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Coronavirus

– in the House of Commons at 1:01 pm on 3rd March 2020.

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Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care 1:01 pm, 3rd March 2020

With permission, Mr Speaker, I shall make a statement about the Government’s coronavirus action plan.

The situation facing the country is increasingly serious. Globally and at home, the number of cases continues to rise. As of 9 am today there were 51 confirmed cases in the UK, and it is becoming more likely that we will see widespread transmission in this country. Our approach is to plan for the worst and work for the best. Yesterday I attended a Cobra meeting chaired by the Prime Minister, during which we finalised our four-part action plan to contain, delay, research and mitigate the virus. The plan has been jointly agreed by the UK Government and the devolved Administrations. Copies have been sent to Members of both Houses, and made available in hard copy.

The plan is driven by the science and guided by the expert recommendations of the four UK chief medical officers and the Scientific Advisory Group for Emergencies. It sets out what we know so far about the virus and the disease that it causes, what long-term planning we have undertaken to prepare for a pandemic, what actions we have taken so far in response to the current outbreak, and, crucially, the role that the public can play in supporting our response, both now and in the future.

The UK is well prepared for infectious disease outbreaks of this kind. The international data continue to indicate that for most people, this disease is mild and the vast majority recover fully. We have responded to a wide range of disease outbreaks in the recent past, and the NHS has been preparing for a pandemic virus for well over a decade. We have world-class expertise to make sense of the emerging data, we have a strong base on which to build, and, while covid-19 is a new virus, we have adapted our response to take account of that fact.

Our plan sets out a phased response to the outbreak. Phase 1 is to contain, and it is the phase that we are currently in. Contain is about detecting the early cases, following up close contacts, and preventing the disease from taking hold in this country for as long as is reasonably possible. That approach also buys time for the NHS to ramp up its preparations. The scientific advice is that if the number of global cases continues to rise, especially in Europe, we may not be able to contain the virus indefinitely.

At that point, we will activate the delay phase of our plan. Delay is about slowing the spread, lowering the peak impact of the disease, and pushing it away from the winter season. We are mindful of scientific advice that reacting too early or overreacting carries its own risks, so, subject to the primary goal of keeping people safe, we will seek to minimise social and economic disruption.

The third part of the plan is research. Research has been ongoing since we first identified covid-19, and I pay tribute to the scientists at Public Health England who were among the first in the world to sequence its genome. Research is not just about the development of a vaccine, which we are actively pursuing but which will be many months away at the earliest. It is also about understanding what actions will lessen the impact of the coronavirus, including what drugs and treatments—existing and new—will help those who are already sick.

The fourth phase is mitigate. We will move to this phase if the virus becomes established in the UK population. At that point it would be impossible to prevent widespread transmission, so the emphasis will be on caring for those who are most seriously ill, and keeping essential services running at a time when large parts of the workforce may be off sick. Our plans include not just the most likely case, but the reasonable worst case.

We will identify and support the most vulnerable. If necessary, we will take some of the actions set out in today’s plan to reduce the impact of absentees and to lessen the impact on our economy and supply chains. We prepare for the worst and work for the best. We commit to ensuring that the agencies responsible for tackling this outbreak are properly resourced and have the people, equipment and medicines that they need, and that any new laws that they need are brought forward as and when required.

This is a national effort. We need everyone to listen to and act on the official medical advice. We need employers to prioritise the welfare of their staff. And the single most important thing that everyone can do to help—I make no apologies for repeating this—is to use tissues when they cough or sneeze, and to wash their hands more often. That is in their interest, their families’ interest and the national interest.

We will get through this, and everyone has a part to play. I commend this statement to the House.

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care 1:07 pm, 3rd March 2020

May I apologise to you, Mr Speaker, and to the House for being a few minutes late? I had a problem with my printer when I was trying to print the Secretary of State’s statement. I thank him for advance sight of the statement, and, indeed, for advance sight of the action plan this morning. Let me also record my thanks for the briefing that the Leader of the Opposition and I received yesterday from departmental officials, the chief medical officer and the Government Chief Scientific Adviser. I believe that the chief medical officer will brief parliamentarians later today, and I think that that is a very welcome initiative.

The Government’s strategy to contain then delay, research and then mitigate has our endorsement, but may I ask the Secretary of State for some specific clarifications? The first relates to containment and self-isolation. The Prime Minister said today—as, indeed, the Secretary of State has said before—that workers who self-isolate are considered to be on sick leave. Can the Secretary of State confirm that those who need to self-isolate will not need to visit a GP to obtain a sick note, given that the Government’s advice is not to visit a GP? As he will know, 2 million workers on low pay or insecure contracts in the gig economy do not even qualify for statutory sick pay. He will also know that those who are receiving benefits are often asked to physically attend appointments. Can he guarantee that no financial sanction will be imposed if they are asked to self-isolate?

Does the Secretary of State accept that people should not be forced to make a choice between their health and avoiding financial hardship? We are told that he is considering emergency legislation. Will he introduce legislation to remove the barriers to self-isolation so that all workers can receive the sick pay that they deserve? That is in the interests of public health. If he introduces such legislation, we will help him to get it on to the statute book quickly. He could do it this week or he could do it next week, and we will support him. Let us give all workers the security that they deserve, so that they do not have to put their health ahead of their financial interests or vice versa.

