Public Health

Baroness Laing of Elderslie Excerpts

Monday 15th June 2020 Commons Chamber

[Jo Churchill]

My understanding is that, as the situation is abating, to push the review out to 28 days while making a constant assessment is deemed the right thing to do to allow a more fluid process.

A full regulatory impact assessment is not required for regulations that last for less than a year. As the regulations are set to expire six months after they come into force, they therefore fit that criteria. However, the Government are considering the economic impact of the regulations on businesses and individuals, as well as the personal impact on those with protected characteristics, on people’s mental wellbeing and on religious groups and many others. As I say, this is an extremely testing and complex situation.

On testing, we have delivered a national response and have rapidly scaled up testing. From some 2,000 tests a day only back in March, we now have the capacity to conduct over 200,000 tests a day across the entire testing programme. Increasing our testing capacity is one of the greatest national mobilisations we have ever seen, and I thank the hon. Member for Hove (Peter Kyle) for his kind words. Back in February, the numbers of cases were such that we could trace at that point.

Moving on, my hon. Friend the Member for Broxbourne (Sir Charles Walker) said how important it is to get businesses open and to get back to work, and I could not agree more. The hon. Member for Westmorland and Lonsdale (Tim Farron) explained the challenges in the tourism industry. My hon. Friend the Member for Mid Worcestershire (Nigel Huddleston) is looking at the unprecedented impact that covid-19 is having on the tourist industry in order to deliver some of the changes that I am sure my constituency of Bury St Edmunds would like to see, as it relies heavily on tourism. I, for one, cannot wait to get back to the hon. Member for Westmorland and Lonsdale’s part of the world. The first walk we ever do when we go there is Swedish Bridge, but to go round the horseshoe or along the coffin trail would be a delight in the current circumstances.

For my right hon. Friend the Member for Forest of Dean, I can make clear that Her Majesty’s Government have given clarification on exactly what is provided for in the regulations and what we additionally suggest as guidance to come out during the review period. There is a complexity in the guidance, and I take on board his broader points. I agree that everybody has so far followed the guidance in a remarkable way.

I thank all Members for their contributions during the debate and provide assurance that we have listened and will take the House’s views into account as measures are kept under review. As I said when I opened the debate, we are incredibly grateful to the public for their sacrifices and their efforts to follow these tough measures. I also pay a fulsome tribute to our NHS and care workers and all the key workers for their ongoing hard work to keep our vital services running, to save lives and to keep all of us safe. I commend these regulations to the House.

Question put and agreed to.

Resolved,

That the Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No.3) Regulations 2020 (S.I, 2020, No. 558), dated 31 May 2020, a copy of which was laid before this House on 1 June, be approved.

[Madam Deputy Speaker (Dame Eleanor Laing)]

In order to allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the subsequent item of business, I am suspending the House now for three minutes.

Public Health

Baroness Laing of Elderslie Excerpts

Monday 4th May 2020 Commons Chamber

[The Minister for Health (Edward Argar)]

I beg to move,

That the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 (S.I., 2020, No. 350), dated 26 March 2020, a copy of which was laid before this House on 26 March, be approved.

[Madam Deputy Speaker (Dame Eleanor Laing)]

With this we shall take the following motion:

That the Health Protection (Coronavirus, Restrictions) (England) (Amendment) Regulations 2020 (S.I., 2020, No. 447), dated 21 April 2020, a copy of which was laid before this House on 22 April, be approved.

The Minister is asked to speak for no more than 12 minutes.

[Edward Argar]

These sets of regulations were made by the Secretary of State on 26 March and 21 April respectively. Following the return of the House after the Easter recess, they are rightly being brought before the House today for the scrutiny and debate that they require. They are exceptional measures, brought forward to reflect exceptional challenges and times, but although it is right that these regulations—necessary to meet the public health needs of the coronavirus pandemic—are brought forward, it is also right that we ensure that this House is able to play its proper role, and that due process and the rule of law are maintained. With that in mind, I thank the shadow Minister and the Opposition parties for facilitating this debate taking place today.

The country has been, and still is, engaged in a national effort to beat coronavirus covid-19. Delivering a strategy designed to ensure that our NHS is protected, with capacity at all times exceeding the demand for intensive care beds for coronavirus patients, flattening the peak, and driving down the rate of transmission of disease and the number of infections, alongside the work to significantly expand NHS capacity, have all helped to protect our NHS and to save lives. Sadly, although this has been working, there have been many who have died from this disease—each and every one of them a tragedy, and each and every one a real person. Our thoughts are with all their friends and families at this time. I also put on record all of our continued thanks and appreciation to NHS and care workers, and to key workers around the country, for the phenomenal work that they are doing caring for people and keeping the United Kingdom going.

The regulations we debate today have played a crucial role in the success we are seeing in reducing infection transmission levels. They impose significant demands upon individuals and society as a whole, with impacts on business, the economy and daily life, and I do understand the sacrifices people are making at this time, their frustrations, and, indeed, their anxieties. But these regulations are necessary, because the single most important step we can all take to beating this disease is to stay at home in order to reduce the spread and to protect ourselves and others.

That is why, in these regulations, the Government introduce three main social distancing measures: requiring people to stay at home as far as possible, with only very limited exceptions; closing certain businesses and venues; and stopping gatherings of more than two people in public. These regulations are similar to those introduced by other countries. We have worked closely with the devolved Administrations, to whom I should also pay tribute, in developing and reviewing these measures.

The main statutory instrument, No. 350, requires enforcement of the closure of some businesses and restrictions on others from 12 pm on 26 March 2020. As set out in the notes, the regulations require the closure of drinking establishments, including bars, pubs and nightclubs, and food and drink venues with consumption on-site, excluding hospitals, schools, care homes, homeless services and prison canteens, as well as other exemptions. Regulation 4(4) requires the closure of entertainment venues including cinemas, theatres, concert halls, bingo halls, museums, galleries, spas, hairdressing and massage parlours, casinos, funfairs, libraries, community centres, and non-food outdoor markets. Regulation 5(1) requires businesses offering goods for sale or for hire, or providing library services, to cease to do so except in response to orders received online, by telephone or by mail order. Types of businesses specified in part 3 of schedule 2 are exempt from these restrictions. Regulation 5(2) excludes hot and cold food collection and delivery from the closure restrictions. Regulations 5(3) and 5(4) require hotels and similar establishments to remain open for permanent residence only to persons in a hotel because they are moving home, attending a funeral, or unable to return home.

The second set of regulations, No. 447, makes a small number of consequential amendments to improve the operational implementation of the main regulations.

These regulations are made under section 45C of the Public Health (Control of Disease) Act 1984, with Her Majesty’s Government clear that the powers under that Act are sufficient to introduce them.

Given the impact that these regulations have on individuals and businesses, notwithstanding the huge support package announced by my right hon. Friend the Chancellor of the Exchequer, I know that a number of issues relating to these regulations have been raised in recent days by members of the public and, indeed, by hon. Members, and I will touch on those now. However, I will endeavour to respond more fully to specific points raised by Members when I wind up the debate.

First, there is the question of enforcement. The Joint Committee on Human Rights and others have expressed concerns about variations in enforcement and in the approach adopted to it by different police forces. As hon. Members will be aware, guidance was issued to police forces, and this has continued to be updated and clarified. It is important that the police operate within the law, which is the law as it is set out in these regulations, and that guidance is treated as just that—clarifying guidance.

The British people have been amazing in their collective response to the restrictions, and compliance has been very high. However, a very small minority have not always complied. The police have been doing their very challenging job at this time with dedication and, by and large, pragmatism. The approach of “engage, explain, encourage, and only then enforce where it is absolutely necessary” is the right one. The small number of examples, while important, of what can seem like over-enthusiastic enforcement should not detract from the fantastic work being done by the police across the country.

The final aspect of the regulations that I draw attention to is the requirement that they be reviewed every 21 days, to ensure that they remain necessary and appropriate. The first review took place on 16 April, with the First Secretary of State confirming that they would remain in place. The next review is due on 7 May. I am aware of the desire of Members and across the country for more detail on the UK’s progress and future steps, which I understand. The review on 7 May will consider the necessity of the regulations against the public health aim, including the five considerations set out by my right hon. Friend the First Secretary of State: first, that the NHS can provide critical care across the UK; secondly, that there is a sustained and consistent fall in the daily death rate; thirdly, that infection rates decrease to an acceptable level; fourthly, that supplies of personal protective equipment and testing meet future demand; and fifthly, that evidence is clear that any changes will not risk a second peak of the virus.

The Prime Minister has set out that further announcements on this will be made soon. As he said on Thursday last week, the Government will set out a comprehensive plan this week, which will explain how we will get our economy moving while continuing to suppress the disease. It will set out how we will seek to get life back to normal for as many people as we can, as quickly, equitably and fairly as we can, while continuing to protect the NHS. And it will, of course, as throughout, continue to be guided by the best scientific and medical advice. I hope the House will understand that I do not intend to pre-empt what the Prime Minister might say later this week on the basis of that advice.

It is right that we made these regulations as and when we did to help tackle the coronavirus/covid-19 pandemic. Her Majesty’s Government consider these regulations to be proportionate and appropriate in the face of this pandemic, but it is absolutely right that this House properly scrutinises and debates them and their impact upon our country, and I look forward to hearing Members’ contributions. I commend these regulations to the House.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Before I call the spokesman for the Opposition, I should draw to the attention of Members in the Chamber and who are going to participate by electronic means that there will be a time limit of five minutes on Back-Bench contributions. I have to adhere strictly to that timetable in order to make these proceedings work in this unusual way, so please do not look for leniency. I also ask Members who are participating from home to have some way of checking whether they have spoken for five minutes. I now call Justin Madders, who I ask to speak for no more than eight minutes.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

We all wish that these regulations were not necessary, but we are all absolutely clear that, given the threat we face, they are required. Before we get into the substance of the regulations, I want to say a little bit about the process, because whether we support these measures or not, given that they represent the biggest peacetime restrictions that this country has ever seen, they do demand full parliamentary scrutiny. I do not intend this to be a criticism of the Minister or anyone else, because we all know the efforts that have been made to get this place up and running again, but a couple of hours’ debate weeks after the regulations were introduced cannot in future be sufficient to provide the level of examination and scrutiny that such sweeping laws require.

We all know the damage that this virus is doing to our society, and we all know that these measures are needed to limit that damage, but we should not forget their impact—the business shut down overnight with no idea if or when it might trade again; the child who cannot understand why they cannot see their friends any more; the grandparents cut off from their family, missing out on their grandchildren growing up. Everyone is facing their own challenges. The physical and mental toll is huge, yet virtually everyone is adhering to these rules in a way that is a testament to the resolve and determination of the British people. So we say thank you to everyone who has played their part in slowing the spread of the virus.

