 Coronavirus cases across the UK continued to be uncomfortably high and citing pressure on hospitals. The chief executive of the NHS Confederation has now called for the government to reintroduce modest restrictions to slow the virus's spread. There has also been pressure from a number of members of SAGE to implement the government's so-called COVID Plan B, which would see mandatory face masks and a request to work from home, both come back into effect. This was the context for the first Downing Street press conference we've had in over a month that happened this afternoon, but health secretary Sajid Javed was clear that he had no intention of reintroducing new restrictions, saying the NHS was not yet overwhelmed. In this clip you'll also hear from Stephen Powis, who is the medical director of the NHS. We don't believe that the pressures that are currently faced by the NHS are unsustainable. Don't get me wrong, there are huge pressures, especially in A&E, in primary care for example as well, but at this point we don't believe they're unsustainable and Steve can answer a bit more about that in a moment, but I will say one of the reasons I think the NHS is able to do what it does still, the number one is obviously thanks to everyone that's working in the NHS, but the extra support we're providing this year for the second half of this year, we're providing an additional £5.4 billion, which is certainly helping and that's what we hear and we will absolutely keep it under review. If we feel at any point it's becoming unsustainable, then the department together with our friends at the NHS, we won't hesitate to act. Steve? Yes, thank you Sophie. So I think the first thing to acknowledge as the Secretary of State has said and indeed as our Chief Executive Amanda Pritchard said at the Health Select Committee yesterday, the NHS is under considerable pressure. We've had a very tough summer as we have continued to treat people with COVID, being admitted to hospitals, a society has opened up again and we've begun to see a return to normal, near normal levels of presentations of urgent people who need urgent and emergency care and of course as we started to make inroads into treatments for patients whose care has been disrupted and delayed during the pandemic, so it undoubtedly feels exceptionally busy in the NHS and our NHS organisations are telling us that all the time. It's not just COVID of course, we have one eye to the flu season and we don't know what's going to happen with flu this year, but there is a risk that we will get more flu back and it will be worse than previous years because we missed out a season last year and there are other viruses around as yet as well as well and of course we are continuing to do all that work around the recovery of our elective and routine services, so it is very very busy indeed. We work very closely with the Department of Health Social Care around the judgment of how the NHS is doing and we will continue to do that as we go into winter, but I think the really critical thing is that the public can help us here. The public can absolutely help the NHS here and as the Secretary of State has said there are things that the public can do that will take the pressure off the NHS, so the first is to remember that for face masks there is guidance in place if you are in a crowded environment, a higher risk environment on the tube, you know a building, a cramped building with low ventilation then wear that face mask it makes a difference it really does and the second thing of course is the vaccine program because the vaccine program is our best protection against COVID and therefore if you've been invited for a booster and you haven't had one or if you are getting your invitation in the next few weeks then get that booster as quickly as possible because we know that the immunity that we get from vaccines will drop off over time and we don't want that to occur going into winter. So it's a slightly odd press conference you had such a javid there saying that there are not unsustainable pressures on the NHS then Stephen Powers listing what sounded like a lot of unsustainable pressures on the NHS and then a call for people to continue wearing masks. I don't know why they keep saying oh we'll leave it up to you, it'll be personal responsibility whether you wear a mask on public transport etc etc. I think everyone understands this that people wear masks when other people wear masks, we're all social beings, we're all kind of sheep when it comes to things like this. I say this about myself as well, I am totally led by what other people in the room are doing, by what other people in the building I'm in are doing. When it comes to buses because it is you know it's legislated even if no one else on the bus or the train is wearing one I'll wear one because that is like we're very specifically a rule but where it's recommendations in my corner shop the people in there don't wear masks so I'm less likely to go in there with a mask. If you just you know it's such a low-cost thing to just say now look there is pressure on the NHS let's introduce some of these measures which have really few costs, masks in indoor spaces encouraging people to work from home instead of traipsing into the office. This stuff would be virtually cost-free and the government is still refusing to do it because they want to wait until the NHS is you know completely on its knees not just kind of on its knees. Dahlia what do you make of the current state of debate on COVID-19? Lots of people saying are we going to have a new lockdown I'm pretty sure we won't but it does seem like some further restrictions seem a bit inevitable at this point in time. Things just aren't they aren't over yet and we know this we are having around 200 deaths a day that might even you know there is early suggestions that the booster vaccine program is not going to be as effective as the original vaccine program not because the booster itself isn't effective but for whatever reason the uptake so far has just not been as high and as the the efficacy of these vaccines wane we you know that is going to present a problem and yet we're repeating the exact same mistakes and one of those is taking NHS staff for granted and seeing them essentially as the sacrificial lambs of