NHS Dentistry
Angela Eagle Excerpts(9 months, 3 weeks ago)
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Victoria Atkins
I am going to make a little progress, but I promise to give way later.
The whole House understands that the pandemic placed a long-lasting and heavy burden on NHS dentistry. [Interruption.] I hear groans from Opposition Members, but they cannot ignore the fact that some 7 million people did not come forward for appointments during that long period of the pandemic because dentists had to shut, and we were unable to accommodate those needs within the system because of the severe strictures under which we were all placed as a society. We shepherded the sector through the pandemic with £1.7 billion of direct support to compensate for NHS activity that could not be delivered. As we recover from the pandemic there are no quick fixes, but our recovery is well under way. Let me give the latest statistics, because the hon. Member for Ilford North missed them out in his speech. The Government delivered 6 million more courses of NHS dental treatment in 2022-23 than in the previous year. [Interruption.] In the two years to June 2023, the number of adults seeing a dentist increased by 1.7 million compared to the number in the previous year, and 800,000 more children saw a dentist in the year to June 2023.
Opposition Members cannot have it both ways. While I was reading out those statistics they were saying, “You cannot make those comparisons because of the pandemic”, but that is the point: people did not come forward during the pandemic, so, as we must all know from experience in our own constituencies, there is a backlog that dentists around the country are having to work through—and they are making progress.
Victoria Atkins
As I have explained, in relation to dentistry but also in relation to wider healthcare, the long-term workforce plan, which was requested by NHS England and by clinicians, is the means of laying those foundations for the future of the NHS. I will now give way to the hon. Member for Wallasey (Dame Angela Eagle).
Dame Angela Eagle
I thank the Secretary of State. I wanted to intervene earlier when she was talking about the pandemic. In my constituency many people were thrown off their dentists’ lists during the pandemic, often with no notice, and then found that they could not register anywhere else. That is what happened, I believe, all over the country. Can the Minister explain what she is going to do about it? It was not that people were not visiting their dentists; they were denied access.
Victoria Atkins
The hon. Lady has raised an interesting and important point, because, of course, dentists are independent contractors to the NHS, and I have to work with the levers that are available to me. As I have said, we have already invested £1.7 billion to try to help with the recovery, and the House will, I hope, look forward to our dentistry recovery plan when it comes to other ways in which we can improve that. The important point, however, is that because those dentists are independent contractors, we must work with the profession to encourage them back to the NHS to offer the services that we all want to see.
Dame Angela Eagle (Wallasey) (Lab)
It is a pleasure to follow my hon. Friend the Member for Wakefield (Simon Lightwood), who made a superb speech. I have childhood memories of much older relatives who grew up before the NHS was created having no teeth left at all—they had had them all extracted because it was cheaper. I never thought that might start to happen again, but I fear that in some cases we are getting far too close to it with the current situation in our dental service. As many hon. and right hon. Members have pointed out in today’s debate, this is not only serious for oral health but has other health connotations. New medical insights link oral hygiene with heart and lung health. If we neglect oral hygiene to the extent that we are—we have heard about that in the debate—that will have huge implications for the health of future generations.
As Labour’s motion sets out, NHS dentistry is in crisis and is approaching breaking point, if it has not already passed it. The people of the UK are paying the price, and the poorest are paying a much heavier price. The Nuffield Trust says that NHS dentistry
“is at its most perilous point in its 75-year history.”
In Wallasey, my constituents are living with the reality of that day to day. As we have heard, a seven-year-old is more likely to be hospitalised for rotting teeth than for any other medical issue. That is an astonishing statistic. Many people—including my constituents—are growing up in places where they simply cannot get access to dental care. In Wallasey, only two dental surgeries will take a child as a new patient, and not a single one is taking any new adult patients on to its books.
In Wallasey, we have seen people kicked off existing lists without notice. That happened often during the pandemic, with the excuse that they had not visited the dentist in two years—they could not, as the dentists were closed because of the pandemic—and they cannot get access to another provider. There are care homes in my constituency where there is no access to dental treatment for those living in them. I have had email after email from constituents writing to me in despair, disbelief and often pain, all unable to get an appointment. NHS workers, an expectant mother, a retired firefighter, concerned parents and disabled people with declining health are all unable to see a dentist because of the terrible 14 years of Tory neglect.
Last summer, Sarah wrote to me when she was at her wits’ end. She had moved into my constituency from Liverpool a few years ago with her partner, pleased to be closer to family as they prepared to welcome a baby. Despite their home being close to four different dentists, Sarah was unable to register with any surgery. Each one was not accepting new patients. None even had a waiting list that she could join. She has now lost one molar and broken three. She has tried and failed to get an emergency appointment numerous times, and she has had to call 111 in desperation. She is in constant pain and still has no access. Her little boy, who is now four years old, has never seen a dentist, despite his parents’ best efforts.
Dentists, too, are outraged. Last year, Annette, a local dentist who has a superb surgery and has worked for the NHS her whole life, wrote to me in total despair. Her surgery has being working overtime to see NHS patients and to try to meet the unmet need—it has even overperformed on its targets to get the NHS to care for local people who desperately need it. She was doing that, but it got to the stage where her surgery was not being paid for NHS work due to errors and unexplained hold-ups in money. Just before Christmas, she said:
“At the end of next year I will have been a dentist for 50 years, always working on the NHS. I don’t think I have ever known it in such a bad state, nor for the Government to have so little care of its state.”
She is over-worked, under-compensated, exhausted and unable to keep up with demand, and she is not being paid for the work that she is doing. It is a terrible state of affairs.
