The Health Secretary’s statement full text. “Hope is on the horizon” in Covid-19 battle.

26 Nov

“Mr Speaker, with permission I’d like to make a statement on coronavirus.

We are approaching the end of a year where we have asked so much of the British people.

And in response to this unprecedented threat to lives and to livelihoods, the British people have well and truly risen to the challenge by coming together to slow the spread and support each other.

I know how difficult this has been, especially for those areas that have been in restrictions for so long. The national measures have successfully turned the curve, and begun to ease the pressure on the NHS.

Cases are down by 19% from a week ago and daily hospital admissions have fallen 7% in the last week.

January and February are always difficult months for the NHS. So it is vital we safeguard the gains we’ve made.

We must protect our NHS this winter. We have invested in expanded capacity – not just the Nightingales, but in hospitals across the land – and we have welcomed thousands of new staff.

Mr Speaker, this morning’s figures show the number of nurses in the NHS is up 14,800 compared to just a year ago – well on our way to delivering our manifesto commitment of 50,000 more nurses.

Together, while we invest in our NHS, we must also protect our NHS. So it will always be there for all of us, during this pandemic and beyond.

Mr Speaker, I am so grateful for the resolve that people have shown throughout this crisis.

Thanks to this shared sacrifice, we have been able to announce that we will not be renewing our national restrictions in England.

And we have been able to announce UK-wide arrangements for Christmas, allowing friends and loved ones to reunite, and form a 5-day Christmas bubble. And I know that this news will provide hope for so many.

But we must remain vigilant. There are still, today, 16,570 people in hospital with coronavirus across the UK, and 696 deaths were reported yesterday.

That means 696 more families mourning the loss of a loved one, and the House mourns with them. So, as tempting as it may be, we cannot simply flick a switch and try to return life straight back to normal.

Because if we did this, we would undo the hard work of so many and see the NHS overwhelmed, with all that that would entail.

We must keep suppressing the virus, while supporting education, the economy and of course the NHS, until a vaccine can make us safe. That is our plan.

We will do this by returning to a tiered approach, applying the toughest measures to the parts of the country where cases and pressure on the NHS are highest, and allowing greater freedom in areas where prevalence is lower.

While the strategy remains the same, the current epidemiological evidence, and clinical advice, shows we must make the tiers tougher than they were before to protect the NHS through the winter and avert another national lockdown.

So we’ve looked at each of the tiers afresh and strengthened them, as the Prime Minister set out on Monday.

In tier 1 if you can work from home, you should do so.

In tier 2, alcohol may only now be served in hospitality settings as part of a substantial meal.

And in tier 3, indoor entertainment, hotels and other accommodation will have to close, along with all forms of hospitality, except for delivery and takeaways.

Mr Speaker, I know that people want certainty about the rules they need to follow in their area.

These decisions are not easy. But they are necessary.

We have listened to local experts, and been guided by the best public health advice, including from the Joint Biosecurity Centre.

We set out the criteria in the COVID-19 Winter Plan, and we published the data on which the decisions are made.

As the Winter Plan sets out, the 5 indicators are:

  • the case rates in all age groups
  • in particular, cases among the over 60s
  • the rate at which cases are rising or falling
  • the positivity rate
  • and the pressures on the local NHS

When setting the boundaries for these tiers, we have looked not just at geographical areas but the human geographies which influence how the virus spreads, like travel patterns and the epidemiological situation in neighbouring areas.

While all 3 tiers are less stringent than the national lockdown that we are all living in now, to keep people safe, and to keep the gains being made, more areas than before will be in the top two tiers.

This is necessary to protect our NHS and keep the virus under control.

Turning to the tiers specifically: the lowest case rates are in Cornwall, the Isle of Wight and the Isles of Scilly, which will go into tier 1.

In all 3 areas have had very low case rates throughout and I want to thank residents for being so vigilant during the whole pandemic.

I know that many other areas would want to be in tier 1. I understand that.

My own constituency of West Suffolk has the lowest case rate for over 60s in the whole country.

And I want to thank Matthew Hicks and John Griffiths, the leaders of Suffolk and West Suffolk Councils, and their teams, for this achievement.

