Below is the text of the speech made by Jeremy Hunt, the Conservative MP for South West Surrey, in the House of Commons on 23 March 2020.
The Health Secretary is not in his place—understandably—but I want to start with a tribute to him. I think I am the only other person in this House who has sat behind his desk, and I can testify that even without a pandemic it takes years off your life. The Health Secretary has made himself exhaustively available. He has worked tirelessly, and no one could have done more or better to prepare the NHS for the crisis we now face. I also want to thank the shadow Secretary of State for the way that he has risen to the challenge of his role. All of us as parliamentarians are proud of the exchanges that we have had this afternoon and on many occasions.
Ordinarily, our role as MPs is to scrutinise every detail of legislation, to understand it and to try to improve it. There are many questions about this legislation, but we are in a national emergency and every day we delay could cost lives. So I support the Bill 100% and I encourage all colleagues to do the same. A week ago, the Government said we were four weeks behind Italy. That then changed to three weeks behind Italy, and today our mortality rates are just two weeks behind Italy. Our hospitals, especially in London, are filling up. We have had a critical incident at one, and others say they are running out of ICU beds. According to the papers, we have one nurse fighting for her life in an intensive care unit. One London hospital has seven doctors with the virus in just that one hospital. Yet still people are going to shops, parks, beaches and holiday homes as if nothing has changed. It may be too late to avoid following Italy, but to have any chance at all of doing so we must move now to lockdown rules that ban non-essential travel. It is time not just to ask people to do social distancing, but to enforce those social distancing rules—not next week, not this week, but right away. I support the call by the shadow Secretary of State to do that, and it is very important we do so as soon as we possibly can.
The Bill can help in two areas. The first is on protective equipment for staff. Last week, Sir Simon Stevens told the Health and Social Care Committee that there were sufficient national supplies of PPE, but there were distribution problems. Since then, I know that the Government have moved heaven and earth to try to resolve those. All hospitals have had deliveries, and I pay tribute to the Health Secretary and everyone in the Department for achieving that, but there is still a lot of concern on the frontline. The main reason for that is because on 6 March Public Health England downgraded the recommendations as to what PPE doctors should use. That appeared to be at odds with World Health Organisation recommendations. I understand that has now been clarified by Professor Keith Willett in a message sent out on Friday that does bring our advice more into line with WHO guidelines.
Most importantly, the advice now makes it clear that doctors should wear goggles if there is any risk of being sprayed, but obviously doctors would feel vastly more secure with more extensive protection, such as full-length gowns and FFP3 masks. Is not the solution just to order manufacturers to make more of that vital equipment—not just a little more, but massively more? If that needs legal powers, the Bill should give the Government those powers to require every factory that is able to devote itself to the production of that life-saving equipment to do so.
Numerous doctors have died across the world, including Dr Li Wenliang, the courageous Chinese doctor who first tried to blow the whistle on this virus. Twenty-three doctors have died in Italy. This weekend, France lost its first doctor. None of us wants that here. Given the total determination of the Health Secretary to protect our frontline staff, would he urgently look into whether we need to manufacture more of the highest-grade equipment?
Does my right hon. Friend share my dismay at my being told just now that masks and PPE that were meant to be delivered to my authority, Wiltshire, tomorrow, will now be delivered on 9 April? I am not sure what the situation is in Surrey, but that seems extraordinary. Does he also agree that it has to be the right PPE—it cannot simply be a paper face mask from B&Q, as we heard earlier? It needs to be appropriate, and people need to know how it works. When they wear it, they are likely to have to work harder, because wearing PPE is not easy or straightforward.
My right hon. Friend knows, as a clinician— and I am concerned—that in our desire to get PPE out we have not understood the vital role that local authorities play in this. Residents in care homes are extremely vulnerable, and their carers need that equipment, so I very much support his concern about that.
The second area where the Bill needs to do more is testing. A week ago today our strategy changed from mitigation to suppression. I strongly support that change in strategy. Suppression strategies are being followed very successfully in South Korea, Taiwan, Hong Kong, Singapore and China, which appear to have turned back the virus. Here, all our public focus has been on social distancing, but testing and contact tracing to break the chain of transmission are every bit as important, if not more important. Those countries that have turned back the virus rigorously track and test every case and every suspected case, then identify every single person with whom a covid-19 patient has been in contact to take them out of circulation. As a result, those countries have avoided the dramatic measures and some of the economic damage that we have seen in Europe.
South Korea has avoided national lockdown, despite having a worse outbreak than us; Taiwan introduced temperature screening in malls and office buildings, but kept shops and restaurants open—it has had just two deaths. In Singapore, restaurants remain open and schools are reopening, although working from home is discouraged. Again, in Singapore, there have been just two deaths. Ten days ago in this country, we went in the opposite direction, and stopped testing in the community. How can we possibly suppress the virus if we do not know where it is? So far, we have had 281 deaths, tragically. According to the modellers, there is about one death per 1,000 cases, which means that we have just under 300,000 cases in this country. According to the same modellers, the number of cases is doubling every five days, which means that at the end of next week we will have about 1 million cases or more in this country. Unless we radically change direction, we will not know where those 1 million cases are.