More broadly on the NHS and social care, I want to look at the response of the NHS and the support that it will be given through the containment and mitigation phases. We know that around 80% of critical care beds were occupied last week. We know that the NHS is short of 100,000 staff, and we also know that staff working in the NHS, particularly those on the frontline such as GPs, need to be protected as well. Even if we take at face value the Government’s insistence that they have provided the NHS with the resources to deliver the commitments of the long-term plan—we obviously disagree on this, but that is a debate for another time—we can surely all accept that covid-19 is going to lead to increased demand on trusts and the wider NHS. Every trust that sends a sample for testing has to pay for it to be couriered. Trusts are likely to take on more agency staff. If retired staff are encouraged to return to practice, the wage bill will increase. By the way, on retired staff, can the Secretary of State reassure us that protections and oversight will be in place, particularly around returning staff who, as we understand it, will not need to go through a revalidation process for their licence?

The Government have recognised that, as we move into the mitigation phase, non-urgent care may be delayed. I assume that means that trusts will be looking at cancelling elective surgery, which will result in waiting lists growing. Again, this will impact on trusts’ finances. Will the Government provide an emergency funding increase for the NHS resource budget to support the NHS through this next challenging period? Directors of public health still do not know their public health allocations for the next financial year, which starts next month. This means that directors of public health could be cutting the nurse workloads they are responsible for commissioning at a time when those very nurses will be needed to deal with covid-19 cases. Will the right hon. Gentleman announce the public health allocations as a matter of urgency?

On social care, we know that many who are at risk from the virus are the elderly and those with chronic conditions. Social care is responsible for and has a duty of care to many of the people who are most vulnerable to the outbreak. What advice does the Secretary of State have for social care providers, and will extra resources be announced for social care services? On the emergency powers that he has briefed about, will he sit down with us and other Opposition parties to discuss the contents of that legislation?

On the global efforts to contain the virus, we know that disease knows no borders. We cannot build a wall or an iron curtain around these islands. Why, then, are the Government apparently walking away from the EU early warning and response system, which plays such a vital role in pandemic preparations? We have been led to believe that No. 10 has overruled the Secretary of State on this. Also, to contain the virus internationally, countries with weaker health systems need to be supported as well, otherwise, we will not contain the virus. Can the Secretary of State update us on what help he is offering to the World Health Organisation on that front?

This is a serious time. Our constituents will be concerned, and many will be frightened. We will raise our concerns responsibly, but we offer to work constructively with the Government, because the public health interest and the safety of our constituents must always come first.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I am grateful to the hon. Gentleman for the constructive approach he has taken from the start, and I will seek to address all the questions that he has raised. His first point was about statutory sick pay. For those who need to self-isolate for medical reasons to protect others, that counts as being off sick. They do not need to go to a GP, because there is a seven-day allowance for self-declaration. I hope that that addresses that point directly—[Interruption.] We keep all matters on this under review because, broadly, I agree with him on the principle that he has set out. On the NHS, he asked about resources. We have already increased resources to the NHS and we stand ready to do so if that is necessary.

The hon. Gentleman asked about doctors and revalidation. In legislation, we are proposing to make revalidation simpler. We will bring forward those measures, and of course we will engage with the Opposition on the potential measures as and when that is necessary.

On public health allocations, we have already been clear that the public health grant is going up in aggregate. As my right hon. Friend the Communities Secretary set out last week, we have seen a 4.4% real-terms increase in local authority budgets this year, and the social care budget is going up by £1 billion. I think that that takes into account the issues that the hon. Gentleman raised.

The hon. Gentleman also raised engagement with the World Health Organisation We have supported the WHO with extra funding. On engaging with the EU, I have regular engagement with colleagues from across Europe, and some of the reports I have seen in the newspapers are not accurate, because the questions of engagement with the EU on matters of health security are a matter for the negotiations, as set out on Thursday in the negotiations document.

Photo of Jeremy Hunt Jeremy Hunt Chair, Health and Social Care Committee, Chair, Health and Social Care Committee

I would like to commend the Health Secretary for the calm way in which he has been dealing with this crisis and for his very clear public messaging. He called me last Friday to tell me that there had been a coronavirus outbreak in my constituency. I would like to thank the staff at the Haslemere health centre for their extraordinary commitment in working over the weekend so that the health centre could be open again on Monday morning. This shows, however, that some of the people at greatest risk are our frontline health workers. One study in China showed that 7% of the people who got the virus in Wuhan were health workers. Will the Health Secretary confirm whether hospitals, GP surgeries, care homes and nursing homes have enough face masks, gloves and hand gel, and will he outline any other measures he is taking to ensure that NHS staff are kept safe?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

My right hon. Friend raises an incredibly important point, and the answer to the question is yes. We are putting out further advice and guidance to the health system, to the NHS, to GPs and to hospitals today. That will go out from Keith Willett in the NHS.

On the point about the kit needed to keep health workers safe: yes, we are putting in place the actions to ensure that it is available at the right moment when it is needed. There are some GP surgeries that do not have that equipment yet, but we are putting in place the actions needed to ensure that they have it as and when it is needed. As my right hon. Friend knows, the number of cases right now is relatively small. It is 51, as of 9 o’clock this morning. The protective equipment is there, so that for each of these cases we can get right on to them, but if the virus becomes more widespread, of course more and more NHS settings right across the country are going to need that sort of equipment.