But despite this, and despite the fact Suffolk overall has the lowest case rate outside Cornwall and the Isle of Wight, our judgement, looking at all of the indicators, and based on the public health advice, is that Suffolk needs to be in tier 2 to get the virus further under control.

Now I hope that Suffolk, and so many other parts of the country, can get to tier 1 soon, and the more people stick to the rules, the quicker that will happen.

We must make the right judgements guided by the science.

The majority of England will be in tier 2, but in a significant number of areas, I’m afraid, they need to be in tier 3 to bring case rates down.

I know how tough this is, both for areas that have been in restrictions for a long time, like Leicester and Greater Manchester, and also for areas where cases have risen sharply recently, like Bristol, the West Midlands and Kent.

The full allocations have been published this morning and laid as a written ministerial statement just before this statement began.

I understand the impact that these measures will have, but they are necessary given the scale of the threat that we face.

We will review the measures in a fortnight, and keep them regularly under review after that.

I want to thank everybody who’s in the tier 3 areas for the sacrifices that they are making, not just to protect themselves and their families, but their whole community.

And regardless of your tier, I ask everyone: we must all think of our own responsibilities to keep this virus under control.

We should see these restrictions not as a boundary to push but as a limit on what the public health advice says we can do safely in any area.

But, frankly, the less any one person passes on the disease, the faster we will can get this disease under control together. And that is on all of us.

Mr Speaker, we must all play our part while we work so hard to deliver the new technologies that will help us get out of this. In particular, vaccines and testing.

The past fortnight has been illuminated by news of encouraging clinical trials for vaccines. First, from Pfizer/BioNTech and then from Moderna. And then of course earlier this week, from the Oxford/AstraZeneca team.

If these vaccines are approved, the NHS stands ready to roll them out, as soon as safely possible. Alongside vaccines, we have made huge strides in the deployment of testing.

Our roll-out of community testing has been successful because it means we can identify more people who have the virus but don’t have symptoms and help them to isolate, breaking the connections that the virus needs to spread.

As part of our COVID-19 Winter Plan, we will use these tests on a regular basis. For instance, to allow visitors safely to see loved ones in care homes, to protect our frontline NHS and social care colleagues, and to allow vital industries and public services to keep running safely.

Mr Speaker, we have seen in Liverpool, where now over 300,000 people have been tested, how successful this community testing can be, and I want to pay tribute to the people of Liverpool, both for following the restrictions and for embracing this community testing.

It has been a big team effort across the whole city. And the result is that in the Liverpool City Region the number of cases has fallen by more than two-thirds.

In the borough of Liverpool itself, where the mass testing took place, cases have fallen by three-quarters.

It hasn’t been easy and, sadly, many people in Liverpool have lost their lives to COVID. But thanks to people sticking to the rules, and to the huge effort of community testing, Liverpool’s cases are now low enough for the whole City Region to go into tier 2.

This shows what we can do when we work together. We can beat the virus.

And I want to pay tribute to the people of Liverpool, to NHS Test and Trace, the University, the Hospital Trust, and Mayor Joe Anderson and so many others, who have demonstrated such impressive leadership, responsibility, and a true sense of public service.

We are now expanding this community testing programme even further, to launch a major community testing programme, honing in on the areas with the greatest rate of infection.

This programme is open to all local authorities in tier 3 areas in the first instance and offers help to get out of the toughest restrictions as fast as possible.

We will work with local authorities on a plan to get tests where they’re needed most and how we can get as many people as possible to come forward and get certainty about their condition.

The more people who get tested then the quicker that a local area can move down through the tiers, and get life closer to normal.

Mr Speaker, viruses can take a short time to spread, but a long time to vanquish, and sadly there is no quick fix.

They call upon all our determination to make the sacrifices that will bring it to heel and all our ingenuity to make the scientific advances that will get us through.

Hope is on the horizon but we still have further to go. So we must all dig deep. The end is in sight. We mustn’t give up now.

We must follow these new rules and make sure that our actions today will save lives in future and help get our country through this.

And I commend this statement to the House.”

