Covid-19 Update

Before I call the Minister to make his statement, I have to say that I am far from happy that yesterday the House heard from a Health Minister giving an update with no mention at all of the NHS pay deal, which is a point of great political interest. I find it hard to believe that any negotiations were still going on beyond that time. I urge the Government again to ensure that the House is the first, not the last, to know. It is not my fault that the Secretary of State got pinged, and if he wants to make announcements from his garden, he can do so, but somebody could have been here and Ministers could have shared that information with us. Glorying in the sunshine should not detract from this House hearing an announcement when it is made. It matters to all of us—we all have hospitals in our constituencies, and we all have constituents who work for the NHS, so the clear message once again is that this House should be told. Now then, let us come to a man who has come to the House to make a statement. I call Minister Nadhim Zahawi to make a statement.

Thank you, Mr Speaker, and may I offer the apologies of the Secretary of State and the Department of Health and Social Care on the inability of the Department to make a statement on the acceptance by the independent pay review body that NHS staff should get 3%? I hope you will accept my apology on behalf of the Secretary of State, as he is self-isolating.

I really do appreciate that, and the Minister is so courteous, but it makes it worse that a Minister was actually at the Dispatch Box when all that was going on outside, and for them to turn to the House and say, “I can’t tell you”—not “I don’t know”, but “I can’t tell you”—is even more worrying.

You make a very powerful point, Mr Speaker.

Before I turn to my remarks today, I want to say something to you, Mr Speaker. I want to take a moment ahead of the House rising for the summer recess to thank you, sir, and everyone who works here in Parliament, your whole team, for everything you have done to keep us all safe over the past few months. The fact that we have kept our democracy running, and running safely, at this time of crisis is an incredible achievement, and we are all extremely grateful to you and your team.

With permission, Mr Speaker, I would like to make a statement on the covid-19 pandemic. This week, we have taken a decisive step forward, taking step 4 on our road map and carefully easing more of the restrictions that have governed our daily lives. Although we are moving forward, we must remember that we are doing so with caution, because the pandemic is not yet over. The average number of daily cases in England is around 41,000 and hospitalisations and deaths are rising too, although at a much lower level than when we had that number of cases during previous waves. So even as we take step 4, we urge everyone to think about what they can do to make a real difference.

Today, we are launching a new campaign to encourage everyone to keep taking the little steps that have got us this far, such as wearing face coverings in crowded public areas, making sure that rooms are well ventilated and getting regular rapid tests. We are also supporting businesses and organisations, helping them to manage the risk of transmission within their venues, including through the use of the NHS covid pass for domestic use. I know that this has been of great interest to Members and want to use this opportunity to reiterate the policy and offer the House the chance to have its say.

This week, after a successful trial, we have rolled out the NHS covid pass, which allows people safely and securely to demonstrate their covid status, whether that is proof of vaccination status, test results or natural immunity. Anyone can access a pass via the NHS app, the NHS website or by calling 119 and asking for a letter to demonstrate vaccine status. People will also be able to demonstrate proof of a negative test result.

I thank the Minister for advance sight of his statement. Let us be frank: it was a shambles yesterday. It was an insult to the House and a let-down for health and care staff.

Ministers have been dragged kicking and screaming to this 3% settlement. Can the Minister accept—and does he accept—that it is not an NHS-wide settlement, as it does not cover the health and care workforce who do not fall under the pay review body? For example, it does not cover our junior doctors who have had an intense year caring for sick patients on ventilators, who have been redeployed to other sites across the NHS and who have seen their training disrupted. Will the junior doctors get a pay rise, especially given that the pay review body, in paragraph 10.6 of its report, urges the Government to recognise the role of doctors who are out of scope? Will all health staff who work in public health receive the settlement? Care workers are obviously not covered by the pay review, and we know how valuable they are, so will care workers finally get the real living wage that they deserve?

How will the pay settlement be funded? NHS trusts do not even know what their budget will be beyond September. The Health Secretary has said that the pay settlement costs £2.2 billion, so where is that £2.2 billion coming from? Is he expecting trusts and general practice to find it from their existing budgets? At a time when the NHS is in a summer crisis, with covid admissions increasing and more patients on ventilators in hospitals, with operations being cancelled again and waiting times growing because of the pressures the NHS is under, rather than getting a funded settlement for the NHS we have seen this week briefing and counter-briefing from the Health Secretary, the Chancellor and Downing Street about what may or may not be coming for health and social care.

