Last Wednesday, this House came together to vote in favour of a new time-limited set of national restrictions across England—our strategy to suppress the virus, support the economy, education and our NHS until a vaccine can be deployed, and in doing so, to ensure that the NHS was not overwhelmed. It is clear that, in tackling this virus, there are no easy or simple choices for anyone. While Members may differ in the perspective they take on what is the right balance to strike, as we would expect in our open and vibrant democracy, it is important to say that it is clear that all Members of this House share a common objective, which is to beat this disease and see our country flourish once again. As Members will know, I entirely respect and recognise the sincerity and strength of feeling of all Members on this most difficult issue, irrespective of the stance they take on it.
Difficult though they are, entailing further sacrifices, the steps that this Government and this House took last week were the right ones, because the alternative of not acting would have been far worse. Throughout the pandemic, we have always sought to base our decisions on evidence, data and scientific advice, but we must also recognise that this is a disease about which we have learnt more every day and about which we knew nothing a year or so ago. Throughout, we have always been willing, and we must remain willing, to reflect on and adapt to changing scientific evidence and scientific debate, and to move with that debate.
The evidence we faced last week before the Prime Minister’s announcement was stark and changing rapidly: an R rate above 1 in every region and more than 100 cases per 100,000 of the population. The data indicated that the number of people in acute hospital beds in England was due to exceed NHS surge capacity in the forthcoming weeks and, in some hospitals, the number of patients was already higher than at the peak of the first wave. To me, one thing was abundantly clear: our NHS was at risk of seeing demand exceed capacity if nothing was done.
There was a sharp acceleration in infections in September and October, as was the case across Europe, and, as we know, many of those infections lead to hospitalisation further down the line, with a roughly two-week lag. As Sir Simon Stevens, the chief executive of the NHS, recently set out, at the start of September there were around 500 people hospitalised with covid. By the start of October there were around 2,000 people hospitalised with covid, and by the start of November, that figure had sharply increased to around 11,000.
We were already at the point where hospitals were becoming very busy, and that was before the normal winter and flu-related demand. It appears that, with the new treatments that are being developed, more people are likely to walk out of hospital after treatment than sadly was the case during the first wave, and I am thankful for that, as I am sure the entire House is, but the fact remains that those people still need hospital treatment. Each day the R rate remains above 1 is another day on which cases rise, with more hospital admissions, more patients deprived of other types of care and, tragically, more deaths.
My hon. Friend is making a very important point about the impact on hospitals. Does he agree that the knock-on impact on elective surgeries and care and treatment in our hospitals means that unless we keep the coronavirus rate under control, we could see other people with non-covid illnesses being adversely impacted in this wave of the pandemic as they were in the first wave? Indeed, in my constituency we saw a 26% increase in deaths from non-covid illnesses in the first nine months of this year.
My right hon. Friend is absolutely right. In taking the action we are taking to protect the NHS, we are of course also seeking to suppress the number of people who need hospitalisations to maintain the availability of those hospital beds for other people in dire need, exactly as she alludes to. I have to say to those who question the impact of this disease or its seriousness when someone gets it that I am reminded—as I suspect other Members will be—of the extraordinary dignity and suffering of the Lewis family in the Rhondda, who were on “Channel 4 News” and various other news outlets last week. Mr Lewis had lost his wife and his two sons in under a week to this disease. It was a truly dreadful story, and I have never seen a more dignified man than Mr Lewis when he was talking about it.
The latest R rate is between 1.1 and 1.3, so it was essential to take action to protect our NHS and to enable us, as my right hon. Friend said, to maintain the vital services for those without covid that sadly had to be paused in the first wave. From the Dispatch Box, I would like to take the opportunity once again—every time we are here it is right we do it—to thank all our staff in the NHS and care sectors for the incredible work they have done and continue to do in the face of these unprecedented challenges.
As I have set out, the virus remains a serious threat. We recorded more than 20,000 positive cases yesterday. Average daily hospital admissions currently stand at 1,366 and, sadly, yesterday we recorded more than 500 deaths—the highest death toll since mid-May. It is a painful reminder that the real battles are fought not here in this Chamber, but in our hospitals up and down the country and by those who are suffering from and fighting this dreadful disease. But in this Chamber, there are steps we can take that I believe will help them in that battle, and I believe that we were therefore right to act as we did.
Despite the seriousness of our current situation, these measures are time-limited. They legally expire 28 days after they were passed by the House—on 2 December. At that point, we will look to return to the tiered system, using local and regional data and trends to determine our response and adapt to local needs.
Of course it is right that the furlough scheme and the support for the self-employed should be reinstated at the levels they were at in March, but the Minister will know—everyone will know—that there are a great many people in our country who did not qualify for the furlough scheme or the self-employed scheme, or whose businesses did not qualify for grants at the start and still do not. May I take this opportunity to remind him that a great many people are still without financial support and will find it increasingly difficult to make it through the coming weeks and months? Will he take that message back to his colleagues across the Government?