The vaccine. The biggest breakthrough so far in the Covid-19 battle. But a logistical challenge unlike anything else.

10 Nov

In recent weeks, it’s been hard to feel optimistic about the UK’s battle with Covid-19. From the introduction of another lockdown, to talk of trying to “save Christmas”, to test and trace still experiencing difficulties, even the most cheerful among us might have struggled to see a light at the end of the tunnel.

But all of that changed yesterday when it was announced that a vaccine for the virus had proved successful in clinical trials. It has managed to protect over 90 per cent of the participants (43,500 in total) from becoming infected.

Although, as Boris Johnson has warned, it’s “very, very early days” and people cannot “rely on this news as a solution”, it cannot be stated enough what an astonishing achievement this is.

Indeed, when I last wrote about the vaccine in October for ConservativeHome, there were actually a lot of reasons to be doubtful that this would be a viable exit strategy. These reasons are broadly:

  • Other members of the Coronavirus family – SARS and MERS – do not have vaccines.
  • Smallpox is the only disease that has ever been fully eradicated by a vaccine.
  • Kate Bingham, the chairman of the UK Vaccine Taskforce, said that a Covid vaccine would probably have the same success rate as the flu jab (50 per cent). 
  • Patrick Vallance said we would be looking at a vaccine model similar to flu, and that the “notion of eliminating Covid is not right.”

Bingham and Vallance’s estimates were entirely realistic at the time. That’s why the vaccine development is so special; it is groundbreaking territory to create something with 90 per cent efficacy, never mind the fact it was developed in such a short period.

But as I wrote before, there will still be some major challenges ahead. Without further ado, here are some of the main takeaways from the vaccine news – and what the big questions ahead are for the Government and scientists.

How does the vaccine work?

It is a new type of vaccine, called an “RNA” vaccine. Although RNA vaccines have been researched in the past, they have never been approved before. It works by using a small part of the virus’s genetic code, which is then introduced to the body. The immune system then identifies this as foreign and begins to attack the virus.

How is it administered?

The vaccine is given in two doses, which are taken 21 to 28 days apart (the Government has ordered 40 million doses of it, which will give the UK the capacity to vaccinate 20 million people). 

It will be delivered at care homes (by NHS workers), at GP surgeries, pharmacies and “go-to” vaccination centres set up in places like sports halls. The goal is to have the vaccine administered seven days a week, and Matt Hancock has announced £150 million extra funding to help GPs carry out this huge task.

Who will get it first?

As age is the biggest risk factor for severe Covid-19, the first people to receive the vaccine will be care home residents and care home staff. Next down the list are likely to be health workers and hospital staff. From then on, people will be ranked by age; those under 50 will be bottom of the list. Children will not be vaccinated (although expect this to be contested, as some scientists are worried about the long-term effects of Covid).

When could it become available?

There have been conflicting estimates of when the vaccine will arrive, but the overall expected is either by the end of this year or early in 2021. Hancock has said that a mass roll out by Christmas is “absolutely a possibility”, although he expects it to come in the first part of next year. Emergency approval could mean the vaccine is with us as soon as November.

What are the challenges ahead?

There are a number of challenges for the Government, which can broadly be categorised as 1) Regulatory/ medical 2) Logistical and 3) Societal. 

To run through these in more detail:

Regulatory

The vaccine will first need to be considered by agencies around the world, and only with their approval can it be rolled out to the masses. This is why Johnson is trying to manage expectations about the vaccine – as this is quite a big hurdle to get through.

Medical

Then there are more considerations about the vaccine’s effectiveness, which will influence Governmental policy. Here are some questions that will be asked:

  • Does the vaccine stop people from catching and spreading the virus? (As well as stopping someone from getting ill).
  • How protective is the vaccine across different age groups? (There is missing data on this at the moment).
  • Do people need repeated doses of the vaccine? How long does its protective effect last for?
  • What is the potential for the virus to mutate?
  • What are the rare side effects of the vaccine? (We can only see this when much larger numbers of people take it).
  • How many people need to be immunised in order to return life back to normal?
  • How do we protect the 10 per cent, for whom the vaccine does not work? 
Logistical

Rolling the vaccine out is an operation of epic proportions; Jamie Njoku-Goodwin, formerly Hancock’s Special Advisor, said on Twitter that it would “require the biggest logistical effort since WW2”.

