Health and Social Care Leadership Review

Baroness Keeley Excerpts

Wednesday 8th June 2022 Commons Chamber

[Sajid Javid]

I thank my right hon. Friend for her comments. I always listen carefully to what she has to say, given her important experience. On the pension issue, she will know that in the 2020 Budget, I believe it was, significant changes were made, especially to where the taper rate kicks in—it went from £110,000 to £200,000. That benefited the top 5% of earners in this country, but it was the right thing to do to encourage and incentivise doctors, in particular, to work more. She is right to talk about what more we can do. We are looking precisely at what further flexibilities we can offer on pension arrangements.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The Health and Social Care Secretary talks about strong leadership and culture change. I point out to him his Government’s and his Department’s dismal record in meeting the pledge to close the in-patient units that are being used to trap more than 2,000 autistic people and people with learning disabilities rather than support them in their own homes. We have just passed the 11-year anniversary of the scandal at Winterbourne View. Not only has his Government failed in their pledge to close down these units, which was the original promise made after that scandal, but 560 people in those in-patient units do not need to be there at all, a quarter of them are more than 50 km from their own home, people are spending longer in units now than they were seven years ago, and more people have been admitted to the units year on year from 2015-16. This is one of the biggest scandals and the worst failures of his Department and Government. When is he going to act on it?

[Sajid Javid]

The hon. Lady is right to highlight the importance of this issue and she will know that my predecessor had asked for a review on it. It was done and we have accepted its outcome, and it is being implemented. I hope she will understand that in implementing the outcome of that review it is important that we listen to clinical advice from within the NHS and make sure that we put the interests of each patient first.

Ockenden Report

Baroness Keeley Excerpts

Wednesday 30th March 2022 Commons Chamber

[Sajid Javid]

Let me first thank my hon. Friend for her approach and her role in helping to make the report happen, and for the way in which she has worked with me, and with Ministers in my Department, on this most important of issues. She is right to talk about the importance of culture, especially given that, as the report makes clear, the voices of women were not heard time and again. I want to reassure her that we will implement all the report’s recommendations, but, more broadly, that women’s voices will be at the heart of the upcoming women’s health strategy.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

Today is an important day for maternity safety, and we rightly pay tribute to the families directly affected, so many of whom have given evidence to the Ockenden review.

James Titcombe, who lost his baby son Joshua during the Morecambe Bay maternity scandal, has said that one of the most harmful experiences for the Morecambe Bay families was

“seeing influential people in the maternity world diminish… the…findings”

of the investigation report. I join James Titcombe in saying that we must not allow that to happen with this report. I urge the Secretary of State to ensure that the bereaved families are allowed a process of truth, reconciliation and healing, rather than any denial of the truth of what took place.

[Sajid Javid]

I agree with the hon. Lady, and she is right to raise the importance of the Morecambe Bay investigation. That report, which I believe was completed in 2015, contained 44 recommendations. Eighteen recommendations that were specifically for the trust have been implemented, and the 26 for the wider NHS are in the course of being implemented.

Elective Treatment

Baroness Keeley Excerpts

Tuesday 8th February 2022 Commons Chamber

[Sajid Javid]

I thank my hon. Friend for her support. Over the past two years, the number of clinicians in the NHS has risen by about 40,000. In the past year, we have 10,000 more nurses, 5,000 more doctors and more people in medical school than ever before, so a huge amount of record investment is going into the workforce. Recently, I also asked the NHS to put together a long-term 10-year-plus workforce strategy and I look forward to receiving it.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The elective care backlog is not the only crisis facing the NHS. Covid has affected the care being delivered by mental health services, primary care, emergency care, community care and social care. In the Health and Social Care Committee’s recent report on tackling the NHS backlog, we recommended that a broader national health and care recovery plan be published to set out a clear vision for how patient care will be improved. Will the Secretary of State confirm that that will be published before April, as the Committee recommended?

