The Secretary of State for Health and Social Care ()
With permission, I would like to make a statement on coronavirus.
We are approaching the end of a year where we have asked so much
of the British people. In response to this unprecedented threat
to lives and to livelihoods, the British people have well and
truly risen to the challenge by coming together to slow the
spread and support each other. I know how difficult this has
been, especially for those areas that have been in restrictions
for so long. The national measures have successfully turned the
curve and begun to ease pressure on the NHS. Cases are down by
19% from a week ago, and daily hospital admissions have fallen 7%
in the last week.
January and February are always difficult months for the NHS, so
it is vital that we safeguard the gains we have made. We must
protect our NHS this winter. We have invested in expanded
capacity, not just in the Nightingales, but in hospitals across
the land, and we have welcomed thousands of new staff. This
morning’s figures show that the number of nurses in the NHS is up
14,800 compared with just a year ago, so we are well on our way
to delivering on our manifesto commitment of 50,000 more nurses.
Together, while we invest in our NHS, we must also protect our
NHS, so it will always be there for all of us during this
pandemic and beyond.
I am so grateful for the resolve that people have shown
throughout the crisis. Thanks to this shared sacrifice, we have
been able to announce that we will not be renewing our national
restrictions in England, and we have been able to announce
UK-wide arrangements for Christmas, allowing friends and loved
ones to reunite and form a five-day Christmas bubble. I know that
this news provides hope for so many, but we must remain vigilant.
There are still today 16,570 people in hospital with coronavirus
across the UK, and 696 deaths were reported yesterday. That means
696 more families mourning the loss of a loved one, and the House
mourns with them.
As tempting as it may be, we cannot simply flick a switch and try
to return life straight back to normal, because if we did that,
we would undo the hard work of so many and see the NHS
overwhelmed, with all that that would entail. We must keep
suppressing the virus, while supporting education, the economy
and the NHS until a vaccine can make us safe. That is our plan.
We will do that by returning to a tiered approach, applying the
toughest measures to the parts of the country where cases and
pressure on the NHS are highest and allowing greater freedom in
areas where prevalence is lower.
While the strategy remains the same, the current epidemiological
evidence and clinical advice shows that we must make the tiers
tougher than they were before to protect the NHS through the
winter and avert another national lockdown. We have looked at
each of the tiers afresh and strengthened them, as the Prime
Minister set out on Monday. In tier 1, if you can work from home,
you should do so. In tier 2, alcohol may only be served in
hospitality settings as part of a substantial meal. In tier 3,
indoor entertainment, hotels and other accommodation will have to
close, along with all forms of hospitality except for delivery
and take away.
I know that people want certainty about the rules they need to
follow in their area. These decisions are not easy, but they are
necessary. We have listened to local experts and been guided by
the best public health advice, including from the Joint
Biosecurity Centre. We set out the criteria in the covid-19
winter plan, and we publish the data on which the decisions are
made. As the winter plan sets out, the five indicators are the
case rate in all age groups; in particular, cases among the
over-60s; the rate at which cases are rising or falling; the
positivity rate; and the pressures on the local NHS.
When setting the boundaries for these tiers, we have looked at
not just geographical areas but the human geographies that
influence how the virus spreads, such as travel patterns and the
epidemiological situation in neighbouring areas. Although all
three tiers are less stringent than the national lockdown we are
all living in now, to keep people safe and to keep the gains that
are being made, more areas than before will be in the top two
tiers. That is necessary to protect our NHS and keep the virus
under control.
Turning to the tiers specifically, the lowest case rates are in
Cornwall, the Isle of Wight and the Isles of Scilly, which will
go into tier 1. All three areas have had very low case rates
throughout, and I want to thank residents for being so vigilant
during the pandemic. I know that many other areas would want to
be in tier 1 and understand that.
My constituency of West Suffolk has the lowest case rate for
over-60s in the whole country, and I wish to thank Matthew Hicks
and , the leaders of Suffolk County Council and West
Suffolk Council, and their teams for this achievement. However,
despite that, and despite the fact that Suffolk overall has the
lowest case rate outside Cornwall and the Isle of Wight, our
judgment, looking at all the indicators, and based on the public
health advice, is that Suffolk needs to be in tier 2 to get the
virus further under control. I hope that Suffolk and so many
other parts of the country can get to tier 1 soon, and the more
people stick to the rules, the quicker that will happen.
We must make the right judgments, guided by the science. The
majority of England will be in tier 2, but I am afraid that a
significant number of areas need to be in tier 3 to bring case
rates down. I know how tough this is, both for areas that have
been under restrictions for a long time, such as Leicester and
Greater Manchester, and for areas where cases have risen sharply
recently, such as Bristol, the west midlands and Kent. The full
allocations have been published this morning and laid as a
written ministerial statement just before this statement began. I
understand the impact that these measures will have, but they are
necessary given the scale of the threat we face.
We will review the measures in a fortnight and keep them
regularly under review after that. I want to thank everybody who
is in the tier 3 areas for the sacrifices they are making to
protect not just themselves and their families but their whole
community. Regardless of their tier, I ask everyone to think of
their own responsibilities to keep the virus under control. We
should see these restrictions not as a boundary to push but as a
limit on what the public health advice says we can safely do in
any area. Frankly, the less any one person passes on the disease,
the faster we can get this disease under control together—and
that is on all of us.
We must all play our part while we work so hard to deliver the
new technologies that will help us get out of this, in
particular, vaccines and testing. The past fortnight has been
illuminated by news of encouraging clinical trials for vaccines,
first from Pfizer-BioNTech, then from Moderna and then, earlier
this week, from the Oxford-AstraZeneca team. If these vaccines
are approved, the NHS stands ready to roll them out as soon as
safely possible.
Alongside vaccines, we have made huge strides in the deployment
of testing. Our roll-out of community testing has been
successful, because it means we can identify more people who have
the virus but do not have symptoms and help them isolate,
breaking the connections that the virus needs to spread. As part
of our covid-19 winter plan, we will use these tests on a regular
basis, for instance, to allow visitors safely to see loved ones
in care homes, to protect our frontline NHS and social care
colleagues and to allow vital industries and public services to
keep running safely.
