Covid-19 - Statement

– in the House of Lords at 6:02 pm on 23rd April 2020.

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The Statement was made in a Virtual Proceeding via video call.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, I shall now repeat a Statement on coronavirus that was made yesterday in the other place. The figures have changed since then and this Statement contains up-to-date figures. The Statement is as follows:

“Mr Speaker, first, may I say how pleased I am that the House is sitting once again? At this important time, it is critical that we have the scrutiny and debate provided by this House. I would like to thank everybody involved in setting up these new arrangements. This has demonstrated that no virus, and no threat, will thwart our democracy.

Coronavirus continues to spread throughout the world. The latest figures show that 18,738 people have sadly died here. Our hearts, and the hearts of the whole House, go out to their loved ones. I know that, across the House, we are all united in our determination to fight the virus with everything we have. Today, I wanted to update the House on each part of our battle plan.

First, on the resilience of the NHS, I can tell the House that, for the first time, we now have over 3,000 spare critical care beds in the NHS. That is over three times more than we had at the start of the crisis. It is thanks to the incredible work of an awful lot of people that we have this extra spare capacity, even before we include the new Nightingale hospitals.

Over the past two weeks, I have been lucky enough to attend, either in person or virtually, the opening of four of these new Nightingales—in London, Manchester, Birmingham, Bristol and Harrogate—and there are several more to come, all across the UK, including in Belfast, Glasgow, Cardiff, Exeter and Sunderland. These incredible efforts from our dedicated staff, supported by our Armed Forces, mean that our NHS has at no point been overwhelmed by the coronavirus. Some said this would be impossible.

Today, I want to reinforce the message that non-Covid NHS services are open to patients; the NHS is there for you if you need advice and treatment. I want to address that message very clearly to those most vulnerable to heart attacks and strokes, to parents with young children, to pregnant women and to people with concerns that they may have cancer. I want to emphasise that people with non-coronavirus symptoms must still contact their GP. If you think you need medical help, please contact your GP either online or by phone to be assessed. If you need urgent medical advice, use the NHS 111 online service, or if you cannot get online, call 111. And, of course, if something is serious or life-threatening, call 999. If you are told to go to hospital, the place you need to be in is a hospital. The NHS is there for you and can provide the very best care if you need it.

The second point of our battle plan is on supply and working to boost supplies of core equipment. The full weight of the Government is behind this effort, and again we have brought in our Armed Forces to help us to meet this demand. This includes ventilators—both purchasing extra stock and increasing the production of new ones. We now have record numbers of ventilators, with 10,800 available for use by patients. It includes medicines, so that we can make sure everyone has access to the supplies and treatments they need. And, of course, it includes personal protective equipment too.

In normal times, the NHS PPE supply chain supplies 233 hospital trusts. Currently, 58,000 separate health and social care settings are being supplied with PPE, so we are creating that whole new logistics network from scratch. We have some of the best minds in the country working on this. I am grateful to colleagues from the NHS and Public Health England, the Crown Commercial Service and the Cabinet Office, the Ministry of Housing, Communities and Local Government, the Ministry of Defence and the Armed Forces—again—the devolved Administrations and territorial offices, the Business Department, the Treasury, the Foreign Office and the Department for International Trade, because they are all playing their part.

Last week, I appointed my noble friend Lord Deighton, who delivered the Olympics, to a new role to drive forward PPE manufacturing here. Since the start of this crisis, we have delivered 1 billion items of PPE. We are constantly working to improve the delivery system by buying PPE from around the world. We are also working to make more at home, and I would like to thank all the businesses that have generously come forward with offers to turn their production lines to part of this national effort. I would also like to thank Members from across the House who have put us in touch with businesses in their constituencies. We are actively engaged with more than 1,000 companies that buy from abroad, and we are working with 159 potential UK manufacturers. We have a rigorous system of verifying the offers that we receive, because not all offers have been credible, and it is important to focus on the biggest, most credible offers first. This work is crucial so that we can get our NHS and care staff the kit they need so they can do their jobs safely and with confidence.

The third part is to scale up testing. I have set the goal of 100,000 tests a day by the end of this month. I am delighted to say that that capacity is ahead of plans, even though the demand has thus far been lower than expected. We are therefore ramping up the availability of this testing and expanding who is eligible for testing and making it easier to access the tests. The tests are being conducted in NHS hospitals, as well as through our drive-through testing sites, mobile units and home deliveries. The tests are then sent to laboratories. We now have completed the construction of three Lighthouse Labs, in Milton Keynes, Glasgow and Cheshire. Each site took just three weeks to complete and begin testing. Further, as we have reached the peak and as we bring the number of new cases down, so we will introduce contact tracing at large scale.

The introduction of the new NHS app for contact tracing is also in development. As we do this, we are working closely with some of the best digital and technological brains, along with renowned experts in clinical safety and digital ethics so that we can get all of this right. The more people who sign up for this app when it goes live, the better informed our response will be and the better we can therefore protect our NHS.