Getting two doses out to tens of millions of people is no walk in the park (to put it mildly). There are other logistical challenges, too; for instance, the vaccine needs to be moved from one station to another, without removing it from a temperature of -70C over four times. 

Societal

The last big headache is trying to manage who gets the vaccine. This is perhaps the most complicated aspect of this exit strategy, as the Government will have to deal with two divides in society; people who want the vaccine, but aren’t on the priority list (some teachers, for instance, are reported as wanting to be prioritised), and those who do not want a vaccine at all. And that’s before we get to the global demand for vaccines.

It’s not clear how many people need to be vaccinated in the UK to get us out of more lockdowns, as it’s ultimately contingent on some of the medical considerations mentioned above. But Bingham has previously said that 30 million out of the 67 million people who live in Britain would get it.

The other difficult aspect is managing what happens before we get the vaccine (if it’s approved). The Government is conscious that people can let their guard down with good news, and it remains to be seen how the prospect of a vaccine effects compliance over the next couple of months. The Government knows it must keep expectations low, in case there isn’t regulatory approval for the vaccine – and it needs to focus more on other strategies.

But whatever happens, it’s still an incredibly exciting week, particularly as this is not the only vaccine on the go. There are 11 vaccines currently in the final stages of testing, and Pfizer and BioNtech have the manufacturing capacity for 1.3 billion doses of their vaccine by next year. All in all, “hoping for the best but planning for the worst” is the mantra Johnson cited early on in the crisis, and – through the vaccine news – these words will carry through.

Dean Russell: As a volunteer in my local hospital, I saw at first hand the damage done by NHS fearmongering

1 Sep

Dean Russell is the MP for Watford and a member of the Health & Social Care Select Committee.

Concurrent with Matt Hancock’s recent announcement about the creation of the National Institute of Public Health (NIPH) came the usual reactionary political cries that this means the NHS is under threat of privatisation.

The sad truth is that whilst politicians are repeating old myths like a broken record, they once again fail to look at the actual record of the NHS under the Conservatives since its inception in 1948; in doing so, they are causing genuine distress to those who are most vulnerable.

I understand that old habits die hard when it comes to political fearmongering; however, in the efforts to win votes through these repeated false claims, they are only hurting the very people they claim to protect – health and social care workers.

The problem with these entrenched and unfounded claims around NHS privatisation is that politicians make it difficult to be open about where issues exist within these large institutions, which, in turn, means that front line staff are the worst hit.

Just this week, I was fortunate to spend a day with St John Ambulance and meet hospital staff who they had been volunteering alongside during the crisis. They all made the point that that pre-Covid the levels of red tape and bureaucracy needed to enable St John Ambulance to help volunteer on wards would have been too immense ever to see it happen.

The nature of the Covid crisis enabled the NHS to be allowed to utilise the assets that an organisation like St John Ambulance teams can provide. This additional workforce during such an unprecedented crisis has provided invaluable support to NHS staff. I am confident if any Conservative politician had tried to suggest this last year, they would have been lambasted for attempting to undermine NHS staff or for putting the UK on a “slippery slope” towards privatisation.

Since March, I have volunteered with my local hospital – something I feel incredibly fortunate to have been able to do as it enabled me to support the frontline in action.

What struck me at the height of the crisis was how impacted NHS staff were by some sections of the media and those who engaged in baseless NHS political point-scoring. When the news was reporting the country was running out of PPE, despite the fact my local hospital had stock, I could hear the concern in the voices of some staff that they thought they were about to run out imminently.

Like the rest of the country, NHS staff, too, are watching the news day after day. When they hear a constant flow of the absolute worst-case scenarios presented as the norm, it understandably affects their anxiety levels.

Whilst the NHS has been presented with challenges it had never faced before, the unhealthy obsession with scaremongering poses a threat to NHS employees mental health and the morale of the nation.