We see a picture of underspent ICB dental budgets and massive unmet need. It is obvious that those things demonstrate a system that simply is not working. The Government know about this as well as we do and announced last April that there was going to be a plan, but we still have not seen one. If they care, where is their sense of urgency? They cannot say that our plan to put NHS dentistry in working order will not work when they will not bring forward their own plan. They must get on with it now. My Wallasey constituents are in pain, and I expect it to be alleviated.
Oral Answers
Angela Eagle Excerpts(1 year, 6 months ago)
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Mike Amesbury (Weaver Vale) (Lab)
Dame Angela Eagle (Wallasey) (Lab)
The Minister for Social Care (Helen Whately)
I want people to live independently in their own homes for longer with the care that they need. We are investing half a billion pounds annually through the disabled facilities grant to pay for housing adaptations, and supporting the home care workforce through our record social care funding increase and workforce reforms. Our new and expanded NHS virtual wards give people hospital-level care in their own homes.
Helen Whately
The hon. Member makes an important point about people spending their last days of life where they would like to spend them, which, more often than not, means at home. That comes down to supporting end-of-life care—hospices play a really important role in providing that care in people’s homes—and supporting the adult social care workforce. We are investing up to £7.5 billion in social care over the next two years and taking forward important reforms to support the adult social care workforce. As I mentioned a moment ago, we are increasing the amount of hospital-level care that people can get at home by expanding our virtual wards, which, by next winter, will mean that up to 50,000 people a month can be cared for to that level at home.
Dame Angela Eagle
Despite ministerial complacency, Age UK has pointed out that, nationally, there are currently 165,000 vacancies in social care, which is a 50% increase on last year. In the Wirral, vacancies run at 16%, which is despite the Wirral paying the real living wage. That means that only 26% of hospital patients are currently being discharged from Wirral University Teaching Hospital when they are actually ready to go. Does the Minister agree that the neglect and underfunding of social care by this Government is costing more money through wasted provision in hospitals, when social care, if it were properly provided, could give a much better experience for people who are ready to leave hospital?
NHS: Long-term Strategy
Angela Eagle Excerpts(1 year, 9 months ago)
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Wes Streeting
I will give way to my hon. Friend the Member for Wallasey (Dame Angela Eagle), who has been waiting.
Dame Angela Eagle
On minimum service guarantees, does my hon. Friend think that the Conservative party has a brass neck to try to enforce minimum service guarantees, which are always made by agreement on any strike anyway, but says nothing at all about the catastrophic loss of service guarantees because of their mismanagement and underfunding on every other day?
Wes Streeting
My hon. Friend brings me neatly to the argument that I want to make about minimum service levels. Let me tell the Health Secretary who they are talking about when the Government attack ambulance crews. Donna Wilkins called an ambulance when she became concerned that her disabled son James may have been having a stroke, which is a listed side-effect of the medication that he takes. She and James waited in an ambulance for nine hours outside the Royal Bournemouth Hospital because there were no beds. Paramedics waited with them for the full nine hours. They chatted with James, loaded his favourite TV shows on their phone for him to watch and ran into the hospital to bring tea for Donna and soft food for James, who has problems with swallowing, which they spoon fed him. This is who NHS staff are. This is who ambulance crews are. These are the very staff the Government would have sacked with the legislation that they are bringing forward next week. As my hon. Friend said, what brass neck from this Government to talk about minimum standards on strike days when they cannot deliver basic minimum standards on any other day of the year.
The two-month target from GP referral to cancer treatment has not been met since 2015. Four in 10 people are waiting more than four hours in A&E. The four-hour target for A&E waits has not been met since 2015. The 18-week treatment target for elective care has not been met since 2016. One in seven people cannot get a GP appointment when they try. More than 1.3 million waited more than a month to get a GP appointment in November. How much more evidence do the Government want that they are incapable of delivering the minimum basic standards that patients deserve every single day of the year?
This has to be seen to be believed: the Government are planning an advertising campaign to urge patients to stay away from the NHS with the tagline “Help us help you.” Do they not see the risk in patients not coming forward for help when they need it? Can they not understand that people are fed up with being told that they have to protect the NHS, rather than the other way round? Instead of asking the public to help the NHS, the public want the Government to help the NHS to help them.
Steve Barclay
The issue of bed capacity does indeed matter. I made the point a few moments ago that flow in hospitals is obviously constrained when bed numbers are high. That is exactly why, in the statement on Monday, I highlighted the importance of discharge, and of things like discharge lounges so that we can better facilitate those patients that are free to leave. But this is not simply about hospital bed capacity; it is about step-down intermediate care capacity and also, as we heard a moment ago, about the innovation that means we are better able to facilitate those patients who want to recover at home but want the safety net of some clinical support when they are doing so. It is about looking at the capacity in the whole of the system, not simply in the hospital; otherwise, the hospital itself becomes a magnet.
Dame Angela Eagle (Wallasey) (Lab)
The crisis this winter was predictable and building long before we arrived here. Normally, the NHS and the Department plan for winter crises in the summer months, but this year something else was going on in the summer months, wasn’t it? The Tory leadership election. Does the Secretary of State regret what the distraction of the Tories’ internal faction fighting has led to, which is the inability of this Government to plan ahead and do the day job, and the fall below minimum standards of the Government service?
Steve Barclay
I do not think those are factors that affected what happened in Scotland, where the First Minister warned on Monday that the hospitals were almost completely full. Indeed, the Scottish Government are taking emergency measures, including cancelling some non-essential operations. I do not think that was a factor in France, where the French Health Ministry is saying that intensive care beds are at saturation point. I do not think that was a factor in Wales, where more than 54,000 patients are waiting more than two years for an operation. I am glad that the hon. Lady highlights the summer, because it was in the summer that we hit the first of our elective recovery targets in terms of the two-year wait, getting those below 2,000, in stark contrast to what we saw in Wales. The surge in flu has happened across the United Kingdom, not just in England, and it has also affected France, Germany and other countries in Europe.