Photo of Philippa Whitford Philippa Whitford Shadow SNP Spokesperson (Health and Social Care), Shadow SNP Spokesperson (Europe)

I welcome the plan, although I have to say that I would have welcomed receiving the briefing yesterday that the shadow Secretary of State mentioned, which I did not receive. The plan lays out a reasonable worst case scenario, and it is clear about the three time phases. Research is of course ongoing, but this will help to prepare the public for decisions that may have to be made down the line. At the moment, containment is based on self-isolation of cases, contacts and those who have travelled to risk areas, but with the spread elsewhere in the world, it is becoming harder to define risk areas. With regard to north Italy, the chief medical officer talked about those with underlying conditions perhaps interpreting the advice more stringently and not travelling, so will the Government either discuss with insurance companies or even consider legislation to make underlying conditions an acceptable reason to cancel a holiday, so that people can get their money back rather than putting themselves at risk?

I agree with the Secretary of State regarding asymptomatic workers and sick pay, but there are staff who have no sick pay in their contract, and some protection has to be given to them. He referred to the seven-day period for self-certification, but isolation is for 14 days, and we do not want people turning up at their GP surgery halfway through that period. Can that be looked at? One issue that I have come across is an employer telling a member of staff returning from a holiday in Tenerife that they should not come to work for two weeks, but the employer does not wish to pay them for that period. We need to look at that, even if it is not health advice but an employer stipulation expecting people to have no income.

As we move into delay, we see that children are not particularly vulnerable to catching this. However, as with other coronaviruses, they may well spread it. Do we have evidence for how much they contribute to transmission, as that will affect decisions on school closures?

What preparations are being made for the long haul? Previous coronavirus outbreaks have lasted not just for a few months but for over a year, so we could be dealing with this next winter. If we move into mitigation, the situation will reverse and it will be about protecting the vulnerable and early discharge to home care. That might require the changing of staff from hospitals and care homes to work in the community, so are the Government in negotiations on such matters as legal responsibility and liability?

The Secretary of State quite rightly talked about what the public should be doing, but should we not already be thinking about stopping shaking hands and about working from home, if possible, without an economic impact? That would also help the climate emergency. Containment moves into delay without a border, so should we not be thinking about trying to get ahead of the curve?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We have been briefing colleagues as much as possible. Clearly, the CMOs’ time is incredibly valuable at the moment. We have worked with the Scottish Government on this plan; it was signed off by both the First Minister and the CMO for Scotland. In fact, it has been developed with the Scottish Government, the Welsh Government and the Government of Northern Ireland, so ultimately it is a multi-party plan.

The hon. Lady made the point about seven-day certification. That is indeed the sort of reason why we are holding this area under review and there is work ongoing, including on the points she has raised. She also asked about shaking hands. The medical advice is that the impact of shaking hands is negligible; what really matters is washing hands. Our public health advice will remain clear and based on the science—what matters, more than anything else, is that people wash their hands for 20 seconds or more, using soap and preferably hot water. That is the core of the public health advice.

The hon. Lady mentioned working from home. There is an incredibly important point about timing written into the plan. There are actions that we may need to take in future that it would not be appropriate to take now. We are not advising people to work from home now, but we do not rule out doing so in future if that might be more effective clinically, given the disruption it could cause.

Several hon. Members:

rose—

Photo of Luke Evans Luke Evans Conservative, Bosworth

With regard to the impact that coronavirus can have, the Secretary of State is right to balance the difference of health and the economy and I welcome his caution in that regard. I want to raise a point about small businesses. If coronavirus does become a more significant problem, are the Government considering making emergency loans available to otherwise good businesses? If not, will he ask other Departments whether they might consider that?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We are considering that; it is being led by the Department for Business, Energy and Industrial Strategy, in conjunction with the Treasury. The Chancellor will be making a statement today, ahead of the Budget on 11 March.

Photo of Rosie Cooper Rosie Cooper Labour, West Lancashire

The Secretary of State will know that there is a system whereby those who are immunosuppressed are not required to sit in crowded waiting rooms in hospital or A&E. That is in normal conditions, never mind the situation with covid-19. Yesterday evening, I attended Aintree Hospital with a patient who had just finished her first round of chemotherapy. Despite the chemo-aware system, she was told by the receptionist to sit in a very crowded waiting room, for a five-hour wait, because there was nowhere else to go. I stood in a corridor, between the front door and some sliding doors, to ensure that she was not subjected to that. How will the Secretary of State ensure that frontline staff who are not necessarily clinicians understand the increased danger to those individuals? Does each A&E and each hospital have a place where those people could wait safely? This is not good enough.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

The answer is yes. Each A&E now has a pod in front of it, which we have funded since the outbreak of the virus, so that suspected cases do not need to go into the main A&E. That is to address exactly the sorts of problems that the hon. Lady raises.

Photo of Graham Brady Graham Brady Chair, Conservative Party 1922 Committee

Does contingency planning include steps to secure additional capacity in private hospitals, which often would lend themselves better to isolation of infectious patients?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

The question of how we deliver and who delivers NHS services is a matter for the NHS, and making sure that we use all the health facilities available is of course something that the NHS is considering.

Photo of Angela Eagle Angela Eagle Labour, Wallasey

Does the Secretary of State agree that, in order for self-isolation to work, no individual, whatever their circumstances, should be out of pocket for doing the right thing? As my hon. Friend Jonathan Ashworth said, currently, millions of people who work in the gig economy and do not qualify for sick pay would be out of pocket for doing the right thing. Does the Secretary of State agree that solving this problem and giving people the confidence that they need to do the right thing by self-isolating is one of the most important things that he can do in the next few days, to ensure that we can continue with containment?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

There is a huge number of things that we need to do in the next few days and, as I have said, this area is under review.