Fourthly, we need to make sure that we make the best possible use of science and research to pursue the vaccines and treatments that are essential to defeat this virus once and for all. Here, the NHS is at the forefront of the global effort. We have put more money into global efforts to search for a vaccine than any other country, and yesterday I announced over £40 million of funding for two important projects at Imperial and at Oxford. The vaccine from the Oxford project will be trialled in people from tomorrow, and I am sure the whole House will agree that this is a very promising development.

I will repeat what I said yesterday. In normal times, reaching this stage would take years, and the combination of innovative groups of people at the Jenner Institute in Oxford and the regulator, the MHRA, deserve our special praise because they are both ensuring that the process is safe, yet conducted probably more rapidly than ever before. They deserve the support of the whole House in that work. At the same time, we will invest in manufacturing capability because, if either of these vaccines work, we must make it available to the British people as soon as humanly possible.

The fifth measure that I will talk about in the time available is the one where everyone can play their part: social distancing. I want to thank everyone, across the country, for their steadfast commitment in following the rules, including in this House. It is making a difference. We are at the peak. But before we relax any social distancing rules, or make changes to them, we have set out the five tests that have to be met: first, that the NHS can cope; secondly, that the operational challenges have been met; thirdly, that the daily death rate falls sustainably and consistently; fourthly, that the rate of infection is decreasing; and, most importantly, fifthly, that there is no risk of a second peak.

Finally, we are working to protect the most vulnerable through shielding—this is the sixth part of our battle plan. There has been a huge effort under way across government to contact and support those at risk. We have been boosted by the support and help of the heroic NHS volunteer responders, who signed up in droves within two days of our call to action. An unbelievable 750,000 people put themselves forward for this initiative. With those volunteers, and with the support of the Ministry for Housing, Communities and Local Government, the NHS and local councils, which have done amazing work on this, we are shielding the most vulnerable.

These are unprecedented times for us all. We have all seen the extraordinary impact of coronavirus in our constituencies and all across the country. And even though today we are physically separated, this House is at its best when we are united in our purpose and our resolve. I will keep working with Members right across the House in this fight against this invisible killer. This may be akin to a war, but it is one where all of humanity is on the same side. I commend this Statement to the House.”

Photo of Baroness Thornton Baroness Thornton Shadow Spokesperson (Health) 6:13 pm, 23rd April 2020

My Lords, I thank the Minister for repeating the Statement. I join him and the Government in saying that our thoughts are also with all those who have lost their lives to this horrible virus. I pay tribute to the NHS and social care staff who have lost their lives. I know the Minister agrees that the number of victims who appear to have come from BAME communities is very concerning. Can he confirm reports that BAME people make up 72% of all NHS and carer deaths with Covid-19?

We welcome the announcement of an inquiry. It would be great if the Minister could provide further information about the scope of the inquiry and when it will report its initial findings.

The Minister said he believes that we are now at the peak, but we are nevertheless heading for one of the worst death rates in Europe. The Government have told the public that their response to the pandemic will always be guided by science but, as the Minister will be aware, there are often different views within the scientific community, so I repeat the call that we have made from these Benches in the past that the Government should publish the evidence underpinning their decision to recommend, for example, a seven-day rule for isolation. This is important for public confidence, given that the Government’s advice appears to contradict the advice by the World Health Organization, which advocates a 14-day rule for isolation based on evidence that people can still transmit the virus after 10 days or more.

Despite many questions, it remains unclear why the UK did not participate in some of the European procurement projects. The Chancellor of the Duchy of Lancaster said this was because we missed an email, whereas a senior civil servant at the Foreign Office said in evidence to a Select Committee that it was a political decision, before retracting that comment several hours later. The lack of transparency is deeply unsatisfactory. It would help if the Government published a background briefing so that we could see exactly what happened. We believe that it is necessary to get to the bottom of this situation now to ensure that the UK takes part in any future EU schemes that may help us deliver PPE to those putting their lives at risk on the front line.

The Government have repeatedly said that they are “ramping up”—this is an expression I do not enjoy, and I certainly intend never to use it myself—testing capacity, but the latest statistics show that only 14,629 NHS tests were carried out in the last 24-hour period, eight days before the Health Secretary’s self-imposed deadline to reach 100,000 tests. This is despite testing centres having a capacity of 39,000 checks a day. Why is more than half the country’s testing capacity still going unused when tens of thousands of NHS and social care staff, along with other critical workers, are being forced to self-isolate because they have not been tested? It is very concerning that the number of tests being undertaken is not increasing. Even if the capacity does reach 100,000, that is not the same as access. The latest statistics reveal that the number of tests performed on Tuesday was two-thirds that of the previous day. The Minister needs to tell the House what on earth is going to happen and when we can see the daily increase of tests.