Dame Angela Eagle (Wallasey) (Lab)
Through neglect, ideological hostility and incompetence, the Tory Government are presiding over the worst crisis the NHS has ever seen. Some 7.3 million people are on the waiting list; there has been a virtual collapse of emergency response; and people cannot see a GP or get follow-up treatment without unacceptably long waits. Today, there have been reports of more than 1,000 excess deaths a week—the highest total, excluding the pandemic, since 1951. There have been many, many preventable deaths on the Government’s watch, and each and every one is a tragedy.
Our NHS is in crisis from top to bottom. There are patients in hospital beds who cannot be discharged because there is no domiciliary care and nowhere for them to safely go. Ambulances are queuing for hours, unable to admit critically ill patients. There are inhumane waits in A&E before anyone can be admitted to beds they desperately need. Staff, who are already burnt out from the stresses of the pandemic, are unable to care properly for patients and are barely able to get through a shift because of the emotional exhaustion of having to deal with those failures.
A nurse at Arrowe Park in the Wirral, which serves my constituency, wrote to me recently. After 21 years of service to our NHS, she says she has
“never worked in such an unsafe environment”.
She says:
“Staff are literally on their knees, leaving shifts late in tears, and leaving in their droves”.
My constituent went on to detail a case in another local hospital in which a patient had a cardiac arrest in a hospital corridor. Frankly, a hospital should be the best place to have a cardiac arrest if somebody is going to have one, but it is now not so in Tory Britain. The individual collapsed and died.
With 132,000 NHS vacancies in England—over 17,800 in the north-west alone—our NHS is dangerously understaffed, under-resourced and under-respected. That is why NHS staff at the end of their tether have taken the desperate decision to go on strike. That is why any Government worth their salt would have decided to negotiate properly with them, to listen to them and to try to deal with and recognise that, in the last 13 years, a real-terms cut of 20% in nurses’ remuneration is simply not acceptable, but what did they do? They chose to have a divide-and-rule strategy, and they chose to try to scapegoat and blame NHS staff for the terrible conditions I have been talking about.
Perhaps the Government should consider legislating for a minimum service outside of strike days, because we are going to be in the absurd position of having, by law, guarantees on strike days—they could be negotiated anyway and always have been—that do not apply on non-strike days. It is an insult when the Secretary of State meets the health unions and says they have to increase their productivity. They are working beyond any amount of time that any human being should be asked to work.
Dr Caroline Johnson (Sleaford and North Hykeham) (Con)
I confess to being a bit confused by the Labour party’s position on minimum service levels. We all want to ensure that our constituents are as safe as possible. The ambulance workers want to ensure that people are as safe as possible. The hon. Lady has said herself that these things would be negotiated anyway. But the challenge people face on the ground is not knowing who is going to come in, the fact that people do not have a say on whether they are going to come in and the fact that a negotiated settlement might be different in different areas of the country, which makes messaging and public health messaging very difficult and puts people at risk. So why is Labour so against minimum service guarantees?
Dame Angela Eagle
I think the hon. Lady, and I know that she is a doctor, needs to recognise that these agreements have always been made when there have been strike days in the NHS—always. I think she also needs to recognise that any Government who were being responsible would have negotiated to put an end to these strikes, recognised the fantastic service that nurses have given and dealt with the issue, instead of going for confrontation.
Dame Angela Eagle
I am not giving way again.
I am going to leave the last parts of my speech to another constituent of mine, an 83-year-old who fell alone in his home and was left. The ambulance was called at 4.15 in the afternoon—it was thought he had a fractured hip—and he was warned of a potential 14-hour wait. My constituent said he
“naively thought this must be the worst case scenario and thought it was very unlikely to be that long”.
He could not move, he could not sleep and he could not go to the toilet. Eighteen hours later, the ambulance arrived—18 hours later—at 10.15 the following morning. At the hospital, things got no better. There were patients on trolleys lining the corridors. For nearly another 24 hours, this 83-year-old man immobilised with pain was to lie on a trolley in a hospital corridor after 18 hours of waiting for an ambulance.
This is in no way acceptable. This should not be accepted by any Government worth their salt. They should hang their head in shame at what they have done to our NHS. We need to have a Government finally, which we will after the next election, who will solve these problems, instead of seeking to blame everybody else—the weather, the pandemic, the staff and any number of other things. It is about time we had a Government who have the guts to take responsibility for the decisions they have made and put it right. We are going to have such a Government soon. Shamefully, we have not now.
Government PPE Contracts
Angela Eagle Excerpts(1 year, 11 months ago)
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Angela Rayner
It is absolute negligence and neglect of due diligence in the whole process. We now know that the issue of the VIP access lane and what it did and did not do has been tested in the High Court, but we also know that there is serious concern among members of the public, and that is what the motion is about. It is about getting to the bottom of it, and I think the public deserve no less than that.
As I was saying, the Minister passed the bid directly on to Lord Agnew. Some time later, officials discussed the fact that the Ministers’ offices were still being furiously lobbied. The former Health Secretary has also described being lobbied in words that I cannot quote in the Chamber—you have made that clear, Madam Deputy Speaker—but without giving any dates or details, so we do not know exactly what conversations or contacts happened behind the scenes. However, we do know that £3.5 billion of contracts have been handed out by this Government to their political donors and Ministers’ mates, so yes, we need an investigation into that as well. In fact, we need an investigation into every pound and penny that has been handed out, and to learn the lessons so that public money is not wasted again.
We should not forget that Ministers had previously denied the existence of a VIP lane. Well, it existed all right. It allowed Conservative politicians to “open doors” for anyone with connections to Ministers. It was the WhatsApp highway express, and earlier this year the High Court declared it unlawful.
