England would have saved many lives? If so, how does that belief inform the quarantine and lockdown decisions that his Government now face?

[Matt Hancock]

We have taken action very rapidly when we have seen rises in cases. The most recent example here in England was, of course, right at the start of this year, when we saw the sharp spike in cases and took very rapid action to close schools after some of them had been open for just one day. We do not take such measures lightly and we understand the impact that they have, but they were absolutely necessary.

[Mr Tobias Ellwood (Bournemouth East) (Con)]

I congratulate my right hon. Friend and the entire team on doing such a phenomenal job in rolling out the life-saving vaccine right throughout the country. It is not, though, in our interest or indeed our character to become a vaccinated island; we have both the means and the desire to help others who do not have such advanced public health infrastructure systems as ours. We are heavily involved in COVAX, Gavi and the encouraging of global vaccine disbursement, but I invite the Secretary of State to go a step further and work with the Secretary of State for Defence and the Foreign Secretary to allocate overseas funds to create an international vaccination taskforce, utilising RFA Argus, our hospital ship, and other military assets to assist practically with the international roll-out of vaccines to developing countries. The UK set an example by stepping forward during the Ebola crisis; I hope we can do the same again today.

[Matt Hancock]

I would be happy to talk to the Secretary of State for Defence about that idea, because we are leaning into the global vaccination effort, not just with the funding to COVAX and Gavi that my right hon. Friend mentioned but with practical support—including, of course, the Oxford vaccine itself, which is the most deployable vaccine and the only one currently being used that has been distributed at cost. AstraZeneca took the decision to license the Oxford vaccine around the world at cost rather than making a profit on it and should be commended for that.

[Chi Onwurah (Newcastle upon Tyne Central) (Lab) [V]]

One year after the UK’s first covid patient arrived at Newcastle’s Royal Victoria Infirmary, I know the Secretary of State will want to join me in congratulating Newcastle’s NHS staff, GPs, public health professionals, volunteers and all those leading the way in vaccinating so many, so quickly. Will he agree to reward such success by handing more resources and control over the failing test and trace programme to local public health teams, who are closer to communities and can better understand local transmission chains, which we need to do if we are to get the virus under control?

[Matt Hancock]

Yes, absolutely. Local authorities are critical to this, and we are working with directors of public health as part of the effort.

[Mark Eastwood (Dewsbury) (Con) [V]]

Yesterday, I had the pleasure of meeting the Prime Minister at the Al-Hikmah vaccination centre to highlight the importance of people from local communities accepting the offer of a vaccine. What message could my right hon. Friend give to the people of Dewsbury, Mirfield, Kirkburton and Denby Dale who may be thinking twice about having an inoculation when given the opportunity?

[Matt Hancock]

I would say to everybody that they should listen to the my hon. Friend, their local representative, and to all those who have looked at the impact of the vaccine. We can see that it saves lives and that it is safe to take. We can see that the rumours that have spread on the internet are just that—they are rumours, not facts. I would listen to local faith leaders too, from churches, mosques and synagogues right across the country, who are all uniting to say that we should take the jab when it is our turn. It is the right thing for you and it is the right thing for your community.

[Bill Esterson (Sefton Central) (Lab) [V]]

The Health Secretary will understand the concern about the discovery of the South African variant in the borough of Sefton, but can he tell us what variant he referred to in relation to a number of cases in Liverpool? He knows that I have raised concern a number of times about the number of people who cannot afford to self-isolate or stay at home. That is even more important now with the spread of new variants and mutations. Will he tell me now that he is going to push his Cabinet colleagues to plug the gaps in financial support, so that everybody can play their part and stay at home to stop the spread of the virus?

[Matt Hancock]

We have put in place the £500 support to ensure that everybody can afford to self-isolate. As for the South African variant that has been discovered in Southport, we are, with the local authority, undertaking very significant action to try to isolate it and any spread. It is vital that all members of the community play their part: stay at home and get a test when it is offered by the local authority. There is more information on the Sefton website. I pay tribute to my hon. Friend the Member for Southport (Damien Moore), who was not able to get on the call list, with whom I have been corresponding on this matter. He, along with the hon. Gentleman, has been playing an important part.