Our NHS is the most prized possession in the Government’s arsenal, and it has become a proud cultural symbol for Britain. The uncorroborated and alarmist claims by part of the media and fed by some politicians deny honest and nuanced debate about the issues facing the NHS and social care both during Covid and looking long-term.

One of the many reasons I am proud to be a new MP as part of the 2019 intake is because of our Party’s renewed focus on health social care. During Labour’s time running the NHS, use of Public Finance Initiatives (PFI) increased to the point that even The Guardian described its crippling effects on hospital budgets.

It was Hancock who wrote £13.4 billion off hospital debts, much of which had accumulated due to PFI contracts. It was formerly Chancellor Phillip Hammond who ended the use of PFI and PF2 contracts. It was the last Labour government who privatised Hinchingbrooke Hospital, which the Conservatives then took back into public ownership in 2015.

More recently, the opposition has found itself at odds with the CMO and BMA over attempts to change testing policies through an amendment in Parliament. Even during the early history of the NHS, it was Labour who introduced prescription charges along with charges for spectacles and dentistry.

As a member of the Health and Social Care (HSC) select committee, I don’t shy away from being critical myself. I am aware of the need for transformation in many areas. It has been clear to me that the parity of esteem between physical and mental health, for example, needs addressing much more robustly. As does the parity between NHS and social care workers.

The good news is I believe the decision-makers for these areas have heard this call loud and clear from the very top and are focussing on solutions.

The announcement by Hancock mid-August regarding the creation of the NIHP was an important step that sadly once again had to battle against the noise of opposition repeating the old “privatisation” rhetoric.

For anyone who listened carefully, they would have heard this critical line at the end of the speech. The Secretary of State said, “It (NIHP) will work hand in glove with the NHS, and it will use the most modern, cutting-edge digital and data analytics tools at its core.” Such remarks are not about privatisation, but about a new era of agile government supported by highly capable health agencies.

The easing of unnecessarily bureaucratic systems, the harnessing of technological capabilities, the rise of telemedicine and enhancing the powers of frontline staff should now become the new norm for healthcare.

We have also seen a robust partnership with AstraZeneca and others with the vaccine development, the use of private healthcare facilities for public purpose and the building of the Nightingale Hospitals’ at a record pace. The Government will enable the NHS to spend £10 billion over the next four years on private hospitals to tackle waiting lists.

Not one aspect of this has been a drive towards privatisation, but a more collaborative way of working that aims to benefit patients and staff.

I am not arguing that the Government shouldn’t be put under intense scrutiny by the opposition – in fact – I welcome it. We must end this knee-jerk media scaremongering that only puts fear into the most vulnerable and those working on the frontline.

What we need is a visionary approach to healthcare for this century if we want to seek ways improving patient outcomes and being the best possible employer for Health & Social Care staff. 65 per cent of the NHS’s history has been under a Conservative government, and privatisation simply has not happened under our watch.

Paul Bristow: The biggest challenge for our NHS may still lie ahead, but it’s also an opportunity

30 Jun

Paul Bristow is the MP for Peterborough and a member of the Commons’ Health and Social Care Select Committee.

Our NHS has done an excellent job looking after us during the Covid-19 crisis. But the biggest challenge for our NHS may be about to begin as the service deals with the backlog of delayed operations and treatments.

The lockdown began in order to protect our NHS. This was the early central message. The Government was concerned that hospitals would be overwhelmed as we saw in Italy and elsewhere at the start of the pandemic. This didn’t happen. Our NHS ramped up capacity as former NHS workers came back to serve, new hospitals were built, and a deal was struck with the independent sector. This push for increasing capacity within the system needs to continue.

We need a national effort backed by the Government PR machine – supported by the charisma and optimism of the Prime Minister – to back our NHS and clear the backlog. I have heard personal harrowing stories from NHS patients through my role on the Health and Social Care Select Committee.

Rob Martinez from Bracknell, who needed a double knee replacement, had his operation due in April cancelled. He told our committee that he had taken early retirement. I asked him if he would have continued to work if his operation had taken place – he confirmed he felt he could have worked for another 5 years. What was the most bitter blow is that he has been told there is ‘zero chance’ of his procedure taking place this year.