We have seen in Liverpool, where more than 300,000 people have
now been tested, how successful this community testing can be. I
want to pay tribute to the people of Liverpool, both for
following the restrictions and for embracing community testing.
It has been a big team effort across the whole city and the
result is that in the Liverpool city region the number of cases
has fallen by more than two thirds. In the borough of Liverpool
itself, where the mass testing took place, cases have fallen by
three quarters. It has not been easy and, sadly, many people in
Liverpool have lost their lives to covid, but thanks to people
sticking to the rules and to the huge effort of community
testing, Liverpool’s cases are now low enough for the whole
Liverpool city region to go into tier 2. This shows what we can
do when we work together. We can beat the virus. I want to pay
tribute to the people of Liverpool, NHS Test and Trace, the
university, the hospital trust, Mayor Joe Anderson and so many
others who have demonstrated such impressive leadership and
responsibility, and a true sense of public service.
We are expanding this community testing programme even further to
launch a major community testing programme, homing in on the
areas with the greatest rates of infection. This programme is
open to all local authorities in tier 3 areas in the first
instance and offers help to get out of the toughest restrictions
as fast as possible. We will work with local authorities on a
plan to get tests where they are needed most and how we can get
as many people as possible to come forward and get certainty
about their condition. The more people who get tested, the
quicker a local area can move down through the tiers and get life
closer to normal.
Viruses can take a short time to spread but a long time to
vanquish. Sadly, there is no quick fix. They call upon our
determination to make sacrifices that will bring them to heel and
upon our ingenuity to make scientific advances that will get us
through. Hope is on the horizon, but we still have further to go,
so we must all dig deep. The end is in sight. We must not give up
now. We must follow these new rules and make sure that our
actions today will save lives in future and help get our country
through this. I commend the statement to the House.
11.51 am
(Leicester South) (Lab/Co-op)
I thank the Secretary of State for advance sight of his
statement. I suppose that we should all thank him for advance
sight of the website, but sadly, it crashed before we could check
what tiers we were in.
The news of a vaccine is indeed light at the end of the tunnel,
but we are still in the tunnel and we have a significant way to
go to drive infection rates down and keep our constituents safe.
We understand why tough restrictions are still needed, but let us
be clear: today, millions of people trying to survive in the
second lockdown will soon be forced to endure further local
lockdown restrictions, so does the Secretary of State accept that
these interventions succeed when made in tandem with local
communities?
I remember that when areas such as Bury and Trafford went into
lockdowns in the summer, the Secretary of State promised that MPs
would be involved in the decision. Has that commitment been
abandoned? Then, Ministers agreed to involve regional leaders,
but took exception to being challenged by , so what role do regional leaders now have in these
decisions, or is the position really that the Prime Minister
imposes from Downing Street restrictions on communities across
the midlands and the north—restrictions that will have a huge
impact on the livelihoods of families and small businesses?
Christmas, the Secretary of State will know, is vital for pubs,
restaurants and entertainment venues across those areas. They
will need substantial financial support to get through this
period. Will those areas that went into tier 3 lockdowns before
the national lockdown, such as Greater Manchester and South
Yorkshire, get backdated economic support for their local small
businesses?
Parts of the country, such as my own city of Leicester, Bury,
Leigh and Heywood, have been under a form of lockdown for months,
with families forced apart and grandparents not seeing their
grandchildren. Those families today will want to know what the
exit strategy is and what voice they will have in that strategy.
The Secretary of State has outlined five criteria by which local
lockdowns will be judged. Will he publish clear, transparent
rules for areas entering and leaving tiers—a score card for every
area, assessing its covid progress against its criteria, so
everyone can judge this publicly?
The Secretary of State talks of mass lateral flow testing, and we
welcome the advances, but over two weeks ago he announced he was
sending, I think, 930,000 of those tests to local authorities,
yet only around 8,500 are being used a day. Can he explain why
that is? He will also be aware—I am sure that he will have
studied this—that Slovakia recently tested more than 3 million
people over a weekend using those tests. The Slovaks incentivised
people to get tested by offering greater freedoms. Is that part
of the Government’s thinking on how those tests could be used?
Evidence from Liverpool suggests that there is a lower take-up of
tests in poorer, harder to reach communities. Is not the problem
that if people and their contacts feel they will be financially
penalised for a positive test, they will avoid a test, they will
switch off the app and they will not answer their phone to
unrecognised call centre numbers? The reason people soldier on
when ill is not a stiff upper lip: it is that they cannot afford
to feed their families otherwise. Surely, after months and
months, it is now obvious that low-paid people such as care
workers on zero-hours contracts need better support to isolate.
Why did the Chancellor not increase statutory sick pay in the
spending review yesterday?
The test and trace budget has now increased to £22 billion, more
than the annual budget for the police and the fire service
combined, yet the Office for Budget Responsibility yesterday
confirmed that its forecasts are based on the fact that
“a less effective TTI”—
test, trace and isolate—
“system necessitates keeping a more stringent set of public
health restrictions in place over the winter.”
At what point will the Secretary of State accept that the current
Serco model has failed? I am not against using the private
sector, but I am against throwing shedloads of taxpayers’ money
at failing private sector contracts. Local authorities,
especially those now in tier 3, should be leading this
retrospective contact-tracing work, and they should be given the
data from day one, so they can get on with it. By the way, why
was there no uplift yesterday in the public health grant? Surely,
this is a time when we should be investing in public health, not
freezing the grant.
On the easements for Christmas, there will indeed be relief in
families across the country, but the Secretary of State will
understand that there will also be nervousness across the NHS. We
need a clear public health message: asking people to be jolly
careful is not good enough. He will know that January is an
immensely busy and pressured time for our NHS. It is not just the
patients filling up covid beds; it is the emergency pathways that
are already running at hot and it is the immense elective
backlog. We know there are fewer beds because of social
distancing. We know staff are exhausted. One in seven hospitals
have restricted electives or planned operations so far this
winter. What plans are in place to protect the NHS through
January, especially if there is a long cold snap? How many
elective operations does he anticipate will be cancelled in
January? Nobody in this House wants to see a third lockdown, so
can he guarantee that the measures he has announced today will be
enough to bring the R down and sustain it below 1 for the coming
months until a vaccine allows life to return to normal?
