Covid-19 Response

We now come to the statement by the Secretary of State for Health and Social Care. In order to allow more Back Benchers to participate during the limited time available, I have asked the Secretary of State to keep his initial statement to eight minutes, with matching reductions for other Front Benchers.

With permission, Mr Speaker, I will make a statement on coronavirus.

This is the most serious public health emergency in 100 years, but through the combined efforts of the whole nation, we have got through the peak. Let us not forget what, together, has been achieved. We flattened the curve, and now the number of people in hospital with coronavirus is half what it was at the peak. We protected the NHS, and the number of patients in critical care is down by two thirds. Mercifully, the number of deaths across all settings is falling.

This Mental Health Awareness Week is an important reminder that we need to look after ourselves, as well as each other. If someone needs support with their mental health, the NHS is there for them. This is particularly important for frontline staff, and we have supported all NHS trusts to develop 24/7 mental health helplines.

Our plan throughout this crisis has been to slow the spread and protect the NHS. Thanks to the resolve of the British people, the plan is working, and we are now in the second phase of this fight. I will update the House on the next steps that we are taking as part of that plan. First, we are protecting the nation’s care homes, with a further £600 million available directly to care homes in England. We have prioritised testing for care homes throughout, we made sure that every care home has a named NHS clinical lead and we are requiring local authorities to conduct daily reviews of the situation on the ground, so that every care home gets the support it needs each and every day. All this amounts to an unprecedented level of scrutiny and support for the social care system, and a level of integration with the NHS that is long overdue.

Secondly, the four UK chief medical officers have today updated the case definition to include a new symptom. Throughout this pandemic, we have said that someone who develops a new continuous cough or fever should immediately self-isolate. From today, we are including anosmia—losing one’s sense of smell, or experiencing a change in the normal sense of smell or taste—which can be a symptom of coronavirus, even where the other symptoms are not present. So from today, anyone who develops a continuous cough or fever or anosmia should immediately self-isolate for at least seven days, in line with the guidelines. Members of their household should self-isolate for 14 days. By updating the case definition in line with the latest science, we can more easily recognise the presence of the virus and more effectively fight it.

Thirdly, we are expanding eligibility for testing further than ever before. Over the past six weeks, this country has taken a small, specialised diagnostics industry and scaled it at breathtaking pace into a global champion. Yesterday, we conducted 100,678 tests. Every day, we create more capacity, which means that more people can be tested and the virus has fewer places to hide.

I call the shadow Secretary of State for Health, Jonathan Ashworth, who has four minutes.

On symptoms, the right hon. Gentleman will know that many healthcare specialists were making these warnings eight weeks ago, so can he explain why there has been a time lag in updating the case definition?

I note what the right hon. Gentleman said about social care, but he will be aware that more than 12,500 people have sadly died in care homes because of covid-19. Last week, he said that he had put a protective ring around care homes from February, but yesterday a care home provider wrote in The Sunday Times:

“Elderly people weren’t a priority”

They also wrote:

“The government was asleep at the wheel.”

Is the reality not that there was no early lockdown of care homes when needed, and there was no testing of people transferred from hospital to care homes until mid-April, seeding the virus? Personal protective equipment was requisitioned from care home staff and given to the NHS because of wider shortages. There was guidance suggesting that infection was unlikely, and that guidance was still in place when there was community transmission.

We still do not have full testing of all residents and care home staff 12 weeks later. No wonder Age UK has said that this is “too little, too late”. I note that the right hon. Gentleman said that testing will be expanded. Can he bring forward the date by which all care home residents and staff will be routinely tested? The document last week says that it will be by 6 June. Why can the date not be sooner?

Has this crisis not shown that our care sector is staffed by exceptional, dedicated people, and that migrant care workers are not low skilled but immensely able? Does the right hon. Gentleman agree that the Home Office should acknowledge that, and praise such potential workers, not penalise them?

I welcome the wider roll-out of testing. The right hon. Gentleman did not mention the antibody test. Could he update the House on that front? It has also been reported today that 20% of hospital patients got covid while in for another illness. Two weeks ago, he suggested to me in the House that he planned to roll out screening of all healthcare workers, whether symptomatic or not. Can he update us on that front?

On tracing, I have long argued that the safe way to transition out of the lockdown is by having a test, trace and isolation strategy in place, but it depends on a quick turnaround of test results. Can the right hon. Gentleman tell us the current median time for test results to be received by someone when carried out by the Deloitte and other private sector testing facilities, and how soon do directors of public health and GPs receive those results?

I now call Secretary Matt Hancock for a concise reply.

I will keep it concise, Mr Speaker—your instruction.

The hon. Gentleman is right to ask detailed questions about care homes, because making sure that we have that ring of protection around care homes is important. Of course, the majority of care homes have not had an outbreak at all. We should thank those running care homes for the incredible hard work and infection control they put in place, meaning that in 62% of all care homes there has not been an outbreak. Where there has been an outbreak, there has been rigorous infection control and a huge amount of work has gone into that. We have, as he said, now got testing for all. That started with testing throughout for people who had the first symptoms in a care home. Now, it is for all staff and all residents, whether symptomatic or not.