As my hon. Friend the Member for Llanelli (Dame Nia Griffith) said earlier, it did not have to be this way. Governments across the world responded to the covid emergency without wasting billions of pounds of taxpayers’ money and relying on dodgy backroom deals. According to the watchdog, the Welsh Labour Government managed to prevent health and care bodies from running out of PPE. The watchdog said:
“In contrast to the position described by the…National Audit Office in England, we saw no evidence of a priority being given to potential suppliers depending on who referred them.”
The Welsh Government created an open and transparent PPE supply chain, which is in stark contrast with the approach that the Conservatives took in England.
Dame Angela Eagle (Wallasey) (Lab)
My right hon. Friend is making a powerful speech. With the benefit of hindsight, does she agree that the House would not have allowed the Government to have the emergency procurement powers that it granted at the beginning of the pandemic if we had known that they would be used in this corrupt manner?
Angela Rayner
My hon. Friend is absolutely right, and I would go further. I know from the correspondence I have been receiving that the public feel that way, and that many Conservative voters are absolutely shocked by what they have seen this Conservative Government do. They do not believe that the Government speak to their values, yet this has happened and we have a Procurement Bill going forward where this could happen again. So for today at least, the question before the House is simple: clean-up or cover-up?
I know that Members across this House care about our democracy, and although we disagree on many things, I hope we agree on the importance of trust in politics, the values of integrity, professionalism and accountability in public office and the public’s wish for more transparency and accountability within these four walls. Put simply, a vote for this motion is a vote in favour of the truth. This Government have presided over scandal after scandal engulfing their party. They appear to have benefited from dodgy lobbying, left, right and centre. Voting today for yet another cover-up will send another clear message to the public that this Prime Minister cares more about protecting vested interests than putting things right, and that his own promise of “integrity, professionalism and accountability” is just more hot air. After what they have put the British people through, this surely cannot be the message that Conservative Members want to send.
Labour has a plan to turn this procurement racket on its head and tackle the obscene waste with an office for value for money, to ensure that public money is spent with the respect that it deserves. It is about time that Conservative Members got with that programme. So I say today—I hope Conservative Members are listening—let us end the cover-up and begin the clean-up, and let us start it now. I commend this motion to the House.
Public Health
Angela Eagle Excerpts(2 years, 10 months ago)
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Sajid Javid
That is a very fair question. I will say more about that in a moment, but I point my right hon. Friend to one of the things I have just mentioned, which is better and better vaccines. In the future, we will have poly-variant vaccines. Because of the orders we have already placed, we are at the front of the queue for such vaccines.
Dame Angela Eagle (Wallasey) (Lab)
Has the Secretary of State noticed, as I have, the view that omicron may have originated in Africa in an immunosuppressed sufferer of HIV, where these viruses can mutate much faster than they would under other circumstances? Does he agree that the best way of dealing with this is to get vaccines into as many people in Africa as possible and to ensure that HIV/AIDS sufferers are given access to the proper treatment?
Sajid Javid
There is lots of speculation on how omicron may have originated. I will not add to that speculation now, but I agree with the hon. Lady’s general point, which is a powerful point, about the need to get more vaccines to people in developing countries, whether in Africa, Asia or elsewhere. We can be proud of what the UK has already done—more than 20 million vaccines delivered through COVAX or directly, and almost another 10 million on the way. We are completely committed to meet our target of 100 million vaccine donations by June 2022.
Wes Streeting
I agree with the hon. Gentleman. We have a big effort to boost the booster this month and we have to boost the workforce as well, and make sure that people are supported.
Wes Streeting
It may have been a speech rather than an intervention, Madam Deputy Speaker, but I thought it was a very good one, and I welcome what my hon. Friend has said.
Dame Angela Eagle
Will my hon. Friend acknowledge that anti-vaxxers are using vicious and very effective psychological propaganda to upset and worry people who may be vaccine hesitant, particularly about issues with fertility, whether the vaccine is halal and all those things? Does he agree with me that the Government should do much more to counter this very vicious and damaging propaganda?
Wes Streeting
I wholeheartedly agree with my hon. Friend. This comes back to the point I made about the Government engaging with the staff trade unions and the royal colleges. Whatever their policy position on having mandatory vaccination, the Secretary of State will find in them willing allies who want to help the Government to persuade colleagues to engage with them and to deal with some of these dangerous conspiracy theories that are knocking public confidence, and creating real fear and anxiety entirely without basis. When the Minister for the Cabinet Office concludes later, I hope that he will set out how the Government plan to engage and that he will give an undertaking to work with the staff trade unions and the royal colleges, because that would do so much to achieve the objectives that we all share, but also to raise morale in the workforce, who often feel that they are slogging their guts out for the Government, but do not get the hearing they deserve.
Covid-19 Update
Angela Eagle Excerpts(2 years, 11 months ago)
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Sajid Javid
My right hon. Friend should be assured that there will be a further update next week, as I have also just committed to. As he says, if—and it is a big if—it were necessary for the Government to take important action during the recess, of course people would expect us to take that action. As for whether Parliament should or should not be recalled, that is something that I will take back to my right hon. Friend the Prime Minister.
Dame Angela Eagle (Wallasey) (Lab)
Will the Health Secretary confirm that he expects next week’s update to contain much more information about the threat that the omicron variant poses in terms of seriousness of illness, so that we can have some insight into that issue, and will he tell us if he does not expect that to be the case? Will he also comment on the fact that more than 25% of Government Members who are in the Chamber today are not wearing masks? What does that do for the compliance of people outside who are meant to wear masks on public transport and in shops?
