19:00 - The House divided: - Ayes: 198 / Noes: 344 - Question accordingly negatived.
The Minister for Care (Helen Whately)
I beg to move amendment (a), to leave out from “medicine” to the end and add:
“and recognises the unprecedented action the Government has taken in its tireless efforts against Coronavirus to protect the NHS and save lives.”
The coronavirus pandemic is the most serious public health emergency that our nation has faced for a generation and our NHS and social care system has been well and truly on the frontline. Today, I would like to outline the work we have done to protect our NHS and social care from the threat of this invisible killer, as well as our work to safely ramp up services now that this virus is in retreat.
On protecting the NHS and social care, we have worked hard to boost the resilience of our health and care system, so it would not be overwhelmed, as we have sadly seen elsewhere across the world. A major part of this mission was our Nightingale hospitals. This was one of the most ambitious projects this country has ever seen in peacetime, building hospitals in just a matter of weeks in exhibition centres and conference venues. That hard work from so many meant that, even at the peak of the pandemic, there was more critical care capacity than there was when coronavirus first hit our shores, so our NHS was able to give outstanding critical care to everyone who needed it.
Our social care system has also been at the heart of the pandemic, and we have worked hard to give it the support it needs. In March, we announced £1.6 billion of funding for local government and £1.3 billion of funding via the NHS. In April, we announced a further £1.6 billion, as well as our comprehensive adult social care action plan. In May, we announced a £600 million infection control fund for care providers in England, which includes funding so that social care staff can be on full pay if they have to isolate due to covid. That work is bearing fruit, thanks to the dedication, expertise and compassion of care workers throughout the country.
Fifty-eight per cent. of care homes have had no reported cases of coronavirus. Every life lost in our care homes fills me with sorrow, whether it is from coronavirus or not. However, we are seeing a sustained reduction in the number of coronavirus deaths. This week’s Office for National Statistics figures for England and Wales show that the number of deaths in care homes has fallen once again—down from 536 to 360 in the last week.
This has been hard, but through this crisis we have strengthened our health and care system, and we are looking to see what lessons we can take forward as we look ahead to the winter.
Suzanne Webb (Stourbridge) (Con)
Will the Minister let me know what steps the Government are taking to protect black, Asian and minority ethnic health and care staff?
Helen Whately
I thank my hon. Friend for that intervention. She makes a really important point. One of the things that I have put much thought into over recent weeks is making sure that our staff of black and Asian minority ethnicities have the protection that they need. Both for the NHS and for the social care system, we have supported the development of risk assessment frameworks to identify the risks, with recommendations on what steps can be taken. I am working with the system to make sure that those are put into practice.
Coming back to the lessons that we are taking forward, one of the things that has been a great success has been the adoption of new technologies such as, for instance, online GP consultations. Some 99% of GP practices now have video consultation capability, while hospitals have been doing virtual out-patient appointments and care homes have been using tablets—the digital kind of tablet!—to keep people in touch with their families. We are also seeing new ways of working to help those on the frontline to make quicker decisions and cut red tape. We will keep driving these important reforms so that we can give everyone a better experience of health and social care.
As the Prime Minister set out yesterday in the House, we have succeeded in slowing the spread of the virus. On 11 May, 1,073 people were admitted to hospital in England, Wales and Northern Ireland with coronavirus, and by 20 June this had fallen by 74% to 283. This has reduced the pressure on the NHS so it has been able to carefully ramp up important services. Hon. Members have raised questions about two specific services in the motion, and I will address them both.
First, coronavirus has had a real impact on many people’s mental health, so there is a lot of concern about mental health services remaining open and available. Our NHS mental health services have remained open for business throughout the pandemic, using digital tools to connect people and provide ongoing support. This has proved especially effective for young people. Throughout the pandemic, we have provided £9.2 million of additional funding for mental health charities. We understand that we may see an increased demand for mental health services in the months ahead, and we are preparing for this, together with the NHS, Public Health England and other partners.
Secondly, hon. Members have raised questions about cancer services—another area where we are working hard to maintain care. For example, we have been operating surgical hubs where providers work together across local cancer services to maintain access to surgery. Although some cancer diagnostics and treatments have been rescheduled to protect vulnerable patients from having to attend hospitals, urgent and essential cancer treatments have continued. The latest data suggests that referrals are back to over 60% of the pre-pandemic levels, partly due to the NHS Help Us Help You campaign. This campaign has an important message that I am keen to repeat today. Anyone who is worried about chest pains, fears that they might be having a heart attack or a stroke, feels a lump and is worried about cancer, or is a parent concerned about their child should please come forward and seek help, as they always would. The NHS will always be there for us if we need it, just as it has been there for all of us throughout this crisis.
Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
On that note, will the Minister also encourage people suffering from vascular disease to seek appropriate treatment as quickly as possible?
Helen Whately
The hon. Lady is absolutely right. The Under-Secretary, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), says to me that the hon. Lady is a very powerful campaigner on this subject. For that and for other conditions, people must absolutely come forward and get the help that they need. The NHS is there for that reason.
My third and final point is on testing. Testing for the virus and tracing how it spreads is critical to containing it as we ramp up services and ease the national lockdown. This is especially important for our NHS and social care system so that we can protect our colleagues and the people they look after. We have already built an immense national infrastructure for testing. Back in March, we had the capacity across all our testing channels to conduct fewer than 2,000 tests a day, whereas yesterday we saw more than 237,000 tests carried out. As we have built capacity, we have prioritised those in need. We started with the patients who needed a test, then expanded to NHS and social care workers and their families, then to other critical key workers, before we expanded to the wider community.
Today NHS England and NHS Improvement have written to NHS trusts and foundation trusts to outline further steps that must be taken in the NHS, including continuing to prioritise testing for all NHS staff with symptoms; extra testing of non-symptomatic staff when there is an incident, outbreak or high prevalence; and regular surveillance testing of staff which, on the advice of our chief medical officer, will be fortnightly or more frequently, depending on local or national epidemiology.
Clive Efford (Eltham) (Lab)
On the testing figures that we get every day, after we take out studies that are being done through testing, along with double testing and those tests that are sent out through the post, are we not down to just about a third of the numbers that the Government claim are taking place? How can we have any confidence in what the Government say about what they are going to be doing about testing going forwards?
Helen Whately
The hon. Gentleman has talked about taking out large numbers of testing; as the Minister for Care, I have seen a huge demand from the social care sector for testing through those channels, so I would not take out other forms of testing. For example, testing through tests sent to people’s homes very much counts and should be considered as part of our testing programme.
We have put a rigorous focus on testing in care homes, too. We met our target of offering tests to all staff and all residents of care homes for over-65s and those with dementia in England by 6 June. We then announced that we were able to extend the testing programme to all adult care homes. Since the launch of whole care home testing, we have provided over a million test kits to more than 9,000 care homes, and we are now able to send out more than 50,000 test kits a day. We are also running a prevalence study to get a detailed picture of coronavirus infection in care homes. Phase 2 of that study has just gone live, meaning that 10,000 residents and staff across 100 care homes will have repeat swab and antibody tests.
Tim Farron
The Minister is being generous in taking interventions. Does she agree that to keep care homes safe from the coronavirus, the testing needs to happen regularly, not just once or even twice, and it needs to include people displaying no symptoms whatsoever? Does she also agree that, particularly for those NHS sites that are deemed to be clean and that are attempting to be covid-free, which are often the places where surgery will take place, the regular testing of staff even on a weekly basis, whether or not they display symptoms, is essential, not only, for example, to bringing back the mental health and maternity services that are currently lost to Westmorland General Hospital, but to making sure that the whole of our health service can operate as normal?
Helen Whately
I absolutely recognise the importance of repeat testing, both in the NHS and in social care. Our policies, and the testing programmes that we have in place and are launching and taking forward, are based on the clinical advice as to what the right programme to have in place is. I have set out the programme for the NHS, which is based on the advice of the chief medical officer, and we have sought advice from the Scientific Advisory Group for Emergencies on what the repeat testing programme should be for the social care sector.
Jonathan Ashworth
I am genuinely grateful to the Minister for giving way. We are trying to engage with the Government on what we think is a constructive proposal, and not to do the usual political knockabout. I did a bit of that yesterday at Health questions, as she knows, but today I am trying to adopt a different tone—
Jonathan Ashworth
Trying, yes. Just so that we can understand this, is the Minister saying that the Government’s position on weekly testing of all NHS staff, whether symptomatic or not, is that that is not an appropriate clinical intervention—as distinct from saying, “We simply do not have the testing capacity at this stage, but it is something we would like to do in future”?