Photo of Caroline Nokes Caroline Nokes Chair, Women and Equalities Committee, Chair, Women and Equalities Committee

Across Government, in different Departments, there are many people with healthcare experience and professionalism. For example, the Department for Work and Pensions has 3,000 trained professionals working on assessments. What conversations is my right hon. Friend having with other Secretaries of State to understand whether there could be access to those individuals so that they too could be on the frontline?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

That is something we are absolutely willing to look at.

Photo of Layla Moran Layla Moran Liberal Democrat Spokesperson (Education)

Last week I asked the Secretary of State about the preparedness of NHS 111. In answer to a written question, the Department said that it does not have the numbers for current staff. I understand that Dudley call centre alone is asking to recruit 150 new call handlers. How many call handlers are we looking for in addition to the current staffing levels for NHS 111, and when does he expect them to be fully trained and online?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We have increased the number by 500 already, and there are plans for more to come, as and when that becomes necessary.

Photo of Dr Caroline Johnson Dr Caroline Johnson Conservative, Sleaford and North Hykeham

An increasing number of people are self-isolating, but they still require routine care. Are GPs providing that routine care, and what advice is being given to GPs on whether they should wear masks, and whether they should visit a patient at home or get them to come to the surgery and so on?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We do not want people who suspect they have coronavirus to go to their GP; we want them to do this via NHS 111. Further to my earlier point about being able to self-validate for sick pay for seven days, they can of course then do that by phone and get an email confirmation, should they need to, to extend that to the full 14 days. Of course, as well as tackling coronavirus, the NHS must do business as usual. We are increasing the amount that people can do over the phone, Skype and other forms of telemedicine. That could be increasingly important if there is widespread concern about communicable diseases.

Photo of Judith Cummins Judith Cummins Shadow Minister (International Trade)

What steps is the Secretary of State taking to ensure continuity of social care, both in care homes and for care given at home, given the problems and workforce implications arising from coronavirus?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We have a huge amount of work under way, including looking at what we can do to ensure that people can get support in care homes. It is not just about the staff, of course; elderly people in care homes are, according to the data, among those most vulnerable to the disease. The care home element of our plan is incredibly important and we will be providing more details in the coming days.

Photo of Greg Clark Greg Clark Chair, Science and Technology Committee (Commons), Chair, Science and Technology Committee (Commons)

It is very important that both the resolution and the management of the crisis are based on the best possible science, and I join the Secretary of State’s tribute to the UK scientists, who are among the most experienced and best qualified in the world. Have UK scientists been part of the World Health Organisation teams deployed to Iran and China? Does the Government’s chief scientific adviser attend the Cobra meetings? Can the Secretary of State update me on the question, about which I wrote to him on Thursday, of when we can expect a bedside test to be deployed in this country and made available around the world?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We are, of course, involved in the World Health Organisation missions and in some direct bilateral missions. I have repeatedly signed off on support for more UK experts to go out around the world. The chief scientific adviser is, of course, at all the Cobra meetings on this, whether they are chaired by me or by the Prime Minister.

My right hon. Friend’s point on the bedside test is incredibly important. We are currently engaged with just over a dozen companies to try to come up with a bedside test, instead of having to take a swab from the back of your throat, Mr Speaker—should you have the misfortune to fall ill—having it sent away and brought back. Working with UK companies to get a bedside test that can be done on the premises is an incredibly important part of the diagnostic mission surrounding this disease.

Photo of Ruth Cadbury Ruth Cadbury Labour, Brentford and Isleworth

Will staff in community settings be issued with protective hazmat suits and masks?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We have extensive stockpiles of personal protective equipment. We are not distributing that at this moment because we have to distribute it at the right time. Each individual case can be dealt with at the moment, because they are relatively few, by those who are expert in using that kit. Of course community staff, as well as primary care staff and hospital staff, will be involved in the distribution of that equipment as and when appropriate.

Photo of Robert Largan Robert Largan Conservative, High Peak

Last week there was a confirmed coronavirus case in Buxton, which led to the temporary closure of a medical centre and a school. Unfortunately, several national newspapers inaccurately reported that Buxton was a town on lockdown. Several local hotels have now reported booking cancellations as a result. Does the Secretary of State agree that the situation calls for responsible journalism and calm reporting of the facts? Will he join me in encouraging people to visit Buxton, Britain’s best spa town?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes. I do not have to check with the chief medical officer before telling you, Mr Speaker, that I love going to Buxton, which is a great place to visit. My hon. Friend makes a serious point. As I said in my statement, there is scientific advice against moving too soon or overreacting, as there is against moving too slowly or not reacting strongly enough. We need to take the measures that are necessary to protect the public.

On taking measures that do not protect the public, the advice is that all of us in a position of responsibility whose communications are heard widely, whether we are Members of this House or members of the media, have a duty of responsibility, because how this is communicated will have a direct impact on how well we as a country cope with this outbreak.

Photo of Nick Smith Nick Smith Labour, Blaenau Gwent

Hospital cleaners and porters keep us safe, so will the Government increase SSP to full pay for all staff forced to self-isolate? Low-paid workers in our NHS should not be financially penalised for doing the right thing.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

As I said, we are keeping the rules on SSP under review. As we directly employ people in the NHS, I am having a conversation about it with the chief executive of the NHS.

Photo of Mark Harper Mark Harper Conservative, Forest of Dean

The Secretary of State will know there are two confirmed cases in Gloucestershire, and I put on record my thanks to the public health professionals who have dealt with those cases in a professional, calm and considered manner.