Earlier this week the Health Secretary pledged to test immediately anyone in the social care sector who needed it. While elderly residents can be tested in the homes they live in, staff still have to travel. I learned earlier from the Minister that there are plans in place to change that, so I would like him to explain how soon those alternatives will come on stream.

Testing and contact tracing are vital to managing the UK’s response and easing lockdown restrictions. The new NHS app mentioned is very welcome. Can the Minister set out the timeline for when that will become available?

Finally, will the Minister confirm that the combination of some spare capacity in the NHS and the Government’s view that we now have reached the peak of the virus means that postponed NHS treatments and procedures will resume imminently? Although we understand why some elective treatments were postponed, the delay for many illnesses, including cancer, involves its own risk. It is therefore important that people receive the necessary treatment as soon as possible when it is safe to do so considering the impact of the virus. What support are the Government giving to trusts to help them manage demand amid the ongoing situation and give patients confidence that they will be treated in a Covid-free hospital?

Photo of Baroness Brinton Baroness Brinton Party Chair, Liberal Democrats, Acting Leader, Liberal Democrats

I thank the Minister for repeating the Statement and for his work on testing. We may have some difficult questions for him, but I hope I have the support of the whole House in saying thank you to him and his team for the work they are doing on this difficult area.

I too thank all the staff and volunteers in the NHS and the wider social care sector and other key areas who have been working during this crisis, whether directly on the front line or in supporting families and our children in schools. We send our condolences to the families of the bereaved, and are pleased that many people are recovering, even though we know that, if they have had it badly, it takes time. From these Benches, we echo the concerns about the high percentage of BME deaths, among workers and non-workers alike.

The Statement says that there are 3,000 spare critical care beds, but ITV reports that care home residents now account for up to half of Covid deaths. However, last week the Daily Mail reported that care home residents were still being asked to sign letters to say that they would not go to hospital in the event that they had Covid-19. Will the Minister confirm that these critical care beds in hospital are not spare? There are plenty of people in care homes who could use those beds but they have been put under pressure, no matter how gently, to sign the letters.

It is good to see the Nightingale hospitals coming on board—even if they are empty, for the right reasons. One of the concerns expressed has been about the staffing and the initial request that any patient had to have staff accompanying them from their previous hospital. Can the Minister say that this has now definitely stopped and that staff with appropriate critical care experience are able to be recruited? I gather that this has also been a problem for increasing the number of beds.

There was a good message in the Statement for people to go to their GPs and to use 999 for emergencies, but today there was a report of somebody who had a severe heart attack not being picked up urgently, as heart attacks are still second-level priorities to Covid. As a result of that 20-minute target rate, sadly the patient died. Is there any rebalancing of priorities for ambulances now that we seem to be over the peak of cases?

On equipment and medicines, it is good to hear that there are now just over 10,000 ventilators. Are they full ventilators, or does that include CPAP and BiPAP machines? How many more are to come? There have been some worrying shortages of medicines for those who need to be sedated, and recently we have heard news that there is a problem with kidney dialysis and kidney medicine for people who have come out of intensive care and require long-term support. Is there a shortage of such medicines, what other medicines are at risk and what proposals are there to remedy that problem?

We have spent many hours today talking about PPE. We are still waiting for supplies for everything outside hospitals. On 6 April, Clipper was heralded as being about to solve this problem, but it is still woeful. Until the social care and community sectors get the support they need, they will continue to be worried about the spread of Covid.

The Turkish ambassador has written to various people in the APPG on Turkey, setting out the actual arrangements—as opposed to those reported by the Government—concerning the delay in the package that appeared to get stuck. Turkey actually donated 250,000 pieces of medical protection equipment to us; the rest came through privately. Can the Minister say when the remainder of the consignment due from a Turkish supplier will arrive?

It is good to hear that formal arrangements for testing, tracking and tracing are now under way, but the WHO always puts in a third word alongside “test” and “trace”: “isolate”. Any mention of isolation in the Statement is notable by its absence. Taiwan, South Korea and Hong Kong have all managed to suppress further bursts of Covid because of the arrangements for not just testing and tracing but isolating. It is good to hear that an app will be available, but the Minister will know that there are people with technical experience concerned about whether it is appropriate to use Bluetooth for it, because of security issues. Can the Minister assure the House that this is not the case and that people’s data will be used only for NHS purposes and will absolutely not be able to be used by any providers of the app or beyond? The 18,000 tracers announced by the Secretary of State just before this Statement are a good start, but we will need more for good national coverage. Worryingly, Mr Hancock said a few days ago that all this will be operated centrally. Is that still the case, or will he use the existing trained tracers that there are in local communities, whether environmental health tracers in councils or in local health teams? It seems rather bizarre to try to cover the country on that level.

On shielding, it is good that there is a request to create more volunteers and to celebrate the volunteers, but notable by their absence in the Statement are the many people who have not yet had their letters on shielding and whether any further groupings may have to consider shielding—which I understand is the case.