I am grateful to the hon. Gentleman for the way in which he made his points, which made, as ever, measured and reasonable. As I have said, I entirely understand—as anyone in this House will, from looking at their own casework and their constituents’ letters—the situations that some people still find themselves in, despite the unprecedented package of support that has been put in place. I know that he would not expect me to speak for the Chancellor of the Exchequer, but I know that my right hon. Friend will have heard the point that he has made. Indeed, other Members of this House have made it on other occasions on behalf of their constituents.
This tough emotional and economic toll is why we are determined to make every day count in our battle against the virus. Our NHS has been preparing for this second wave for months, and as we move into winter, it is better prepared than before, with 30,000 ventilators and billions of items of PPE, mostly made here at home. In that context, I would like to take this opportunity to pay tribute to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who has done so much, as the Minister with responsibility for this area, to ensure that we have the PPE that we need at this time. There are also over 13,000 more nurses and almost 8,000 more doctors, and £450 million is being spent as we speak to further upgrade accident and emergency departments. There is increased capacity in our hospitals, and the Nightingales are standing ready as an insurance policy.
What is more, we know more about the virus than before. We know how we can better stop it and how we can better treat it. We have therefore strengthened infection control procedures and, as a result, we are driving down hospital-acquired infections. We have also improved clinical techniques, and I pay tribute to the clinicians and scientists who have driven these developments. As a result, the number of people surviving covid in hospital is up, as I said earlier. But of course, an increase in survival rates means that the pressure on NHS beds remains high. Equally concerning to the House will be the toll this disease takes not just on immediate physical health but on mental health. Our medical community is also working hard to understand the impact of so-called long covid and the potential for long-term chronic conditions resulting from the illness, even when people may have felt they were unaffected when they had it.
Before I call Justin Madders, and to help Members plan a little better, let me say that the time limit will come in after Sir Desmond Swayne, who sits fifth on the call list. So Members who are between five and 10 on the list will have five minutes, and those after 10 will have four minutes. The time limit may be reduced later on, depending on what Dame Rosie Winterton wishes to do.
It is now 293 days since the Secretary of State first came to this House and spoke about the emerging threat of covid-19. Since then, thousands of lives have been lost, both directly and indirectly, and billions of pounds have been spent. There has been great personal sacrifice, and we have all heard so many stories of individual courage and dedication that have been an inspiration, but there is no doubt that people are now weary. Not one corner of this isle or one aspect of our lives has been immune to the impact of this virus, so the news this week that there may be a way out of this nightmare has given people hope, and we all need hope at this difficult time.
However, that hope should not obscure the truth that we are in the midst of a second wave, so we must be sure to maintain vigilance. As we heard from the Minister, as of yesterday there were 20,000 new infections; more than 13,000 people are in hospital in England, with more patients in hospital in the north of England than there were at the peak of the first wave; and sadly, there were another 532 deaths yesterday, the highest number in one day for approximately six months. That is another 532 families who have lost a loved one, and among the huge numbers we talk about, we should never lose sight of the fact that each one of those numbers is a person. With the news today that we have now passed 50,000 deaths since the start of the pandemic, we know that the scale of human loss has been immense.
Those figures remind us that we still have a long way to go. Hope for the future is important, but it is not guaranteed, and neither is the end likely to be reached before we enter the difficult winter months, during which it is sadly likely that more people will catch the virus and more will die. It is right that plans are now being made for the roll-out of the vaccine, but that should not mean we take our eye off the ball when it comes to the immediate and pressing challenges that this virus presents. I know that time is at a premium today, so I will not detain the House for too long, but I want to say a few words about some of those immediate challenges.
I had hoped to speak in this debate but, unfortunately, there are limited flights to Belfast. Does the hon. Member agree that there needs to be additional testing in the care home sector, particularly for family members who could be designated as care workers? I know that the Minister brought forward a pilot scheme. Does the shadow Minister agree that that should be rolled out right across the United Kingdom and that loved ones should get access to their family members in the care home setting?
I thank the hon. Member for her intervention. The recent developments in rapid testing give us the ideal opportunity to allow relatives of those in care homes to go in and see them and give them the support that they have been so sadly lacking in recent months. None of us could fail to be moved by the many representations we have had from family members who have been unable to see their loved ones for many months.
On the health and social care workforce, we know, sadly, that over 600 staff have lost their lives so far to covid-19. They have paid the ultimate price just for doing their job. It is important that lessons are learnt about how we stop transmission, and it is right that the Government opened up their life assurance scheme to all health and social care staff, but over half of all families who have lost someone to the virus have still not received their payment, so we need the Government to be much more proactive in making sure that everyone who is entitled to that payment receives it.