My specific question is about the action the Department for Work and Pensions will take for those members of the public who, whether because of business downturn or because of self-isolation, have to access the benefits system. Will frontline DWP staff and systems accommodate the fact that self-isolation, as the Secretary of State says, should be treated as an illness and that no inappropriate sanctions should be applied?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We are absolutely clear that that is the rule, and I frequently talk to the Secretary of State for Work and Pensions about this matter.

Photo of Matt Rodda Matt Rodda Shadow Minister (Transport) (Buses)

Following the outbreak at Willow Bank Infant School, will the Secretary of State update the House on the work he is undertaking with the Department for Education, local authorities and schools to help contain the outbreak?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

The broader point is that it is very important that schools do not close if they are not advised to close. Again, it is about following the medical advice. If there is no epidemiological reason to close, a school should not be closing.

As of 11 am today, I understand that 10 schools are closed. Seven of the 14 schools that were reported yesterday as having closed are now open, so this is a dynamic situation. The DFE is doing a fantastic job, and I pay tribute to my right hon. Friend the Minister for School Standards, who has been working night and day to make sure that, where possible, children are at school.

Photo of Alec Shelbrooke Alec Shelbrooke Conservative, Elmet and Rothwell

My right hon. Friend will recall that I raised the issue of motorway service stations a couple of weeks ago. Coming down this week, I still did not see any signage about the health precautions that can be taken. May I urge him to investigate whether he can buy up advertising space in lavatory areas to make sure the message is clear so that people understand the hygiene steps to take?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

That is an important point. We are launching an enhanced communications programme tomorrow, and I will check with my team whether it includes adverts in motorway service stations.

Photo of Liz Saville-Roberts Liz Saville-Roberts Shadow PC Spokesperson (Home Affairs), Shadow PC Spokesperson (Women and Equalities) , Plaid Cymru Westminster Leader, Shadow PC Spokesperson (Justice), Shadow PC Spokesperson (Business, Energy and Industrial Strategy)

Rural Wales has a high percentage of self-employed people, and data from the Office for National Statistics suggests that 23% of households in Gwynedd are self-employed, compared with a Welsh average of 16%. What provisions have the four Governments made to assure self-employed people that they will be compensated for lost income arising from the covid-19 outbreak?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I am working with both the Secretary of State for Work and Pensions and the Welsh Government, who have played their part with great care and responsibility in rising to this challenge.

Photo of Stephen Hammond Stephen Hammond Conservative, Wimbledon

I thank my right hon. Friend for his statement and commend him for his handling of this outbreak. The public health advice has been absolutely clear during the contain phase. As we move into the delay and mitigate phases, will he make sure the advice on social distancing and longer isolation periods, particularly for vulnerable groups, is as fast and has the same clarity?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes. We are upgrading the communications activities tomorrow but, should we move into the mitigate phase, the communications will clearly need to be different and will need to be upgraded yet again.

Photo of Meg Hillier Meg Hillier Chair, Public Accounts Committee, Chair, Public Accounts Committee

We have known for years that people on outsourced contracts do not have access to sick pay. The coronavirus is now throwing up that problem for the wider community, yet we heard the Secretary of State for Business, Energy and Industrial Strategy talk about people going on to universal credit—he does not live in the real world if he thinks that is possible within three days—and the Secretary of State for Health and Social Care talk today about seven days’ isolation and, when pressed, about ringing the GP. Can he give very clear advice to those who have to choose between working and eating, so that we make sure they do not go to work when they are ill?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I have been absolutely clear about the legal position, and I have said that we are keeping the area under review.

Photo of Craig Mackinlay Craig Mackinlay Conservative, South Thanet

As cases escalate, and we have to assume they probably will, even a well-prepared NHS will become stretched, with health professionals likely to be affected. Self-help will become important, and we are already seeing a national shortage of hand-sanitising gel. Will my right hon. Friend work with the manufacturers to ensure basic products such as paracetamol, ibuprofen and cough medicines remain widely available on the high street?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

My hon. Friend is completely right and, in fact, our no-deal planning and our no-deal stockpiles are playing an important part in making sure we are fully prepared and ready.

Photo of Hilary Benn Hilary Benn Chair, Committee on the Future Relationship with the European Union, Chair, Committee on the Future Relationship with the European Union

On when to move to the delay phase, the Secretary of State said that he was

“mindful of scientific advice that reacting too early…carries its own risks”.

Could he set out for the House what those risks are?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I would highlight two. The first is that there is an economic and social impact of disruption; if an action has no medical benefit, there is no need for that disruption. The second is a medical risk. Behavioural science and experience from previous similar outbreaks shows that, if we ask people too early to do things that are disruptive to their normal life, they may try to return to normal earlier than they otherwise would. At the moment, the number of cases is relatively small. If we go into the reasonable worst-case scenario, it will rise sharply and be high for a number of weeks. We need to keep people doing the right, responsible thing over a period of weeks and, if we ask them to move too soon, they may question whether that advice was the right advice.

Photo of Steve Brine Steve Brine Conservative, Winchester

Experience here suggests that these outbreaks are about cool heads and timing, and I suggest that the Secretary of State, his chief medical officer and his Public Health Minister have been exemplary in both those things. Does he agree that the media have a responsibility in this regard? You do not release everything in the locker at once. That is not about the Government being slow to this; it is about the Government having a plan. What they have set out today is a clear, strategic and staged plan to do what is needed, when it is needed, in the national interest.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I am grateful to my hon. Friend for what he says. We are trying to take exactly the approach that he sets out. It builds on my answer to Hilary Benn on getting the timing right as well as the decisions on the correct actions to take. We need to get both right. We will be guided by the science in supporting the public through what will be a difficult time.