I congratulate the Government on their progress on test and trace, but confirm that we are extremely concerned about supplies of equipment and medicine and hope that things will be remedied speedily.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My Lords, I greatly thank the noble Baronesses, Lady Thornton and Lady Brinton, for their extremely perceptive and thoughtful questions. I will answer them, in the words of the moment, at pace.

The noble Baroness, Lady Thornton, asked about BAME. The precise figures for BAME deaths are not to hand. PHE will have a very thorough investigation into this. It will come up with a scope and a delivery date shortly.

On isolation, one of the frustrating and awkward things about the virus is how unpredictable it is and how many unknowns there are. It confounds expectations. The question of isolation remains one for which we are reviewing our advice. We are in constant contact with other countries to learn more about best practice.

On the European project, I make it absolutely 100% clear that there was a cock-up, not a conspiracy. There were emails from Europe to us that were missed; there were meetings that our side missed. It was a great shame that that opportunity was missed, but we have put in place the processes and arrangements to work with our European partners on future procurement if they are helpful to the NHS and our care system.

The noble Lady, Baroness Thornton, is quite right to ask about capacity and testing. The blunt truth is that infection rates have gone down dramatically. The lockdown has had a profound impact. The KCL infection rate graph has gone from 2 million to half a million. That has a profound effect on demand for tests. Access is no longer a problem. At 5 pm, on the No. 10 presser, the Secretary of State explained how key workers can access a test for themselves. A major advertising campaign will begin tomorrow. They can either attend the drive-ins or Amazon will deliver a test to their home. Therefore, for those without a car, travel is not necessary. That capacity will be essential when we build the kind of track and trace capability that we will need to take us out of lockdown.

The noble Baroness, Lady Thornton, asked about postponed treatments. I echo her sentiments entirely. It is of grave concern that the numbers of non-Covid deaths can be worse than of those who die of Covid themselves, as in any epidemic. The message in the Statement is crystal clear: if you need treatment, contact your GP or your hospital. We will do everything we can to give you the treatment that you need. We are trying to use this hiatus to clear some of the backlog. The noble Baroness mentioned cancer. That is a particularly tricky problem because those cancer patients in treatment who have challenging immune systems will not wish to attend hospitals where there is Covid. We are doing all that we can to try to make arrangements and provide hygienic arrangements for them.

The noble Baroness, Lady Brinton, asked about care beds. Let me slay one myth: the ONS is very clear about the proportion of deaths at care homes. It is 10%. It is an offence to misrepresent the cause of a death. Causes of death are reported to PHE. The CQC carries that information to the ONS. These are reliable figures and I would be glad to send those who suggest that it is more than that the details on the ONS website. There is no pressure on anyone to be in a bed that is not recommended by strong clinical advice. It is true that we have spare hospital bed capacity, but it is not true that we are pressurising anyone to stay in a care home who should be in a hospital bed.

The noble Baroness, Lady Brinton, raised the question of medicines. That is an area where our supply chains have been put under extreme stress. Suppliers in China, India and America have all been under pressure and we have been in conversation at government and corporate level to ensure we have supplies. The noble Baroness is right that some of the first-choice medicines for sedation have been in short supply, but there are ample and various back-ups for those medicines. She is right that a feature of the Covid disease, is, it seems, that it attacks the kidneys and there has been a big increase in the need for kidney dialysis and the drugs associated with it. We are putting in place the supply chains necessary to fill that need.

As for the Turkish ambassador, I am not going to give a blow-by-blow account of every plane and truckload of kit that comes to Britain; all I can say is that we are extremely grateful to both the Turkish ambassador and to our Turkish corporate providers and we find the scrutiny they have been put under unfortunate and regrettable.

Turning to track and trace, I confirm that isolation is an absolutely intrinsic part of the track and trace regime: it just does not rhyme so well, so you never put it at the end, but “track, trace and isolate” is the programme. I have been given a thorough briefing by the Taiwanese CMO on their use of track and trace and, having a Taiwanese wife, I can tell noble Lords that I am up to speed on their achievements in that area.

On app security, I assure the House that the Bluetooth we are using is the latent, not the overt, Bluetooth: data is not carried in the same way as in overt Bluetooth, and one of the reasons we have chosen that method is the strong security offered. I also reassure the House that we have strong data arrangements. It is one of the reasons we have gone for a latent Bluetooth technology, and no data will be shared with our technology providers.

Lastly, the noble Baroness, Lady Brinton, is entirely right to raise the tracing part of track and tracing. I reassure her that we will be using a variety of different methods. There will be a central bank of callers. We will also be using local resources where they are necessary, and we will also be using friends networks. We have learned from the best case studies from abroad that often the influence of friends in persuading people to isolate has the most profound effect.