Let us support the staff, but let us not forget the impact on patients as well. We know that the NHS could cope with the first wave only because so many planned operations were cancelled. We know that the need to operate in a covid-secure environment presents additional challenges to the NHS in reaching previous levels of activity. We know that before the pandemic started, waiting lists were already climbing to record levels. Covid-19 has accelerated that increase so that by August this year, over 100,000 patients were waiting over a year just to start treatment. Cancer Research UK estimates that around 3 million people are waiting for breast, bowel or cervical screening, and there were over 1.2 million patients waiting for a key diagnostic test at the end of August. We need to hear what the plans will be to address these spiralling waiting lists, and we need a cast-iron guarantee that no patient will be discharged from hospital into a care home if they have tested positive for covid-19.
I pay tribute to all those in my own constituency who have helped our community through the pandemic—the medical and emergency staff, other key workers, our volunteers, and the neighbours who have made all the difference.
I want to say a few words about how we can ensure that public confidence in our policy remains high, but first I will make a few comments on the current lockdown. I reinforce my hon. Friend the Minister’s point that when we leave the national lockdown on 2 December, we are not going into a national free-for-all in the run-up to Christmas. Ministers must make it very clear that we are transitioning back to a regional tiered system, because over-optimism, just as if people believe that a vaccine coming means they do not have to obey the rules, would be very dangerous to public health.
But if we are going to move successfully back to the tiered system, we have to deal with some of the illogical rules that still exist despite the best efforts of Ministers. This is not frivolous—it is important in getting people to conform to the restrictions that are in place. For example, we want people to play sport, so do we really believe that a spaced round of golf is more dangerous to public health than people going to a supermarket? When it comes to religious observation, is it credible that people who go to church for private worship and are properly spaced are a greater danger than the same number with the same spacing who take part in a service? These issues are important to a lot of people out there. The Government need to deal with some of these illogicalities if we are to deal with conformity.
There is something that Ministers can do immediately, and that is about free testing for families of key workers. I have a constituent who is a key worker and has been sent home because her son has also been sent home from school to isolate. She cannot go back to work until her son has a negative test, but he does not qualify for free testing. In other words, she must pay to get her son tested before she can go back to a key occupation. That cannot be the right way to treat our key workers. I urge the Minister to look as quickly as possible at how we deal with these key members of our society.
Despite its dreadful impact, the coronavirus pandemic has brought out the very best in people, from Captain Sir Tom Moore’s inspiring fundraising efforts to volunteers in communities across my Kirkcaldy and Cowdenbeath constituency who have mobilised to ensure that the vulnerable among them receive food and medicine as they shield from this deadly virus. I would like to pay tribute to some of them today: Fife Voluntary Action, Benarty emergency response team and the many “Scotland Loves Local” high street heroes award winners, to name but a few. But of course I also add my thanks to all the key workers who kept us all going throughout lockdown.
The pandemic has also, however, laid bare the opportunism of some: a profiteering cronyism that runs through the heart of this Westminster Government—what Canadian author and social activist Naomi Klein calls “disaster capitalism”. In her award-winning book “The Shock Doctrine”, Klein presents a convincing narrative of a political strategy that exploits large-scale crises, such as this pandemic, to push through neo-liberal policy that systematically deepens inequality while simultaneously enriching the already wealthy with connections to those in power.
In the crisis we face today, ordinary people are focused on the daily challenge of survival, yet in parallel we have repeatedly witnessed new private companies springing up to profit directly, greatly assisted in those efforts by a political class prepared to make strenuous efforts to line the pockets of many with close links to the party of government. As my hon. Friend the Member for Gordon (Richard Thomson) incisively said of this phenomenon, people across these islands are in the grip of a cronyvirus at the heart of this Government that may be every bit as deadly as the coronavirus.
Does the hon. Gentleman accept that the private sector has played a role in helping to tackle the virus, and specifically that Pfizer, as a private company, has only got the money to invest because of its profit and share nature?
I do not dispute the role of private companies in meeting the challenge of the coronavirus. I will go on to discuss the transparency and the appropriateness of the way in which contracts have been awarded by this Government during the pandemic.
We have only to look at the PPE fiasco to see how this has been brazenly put into action, with large contracts awarded to small firms with little to no experience in the relevant field but with numerous links to the Conservative party. How on earth did the Government find them? In what amounts to a covid bonanza for these tiny companies, Government contracts worth more than £10 billion have been awarded in this way since March. Under cover of the pandemic, the standard rules have been put aside, enabling contracts to be issued in extreme urgency with little to no oversight; I refer here to the comments made by the right hon. Member for North Somerset (Dr Fox) about scrutiny.