Sajid Javid
As each day goes by, we are getting a little bit more information, but I do think that by next week we will have more information, given the samples that have arrived at Porton Down and other labs across the world. However, I will caveat that by saying that I cannot give any guarantee about how much information we will have; I am sure that there will still be many unanswered questions at that point. As for masks, our rules are clear.
Randox Covid Contracts
Angela Eagle Excerpts(2 years, 11 months ago)
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Angela Rayner
My hon. Friend makes a good point on probity. If Ministers have nothing to hide and no rules were broken, surely they would be happy to publish the details of these meetings and the correspondence. But they have refused time and time again to do so. So today we have tabled this motion and we will put it to a vote, because the only logical conclusion is that there is something to hide—that the dodgy lobbying at the heart of this scandal has played a part in how vast sums of taxpayers’ cash have been spent.
Dame Angela Eagle (Wallasey) (Lab)
My right hon. Friend is making a strong case indeed for reforming this rotten process. Does she agree that when this House granted the Government the powers under emergency legislation to handle the procurement of important medical supplies, it did not expect for one second this orgy of procurement outrages, this feeding frenzy of money for their friends and donors, and the ransacking of public money to help their own that we have seen?
Angela Rayner
My hon. Friend makes a crucial point. I say it again: in all my time in Parliament, I have never seen the Benches opposite so empty. I will be gracious to a number of Conservative Members who have expressed, both in public and in private, their concerns about this issue. I urge Members from across the House to look at this issue not in a party political sense, but by examining the damage it has done. The Prime Minister talks in PMQs about the UK and sleaze and corruption, but he has brought that to the UK and has undermined—[Interruption.] Even former Conservative Prime Ministers have raised concerns about the Prime Minister’s conduct. So I do not want to make it too party political, because I can see from the sparseness on the Benches opposite that many Conservative Members absolutely agree with us.
Dame Angela Eagle
On a point of order, Mr Speaker. We have just heard the Minister say that there are no minutes of this so-called courtesy call. Can you tell us what we, as Members of the House, can do on learning this through this House, given the astonishing nature of the revelation that the Minister has just made that there have been meetings with no minutes? These are official meetings that involve Government Ministers, and she is unable to locate a copy of what happened at a meeting that clearly took place.
Mr Speaker
In all fairness, the Minister should be given time. There are Parliamentary Private Secretaries here, and I am sure that they will have heard and will try to get an answer to the question if we do not have that information. I would expect Government meetings with other people present always to be minuted. If they are not, it opens up another question. I do not want that question to be opened up, as I would prefer it to be answered. Therefore, I am sure that, at some point, we will get that answer. It is a fair point to be made, but in fairness to the Minister, I do not want to end up with a frenzy. Hopefully, some information will be fed back to her—I am looking to the Parliamentary Private Secretaries behind her to see whether it can be fed in at the moment.
Covid-19: Vaccination of Children
Angela Eagle Excerpts(3 years, 1 month ago)
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Dame Angela Eagle (in the Chair)
Before we begin, I encourage Members to wear masks when they are not speaking. This is line with current Government guidance and that of the House of Commons Commission. Please also give each other and members of staff space when seated, and when entering and leaving the Chamber.
Miriam Cates (Penistone and Stocksbridge) (Con)
I beg to move,
That this House has considered the vaccination of children against covid-19.
It is a pleasure to serve under your chairmanship, Dame Angela. I thank the Backbench Business Committee for granting this important debate, and draw Members’ attention to the three e-petitions that relate to this topic, which have amassed more than 100,000 signatures between them.
Vaccination has transformed public health over the last two centuries. As a science teacher, I remember teaching students about the amazing work of Edward Jenner, who famously developed the smallpox inoculation. Two hundred and fifty years later, vaccinations have again ridden to our rescue with the rapid development and roll-out of covid vaccines across the UK. The phenomenal success of the vaccination programme can be seen clearly in the data. Of the 51,000 covid-related deaths from January to July this year, 76% were of unvaccinated people, and a further 14% had received only a single dose. Just 59 deaths—0.1%—were of double-vaccinated adults with no other risk factors, and 92% of adults now have covid antibodies.
Those figures are a ringing endorsement of the Joint Committee on Vaccination and Immunisation’s strategy to recommend vaccination based on the medical benefits and risks to the individuals concerned. The Government have repeatedly defended both this strategy and the independence of the JCVI, and resisted calls to prioritise the vaccination of teachers or police officers over those at higher risk of serious illness. That was the right approach, and the UK has led the world in falling rates of deaths and hospitalisations.
It was therefore surprising, to say the least, when the Government put political pressure on the JCVI to quickly reach a decision about the vaccination of children. On 3 September 2021, the JCVI announced that it was unable to recommend the mass vaccination of healthy 12 to 15-year-olds. The reason was that, although there are marginal health benefits of covid vaccination to children based on the known risks of the vaccine, there is considerable uncertainty regarding the magnitude of the potential harms, such as the long-term effects of myocarditis.
Paediatrician and JCVI member Adam Finn wrote in The Sunday Times that a high proportion of myocarditis patients showed
“significant changes of the heart. It is perfectly possible that these changes will resolve completely over time. But it is also possible that they may evolve into longer-term changes.
Until three to six months have passed, this remains uncertain, as does what impact on health any persistent changes may have.”
According to the JCVI, for every 1 million healthy children vaccinated, two intensive care unit admissions will be prevented, and three to 17 cases of myocarditis caused. With two doses, that rises to between 15 and 51 cases—finely balanced, indeed.
There is no rush to roll out the vaccine to children. We know that children are not at risk from covid; teachers are no more at risk than the rest of the population; the vast majority of vulnerable adults have been vaccinated; over half of children already have antibodies; and there is no evidence that schools drive transmission.