The cases in Liverpool I mentioned were in fact raised in the local media and described by Liverpool City Council a couple of weeks ago. I included them for completeness to describe all those cases where we have seen a mutation, along with the 11 cases in the Bristol area that I also described, which have been set out in a scientific study from the University of Leicester today. We have been working very closely with Liverpool City Council and Bristol City Council on those two clusters, along with the councils of all those where a variant of concern, such as the South African variant, has been found. I hope that that is a complete enough answer and I am very happy to talk to the hon. Gentleman if he has any further questions.

[Bob Stewart (Beckenham) (Con)]

Yesterday I was speaking on the telephone to Mrs Bunny England, who was a WAAF in the second world war, and, at 92, is very, very young. She tells me that she is housebound and no one has contacted her about a vaccination. I assured her that I would inform the quite excellent and responsive South East London Clinical Commissioning Group about her case, and that I was sure she would be contacted very quickly. Can I ask my right hon. Friend, who is doing extremely well, whether we are going to be able to get to every single person in groups 1 to 4 who is housebound by 15 February?

[Matt Hancock]

Mrs Bunny England is certainly going to get her jab now. I am very grateful to my hon. Friend for raising her case. I will get straight on to the CCG, which, as he says, is excellent. Of course, we have roving teams right across the country going to people who are housebound. It is very important that we reach all with that offer, and we are on track to ensure that everybody can have the offer of a vaccination by 15 February. I appreciate that somebody in their 90s will have been waiting for that call for a couple of weeks now, but we are making good progress and I will make sure that Mrs England gets her jab.

[Afzal Khan (Manchester, Gorton) (Lab) [V]]

Last week I visited a number of new pharmacy-led vaccination centres set up in my constituency. It was incredible to see the tireless hard work of staff and volunteers. These vaccination centres are struggling to navigate the confusion caused by the two online booking systems. They are seeing patients being sent to centres much further away, rather than staying local, and patients aged over 70 who cannot get an appointment as the national booking system is not updated in line with the Government guidance. Will the Secretary of State look into these issues with some urgency?

[Matt Hancock]

First, may I pay tribute to the hon. Gentleman’s leadership in his local area and community in demonstrating how important it is to get the jab, as so many colleagues across the House are doing? It is wonderful that we have total unanimity in this House on the importance of the vaccination programme, and the work that people are doing—on all sides of the House and from all backgrounds—to promote the vaccination effort really makes me very proud; it is humbling.

Of course I will look into the specific issue that the hon. Gentleman raises. I will ask the Minister for vaccine deployment, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), to call him to talk specifically about it. There are two different routes through which people can get a jab: the mass vaccination centres or GPs. People are often invited to both, and that is okay. They can take one or the other, whichever is most convenient. If they get an invitation to a vaccination centre that is a bit of a distance away and want to wait for a closer one, they can do so. That closer invitation from the local GPs will come. A lot of people appreciate the opportunity essentially to go as soon as possible, which is why we have two different routes. I understand the importance of making that clear to everybody and ensuring that they are as deconflicted as possible. I hope that we can make sure that this process goes as smoothly as possible, and that the hon. Gentleman and my hon. Friend the Under-Secretary can make that work.

[Andrew Griffith (Arundel and South Downs) (Con) [V]]

Sussex today reached the twin milestones of vaccinating 85% of its over-80s and every care home bar the small number with recent outbreaks. Will the Secretary of State join me in thanking Siobhan Melia, Adam Doyle and their teams in NHS Sussex, and all the many GPs and the army of volunteers in Arundel and South Downs?

[Matt Hancock]

Absolutely; I am very happy to congratulate everyone in Arundel and South Downs and across Sussex, who have done a magnificent job so far. There is a lot more still to do, but they are doing a great job. I particularly pay tribute to those who have volunteered their time; they can often end up standing in the car park in the cold for an eight-hour shift. The spirit that is being shown in Sussex and right across the country is really uplifting, and we all need something that is uplifting in these difficult times.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op) [V]]

The Secretary of State is very well aware that when he does good things, I tell him so, and there is much to celebrate today. But before we get too euphoric, can I remind him that 406 people died yesterday of covid and that 70 people have died in Huddersfield hospitals since 1 January? The fight is still on, but the team working in my constituency and beyond is brilliant. They are all keeping to the rules, but will he please stop the Prime Minister breaking all the rules, going around the country and stirring up discontent?

