Covid-19: PPE Procurement
Baroness Smith of Basildon Excerpts(2 years, 1 month ago)
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Baroness Smith of Basildon (Lab)
My Lords, I have raised the issue of fraud in PPE contracts previously. Apparently, PPE Medpro was awarded contracts via the VIP lane amounting to £200 million, despite it not even existing when Ministers were first contacted. Then, just over a year ago, the noble Lord, Lord Bethell, then the Health Minister, admitted that the department was engaged in ongoing
“discussions (potentially leading to litigation) in respect to 40 PPE contracts with a combined value of £1.2 billion covering 1.7 billion items of PPE.”
The following January, the noble Lord, Lord Agnew, resigned, criticising the Government’s track record in countering fraud across government. In relation to the PPE contracts of £1.2 billion, will the Minister update the House on how much of that money has now been returned to the taxpayer? Can he say what amount is outstanding, either where negotiations continue or where legal action is now being taken or is pending? If he does not have that information immediately to hand, will he commit to write to me and place his letter in the Library?
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Markham) (Con)
I thank the noble Baroness, and I commit to write with the precise figures. To put it into context, we should remember that this was at a time when unprecedented action was required. Of the 38 billion PPE items ordered, 98% were delivered and just 3% were unfit for purpose. Within that, clearly there is action that needs to be worked on and action is being taken to pursue those damages. I will put those in writing, so that the noble Baroness can understand them all. As I say, it is good if noble Lords recall that the priority at the time was clearly getting equipment to help protect and save lives, and that was what was done. Were mistakes made? Of course. Are we seeking to address those now by going back to take action against those people? Yes, of course we are, but we need to keep it in the context that the undoubted priority was to buy PPE and protect lives.
Covid-19 Update
Baroness Smith of Basildon Excerpts(3 years ago)
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Lord Kamall (Con)
I will try to answer as many of the noble Baronesses’ questions as I can. Regarding the more scientific data and evidence, I hope that Peers have received an invitation—if not, I will make sure that it is sent out—to a call with Dr Jenny Harries and me on Friday, during which we will be providing further details and data. It will be an all-Peers call, so noble Lords can discuss a lot of the scientific facts and evidence.
We are advising that you should work from home if you can. If you cannot, you should take lateral flow tests regularly when attending the workplace. We are requiring the wearing of face coverings in a wider range of settings. If noble Lords will forgive me, I will go into some detail here and, if appropriate, I will place these details in the Library.
Last week, we took the initial step of making face coverings mandatory again in England in shops, including contact services such as hairdressers, on public transport and on transport hubs. We are now going further, requiring the wearing of face coverings in a wider range of locations. Police and community support officers can take measures if members of the public do not comply with the law. Exemptions apply for children under the age of 11 and those unable to wear a mask covering due to health, age, equality or disability reasons.
From Friday, the settings requiring face coverings will be attractions and recreation venues—concert halls, exhibition halls et cetera—cinemas, theatres, museums and galleries. I have a longer list and I am happy to share that as appropriate with noble Lords. Other settings include bingo halls and casinos, snooker and pool halls, skating rinks, circuses, other business ventures such as public areas in hotels and hostels, play and soft play areas, sports stadia, other indoor public venues, places of worship, crematoria, chapels, community centres, public libraries and polling stations.
Places that already require face coverings, just to remind noble Lords, are shops and supermarkets, shopping centres, auction houses, post offices, banks and building societies et cetera, estate agents and letting agents, premises providing personal care, veterinary services, retail galleries, retail travel agents, takeaways without space for consumption, pharmacies, public transport and others.
So, face coverings have been reintroduced. We know that they are effective at reducing transmission indoors. I thank the noble Baroness for the support for these measures. We appreciate it on this side of the House.
It will not be a legal requirement to wear a face covering in hospitality settings, restaurants, cafés, canteens, bars, shisha bars and premises other than registered pharmacies providing medical or dental services, including services relating to mental health, and photography studios. The reasoning behind that, I am sure, will be covered in the call on Friday. I do not have all the details and the scientific evidence to hand, given the late notice of this, but I hope that Dr Jenny Harries can share much of that detail with noble Lords.
On the booster rollout, we have already seen nearly 21 million people take up their booster dose, with 1.9 million people coming forward last week. The NHS vaccine programme is to be extended today. People over 40, along with those in high-risk groups, can take their dose.