[Sajid Javid]

I thank the hon. Lady for her work on the Committee. She is right to raise the importance of mental health. Although today’s plan is focused on elective surgical procedures and diagnostics, she is right to talk about other types of care, especially mental health care. I know that she supports the huge amount of record investment going into the NHS for mental health care. Under the NHS long-term plan, it is an additional £2 billion a year. She is also right to raise the importance of patient care. I believe that there is a lot in this plan on patient care that she will support.

Elective Care Recovery in England

Baroness Keeley Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

I am grateful to the Father of the House, who once again brings his typical wisdom and experience in this House to our deliberations in the final point that he makes. He is absolutely right. I am happy to join him and his constituents in expressing gratitude to all those who work in the NHS for the work they have been doing throughout the pandemic and that they do every day, irrespective of the pandemic. I know that those on both sides of the House will share in that. The term “elective” is a technical term used within the NHS, but I take his point that it is easy for us in this House to use the technical terms used within our Departments or in the system, but that it is often helpful if we talk in rather more simple terms that mean something to all our constituents.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

As a survivor of breast cancer that was treated in 2019, I was grateful to be seen within 10 days of the referral by my GP and to start treatment within a month. It is frightening that in the months between April and November last year over 90,000 women who might have breast cancer were not seen by a specialist within the target of 14 days of being urgently referred by a GP, and that this year half a million people with suspected cancer will wait longer than the supposed two-week maximum to see an oncologist. The Minister will know that an early diagnosis can be life-saving. What does he think the impact for potential cancer patients will be of the delay to the NHS recovery plan when waiting times are spiralling so much?

[Edward Argar]

The hon. Lady and I often exchange views across the Dispatch Box, and she always asks sensible and reasonable questions. She is right to highlight the importance of cancer care, and that there are some illnesses and diseases like cancer where delay can have a significantly detrimental impact on the outcomes experienced by patients.

Between March 2020 and November 2021, more than 4 million urgent referrals were made for cancer, and over 960,000 people received cancer treatment. Thanks to the amazing work of NHS staff, we maintained cancer treatment at 99.7% of pre-pandemic levels in the latest month for which I have statistics, which is November 2021.

As well as looking to the future with the announcement of community diagnostic hubs and a range of other measures, the plan is not necessary for us to do the work, as we are already doing it. The plan is important for mapping out the future direction of care, but we are not waiting for the plan to improve services, to build back better and to tackle the waiting lists.

Covid-19: Purchasing Effort

Baroness Keeley Excerpts

Thursday 3rd February 2022 Commons Chamber

[Edward Argar]

I am grateful to my hon. Friend. Far be it from me to suggest that hindsight characterises the approach adopted by Opposition Front Benchers, but he is absolutely right. I mentioned the shadow Chancellor, the hon. Member for Leeds West (Rachel Reeves). She also said in this place:

“Those who look after the sick and the vulnerable deserve our protection, and getting PPE to them is the priority of all of us.”—[Official Report, 4 May 2020; Vol. 675, c. 412.]

She was absolutely right and remains right, and that is why this Government did exactly that. Protecting the taxpayers’ pound is hugely important. Equally, so too is procuring the kit that protects lives. In the unique circumstances that we faced at the time in 2020, I believe that this Government made the right choices.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

For context, £9 billion would have given every NHS nurse a 100% bonus on their salary or it could provide the funding needed to solve the issue of autistic people and people with learning disabilities being detained in inappropriate units because no funding is available to support them in the community. Instead, it is clear that large amounts were wasted on unused and unsuitable PPE, some of which, we understand, will have to be burned. I remind the Minister that we could have had a stockpile of PPE in this country if Exercise Cygnus in 2016 had been handled responsibly. Exercise Cygnus showed gaping holes in our emergency preparedness and we have to learn the lesson from that.

[Edward Argar]

I am grateful to the hon. Lady; to be fair, we may not always agree, but she always makes thoughtful points and knows this subject well. However, many right hon. and hon. Members across the House have regularly said that Exercise Cygnus gave everyone everything they needed to know in how to manage this pandemic, which is completely not the case. That was a flu pandemic exercise with a number of preconditions, one of which was that, at a certain point, it was assumed that antivirals would become available within—I think, off the top of my head—nine weeks of the pandemic beginning. That was not the case, because we were dealing with a completely new virus, so although there are valuable lessons to be learned, we need to be very careful about drawing direct parallels.