[Matt Hancock]

The hon. Gentleman was doing so well: I agreed with all of what he was saying until the last bit. Of course the Prime Minister is going to go around the country and thank people for what they are doing. We just heard from my hon. Friend the Member for Dewsbury (Mark Eastwood) about the very positive impact the Prime Minister had during his visit to Dewsbury. I know that people across Scotland were very enthusiastic to see the Prime Minister visiting Scotland to say thank you to those working in the labs, on the testing and on the vaccinations. Perhaps the Prime Minister will come to Huddersfield and the brilliant vaccination centre there. If he cannot make it, perhaps I should go there, with the hon. Gentleman, to say a great big thanks. Travelling around the country to thank people for their efforts is an important part of keeping the nation going in these difficult times.

[Mark Pawsey (Rugby) (Con) [V]]

There is more positive news because among the half a million vaccinations provided across the country last Saturday were 750 at Locke House in Rugby, where more than 11,000 have already been given and priority groups 1 to 4 will be completed ahead of schedule by this time next week. Will the Secretary of State thank the GPs and everyone involved in this achievement, particularly the 100 or so volunteers at the site, who have turned out for long shifts in all weathers, led by the inspirational centre manager, Gita Natarajan? Could he say a little more about the steps being taken to ensure that the second dose of the vaccine will be of the same variety as the first?

[Matt Hancock]

I have always loved Rugby, and the idea that Rugby is going to deliver on everyone in categories 1 to 4 having an offer of a jab a week early is music to my ears. I am delighted to hear about it. I can absolutely confirm that we have confidence in the supplies of vaccine to ensure that everybody can get a second jab of the vaccination they had the first time, unless there is a specific clinical reason not to; that would happen only in very rare circumstances. The plan is that you get the same jab second time around as you got the first.

[Chris Stephens (Glasgow South West) (SNP) [V]]

According to the Global Institute, high-income countries representing 16% of the world’s population currently have about 60% of the vaccines purchased so far. So can the Secretary of State tell us what plans the Government have to start sharing supplies with low-income and middle-income countries? Can he share with us the Government’s plans on an international approach?

[Matt Hancock]

This is a very important question. Although I am incredibly proud of the UK vaccine roll-out and very pleased that we bought early so that we have access to the supplies of 407 million doses, we are also deeply aware of our international obligations, with the provision of the Oxford vaccine to the world, but also the financial support essentially through COVAX and GAVI, to make sure that people across the world have access to this vaccine. It is not “either/or”; it is “and”. Although my first priority and responsibility as UK Health Secretary is to ensure that the UK has access to this vaccine, this disease has demonstrated that it does not respect international boundaries and it is important that everywhere gets access to the jab.

[Katherine Fletcher (South Ribble) (Con) [V]]

The variant of covid that was first identified from South African samples has been found within the PR9 postcode. That postcode covers the town of Banks, which is within South Ribble in Lancashire. There is understandable concern among residents and a celebratable desire to do the right thing. Can my right hon. Friend offer any reassurance to the residents so close to Southport, and set out what they can do with testing, for example, to do the right thing in this situation?

[Matt Hancock]

Absolutely. Sefton Council leads on this particular outbreak, but I understand that there are some residents in Lancashire who are in that postcode area. The website sets out where the door-to-door testing will cover and the activities that the council is leading on, working with us, making sure that we get testing as broad as possible.

If you are in the PR9 postcode area, or any of the other postcodes that I set out yesterday, it is very important to be especially vigilant. It is imperative to stay at home unless it is absolutely essential that you leave home. I understand the concern—of course I do—but the reason that we have been so clear that these are the postcode areas is that we do need people to take action to limit the community spread in the vicinity of the cases that we have found.

[Yvette Cooper (Normanton, Pontefract and Castleford) (Lab) [V]]

The Health Secretary rightly said that our mission should be to stop the South African variant spreading. The community spread shows that border measures are failing to do that. He has set out no timetable for quarantine hotels today and, seven weeks after the variant was identified, it is still possible for people to travel home from South Africa and elsewhere, with no quarantine hotels, no quarantine taxis and no test on arrival, and go straight on to public transport in the UK. Why is that still allowed and how long is he going to allow it?