I was interested to hear from the noble Baroness, Lady Brinton, that people were still reporting that the booster was not on their app. I was not aware of that. In fact, a number of noble Lords had told me that it was on the app. I apologise for not recognising this—this is the first I had heard of it.
Lord Kamall (Con)
I am told the app has crashed. Thank you. I am being heckled about technology now. I will endeavour to look into that and clearly, the relevant people at NHS Digital can do so too. I will try to report back, probably by the Friday meeting.
The NHS will offer anyone who is eligible their booster jab by the end of January and will contact each group to be vaccinated. In addition, as I am sure a number of noble Lords will appreciate, there have been other settings in their area; for example, a number of pharmacies have erected marquees outside their premises and have rolled out to local communities. There have been partnerships with sports stadiums and places of worship, and I have read of a number of inspiring partnerships that have been formed in order to vaccinate as many people as possible.
We have been working with a number of local community groups, experts and others to try to get to those hard-to-reach communities and those who are more suspicious and less trustful of authority. We are looking at ways to do that. I am also grateful to the many noble Lords who have given me their advice on how we should reach more groups. I continue to welcome that advice, but we stress, as noble Lords across the House recognise, that we really need to roll out the vaccines as much as possible.
On ventilation, oxygen monitors were provided for all state-funded education settings from September so staff can quickly identify where ventilation needs to be improved. Letting fresh air into indoor spaces can help remove air that contains virus particles and is important in preventing the spread of Covid-19. Backed by a £25 million government investment, the new monitors will enable staff to act quickly when ventilation is poor and provide reassurance that existing ventilation measures are working.
The noble Baroness, Lady Brinton, also asked about the immunosuppressed. Shielding was introduced at the start of the pandemic urgently to protect the most vulnerable. While the advice serves the important purpose of safeguarding the most vulnerable people from the risk of infection, this has always been balanced against the significant impact that such restrictive guidance has on individuals’ lives and their mental and physical well-being. Following the advice, we ended that shielding and are now doing everything in our power to make sure that the severely immunosuppressed are able to get their third dose and that those at higher risk who test positive for the virus will be able to access the novel monoclonal antibody Ronapreve or the antiviral molnupiravir from 16 December.
Covid-19: Personal Protective Equipment
Baroness Smith of Basildon Excerpts(4 years, 8 months ago)
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Baroness Smith of Basildon
To ask Her Majesty’s Government what arrangements are in place for cross departmental working across Government for the distribution, supply and manufacture of PPE.
The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con)
My Lords, the full weight of the Government is working to get every NHS and care worker the personal protective equipment that they need. A cross-governmental team is working to source PPE from around the globe, drawing on Foreign Office and Commonwealth teams and a global network stood up by the Department for International Trade. The Armed Forces are helping with logistics. My noble friend Lord Deighton leads the efforts to boost UK PPE production.
Baroness Smith of Basildon (Lab)
I am grateful to the Minister. I was rather surprised to see him answering this Question, because I am asking about cross-governmental work and I expected a Cabinet Office Minister. Can I push him on the issue of procurement policy? He will have heard industry complaints, including from overseas manufacturers, that they have been unable to provide PPE to the UK because of the bureaucracy and hurdles involved in the procurement process, so instead they are selling their equipment to other countries. There are also numerous reports of small and medium-sized manufacturers, with the ability and capacity to produce PPE here in the UK, feeling that they have been ignored by the Government and that their approaches are just dropping into a black hole.
Noble Lords are aware that this is urgent; it has been urgent for weeks. It will continue to be urgent and the Government need to be fleet of foot and flexible. We all welcome the appointment of the noble Lord, Lord Deighton, but is there one Minister with responsibility for PPE, with the authority to work across government departments to unblock any hurdles there could be or any problems in provision and distribution? If there is, who is it and, if not, why not?
Lord Bethell
The noble Baroness makes a completely fair point. The background is that procurement in the NHS has been lean and efficient. It has been dedicated to choices for local organisations. Therefore a challenge such as Covid, which requires a massive four-nation international procurement programme, requires a different approach. We have stood up that approach and the NHS Supply Chain is working with officials from all the departments. I attended Skipton House to witness for myself the amazing work done by that joint procurement team. Jo Churchill, the Minister responsible, is achieving an enormous amount in this area.
South East Coast Ambulance Service
Baroness Smith of Basildon Excerpts(7 years, 1 month ago)
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Baroness Smith of Basildon
To ask Her Majesty’s Government how many 999 calls were made to the South East Coast Ambulance Service on 23 September to which no ambulance was sent; and what was the average waiting time for ambulance attendance on that day in that area.