There was no large-scale removal of people from hospital into care homes towards the start of the crisis, as has been implied by some. In fact, the number of people moving from hospital into care homes has fallen throughout the crisis and those movements have been done with care. But I agree with the hon. Gentleman that the crisis has shown that there are many lessons for reform in the social care sector, not least the much closer integrated working with the NHS that we have seen in these crisis days.

The hon. Gentleman asked about the roll-out of contact tracing. We now have the people in place. The app is successfully being piloted, and we are ready and preparing for rolling out that system.

The hon. Gentleman asked for the median time for a test to get back. The median time is, as far as I understand it, under 48 hours. He made a rather uncharacteristic dig at private sector businesses which are helping us to deliver that. None of the testing capability—not a single test—would be possible without the private sector. His attempt to divide people between private and public sector is entirely wrong. I think he should remember that that bit of the Labour party left the shadow Cabinet a couple of months ago. I thought good sense had returned.

We now go across to the Chair of the Select Committee on Health, who I understand is audio only.

Thank you, Mr Speaker. I would like to ask the Secretary of State for three pieces of data, all of which are essential for this strategy. First, what level of new daily infections do we need to be down to before contact tracing happens for all new infections? Secondly, how many daily tests will the test and trace system need? Thirdly, if we are going to introduce weekly testing for all NHS and care-home frontline staff, when will our testing capacity be sufficient to deliver that on top of test and trace?

With 21,000 contact tracers now employed, we think that that is capacity for the current level of new cases that have been demonstrated by the Office for National Statistics surveys, but I am perfectly prepared to hire more to make sure that we have spare capacity within contact tracing.

On the number of tests needed daily to service test and trace, it depends on exactly how many new cases there are. It depends on the relationship between the symptoms and the number of positive cases. There are many more people with symptoms than there are positive coronavirus cases, but the number is falling because we are moving away—well away now—from the flu season, and at this time of year the number of positive symptoms, including coughs and fever, tends to fall, because other non-coronavirus communicable diseases such as flu are falling. There is not a specific answer to that question, because it changes over time. On weekly tests, we are looking to put together a plan to ensure that we cut in-hospital transmission, which will include appropriate, regular testing of the right staff in the NHS. I shall write to my right hon. Friend with more details as and when that policy is fully announceable.

We have a technical problem with Dr Philippa Whitford, whom we will return to shortly. We will go to Sir Desmond Swayne.

The regional dental hubs offer little more than extractions —but I want to keep my teeth. When will dentists be able to treat their own patients?

My right hon. Friend rightly points out that we have urgent dental hubs, so anyone who needs urgent dentistry can get a dentist’s appointment through their GP. Many people have asked how, in an emergency, they can see a dentist. Dentistry is there and available—it is an important message for all our constituents. However, we are also working on the restart of dentistry more broadly. I understand the challenges, especially for those who want to see their own dentist and for dental practices. With NHS contracts, we continue to keep the funds flowing, but of course many dentists rely on their private income as well, and we support the mixed market in dentistry. What we need to do is get dentistry up and running when we can, but it has to be safe.

I am pleased to say that we have reconnected with the SNP spokesperson, Dr Philippa Whitford, who has 90 seconds.

I welcome that eligibility for testing is being widened to all symptomatic cases as the first step towards a test, trace and isolate approach, but does the Secretary of State agree that the system should have been in place before lockdown was eased? Without it, how can he know that the crowded public transport systems that we saw last week are not already leading to a rise in infections? The Secretary of State prides himself on having ramped up testing, but we know that many thousands of those are just in the post, so will he clarify whether those tests are counted again when they are actually carried out?

The Royal College of GPs has highlighted the difficulty in getting test results back from the Deloitte regional test centres. As it is contact tracing and isolation that stop the spread of the virus, how will the Secretary of State speed up results and ensure that they are fed back to GPs and public health teams, who are critical to detecting and controlling local outbreaks? The UK still has more than six times the number of new cases per day than when the lockdown was brought in. Does he not think that that is still too high to be sending people back to work and school?

We have been working very closely with the SNP Scottish Government on testing, so I am slightly surprised at some of the questions from the SNP spokeswoman. Of course the tests are not double-counted. There has been a ramp up in testing capacity. I am very glad to see in Scotland that testing capacity is now starting to rise—in the latest figures, it was up to around 5,000. I work very closely with my SNP opposite number on making sure that everybody has the very best capacity. The contact tracing system was also stopped in Scotland. The reason was that the number of cases right across the UK became very high. We needed social distancing to bring that number down. Now that that number is coming down right across the UK, contact tracing is once again effective. That is the reason we are bringing it in now, and I am pleased that we have hired 21,000 contact tracers in England to ensure that we can get it going. Therefore we are on track for the current proposed 1 June changes. That date is dependent on making sure that everything is right, and that it is safe to make the changes then.

The Minister has just confirmed that there will be thousands of contact tracers who are not medically trained, but who will be handling highly sensitive patient information and issuing clinical advice given to them. Will he bring forward primary legislation to govern the collection and any potential misuse of data, whether that is via an app, by qualified health professionals or by the non-medical call handlers, so that members of the public can have confidence that all strands of his data collection plans are effective and safe?