We acknowledge that this is incredibly difficult, and we do not want these measures to be in place for a day longer than is absolutely necessary. The first duty of any Government is to protect its citizens, and if it is necessary to curtail basic freedoms—freedoms for which people have fought and died—to protect them, reality dictates that that is what has to happen. That reality must be accompanied by openness, accountability and scrutiny at a greater level than we would ordinarily see. We accept that the regulations had to be introduced hurriedly in response to the rising number of infections, but there is now a new rhythm to life, and there ought to be time and space to ensure that any future changes have democratic consent before they are introduced.

The regulations require a review every three weeks—as the Minister said, one is due in the next few days. The Secretary of State is legally required to terminate any regulations that are not necessary or proportionate to control the transmission of the virus. A statement in the House following the review will provide a helpful examination of that requirement. I hope that when the Minister responds he will commit to that and to an oral statement after each subsequent review. If that review envisages some relaxation of the measures, we hope that any new regulations on the back of that are debated here before they are implemented and, most importantly, that they follow a wider conversation with Opposition parties, employers, trade unions and, of course, the public.

There are reports that that has begun to happen, but it needs to be done in a structured, open way, not through media briefings or leaks. I do not say that to make a political point, but because I believe that consent for an application of the rules will be better after full and transparent dialogue than it would be without that. We need only to look at the way in which some of those rules were interpreted and applied in the early days to know that there was confusion about their exact meaning. Again, that is not intended as a criticism—no law, let alone one that is completely unprecedented in its reach in modern times could be implemented without areas where there is ambiguity, and clarification is required.

Much of that was most likely due to the unusual and sudden nature of the regulations, but even recently we have seen a divergence between ministerial pronouncements and what the law actually allows. For example, the Secretary of State for Housing, Communities and Local Government has recently said on a number of occasions that tips should be able to reopen. Regulation 6 does not state that such a visit is a reasonable excuse for leaving home.

That leads to my next point—the current rules, sweeping as they are, are not numerous. If the next phase is likely to contain a longer list of reasonable excuses to leave home, it is even more important that those rules are clear and consistent. The rules need to be harmonised with advice, guidelines and all forms of official communication. We do not want people to imply legal authority where there is none, or to act outside the law. That is vital to preserve the rule of law. We know that the lockdown was a blunt tool—effective nevertheless—and one that will change by definition as restrictions ease. There will be a measure of nuance, distinction and variation that requires careful explanation and policing. People will inevitably ask why one set of businesses can reopen, but not another. We believe that full disclosure not just of the names of the attendees of the Scientific Group for Emergencies but of all the scientific evidence and advice that has been provided is required to give the public confidence and reassurance on any changes to the rules.

It is in the area of transparency that we need a change from what have seen so far. To take people with us, and for the morale of the nation, any changes to the rules must be viewed in the context of a published exit strategy. We need clear sight of the proposed areas where restrictions will be eased, and a robust plan to protect workers and the public alongside a published impact assessment. So far, there has been no impact assessment—again, we understand why that was not possible in the circumstances, but we do not want that to become the norm, especially for regulations such as this. We see the impact every day and we know that it is not distributed equally.

I should like the Minister to provide assurances that there will be adequate personal protective equipment for all those working on the frontline and facing exposure to the virus. I should like to put on the record our thanks for the extraordinary bravery and dedication demonstrated by NHS staff and other public servants. Our thoughts are with those who have lost loved ones to the virus, and we hear the concerns from many royal colleges and trade unions in the NHS and social care sectors about the availability of PPE. That matters going forward. If, for example, any changes to the lockdown rules involve the wearing of masks in public what steps will the Government take to ensure that everyone can access them consistently and securely?

Will the Minister also address the question of what resources will be devoted to helping businesses make physical changes to ensure safe working and to increase capacity for the official enforcement of safe working practices? The Health and Safety Executive has experienced significant cuts to its budget over the past decade, and demands on it will be higher as questions inevitably arise about safety. What extra funding will be available to meet that demand?

Will the Minister provide clarity on the status of the 2-metre social distancing rule? It is probably the most effective tool in helping to stop the spread of the virus, yet it does not appear in the regulations. Does it appear elsewhere? Is it actually enforceable? On the question of enforceability, the comments today from the TUC about the lack of enforceability of the proposed guidelines that it has seen are extremely troubling. We cannot allow people back into work unless there is confidence that a robust and enforceable system is in place to guarantee their safety.

Finally, we require clarification on the list of vulnerable people in schedule 1 of the first set of regulations. For example, motor neurone disease appears in the schedule as an underlying medical condition for those in the vulnerable category, but it is not among the high-risk category of patients on the NHS shielding list. This may well be another example of where there needs to be greater harmony between the regulations and other guidance.

In conclusion, we will not oppose the regulations but, given that they represent the most severe restrictions imposed on British liberty in modern history, it is critical that they are subject to continual comprehensive and transparent scrutiny. Democracy demands no less.

[Madam Deputy Speaker (Dame Eleanor Laing)]

We now have a formal time limit of five minutes.

--- Later in debate ---

[Mr Steve Baker (Wycombe) (Con) [V]]

These rules are necessary and the Government made the right call when they put the country into lockdown in order to protect lives. Nothing that I am about to say should in any way be taken to diminish people’s obligation to obey the law.

My first point is that we see that these regulations were made on 26 March at 1 pm. The Prime Minister announced these rules on 23 March and police officers quickly set about enforcing them, stopping people on trains and, in one case, overturning a barbecue. People very quickly found themselves subject to what seemed to be enforcement action. On 24 March, the Government sent a text message, saying that new rules were “in force now” and that people “must stay at home”. The problem is that those rules were not in force at that time; they were not in force until 26 March. I press on the Minister the fact that we must not again have a situation where the Prime Minister makes an announcement at a press conference and police officers start enforcing rules before they are made. We must in future make the law and then tell the public that it is enforced. I press on him the fact that that must not happen again.

Secondly, there is a good case that these regulations are ultra vires, and I recommend that the Government have a contingency plan in place in case a court case— a judicial review—succeeds in demonstrating that. I will try to sketch out the position very quickly—if I have understood it correctly. This is from an opinion from Blackstone, and I have tweeted the original article if people have an interest in the detail. It says:

“The regulations purport to authorise conduct which would otherwise constitute the torts of false imprisonment and trespass to the person”—

that is the physical restraint and forcible removal to one’s home. It goes on to say that for primary legislation to sanction such tortious conduct there must be

“express words or necessary implication”

to that effect. But section 45G(2)(j) of the Public Health (Control of Disease) Act 1984, under which these rules are made, does not expressly, or by necessary implication, authorise physical confinement.

It is also the case that the Act expressly prohibits the Secretary of State from imposing certain of the special restrictions on people; they can only be imposed by a magistrate. It suggests that, under the 1984 Act, the Secretary of State was not meant to be able to put on people restrictions that would otherwise be tortious—false imprisonment or physical restraint, for example. Therefore, we may be in a position where these draconian rules—these necessary rules—are not well founded in law, and I would like to know today the Government’s position on that. I would like to be assured that, if the lockdown needs to continue, the Government will have a contingency plan in place to ensure that it is well founded in law.

The third point was very well made by the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders). He called for harmony between the guidance and the law. There have been very severe, absurd problems arising because the police have sought to enforce rules that were not actually in law. For example, the law in England does not specify that people may not drive to exercise. I know of people who have stayed at home because they need to drive a short distance from a place where they cannot exercise to one where they can. People have been accused, for example, of not sweating adequately when cycling. When doing yoga, they have been accused of not exercising. These things are absurd and wrong and worrying for law-abiding people. The Government may not in future be able to close this difficult area by harmonising the guidance with the rules, so what I suggest is for them to have a look at the Highway Code, where there is already a precedent for rules given with a “should”, which means that they are, in a sense, guidance and not enforceable, and for things that people must or must not do. Given that we have that precedent, can we please close this gap, so that police officers are not put in the invidious position of trying to enforce what are really no more than Ministers’ opinions of what should be done—in other words, things that are not in law.

I want to finish by saying that I am very grateful to the Prime Minister for his liberalism. I am extremely thankful for the exceptionally high-quality policing in Wycombe, where I have had no complaints. None the less, the people of the United Kingdom should not have to rely on the goodwill of the Prime Minister and the Government or the good sense of police officers in order to go about their lawful business. I implore my friends on the Front Bench to ensure that we uphold the rule of law and the freedoms on which they depend.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The Opposition Member who was due to speak next is not now taking part in the debate, so we go to another Government Member, Selaine Saxby.

--- Later in debate ---

[Philip Dunne (Ludlow) (Con) [V]]

Madam Deputy Speaker, I am grateful to you for calling me on my first occasion of trying this virtual system.

I would like to take this opportunity to put on record my thanks to the Minister and his team for the extraordinary efforts they have displayed during this crisis in galvanising both the health service and the entirety of Government to get behind combating this disease. This is no easy task, and I think they have done it admirably, if I may say so. I would also like to pay a brief tribute to everybody working in the NHS, in the care sector and in the public services generally—local authorities, emergency services—right across the country and particularly in Shropshire in keeping a grip. As some other speakers have said, we are some way behind the rest of the country, being a rural shire county, but that does not mean to say that the disease is not now present and, regrettably, killing people.

On the debate today, it is very clear that we are making regulations that are unprecedented in scope in taking away people’s liberty. It is therefore absolutely right that Parliament, which regards itself as the beacon of democracy around the world, is here to scrutinise, to hold Ministers to account and to hold the Government to account. I share the comments made by earlier speakers that it is absolutely right that we have the ability to review these measures every 21 days, and I encourage Ministers to acknowledge—perhaps the Minister can do so in his winding up—that it is the Government’s intent to speak to the measures as they are either repeated or relaxed over the coming weeks.

I would like to make three quick points in this debate. First, and directly related to the regulations before us, some of the most heartrending cases I have heard of during the weeks of lockdown have been the difficulties for family members of those who are patients in intensive care units in hospitals, where they quite properly cannot be visited because they are on incubator ventilators. However, when that treatment does not succeed and, regrettably, there is a tragedy and the death of a patient, it has been difficult for family members to be able to come to terms with their own grief because they are initially not able to attend either burials or cremations. I warmly welcome, first, the announcement by the Secretary of State for Housing, Communities and Local Government that close family members should be able to attend burials or cremations, but also that this is being confirmed in these regulations.

I would just like to add my support for care, when the Government look at relaxing the regulations, and for not imposing age-related restrictions on individuals. As we have seen all too vividly, it is possible to reach 100 and to walk—with assistance, but to walk—and take exercise in the way that Captain, now Colonel, Tom did so magnificently and galvanised the nation. We cannot introduce specific restrictions for those aged over an arbitrary limit—70-year-olds have been mentioned —without imposing very great inequality, in my view, on healthy individuals, so please do not do that.