Photo of Lord Mackay of Clashfern Lord Mackay of Clashfern Conservative 6:32 pm, 23rd April 2020

My Lords, any decisions on relaxing the present restrictions and on research into treatments and vaccines are very difficult and therefore liable to give rise to differences of opinion, even among scientists and doctors. Will the Government do all in their power to reach agreement with the devolved Administrations on any decision on these subjects? Today, the Scottish Government published Coronavirus: Framework for Decision Making, a valuable aid to reaching the agreement I have mentioned.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I reassure my noble and learned friend that one of the most distinctive and reassuring aspects of the government response to Covid has been a very strong collaboration between the four nations. That has been epitomised by the strong relationship between the four CMOs, and operationally it has been given teeth by the presence of the devolved Administrations at COBRA meetings, which I attend.

Photo of Baroness Meacher Baroness Meacher Crossbench

My Lords, I thank the Ministers for all that they are doing in this very difficult situation and, of course, all our wonderful NHS and care staff for what they do every day and every night.

As the Minister knows, the countries most successful in controlling Covid-19 are those with comprehensive testing and contact-tracing systems. We are thrilled to bits that we have two leading research teams in the country—great applause to them—but, until their vaccines are available across the country, the testing regime will be the only approach that will enable a return to any kind of normality. A large-scale sample, or provision, of testing and tracing and so on for care workers will not achieve that objective. Will the Minister tell the House if or when the Government will introduce a comprehensive—I emphasise that word—scheme of testing, contact-tracing and, as has been said, isolation, of all who have symptoms of Covid-19? This means not a sample and not just people in the care sector, but the nation. That is the only way out of the tight corner we are in. If not, can the Minister explain why?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Baroness, Lady Meacher, is entirely right in the way that she explains things. The driver of that decision is the need to get our prevalence rates and the velocity of the infection down to a reasonable level, so that we have reasonable resources to keep R down by track and trace. I remind her that South Korea, which has used this technique most effectively, does only 20,000 tests per day, because its prevalence levels and velocity of infection are so low.

Photo of Baroness Buscombe Baroness Buscombe Conservative

My Lords, I should like to say how encouraged I am by what my noble friend the Minister has said today on the progress made in tackling this virus. In asking my question, I stress that I have been urged so to do by many businesses, large and small, across the country—the backbone of our economy.

Will the Minister and his colleagues now accept that we must expect a second wave of the virus, even though we do not know when? If so, it is now crucial to look at working both with and beyond the science, and to take a balanced, proportionate and, frankly, brave decision, with Cabinet colleagues, to put trust in the good sense of the public to ease the lockdown as soon as possible—to allow the economically active to return to work, while retaining sensible social distancing —given that the situation is now having a devastating effect on our economy, and on our ability to afford our NHS, our welfare system, education system and other public services into the future.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I note my noble friend Lady Buscombe’s question, but I reject the sentiments behind it. I do not regard a second wave as inevitable; I do not share her fatalism. The priorities of the Government are to save life and to protect the NHS and our care system. That requires us to lower the prevalence level, reduce infection and put in place systems such as track and trace to keep a lid on the disease so that we can protect life and our systems.

Photo of Lord Liddle Lord Liddle Labour

My Lords, I thank the Minister for his frankness on this occasion. On European co-operation, how have we got ourselves into a situation where for PPE we are so dependent on supplies from China, Turkey and other faraway countries, and allowed ourselves to get into a position where we do not have much domestic manufacture? Similarly, on vaccines, I read a report in the Financial Times that we have no vaccination manufacturing capacity at scale in Britain. If that is the case, should we not look at whether European co-operation can help us there?

I welcome what the Minister said about testing. I had a report locally of care workers in Silloth, in the west of Cumbria on the coast of the Irish Sea, being told that if they wanted to be tested, they had to go to Gateshead, some 80 miles away, with no means of transport to do so. Will there be no repetition of that problem?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Lord, Lord Liddle, is not entirely right. We have fantastic manufacturing in the UK—I reinforce the view of my noble friend Lady Buscombe that the sector provides jobs for the economy—but we do not have low-margin, high-volume manufacturing. The image of a Burberry gown always sticks in my mind on this point. Burberry makes £500 shooting jackets, but it does not make £5 surgical gowns. That is something that we need to address, and it will be the priority of my noble friend Lord Deighton.

Photo of Lord Scriven Lord Scriven Liberal Democrat

My Lords, the South Korean prevalence rate is so low because they have tested, traced and isolated since day one. The Government initially did this and then stopped it. Ten days ago, they said that there would be 1,000 tracers; now, the figure has gone up to 18,000. Why have the Government not kept this system going consistently, which South Korea has proved reduces the prevalence rate of the virus?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Lord, Lord Scriven, is not correct to say that the Government decided to stop track and trace; there are still PHE track and traces, but when the disease reaches a certain level of prevalence, it simply is not arithmetically possible to track down every new incidence of the disease. Nor is it true that anyone in the Government said that we would have only 1,000 tracers in our call centres. Plans which I have seen are being drafted at the moment which are wildly more ambitious than that. It is our plan to put together a system that is proportionate to the challenge.