Photo of Yvette Cooper Yvette Cooper Chair, Home Affairs Committee, Chair, Home Affairs Committee

The Health Secretary will know that many people are caring for elderly relatives, sometimes just popping in every day to make sure they are fed or to get them up in the morning. If those people end up having to self- isolate or getting ill, what support will there be for them —they may not be getting any sick pay—and for the elderly relatives who depend on some urgent support and may not have any other relatives nearby to provide it?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We are very concerned about this issue. We will address precisely the issue that the right hon. Member raises in the communication that I indicated we will publish soon to social care providers. This is an important and difficult consideration for what we do in a reasonable worst-case scenario. Of course, all the time, we are working to avoid that scenario. One area that has been highlighted in public is making it much easier to onboard volunteers, but they are not the only part of the answer to this problem.

Photo of Craig Whittaker Craig Whittaker Assistant Whip

GAMA Healthcare in my constituency is playing a vital role in China as part of a bundled approach to infection control of covid-19. Adrian Fellows, a scientist from GAMA, says that washing hands is vital, but his concern is that every handwash is being promoted as an effective intervention, even those that are cosmetic-based, and supermarket sanitisers without a log 4 reduction are running the risk of giving a false sense of security. Will my right hon. Friend ensure that Government advice on hand washing is thorough, so that people do not run that risk of having a false sense of security?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I will look into our guidance on the nature of hand sanitisers and make sure that it takes into account the very best scientific advice. There is a broader point here, which is that although sanitising one’s hands with hand sanitiser is good, it is not nearly as good as washing one’s hands for 20 seconds with soap and, preferably, in hot water. That is the best thing to deal with the virus.

Photo of Lloyd Russell-Moyle Lloyd Russell-Moyle Labour/Co-operative, Brighton, Kemptown

I thank the chief medical officer for ringing me when we had cases earlier in the month in the city; it was very helpful advice. The advice that the Secretary of State has just given is that we need to wash our hands. So will the Government make moves to ensure that, when you enter any building in this country, there is a place for you to wash your hands? I am not just talking about advice; can we introduce health and safety guidelines to put a requirement on every employer, every restaurant and so on? If we are going to take this seriously, we need to up our game. Will the Government commit to that now?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I will look into the extent to which that can be done. Many public buildings do have sinks available. At the core of our response to the problem, which the hon. Gentleman reasonably raises, is getting the communications right, so that people can use existing sinks and soap to do what I know he wishes them to do.

Photo of Anthony Mangnall Anthony Mangnall Conservative, Totnes

I thank the Secretary of State and his team for keeping me informed yesterday of the two local confirmed cases of covid-19, but a number of schools decided to close their doors as a precaution. What message does he have for those schools and others across the communities as to how to deal with this issue?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I commend my hon. Friend for the responsible and calm way in which he has responded to the news in his constituency. The message to schools is clear: if you do not have both a positive case and the advice from Public Health England to close, you should not close. The Minister for School Standards, who is sitting next to me, reiterates that message. We have a hotline that schools can call to get that advice from Public Health England, and schools that close without the advice from PHE are contacted by the regional schools commissioner, who explains to them the position.

Photo of Daisy Cooper Daisy Cooper Liberal Democrat Spokesperson (Justice), Liberal Democrat Spokesperson (Digital, Culture, Media and Sport)

There are now four confirmed cases of covid-19 in Hertfordshire, yet Hertfordshire has an unfunded burden in next year’s financial budget of £2.8 million from the cost of the pay uplift for nurses and health visitors under the “Agenda for Change” programme. I am told that potentially up to 30 directors of public health across this country are poised to have to cancel contracts and make school nurses and health visitors redundant if this money is not confirmed. With less than a month until the next financial year, can the Government confirm today, or within the next 24 hours, that the money for the “Agenda for Change” pay uplifts will be made available?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We have increased the public health grant and we have increased local authority spending power by 4.4% in real terms next year, which of course comes in at the start of April.

Photo of Alan Mak Alan Mak Conservative, Havant

My constituency includes a number of semi-rural, coastal and isolated communities, where information on as local a basis as possible will be needed, not just the national picture. Can my right hon. Friend provide me with the relevant departmental and Public Health England contacts so that I can obtain this information in real time?

Photo of Emma Hardy Emma Hardy Labour, Kingston upon Hull West and Hessle

Can the Secretary of State confirm that claimants will not face benefit sanctions if they miss appointments because they are choosing to self-isolate?

Photo of Robert Halfon Robert Halfon Chair, Education Committee, Chair, Education Committee

Will my right hon. Friend thank the Princess Alexandra Hospital in Harlow for dealing with a case and for all the work it does? May I bring him back to the issue of workers? In Harlow, at least 8,000 people are working in retail, food, customer service, front-of house, leisure, transport and accommodation services. Those people, who are often on lower pay, could lose their wages, especially if restaurants cut the number of staff, for one reason or another, in the event of a serious outbreak. Will the Government consider setting up an insurance scheme if things get much worse to ensure that individuals such as the workers I have mentioned do not lose their incomes?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

As I have said several times, we are keeping this area under review. We are also looking into what we can do to support successful businesses that might have a short-term negative impact from some of the disruptions that have come with, and could come further with, coronavirus.