The NHS needs more investment now to cope with the pressures that it is under. Will the Minister confirm that the Government will break their manifesto pledge to increase national insurance, or is the Business Secretary correct in what he said this morning? He said:

“I don’t see how we could increase national insurance”.

The Prime Minister promised, on the steps of Downing Street two years ago this Saturday, that he would have a social care plan, but this is not a plan for health and social care; it is a Government in disarray.

That brings me on to the so-called pingdemic, with the problems of isolation. The problems of isolation that we are seeing are a symptom of what happens when Ministers allow infections to get out of control. The Government are apparently U-turning today and agreeing a list of workers who could be exempt from isolation, based on a negative PCR test. With infections running at more than 50,000 a day, and possibly on the way up to 100,000 a day, can the Minister absolutely guarantee that PCR testing capacity will be available to cope with the inevitable increased demand this summer?

The right hon. Gentleman asks who is included in the 3% pay rise recommended by the independent NHS Pay Review Body. They are the 1 million NHS staff, including nurses, paramedics, consultants and, of course, salaried GPs. The junior doctors he mentions have a separate, multi-year pay rise over three years, amounting to 8%.

The right hon. Gentleman asks about the capacity for testing. I looked at that before coming to the House, and the capacity currently for PCR tests is not 600,000 but 640,000 a day, according to the latest data that I looked at. He asks about schools. There will be two supervised tests for schools. He knows that in Monday’s statement we announced our acceptance of the JCVI guidelines on vaccinating vulnerable children, vaccinating children who live with vulnerable adults, and vaccinating those who are 17 but within three months of their 18th birthday. The JCVI will keep under review the vaccination of healthy children as more data becomes available from countries such as the United States of America and Israel.

The right hon. Gentleman asked a question around the covid vaccination pass and nightclubs, other crowded unstructured indoor settings such as music venues, large unstructured outdoor events such as business events and festivals, and very large structured events, such as business events, music and spectator sport events. They are the ones that we are most concerned about. We have seen other countries, whether it is Holland or Italy, opening nightclubs and having to reverse that decision rapidly. What we are attempting to do, and the reason we have the covid vaccination pass in place, is to work with industry while we give people over the age of 18 the chance to become double-vaccinated. It would be hugely unfair to bring in that policy immediately. Giving people until the end of September is the right thing to do, while at the same time allowing businesses to open safely, using the app now—because the app went live and the industry is very much engaging with it.

May I start by wishing you and your family a ping-free summer, Mr Speaker? Thank you for upholding the values of this House over the past few months.

The Minister of State will have heard of YouGov, which said this week that a tenth of the people who had the NHS covid app have deleted it, and that a further fifth are considering doing so. Given that he made his living from listening to public opinion, does he not think it is time for the Government to listen to public opinion and immediately scrap the 10-day isolation requirement for double-jabbed people who are pinged, in favour of having to isolate until they take a negative PCR test? Otherwise we risk losing social consent for this very important weapon against the virus.

With your permission, Mr Speaker, I would briefly like to ask you about the issue we were not able to ask Ministers about in the House yesterday, which is the decision on NHS pay. I support the decision to accept the pay review body’s recommendations. It is the right thing to do, but it costs £1.5 billion. Can the Minister confirm it will not be paid for by cuts to other parts of the NHS budget? If it is going to be funded through a new national insurance rise for health and social care, as The Times says today, will he confirm that the funding for social care will be ring-fenced, so that we do not have a situation in which social care, once again, loses out because of pressures in the NHS?

The right hon. Gentleman said “you,” but I was not responsible for the decision yesterday.

I will take those questions in reverse order. I thank the Chairman of the Select Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), for his always diligent and thoughtful questions. As he will know, we gave the NHS in England an historic settlement in 2018 that will see its budget rise by £33.9 billion by 2023-24. We have provided over £27 billion to support the NHS in England since the start of the pandemic, including £9.7 billion so far for 2021-22. We will continue to make sure the NHS has everything it needs to continue supporting its staff and providing excellent care to the public, throughout the pandemic and beyond.

My right hon. Friend specifically asked about social care, and I know the Secretary of State and the Prime Minister are committed to making sure we deliver on our social care promise by the end of this year.