Secondly, it is very clear from the Government’s five markers for relaxing restrictions that testing is one of the key platforms. I take my hat off to the Government again for the extraordinary effort in galvanising academia, the scientific research laboratories, the NHS laboratories, industry and even the military in achieving the very demanding testing target set by the Secretary of State for April. It is a tremendous achievement. However, these tests have all been swab tests—the antigen test—which tell whether an individual currently has the disease, so such a test is of limited use for as long as that individual is presenting symptoms. It does not help in identifying whether they have had the virus. Therefore, the antibody test is vital in order to allow us to get back to normal. It would be helpful if the Minister could give an indication to the House of what prospects we as a nation have of moving towards an antibody test that is effective.

Finally—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I trust that the right hon. Gentleman is going to conclude very soon, because his five minutes are up.

[Philip Dunne]

I apologise, Madam Deputy Speaker. I would just like to echo the comment made by my hon. Friend the Member for Yeovil (Mr Fysh) that the contact tracing and tracking app needs to be introduced on a voluntary basis, and the Government should take great care in explaining to the public why it is such an important tool in fighting this disease.

[Madam Deputy Speaker]

Once again, the Opposition Member who was next on the list is not now going to participate in the debate, so I go to another Government Member, Sir John Redwood.

--- Later in debate ---

[Robert Courts (Witney) (Con) [V]]

Unprecedented times call for unprecedented measures, and that is the case here. The entry of coronavirus on the scene and the terrifying wave of deaths it unleashed across the world led to a very real fear that our NHS would be overwhelmed and that we might see here some of the horrifying scenes we have seen in Italy. Therefore, the public rightly demanded action—action to keep them safe and to save their jobs. The Government have responded, quite rightly, in huge measure, unveiling a package of support of all types that has addressed almost every area of national life. Thanks to that massive effort to shield the NHS, we have avoided that uncontrollable, catastrophic epidemic, where the reasonable worst-case scenario was 500,000 deaths.

Yet, it remains the case that what has had to be done is quite extraordinary in two respects: we have seen an extraordinary suspension of normal personal liberties and extraordinary measures by means of which the state is intervening in the economy. I want to make the case today that every Member of this House should be drawing attention over and over again to how truly extraordinary these measures are.

It says something for the respect in which the country’s institutions are held that there has been such wide acceptance. The police are trusted, and the bobby is seen as our friend. There is not the suspicion here that we often see in other countries—even democratic ones. That speaks of a country whose structures are mature, stable and secure, but I confess that I am, in some ways, slightly disturbed by the extent to which these restrictions have been accepted. Overwhelmingly, of course, that is down to a desire to do our bit—to be seen to be in every way the equal of our grandparents as we face a very different challenge—and some of it, of course, is fear. However, that does not mean that we should be complacent, and that complacency would be shown by starting to accept these restrictions as normal, rather than stressing over and over again how truly exceptional they are.

I will be absolutely clear: I have total faith in the Government’s good intentions. They have done what they had to do to save lives and jobs, and I support them wholeheartedly, but it is not this Government I am concerned about. What I want us to do is to guard against a change in the national mood music and to prevent a ratchet effect, such that we become used to restrictions we never would have tolerated in normal times, not least because there will always be some who argue we should do more.

We can see how the acceptance of restrictions has an effect long after their intended period in the economic sphere. When I was my son’s age—he is three now—Margaret Thatcher was beginning the huge task of dismantling the vast socialist edifice that had dominated the UK since the war. What is not always appreciated is that that edifice was not just the result of Labour party manifestos from 1945 onwards, but was essentially the basis of a command economy set up during the second world war. In essence, that wartime command economy was not dismantled until the 1980s, despite there being Conservative Governments during that time. There was a Butskellite consensus that did not challenge the basic premise that the state owned and controlled the essential parts of the economy. Why were Conservative MP so complicit? There were many reasons for that, but one was that the level of state control had become something people were comfortable with—something they were used to—and they failed to question it. That state control had been the new norm.

We are now in a world in which huge amounts of workers’ wages are being paid by the state, and I wholly support the action taken and the reason for it. It was right to protect the economy in the short term to enable it to bounce back in the medium to long term, but that does not mean that we ought to tire of pointing out how unusual these measures are and that we have no intention of allowing them to continue for the long term. This applies to these regulations as much as to the economic effects. If not, we will see that those on the left who want to see a bigger state anyway will find an excuse to say, “Well, that wasn’t so bad, was it?”, so the ratchet cranks up another notch. We will see arguments for things such as universal basic incomes and all the failed ideology of the state finding a specious pretext for an unwelcome return. What we Government Members have to do is to tirelessly make the case that economic liberalism put us in a good place to meet this crisis, and it is to economic liberalism that we must return. That starts by pointing out how unusual and, in the long term, undesirable the current restrictions are.

The police have been given powers that are in some ways greater than the Emergency Powers (Defence) Act 1939—a raft of powers that they are now trying to make sense of and apply in a practical way. As constituency MPs, we have all been inundated over the last few weeks with requests by the public to help them to understand what they are and are not allowed to do.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I trust that the hon. Gentleman is concluding as his five minutes are up.

[Robert Courts]

I am indeed, Madam Deputy Speaker. I am very grateful for the efforts that the police have made in very difficult circumstances. I simply ask that all Members of the House keep vigilant at all times as to the effect of the regulations that we are currently supporting.

--- Later in debate ---

[Edward Argar]

Today we have had in this Chamber a very important debate on regulations that, while absolutely necessary to help beat covid-19, are having a profound effect on people’s lives and businesses. Despite that necessity, it is equally necessary that we uphold the hard-won rights we have in this country: the rule of law and the right and duty of this House to scrutinise and question the Government—something that Members have done with determination and, indeed, enthusiasm today.

In the course of the debate Members have raised a number of important points, to which I will endeavour to respond as fully as I can in the time allowed to me. First, the hon. Member for Ellesmere Port and Neston (Justin Madders) raised a number of key points. He talked about the need for clarity around an exit strategy and how it develops and the importance of taking the British people into our confidence, because in this country we govern and police by consent, and therefore it is important that it is a shared endeavour, where we take the British people with us.

As I mentioned in my opening remarks, the Prime Minister said last Thursday that the Government will set out a comprehensive plan this week, which will explain how we will get our economy moving while continuing to suppress the disease, seeking to get life back to normal for as many people as we can as quickly and, importantly—this goes to a point made by my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady)—as fairly across our society as we can, while continuing to protect the NHS.

The hon. Member for Ellesmere Port and Neston was right: that needs to involve a conversation and a dialogue. As he alluded to, that dialogue on where things may go in the future has already begun, which is a positive step forward. I am grateful for his typically reasonable and measured tone, and I want to put on record once again my gratitude to him and to the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), my constituency neighbour. He, too, has adopted a constructive and reasonable tone throughout this, and I am grateful to them and Members across the House for the tone they have adopted.

I turn to other points that have been raised. If I miss anything, the shadow Minister is welcome to come back to me privately, and I am happy to write to him to fill in any gaps in my answers. My hon. Friend the Member for Altrincham and Sale West mentioned the importance of scrutiny, as did many Members, and that is absolutely right. It is important that we remember that these regulations are born out of necessity, but they are exceptional and should only be kept as long as the exceptional circumstances necessitate. He, too, mentioned the importance of a route map and giving the UK a route out of the current restrictions as quickly as we can when we can do so safely; he is right. Sadly, the necessity of the time means that we are not there yet, but it is important that that dialogue with the British people continues and is open, including in this House.

I am grateful to the hon. Member for Westmorland and Lonsdale and my hon. Friend the Member for North Devon (Selaine Saxby) for the tone of their remarks and their support for the necessity of what we are doing. They highlighted the impact—the hon. Gentleman in respect of the south lakes area and my hon. Friend in respect of rural north Devon—of these necessary regulations on the hospitality and tourism industries that play such a huge part in their local communities and economy. That is why it is absolutely right that my right hon. Friend the Chancellor of the Exchequer is looking carefully at the matter and has put together a package designed to do everything that he can to support industry and businesses in this country. Nevertheless, I hear what they say, and I know that my right hon. Friend the Chancellor will have heard it as well.

My hon. Friend the Member for Broxbourne (Sir Charles Walker) was the Chair of the first Select Committee that I served on after I became a Member of this House in 2015, and back then he emphasised to me that the key Committee to get on was the Procedure Committee, because by learning how this place works a person will not go too badly wrong. I do not know whether it has yet been long enough for me to have proven or disproven that, but he is right, and he is a doughty champion of the rights of this House and the importance of scrutiny and due process. He is also right to emphasise that just as we must ensure that we protect the NHS and protect people’s health, we must also recognise the need to support and protect our economy, because it is indeed a vibrant economy that pays for the NHS that we all rely on. My hon. Friend highlighted the need for openness, and his contribution was typically decent and insightful.

The hon. Member for Carmarthen East and Dinefwr (Jonathan Edwards) was right to emphasise the importance of the four nations working together and taking a co-ordinated approach. I again re-emphasise my gratitude and the Government’s gratitude to the devolved Administrations for the spirit of genuine partnership in which we have all been working in recent weeks. The hon. Gentleman talked about whether the fixed-penalty notice amount was an adequate deterrent; it is arguable that the far more effective penalty is, rather than the penalty imposed, the sense of common national endeavour in this country and everyone wishing to do the right thing because it is the right thing to do.

My hon. Friend the Member for Wycombe (Mr Baker) is not only an hon. Friend but a friend, and a good and decent man. He has long been a champion, inside and outside the House, of due process, the rule of law and the need, despite the safeguards in this country, always to be vigilant and protect the hard-won freedoms that we enjoy. Such voices as his are absolutely vital to the health of a vibrant democracy such as ours. He was right to emphasise the difference between guidance and law. As I said in my opening remarks, what is in the regulations is the law; guidance may be helpful but it is not the law. My hon. Friend drew on the highway code to make a point about the difference between “must” and “should” in the way we communicate these things. That is a good and valid point that my hon. Friend the Member for Witney (Robert Courts), who is not able to be present today, has made to me in the past.

My hon. Friend the Member for Wycombe also asked whether the regulations might or might not be ultra vires. I will say only a few more words on the issue, because I am conscious that, if the press reports are to be believed, there is a possibility that some may be considering legal cases on this issue and I would not wish to stray into that territory, save to reiterate what I said in my opening remarks: the Government believe that section 45C of the Public Health (Control of Disease) Act 1984 does give sufficient authority to Ministers and to the Government to implement the regulations.

The hon. Member for Oxford West and Abingdon (Layla Moran) was right to highlight the challenge posed in some businesses—she highlighted the experience of call-centre staff—and the need for businesses to do everything in their power, if people are working in a job that they cannot do from home, to ensure that their workers are supported and protected and that appropriate social-distancing measures are in place to protect workers who are fulfilling important roles to help everyone else in our society.