With the emergence of promising vaccine candidates, we collectively hope that there is light at the end of the tunnel. However, the darkness of our journey through this pandemic must not be allowed to obscure our important public duty to act in good faith and with financial probity. We simply cannot emerge from this experience with the dismissive “at any cost” excuse deployed from the top of this Government down. We must ensure that the burden is shared equally.
Enormous amounts of public money have been dished out in the absence of any tendering process, value for money assessment or assessment of whether any of these companies have relevant experience. We have all heard stories of UK businesses with expertise whose offers of help went unanswered by this Government. Why? On PPE, £108 million went to a tiny pest control company with net assets of £18,000. Another £108 million went to a modestly sized confectioner in Northern Ireland, while a third contract worth £252 million was awarded to an opaque private fund owned through a tax haven. The more that Members and external interested parties scratch the surface of this Government’s contract profligacy, the more serious are the questions that arise.
On a point of order, Mr Deputy Speaker. This debate is about covid-19, the pandemic in our constituencies right now, but the hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey) is taking us back to the 1980s. Is that as it should be?
I am not responsible for the hon. Gentleman’s speech, but I know that he will be conscious of the number of people who wish to contribute to this debate. I know him to be a fair man and we are coming now to exactly the same timings of the other Front-Bench contributions, so if he could come to a conclusion, that would be really useful.
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The measures in place are also quite different from last time. Schools and universities rightly remain open to avoid further disruption to education. People can establish childcare bubbles, take unlimited exercise and meet one person from a different household outside. More than that, however difficult it has been, I believe that we as a nation have made huge strides to better overcome the challenges that these measures bring. However, I am acutely aware that for many people in our country any restrictions are still incredibly difficult, especially this second time around. They are difficult for our NHS and care home staff, who have shown such resilience but still face a difficult winter ahead; for the families who have not been able to see their loved ones and once again cannot meet them in the ways they would wish to; and for individuals who live alone and are still, despite support bubbles, having to cope with the challenges posed by these restrictions.
It has also, of course, been an especially tough time for the businesses that have had to close their doors just as they were coming back, and that is why we are providing an unprecedented package of economic measures, with more than £200 billion of financial support since March to protect lives and livelihoods in every region and nation of the United Kingdom. The package was recently described by the International Monetary Fund as
“one of the best examples of coordinated action globally”.
Of course I feel deeply for those businesses and individuals, and I appreciate the position they find themselves in, especially when they have done all they can to do the right thing. That was why it was important to extend the furlough scheme and to provide further support in extending the scheme for the self-employed.
In social care, too, we have rightly taken important steps to protect people in care and those who care for them. Our social care winter plan, led by my hon. Friend the Minister for Care, strengthens protections in social care, including the provision of PPE, regular testing and updated systems for safe discharge. Those will be crucial in the months to come. She recently set out the latest guidance for care home visits, which sought to strike the incredibly difficult balance of providing vital protections for the health and wellbeing of our most vulnerable people, while protecting the people who work there and seeking to allow those vital family visits.
We have also built the largest testing capacity of any country in Europe. From an almost standing start in the spring, we have conducted some 34 million tests so far, and yesterday our polymerase chain reaction testing capacity stood at 504,491. More than 10 million people in the UK have been tested at least once through NHS Test and Trace, and our NHS covid-19 contact tracing app is approaching 20 million downloads. In Stoke-on-Trent and Liverpool, we are piloting cutting-edge lateral flow tests, which can deliver a result on infection in just 15 minutes. Starting yesterday, we are rolling out twice-weekly testing for all NHS staff, using a range of testing technologies so that we can better seek to keep both staff and patients safe. On Monday, the Secretary of State wrote to 67 directors of public health who had an expressed an interest to him to make 10,000 tests immediately available to other areas across the country and to make lateral flow tests available for local officials and devolved Administrations according to local needs, at a rate of 10% of their population per week.
Those bold new steps are a key weapon in our battle against the virus, but of course I know that the hopes of the nation are, understandably, pinned on the possibility of a safe and effective vaccine. That felt another step closer on Monday, as we all welcomed the announcement from Pfizer and BioNTech of a vaccine that they state is more than 90% effective. As an early mover, the UK has already secured 40 million doses of that vaccine. It is important to note that it is just one of many vaccines in development, and we have placed orders for 300 million further doses from five other vaccine candidates that are yet to report phase 3 results. I always seek to sound a note of caution at this Dispatch Box and in the media, and it is important that I echo the words of caution from the Secretary of State yesterday: the full safety data for the Pfizer and BioNTech vaccine is not yet available, and our regulator the Medicines and Healthcare products Regulatory Agency and the Secretary of State will not approve any vaccine until it is proven clinically safe. This is a promising step forward, but we must remain cautious. So until we can roll out a proven vaccine, we must continue to follow the existing rules of “hands, face, space” because this remains a deadly virus.