Helen Whately
I am sure the hon. Gentleman was listening when I outlined the policy for the national health service. That is based on the chief medical officer’s advice. I think that is pretty clear. The Opposition’s position is not entirely clear, given that the hon. Gentleman started out saying “Weekly testing when necessary”, but said in his speech that it was weekly testing, whatever. On the other hand, we have been clear and the hon. Gentleman can look at the letter from NHS England and NHS Improvement to NHS trusts for further information.
I should move to the conclusion of my remarks—[Interruption.] Hold on, I thought we were not having any more political knockabout. We have established a national testing programme on a scale and at a pace that has never been seen before in this country. We will keep expanding that so that we can use high-quality testing to give confidence and certainty to anyone who needs it.
As I have set out today, there has been incredible action across our NHS and social care as we respond to this invisible killer. Thanks to the efforts of so many, crucial services have not been overwhelmed and all coronavirus patients who were admitted to hospital were able to receive urgent care. Because we have made such progress on slowing the spread of the virus, we have been able to ramp up other important services as part of our plan to get Britain back on her feet. However, we cannot be complacent and we must be ready for any increase in the rate of coronavirus infection and also for the winter, when, as hon. Members know, there is a greater risk of seasonal flu. As we keep ramping up services, we will ensure that we have the surge capacity to act quickly if necessary.
I want to finish by thanking the incredible NHS and social care staff who have been on the frontline of the pandemic. There has been a collective effort from so many, including healthcare professionals who have volunteered to return, and medical students, allied health- care profession students and nursing students who have stepped up at this important time for our country. The whole House and the whole nation are grateful to them for their heroic work.
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
Like all other Members from all parts of the House and from all four nations, I add my thanks to all those in the NHS and across social care, although actually it is broader than that. There are those in primary care, our community health teams, those who have adapted the way they work in addiction services and so on, because all these things have had to change at pace.
When we started to get the news towards the end of January that this was a pandemic, we started to realise that we were dealing with a completely unprecedented time, and all those people stepped forward. We have heard repeatedly this afternoon that more people stepped forward to make this a journey of collaboration and innovation. We have seen changes right across the national health service and the services that we have had to build to make decisive changes.
I gently say that 12 weeks ago, as we went into lockdown, many of those services were very different: the delivery of PPE to just over 200 national health trusts has now ramped up to 58,000 providers; we have developed Clipper and local resilience forums to help us with the distribution of PPE throughout these extremely complex changes; and a large amount of work has been done on vaccines and testing. All these things are a tribute to collaboration and we need to thank the innovation of not only private industry, as my hon. Friend the Member for Witney (Robert Courts) mentioned, but the Army. This truly has been an effort of public service, and as we have come together—as we have done across the House—we have achieved so much more.
How do we carry on achieving more? There was a challenge before we went into the crisis, and the decision to postpone non-urgent elective treatment was the right one, because it allowed us to have the capacity required to help us to manage increased demand in the NHS. Throughout the outbreak, we have ensured that patients who require urgent treatment have been able to access it and, like many Members, we encourage people not to delay in coming forward for treatment as they normally would, should they require it. NHS has a firm “Help Us Help You” message.
We heard of how, as my hon. Friend the Member for North Devon (Selaine Saxby) put it—I do not think I can put it better—we achieve much more by working together and focusing on what we do best. How do we drive down waiting times and have routine services return as quickly as possible to their normal provision? We must ensure that that is done in a safe and managed way to maintain capacity but avoid any further surge in covid. As outlined in the guidance already issued to the NHS, the restarting of routine electives should prioritise long waiters first and make full use of all contracted independent-sector hospital and diagnostic capacity.
Cancer was mentioned by severable Members. Urgent cancer care and treatment has continued throughout the pandemic. We know how important it is that referrals, diagnostics and cancer treatment reach pre-pandemic levels as soon as possible. Urgent action should now be taken by hospitals on the two-week-wait referrals, and they should provide two-week-wait out-patient diagnostic appointments at pre-covid-19 levels. That is easy to say but really hard to achieve.
The work done by protected hubs and to ensure that rapid diagnostic centres have been pushed out has been important. During the outbreak, the Secretary of State and I have regularly met the national cancer director, Dame Cally Palmer, to discuss progress not only on how we were dealing with cancer during the crisis, but on restoring cancer services as quickly as possible. We will keep a laser focus on that.