The goal of the Government is to bring R to below 1 to suppress
the virus until a vaccine can keep us safe. That is the strategy.
I shall take the precise points that the hon. Gentleman raised.
He asked for an exit strategy. The statement I outlined is the
exit strategy: it is to keep the virus suppressed with the
minimum damage possible to the economy and, indeed, to education,
while we work as fast and as hard as we can towards a vaccine and
with the widespread use of community testing across the piece to
help to keep the virus under control.
I would have expected the hon. Gentleman to welcome the massive
progress in Liverpool that has shown that a combination of
sticking by the rules and community testing at very large scale
can help to bring this virus right under control. Instead, he
criticised that it does not get into harder to reach communities.
That is exactly where we need to get into, and that is why we do
it in combination and hand in hand with the local authority.
I praise Joe Anderson, and I also praise other local leaders,
such as in Tees Valley, who is working with us on this,
and leaders across the west midlands, and the hon.
Member for Barnsley Central () in South Yorkshire, who we are working with to get a
community testing system up and running in places such as
Doncaster. I want to see the community testing that has been
successful in Liverpool rolled out right across the tier 3 areas
as much as is possible, and I invite all councils to engage.
We invited councils to engage ahead of the decisions today, and
we also invited all colleagues in the House to have an input, but
it is important that we have clear public health messaging,
because unfortunately we did see the number of cases going up and
continuing to go up in those areas where local leaders were not
working alongside us. It was a sharp contrast to what happened,
for instance, in Liverpool, but also in other areas where the
local leadership was so constructive and positive.
The hon. Member for Leicester South asked for a scorecard for the
exit strategy. We publish the data, and if we can make it into an
even more accessible format, I think that is a good idea. He
asked about supporting the NHS—absolutely. I am delighted that,
yesterday, my right hon Friend the Chancellor of the Exchequer,
with the support of the Prime Minister, put another £3 billion
into the NHS, on top of the £6.6 billion that is already being
invested. That money starts flowing this financial year for this
winter and then runs into next year.
The hon. Gentleman mentioned the need to support people who have
tested positive. We have put in place a £500 support payment. On
NHS Test and Trace, I thought from the figures this morning that
he would have welcomed the fact that the majority of in-person
tests are now turned around within 24 hours. That is significant
progress on the speed of turnaround in testing, for which I am
very grateful to my team. There will be further support for local
councils that find themselves in tiers 3 and 2 to support the
action that is needed. But all in all, let us come together and
work together to get this virus under control and keep it under
control, so that we can get life back to normal as soon as
possible.
(South West Surrey) (Con)
May I welcome the Prime Minister back from his splendid isolation
to the place that he has no doubt been itching to get back to
more than any other—this House of Commons—and say how wonderful
it is to see him here?
The Prime Minister ()
It is great to see you.
From a sedentary position, I think the Prime Minister said that
he was delighted to see me here. [Interruption.] Indeed, he is
delighted to see me here—on the Back Benches. [Laughter.]
Turning to more serious matters, these are very difficult
decisions, and part of the leadership we have to show in a
pandemic is telling people unwelcome news. I want to salute the
Health Secretary’s cautious approach to Christmas because, much
as we all want Christmas to be as normal as possible, nothing
would be more crazy than to take our feet off the accelerator at
this moment and then see a spike in deaths in February, so I
think this is the right approach.
There is one bit of further good news—on top of the news about
vaccines and on top of the news about mass testing—that I know
the Health Secretary would like to be able to give and that would
be enormously welcome: that every single person living in a care
home could be sure that they could be visited by a close relative
before Christmas. I know he wants to do that, but there are huge
logistical challenges in getting that mass testing technology to
work in time. May I urge him to do everything he can, because
that would make such a big difference to the nearly 400,000
people in care homes?
I hesitate to interrupt the love-in between the Prime Minister
and my predecessor, but I am grateful for his support—for their
support. This is a set of difficult measures, but I think the
public understand why we have to take them and why they are
necessary.
On the point about getting visiting going in care homes, my right
hon. Friend is absolutely right. Sometimes we talk about these
tests and this new technology in an abstract way or from a
scientific point of view, but it really matters and it really
improves people’s lives. Where we can use testing to make
visiting safe in care homes, that is an example of the way in
which these new technologies can help to get life a little bit
back towards normal. Of course, it must be done in a safe way and
carefully, but we are now developing the protocols for exactly
how that can happen and working hard with the goal that everyone
should have the opportunity to visit a loved one in a care home
before Christmas.
(Central
Ayrshire) (SNP) [V]
Many scientists have expressed concern that the easing of
restrictions at Christmas could lead to another surge of covid
cases in January. With cases still over 80% of the level at the
start of lockdown, is the Secretary of State not worried that
allowing outdoor events of 2,000 participants and indoor events
of 1,000 in level 2 high-risk areas could drive up infection
rates ahead of Christmas? Although lateral flow testing is very
welcome, given how it increases capacity, the Secretary of State
previously stated that the mass testing in Liverpool was a pilot
and would be evaluated before being rolled out elsewhere. As the
city has also been under tight restrictions and then lockdown,
how will the impact of mass testing alone be evaluated? How does
he plan to counter the lower uptake among deprived
communities—the very ones at highest risk, as seen in
Liverpool—and with no clinical evaluation yet published, how can
he justify putting out contract tenders for an eye-watering £43
billion and rolling out this approach to 67 other areas? Should
this strategy not be compared with investing money and energy in
getting the traditional test, trace and isolate system working
properly? Currently, over 40% of contacts in England are still
not even informed that they should be isolating.