In closing, let me say that in recent months this country has faced some tough and challenging times. We continue to face tough and challenging times, and many up and down our country have made huge sacrifices and continue to do so, be they individuals, families or businesses. I pay tribute to them all. There are no easy solutions, but we have risen to and beaten such challenges in the past, although different ones, and we can do so again, through a unity of spirit, by coming together as a country and by our shared determination to do the right thing. The recent announcement of a potential vaccine offers hope for the future, and while we pursue that prospect at speed, our greatest strength lies in the common sense, determination and resilience of the people of our great country. I am convinced that, with those and together, we will beat this dreadful disease.
Every challenge in the NHS is faced, first and foremost, by its workforce, so I will start by paying tribute—as the Minister did—to everyone in the NHS: the doctors, the nurses, the many allied health professionals, the porters, and everyone who has gone above and beyond over these past nine months to keep the NHS going. We know that working in the NHS is never easy, but the pressure, the workload and the trauma this year are of a scale and intensity we have never seen before. Not only must we show our gratitude to those who have given their all; we must demonstrate that we are listening to them by addressing their well-documented and legitimate concerns. That has to be more than a clap or a badge: there has to be tangible recognition that there are only so many times people can go to the well before they become physically and mentally exhausted. It is clear that burn-out is a real risk, as 14 health unions and royal colleges warned in their letter to the Prime Minister earlier this week. They say that asking staff to carry on at this level of intensity is “increasingly unrealistic”. We have to listen to that warning.
Addressing workforce fatigue is not just the right thing to do: it is the only thing to do if we want the NHS to continue to be the jewel in this nation’s crown. I hope that the rumours of another two-year pay freeze for NHS staff are just that—rumours—because if that were true, it would send the most appalling message about the value this Government place on the NHS workforce. When the Minister winds up the debate, I will be delighted if she can put that particular rumour to bed.
Of course, NHS staff should be properly rewarded for the work they do, but they also need to be properly supported when doing the job. We cannot have a repeat of the obscenity of doctors and nurses bringing in home-made PPE while UK manufacturers are selling it overseas. I know that general practice is particularly concerned about the availability of PPE this coming winter, and while many of these debates have rightly focused on the hospital-based issues that covid presents, we should not underestimate the demand there has been on GPs this year. We know it is always the case that, when general practice struggles, the impact is felt elsewhere in the NHS. It is not yet clear what role GPs will play in the roll-out of any vaccine, but any additional demands placed on them in that respect must be matched by additional support.
We welcome the news that at last, many months after we first suggested it, there will be routine testing of frontline NHS staff. The Healthcare Safety Investigation Branch report on the transmission of covid in hospital settings, which came out last month, stressed the importance of increasing pillar 1 testing capacity, and it is a matter of deep regret that we are only just starting to see that now. Let us hope that that pledge does not face the same problems with availability that we had in the social care sector.
I turn to what awaits us in a few weeks’ time, because we all hope that the current lockdown will end on 2 December as planned, and as promised, I believe, by the Prime Minister. If it does end on that date, it seems likely that we will still have some system of tiered restrictions. That is another area where we need to see improvements, because the Government’s approach to restrictions to date has at times been contradictory, muddled and rushed. I accept that the Government have had on occasions to move quickly, sometimes because of a rapidly changing picture—but sometimes, regrettably, because of leaks to the press too. Of course, we would not expect things in this kind of situation to be perfect, but they can be better than they have been.
The time that this lockdown buys us should be used not just to fix test and trace, to prepare for a roll-out of the vaccine and to fine-tune the mass testing pilots, but to set out a clear and consistent framework for determining and implementing future restrictions. The Minister and his colleagues have spent many Monday afternoons in Committee Rooms with me and others going through increasingly convoluted and amended statutory instruments dealing with each new restriction, often published only hours before they became law and always debated weeks after they came into force. We cannot go back to that style of governing. Public trust is eroded when decisions are not made in a transparent and timely manner, so when the Government decide what their exit strategy for the lockdown will be, they also need to consider what the process will be for making and communicating those decisions. It is critical that individuals and businesses get sufficient advance warning in future to enable them to prepare properly for whatever comes next. This point is as much about process as it is about substance, but the process matters, because restrictions need to be tested in this place; if they do not stand up to scrutiny here, we cannot expect them to stand up to scrutiny out there.
I want to say a few words about test, trace and isolate. The Serco side of the system is underperforming badly, and the decision to place responsibility for mass testing into the hands of local directors of public health is a welcome one. It recognises, perhaps belatedly, where the real expertise lies. The latest figures for the national test and trace system are frankly shocking, with 26% of test results received within 24 hours. We should not forget that the Prime Minister said we would have all results turned around in that timescale by the end of June, yet the figures have been getting worse in recent weeks, not better. We know how important it is for results to be turned around quickly if we are ever to get test and trace playing the part it was meant to play in controlling the spread of the virus. Ministers can boast about record capacity, but capacity is meaningless if the results are not coming back quickly enough to be effective.