The Prime Minister talked about expanding testing from 5,000 to 10,000 to 25,000, which is welcome. He even talked about 250,000 tests a day, which would be more than anywhere in the world—I welcome that ambition, but ambition is not the same as a national plan, and we have not seen a national plan on testing.
The right hon. Gentleman may have seen reports today that some care providers are refusing to take patients being discharged from hospitals because those hospitals are unable to test them before discharge. Quite understandably, care homes are concerned about admitting patients who may be carrying the virus, given the other vulnerable people there. Does he agree that as testing is ramped up, not only health and care professionals but patients being discharged should be a priority?
I am very worried about that. A doctor in my constituency told me of exactly the same problem, and of course, the risk is that hospitals then fill up and do not have the space to treat people who urgently need hospital treatment.
We have an ambition to increase testing to 25,000 tests a day, but at the moment we are still only testing between 5,000 and 8,000 people every day. On Saturday, we tested 5,500, which is no significant increase on a week ago. It is not just South Korea that is testing more than us per head of population—Germany, Australia and Austria are as well. Now is the time for a massive national mobilisation behind testing and contact tracing.
If we have the antibody test, now is the time to become the first country in the world that says, “We are going to test every single citizen.” Now is the time to introduce weekly tests for NHS and social care staff, to reduce the risk of them passing on the virus to their patients. If the Francis Crick Institute in London is doing any research into anything other than covid-19 right now, it should stop—we need it to be designing tests. If the Sanger Institute in Cambridge is still decoding genomes, it should not be—we need it to process covid-19 tests.
And it is not just the science. Contact tracing is manpower-intensive, yet Public Health England has just 280 people devoted to this. We probably need 280 people in every city and county in the country. Every local government official doing planning applications, every civil servant working on non-corona issues and volunteers all should be mobilised in this vital national task.
As we have heard, testing is vital for NHS staff who are desperate to get back to work. Here is one tweet from a midwife called Katie Watkins, who speaks for so many:
“I know this is happening all over but had to call in sick for my clinical shift on labour ward today as my husband spiked a temperature last night. I feel fine and yet cannot go to work… Where are the tests for #NHS staff?? I could be helping but instead sat at home.”
Testing is also vital for the economy. If we are going to have a year of stop-go as we try to protect the NHS if the virus comes back, testing and contact tracing allows an infinitely more targeted approach and way to control the spread of the virus than economic measures that are much more blunderbuss and do much more damage. This Bill could help that by giving the Government powers to require any pharmaceutical company in the country to manufacture tests and any laboratory in the country to process those tests. It could stop the scandal of £375 tests being available to wealthy people in Harley Street when, in a crisis, every spare test should be used by NHS staff to get them back to work.
This Bill could help with something else being done very successfully in South Korea and Taiwan: the use of mobile phone data. In those countries, they look at the mobile phones of covid patients to identify other phones that they have been nearby when that patient was infectious. That has civil liberty implications, but in this national emergency, being able to do that would save lives, so those powers too should be in the Bill.
Finally, please do not take my word for it on testing. Dr Tedros Adhanom, the director general of the World Health Organisation, and virtually every epidemiologist at the World Health Organisation makes the same point: it is not possible to “fight a fire blindfolded”; social distancing measures and hand washing will not alone extinguish the epidemic; and
“our key message is: test, test, test.”
I know that time is short, but I want to touch briefly on two other issues. Some good points have been made about social care this afternoon. The Bill replaces local authorities’ duty to meet care needs with a power to meet care needs, except when it is a breach of human rights. Bluntly, there may be less provision of social care as a result. We understand in this House why that may be necessary, but if it lasts as long as a year, that will mean more pressure, not less pressure, on hospitals. If there was any lesson from my time as Health Secretary, it is that we need to invest in social care as well as in health. We need to ensure that these new measures do not have the unintended consequence of putting yet more pressure on hospitals that are already on the point of falling over.
My final point is on mental health. Under the measures in the Bill, someone can be sectioned not by two doctors, but by one, and that doctor does not have to know the patient. I understand why we have to take these measures, but obviously it causes huge concerns in the mental health community that someone could be locked up on the say-so of a doctor who does not even know them. I want a commitment from the Government that all cases will be reviewed on the basis of the current procedures as soon as this virus is behind us, and certainly within the first three months.
I end my remarks with a tribute to frontline staff, not from me, a politician, but from an eight-year-old constituent of mine called Tamsin. She says:
“I really want thank all the doctors and nurses who are working so hard to look after all the sick people…they are all risking their own lives to try and stop the coronavirus instead of being safe at home. I’m missing my Nana, Gamma and Grampy a lot because they have to be isolated at home but if they get sick they will need the doctors and nurses to help them get better. Doctors and nurses are amazing.”
Tamsin is right. We must not let them down.