Chris Green (Bolton West) (Con)
The advice being given out on consent forms states that you get to see your family doctor. However, when I and my hon. Friend the Member for Winchester (Steve Brine) challenged the former vaccines Minister, my right hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), on the ability of families to access their family doctor to get advice about vaccines, he could not and would not give an assurance that families could have that advice. Is not such access necessary, especially if the Government are stating on the vaccine form that you do have that access?
Dame Angela Eagle (in the Chair)
Order. Before I call Miriam to continue, Members ought to realise that when they say “you” they are referring to the Chair. Can we please try to get the formalities right? I know that it is less important on Zoom, but we are now back.
Miriam Cates
My hon. Friend is right. It is widely known that access to GPs is challenging at the moment, and that presents challenges in this situation. It is widely understood that if a child can consent, contrary to parental consent, that is not a tick-box exercise; it is a matter for a medical professional to assess whether the child is competent to consent. If there are problems accessing GPs, there are clear issues here.
There is no rush to roll out the vaccine, and there is no evidence that schools drive transmission. Indeed, recorded covid cases are now at their lowest level since June, despite schools having been open for two weeks. It is also unlikely that vaccinating children will have a major impact on infection rates in the population as a whole, with the JCVI saying that
“the committee is of the view that any impact on transmission may be relatively small, given the lower effectiveness of the vaccine against infection with the Delta variant.”
However, instead of accepting the JCVI’s assessment and waiting for more evidence to emerge, the Government asked the chief medical officer urgently to review the decision based on the wider benefits to children, including from education. Last week, the CMO announced that he would recommend child vaccinations on the basis of these wider benefits.
That decision is a marked departure from the principle of vaccinating people for their own medical benefit, because those wider issues—educational disruption and concerns around mental health—are the consequences of policy decisions and are not scientific inevitabilities. Children in the UK have already missed more education than children in almost any other country in Europe, despite comparable death rates. Since January 2020, British children have lost on average 44% of school days to lockdown and isolation. That is not a consequence of covid infections in children, but rather a result of policy decisions to close schools and isolate healthy children.
According to the Government’s modelling, vaccinating children could save 41 days of schooling per 1,000 children between October and March. That equates to an average of just 15 minutes of education saved per child over this period—surely an insignificant amount, and negligible when we account for the time it takes to vaccinate and the subsequent days off school to recover from potential side effects. There is a much simpler way to stop harmful educational disruption, and that is to follow the advice of the Royal College of Paediatrics and Child Health and end the mass testing of asymptomatic children. This unevidenced and unethical policy is costing tens of millions of pounds a week—I would be grateful if the Minister could confirm the exact cost—and is continuing to disrupt education. Even the CMO acknowledges that a vaccination programme alone will not stop school closures. Perhaps the Minister could clarify how the Government intend to end educational disruption.
On the potential mental health benefits from reducing the fear of covid, it is not covid infection that is making children fearful; it is the uncertainty, frustration, loneliness and anxiety that they experience as a result of lockdowns and harmful messages such as, “Don’t kill granny.” Children need not fear catching covid, but they have every right to fear policy decisions that cause them significant harm, and sadly we cannot vaccinate against those.
Nonetheless, the decision has been made, and we have to be very clear that the risks to children, both from covid and from vaccines, are tiny. Concerns should now focus on making sure that the necessary safeguards are put in place as vaccination is rolled out. The previous vaccines Minister, my right hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), assured MPs that there will be no differential treatment of children in schools on the basis of their vaccination status. That is crucial, because any suggestion that unvaccinated young people may be denied education or be subjected to social disadvantage will inhibit the ability of both parents and children to make a free and objective decision. While I appreciate Ministers’ commitments, children already face discrimination in some schools over mask wearing and testing.
We must also make sure that travel rules that differentiate between vaccinated and unvaccinated children do not amount to coercion when parents are making a decision. Can the Minister say how we will ensure that there is no discrimination in practice as well as in theory?
Vaccination must be a free and informed decision. Choosing to have or not to have the vaccine are both perfectly reasonable and sensible decisions where children are concerned. We must ensure that correct and impartial information is communicated and, as my hon. Friend the Member for Congleton (Fiona Bruce) said, that there is access to health professionals where necessary. Parental consent must also be respected. Much has been said on this subject, but the heart of the matter is that parental responsibility and authority are foundational to society.
I am optimistic that these protections can and will be put in place. None the less, the way that the decision to vaccinate healthy 12 to 15-year-olds has been made should give us pause for thought. For no other cohort have the Government questioned the JCVI’s advice. Why have we departed from this stance when it comes to children and looked for reasons other than direct medical benefit to press ahead? When there are concerns about the future health of our children, why have we not waited for more evidence to emerge? I fear that this situation, rather than being an isolated incident, epitomises a worrying attitude to children that has been evident since the start of the pandemic.
Throughout the past 18 months, “protect the vulnerable” has been our clarion call. We have rightly made significant efforts to protect elderly people and those who are particularly susceptible to covid, but children, who cannot speak out, do not own property, and have no legal agency, are also very vulnerable. Yet during the pandemic, we have asked this group of vulnerable people to make huge sacrifices to protect the rest of us. The harms of lockdown for our children are significant and, for many, will be irreversible: lost education, missed opportunities, abuse and horrific online harms. The number of children presenting in A&E with acute mental health conditions has risen by 50% since the start of the pandemic.
A climate of fear and uncertainty has robbed children of the structure, routine and security that they need to thrive and has placed on them a heavy emotional burden from inferring that they may be responsible for the deaths of those they love. We have pretended that online learning is somehow a substitute for being in schools, and closed our eyes to the consequences of social isolation for children and young people.