the economy of seeing their their mental health their physical health as being you know things that we just sacrifice in order to keep this mirage of back as normal you know back to normal going and you know I say this all the time when we talk about the NHS being overwhelmed or the NHS being in an unsustainable condition we don't mean one day you're going to wake up and you know what was once an NHS building is just going to be rubble on the floor that's not what it that's not what we mean what we mean is that staff are so overwhelmed and under resourced that they aren't able to provide the levels of care that you would expect in you know a modern healthcare system and that is the message that we are getting for example from you know the Chief Executive of the NHS Confederation it's that we are on the precipice of being back where we were in that peak condition of the pandemic where you know I I always go back to it because I think it was such a kind of powerful interview but that interview we did I think it was last year with Silas Webb where he talked about you know he's an A&E doctor and he talked about the trauma and the moral injury of being a you know a staff member of being a health worker on an overwhelmed COVID ward and the fact that you know we're sort of playing this game again and we're talking about you know not really putting in something so simple as mask mandates which I don't know anyone who's been on a bus or a tube or a train recently will tell you that the mask mandate on TFL is basically not being adhered to because the message is not coming from the government the message is not coming from the top it's coming from the mayor but that clearly is not enough to actually get people to take that advice and so we are looking down the barrel in Christmas with a combination of flu season wailing vaccines and the fact that people really have received this message from the government that the pandemic is over that we can go back to normal we've announced freedom day and so once again we are putting those incredible NHS staff members on the brink physically and mentally and it's absolutely shocking that the government after you know clapping for carers and after all of you know this lip service about understanding the value of NHS workers that they would turn around and and do that again and when when the winter plan was was first announced you know from the beginning I've always said that the idea of scrapping the mask mandate of scrapping masks in indoor spaces is absolutely ludicrous and you know in Sadja Javid's press conference today he again indulged this absurd notion that masks are somehow a violation to personal freedom it's actually the exact opposite it's masks that prevent us from having to go into very restrictive lockdowns that actually are quite worrying violations of freedom that actually do restrict our freedom and do create you know mental and physical health consequences later down the line it's that low risk you know low kind of low hanging fruit that this government is repeatedly refusing to adhere to not because it's not doesn't make sense or because it's not the logical thing to do but because instead of being sage medical advice which is what masks are mask wearing and where working from home is it's been mired into a nonsensical culture war which is so irresponsible for a government to do in the midst of a health pandemic but culture wars is the terrain that this government likes to play because it's the one that it wins most effectively on and it's just scary to think about how many lives are actually going to be impacted by by this sort of misuse of power it was also I suppose notable in that press conference that what we were constantly told is basically we're leaving this down to individual responsibility but we're very clear if you are in an indoor space with lots of people and wearing a mask is you know a practical thing to do obviously you can't really do that in a bar or a nightclub that's why I'd be in favor of vaccine passports but that's another issue if you're in a crowded place where you can wear a mask you should do so well if you watched PMQs today what you would have noticed is that all their labor MPs were wearing masks none of the conservative ones were one more thing I do want to mention is that Sajid Javed I think very disingenuously sort of suggested oh that the NHS is going to be fine because we bunged it an extra three billion or whatever however much we we bunged it this winter and and why that doesn't stack up is because the reason the NHS is at breaking point is is staffing right we have underfunded the NHS for 10 years huge shortage of nurses and you can't bung them three billion quid and suddenly they employ loads more nurses to get us through this very very difficult winter we know why it's difficult flu COVID and then also the backlog of operations and the backlog of people who haven't appeared at at hospitals over the past 18 months because of COVID so it can be a very difficult winter and the reason it's going to be almost you know impossible to get through if we treat everything as if we are in a normal situation is that we have been running the NHS at capacity for a decade called efficiency savings if there is ever a free bed in a hospital that means something's going wrong that that's that's a bed we shouldn't have we need to sell that bed we need to reduce that space get some extra money from real estate by by selling off part of the hospital to develop a new block of flats that has been the attitude of the government over the past 10 years any any any extra capacity is actually a failure and now when we have a global emergency they think oh we'll give them a few extra billion pounds and they'll get through it that's not how it works and that is why we are in I think a pretty dangerous situation that's why you are hearing the people at the top of the NHS saying we absolutely need the government to take this more seriously the government especially Sajid Javid just saying no no it's fine we don't think anything is going particularly wrong it doesn't stack up to me and I think presumably we will enter plan B in a couple of weeks or so I mean hopefully the booster shots will will will speed up as will the vaccinations for the teenagers fingers crossed