Photo of Baroness McIntosh of Pickering Baroness McIntosh of Pickering Conservative

My Lords, I declare an interest: I work with the Dispensing Doctors’ Association. It is emerging that all gowns are made to one size, which is posing a problem particularly for larger men and all women. I realise that this matter is being addressed. Can the Minister update us on it today?

I warmly congratulate my noble friend and the Government on introducing the new measures on testing and tracing. It strikes me that, if we could do this as locally as possible and perhaps look to training environmental health officers to be able to do some of the tracking and tracing, it would be a good use of their time.

When it comes to ending the lockdown, I urge the Government to follow the Swedish example of maintaining self-isolation but allowing hospitals, bars, pubs and cafés to open in a regulated and controlled manner.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My noble friend Lady McIntosh is quite right that we should look at several different workstreams for our track and trace model. As the noble Lord, Lord Scriven, implied, one of the most important things to consider is having surge capacity. Track and trace is very important when you have an outbreak or second epidemic. We need to have in place that additional capacity to track down and isolate those who bring in new infection.

Photo of Lord Touhig Lord Touhig Shadow Spokesperson (Defence)

My Lords, refugees and people with irregular status who are medically extremely vulnerable are being deterred from seeking treatment because of concerns around immigration enforcement and charging. What steps are the Government taking to ensure that no one in these circumstances is discouraged or prevented from receiving the treatment that they need?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Lord raises an issue that I remember was raised during discussions on the emergency Coronavirus Bill. It is my understanding that a generous and open-hearted view is taken on the treatment of those with irregular status in the UK. Now is clearly not the time to try to put in prison those who have irregular status. The precise arrangements escape me, but I would be glad to write to the noble Lord with a precise description.

Photo of Lord Patel Lord Patel Chair, Science and Technology Committee (Lords), Chair, Science and Technology Committee (Lords)

My Lords, the Minister mentioned in his Statement the introduction of app-based tracing of contacts, which others have already mentioned. At the same time, I assume that the Government will introduce serology testing and expand the current molecular testing. When will the Government publish the protocol for implementation of this, and how will the public be informed?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Lord, Lord Patel, will be interested to read the details of our ONS serology tests that have begun earlier this week, which will be published in mid-May. These are surveillance tests and will provide us with the information that we need to understand how the epidemic is developing. At the right time we will also bring in mass serology testing. However, as the noble Lord will be aware, when prevalence rates are around 3%, 4% or 5%, as they seem likely to be, serology tests for managing the epidemic are not relevant yet.

Photo of Lord Lucas Lord Lucas Conservative

I am delighted that the Government are taking resilience seriously. Will my noble friend confirm that the Government will have a permanent stake in the facilities and the intellectual property that they are creating, to ensure that it stays here and is well maintained? Will he also extend the interest in resilience to pharmaceutical intermediates and generics, where we are also seeing problems developing which were also problems when we were contemplating no deal? There seems to be a strong argument for having a better set of arrangements in place in this country to ensure supply in difficult times.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My noble friend Lord Lucas is quite right about IP, although I bear testimony to the private companies and major corporations which have reacted incredibly generously and enthusiastically by supporting the Government during this crisis. Our supply chains absolutely need to be reviewed. Resilience is clearly more important now than it has ever been. When we look at the way in which our medical, pharmaceutical and device supply chains are put together, they will look quite different in years to come.

Photo of Baroness Walmsley Baroness Walmsley Co-Deputy Leader of the Liberal Democrat Peers

My Lords, the Secretary of State said that he would mention treatments, but he focused only on vaccinations, which are of course important. However, I would like to ask about progress on developing antiviral drugs and the use of serum treatments, about which I have heard encouraging reports. Can the Minister say whether there are any plans to ask recovered Covid-19 patients to donate blood after a suitable recovery period so that the serum could be used to treat very sick patients and help them recover?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Baroness is entirely right. Serum offers an encouraging opportunity, not least because it is a proven technology. The national blood transfusion service has been asked to start investigating how to collect serum, and a grant for the purchase of new machines to help that has already been made.