My hon. Friend the Member for Yeovil (Mr Fysh) and my right hon. Friend the Member for Wokingham (John Redwood) both highlighted the importance of reassuring the British public and this House about the need for openness and for scrutiny. They highlighted the fact that we must always treat liberty as a precious thing, protect it, and ensure that we do not see it whittled away: I reassure my hon. Friend the Member for Yeovil that there is no intention to do any such thing.

My right hon. Friend the Member for Wokingham also touched on the need to be open about the science. He spoke with a degree of erudition and knowledge that I will not seek to emulate, but he is right to say that we must interrogate the science carefully when making the decisions on where to go in future with these regulations.

Turning to the hon. Member for Strangford (Jim Shannon), we are, as ever, very grateful for his support and for his contribution to this debate. He is always a strong voice for his constituents. Among a number of points that he made, he was quite right to highlight the importance of doing what we can to ensure that people’s mental health is supported and protected at what is a very difficult time for many, many people. He also alluded to human rights implications. I reassure him that the Government are clear that these measures are fully compliant with the Human Rights Act 1998.

My right hon. Friend the Member for Ludlow (Philip Dunne) and a number of other colleagues, including my hon. Friend the Member for Witney, my right hon. Friend the Member for Forest of Dean (Mr Harper) and my hon. Friend the Member for Newcastle-under-Lyme (Aaron Bell), made the point, as have other hon. Members, that these regulations, while necessary, should be in force only for as long as they are absolutely necessary, highlighting not only the health impact but the broader impacts on society and on the economy. I reassure them that we are absolutely clear about that. These measures are a necessity at the moment, but the Government have always been clear that they will be retained only for so long as they are a necessity to tackle this disease.

My right hon. Friend the Member for Ludlow was right about the importance of testing, and also right to highlight the work of the Secretary of State in this respect. The Secretary of State has always been very clear in saying that it is a team effort that has got us to reaching the target, last week, of 100,000 tests per day. I would say, however, that in a team, leadership is important. He has shown that leadership in this very important matter, and I pay tribute to him for that.

My hon. Friend the Member for Arundel and South Downs (Andrew Griffith) was absolutely right to highlight the importance of consent. Consent comes from us following due process and adhering to the rule of law through this Chamber—through this House. We will always bear that very much in mind. The shadow Minister and others made the point very clearly that they would expect this House to be very much involved, as swiftly as possible, in any further decisions or changes. I know that will have been heard by my right hon. Friend the Prime Minister in Downing Street.

I conclude with my thanks—and indeed, I suspect, all of our thanks—to NHS and care staff and key workers around this country, all of whom are doing so much for all of us. These are exceptional measures that we should only maintain for as long as necessary, but at the moment, regrettably, they do remain necessary. Therefore, I also thank the British people for their incredible spirit and support for these measures. The fight against covid-19 is a tough one that has brought forth a national effort in this country. I am convinced that we will beat it, for when this great country comes together, it is unbeatable. I commend these regulations to the House.

Question put and agreed to.

Resolved,

That the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 (S.I., 2020, No. 350), dated 26 March 2020, a copy of which was laid before this House on 26 March, be approved.

Public Health

Resolved,

That the Health Protection (Coronavirus, Restrictions) (England) (Amendment) Regulations 2020 (S.I., 2020, No. 447), dated 21 April 2020, a copy of which was laid before this House on 22 April, be approved.—(Edward Argar.)

[Madam Deputy Speaker (Dame Eleanor Laing)]

We have concluded this session a few minutes earlier than expected—not through bad arithmetical calculation, I would like the House to know, but because a few people who had indicated that they wished to speak and had been on the list to speak decided at the last minute not to. I therefore suspend the House for rather more than 30 minutes, until 7.30 pm.

A& E Departments: Staffing

Baroness Laing of Elderslie Excerpts

Monday 23rd March 2020 Commons Chamber

[Chris Bryant]

That is an extremely good point. I wonder whether Tesco, Sainsbury’s, Morrisons and all the other supermarkets—once they have managed to recruit more delivery staff—should think about making deliveries specifically to hospitals and other care points, so that there is specific provision for key workers. That could make a significant difference.

What is essential to running a good accident and emergency department is, first, good, strong leadership. That means consultants who are well trained, and not just relying on locums who are on a part-time contract. It requires really strong teamwork. There is just as much value in a calm receptionist or a meticulous cleaner as a well-trained doctor, consultant or a nurse. We need resources and training to make an A&E flourish. We need people with an extraordinary set of skills, including the ability to make swift and yet very important, time-critical decisions. We need a wide range of disciplines that feed into the whole of the rest of the hospital. Those people have to be able to deal with strong emotions, from rage and anger to grief, anguish, upset, fear and love, all mingled in a very difficult situation. Unfortunately, they have to be able to deal with the particularly strange combination of adrenaline and alcohol, which sometimes makes an accident and emergency department—especially on a Friday or Saturday night—a very difficult place to be.

The truth of the matter is that we have a great number of shortages in our A&Es across the country. In terms of consultants, we are somewhere between 1,200 and 1,500 consultants short across the whole of the UK. There is a particular shortage at my local hospital, the Royal Glamorgan, which is why it has had to rely substantially on locums for the last year. That is not a sustainable model for the future, which is why I am determined to make sure that the local health board campaigns to recruit more consultants for local hospitals. Other countries have a much higher number of A&E consultants per 1,000 people than we do in the UK. We are aiming to get to one for every 7,000 people, and in most other countries it is one to every 4,000. We still have not reached one to every 7,000, so that is a problem. I would urge any doctor who is thinking of training now, or any young person who is thinking of going into medicine, to please think about being an A&E doctor. You will see over the next few months that we love our A&E doctors almost more than anybody else in the whole of the NHS.

Beds are another real issue. We have one of the lowest numbers of critical care beds in Europe, fewer than Spain and France, half of those in Italy, and only a fifth of what they have per 1,000 head of population in Germany. That puts us, as we will discover over the next few days, in a really difficult position. Some areas of the country will face even bigger challenges than others. The most rural parts of the country, where there is an older population and where there are significant health problems—in particular, in the south-west and in the semi-rural areas of the south Wales valleys—will face a particular difficulty, because they already have 83% to 90% occupancy of all their intensive care unit beds, and that is before anybody else comes in through the door.

Lots of hospitals have done an amazing job over the past fortnight, trying to turn other wards into intensive care units that can be used specifically for coronavirus patients, and recruiting additional staff who have previously retired to come back into the service. Hospitals are doing a phenomenal job in all of that, but the truth is that across the whole of Wales we have only 153 intensive care unit beds, and 90% occupancy. That will pose a phenomenal difficulty for my constituency, where we have a large number of people with chronic obstructive pulmonary disease, a large number of people with diabetes and many with the conditions that make them the most vulnerable—and an ageing population at that. The whole nation will have to think very hard about how, in the long term, that situation is sustainable, even if we do manage to struggle through the next few months. In a sense, in our NHS at the moment, intensive care needs intensive care.

On coronavirus specifically, I praise every single doctor, nurse, cleaner, decorator and builder who has been involved in the process of reshaping intensive care units and emergency departments. The turnaround has been remarkable. Sometimes they have had to devote hours to training to use PPE, and then they have discovered that the equipment is not easy to use, and they have used all the equipment that they had on training in how to put it on and take it off. They have been working at pace, and undoubtedly they have been working many, many more hours than they are contracted to do, and I think we would all want to say thank you to them for that.

I also want to praise all the staff who work in accident and emergency departments, because I know from talking to doctors over the past few days that they know they will have to make some very, very difficult and horrible decisions—decisions that none of us in this House would ever want to make. They know already—they have protocols that were put in place in 2009 when we were looking at the H1N1 strand—that they will have to make decisions about who they can provide ventilator beds for and who they cannot provide ventilators beds for. That will obviously be horrible for the families and the individuals concerned, but just think of the emotional stress and strain for each of the doctors and nurses who at some point over the next few months are going to have to say, on occasion, “I’m sorry, there is no bed for you, because you are not a priority.” That will hurt because that is not what anybody was ever trained to do when they became a doctor or a nurse. The trauma—the emotional trauma—of that for many people will be phenomenally difficult.

My heart is just full of praise for all those doctors, all those nurses, all the cleaners and all the other parts of the A&E teams. Madam Deputy Speaker, I know you know that I do not like clapping in the Chamber, and I am sure you do not like it either, but I think there are very exceptional moments when this House would like to thank people who do a phenomenal job on behalf of all of us, so if you could close your ears for a moment, I am going to applaud the A&E staff up and down the land. [Applause.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Just for clarification, clapping is not the norm in this Chamber. The reason why it is banned is that if it became the norm and was done many times every day, it would be meaningless once we were in an exceptional situation. This is an exceptional situation, and the hon. Gentleman is right—the whole Chamber and, indeed, our whole Parliament is right—to pay tribute, in a way that will be noticed, to the many people who work in our wonderful health service.

Coronavirus

Baroness Laing of Elderslie Excerpts

Monday 9th March 2020 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

Before I call the shadow Health Secretary to ask his urgent question about the coronavirus, I draw to the House’s attention the fact that it is being streamed live with accompanying British Sign Language interpretation, which means that people will have to be very careful what they say and how they wave their hands around during this important piece of business.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. A lot of people are standing, and I cannot really let this business run much past quarter past 4. People are being quite brief and the Secretary of State has been brief, but I give notice that not everybody will be called.

[Mr Barry Sheerman (Huddersfield) (Lab/Co-op)]

May I press the Secretary of State on this matter? Yes, it is very important that we follow good science, but we also need good management. It is all right having a national Cobra, but what about local Cobras? Every community and every local authority has to deliver on the ground as this gets worse, and that needs partnership across health, the police and local authorities. Is he sure that is in train?

Health Inequalities

Baroness Laing of Elderslie Excerpts

Wednesday 4th March 2020 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

I inform the House that Mr Speaker has selected the amendment in the name of the Prime Minister.

--- Later in debate ---

[Zarah Sultana]

I thank my hon. Friend for giving way. Health inequalities between regions are stark, but there are also huge disparities across short distances. In my constituency, the life expectancy of men in St Michael’s is 13 years shorter than it is of men just 2.5 miles away in Stoneleigh, just south of Coventry. Does he agree that to reduce those shocking health differences, the Government need to tackle underlying economic inequality and systemic poverty, and reverse 10 years of Tory cuts?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The hon. Lady’s intervention might not have seemed very long to her, and I appreciate that she is new to the House, but it was very long. I thank the hon. Member for Leicester South (Jonathan Ashworth) for what he said before he took that intervention. It would be much appreciated if the Front-Bench spokespeople took only a few interventions. This is a debate—we can have some interventions—but if Members who intend to intervene and then leave take up all the time at the beginning of the debate, those who sit here all afternoon will not get to speak at the end. We are talking about unfairness here, and that is unfair. The hon. Gentleman has been most courteous, and I know that the Minister has also been courteous in saying that she intends to take only a few interventions.