The hon. Lady rightly talked about the sum of money and highlighted the impact. She is right that £8.7 billion is a very significant sum of public money, but she also must acknowledge that that £8.7 billion was not wasted, because the PPE exists. This is an accounting point about what the purchase price was compared with the value now, with a stable marketplace for that. Only a very small fraction of that stockpile has been deemed not fit for use and, in those cases, we continue to investigate, through contractual mechanisms and elsewhere, what we can do to recover that money.

Oral Answers to Questions

Baroness Keeley Excerpts

Tuesday 18th January 2022 Commons Chamber

[Sajid Javid]

I do agree with my hon. Friend. That is why, as part of our continued response to the covid-19 pandemic, on 2 December last year NHS England asked local systems to consider ways to increase patient flow out of acute hospital settings. That includes surge capacity in care homes, identifying unused hospice capacity and, in some cases, repurposing hotel accommodation where appropriate. NHS England is reporting to me on this regularly, and it is something that we will closely monitor progress on.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The Government’s own impact assessment of discharge to assess in the Health and Care Bill, which was published almost two months after the Bill was voted on, expects unpaid carers to have to give up working hours and bear the financial burdens of the discharge to assess policy. In the light of that assessment will the Government provide greater support to unpaid carers, or will they actually reconsider this policy?

[Sajid Javid]

Throughout the pandemic especially we have been providing more and more support, quite rightly, across the care sector, including for domiciliary care in care homes and unpaid carers. We have made £3.3 billion of extra funding and support available since March 2020.

Public Health

Baroness Keeley Excerpts

Tuesday 14th December 2021 Commons Chamber

[Sajid Javid]

My hon. Friend will understand that there has been a huge surge in demand for lateral flow tests, perfectly understandably of course. The situation at present is that the warehouses of the UKHSA have plenty of stock, but the distribution channel has been limited, although it has added to that significantly in recent days, including building on the channels it has with Royal Mail, Amazon and other suppliers, and also opening up more access points other than direct ordering online so that people can pick up tests from far more pharmacies, for example, than they currently can. It is being worked on, and whatever the current situation is, it will be improved very, very quickly. I hope that reassures my hon. Friend.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The Secretary of State is making some vital points about testing and self-isolation, but yesterday I raised a point with him about PCR testing that I would like to come back to. Although the supply of lateral flow tests is important, so is the PCR testing, which is a more reliable gold standard. Today there was a point when it was reported on social media that there were no PCR testing slots available in any region of England. Yesterday I asked him if he would authorise each director of public health across the country to have a float stock of 500 PCR tests they can use to disrupt covid outbreaks and to slow the transmission of omicron. This is a really important point. Only nine directors of public health have that float stock at the moment. Will he take this vital step and authorise it for all the other directors of public health?

--- Later in debate ---

[Wes Streeting]

I hope I can reassure the right hon. Gentleman that it will not be a case of saying to people, “If you don’t take up the jab, that’s it—you’re out.” There will also be the opportunity for redeployment to other roles where vaccination would not be mandatory. I hope that gives him the reassurance that he needs.

[Barbara Keeley]

My hon. Friend is handling his speech in just the right way. There is a balance of rights here, and patients have a right to be treated by staff who are fully vaccinated to protect them. I have a constituent who is clinically extremely vulnerable. She contacted me to say that she was not willing to go to her necessary hospital appointments once she realised that the hospital staff were not fully vaccinated. Does my hon. Friend agree that we have to think of that pretty large number of clinically extremely vulnerable people in this country?

[Wes Streeting]

My hon. Friend is absolutely right.