Public compliance is incredibly important, and I thank each and every person who has come forward and got themselves protected. Over the past few days, we have seen an almost doubling of the number of people going on to the NHS website to book appointments. There has almost been a doubling of appointments, too, which is incredible, considering where we are at the moment—we are almost touching 90% of all adults. These are the hard yards, and people are still coming forward. There are no easy decisions on this, as I said in answer to the shadow Health Secretary. We know that our most effective tool is the vaccination, but the second most effective is self-isolation. We are attempting to transition this virus from pandemic to endemic status. If we allow all these things to happen too rapidly and people then decide not to self-isolate, we run the risk of infection rates running away with us and challenging the strategy of our being the first major economy to transition. So we are working with business, and we are working flat out with the frontline critical infrastructure and key workers to get that guidance out. I am sure that colleagues in this House will be the first to receive it—I will make sure of that, even during recess.

I wish you, colleagues and all the House staff a safe and happy summer recess, Mr Speaker. Clearly, vaccination is critical to fighting this pandemic. We all need to encourage uptake among younger adults, but is the Minister in a position to guarantee sufficient supplies of Pfizer or Moderna vaccines to vaccinate them before the end of September? Whether this is done legally, as in the case of care homes staff, or through excluding people from social activities, does he recognise that making vaccination mandatory can increase distrust among those who are hesitant and drive them to become outright vaccine refusers? Despite the talk about caution, covid cases in England were already surging when the Government ploughed ahead with lifting all legal restrictions on Monday. Although vaccination has reduced the hospitalisation rate to between 2% and 3%, the Secretary of State suggested that covid cases could soar to 100,000 a day, which would result in 2,000 to 3,000 admissions, which is similar to what happened in the first wave. Does the Minister really not recognise that that would put health services under enormous pressure and cause the patient backlog to grow further? Are the Government even considering the impact of uncontrolled virus spread on vulnerable people, the incidence of long covid or the risk of generating yet another variant, with even greater vaccine resistance than delta? Finally, what contingencies are being put in place in case during recess the Government need to reintroduce covid restrictions, as has happened in Israel and the Netherlands?

The hon. Lady makes a number of important points, especially the final one, where she reminded the House, as I did in my statement, that a number of countries have opened up and then had to reverse some of their decisions, which is why we are being very careful to ensure that this transition is successful and then that transitioning the virus from pandemic to endemic status is as successful as possible. She asked about children’s vaccination. She will know that the Scottish Health Minister, Humza Yousaf, has accepted, as the Welsh, Northern Irish and ourselves in England have done, the JCVI guidelines on vaccinating vulnerable children, children living with vulnerable adults and those approaching their 18th birthday. If the JCVI goes further, as it is reviewing more data on vaccinating all children, I assure her that we have available the supply of Pfizer and Moderna to undertake that, while we also continue to deliver on the double vaccinations of all adults by the end of September. She asked about the immunosuppressed and of course the guidelines have gone out on the precautionary measures that immunosuppressed people would take; similar to the rest of the country, they should be careful and wear masks in crowded indoor spaces—there is advice on ventilation as well. The JCVI has gone further in its interim advice for our booster campaign, where it has placed the immunosuppressed at the top of the priority list. That campaign will begin in early September—that is the operational target we are working to for beginning boosting and of course co-administering, wherever possible, the flu vaccination.

Given the massive opposition that there is among those who operate nightclubs and events, the decision of the Government to make the introduction of covid identity cards voluntary is probably a sensible one, but may I explore with the Minister what he means when he says, “We reserve the right to mandate their use in the future”? We might have hoped, Mr Speaker, that the right that the Government sought to reserve was the right to seek the permission of this House to make their use mandatory in the future. I hope that this was just a small piece of ministerial arrogance that led the Minister to mis-speak, but I would like his assurance that we will be given the opportunity to express a view on this before the mandatory use of covid identity cards is introduced.

Last week, I asked the Secretary of State for Health and Social Care a whole range of questions about the practical consequences of this voluntary scheme. I asked what constituted large events, who would be the judge of what they were, what was meant by encouraging businesses, and what would be the consequences for any businesses that resisted the encouragement from the Government. The Secretary of State had no answers to those questions. Will the Minister today answer the questions, if not necessarily for the benefit of the people in this House, then at least with a bit of respect to those who operate nightclubs, big events, restaurants, bars and others who have absolutely no idea what is going to be required of them?

It is unlike the right hon. Member for Orkney and Shetland (Mr Carmichael) to accuse any colleague of being arrogant, and I certainly hope that I did not come across as such. He is always courteous and polite—I have certainly found him to be so over the years. He asks several important questions. On reserving the right, the Government will of course come back to the House if the decision is to mandate the double vaccination requirement for nightclubs, crowded unstructured indoor settings, large unstructured outdoor settings and, of course, the very large events such as business, music hall, and spectator sports events. In the meantime, we encourage the use of the NHS covid pass in facilities or at events where people are likely to be in close proximity to large numbers of people from other households. We are working with the sector. Indeed, the Under-Secretary of State for Business, Energy and Industrial Strategy, my hon. Friend the Member for Sutton and Cheam (Paul Scully), met people from the sector yesterday, as he does regularly. The sector itself will have seen what has happened in other countries such as the Netherlands. It is in the interests of all of the sector and of businesses to reopen and reopen permanently, and not have to open and close, open and close, which is why we are working with the sector in this period and giving people a chance to get their double vaccinations by the end of September.