Of course, we should raise our children to take responsibility for their actions, but as adults we should always shoulder the greater burden. We have imposed absurd rules on our young people, right down to deciding whom they can play with at playtime and whether they are allowed to change for PE.
However, we have not seen that much action to urge adults to take responsibility for their own covid risk by, for example, losing weight or exercising—something that would have had a far greater impact on our rates of hospitalisation and death.
Karl MᶜCartney
I picked up on the hon. Gentleman’s comments earlier about being sociable and being back in this place, and I did not want him to sit down having made a speech without being intervened on, as he is probably one of the most social Members across the House. Well done.
Jim Shannon
I thank the hon. Gentleman for that intervention. Our friendship goes back to when our offices used to be across from each other on the same corridor, and I am very pleased to renew it again in this House.
I believe that we have seen a decline in covid due to the vaccine, and the benefits are clear to see. However, from a child’s perspective the tale is very different, and parental consent, hand in hand with medical guidance in specific cases, must be the way we move forward. I believe that is what we should be doing. I am pleased to have had the debate and I thank the hon. Member for Penistone and Stocksbridge again for securing it. I look forward to other contributions, which I hope will endorse what we have all said.
Chris Green
I absolutely agree with my hon. Friend. Confidence needs to be restored in the wider vaccine programme. There needs to be a renewal of focus, because vaccinations for infants have dipped—slightly, but they have dipped. For older children and teenagers, the wider vaccine programme has dipped more substantially, so we need a significant catch-up in our broader vaccine programme.
We will also see increased concerns as drug companies seek approval to get the age for covid vaccines reduced to five years old. We therefore see the potential for an undefined point at which we can declare our position a success. If we do not have a clear understanding of what success means, will Government advisers say, “We now have approval for drugs to be given to five-year-olds, and that is the next step”? That question is for my hon. Friend the vaccines Minister, whom I welcome to the Front Bench. Will she clarify a couple of points? We here, broader society and health professionals outside the scope of Government can understand the end point. Professor Whitty said that at a certain point we will be able to treat the coronavirus as we treat influenza. What are the objective criteria by which we and others can judge that?
I asked the Minister’s predecessor, my right hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), about the transition point when we as a society understand that we have moved from a pandemic disease where we need restrictions and other lockdown measures, and when we move to an endemic disease where we treat coronavirus as we treat influenza and other diseases, many of which are incredibly dangerous to people who are vulnerable—influenza is very dangerous for vulnerable people. We need to know when coronavirus goes from pandemic to endemic. We need objective criteria, because when the previous vaccines Minister replied to me, I could define what he said as, “We come out of pandemic status tomorrow” or, “We come out in 10 years’ time.” I do not think that is good enough when schools and families need more certainty.
Dame Angela Eagle (in the Chair)
I intend to call the Front-Bench speakers at 10.38. I call Andrew Lewer.
Derek Thomas (St Ives) (Con)
Dame Angela, I have worked out from your timings that I get 20 minutes to speak—
Dame Angela Eagle (in the Chair)
Order. The latest that I will bring in the Front Benchers is 10.38 am, so you do not have to take the full 20 minutes.
Derek Thomas
I am pretty sure I will not. I congratulate the Minister, who until last week was my favourite Whip and is now the vaccines Minister. It is a great honour to do that job, and I am sad we have to come up against this particular policy because across the board the vaccine programme has been remarkable. I congratulate my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates) on securing the debate. The issue is agitating and concerning, and enormous numbers of people, including parents, schools and many others, feel it is a step too far.
I am a Conservative. I joined the Conservative party because of a belief in giving people freedom of choice, the ability to deliver and develop their own destiny, and the opportunity to live full, vibrant and fulfilling lives. I think this particular policy goes right against that, and I feel uncomfortable with it. It feels wrong, and I believe it is wrong to introduce this vaccination programme for children aged 12 to 15, considering all that has been said about consent this morning. Before I get started, may I just say that I feel privileged to be in this room where such great points and speeches have been made, because we care about families, children and how our schools are supported in a very difficult and unprecedented time?
Earlier in the year I went to visit St Clare medical centre in my constituency, which was delivering the vaccine programme with great fervour. It has an amazing system going on. In fact, with other primary care networks in my constituency, it was mentioned in dispatches for the incredible effort it put in to get the vaccine out to the most vulnerable people. My constituency was the fifth in the country in getting the most people vaccinated by the February half term.
I observed the logistical challenge and triumph of rolling out the vaccine programme and talked to the practice manager. She described why the additional workload was acceptable: a massive volunteer army was motivated and mobilised, there was an incredible collaboration of GPs, the NHS and all sorts of organisations that had got behind this, and there was organisation across the primary care networks. She said that all of that extra effort—the long weekends and the massive amount of work that went into it—was possible and worthwhile because it was part of the national effort. It really struck home that people right down at the end of the country, in the most beautiful part, who are often tucked away and not necessarily engaged in national efforts, were so enthusiastic and determined to make this work. West Cornwall primary care networks were mentioned by the Secretary of State at the time for their incredible effort in getting vaccines to people in such a quick and effective way.
During the roll-out of the vaccine programme, Ministers fiercely defended the decisions made by the JCVI. The JCVI determined the priority groups—who would get the vaccine and when—and Ministers refused to intervene. They were determined not to intervene, not even to prioritise teachers as schools opened in September last year. They refused to intervene to prioritise the police when some 10,000 policemen descended on my constituency in Cornwall for the G7. There was great concern about that, but Ministers refused to intervene to allow police officers of all ages to have the vaccine ahead of the priority groups set out by the JCVI. Why now, with the help of the chief medical officers, do the Government reject the advice of the JCVI? That advice states:
“The margin of benefit…is considered too small to support advice on a universal programme of vaccination of otherwise healthy 12 to 15-year-old children”.