Finally, the Secretary of State knows that it is not testing, but
isolation, that stops the spread of the virus. If people who are
infected or could be carriers are not isolating, no amount of
testing will stop viral spread. A study by King’s College London
that suggested that fewer than a quarter were isolating when
advised was incredibly worrying, so what assessment are the
Government doing to clarify current isolation rates and
understand the reasons why people may not follow the advice they
are given?
Of course, we are constantly evaluating the impact of people
isolating, and how many people isolate when asked to. I would
encourage the hon. Lady to look at a broader range of studies
than just that one from King’s College, especially those dealing
with the self-isolation of those who test positive, for whom the
rate tends to be higher.
The hon. Lady asked about the use of these lateral flow tests to
have a negative impact on the number of cases in an area. Of
course, we have been evaluating this all the way through the
study in Liverpool, which is why we can have confidence in
rolling out more broadly across tier 3 areas. I included in my
statement a high-level assessment of this. The number of cases in
Liverpool city region is down by two thirds, but in the city
itself, where the testing took place—the testing was of people
who live in the city and of people who work in the city and live
largely in the wider city region—the number of cases is down by
over three quarters. That is one piece of evidence. It is clear
that it is the combination of people following the rules and
community testing, with appropriate incentives to get people to
take up that mass community testing, that can help to make this
work. We want to work with local directors of public health to
understand how this can work effectively in their areas,
precisely to reach those hard-to-reach people whom the hon. Lady
mentioned.
Finally, I echo the hon. Lady’s request that we be cautious this
Christmas. However, I am delighted that we have agreed an
approach across the whole UK, including with the SNP
Administration in Edinburgh, with the Welsh Labour Administration
and the cross-party Administration in Northern Ireland, because
there are so many ties that bind us together and mean that we are
stronger as one United Kingdom, working together to tackle this
virus.
(Buckingham) (Con)
It is incredibly disappointing news that Buckinghamshire, having
entered the national lockdown in tier 1, will emerge from that
lockdown into the more punitive restrictions of tier 2—a decision
that will be hard to understand in the rural communities of north
Buckinghamshire that have relatively low infection rates, and one
that is hard to understand given that there has been zero
consultation between central Government, Buckinghamshire Council
and our local NHS. Appreciating that my right hon. Friend has
impossible choices to make in order to control this virus, will
he commit to ensuring that Buckinghamshire Council and our local
NHS are fully consulted as these tiers are reviewed going
forward?
Yes, of course. Along with my hon. Friend, the director of public
health in Buckinghamshire was invited to engage with the team as
we were looking at the indicators and making this decision. These
are difficult decisions; he is right about that. The case rate in
Buckinghamshire is 138 per 100,000, and positivity is above 5%.
We will review these allocations in a fortnight and then
regularly thereafter. I look forward to working with my hon.
Friend and supporting the people of Buckinghamshire to do what is
right, to get the case rate down and to get Buckinghamshire—if at
all possible, and if it is safe—into tier 1, with the lighter
restrictions. But it is critical, to keep people safe, that we
take the action we need to today.
(Twickenham) (LD)
A recent University College London study found that less than
half the public understood what the rules were in the previous
tier system. Today we have a new tier system. We have a five-day
relaxation at Christmas. We have a Government website that has
crashed this morning. The written ministerial statement published
this morning has a number of question marks against different
areas. There are inconsistencies between what the Prime Minister
has said, what the OBR has said and what the Secretary of State
has told MPs about the length of restrictions. I have a simple
request: will the Secretary of State ensure that there is a
clear, consistent and honest communications campaign to ensure
public trust and compliance and so that we do not overly raise
expectations?
Yes, there will be a widespread public information campaign about
these new tiers. It is on all of us to follow the rules in our
local area. Notwithstanding the rules, we all need to behave in a
responsible way, because we all have a role in controlling the
spread of the virus.
(York Outer) (Con) [V]
As the Government continue to impose further unprecedented
restrictions on people’s freedoms, it is important to give people
hope and justification. As York’s covid rate continues to fall
and is the lowest in Yorkshire, can the Secretary of State
outline how we can get to tier 1 as fast as possible? Will he
publish the assessment and the data based on which York was
placed in tier 2, so that we can best judge how to get to tier 1?
He talks about regular reviews, but a weekly review would be much
more desirable.
Yes; I can answer positively on all counts. We have a regular
weekly session to go through all these. I am committing to
regular reviews rather than weekly ones simply because we
sometimes have to do it more than weekly, especially if cases are
shooting up in an area. On my hon. Friend’s point about
publication, we have published today not only the data—and we
will publish more data on each area—but an explanation of the
reason for the decision taken in each area. I know that he and
colleagues across York have worked hard, because there was quite
a serious spike in York, and it is coming down at the moment.
Overall, we still require the whole of North Yorkshire to go into
tier 2 because the case rates are still elevated right across it,
and we all need to work together to get them down.
(Brentford and Isleworth) (Lab)
I share the concern of my neighbouring colleague, the hon. Member
for Twickenham (), about clarity over tiers and messages. One message
and rule that is clear but unwelcome is the 11 pm curfew for pubs
and restaurants. Curfews fail to address the issue of crowds in
the streets and on public transport, which risk spreading
infection. Will the Secretary of State commit to meet London
government, including the Mayor of London, as soon as possible to
discuss this and agree the criteria that London needs to meet to
de-escalate as soon as possible?
Of course we have been engaging with the team who work across
London. There is a lot of work to do in London. There are parts
of London where cases continue to rise, and we need to get that
under control, but there are also parts where they are falling
and things are very much going in the right direction. Likewise,
there is pressure in some parts of the NHS, but there is a lot of
mutual aid within the NHS across London. There is a lot of work
to do in London to keep it in tier 2, and I look forward to
working with the hon. Lady and other London colleagues on that.
(Runnymede and Weybridge) (Con)
People living in Runnymede and Weybridge often ask me on what
basis we are subject to local tiers and to restrictions, and it
is clear that, alongside the data, other factors are taken into
account in the two decisions. I thank my right hon. Friend for
his response to the question from my hon. Friend the Member for
York Outer () that the reasons and the data will be published. Will
local hospital bed utilisation be part of the reasons published?