Another patient from Sevenoaks had her chemotherapy stopped. And while it has restarted, there remains huge concern that the number of patients receiving chemotherapy is far fewer than would be expected. Cancer Research UK estimates more than 20,000 patients did not get treatment because of the virus crisis.

Whilst official statistics have been paused, it is estimated almost two-thirds of Britons with common life-threatening conditions have had care cancelled. The NHS Confederation is saying that NHS waiting lists could rise to 10 million in the autumn, and take up to two years to clear. The Royal College of Surgery has called for a five-year strategy to tackle the waiting list situation.

This is now one of the Government’s central challenges.

We can do this. The NHS has shown its remarkable ability to cope, and yet again the British people have shown great resilience through this emergency. But it needs to be framed as a national effort with the Prime Minister and the Secretary of State personally leading this.

Those who have re-joined the NHS to help with the Covid-19 crisis need to be persuaded to stay. I appreciate staff will be tired, and those that have returned will need to be properly motivated. The appreciation that the public has shown to our NHS staff should help, but efforts will need to be made to make the NHS a better place to work and should be prioritised.

The Prime Minister had it right with the simple message about workforce at the General Election, promising to recruit and retain 50,000 nurses. We need to look with urgency at long-term recruitment issues. The NHS needs staff in almost every setting, as many begin to reach retirement age. According to the latest annual census from the UK Royal College of Radiologists, in 2020 approximately 200 doctors will qualify as radiology consultants – not enough to fill even half of the estimated 466 vacancies.

The Government needs to be alive to the challenges associated with the safety of NHS staff and patients. The need for PPE and new designed layouts will affect theatre capacity. Diagnostics, which underpin clinical activity in hospitals, and a backlog in MRI/CT scans, endoscopy and laboratory tests are also limiting factors.

Back in March, Matt Hancock was right to sign a deal with the independent sector. In peace time this would have been an incredibly courageous thing to do with those on the left gleefully pointing to proof of Tory privatisation. I hope that the Covid-19 emergency has dismissed the lazy assumption that the independent sector and the NHS cannot work in partnership.

A similar long-term deal agreement with independent providers to retain capacity will be crucial in the years ahead. They can help ramp up elective capacity, power through knee, hip and cataract procedures, and improve lives – and in the case of Mr Martinez may even allow him to return to work and generate more tax revenue to fund public services. It will also allow for cancer treatment and cardiology procedures to resume at pace and scale. With appropriate testing arrangements, these could quickly become a significant proportion of the ‘Covid-light’ units that are being regularly discussed as the means to reduce the elective backlog.

The NHS does so many things well. But few would claim – especially staff – it cannot become more productive. We have seen the NHS conduct GP appointments and other consultations through digital challenges. This has worked. It is also worth noting that much of this would have been impossible if it wasn’t for the visible presence of the NHS on our streets in the form of community pharmacies offering that face-to-face reassurance for many routine issues.

This obviously needs to continue, but it is only the beginning. Let’s start a conversation about how the NHS can change many care pathways to become more productive. We can accelerate the uptake of already established treatments, which can keep patients out of a secondary care setting or at least not in expensive hospital beds for days at a time, by the adoption of less invasive procedures.

Changing pathways to enable the adoption of technology has often meant local evidence needed to be established – this could take years and was often completely unnecessary. We can expediate the move to integrated care working, especially with regarded to initiatives such as shared waiting lists and flexibility in payment mechanisms. This is a chance to improve existing practice.

We can be optimistic and ambitious for the future of our NHS. So much goodwill has been garnered and our staff are more valued than ever. But it is also an opportunity for change. A national effort led by a transparent and upfront Government is what is required.

Caroline Nokes: Spare a thought for women. Male ministers have forgotten we exist in their lockdown easing plans.

30 Jun

Caroline Nokes is Member of Parliament for Romsey and Southampton North. 

Covid-19 has taught us many things about the importance of physical and mental wellbeing. We discovered (if we actually needed to be told) that your chances of recovery were greatly improved by being physically fit and in the normal weight range for your height.

We found out that mental resilience was important to cope with long periods of relative isolation, and social contact carried out mainly by Zoom. We were told very firmly that an hour of exercise should be part of our daily routine, and pretty much the only way to escape the house legitimately.