[Jonathan Ashworth]

I am grateful, Madam Deputy Speaker, but the point made by my hon. Friend the Member for Coventry South (Zarah Sultana) was an excellent one. She is right: this variance in life expectancy and these widening health inequalities are surely intolerable, and we have been sent here by our constituents to do something about it.

Taking your guidance, Madam Deputy Speaker, I will try not to take any further interventions, because I am aware that Members want to make maiden speeches. I am sure that Members who have been in the House a bit longer will testify that I am usually very generous in taking interventions. I hope Members will understand.

I dare say that the Minister will pray in aid the Office for National Statistics data that came out last night, but that is just a single data point. The ONS data also shows that regional inequalities in health have widened since 2010 and confirms that life expectancy for women in the most deprived decile outside London and the north-west has fallen. The rate of increase in life expectancy slowed markedly after 2010, which just happens to coincide with the swingeing cuts to public services and working-age benefits that the Tory Government imposed upon our society.

When life expectancy stops improving, inequalities widen and health deteriorates. That is why Sir Michael Marmot found that time spent in poor health is increasing for men and women in the most deprived areas of England. He found that there is a north-south gap opening up, with some of the largest decreases seen in the most deprived 10% of neighbourhoods in the north-east. He found that the mortality rate among those aged 45 to 49 is increasing. So-called deaths of despair—the combined effect of increasing death rates from suicide, drug abuse and alcohol-related illness—are a phenomenon we have seen for many years in the United States, and they are now making their morbid presence felt here. Perhaps most shamefully of all, the most deprived 10% of children are now twice as likely to die as the most advantaged 10% of children, with children in more deprived areas more likely to face a serious illness during childhood and to have a long-term disability. Surely this stands as a devastating and shameful verdict on 10 years of Tory austerity and cuts. Of course, we have always had health inequalities since the NHS was created 70-odd years ago, but the point is that the Government should be trying to narrow them, not widen them, because as Professor Marmot says,

“if health has stopped improving it is a sign that society has stopped improving.”

Perhaps some will quibble with Marmot’s findings, but they coincide with what others have found. For example, the all-party group on longevity found a few weeks ago that men and women in our poorest areas are diagnosed with significant long-term conditions when they are, on average, only 49 and 47 years old respectively. The Institute for Fiscal Studies’ Deaton review has also warned about deaths of despair, pointing out that rates of long-standing illness and disability among people aged 25 to 54 have been increasing since 2013. The Royal College of Paediatrics and Child Health has today warned of stalling infant mortality rates and how a generation of children is being failed.

I am afraid that this does not suggest that the Government are “moving heaven and earth”, in the words of the Secretary of State, to tackle widening health inequalities, and it does not fill us with much confidence that the Secretary of State is on target to meet his goal of five years’ longer healthy life expectancy by 2035. Will the Minister update us on how we are getting on in meeting that target?

I hope that the Minister, who has responsibility for public health, will also give us some reassurance about the Government’s plans to mitigate the health inequality implications of the covid-19 outbreak. May I press her to explain exactly what the Prime Minister meant at Question Time earlier? Is the Prime Minister saying that statutory sick pay will kick in from day one? If so, we welcome that, but because of low pay, the earnings threshold, precarious work, the gig economy and zero-hours contracts, about 2 million people are not eligible for statuary sick pay. The Prime Minister seemed to suggest at Question Time that such people would be eligible for universal credit, but the Government’s own guidance—I checked the website just before the debate—makes the position crystal clear. The Government’s website says:

“It usually takes around 5 weeks to get your first payment”

in respect of universal credit. The public health implications of that should be blindingly obvious: some of the lowest-paid workers who need to self-isolate will be forced to make a choice between their health and financial hardship. Surely it would be far simpler and smoother just to guarantee statutory sick pay for everyone from day one.

There are also practical problems with sick notes. People are being asked to self-isolate for a fortnight, but as the Secretary of State himself said yesterday, self-certification lasts for only seven days. Will this now be extended from one week to two weeks? I put it to the Minister, as I put it to the Secretary of State yesterday, that we will co-operate and help the Government with emergency legislation to ensure that statutory sick pay for all from day one is on the statue book as quickly as possible. Will Ministers take up our offer?

I dare say that the Minister will want to remind us of the funding settlement for the NHS for the next four years, but she will not be able to remind us of the public health funding settlement for local authorities for the next month because Ministers have not told local authorities what their public health allocations are for the next financial year, which starts next month. It is not good enough to say that the grant overall will increase. These are services that prevent ill health and promote health and wellbeing, as she knows, and those services have been left teetering after years of real-terms cuts of about £1 billion. Smoking cessation services have been cut, obesity services have been cut and drug and alcohol services have been cut, while health visitor numbers are falling, school nurse numbers are falling and mandated health visits are abandoned, yet directors of public health are expected to plan for the next 12 months when they have not even been given their local public health allocations. When will they be published? We are expecting directors of public health to put in place plans to deal with the covid-19 outbreak, and they do not even know their budget lines. That is clearly irresponsible and unsustainable.

It is not just about health funding, however, because that does not tell the full story, as the Secretary of State, in fairness to him, has recognised. He has said before that

“only around a quarter of what leads to longer, healthier lives is…what happens in hospitals.”

We need the Government to focus on the wider social determinants of ill health, too: the childhood experiences we are all exposed to; the neighbourhoods we grow up in; the schools we are nurtured in; the conditions of the work that we do, especially in today’s gig economy; the food we eat; the quality of air we breathe; and the support we rely on in our older years.

Whether it is air pollution, the toxic stress of precarious work or how the benefits system operates, it is those in poverty whose health suffers as a result. Just last week, a longitudinal study in The Lancet found that universal credit is exacerbating mental health issues among claimants, causing tens of thousands to experience depression and mental distress. The Government cannot deny the links between poverty and ill health, because poverty, as Sir Michael Marmot says, “has a grip” on our nation. Some 14 million adults live below the poverty line. We have record food bank usage. More than 4,000 of our fellow citizens sleep rough on our streets, a huge increase since 2010, and over 700 die on our streets.

The poverty a child experiences harms their health at that time and through the rest of their life. Child poverty impairs cognitive development and creates an environment in which mental health and emotional disorders fester. Children in poverty are more likely to be obese, less likely to be up to date with immunisations, and more likely to be admitted to hospital, yet under this Government, the number of children living in poverty has already risen to 4 million, and we have reports of children scavenging in bins. We have 120,000 children pushed from pillar to post in temporary accommodation—a huge increase under the Tories. The working-age benefit cuts that are set to come in will push child poverty levels to the highest since records began in 1961—higher than even in the Thatcher years. That is not levelling up; that is condemning future generations to ill health and shorter lives.

But poverty need not be inevitable and life expectancy does not have to stall. This House should not let health inequality leave an indelible stain on our society. There is a better way, and I commend our motion to the House.

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Before I call the Minister to move the Government amendment, I should tell the House that we will start with a time limit on Back-Bench speeches of seven minutes, but that will very soon reduce to around five minutes, as there is a very large number of people who wish to speak. I am trying to keep the time limit a little more flexible for those who are making their maiden speeches.

NHS Funding Bill

Baroness Laing of Elderslie Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Alex Cunningham]

You, Dame Eleanor, were not in the Chamber when the hon. Member for Glasgow North (Patrick Grady) indicated that SNP Members might pass through the Lobby, although of course they will not be counted. I seek your help. I want to make sure that the Government Whips do not get confused by my accent and count my vote on behalf of the people of Stockton North when I support the amendment.

[The Chairman of Ways and Means (Dame Eleanor Laing)]

The hon. Gentleman asks for clarification and raises a point that I have many times had cause to raise myself, so I am in total sympathy with him, and I am quite sure that his plea has been heard.

[Alex Cunningham]

I am very grateful, Madam Deputy Speaker.

Amendment 2 concerns spending on mental health services and the Secretary of State’s plans to achieve parity of esteem. Mental illness is often not viewed as a risk to human life, but it is exactly that. In 2018, according to the Samaritans, 6,507 deaths in the United Kingdom were registered as suicides—an increase of 10.9% on the previous year. That means that nearly 7,000 people did not believe that there was help, or another way out of what they were going through.

It can be hard for adults to talk about the feelings that come from being mentally unwell. The words are in their vocabulary, and it may be simple enough to string them together into a sentence, but it is incredibly difficult to say them out loud. I can only imagine how hard it must be for children to express how they are feeling when something is not right. Perhaps they do say the words that are in their heads, but they are not taken seriously. It is a scandal that there are suicidal children as young as 12 who are having to wait more than two weeks for a mental health bed. By not viewing mental illness as life-threatening, we are letting generations down.

There is much debate about what causes mental illness and what is the best form of treatment, but it can take several visits to a GP for people to be taken seriously about not being OK—although many GPs, of course, respond immediately. When parents are fighting for their unwell children to be taken seriously and receive the urgent care and treatment they need, it is horrifying for that to be delayed.

At this stage I should pay tribute to my former colleague Paul Williams, who was the Member of Parliament for Stockton South. He is a GP, and as a member of the Health Committee he spoke extensively about health matters, but locally he took on the child and adolescent mental health services. He knew, as I did because we shared the same area, that it was taking well over two years for young people to be seen by CAMHS. As a direct result of his work, that ended, up to a point, because some children who were due to be seen quickly were actually seen when they should have been. However, those long waits still exist in our area. As we heard earlier from the right hon. Member for South West Surrey (Jeremy Hunt), the former Health Secretary, sometimes children are just not taken seriously.

It is right for the Secretary of State to answer to the House on exactly what the Department is doing, because this is a matter of life and death. Not only the House but the country needs assurance and answers. The state of mental health services will only get worse unless we take action to deliver what is required. The additional money is more than welcome, but I see the amendment as the first, necessary step to provide the funds that are so desperately needed. Equally important is the ability to monitor what those funds are being spent on, and how.

There are many other services on which people depend heavily, including some that we may take for granted, such as smoking cessation services. There is widespread concern about existing funding for services to help people stop smoking. Nearly a third of local authorities no longer provide specialist “stop smoking” services. Stopping smoking is not just a matter of nicotine patches or vaping; people need behavioural support as well, particularly pregnant women, children, and people who are already unwell. One ward in my constituency has some of the highest incidences of smoking in families—whole families smoking—but we also have some of the highest incidences of smoking during pregnancy, and that is not good for the unborn child.

We cannot afford to lose the progress that we have made. We have made tremendous progress over the years, but we need local services that are effective and properly funded. The Government also need to return to funding the multi-media approach to smoking cessation services. I was particularly pleased to learn last week that research has shown that the ban on smoking in cars when a child is present has produced a 75% drop in children being exposed to cigarette smoke in a car. I led on that issue during my first few years as an MP, through private Members’ Bills and a ten-minute rule Bill. The Bills were unsuccessful, but I was delighted when the Government adopted my clause a few years later. We still need to be ambitious and bold about helping people to quit smoking, but services need the resources. I hope the Minister will commit to ensuring that such services are provided, whether for mental health or for smoking cessation, and that they are fully funded so that we can continue to make real progress in that area.

