Covid-19 Update

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.

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, for instance 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?

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 postcodes neighbouring 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.

The hon. Gentleman 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.

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?

My right hon. Friend knows that we set out a commitment in our 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.

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 prevent it from 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?

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.

I pay tribute to my right hon. Friend and to the vaccines Minister, my hon. Friend the 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?

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.

SAGE warned about the dangers of the South African 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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

Yes, of course.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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 happened 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.

There have been scare stories in Lancashire about vaccines being diverted to places 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?

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 and 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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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 wraparound care for our young people when lockdown is over?

Order. 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.

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.

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?

Because people in their 60s are more likely to die from covid than people who are younger.

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?

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.

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?

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.

I congratulate my right hon. Friend and the entire team on doing such a phenomenal job in rolling out the life- saving vaccine 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.

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.

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?

Yes, absolutely. Local authorities are critical to this, and we are working with directors of public health as part of the effort.

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?

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. I would say, “It is the right thing for you and it is the right thing for your community.”

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?

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, but 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.

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?

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.

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?

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 of State can make that work.

Sussex today reached the twin milestones of vaccinating 85% of its over-80s and those in 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?

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.

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?

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.

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?

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 vaccine 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.

According to the Duke Global Health 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?

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.

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?

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.

For those 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 for them to stay at home unless it is absolutely essential that they 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.

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?

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.

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?

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 straight away 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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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?

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.

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.

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.

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?

The vaccine programme has involved enormously 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.

I thank the Secretary of State for his statement. We will now have a three-minute suspension for cleaning.