Let me turn to the contact tracing system itself. In the most recent weeks for which figures are available, 40% of close contacts were not reached and asked to self-isolate, amounting to over 130,000 people in one week. That is a failure. When every one of us in here has those difficult and distressing conversations with our constituents about the restrictions that we currently face, we need to reflect on that failure, and question not only why these unproven private providers have been given the task in the first place, but why they continue to be responsible for a system that they are clearly not delivering on. Every scientific adviser said that relaxing lockdown measures would work only if we had an effective test and trace system in place, yet on just about every measure the system is going backwards. How much longer will Ministers tolerate this failure? However, whoever is doing the contact tracing, that is only half the story. Without people adhering to the rules of self-isolation thereafter, the success of the entire system is in doubt.
Yesterday when Baroness Harding gave evidence to the joint inquiry of the Science and Technology Committee, and Health and Social Care Committee, made the important point that the reason people were not self-isolating was that they could not afford the loss of income, rather than a refusal to comply. She also made the rather remarkable claim that the surge in cases that we have seen in the last couple of months was not anticipated, which I thought was an incredible admission.
The Committees also heard from Professor Sir John Bell, who said that the self-isolation system was “massively ineffective” and spoke about using the increased testing capacity perhaps to cut short the self-isolation period for negative cases. No doubt the Government are actively considering that, but we are still left with the need to do more to encourage people who test positive to self-isolate.
In September a report for the Scientific Advisory Group for Emergencies concluded that self-isolation rates would be improved if additional financial support were available, ensuring that those required to self-isolate—let us not forget that these are people who are doing the right thing—are not penalised and do not experience financial hardship when doing so. This survey found that only 18% of people with symptoms self-isolated, and that figure went down to just 11% of those told to self-isolate by Test and Trace after coming into contact with a confirmed case. I know that these are preliminary figures and that other studies have suggested slightly higher levels of compliance, but no study that I have seen has shown levels anywhere near close enough to where they need to be for us to have an effective system.
The entitlement to a self-isolation payment is tied to being in receipt of certain benefits, which means that a significant number of people do not qualify, although those not in receipt of those benefits and those who do not receive contractual sick pay can also receive statutory sick pay or employment and support allowance. But that is frankly not good enough. SSP is far below the rate set for a self-isolation payment. The Secretary of State famously said that he could not live on such an amount, so we should not be surprised when we see low rates of compliance, because asking those who are not eligible for a self-isolation payment to accept a significant drop in their pay for a fortnight inevitably causes hardship and discourages compliance. I urge the Government seriously to consider doing more to encourage people to self-isolate.
It is a massive oversight that those notified through the app are not entitled to the payment. I understand that the Government are actively looking at this, but given that it is over six months since we started hearing talk about the world-beating app, it is staggering that we are only now looking at how properly to tie it in with support for self-isolation. Action on that issue cannot come soon enough.
There has been newspaper speculation that the actual period of self-isolation might be cut, with a suggestion that it could end at 10 days following a negative test. A report in The Guardian on Monday says that a compromise was “cooked up” to placate Dominic Cummings. Frankly, he ought to be the last person in government to be determining the self-isolation rules, given that he has found it impossible to follow them himself. Any change to this period should be based on medical advice, so I do hope that we get clarity from the Government during the wind-ups that any decisions on shortening the self-isolation period will be based on advice from the chief medical officer, rather than any Dom, Dick or Harry who happens to be in the Prime Minister’s office.
I hope that those on the Government Benches have been listening today and considered the issues and the suggestions that I have made, as none of us wants to be back here in another month or two debating another lockdown because the time this lockdown has bought was wasted. We do not want to be here talking about how the second wave saw us with one of the highest death rates in the world again, and we do not want to be here in a few months’ time seeing cases rising again because demand was not anticipated. We all want to hear that cases are falling, that hospital admissions are reducing, and that other NHS patients are getting their treatments quicker. Human endeavour has given us the opportunity to get to that place. While reaching that destination is not entirely within the Government’s gift, it would be inexcusable if we failed to get there because of incompetence or neglect on the Government’s part. The people would never forgive that, and nor should they.
May I ask the Minister to look again, through the Treasury, at those who were remunerated through dividends? Many of those people are hard-working and decent, not tax dodgers. They were able to get by for a short time, but as the lockdown goes on, it is becoming impossible for them and they are facing absolute undue hardship.
My main comments relate to our great maxim in medicine—do no harm. That means that the patient must not be worse off from the cure than they were from the original disease. This is a dilemma facing all Governments. How do we protect public health while ensuring the economic viability by which the funding for public services is generated? So far, the public remain very supportive of the Government’s position, but that cannot be guaranteed. Recent controversies over the use of data have made it more difficult for the Government simply to say that they are following the science. Sadly, there is growing resistance to the concept of lockdowns, which is inevitable as economic concerns rise to the fore. It is utterly irrational to say that one is against all lockdowns, because that needs to be a decision taken on the basis of the evidence at the time. However, we need to understand the anxieties and the frustrations if the Government want to keep their options open and retain credibility with the public.