Finally, I shall turn to the matter of capital. The Minister has already heard me talk about the needs in my own constituency. In one ward—the same one I referred to earlier: the Town Centre ward in Stockton—men live 14 years less than those in the Prime Minister’s constituency. His constituency is getting a new hospital, but there are no plans yet for us. However, I have good news for the Minister, because the plan for our hospital is still sitting there. I met the chief executive of North Tees and Hartlepool NHS Foundation Trust just two weeks ago, and she told me that they were ready to dust off the plans again and see how we could provide a hospital. At the time we asked for £100 million from the Government as a guarantor in order to make the project work. The numbers do work, and the health inequalities need to be addressed.

We need to be able to attract the best doctors and clinicians that we can to address the problems in our society. The heart problems are higher on average than anywhere else in the country. We have smoking problems, as I have mentioned, with their related lung and respiratory problems. We also have the legacy of our heavy industry on Teesside, where men who have now retired are in extremely ill health but sometimes cannot get the support they need because we do not have the experts locally to provide it.

In my final sentences, I appeal to the Minister to meet me and the trust members so that we can sit down and talk about this project.

--- Later in debate ---

[Patrick Grady (Glasgow North) (SNP)]

On a point of order, Dame Eleanor. I notice that it is now 5.10 pm and that the Minister is about to get to his feet. If the knife falls at 5.30 pm, while the Minister is still speaking, or a Division is under way, can you confirm that that means there will be no Report stage, and no chance for the SNP amendments to be tabled or voted on?

[The Chairman of Ways and Means (Dame Eleanor Laing)]

The hon. Gentleman is absolutely right in regard to the procedure. If we finish this part of the procedure before 5.29 pm, there will be a very short time for the next part of the procedure. If this part of the consideration of the Bill goes to 5.29 pm, there will indeed be no time for the Report and consideration stage. That is correct, as is normal in any Bill, but I am grateful to him for pointing it out so clearly.

[Edward Argar]

In the 15 or so minutes remaining to me, I will endeavour to address all the points that have been raised. First, I thank Members on both sides of the House for their contributions and for the amendments that have been tabled. I particularly thank the shadow Minister for his typically reasonable tone in making his case forcefully. This Committee debate has been a wide-ranging and important one.

I will turn in detail to the amendments shortly, but, in the interests of time, I will swiftly address the requests for meetings or visits. The hon. Member for Stockton North (Alex Cunningham) was right when he said that he saw me nodding. I will be very happy to meet him, my hon. Friend the Member for Stockton South (Matt Vickers) and the chief executive of his hospital trust to discuss the issues that he raised. I will also be very happy to meet the hon. Member for Harrow West (Gareth Thomas) separately to discuss the issues that he raised.

--- Later in debate ---

Three hours having elapsed since the commencement of proceedings, the debate was interrupted (Programme Order, 27 January).

[The Chairman of Ways and Means (Dame Eleanor Laing)]

Under the programme order of 27 January, I must now put the Questions necessary to dispose of the proceedings in the Legislative Grand Committee (England) on the Committee stage of the Bill, and on the consideration —Report—stage and the consent motion in the Legislative Grand Committee (England). I can see some puzzled faces around the Chamber, and not only among those who have newly been elected to this place, so for the sake of Members unfamiliar with our procedures in respect of Legislative Grand Committees, I will set out what is about to happen.

I will put the Question on amendment 2, which has already been proposed from the Chair. I will then call a member of the Legislative Grand Committee (England) to move amendment 3 to clause 1. When he has done so, I will put the Question on that amendment. I will then put the single Question that clause 1—or clause 1, as amended, if it has been so amended—and clause 2 stand part of the Bill. I will then call a member of the Legislative Grand Committee (England) to move new clause 4. When he has done so, I will put the Question that the new clause be added to the Bill.

[Pete Wishart]

Can you read it again?

[The Chairman]

I could, but we might get to the stage where there are no votes at all.

When the proceedings in the Legislative Grand Committee (England) on the Committee stage of the Bill are concluded, I will resume the Speaker’s Chair for the Whip to report the Bill from Committee. As the three-hour knife has now fallen, there are no amendments for consideration on Report, as the hon. Member for Glasgow North (Patrick Grady) rightly pointed out in his point of order earlier.

The House will again resolve itself into the Legislative Grand Committee (England) to give consent to the Bill as a whole. I will call the Minister to move the consent motion formally, and I will put the Question on the consent motion forthwith. I can see that everybody understands this a lot better now. When the proceedings in the Legislative Grand Committee (England) on the consent motion are concluded, I will resume the Speaker’s Chair and call the Minister to move the Third Reading of the Bill.

I remind hon. Members that, if there is a Division in the Legislative Grand Committee, only Members representing constituencies in England may vote. All Members may vote on the Third Reading of the Bill.

[Pete Wishart]

On a point of order, Dame Eleanor. I am very sorry, but although I was listening very carefully, I did not quite catch all of that. Do you mind repeating it once again, please?

[The Chairman]

I fully appreciate that the hon. Gentleman may not have caught all of that, but I happen to know that he is one of a handful of people in this House who does actually understand this procedure. I hope that I am one of the others, and everyone else will pick it up as we go along.

The Chair put forthwith the Question already proposed from the Chair (Standing Order No. 83D), That amendment 2 be made.

The Committee having proceeded to a Division.

[The Chairman]

Will the Serjeant at Arms please investigate the delay in the Aye Lobby?

--- Later in debate ---

[Patrick Grady]

On a point of order, Dame Eleanor. I think that we should mark this moment. This is the busiest that the English Parliament has been since 1707. I have never seen so many people so keen to take part.

I am interested in the numbers that have just been read out, Madam Deputy Speaker, because 163 for the Ayes seems very low to me. Just by means of a headcount, I counted a significant number more than that. In fact, according to my calculations, at least 46 Members from Scotland, Wales and Northern Ireland were in the Lobby just now. Can you tell me whether the number that was read out in the House accurately records the number of Members of Parliament who wished to express their view on the amendment?

[The Chairman of Ways and Means (Dame Eleanor Laing)]

I am grateful to the hon. Gentleman for expressing his concerns in such an articulate fashion, and I note the words that he has used. I can confirm to him that, although his count of the number of Members who wished to express their view might well be correct, the numbers that I have announced to the House and on which I will rely from the Chair constitute the number of Members who have a right to vote on this matter. As the hon. Gentleman knows, under the procedures set out in Standing Order 83W—with which he, if not the rest of the House, must of course be familiar—Members who do not represent constituencies geographically situated in England do not have a right to vote in these particular Divisions.

[Ian Blackford (Ross, Skye and Lochaber) (SNP)]

On a point of order, Dame Eleanor. Perhaps you can enlighten me. Is this indeed the first time that Members from Scotland have had their votes discounted in this place? What conclusion should we draw, Madam Deputy Speaker, when an item such as this Bill will have spending consequences for Scotland, and yet Scottish MPs are locked out of this place? Can we not draw our own conclusion that this is indeed the English Parliament? The answer to the people of Scotland is very clear: if you want your votes to be counted, we had better become an independent Parliament in Scotland.

[The Chairman]

I am afraid that the right hon. Gentleman does not quite explain the situation as it really is. You see, this Parliament, as the Parliament of the United Kingdom, passed certain rules some time ago, and it is not correct to say that Members from Scottish constituencies are locked out; far from it. Members from Scottish constituencies, and constituencies in every part of the United Kingdom, have not been locked out. They have been allowed to participate in the debate, but not to vote in it. Members from Northern Ireland constituencies and from Welsh constituencies are similarly categorised for the purpose of these particular Divisions.

[The Chancellor of the Duchy of Lancaster (Michael Gove)]

Further to that point of order, Dame Eleanor. Is it not the case that health is a devolved matter, and that the NHS in Scotland is the responsibility of the Scottish Parliament? Is it not the case that, therefore, Members of this House have no votes on, or say in, what happens in the NHS in Scotland, and is it not appropriate to point out to SNP Members that while they stage these stunts here, the Royal Hospital for Sick Children in Edinburgh, for which they are responsible, remains closed, and cases of poisoning in hospitals in Glasgow for which they are responsible remain undealt with? Until the Scottish Government make sure that the health of the people of Scotland is looked after, the people of Scotland will regard this as a transparent stunt on the part of people who, instead of representing their constituents, seek to manufacture grievance.

[The Chairman]

I fully appreciate the point—[Interruption.] Order. This will not degenerate into a shouting match.

The right hon. Gentleman has expressed his view with his usual rhetorical flourish. My only comment must be that this is a very narrow Bill, specifically making provision for the funding of the health service in England. I have to go with what it says on the Bill, and it is therefore correct for it to be administered in this way.

[Martin Docherty-Hughes (West Dunbartonshire) (SNP)]

On a point of order, Dame Eleanor. I have due regard for your judgments. When I first rose to speak in the House in 2015, I said to the then Speaker that, while I was no Unionist or home ruler, I would stand shoulder to shoulder in defending the role of the Speaker. My concern, if this is the Parliament of the United Kingdom of Great Britain and Northern Ireland, is that this Bill has Barnett consequentials for the nation of Scotland, the nation of Wales and the communities of Northern Ireland. Therefore, I am gravely concerned that the EVEL system is being used to exclude the notion that there are Barnett consequentials. You may wish to clarify this for the Members of the Conservative and Unionist one nation party.

[The Chairman]

I fully appreciate the point that the hon. Gentleman raises, and there may well be Barnett consequentials—[Hon. Members: “Ah!”] There may be further opportunities when further legislation about these matters comes before the House, but this particular Bill is a very narrow one, and therefore the ruling is quite clear. I appreciate what the hon. Gentleman says about protecting the Chair and rulings from the Chair. In this case, there is no grey area. Under Standing Order No. 83W, no matter who passes through the Division Lobby in these three Divisions before us—or however many Divisions there might be—only the votes of Members sitting for English constituencies will be counted.

[Mrs Maria Miller (Basingstoke) (Con)]

On a point of order, Dame Eleanor. I know that Mr Speaker has strict rules about the use of promotional material in the Chamber of the House of Commons, and I am sure that, quite unintentionally, some Members might be displaying material that perhaps would be inappropriate. Will you point out that there are strict rules on that, and that it should not be done in the way that it has been done?

[The Chairman]

I am grateful to the right hon. Lady. I must say to her and to the Committee that I was hoping that I would not see any promotional materials—[Interruption.] Oh no! I see one! I was hoping that such an occurrence would not happen right now. No promotional materials should ever be displayed in the Chamber. For the avoidance of doubt, I refer hon. Members to paragraph 21.29 of “Erskine May”—Mr Blackford, you will like this one—which states clearly that

“all Members should be sufficiently articulate to express what they want to say without diagrams”.