Photo of Baroness Pidding Baroness Pidding Conservative

My Lords, my question is with regard to testing, and in particular the drive-through testing centres, where we are not seeing maximum take-up. On the priority for testing, that is obviously our key workers, both in the NHS and care homes, but I am mindful that some who may not be able to drive or who may not have access to cars. Therefore, this itself presents a challenge with regard to drive-through centres and their geographic positioning, as they can be considerable distances away. I appreciate that the Minister has already spoken about home testing, and the Statement makes brief reference to the use of mobile units. Surely this has to be the way forward, taking the testing to essential people who are in the front line. Can we not ramp up this operation, employing the expertise in logistical functions of the military? I would be grateful if my noble friend could provide more detail as to what mobile units are and how they operate.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I would like to recruit my noble friend to our testing organisation, because she has exactly the right ideas, and the programme she described is exactly what we are doing. The Army is putting together 50 transit vans with tents and cones to be able to travel to places such as care homes to conduct testing, particularly at times of epidemic. Amazon is putting together home testing kits, which means that no one need drive anywhere to have a test, and we are working with care homes so that care workers can take the swabs and then drop off bags of them at a reasonable place so that they can be processed by our laboratories. Drive-in testing was an early but limited programme, and we have a lot more going on than that.

Photo of Lord Hunt of Kings Heath Lord Hunt of Kings Heath Labour

My Lords, I thank the Minister; he has had a lot of work to do in the Lords today. He commented on ONS figures and the analysis it has done on the number of people who have so sadly died. The figure he gave in the Statement was, I think, around 18,000. I assume that these are deaths from the virus of people in hospital. I suspect he will have seen a piece in the Financial Times earlier this week which did some analysis of the ONS figures. It suggested that the figure of deaths caused by the pandemic was as much as 41,000. Have his officials looked into this and can he comment on its veracity?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I have not seen the piece in the FT, so cannot comment on the noble Lord’s remarks. All I would remind him, as I have said in previous answers to similar questions, is that false reporting of a death is an offence. Doctors are required to make a clear report of a death. If it is associated with Covid in any way, the word “Covid” will be in the death certificate. If it is in the death certificate, it will make its way through the CQC to the ONS figures. There should be no ambiguity about this at all.

Photo of Baroness Ritchie of Downpatrick Baroness Ritchie of Downpatrick Non-affiliated

Will the Minister provide an assurance that there will be rigorous tracking, tracing and isolation of those in care homes, including the staff and residents? Through its European director, the World Health Organization told us today that there were significant deaths across Europe, including in the United Kingdom and Ireland, and that there is a need to address this.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Baroness, Lady Ritchie, addresses a very difficult problem. The programme we are looking at, announced earlier today with the change to our guidelines, is the testing of asymptomatic carers and residents in care homes. It is a natural and growing concern that the disease may be present in an asymptomatic form. We are determined to get the infection out of our care homes and the NHS.

Photo of Lord Robathan Lord Robathan Conservative

My Lords, this lockdown is hugely damaging to the country, particularly to the future prosperity and education of our young people. Nobody knows, as the Minister has just said, how many people have had or have this ghastly virus and recovered. Many suggest that it is several million, possibly many millions. If that is the case, it leads to another suggestion: the mortality rate may be less than 1%. Some say—I am not an expert on this at all—that it is as low as 0.1%. If that is the case, what implications would that have on the Government’s policy of balancing the future well-being of this country and its people with dealing with this ghastly health crisis?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Lord, Lord Robathan, makes a fair point. I reassure him that we are investing in a massive 20,000-person surveillance by the ONS to get to the bottom of the mystery which he describes. Every piece of evidence we have from every country around the world suggests that the number of people who have been through the disease is a tiny proportion of the population, and that the amount of recovery and antibody immunity in the country is likely to be in single figures. This is one of the great challenges of the virus and the situation it presents to us.

Photo of The Earl of Clancarty The Earl of Clancarty Crossbench

My Lords, a test, track and trace policy is clearly right, but a week ago, Matt Hancock admitted that 15,000 people a day are entering the UK through airports without medical checks. In just over a month’s time, that will be an extra half a million people entering the country, many of whom may have Covid. Will the Government address this and plug what is surely a gap in their Covid policy?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

The noble Earl, Lord Clancarty, is right that our present guidelines state that those arriving in Britain should isolate if they have symptoms and seek a test from a hospital if it develops seriously. It is clear to me that the way we travel around the world is set to change dramatically in the future, but the CMO has reviewed our airport and port guidelines. He is happy with them, and the evidence suggests that this is not currently a source of new infections in the UK.

Photo of Baroness Altmann Baroness Altmann Conservative

My Lords, may I press my noble friend on treatment, particularly with convalescent plasma? As I understand it, other Governments are urgently looking into this. France has put its medical staff into LFB. Have we put any pressure on BPL, which is the only fractionating company available in the UK, to produce pure, hyperimmune immunoglobulins, rather than the whole plasma, so that we can start parametric testing of IVIG and injections of convalescent plasma in the pure hyperimmune form?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I reassure my noble friend Lady Altmann that we are making this a massive priority. It has huge advantages over other therapeutics because it is plasma and can therefore have an accelerated regulatory advance. I signed for procurement of £20 million-worth of fractionating machines last week to help the blood transplant service create the hyperplasma to which she alludes.