So how can Parliament play its part in that process? Covid-19 is not just a health issue; it is also an economic issue, affecting welfare and employment and our personal and social wellbeing. And of course there is no such thing, actually, as “the science”; rather, there is a range of scientific views, and we need to understand what that range is and the weight given to the respective parts of it if we are to have faith in the outcome of the judgments that have been made.
Our current Select Committees are very good at looking at departmental functions and policy, but they are very vertical and do not look across the whole of Government. In 2012, after the banking scandal, David Cameron set up the Parliamentary Commission on Banking Standards; it was a full parliamentary Committee of inquiry involving both Houses. I believe we need the same now: senior but temporary, cross-party and with both Houses. Of course, the reaction from the Front Bench is likely to be “no more scrutiny”—I have been there and done that; I have been on the Front Bench and know what all those arguments are—but I think it would be a mistake and something the Government would come to regret, because such a Commission would help show that across the whole of Government, advice and data had been properly scrutinised. It is an opportunity to reinforce public confidence as we face the covid pandemic into 2021.
Finally, there is another reason why we should have such a set-up. This will not be the last pandemic we face. In the era of globalisation, when in normal times, for example, we have 700,000 people in the air at any one time, we will face further pandemics, and although this has been a tragedy for every single case, it has not been a particularly lethal pandemic by historical standards. We must set up the structures that we will need to deal with future pandemics, and we need internationally to work out the protocols we will put in place when we have the emergence of new viruses and the metrics we will use to measure that, because we cannot have the disorganised and shambolic international response that we have had to this particular pandemic. Meanwhile, at home we need transparency, with all the evidence scrutinised, if we are to maintain public confidence and see off the political opportunists and the conspiracy theorists, and, with that transparency, we need that scrutiny in this House and we need it urgently.
It is not just PPE. Under the fast-track rules, private firms have been handed a total of 843 direct contracts, including those that administer covid-19 tests and provide food parcels and medical supplies. Then, of course, there is the disastrous £12 billion test and trace failure, led by Conservative peer Baroness Harding. In yesterday’s joint Select Committee hearing, a possible reason for that was revealed. In July, the CMO claimed in a Select Committee that the ability to ramp up testing was “significantly strained”. Yesterday, Professor Sir Chris Ham gave evidence that increasing capacity over the crucial summer months was too slow, yet Baroness Harding claimed that testing capacity was increasing throughout the summer. What is the truth of the matter? Unfortunately, that was not the only incongruity, as Baroness Harding did not show a clear command of her brief, failing to answer or, in some cases, understand what was being asked.
The global pandemic is an absolute disaster for so many, with an unimaginable loss of life, yet the brightest and best of humanity have been working tirelessly on effective treatments and a vaccine. Rightly or wrongly, the appointment of Kate Bingham has proved controversial. There are no doubt questions to be asked about the absence of any clear recruitment process, but when she appeared before the Health and Social Care Committee recently, she was impressive. She was clearly on top of and in command of her brief.
However, that does not vacate the responsibility of this Government and any appointees to act ethically and in good faith and, most important, to account transparently for their actions. There are concerns about Kate Bingham’s astronomical public relations bill and claims that she shared sensitive information with investors. Further concerns emerged in The Guardian yesterday—in simple terms, how can a job be considered unpaid when the postholder has a position of influence or control in the process of awarding a £49 million investment to a company in which they remain a managing partner and from which they will surely benefit? Whatever the Prime Minister’s bluster, these matters must be fully scrutinised.
Sad as the pandemic is, what saddens the most is that these conditions are seen by some as an opportunity for Governments and corporate interests to implement political agendas that would otherwise be met with great resistance and opposition. The Government are on notice that, despite the disorientation of the public health crisis we are living through, these matters are being pursued.
This chain of events is not unique to the current crisis; it is a blueprint that neo-liberal politicians and Governments have been following for decades. Many thought that the meltdown of the global financial system in 2008 would prompt a comprehensive rethink of the principles underlying global capitalism, but in reality it was exploited to implement austerity and defund public services and social welfare provision on a grand scale. Covid illustrated that no more keenly than in respect of social care.
The 2018 report on social care from the other place pointed to a gap in service for 1.4 million people. This year, the Independent Care Group suggested that 1.5 million people are already living without the care that they need. The number keeps growing. One and a half million vulnerable and elderly people throughout England—husbands, wives, parents, grandparents, brothers and sisters; each and every one deserves much better from their Government. The Government are presiding over a social care system that is close to collapse.