We have heard the arguments in outline: this is about protecting staff and patients; it is not a new precedent; and there is a professional obligation, which makes it slightly different from the experience in the social care workforce. I will come on to talk about what the Government need to do. Those are broadly the arguments—

Covid-19 Update

Baroness Keeley Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

First, I very much agree with my right hon. Friend on the importance of never losing sight of potential unintended consequences. He points to an excellent report by the Centre for Social Justice, which looked at this in the light of past actions. That is certainly not lost on me or my colleagues in Government, but he is right to highlight that to the House once again. I hope he agrees, however, with the messages we have set out so far. They are measured and they are proportionate. The focus should be on the booster campaign because that is our way out of this. On the 15-minute wait, it is being very actively looked at, and I am sure that I will have something more to say on that very shortly.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

The Secretary of State says that there are millions of tests available, but only nine local authorities out of the 153 across England have access to a float stock of 500 PCR test kits to use at their discretion, using local knowledge, to tackle covid clusters before they become significant outbreaks. This is very important to disrupt outbreaks and slow transmission, but it is not available outside those nine pilot local authorities. Given the importance of slowing transmission of the omicron variant, will the Secretary of State agree to authorise the same float stock of 500 PCR test kits to every director of public health and every area, to give them the tools they need to fight this variant?

[Sajid Javid]

I was referring to lateral flow tests earlier, but I think the hon. Lady asked me about PCR tests. I will look into what she said.

Covid-19 Update

Baroness Keeley Excerpts

Wednesday 8th December 2021 Commons Chamber

[Sajid Javid]

I very much agree with my hon. Friend. He is right to point to the huge importance, more than ever, of the pharmaceutical defences—let us call them that—against this pandemic. Top of the list are the vaccines, and especially the booster programme. Although it is already the most successful in Europe, there are a lot more people whom we want to boost. I hope he will agree with me that in doing so, it is not just about the quantity, although that is hugely important; it is about getting through to the most vulnerable people first and making sure that we prioritise them. I should also point out that, as I said in my statement, the antivirals are hugely important pharmaceutical defences. Building on all these things—whether it is the vaccinations with the new hubs, the 10,000 new vaccinators we are hiring, the use of the military or the use of pharmacies more than ever before—will really help us to turbocharge access to those pharmaceuticals.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I want to raise the vital issue of public trust in restrictions during the pandemic. People across this country have followed the rules, even when that meant being separated from loved ones at the end of life, and families not being able to be together at funerals. Does the Secretary of State agree that the people of this country have the right to expect the Government to follow the rules as well? The measures he has just announced rely for compliance on people having trust and confidence in the Government, and that has been shattered by the news of the Downing Street party. How is he going to restore it?

[Sajid Javid]

Of course everyone should follow the rules—no one is above the rules. The hon. Lady refers to the exchange that took place earlier in Prime Minister’s questions; the Prime Minister set out the Government’s position in that exchange.

Covid-19 Update

Baroness Keeley Excerpts

Monday 6th December 2021 Commons Chamber

[Sajid Javid]

I fully understand my right hon. Friend’s point about the impact on the travel sector; that should not be lost on anyone. We all understand why the action has been taken, but we must not forget that the sector is hugely important to the economy, and that it has been hit hard again and again. Next week’s update—the review point—will be important to provide more certainty. As I said to the hon. Member for Wallasey (Dame Angela Eagle), we cannot guarantee that we will have all the answers to our questions, but that information will certainly help to provide more certainty.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I have a constituent whose mother has been fast-tracked for end-of-life nursing care in a local care home. However, my constituent was told that she would not be able to visit her mother at Christmas, despite this being her last Christmas. The reason that the care home gave for suspending visits on Christmas day was to make it easier for the staff, because the covid

“testing would be too time consuming”.

That flies in the face of Government guidance, which says:

“Visits at the end of life should always be supported…in the final months and weeks of life…not just the final days or hours”.

Will the Secretary of State issue guidance to care homes, emphasising the importance of visits at Christmas, particularly for people at end of life?

[Sajid Javid]

Yes, I most certainly would like to help with that. I am sorry to hear about the hon. Lady’s constituent. As she says, visits at end of life should always be made available; there should be no excuses. I would be happy to look into the case that she has mentioned, if she provides me with more details. I will also check the general guidance.