But for women in particular the importance of wellbeing seems to have gone well and truly out of the window as lockdown is relaxed.

Why oh why have we seen the urge to get football back, support for golf and fishing, but a lack of recognition that individual pilates studios can operate in a safe socially-distanced way, rigorously cleaned between clients?

Barbers have been allowed to return from July 4 because guess what – men with hair need it cut. They tend not to think of a pedicure before they brave a pair of sandals, although perhaps the world would be a better place if they did. Dare I say the great gender divide is writ large through all this?

Before anyone gets excited that women enjoy football and men do pilates can we please just look at the stats? Football audiences are (according to 2016 statistics) 67 per cent male and don’t even get me started on the failure of the leading proponents of restarting football to mention the women’s game.

Pilates and yoga (yes I know they are not the same thing) have a client base that is predominantly women and in the region of 80 per cent of yoga instructors are women. These are female-led businesses, employing women, supporting the physical and mental wellbeing of women, and still they are given no clue as to when the end of lockdown will be in sight.

Could it be that the decisions are still being driven by men, for men, ignoring the voices of women round the Cabinet table, precious few of them though there are? I have hassled ministers on this subject, and they tell me they have been pressing the point that relaxation has looked more pro-men than women, but it looks like the message isn’t getting through.

I will declare an interest. Since I first adopted Grapefruit Sparkle as a suitably inoffensive nail colour for an election campaign in 2015, I have been a Shellac addict. The three weekly trip to Unique Nails is one of life’s little pleasures, an hour out, sitting with constituents, chatting, laughing, drinking tea.

It is good for the soul, a chance to recharge and chill out. And for many of the customers it is their chance to not have to bend to get their toenails trimmed, it is a boost to their mood, that can last for a full three weeks until it is time for a change.

And it is a fairly harmless change to go from Waterpark to Tartan Punk in an hour. Natural nails have done very little for my mood since a nice chap from Goldman Sachs told me: “you could go far if only you opted for a neutral nail, perhaps a nice peach.”

At school I was described as a “non-participant” in sport – I hated it, and it has taken decades to find the activities I can tolerate to keep my weight partially under control. Walking the dog is a great way, but nothing is as effective as the individual work-out rooms in a personal training studio – where it is perfectly possible for those of us who do not like to be seen in lycra to exercise in isolation and then have the place cleaned for the next victim.

I am not suggesting it is only women who do not like to exercise in vast gyms, there are men with similar phobias, but what I cannot get over is the lack of recognition that a one-to-one session in a studio is not the same as toddling off to your local treadmill factory.

The Pilates studio owners of Romsey and Southampton North are deeply frustrated at the apparent inability to draw the distinction between their carefully controlled environments and much larger facilities where, to be blunt, there is a lot of sweat in the atmosphere.

I know I get criticised for being obsessed about women – it goes hand in hand with the job description – but I cannot help but feel this relaxation has forgotten we exist. Or just assumed that women will be happy to stay home and do the childcare and home schooling, because the sectors they work in are last to be let out of lockdown, while their husbands go back to work, resume their lives and celebrate by having a pint with their mates.

(And yes I do know women drink beer too, but there is a gender pint gap, with only one in six women drinking beer each week compared to half of men.)

Crucially, women want their careers back and they want their children in school or nursery. Of course home working has been great for some, but much harder if you are also juggling childcare and impossible if your work requires you to be physically present, like in retail, hairdressing, hospitality.

These are sectors where employees are largely women, and which are now opening up while childcare providers are still struggling to open fully – with reduced numbers due to social distancing requirements. It is a massive problem, which I worry has still not been fully recognised or addressed.

Perhaps if the PM needed to sort the childcare, get his nails done and his legs waxed it might be different. But it does seem that the Health Secretary, the Chancellor, the Business Secretary and the Secretary of State for Sport and Culture, who all have a very obvious thing in common, have overlooked the need to help their female constituents get out of lockdown on a par with their male ones.

Am I going to have to turn up to work with hairy legs to persuade them that women’s wellbeing matters?