Photo of Alex Norris Alex Norris Opposition Whip (Commons)

Sick pay and statutory sick pay can be complex, but there is one simple truth within that system: the poorer someone is, the poorer their protections are. Those very worst-off at work want clarity from us that doing the right thing and following the Secretary of State’s guidance will not put them at a detriment. Nothing in the public conversation and, frankly, nothing we have heard today gives me confidence to say that to people in my community, so will he take this opportunity to say, from the Dispatch Box, that not one single person in this country who is following his advice will suffer a detriment to their terms and conditions?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I have already made it clear that we have a robust statutory sick pay system in this country, that self-isolation counts as illness within that system and that we are keeping the system under review. So people can have confidence that, if they are asked to self-isolate, that is exactly what they should do.

Photo of Laura Trott Laura Trott Conservative, Sevenoaks

Sadly, it is healthcare professionals who are likely to be most exposed to the virus. What steps is the Secretary of State taking to make sure that we have sufficient numbers of healthcare professionals at work to deal with this crisis?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

That is an incredibly important issue, not least because of the impact of the virus directly on healthcare workers in other jurisdictions—we have seen the impact here, too. We have a broad programme, led by the NHS, to make sure that we protect healthcare workers—not only clinicians but the non-clinicians mentioned by Daisy Cooper—and have as much support in the NHS as possible, including from, for instance, recently retired people, and from volunteers, as mentioned earlier. If the virus becomes widespread, it will be all hands to the pump in the NHS, as with social care. We have extensive planning under way to make sure that the NHS can respond.

Photo of Chris Matheson Chris Matheson Shadow Minister (Cabinet Office)

I have been contacted by a constituent who is a consultant in emergency medicine at the Countess of Chester Hospital, which the Secretary of State knows well. My constituent has expressed concern about the use of nebulisers for the delivery of medicines for respiratory illnesses, on the basis that there is evidence that they might enhance the spread of airborne viruses in a confined space. I have been in touch with Public Health England about the issue, and there is some debate as to whether it agrees with my constituent, but he has provided evidence from the 2003 SARS outbreak that demonstrates that his fears may be upheld. It is a technical point, but will the Secretary look into it and get his officials to check it out?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes, of course. I would not dare to pronounce on the science and medicine behind that, but I can ensure that the experts, including the deputy chief medical officer, who is an expert in these things and is in the Box, will respond.

Photo of Stephen Crabb Stephen Crabb Chair, Welsh Affairs Committee, Chair, Welsh Affairs Committee

I commend the Secretary of State for the constructive way in which he has worked with the other Health Ministers in the devolved Administrations to get this plan ready for today, but may I remind him of the importance of continuing this approach as the situation unfolds in the days and weeks ahead, to ensure that there is a genuine, joined-up, UK-wide strategy to combat coronavirus?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes—I would say that this is an example of the devolved Governments and the UK Government working well together. The best example of that is the four chief medical officers. As my right hon. Friend well knows from his time as a Secretary of State, each devolved nation has its own CMO, and the forum of the four of them provides an extremely useful place to debate and then to agree, so that we can have a UK-wide answer even though some areas, such as NHS delivery, are devolved.

Photo of Caroline Lucas Caroline Lucas Green, Brighton, Pavilion

In times of crisis, fear can foster discrimination. There is serious concern about reports of racism being linked to the coronavirus outbreak, with people being singled out and abused simply because of east Asian appearance, and some children being bullied. Does the Secretary of State agree that inaccurate terms such as “Wuhan coronavirus” should be avoided because they sadly reinforce racist views? Will he take steps to ensure that Government communications always use medically accurate terms? Will he ensure that the Cabinet acts to ensure that everything possible is done to stop the denigration and blaming of people in relation to this outbreak?

Photo of Andrew Bowie Andrew Bowie Conservative, West Aberdeenshire and Kincardine

I thank my right hon. Friend for his statement. Following on from the question by my right hon. Friend Stephen Crabb about working with the devolved Administrations, will my right hon. Friend the Secretary of State confirm that although the delivery is devolved, this is a whole-UK plan? There should be no confusion in any of the devolved areas of the United Kingdom: this is a UK-wide plan and the information published today is applicable to and the same for every part of the United Kingdom.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

That is right; in fact, the document is badged with the emblems of the four nations. There are of course elements of it that are technically different in terms of delivery, but they are set out in the plan.

If I may take a step back, the deputy chief medical officer has already got a note to me to answer the question from Christian Matheson. The expert committee NERVTAG —the new and emerging respiratory virus threats advisory group—has looked at the issue of nebulisers and does not consider their use an infection-prone procedure.

Photo of Chris Bryant Chris Bryant Labour, Rhondda

Unless something has changed overnight, the 111 service is not available in most of Wales. Most people in Wales would be far better advised to ring 0845 46 47, which is the NHS Direct Wales telephone number. My bigger anxiety is that so far, despite all the good things he has done, the Secretary of State has still not been able to answer the central question of people on zero-hours contracts. They include a large number of my constituents, who would want to do the right thing but, according to what he has said so far, would be financially out of pocket because there is no means of recompensing them. Surely we must put that right; otherwise, we have a massive hole in the plan.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

As I have said many times, we have a robust SSP system and we keep it under review. On the hon. Gentleman’s point about 111, we have changed the system so that if someone dials 111 from Wales, they are automatically redirected to the NHS Direct number in Wales.