Yes. There are five indicators that we take into account in
deciding on which tier. One is pressure and anticipated pressure
on the local NHS, and bed occupancy rates are of course a
critical part of that assessment. I know that people are looking
for a clear numerical boundary between the different tiers, but
because we are looking at five different indicators rather than a
single one, there is no automatic figure at which a different
tier is triggered. We have to look at all the circumstances,
including, for instance, outbreaks. Some cities, on their pure
numbers, would be in tier 3, but because an outbreak is
specific—for instance, in a school or care home—it is appropriate
that they are in tier 2. We have to look at these very localised
issues as well, and that is why the engagement with local
directors of public health is so important.
(Poole)
(Con)
There will be bitter disappointment in Dorset, in both the urban
and rural areas, that we are in tier 2 even though our infection
rates are now falling quite rapidly. My main interest today is
finding out how we get out of tier 2 and into tier 1. If we are
going to have regular—that is, weekly—reviews, that is great and
fine, but if we are not, and we are stuck in that tier for two or
three weeks, would the Secretary consider some kind of appeals
process, and might his admirable Minister for Health be the
appeals process?
We work as a very cohesive team of Ministers in the Department,
and we all work on covid-related issues. I take my hon. Friend’s
gentle chiding that he would rather my No. 2 took these
decisions, but I am afraid he is stuck with me for the time
being.
On the serious point that my hon. Friend raises, we will review
the tiers in a fortnight and then regularly, which he can
reasonably take to be weekly. We have a weekly cycle of meetings,
with the chief medical officer chairing a meeting, typically on a
Tuesday. I then chair a meeting on a Wednesday for an
announcement on Thursday of any change to the tiers.
(Swansea West) (Lab/Co-op) [V]
The Secretary of State knows I chair the all-party parliamentary
group on air pollution, so he will not be surprised if I point
out that tier 3 areas tend to be the areas with the highest
pollution. Every microgram of PM2.5 per cubic metre increases
covid deaths by between 14% and 18%, and that is on top of the
40,000 deaths annually from air pollution. Does he agree that we
need cross-Government activity and an all-Government report
annually—from the Department for Environment, Food and Rural
Affairs, the Ministry of Housing, Communities and Local
Government and the Department for Transport—on what they are
doing individually and collectively to combat air pollution and,
in so doing, to reduce the covid death rate and the overall death
rate? I can see the Prime Minister nodding sagely. Would the
Secretary of State agree to an annual report?
It is very impressive that the hon. Gentleman can see the Prime
Minister, since he has just left the Chamber, but I am sure the
Prime Minister is nodding sagely, wherever he is. The hon.
Gentleman makes a very serious and important point, on which we
agree. Air pollution is a very serious issue. In lockdowns, air
pollution has been reduced; that is one upside to what are
otherwise very damaging things to have to do, but they are
necessary to keep the virus under control. I hope we can continue
to work together on tackling air pollution long after this
pandemic is over.
(Gloucester) (Con)
With Gloucestershire in tier 2, next to South Gloucestershire, in
tier 3, and the Welsh border, will the Secretary of State confirm
that there will be no travel restrictions between different tiers
or across the Welsh border? Since the Government can change tiers
without debate, which has a huge impact, especially on the
hospitality sector in terms of moving from tier 2 to tier 3, will
he also confirm when the tier decisions will be published?
I am afraid that I cannot confirm that with respect to the Welsh
border, because the legal restrictions on travel were a decision
by the Welsh Administration, rather than by the UK Government for
England. We have taken the view that travel restrictions should
be in guidance, because there are all sorts of complicated
circumstances in which people might need to travel. We have done
that when we have been in national lockdown across England, as
well as locally. I am sorry that I cannot be clearer than that.
On the point about renewal and when we review these matters, we
are proposing to review first on 16 December and then regularly
thereafter to ensure that we keep the tiered restrictions as up
to date as possible.
(Normanton, Pontefract and Castleford) (Lab) [V]
The Health Secretary will know the pressure that Pinderfields
Hospital, especially, has been under. The staff there have been
doing an incredible job. It is welcome that the number of covid
patients in hospital is starting to fall and that the number of
infections locally has fallen by around 30% in the last week, but
he will also know that our NHS, social care and public health
staff have had a really difficult year and that the winter is
going to carry on being tough, with many operations to catch up
on. Will he now look swiftly at the case for added support and
pay for NHS, public health and social care staff this winter, in
recognition of the incredible job they have been doing to care
for all of us?
I am delighted that we have a significant increase in the number
of NHS staff. The figures published this morning show that there
are 14,800 more nurses than there were this time last year in the
NHS. I am really pleased about that. The right hon. Lady will no
doubt have seen yesterday that the pause on pay increases across
the public sector announced by my right hon. Friend the
Chancellor does not apply to nurses and doctors. That is, in
part, in recognition of the incredible work that they have done
during this pandemic.
(Kenilworth
and Southam) (Con)
As the economic damage the pandemic is doing becomes increasingly
apparent, it is clearly right that businesses of all types are
reopened as soon as it is safe to do so. This will take longer
than it needs to if the restrictions on those businesses are
calculated on the basis of virus information for places a long
way away or as a geographical average for a wide area
encompassing urban and rural parts. That is exactly what is going
to happen to the businesses in my constituency, which will not be
able to open next week if they are hospitality businesses, not
because of the rates where they are, but because of the rates
somewhere else. Surely it is more sensible to calculate
restrictions on the smallest geographical area where data is
reliable, which is largely boroughs and districts. Will my right
hon. Friend commit in his review in two weeks’ time to look not
just at whether individual areas are in the right tier but at
whether the areas are properly constructed?
Yes, absolutely. My right hon. and learned Friend is absolutely
right about the importance of this. We have to balance the need
for an area to reflect the human geography in which people live
and effectively communicate the tiering decisions across that
geography, with precisely the concerns that he mentions. For
instance, Slough is in tier 3, despite the fact that Berkshire,
of which it is a part, is in tier 2, so we are prepared to take
those decisions at a lower-tier local authority area level. That
is the exception rather than the norm, but we look at this every
single week.