Photo of Lord Randall of Uxbridge Lord Randall of Uxbridge Conservative

The Statement rightly reinforces the message that non-Covid NHS services are open for patients. Would my noble friend agree that it is important to give parents confidence that essential vaccinations, especially MMR, should not be ignored and that they should speak to their GP for further advice and support?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I entirely agree with the sentiments and intent of my noble friend’s point. It occurs to me that we should perhaps set up some kind of advertising or promotion of this. I will take that point back to the department.

Photo of Lord Balfe Lord Balfe Conservative

In the Statement, the Minister referred to the need for people who have other medical needs to still contact their GP. In Cambridge, where I live, the opticians, chiropodists, dentists and surgeries are all closed, with different fierce notices on their doors. When the isolation requirements are lifted, could the Government make it a priority to get these vital medical services open again and get doctors back into surgeries, not at the end of the telephone? Perhaps we could at least teach them that Zoom exists.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I reassure my noble friend Lord Balfe that the amount of video treatment being given by doctors has gone through the roof. During this epidemic, we have seen the medical trade and patients embrace a huge amount of digital technology. We are working with the colleges to try to get all the services of the medical profession open at this time and the response has been largely positive.

Photo of Lord Dobbs Lord Dobbs Conservative

Minister, are prisoners in our prison system participating in the manufacture of PPE? Does the crisis not represent an opportunity for many prisoners to not only contribute but move towards some rehabilitation?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

My noble friend Lord Dobbs is right that there seems to be an opportunity, but I have to be candid with him. Our need for PPE runs into hundreds of millions of items. We have delivered more than 1 billion pieces of PPE since Covid began. I am afraid to say that the manufacturing abilities of Her Majesty’s prisons do not reach to that kind of level.

Photo of Lord Blencathra Lord Blencathra Chair, Delegated Powers and Regulatory Reform Committee, Chair, Delegated Powers and Regulatory Reform Committee

As my noble friend the Minister has just said, in January the NHS had to deliver half a million PPE items to 233 hospitals. It now has to deliver 1 billion items to 58,000 health facilities. The experts in logistics are the military, as we saw from the brilliant No. 10 briefing by General Carter yesterday. Will the Government now hand over complete control of distribution to the Armed Forces? Will the Minister comment on reports that the much-vaunted EU purchasing scheme has not delivered a single item of kit to any EU country?

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I would like to take my noble friend to Skipton House in London’s Elephant and Castle to see the very large room where there is a combination of the diplomatic skills of the FCO, the trade skills of DIT and BEIS, the military skills of the Army and the clinical skills of Health. Seeing all those different skills and abilities work together to deliver the kit that our health workers need is a really impressive sight. That collaboration is the secret to success.

Photo of Lord Sheikh Lord Sheikh Conservative

My Lords, my noble friend the Minister referred to the fact that the number of deaths that have occurred as a result of coronavirus stand at 18,738. The BAME community represents about 14% of the UK population, but unfortunately accounts for about 35% of all coronavirus patients in intensive care. The number of people in the BAME community who have contracted coronavirus and died as result is disproportionately high.

My noble friend might perhaps recall that I talked about the burial of Muslims when the Coronavirus Bill was discussed in your Lordships’ House. The Muslim community has got together, and burials are taking place in very difficult circumstances. However, I have been told by leaders of the community that the availability of land for burials should be kept under review and that a system should be provided if the land issue becomes a major problem and burials cannot take place. Secondly, the Government should consider providing additional funds to local authorities, which are dealing with very difficult circumstances. They are stretched to the limit and need additional resources for burials and cremations. Will the Minister comment on those two points?

Photo of Baroness Finlay of Llandaff Baroness Finlay of Llandaff Deputy Chairman of Committees, Deputy Speaker (Lords)

Minister, if you could be very brief, we might be able to fit in the noble and learned Lord, Lord Woolf.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I am very grateful for my noble friend’s helpful update, but I remind him that these arrangements are conducted by local authorities. The question that he asks is best answered by those local authorities.

Photo of Lord Woolf Lord Woolf Crossbench

I thank the noble Baroness for her consideration. I am afraid that at a critical moment my microphone turned itself off. It is back on now. The Minister rightly referred to hero volunteers. He will be pleased to hear that those volunteers include members of the staff of this House, such as my part-time secretary, who has volunteered. That is worth noting, as are the many others who I am sure are in the same position.

Photo of Lord Bethell Lord Bethell The Parliamentary Under-Secretary for Health and Social Care

I thank the noble and learned Lord. Will he please express my and the Government’s profound thanks to his secretary for their contribution? I hope it is proving to be rewarding to him or her personally and impactful to the causes in which he or she serves.

Photo of Baroness Finlay of Llandaff Baroness Finlay of Llandaff Deputy Chairman of Committees, Deputy Speaker (Lords)

My Lords, the time allotted for the Statement is now up. I thank all noble Lords for being concise, in particular the Minister for his very concise answers.

Virtual Proceeding adjourned at 7.04 pm.