It also says that
“any impact on transmission may be relatively small”.
In other words, schools would still be disrupted because the vaccine does not manage transmission. I, along with many others, recognise the wisdom of the JCVI’s advice JCVI in this area. We were surprised when, just weeks later, the Government and chief medical officer seemed to take a completely different course. I was relieved when the JCVI made its case and gave that very sound advice. Like many others, I was then disappointed and concerned that the Government seemed to go against it.
The reason for my concern is that the decision to override the JCVI advice will undermine confidence in the vaccine roll-out programme. Up until now, because of the way the JCVI has operated, the country has welcomed the approach, has supported it and had confidence in it. I wonder whether the Government are actually doing it a disservice by potentially undermining confidence in the roll-out. So far, the great strength of the vaccine roll-out is its voluntary nature, based on sound advice and a national united effort.
My fear is that the decision has been made for seemingly unsubstantiated reasons. There are gaping holes in the argument that it will minimise disruption of children’s education. My fear is that it risks turning a national effort into a tool to pressure children, undermine parents and drive an inadvertent wedge between families and schools. Under a new Secretary of State, the Government’s primary priority should be allowing schools to do what they do best: educating children. I ought to declare an interest as I have three children, who are in school at this very moment—or so I hope.
At the beginning of the year, I secured an Adjournment debate on the experience of schools. They have had a blooming rotten time, with changing advice and all sorts of things coming down from Government; they did not know if they were coming or going. What has really concerned schools, teachers and headteachers is that they have taken on a new role—trying to manage children’s health and parts of their welfare—that they never signed up for. It is not that they are unwilling, but that they do not have the time or resources, and they might even add the expertise, to take on those additional responsibilities when what they want is to educate children and give them the best start in life.
All Members’ constituency offices have supported schools in the bizarre work they have had to do to manage parents on different sides of different arguments when it comes to managing covid in schools. I have had parents who are furious with a school for insisting on face coverings in parts of the school, both before that was the official advice and since; I have also had parents furious with a school for saying children do not have to wear a face covering in the classroom. Those poor headteachers and staff have had to deal with that along with all the pressures of teaching children.
What do we do? We make their job a whole lot more difficult by putting schools at the centre of a decision that most of us in this room do not believe is robust or stands up to what scientists have said. We have asked them to take on the additional responsibility of vaccinating 12 to 15-year-olds, and to manage the various pressures that come with it, when all they want to do—all they thought they were doing—is go back to school in September, catch up and give their children a happy, healthy and wonderful experience being educated. I really feel for our children.
Miriam Cates
The hon. Lady is absolutely right; I am not saying that other countries are not basing decisions on their own evidence. I am saying that the success of our programme was based on the JCVI’s advice and its particular method of offering vaccination based on individual medical benefit, which gave us an incredible advantage that could have allowed us to wait a further six or nine months to make this decision.
Dame Angela Eagle (in the Chair)
Prior to the hon. Lady responding, the hon. Member for Penistone and Stocksbridge must remember that she has to put questions.
Liz Kendall
Thank you, Dame Angela. I will come back to this point, because several hon. Members have talked about what the JCVI recommended, and I hope I will be able to set out a little more information about what it actually said later in the debate. Before I go on to talk about the evidence—
Karl MᶜCartney
I am conscious there are a few minutes left in this debate, so I want to refer quickly to three more issues. First, the Minister may have noticed that the first speech in support of the Government’s position came from an Opposition Member, who claimed to be speaking on behalf of all Opposition MPs, although there is only one here.
Secondly, a point was made about the seat of the hon. Member for Leicester West (Liz Kendall) and the number of young people who have, I believe, covid, although she did not give the actual number. However, if school children were not tested over the summer, surely they are now being tested in school and the incidence of those with covid will be rising. Therefore, I am being very gracious to both Front Benchers—
Karl MᶜCartney
It is, but I am coming to the end of my comments, Dame Angela. I am conscious of that. When I was growing up, there was a very famous pop song called “Don’t Believe the Hype”. Surely that is something we should all be taking notice of.
Covid-19 Update
Angela Eagle Excerpts(3 years, 1 month ago)
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Dame Angela Eagle (Wallasey) (Lab)
In Wirral there has been a 13% increase in levels of infection in one week, and sadly four people have died in hospital. After a period of there being very few deaths, we now have a much higher infection rate. What level of deaths are the Government prepared to accept from covid before they consider measures to try to prevent the ongoing spread?
Sajid Javid
No one wants to see deaths from any disease, including covid. As we have learned more about covid, everyone understands that it is not completely preventable, but our vaccines are making a difference in Wirral and across the country. There is no level of deaths that I would describe as acceptable, and the job of the Government is to keep that to an absolute minimum. However, there are not just covid deaths, and we must also be alive to deaths from cancer, heart disease and other things. As the hon. Lady will know, at the height of the restrictions many people suffered in other ways because they were not able to go to the NHS, and we must keep that at the front of our minds.
Covid-19 Update
Angela Eagle Excerpts(3 years, 3 months ago)
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Dame Angela Eagle (Wallasey) (Lab) [V]
I hope that I will get an equally happy response to my question. The Secretary of State has said that he is anticipating as many as 100,000 covid infections daily. If that were actually to happen, according to his figures how many people would he expect to be hospitalised, and how many would he expect to develop long covid as a result?
Sajid Javid
I can tell the hon. Lady that there are currently about 30,000 infections a day. In the last 24 hours in England, we have seen about 400 people being hospitalised. The last time that infections were around the same level—at 30,000 cases a day—I believe that more than 2,000 people a day were being hospitalised. That is what I mean when I say that the link has been severely weakened, and for that we have the vaccines to thank.