(North
Ayrshire and Arran) (SNP) [V]
Covid-19 is a world pandemic and it needs to be tackled on a
global basis. International travel will expose the UK to future
outbreaks, particularly if the virus mutates, so on both
humanitarian and public health grounds, does the Secretary of
State not agree that it is indefensible to cut the international
aid budget, just as a global vaccine roll-out begins?
Of course, we have been hugely supportive. In fact, the UK is the
biggest supporter internationally of providing vaccines in
countries that would not be able to afford them themselves. I am
sure that that will continue, because we will continue to have
one of the largest international aid budgets in the world.
(Waveney) (Con)
I know that my right hon. Friend will thank everyone in both East
and West Suffolk for getting down the level of infections, and
that it is with a heavy heart that he has concluded that the
county cannot exit to tier 1. Will he ensure that there are clear
indicators as to what else needs to be done so that Suffolk may
move to tier 1 as quickly as possible, and will he liaise with
the Chancellor of the Exchequer to put in place additional
support for the hard-hit hospitality sector?
I have constant discussions with the Chancellor of the Exchequer
about the support needed. My hon. Friend is right to raise that,
especially in Suffolk. It is with a heavy heart that we took the
decision on Suffolk. Its case rate is higher than the Isle of
Wight or Cornwall, which are the two areas in tier 1, but that
gives an indication of where we need to get to. I am sure that if
we all work together, we will be able to get there.
(South Shields) (Lab)
We are stuck in an endless cycle of lockdowns that are simply not
working. The Government have again wasted the opportunity over
the past few weeks to get a handle on testing, tracing and
isolating. Once again, hospitality in South Shields will be
absolutely battered, and my constituents’ liberty impacted on.
Will the Secretary of State tell us exactly what will be
different this time that will make our sacrifices yield a
reduction in the infection rates?
First, I urge the hon. Lady to look at the figures published this
morning, which show that the majority of tests when done in
person are now turned around within 24 hours across the country,
and capacity has increased radically. What I would ask of her for
the future, to help the north-east get out of tier 3, is to work
with her local councils, with the directors of public health, to
embrace the community testing that has been effective in
Liverpool. If they are up for doing that—it has to be in
consultation and conjunction with the local council, because they
know the area—I very much hope that they will come forward to
pick up the baton and make that happen.
(Tewkesbury) (Con) [V]
This is not an easy question, but how will the Health Secretary
take into account the wider mental and physical health
implications for people who are prevented from living their lives
as they would wish to live them?
We look as much as we can at taking the impacts into account. For
instance, the mental health of people under lockdown is of course
more challenged than in normal circumstances. We balance that
against the impact of covid both directly and in filling up the
hospitals on the healthcare that we all get for all the other
conditions that exist. It is a difficult balance to strike. On
the particular impact on mental health, which my hon. Friend
raised, the Royal College of Psychiatrists has done very
interesting work to understand the nuanced balance between the
impact of covid on people’s mental health and the impact of
lockdown. Both are significant and I commend its work to him.
(North
Tyneside) (Lab) [V]
It is devastating that after all its efforts, the north-east will
be in tier 3. Across the whole country, obesity remains a serious
factor in covid-19. Yesterday, the all-party group on obesity
launched its report to build on the Government’s obesity
strategy. Will the Minister meet officers of the group to discuss
the report’s recommendations and work with us to ensure a focus
on the prevention and treatment of obesity in the fight against
covid-19?
Yes. the hon. Member and I share an enthusiasm for this agenda
with the Prime Minister, who is a personal convert to the need to
tackle obesity. In fact, this crisis shows how important it is,
because people who are obese are more likely to have a more
serious impact from covid, if they catch it.
(Aylesbury) (Con)
We have consistently been told that we must accept restrictions
to protect the NHS, and Buckinghamshire Healthcare NHS Trust has
done an amazing job in dealing with the pandemic from the very
beginning. Can my right hon. Friend therefore explain the
weighting that he puts on the pressures on the local NHS as one
of the five indicators in the decision-making process over tiers?
It will be very difficult for people in Aylesbury to accept
stringent controls on our lives and livelihoods if, in fact,
there is plenty of capacity in hospitals for both covid and
non-covid cases.
We look at all five indicators essentially equally. The point
about pressure on the NHS is a more sensitive indicator on the
decision to go into tier 3. If an area is in the situation that
Buckinghamshire is, for instance, where the case rate is
elevated, but not as high as in many other parts of the country,
the key thing to do is to keep that case rate where it is or
lower. We could not make the decision to put Buckinghamshire into
tier 1 because, if it went up from where it is, it would not be
long until Buckinghamshire were in trouble. Therefore, the
decision was to put it into tier 2.
I very much hope that the cases can continue to go down until
they are very low—like they are in Cornwall and on the Isle of
Wight, for instance. We will then be able to review and consider
tier 1. I hope that that is a reasonable explanation. We need to
continue to debate this matter as we try to ensure that we get
the judgments around these geographies exactly right.
(Luton South) (Lab)
The good people of Luton will want to get out of tier 2 as soon
as possible, but the current resources provided to Luton Borough
Council for the lateral flow rapid testing pilot are insufficient
to enable it to provide the level of mass testing that is being
described nationally. The contained funding—£8 per person—just
will not cover tests for 10% of Luton’s population, as the
funding also needs to be used for the wider covid response,
including wellbeing support for vulnerable residents. Can the
Secretary of State confirm that there are national plans to
provide additional support and resources to expand testing if the
intention to test close contacts daily is pursued?
Yes, there will be further funding for those areas that go into
tier 2 and yet more funding for the areas that go into tier 3.
That funding will go to the councils for the extra support that
is needed.
(Bury
South) (Con)
I thank the Prime Minister for the flexibility that the
Government are providing so that we can all have a family
Christmas. However, let me ask my right hon. Friend the Health
Secretary: what consideration has been given to Hanukkah, which
starts two weeks today, regarding family gatherings and public
menorah lightings? Does he think it is fair if no flexibility is
shown to the Jewish community?