Just on that last point about the decision, the statement is very clear that the Government have decided. It says, “We plan to make full vaccination a condition of entry”. My reading of that is that a decision has been taken, so the Government need to come to the House to ask the House’s permission to legislate; the right hon. Member for Orkney and Shetland (Mr Carmichael) was exactly right.

May I ask the Minister about the pingdemic? We have just had the data for last week. More than 600,000 people using the app were told to self-isolate. The Minister has set out clearly that, on 16 August, the right way to proceed is that those who have been double vaccinated will be advised to take a PCR test, and, if that is negative, they can then go about their business, reflecting the reduced risk of their being infected and therefore passing on the disease.

In a discussion this morning on the “Today” programme, the Secretary of State for Business, Energy and Industrial Strategy was told that businesses in a key sector were operating in that way now, with the advice from the app, and he was asked whether that was appropriate and safe. He said that it was not. If it is not safe now—I think it is safe—how does it suddenly become safe on 16 August? Given that it is safe on 16 August, because that is the Government’s policy, can we not just implement it now? The danger is that large numbers of people will either delete or stop listening to the app, and then, when we get to 16 August, they will not be getting the advice to take a PCR test, and we will have actually made ourselves less safe and less well protected. I urge the Minister to think again and to bring it forward now, because people will then be taking tests when they are advised to. If he does not do that, people will simply stop listening, which is very dangerous for public health.

I am grateful for my right hon. Friend’s questions, as always: challenging but nevertheless the right challenges to think through. As I said, there are no easy decisions in what we are attempting to do. We will, I hope, be one of the first nations, certainly one of the largest economies in the world, that will see a transition of this virus from pandemic to endemic status—to manageable menace—through our vaccination programme, which is our primary tool.

The second most effective method is to make sure that people do self-isolate: I take on board his point and the point made by my right hon. Friend the Member for South West Surrey (Jeremy Hunt). That is why we are working flat out with critical infrastructure and key workers—of course with frontline NHS and social care staff, as I announced on Monday—to make sure that people have the ability to do a PCR test and then follow it up with a week or up to 10 days of daily lateral flow testing instead of self-isolation for 10 days. The honest truth is that there are no easy answers, because the very clear clinical advice and evidence is that if we do not do this carefully and slowly, we could risk the transition of the virus.

On the requirement around nightclubs by the end of September, I assure my right hon. Friend that we will be coming back to the House to make sure that it has an appropriate say on the matter. As we have seen with this virus in other countries, it is the right thing to do.

I thank the Minister for his statement and for all that has been done on the covid-19 vaccine roll-out. The Northern Ireland Assembly’s Health Minister recently stated that at the end of July the closure of mass vaccination centres—for example, the SSE centre in Belfast—will come into force. The Minister in this House has today taken the opportunity through the press to urge people one last time to get the vaccine. Has he come to an assessment on the closure of mass vaccination centres in England, given the clear success of the vaccination process, and ever mindful that this autumn we will be doing a covid-19 vaccine booster process, which, along with the flu process, will add pressure to the health system? Will he ensure that there are options in place—for example, pharmacies and community centres—to bridge the gap?

I thank the hon. Member for his excellent question. He is absolutely right. We are preparing a pretty ambitious vaccination programme, beginning in early September, for the covid boost. The interim advice from the JCVI could adjust as more clinical data comes through from the cov-boost trials that we are currently conducting. Wherever possible, we will co-administer flu vaccines at large scale. My big concern is that we have not had much flu circulating in communities and we could be in a position where in a bad flu year we could lose 20,000-plus people. Hence our ambitions are equally high for flu. We will look to co-administer wherever possible. We are looking to increase the number of pharmacies as well. We currently have over 600 pharmacies in the covid vaccination infrastructure, as well as the brilliant primary care networks, the hospitals and the vaccination centres. The cov-boost and the flu process will be equally ambitious as we look at the whole of the structure and how we utilise it, as well as making sure that GPs are able to get back to doing the work they need to do—looking after their patients.