The Parliamentary Under-Secretary of State, Department of Health (Lord O'Shaughnessy) (Con)
My Lords, we do not centrally collect that level of information on ambulance trust activity. However, the latest available data published by NHS England shows that in August 2017 the South East Coast Ambulance Service received 68,855 emergency calls, 52,832 of which received a face-to-face response from the service. The median response time for emergency category A calls—that is, the most serious— during that month was 8.7 minutes.
Baroness Smith of Basildon (Lab)
My Lords, that does not really answer my Question. I could have picked any day to ask about but I specifically chose 23 September because on that day Bognor Regis Town Football Club called 999 six times and eventually, after almost three hours, had to take an injured player in considerable pain to hospital by car. That is not an isolated incident. This service is in special measures. A recent report exposed a toxic atmosphere, a culture of bullying and a fear of speaking out. The CQC confirmed that the service is inadequate. The noble Lord quoted figures at me but what is really important is that the response rate for 999 calls is getting worse. Only 50.8% of Red 1 calls and 39% of Red 2 calls—both of them codes for life-threatening situations—attended within the Government’s eight-minute time limit. This is the worst performance ever in the UK since these records have been kept. Will the Government now accept their responsibilities to the public and to National Health Service staff and step in to ensure both proper funding and decent and effective management?
Lord O'Shaughnessy
I would have liked to have given data at the level that the noble Baroness asked for but it is not available in a way that has been centrally assured by NHS England. I have a responsibility to provide good-quality, verified data, and I hope she will understand that. However, the bigger point, with which I do not disagree, is that this is the worst-performing ambulance trust in the country, and that is the case whether you look at calls data or performance standards for call-outs. The question, as she rightly points out, is what you do about it. The CQC rated the service as inadequate about a year ago and has just followed up. Unfortunately, it is still inadequate, although the CQC says that some progress has been made. About half a million pounds of special measures funding has gone in. A new CEO has been in place since spring this year, and the local sustainability and transformation partnership has asked the ambulance trust for a business-case bid for transformatory funding. Therefore, I realise that this is playing catch-up, because clearly the level of service is not good enough. I understand that the latest data month on month—that is, September compared with July—shows some improvement since bottoming out in July, but I agree with the noble Baroness that it has a long way to go.
NHS: Keogh Review
Baroness Smith of Basildon Excerpts(11 years, 5 months ago)
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Earl Howe
The noble Baroness is right. There is a serious shortage in certain specialties, and emergency medicine is one of them. Work is currently going on in Health Education England to ensure that we boost the numbers in that specialty. As for what the CQC can do, there are a range of actions available to the chief inspector. In most such instances he would draw the attention of the chief executive and the hospital board to whatever problem he had found, and it would then be incumbent on the trust to put its own house in order within a reasonable space of time. That would be the norm. We should not forget that commissioners of care, too, will be encouraged to join in that conversation, to ensure that providers are properly held to account through the NHS contract. There are a range of actions that could be appropriate, and only in the most extreme cases will warning letters have to be issued or more drastic action taken.
Baroness Smith of Basildon
Despite the rather alarmist —and, as it turns out, inaccurate—briefing over the weekend, this is, as we have heard, not a historical report; it is about what is happening here and now in 14 hospitals in the NHS. I was sorry that the Minister skirted round the problems of staffing in the NHS. My local hospital, in Basildon and Thurrock University Hospitals NHS Foundation Trust, is named in the report as one of the 14 hospitals. Yet since the general election it has lost 345 nursing staff. The report found,
“inadequate numbers of nursing staff … compounded by an over-reliance on unregistered support staff and temporary staff”.
The noble Earl himself referred to this when repeating Jeremy Hunt’s Statement. May I tell him that that hospital is now recruiting 200 staff this week? That is welcome, but it can be no coincidence that, after the report, it is recruiting the staff that it needs. Does he now really believe that the £3 billion spent on reorganising the NHS was the best value for money, when staffing levels are so low?
Earl Howe
It was not £3 billion that was spent on reorganising the health service. As the noble Baroness knows, it was probably less than half that figure. The important point is that the saving in this Parliament will be at least £5.5 billion, with a £1.5 billion saving every year thereafter. I therefore suggest to her that it is meaningless to bandy that figure around. I am very glad that Basildon hospital is taking the action that it is. It has recently undergone significant leadership changes. A transformation programme is under way, and that is part of it.