We carefully considered this issue, consulted on it and discussed
it widely. Christmas is a national holiday, as well as being very
much a Christian celebration. That is reflected, for instance, in
the fact that we have two days of bank holidays. We consulted
members of different faiths around precisely the question that my
hon. Friend rightly raises, and there was a strong degree of
support for having something special in place for Christmas for
everybody, even though we have not been able to put that in place
for Hanukkah or for other celebrations of other faiths.
(Blaydon) (Lab)
May I start by assuring the Secretary of State that directors of
public health and local authorities in the LA7 area and the wider
north-east are certainly very focused on getting that figure down
and have had some success? I would like to make that absolutely
clear. The second point I would like to make is that my
constituents and others across the north-east will be hugely
disappointed to find they are in tier 3, particularly those
businesses in hospitality and leisure which are going to be so
desperately hit by this. The real point I want to make, however,
is about public health. Nothing has shown more than this pandemic
that public health should be at the heart of what we do. We know
it affects outcomes in covid-19, and we know it affects health
inequalities and the rate of transmission. Will the Secretary of
State ensure that he impresses that on the Chancellor, and ask
him for more funding for public health services, both now and in
the future?
Yes, I agree with every word of what the hon. Lady said.
(Beckenham)
(Con)
My constituency of Beckenham is very relieved to be in tier 2.
Very kind of you, Secretary of State. I have had a couple of
constituents ask me whether they have to have a vaccination. I
have said that no, they do not, as far as I know. Can he tell the
House what percentage of the population is required to be
vaccinated in order for the measures to be effective, so we can
get back to normal?
I would urge everybody to get a vaccination, if we manage to get
a vaccine that is approved by the authorities, because the
regulator will only approve a vaccine if it is safe and
effective. Having said that, we are not planning to make it
mandatory, because we hope that the vast majority of people will
take it up, not least because it will help to protect them and
their community, and get the whole country and indeed the world
out of the mess we are in.
(Worsley and Eccles South) (Lab) [V]
The winter plan confirms that the Government will be taking
action to restrict the movement of care staff between care homes.
On the face of it, that is a perfectly sensible infection control
measure. However, many care staff are forced to work between
multiple homes because of low hourly wages. Can the Secretary of
State therefore give a commitment that care workers will suffer
no loss of income as a result of the policy? Can he set out what
he will do to ensure that no care staff lose any of their jobs
because they are being forced to choose between the different
homes they work in?
I hope that, partly through this measure and the increase in the
national living wage that the Chancellor confirmed yesterday, we
can improve the pay and conditions of staff across social care.
The proportion of people in social care who work in a number of
settings and work in agency and less secure work is, in my view,
something we should tackle together. I hope we can use what has
obviously been put in place, as the hon. Lady rightly says, for
public health infection control reasons also to improve
employment standards across social care. That is, of course,
directly contracted by local authorities, rather than by central
Government. Nevertheless, this is an area that I think we all
know we need to work to improve as a nation.
(New Forest
East) (Ind)
I am sure my right hon. Friend appreciates that many elderly
people die with serious illnesses, such as prostate cancer, but
not from those illnesses. How certain is he that statistics
showing the number of people dying with covid-19 are not being
presented or misinterpreted as people dying from covid-19?
The statistics on the number of people dying with covid-19 are
the best estimate that the statistics authorities, both in Public
Health England and the Office for National Statistics, come up
with. It is one of the widest definitions, which countries use
internationally. Therefore, as my right hon. Friend implies in
his question, it does include people who may have died of
something else, but with covid. Nevertheless, each of these
deaths we should work to avoid. The best measure, according to
the chief medical officer, is the total number of excess deaths
compared with this time of year last year. That is elevated now
and we need to get it down.
(Oxford
West and Abingdon) (LD) [V]
May I first thank the Secretary of State for listening to local
leaders, who have been pushing for a one-Oxfordshire approach to
coronavirus as we go into tier 2? I am sure many residents
understand the need to be careful for Christmas. Despite
Oxfordshire’s data being better than that of surrounding
counties, we cannot risk any further damaging lockdowns. The
reason we have done so well is superb team working and a
county-wide systems approach, involving all councils, the NHS and
businesses. In particular, we were quick off the mark to
implement a local test, trace and isolate system, which is paying
dividends. Does the Secretary of State agree that the key to
beating this virus is to treat local areas as partners, and when
they say they should be moving up and down tiers will he give
their voice considerable weight?
Yes, I do give considerable weight to local leaders when they
make a case for a particular tier for their area, and in the hon.
Member’s case I would like to pay tribute to Ian Hudspeth, who
has worked incredibly hard during this crisis for the benefit of
people right across Oxfordshire. I talk to him regularly about
the situation in Oxfordshire, which has made great strides in
tackling this virus, including tackling the student outbreak at
the universities in Oxford. I hope they can work to get
Oxfordshire appropriately down into tier 1 as soon as possible,
but there is some work still to do.
(Burnley) (Con)
Today’s decision will be disappointing to businesses and
residents across Burnley, who have had extra restrictions on
their lives and their businesses for longer than most, so can my
right hon. Friend set out exactly what support is going to go to
Burnley and the wider Lancashire area, and when it will be
delivered, so we can end these restrictions as soon as we
possibly can?
Yes, Burnley has been in restrictions for a long time now. It has
brought its case rate down by about half since the peak in late
September. My hon. Friend has played a dutiful and impressive
role in his public leadership within Burnley. I hope that we can
work with Burnley Borough Council and Lancashire County Council
to get the case rate down and get Lancashire down into tier 2, in
the same way that Liverpool has managed to come down into tier 2:
a combination of people following the rules and community
testing. That is available to people in Lancashire, and I very
much hope to be able to work with the team in Burnley and across
Lancashire to make this happen.
The final thing I would say is that these are tough measures; I
get that. I understand the impact on hospitality, but they are
done for the right reasons, which is to keep people safe and stop
the local NHS being overwhelmed.