[Matt Hancock]

As the right hon. Lady knows, we have brought in very significant measures at the border to control the arrival of those from countries at risk, for instance, South Africa and other southern African nations, Brazil and nations around Brazil, and Portugal. The self-isolation requirements that she mentions are absolutely critical, but we are also of course looking at what further measures are necessary.

[Martin Vickers (Cleethorpes) (Con) [V]]

The roll-out of vaccines in north and north-east Lincolnshire is going extremely well and I am sure that my right hon. Friend will want to join me in congratulating all those involved on their magnificent efforts. To follow on from questions about the housebound, yesterday I was contacted by the family of an elderly gentleman who lives alone in a rural part of my constituency, who received an invitation for a vaccination at a centre considerably far from his home, and he wanted it locally. I appreciate that there is a follow-up, but the initial letter can cause confusion for people. Will my right hon. Friend do all he can to assure me that the follow-up letter inviting people for a local vaccination comes swiftly after that first letter?

[Matt Hancock]

Yes, I am happy to work with my hon. Friend. The best thing might be if I ask the Minister for Vaccine Deployment to call him straightaway to ensure that his constituent gets the vaccination as locally as possible.

I also take on board the broader point, because it is not just about that constituent, important though that is; it is also about making sure that everybody can have the vaccine as locally as reasonably possible. We also need a local voluntary effort, which is happening in so many parts of the country, to help elderly people to be able to get to a vaccination centre. If a constituent is housebound, the roving vaccinations teams need to be able to reach them. That takes longer than vaccinating through any other route, for obvious reasons, but it is a very important part of the scheme.

[Layla Moran (Oxford West and Abingdon) (LD) [V]]

I welcome the commitment from the Secretary of State to lean in, I think he said, to the international effort to roll-out vaccines everywhere across the world. No one is safe until we are all safe, anywhere, not least because if we do not do this in tandem, it increases the chances of variants coming here that would undermine our own impressive efforts. When does the Government plan to start parallel distribution of the vaccine, particularly to low-income countries, some of which have had no vaccines at all? Should it not be as soon as we have completed the vaccination of our clinically most vulnerable?

[Matt Hancock]

After we have completed the vaccination of the clinically extremely vulnerable, there are still many millions of people here who are at risk of dying from this dreadful disease. We will absolutely lean in to the international effort. Thanks to the fact that we chose not to join the EU scheme, we are of course far further ahead than we would have been otherwise, as the hon. Lady knows. We will play that vital role internationally, but she will also understand why it is so important that we fulfil our first duty to keep people in the UK safe.

[Fay Jones (Brecon and Radnorshire) (Con) [V]]

It has been a privilege to be one of the volunteers at my local vaccination centre in Builth Wells and I commend Powys Teaching Health Board and all the vaccination staff for their efforts. Residents in Ystradgynlais, the largest town in my constituency, currently have to travel more than 50 miles to get their jabs. As a result, the local GP is working almost around the clock to ensure that people who cannot travel can get their vaccine. As well as thanking everyone involved in delivering the vaccine in Brecon and Radnorshire, will my right hon. Friend confirm that the roll-out is an agile system and that the Government will not allow the challenge of rural areas to impede our progress?

[Matt Hancock]

Yes. Across England, we have set the goal of having a vaccination centre within 10 miles of where anybody lives. It is harder in more rural parts, such as my hon. Friend’s constituency, of course. We are absolutely willing to support the Welsh NHS in delivery locally. In fact, the British armed services are involved in support of the roll-out across Wales, as they are in England. I am happy to meet my hon. Friend to discuss what more we can do to ensure that people can get the vaccination as easily and closely as possible in her sparse and very beautiful constituency.

[Liz Twist (Blaydon) (Lab) [V]]

A new research paper published today by Newcastle University demonstrates the link between poor mental health and welfare support, and this pandemic has particularly tested the mental health of so many of us. Will the Secretary of State urge the Chancellor of the Exchequer to keep the £20 universal credit top-up after March and to extend it to those on legacy benefits so that the mental health of those on benefits is not even more affected?

[Matt Hancock]

I will take those representations to my Cabinet colleagues, as I know that they are working hard to ensure that everybody gets the support they need.

[Sir David Evennett (Bexleyheath and Crayford) (Con) [V]]

The roll-out of the vaccine across my borough of Bexley has been very successful to date, and I congratulate all involved. Will my right hon. Friend note that NHS information and co-operation across our area of south-east London has been absolutely superb? Will he confirm, though, that the second doses of the vaccine will be delivered on time, including to the housebound?