Sir Simon Stevens, chief executive of the national health service, told the BBC that the covid-19 crisis had shone “a very harsh spotlight” on the “resilience” of the care system. The truth is that it comes down to priorities and political choices. To reform social care to pre-austerity levels will now cost more than £14 billion. That is a large sum, but it is £9 billion less than the bank bail-outs of 2007-08, which cost the public purse £23 billion overall. The annual operating costs of Trident nuclear weapons come in at £2 billion—far short of the £14 billion we need to repair the economic vandalism of austerity but, according to the costs worked out by Skills for Care, enough to recruit and train almost 550,000 new social careworkers every single year.
According to Age UK, 167,000 older people and their families throughout England now have to fund their own care because of the means test for free or subsidised support. Older people who are obliged to buy their own care have spent more than £7 billion in the 12 months since the Prime Minister took office and promised to fix social care. Every single day in England, 14 people exhaust their assets paying for care.
The reality is that the social care system that entered the pandemic was underfunded, understaffed, undervalued and at risk of collapse. Any response to covid-19, however fast or comprehensive, would have needed to contend with this legacy of political neglect. Government policies to support social care have faced major and widespread problems, not least the PPE crisis, which has led to a lack of protection for some people using and providing adult social care. Local authorities report that additional Government funding has been insufficient to cover the additional costs.
As has become all too clear throughout the recent crisis in England, protecting social care has been given far too low a priority. When the Minister for Care appeared before the Health and Social Care Committee last month, despite admitting that
“the social care system needs fixing”
and making a commitment to do so, she was unwilling to give any date for when the disinvestment of austerity would be rectified. If not now, when?
The UK Government do not even need to look far for inspiration: although challenges remain, they could learn much from Scotland’s approach. The story north and south of the border is very different, as is evident in our approaches to social care post covid. The Scottish Government have established an independent review to look at the creation of a national care service for all. As the Nuffield Trust points out, Scotland’s reforms are
“the most advanced of the countries…having set out an ambitious and comprehensive vision for a social care service.”
Because free personal care has been in place in Scotland since 2002, two thirds of those receiving social care support in Scotland do so in their own homes.
A further lesson from Scotland is the introduction of Frank’s law in April 2019. Under this legislation, free personal care was extended to all adults. Despite all these significant advances being made in Scotland, the system continues to struggle because we are part of the UK. Let us take funding, for example. The simple truth is that, without independence, we are limited in our funding options. Hoping for Barnett consequentials any time soon seems unlikely, given the UK Government’s timidity towards social care reform in England. Then there is Brexit. While the Government celebrate the end of freedom of movement, the loss of its opportunities is lamented in Scotland. The Migration Advisory Committee is entirely right that this poses a stark risk for social care, given that the services are dependent on EU nationals. UK policy delivers to Scotland a triple threat: a lack of reform to tackle the many pre-existing issues; the Government’s irrational and ideological approach to the EU; and an immigration policy that refuses to acknowledge, never mind accommodate, the specific needs of Scotland.
I had a fleeting hope in March that covid would raise this Government’s eyes to injustice and the value of those in healthcare. I felt sure that honouring all the heroes in our NHS and care sector would naturally follow, but no. With the weekly clapping now a distant memory, many do not feel valued or do not feel that their efforts are properly recognised. Campaigners are calling on Ministers to boost nurses’ pay without delay. The Scottish Government are currently delivering the highest pay award in the UK for NHS Agenda for Change staff of at least 9% over the three years from 2019. They also gave an immediate 3.3% pay rise to social care workers and have just announced £50 million for the social care staff support fund for those who contract covid-19.
This Government sprang into action to approve countless contracts for their wealthy friends at the start of the pandemic, but that sense of urgency is sadly lacking when it comes to taking action on nurses’ pay or addressing the poverty of carers. The Prime Minister demonstrated yet again today that his ears are made of cloth. He ignores repeated calls for the £20 uplift to universal credit to be made permanent and extended to legacy benefits, which is backed by the Joseph Rowntree Foundation and Save the Children, and he defended his Government’s refusal to feed children in poverty during the summer holidays, yet brags about Marcus Rashford’s campaign this winter. It was support grudgingly given through shame.
We are seeing a return to the lack of compassion of the 1980s, but what we are witnessing now casts minds back further still, not just to the Thatcher years but to Dickensian Britain where great wealth and extreme poverty existed cheek by jowl, conjuring images of barefoot children with empty bowls and a population without access to medical or social care. This is the stark reality of Tory Britain: poverty, a pay-to-access suboptimal social care system, an assault on employment and working conditions, and the exclusion of the self-employed. Coronavirus must not be allowed to cover for the cronyvirus at the heart of this Government. Some say that Scotland gets too generous a settlement, but that is a false narrative. These policies exist in Scotland because—