Photo of Richard Graham Richard Graham Conservative, Gloucester

I welcome the Secretary of State’s clarification that schools should not close unless they absolutely have to—not least because if parents are having to look after their children, there may be fewer nurses and doctors who can get to hospitals. My right hon. Friend knows that the average age of hospital volunteers—including my fellow workers at the Gloucestershire Royal Hospital—is in the range that could be at risk of this virus, and they are often receptionists, so will he consider asking the NHS to give guidance to hospitals on whether such people should be on the frontline, with people still coming to hospitals thinking that the best thing to do is to be checked?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

In the first instance, the best thing to do if you think you have coronavirus is not to go to a hospital or GP surgery but to ring 111, wherever you are in the UK. My hon. Friend is quite right on the other point he made.

Photo of Alison Thewliss Alison Thewliss Shadow SNP Spokesperson (Treasury)

I am strongly in favour of getting the habitually clarty to wash their hands, so I am glad that the Secretary of State is reinforcing that message. May I ask him specifically about the advice to Department for Work and Pensions decision makers? What advice has been circulated within the DWP, and can all elected Members get a copy of it, just in case any of our constituents find that that advice is not being followed through?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

I will take that issue up with the Secretary of State for Work and Pensions.

Photo of Paul Holmes Paul Holmes Conservative, Eastleigh

I thank the Secretary of State for his statement. I am sure he would agree that as the virus possibly spreads, members of the public will be worried about what they should and should not be doing, so will he confirm how he will specifically communicate with members of the public to prevent panic, particularly if we have to restrict public meetings and the use of public transport?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

That is a very good question and it is important that we get that right. One reason why we have set out this plan, which includes measures that we hope not to take and may not take but are prepared to take if necessary, is that, should those measures be taken, it will not be a surprise to people—they are clearly part of a plan. I do understand—of course I do—that people are worried about this, and I also understand that some of the things we are proposing, and some that other countries are doing, are not the sort of things that a Government in a free country normally does. That is why we have taken this approach. It is quite unusual in Government to set out a plan of things that we might do; we normally set out what we are going to do. The reason we have done so is precisely in response to the concern that my hon. Friend wisely raises. We want to do everything we can to reassure people, while not over-reassuring and instead being totally transparent about our frank assessment, based on the science, of the situation that the country is in and what we can best do to get ourselves best through this and fight this disease.

Photo of Diana R. Johnson Diana R. Johnson Labour, Kingston upon Hull North

For the trusts that host regional infectious diseases units, will the Secretary of State say what additional emergency money is going into them now and whether there are plans to extend those units to increase bed capacity?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

We do have plans to be able to ramp up the bed capacity that can be used to deal with coronavirus patients, and, as I said earlier, we have already extended funding to trusts and are willing to consider that further if necessary.

Photo of James Wild James Wild Conservative, North West Norfolk

People are understandably concerned, and I have been contacted by some of my constituents about potential treatments, including vitamin therapy, that are appearing on the internet. Will my right hon. Friend send a clear message from the Chamber that it is the NHS and the Government who will provide the authoritative advice on medical treatments? Will he work with social media companies to remove any misleading content?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes, and that is a very important point. Fake news in response to a virus like this can be dangerous and damaging to health and it should be taken down. I am working with the social media companies—I spoke to the main social media companies yesterday—and the biggest of them are playing a very responsible role. If someone searches on Google, the top two sites that come up for coronavirus are from the World Health Organisation, and the NHS is third. Google is promoting good, high-quality, medically informed advice, and the other social media platforms—the major ones with which we are working—are also taking this very seriously.

Photo of Geraint Davies Geraint Davies Labour, Swansea West

Does the Secretary of State agree that the key drivers of aggregate transmission are, first, the level of movement and, secondly, the level of assembly? Will he therefore take this opportunity to advise elderly people in particular, who are more at risk, that they would be well advised to restrict their movements—perhaps go to the shops once a week instead of twice—and to work as and when they can in a sustainable way from home rather than at work? Does he also agree that we should, if at all possible, avoid big assemblies of people as transmission rates are higher there? If not, we will end up having to enforce roadblocks and confinement much more quickly than otherwise.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

No, we will be advised by the science. The point that has been raised many times is that timing is really important. There are downsides in terms of the destruction and medical downsides in terms of controlling the spread of this virus if things are done too soon. I am very happy to arrange a briefing for the hon. Gentleman —a briefing is available with the chief medical officer at 4.15 pm today for anybody who wants a private briefing—and to take him through some of that science.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

I thank the Minister for his diligence. There are some 11.8 million elderly people, which is 18% of the population, and some 4 million diabetics, which is 6% of the population. I declare an interest as one of those. Those who have had the flu jab to protect them from the flu may feel that they are okay. Will the Minister give guidance to this section of people—those with chronic diseases and the elderly who have had the flu jab?

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

Yes, we are paying particular attention to vulnerable people—the elderly and those with other health conditions that may make them either more susceptible or more at risk should they get this virus—and there will be additional advice in due course, guided by science, as all of us should be in tackling this disease.

Photo of Vicky Foxcroft Vicky Foxcroft Shadow Minister (Digital, Culture, Media and Sport) (Civil Society)

The Secretary of State has been asked about this several times, and I am slightly worried that he just does not get it. Some working people do not get sick pay. We really need to know what his plans are for them.

Photo of Matthew Hancock Matthew Hancock Secretary of State for Health and Social Care

As I have said, I have provided answers to that question a number of times, including that we are keeping this under review, and that the sick pay system is robust. I look forward to answering more questions in the same way. I cannot give a different answer to the one I have given to the same question when it has been repeatedly asked.