The NHS has continued to deliver over and above. Guidance has been issued and further guidance to restore urgent non-covid services in a safe way while ensuring that surge capacity can be stood up again, should it be needed, is already being planned. Preparations for going forward have already begun: we are learning lessons from where we have been but also driving ourselves to where we need to go. My hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) said that we should think about what we can learn, how we can reset and how we can make sure that as we go forward we can take the best of what has changed, develop it and weave it in.
Stephanie Peacock
I really appreciate the Minister giving way. I just wondered whether she could respond to the question that I put in my contribution to the debate, which is around the relaxation of guidance on death certificates for those suffering from industrial diseases. I am just asking the Government to revise their guidance so that anyone who has an industrial disease has that recorded on their death certificate.
Jo Churchill
If the hon. Lady will forgive me, I will write to her on that exact point after the end of this debate. If I segway off, I will not make the points that I would like to make.
I was very grateful to my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who said that the decision by the Secretary of State to put in a stretch target for testing was indeed courageous—something with which many hon. Members, I am sure, would agree. That dramatic expansion of testing has got us to where we are today.
My hon. Friend the Member for Peterborough (Paul Bristow) spoke of improving care pathways and the joint work between the private sector and the NHS, being ambitious and changing methods of working to meet demand. My hon. Friend the Member for Wimbledon (Stephen Hammond) spoke articulately about the issues, including the stretch target, but also about preparation and how we make sure that our hospitals are ready and fit for the future. My hon. Friend the Member for Moray (Douglas Ross) talked about how challenging it is but pointed out how the four nations have worked together. I join him in supporting the fact that we are stronger together. I have missed out my hon. Friend for—
Jo Churchill
I am sorry. I put Worcestershire, but I knew that it had a bit of the compass before it.
My hon. Friend the Member for West Worcestershire (Harriett Baldwin) spoke of innovation. She said that the appointment of Lord Deighton had led to a revolution in the UK manufacturing of PPE to support all our NHS workers as we drive forward. Some 2 billion items have been ordered to be made in this country. She also mentioned innovations by our GPs, pointing to the fact that the number of surgeries delivering video consultations has risen from 3% to 99%. She talked about innovations in medicines and treatment, and about the first effective treatment to save lives. On testing, she said how proud she is of everything that is going on there.
My hon. Friend the Member for Crewe and Nantwich (Dr Mullan) talked about managers and workloads as normal services return. He, like many hon. Members, brings to the House his experience from the NHS. One thing struck me in particular—that we target messages at the right groups. We know that health inequalities are persistent and stubborn, so we must get the messaging right as we go forward.
My hon. Friend the Member for Meon Valley (Mrs Drummond) spoke about the importance of preparedness, including assisting staff. This afternoon, mental health came up repeatedly and ensuring that helplines are in place to assist all our NHS recover and gain resilience throughout the next phase.
Jo Churchill
I am sorry, I will not give way, as I have only a minute left.
On testing, we are continuing to prioritise our frontline NHS staff with symptoms for testing and testing asymptomatic NHS staff where appropriate, where there is an incident. We are surveying the health and care settings in Public Health England’s SIREN study and monitoring prevalence. Although the CMO has recommended that testing happens fortnightly at the moment, all these issues are currently under review.
At the start of this crisis, we made sure that NHS capacity was always there at the time of need. The goal was clear that, however tough things got, the NHS would never fall short of that founding promise to be there for somebody who needs it. It meant taking difficult decisions and, as we rebuild and refocus on delivering for all those on the waiting list, I want to put on record my thanks to those on the frontline for their heroic efforts.
At the same time, the NHS has been instrumental in carrying out the world’s first successful clinical trial and, in just a few months, it has achieved much. The NHS is also playing a crucial role to help to operate one of the largest and most comprehensive test and trace systems in the world, with capacity for 280,000 tests today. I have gone on the record many times to say that our colleagues in the NHS and across the public services are always there for us. If you are concerned about anything, you should seek help. The NHS will always be there for you. But what we have discovered from the speech by the shadow Secretary of State—
Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)
claimed to move the closure (Standing Order No. 36).
Question put forthwith, That the Question be now put.
Question agreed to.
Question put accordingly (Standing Order No. 31(2)), That the original words stand part of the Question.