I will now proceed to amendment 3 to clause 1, which I have selected for a separate decision.

The Chair then put forthwith the Questions necessary for the disposal of the business to be concluded at that time (Standing Order No. 83D).

Amendment proposed: 3, in clause 1, page 1, line 18, at end insert—

“and that the sums set out in the table are not permitted to be augmented by or composed of any virements from NHS capital budgets.”—(Justin Madders.)

The amendment would stop the Secretary of State meeting the NHS England allotment for resource spending by using funds from NHS capital budgets.

The Committee proceeded to a Division.

[The Chairman]

I ask the Serjeant at Arms to investigate the delay in the Aye Lobby.

--- Later in debate ---

[Madam Deputy Speaker (Dame Eleanor Laing)]

There are no amendments on consideration.

[Patrick Grady]

On a point of order, Madam Deputy Speaker. It is great to be back in the United Kingdom Parliament—just like magic! I congratulate you on your skilful chairing of the English Parliament from the lower Chair over the last three hours. You have just announced that there are no amendments to be considered on Report as none had been tabled because the knife fell more than an hour ago. Could you confirm that that is correct? I notice that the selection list says:

“Mr Speaker has provisionally selected…New Clauses…as long as the 3 hour time limit has not expired: NC6 [SNP] + NC7 [SNP].”

For the record, can we confirm that the effect of all this has been that amendments tabled by Members of the Scottish National party have not been debated tonight and could not been divided on because the Government did not provide enough time, or Members took up so much time in the meeting of the English Parliament—the Legislative Grand Committee—that they have effectively denied the rights of SNP Members to table amendments to a Bill that directly affects our constituents?

[Madam Deputy Speaker]

The hon. Gentleman’s analysis is not wrong. The knife has fallen. The House voted some days ago to provide three hours, or four hours in total, for consideration of this Bill, and it is indeed the case that because those four hours have passed, there is no time for debate on consideration and Report—that is absolutely correct. There is also no time for debate on Third Reading.

As to whether the Government did not provide sufficient time, or Members of this House took up all the time in the early part of the proceedings, that is not a matter for me to judge; I have merely facilitated it. Members might have decided not to speak for very long at the beginning. If so, the hon. Gentleman and his colleagues would have had the opportunity to discuss the matters that they had tabled. I thank him for his further points.

Does the Minister intend to move a consent motion in the Legislative Grand Committee?

[Edward Argar]

indicated assent.

The House forthwith resolved itself into the Legislative Grand Committee (England) (Standing Order No. 83M(3)).

[Dame Eleanor Laing in the Chair]

[The Chairman of Ways and Means (Dame Eleanor Laing)]

I remind hon. Members, although I do not think there is any need for reminding at this stage, that if there is a Division, only Members representing constituencies in England may vote.

[Patrick Grady]

On a point of order, Dame Eleanor. We are back in the English Parliament again and the absurdity of this procedure is now being laid bare. [Interruption.] I am delighted that Conservative Members are groaning because several of them voted for it when it was introduced way back in 2015. They did not have to—it was a choice. I am not trying to beat the record of my hon. Friend the Member for Perth and North Perthshire (Pete Wishart), who has spoken in the Legislative Grand Committee for England more times than any other Member of this House over the past four years, but can we just confirm again that, as you said, if Scottish Members, for whatever reason, were to object to the consent motion, you would not even be able to hear their voices —it is as if we are invisible?

[The Chairman]

It is not as if any hon. Member of this House is ever invisible or, indeed, inaudible, but merely, once again, following Standing Order No. 83W, which this House resolved to put into the Standing Orders of the House.

[Pete Wishart]

On a point of order, Dame Eleanor. [Interruption.] I hear the groans from my Conservative colleagues. I have to keep my record of speaking in the English Parliament—it is a record that I very much cherish and look forward to maintaining. These events are being televised and people throughout the United Kingdom, particularly those in Scotland, are observing our proceedings with a degree of mystification and bewilderment. What Scottish viewers will see is the baying, groaning and booing of Conservative Members about Scottish Members of Parliament asserting their rights to have their say on the funding of the national health service. Can you confirm that that is the case and that this House really needs to grow up, behave itself and come into the 21st century?

[The Chairman]

I understand the point that the hon. Gentleman makes. I would say, as Mr Speaker always says, and as every occupant of the Chair always says, that our behaviour in this Chamber should, at all times, be of a standard that makes us never ashamed to be watched by anyone on television or in any other way, regardless of the subject of our proceedings. I notice that that has engendered some slightly better behaviour—thank you.

Motion made, and Question put forthwith,

That the Legislative Grand Committee (England) consents to the NHS Funding Bill, not amended in the Legislative Grand Committee (England).— (Edward Argar.)

Under the terms of the Order of the House of 27 January, I must now put the Question necessary to bring to a conclusion the proceedings in the Legislative Grand Committee on the consent motion. The question is the consent motion. As many are of that opinion say “Aye”—[Hon. Members: “Aye!”]—of the contrary “No”—[Hon. Members: “No!”]. The Ayes have it—[Interruption.] We now come to a scientific matter. Members representing Scottish seats are well aware that they do not have the right to vote on this particular motion. They therefore do not have the right to shout “No” when I put the question. I can hear “Aye” from the Government Benches. The hon. Member for Perth and North Perthshire (Pete Wishart) knows that I am more than capable of discerning a Scottish “No” from a non-Scottish “No”—[Interruption.] Order. I am ruling that the shouting of “No” from the SNP Benches does not mean that we are going to have a Division.

Question agreed to.

[Martin Docherty-Hughes]

On a point of order, Dame Eleanor. I always have due regard for you and anyone who sits in the Chair of any Parliament. You said that you could discern Scottish MPs shouting “No”; I fully understand that. Can you advise me whether you can hear Scottish constituency MPs on the Government Benches shouting “Aye”?

--- Later in debate ---

[The Chairman]

I believe I can, but as their voices have been drowned out by the English “Ayes”, I cannot hear the Scottish Members on the Government Benches. [Interruption.] The hon. Member for Milton Keynes South (Iain Stewart) points out that, although he has a Scottish voice, he has an English vote. We have had enough of this.

[Ian Blackford]

On a point of order, Dame Eleanor. I am grateful to you for allowing this point of order. I wonder whether you can help me. When we were all elected to this place in December 2019, we were sent here to represent our constituents. What message does it give to the people of Ross, Skye and Lochaber and the constituents of my many hon. Friends that we are not permitted to vote on matters in this House that have direct consequences for spending in Scotland?

[The Chairman]

That is not a point of order for the Chair, and my opinion on the matter is irrelevant. We have had enough points of order; it is time to continue with business.

The occupant of the Chair left the Chair to report the decision of the Committee (Standing Order No. 83M(6)).

The Deputy Speaker resumed the Chair; decision reported.

Wuhan Coronavirus

Baroness Laing of Elderslie Excerpts

Monday 3rd February 2020 Commons Chamber

[Matt Hancock]

A lot of thought is being put into how we communicate with the public. We need to win both the battle against this disease and the battle for public confidence. This is a bit like my answer to the hon. Member for Sefton Central (Bill Esterson), and, indeed, my answer to the hon. Member for Rhondda (Chris Bryant), who asked about masks. Washing one’s hands is much better than wearing a mask. That is the correct advice, and we are trying to get the correct, straight communications out whenever we possibly can.

[Madam Deputy Speaker (Dame Eleanor Laing)]

And the prize for perseverance and patience goes to Geraint Davies.

[Geraint Davies (Swansea West) (Lab/Co-op)]

Thank you very much, Madam Deputy Speaker.

Figures issued yesterday—I appreciate that the Secretary of State has updated them today—showed that, out of 14,500 people diagnosed, 304 had died and 342 had recovered. What is of concern is the similarity of the number of people dying to the number of people recovering.

The Secretary of State has already mentioned that the transmission rate is doubling every five days. He will also know that, as well as introducing flight blocks, China has introduced road blocks, and has prevented people from going to work for 14 days in districts where there is no transmission at all. What does the Secretary of State plan to do if a number of cases emerge in cities up and down Britain? Has he any plans to reduce people’s movements, for instance, to contain the virus?

[Matt Hancock]

Let me make it absolutely clear that I do not recognise, and the Government do not recognise, the figure that the hon. Gentleman has given for the number of people who have recovered. The mortality rate is estimated to be about 2%. Of course we will revise that figure as more information comes to light, but the figure that he gave for the number who have recovered from the disease appears to be very low in comparison with the information that we have.

Of course we have plans in case the disease becomes widespread globally and widespread here, and we are constantly working on those plans to ensure that we are as ready as possible. We have plans in place, and we had them before the virus arrived here. We are working through those plans, and I will endeavour to update the House whenever I possibly can.

I began by paying tribute to the shadow Secretary of State. Normally when I am nice about the shadow Secretary of State, he thinks that I am doing it to damage his political career. There may be some truth in that, but in this case he is acting in the most responsible and high-minded way, and I think that the whole House should pay tribute to him.

[Madam Deputy Speaker (Dame Eleanor Laing)]

We now come to the statement on the Government’s response to the Streatham incident. I will just allow Members who need to leave to do so swiftly and quietly so that I can call the Lord Chancellor and Secretary of State for Justice, Mr Robert Buckland.

NHS Funding Bill

Baroness Laing of Elderslie Excerpts

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

As well as the question of what the money will be spent on—and I welcome the extra investment—there is the question of—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. There is a separate Scottish debate going on, and, however interesting it might be, it is not good if I can hear that and cannot hear the hon. Lady.

[Debbie Abrahams]

I could not hear myself, Madam Deputy Speaker.

It is also a question of who and where. We know that life expectancy is flatlining, that healthy life expectancy is flatlining, and that in some parts of the country, including the north-west, it is actually going backwards. How are we to ensure that we target the money where it is most needed?

--- Later in debate ---

[Siobhain McDonagh]

Is my hon. Friend aware that there is also a tendency for capital funding in new schemes to go to those areas that are far more wealthy than those with the greatest health inequalities? Let me give my own experience of Epsom and Saint Helier Trust, where the local NHS is consulting on moving all acute services to Belmont.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The hon. Lady will have her chance to speak for quite some time later in the debate, and I think that the hon. Gentleman is just concluding his speech.

[Jonathan Ashworth]

My hon. Friend’s point is absolutely right, and she is right to raise it.

The point is this: those most in need of health services now experience the poorest quality of care. It is an absolute disgrace. This political stunt of an underfunding Bill will not deliver the scale of improvements that our constituents deserve. We will not divide the House tonight, but instead seek to amend the Bill. Let us be clear: the Government should have brought forward a fully funded financial settlement for our NHS and social care. The ever lengthening queues of the sick and elderly in our constituencies deserve so much better.