--- Later in debate ---

[Matt Hancock]

Yes. The second doses are important. Although the time from the first dose to the second is 12 weeks, that does not make it any less important that we have the vaccines ready. We have a high degree of confidence that they will be there and we are already planning for the roll-out of the second doses; we know when each of those doses becomes due, because it is 12 weeks after the first dose. That planning is in hand and, frankly, compared with the time we have had for planning during most of the pandemic, 12 weeks is an absolute age.

[Rachel Hopkins (Luton South) (Lab) [V]]

The Joint Committee on Vaccination and Immunisation states that the implementation of the vaccine should also involve flexibility in vaccine deployment at a local level, with due attention to, among other things, mitigating health inequalities. Will the Health Secretary outline whether his Department believes that homeless people who have complex health conditions because of their accommodation status should be prioritised for vaccination?

[Matt Hancock]

Yes, I am working with the Housing, Communities and Local Government Secretary on a specific programme for the roll-out of the vaccine to people who are homeless.

[Sir David Amess (Southend West) (Con) [V]]

I very much associate myself with my right hon. Friend’s remarks about the noble Lord Fowler, who of course was in charge of the combined Department of Health and Social Security. While I applaud the Government’s very wise decision not to sign up to the EU vaccination procurement programme, when I visit Highlands vaccination centre tomorrow, will I be able to reassure my constituents that they will still receive their second doses of vaccine on time now that we have left the European Union?

[Matt Hancock]

Yes, I am glad to say that we are working with our EU counterparts to ensure the fair distribution and manufacture of vaccines according to signed contracts, which is the right and proper way that it should be. Thankfully we signed those contracts early and we made sure that we got solid contracts to deliver the necessary doses to the UK. I look forward to those being delivered on, and I have assurances from all quarters that that is what will now happen.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

We know that there is a reduced antibody response against the new covid variants for vaccinated blood, but what is the level of change in vaccine efficacy, and what action is under way to update and approve new vaccines to address this? I am particularly thinking of the E484K mutation found in both the Brazilian and South African variants.

[Matt Hancock]

The hon. Lady is absolutely right to ask this critical question. We are doing a huge amount with the scientists and the pharmaceutical industry to develop modified vaccines should they be necessary. We are also monitoring the results of work to understand the efficacy of the existing vaccines against the variants of concern. We do not have a point estimate for the difference in the efficacy of the vaccine. The efficacy needs to be measured both in terms of someone’s likelihood of catching the disease and in terms of their likelihood of being hospitalised or dying from the disease. There is a significant amount of work under way to understand all those things, both in labs and in the field. For instance, AstraZeneca has a trial in South Africa that it is revisiting to understand the progress of those who were vaccinated as part of the trial. We will publish as much information as we get as soon as we credibly can. I wish I could give a number in answer to the hon. Lady’s very astute question, but unfortunately it is not scientifically credibly available yet.

[Stephen Hammond (Wimbledon) (Con) [V]]

I congratulate my right hon. Friend on his decisions of last year to guarantee the surplus supplies of vaccine, and I thank all the NHS staff and volunteers in Wimbledon who are delivering it. Clearly, getting the vaccine rolled out as fast as possible is key. Therefore, can he confirm that he will make sure that best practice advice is being given to every vaccine centre to ensure that there are no supplies unused at the end of the day and that there is a reserve list for appointments?

[Matt Hancock]

The vaccine programme has been enormous hard work by a huge number of people. It is very heartening to see it progress as it is, including in Wimbledon, where it is going well, and I am very grateful for my hon. Friend’s support in making that happen. The need to use every last drop of this precious vaccine is paramount. The standard operating protocol clearly states that all vaccine doses that are available should be used. If we can get 11 doses out of the 10-dose AstraZeneca vial, then we should do so. It is now standard practice to get six doses out of the previously five-dose Pfizer vial. There should also be a reserve list of people in categories 1 to 4 who can be called up at the end of the day if there is any spare. But the most important thing is that if the vaccine is going off—if it is coming to the end of its time out of the freezer, for the Pfizer jab—then it should be used in all circumstances. We need to use every last drop.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I thank the Secretary of State for his statement. We will now have a three-minute suspension for cleaning.