(Warrington North) (Lab)
Warrington will be breathing a sigh of relief that we are
emerging from national lockdown into tier 2, but while I welcome
the return of fans to stadiums, I cannot support the extension of
the substantial meal requirement to tier 2, which will leave many
pubs across my constituency closed. The pub sector faces an
existential threat and it flies in the face of logic and fairness
that thousands can congregate at the rugby but wet pubs that are
at the heart of our community must stay closed. Will the
Secretary of State commit to publishing the specific evidence
that underpinned the substantial meal requirement extension and,
if he cannot, to removing this requirement?
Unfortunately, we will not be removing that requirement from tier
2. It is incredibly important that we keep the cases under
control. The local team in Warrington has worked very hard along
with the Liverpool city region to get the case rate down. They
went into national lockdown in tier 3 and have come out in tier
2, and the people of Warrington should be commended for that, but
the measures of tier 2 are necessary to keep the virus under
control because, unfortunately, the virus thrives when people get
together. The hon. Member mentioned the point about events in
larger scale. They will only be held where there is very
stringent social distancing, so there will not be congregations,
as she said, of thousands of people—I would like to reassure her
of that—because these events will only take place when the
capacity in normal times of any venue is much, much bigger than
the number of people who are there.
(Stourbridge) (Con)
First, I want to thank residents in my constituency for their
hard work and sacrifice; their borough has been hard hit by the
virus. With my constituency being in one of the worst affected
areas, will my right hon. Friend consider rolling out the vaccine
as a priority when it is ready to the country’s worst affected
areas, which have been not only blighted by this virus, but hard
hit economically? These are the areas that will be in much need
of assistance to get back on their feet following prolonged
lockdown of the local economy. The vaccine would provide much
needed respite in these worst affected areas.
We have taken the decision to roll out the vaccine UK-wide at the
same pace. I want to get it as soon as possible to the west
midlands and to everywhere else, but it is fair to the areas that
have had a low, or relatively low, incidence of the disease to
make sure that they also have access to the vaccine. Also, the
incidence in different parts of the country changes, and the
vaccine roll-out programme is very complicated. It does not speed
up the delivery of the vaccine in one area to have slowed it down
in another. That is why we have taken a UK-wide approach.
(Wealden) (Con)
In keeping with my right hon. Friend’s spirit of working
together, I stand not only to represent Wealden, but to speak on
behalf of my hon. Friends the Members for Bexhill and Battle
(), for Eastbourne () and for Hastings and Rye (). We wish to
collectively thank the CEOs of the clinical commissioning group
and East Sussex Healthcare NHS Trust, our county leader, Keith
Glazier, and our local department for public health for working
with us day in, day out to understand the data and the reason for
the infection rates.
We are deeply disappointed that, considering all the five
indicators, where we mark extremely low, we are in tier 2, and we
are disappointed that central Government have not consulted local
leaders, because they would then have been able to investigate
the data and, hopefully, show us how we can move into tier 1 from
tier 2. Will my right hon. Friend provide some assurances that
these conversations will take place with local leaders and
confirm that transparent objective criteria will be published for
each tier, and how we can slide between each tier?
Yes, absolutely—I can give both those assurances. Across Sussex,
case rates are at 120. They do need to come down. Like my hon.
Friend, I would like to see Sussex get to tier 1 as soon as
possible, and we will keep talking to the local area. As I said
earlier, all directors of public health have been invited to
discussions and consultations with the public health team. That
feedback fed into these decisions, but we have to make sure that
those conversations continue. The key message to everybody across
Sussex and in the Weald, in particular, is that if we all stick
together and follow the rules, we know that we can get this virus
under control, and that will then lead directly to the lifting of
restrictions, which we will regularly review.
(Motherwell and Wishaw) (SNP) [V]
The Secretary of State will be aware of reports on the Oxford
vaccine that the sub-group that suggested 90% effectiveness was
due to a manufacturing error, rather than being a planned
protocol. It included fewer than 3,000 people and did not have
any participants over 55. Does he agree, therefore, that further
research is required to verify the efficacy of the lower dose in
all age groups before it can be adopted as a standard regimen?
Questions over the interpretation of the data in the clinical
trials are rightly for the Medicines and Healthcare Products
Regulatory Agency, which will assess these clinical trials and
will only approve a vaccine for use if it is effective and safe.
(Colne Valley) (Con) [V]
The first review of Kirklees being in tier 3 will be on 16
December. Will the Secretary of State please confirm that his
Department will consult local MPs, council leaders and the local
director of public health? Will he publish the full numerical
criteria so that we know what we need to achieve to get out of
tier 3? Will the Government support Kirklees in delivering mass
testing? Finally, will the Secretary of State have a conversation
with the Chancellor about delivering extra financial support for
our hospitality businesses?
I will absolutely take up all those suggestions. We are in
discussions with Kirklees about what more we can do, including in
the area of large-scale community testing and the other
considerations necessary to make that happen.
(Upper Bann) (DUP) [V]
The Secretary of State is to be commended for the initiative that
he and the Minister for Care have spearheaded to allow
close-contact visits between relatives and residents in care home
settings. Will the proposed access vary depending on what tier a
home is located in? I acknowledge that care is a devolved issue,
but with little progress being made in this regard in Northern
Ireland, will the Secretary of State undertake to share the
experiences of his pilot with the Health Minister in Northern
Ireland so that my constituents can also look forward to visiting
loved ones as soon as possible?
Subject to the results of the pilots, which are ongoing, we hope
to allow testing in England to allow for visiting in care homes
before Christmas. I will absolutely have another conversation
with my opposite number , who is the
Health Minister for Northern Ireland. is an excellent
Health Minister, we work very closely together, and I am
absolutely sure that together we will be able to make progress on
testing and other matters. He and I are constantly in touch about
how we can best serve the communities of Northern Ireland, from
the position of the UK Government’s role in procuring tests
around the world and, of course, his vital role in keeping people
safe right across the Province.