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. It will be obvious to the House that a great many people wish to speak this evening and that there is limited time. We will begin with an immediate time limit of nine minutes, but I give notice that that is likely to be reduced later in the evening. I also point out to new Members that, because the time limit is nine minutes, it is not required that they take up the whole of the nine minutes. Brevity is, and always will be, the soul of wit.

Health and Social Care

Baroness Laing of Elderslie Excerpts

Thursday 16th January 2020 Commons Chamber

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

First, may I draw your attention, Mr Deputy Speaker, and that of all Members to my declaration in the Register of Members’ Financial Interests as a practising NHS psychiatrist?

Before I address the motion and speak in support of the Queen’s Speech and its focus on health and social care, I pay tribute to the hon. Member for Ealing North (James Murray). I have no doubt that he will have the eloquence of his predecessor—somebody we in the House knew for his many jovial speeches. I also have no doubt that he will match the diligence that his predecessor showed as a constituency MP in fighting for the needs of his local residents, not least by standing up for his local NHS and maintaining a health service locally that meets the needs of people in Ealing. I wish the hon. Gentleman very well in all that he does in this place.

Many commendable and positive things can be recognised in the contribution by my right hon. Friend the Secretary of State. He rightly talked about the need for increased investment in the health service and about the need to support the staff who work on the frontline. He rightly identified the need to improve mental health provision and talked about the need to find political consensus on social care.

I intend to talk briefly about a couple of those issues, but before I do so it is worth observing that we now have a new Prime Minister and the Government have a strong mandate. That is an opportunity to reflect on what we could do as a Government to improve the legislation that we ourselves have passed and that has perhaps had unintended consequences. There is a particular concern among patients and people who work in the NHS about the fragmentation of services, which has been the result of the sometimes market-driven approach to the delivery of healthcare and the encroachment of the private sector on the delivery of traditional NHS services.

As a clinician, what matters most to me is that we deliver the right services for patients. We need to recognise that the involvement of private sector provision has sometimes led to greater fragmentation and a lack of joined-up care for patients. In particular, if we look at how addiction services are commissioned, we see the impacts of that on increasing homelessness and people not getting treatment in a timely manner, or on the joined-up care with the NHS afterwards. If we look at how some sexual health services are now commissioned, we see that it is done in a fragmented way that often lets patients fall through the cracks. With a fresh mandate and a new Prime Minister, I hope we have an opportunity to look at that and be honest that the answer is not always in the market—that the answer is in well-funded, properly delivered public services that are free at the point of need and often run by the state. We have to be honest about that and recognise where we could do things better in future.

The second point I wish to make is on the need to value our staff. NHS staff have had a difficult period, with wage restraint and morale issues—for example, as a result of the junior doctor dispute. We also need to recognise the challenges relating to the NHS workforce which Brexit has brought into focus. We are very reliant, and have been historically, on the contributions made by members of the NHS who come from all over the world, from within the EU and from throughout the country, and frankly our NHS could not work without them. We are very grateful for those contributions and it is right that we support those people in our NHS.

Of course we need to focus on improving the number of British-trained graduates across the health service, but we also need to recognise that the staffing crisis is the biggest issue that we now face. If we want to realise the ambition to increase nursing numbers and GP appointments, we have to recognise that across the piece there is a need to take staff training, recruitment and retention seriously. We need to look at the fact that in different parts of the United Kingdom—for example, the north-west or the north-east—there are fundamental staffing challenges and a difficulty in recruiting and retaining staff that is much more acute than it may well be in the south of England. I know the Government want to look at that, but we need to come up with meaningful answers.

We need to look overseas at examples in Australia, where they have to cover a very large land mass. They have had challenges attracting staff to work in parts of rural Queensland and the Northern Territory; we need to take lessons from those healthcare systems and apply them here so that we can address workforce shortages on the frontline. Without the staff, we cannot deliver the care. It is all very well to talk about improvements in patient safety and other things, but unless we have the staff to do it, we cannot deliver it. I hope that there is now an opportunity for the Government to grip these issues. Staff planning takes more than just one parliamentary cycle until the next general election; it is a five or 10-year mission, but it is one that we need to grip now if we do not want to have lasting workforce shortages in many regions of this country.

In particular, I draw the attention of those on the Treasury Bench to the challenges that we face in mental health. It is absolutely right and commendable that we have focused on destigmatising mental health and on the importance of mental health liaison services. Professor Simon Wessely did a welcome review of the Mental Health Act 1983 that was long overdue. I am sure we will address those issues.

We have to recognise that community mental health services have been substantially the Cinderella of mental health services for far too long. If we want to improve care and prevent people with mental ill health from getting so unwell that they need to turn up at hospital, we need to recognise that the primary focus of investment in mental health services—indeed, one of the issues we face is a staffing crisis in mental health, with falling numbers of frontline mental health nurses in the community —must be in community services. They have been hollowed out for too long and now need investment.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I hesitate to interrupt the hon. Gentleman, but he has now spoken for seven minutes and we are on a six-minute time limit, so I know that he will finish soon.

[Dr Poulter]

Thank you, Madam Deputy Speaker. I am sure that Members on the Treasury Bench will take away and look at the issue I just outlined.

The Government are rightly looking for political consensus on social care and on finding a sustainable funding formula. However, as part of that, they should also consider how social care services need to look. It is no good bringing in money when the mode of delivery is wrong. I hope that, as part of the consensual approach, there will be a renewed focus on delivering care in the community in an integrated way, thus joining up the health and social care systems. I hope that that will be part of the important review and the approach to political consensus that the Government are trying to deliver.

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The reason why we do not have a formal time limit is to try to help people who are making maiden speeches. It is difficult to make your maiden speech against the clock. It should not be difficult for people who have spoken in the Chamber many times to speak for six minutes, so when we get to six minutes, I will call “Order.” I call Julie Elliott.

[Julie Elliott (Sunderland Central) (Lab)]

Thank you, Madam Deputy Speaker, and I will take that amount of time.

I want to speak today on eating disorders, an issue that is important to me and many of my constituents and friends who have approached me about the subject. Awareness of mental health issues has been on the rise, with recent examples such as the Football Association’s Heads Up campaign encouraging people to take a minute out of their lives to think about their mental health. The ongoing work of organisations such as Mind and Beat has meant good progress on combating the stigma of mental health issues and informing the public about the importance of taking care of mental health.

There is undoubtedly still a lot of work to do on eating disorders. It is such an incredibly important and pressing issue, and at the same time so preventable with proper support, funding and attention, that I am disappointed that it was not named in the Gracious Speech as a subject on its own. The only mention of mental health is:

“My Ministers will continue work to reform the Mental Health Act.”

I very much hope that eating disorders will be part of the reform.

There is a major problem with the way eating disorders are dealt with in this country. From poor staffing levels to the way disorders are diagnosed and the wait to be treated, too many people who need treatment urgently do not get it. More than 1 million people in the UK suffer from an eating disorder and it is about time they got the services they deserve.

As Hope Virgo has shown in her excellent Dump The Scales campaign about the diagnosis of eating disorders, multitudes of people around the country are being turned away by their GPs as a result of their body mass index not being low enough. They are being refused treatment, not because of any psychological assessment, but because their weight is not low enough. Although National Institute for Health and Care Excellence guidelines advise against the use of single measures such as BMI to determine whether to offer treatment, that does not mean it does not happen. As much as I would like to present case study after case study of young people being turned away from treatment because they were not considered ill enough, only to go on to do more damage to their bodies in the hope of actually receiving treatment, time does not allow it. But it happens, and that has to change. It is shocking that it has happened once, but we are talking about hundreds of people being turned away from services they desperately need.

Those first connections with medical professionals are so important, not least because of the bravery shown by sufferers in seeking help and talking about their illness, but also because the earlier the treatment is administered, the more effective it can be. Identifying problems as early as possible does not just allow people to be treated quickly and more efficiently, but can mitigate the long-term effects of illness and decrease the chances of relapse. Early intervention is the key to proper treatment for those suffering from eating disorders. It might mean that the person seeking help no longer needs a hospital stay, or that they recover quicker, or that they feel stronger fighting their illness knowing they have the support behind them that they need. That is why the Government need to do a full review of treatment and care pathways for people who suffer from eating disorders and ensure that there are services that people can approach, and that they can be treated quickly and effectively.

However, there is also a big variety in quality and speed of treatment depending on where people live in the country. We need to see the end of the postcode lottery, which means that the quality and speed of care is based on where people live and what age they are, and sometimes ends in those lucky enough to be referred being sent to hospitals more than 200 miles from where they live. Only yesterday, I saw a letter to a young woman who, after an urgent referral, has been told she should expect an 18-month wait to be seen by a psychological therapist. That is truly shocking. I therefore fully agree with the calls on the Government by leading eating disorder charity Beat to hold the NHS to account for comprehensive implementation of the access and waiting time standard for children and young people in every region and community.

There is desperate need for direct investment in a fully supported NHS that does not need to divert the funds assigned to mental health to other areas to plug massive funding deficits in an attempt to continue to provide basic care.

We also need to ensure that our medical professionals understand the signs of eating disorders and the pathways available. Trainee doctors can receive as little as two hours’ training on eating disorders throughout their several years of training. We need to invest in services to get parity of esteem for mental and physical health, and there are simply not enough beds to deal with the growing demand from those suffering from eating disorders and those who need mental health treatment more generally.

We need more staff. Those who work for the NHS are stretched as it is, and we need more staff in frontline services to help ease the pressure and ensure that treatment is effective and quick. We need more and proper support in our schools. I implore the Government to act on those measures.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am delighted to call Laura Trott to make her maiden speech.

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[Madam Deputy Speaker (Dame Eleanor Laing)]

I am pleased to call Feryal Clark to make her maiden speech.

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[Jackie Doyle-Price (Thurrock) (Con)]

It is a pleasure to follow the maiden speech of the hon. Member for Enfield North (Feryal Clark). She has just proved that what she lacks in height she makes up for in her energetic performance, and I have no doubt that she will give the Treasury Bench considerable challenge in the future. So many firsts, but I must congratulate her specifically on being the first refugee Member of Parliament. Does that not show that this country is open and liberal, and welcomes those from all parts of the world, whatever their circumstances, who want to make a contribution and do the right thing? I congratulate the hon. Lady. When I go around schools, I give the message to everyone that if they work hard and take advantage of every opportunity that comes to them, they will get on in life. I now have a new poster girl, and I look forward to hearing more contributions from her.

I was struck by the opening speeches, because it is getting a bit boring that all we hear is, “We’re spending this much money” and “Well, it’s not enough and we would spend more than you.” That will not get the best for our NHS. The truth is that whichever side of the House we sit on, we all want our NHS to be the best it can be. Every Government, of whatever colour, will always make the NHS a priority when it comes to the Budget. Let us not make this debate all about money. When we do, we let those areas in which we are not doing as well as we should off the hook. Getting the best out of the NHS is not just about money; it is about leadership and about behaviour—on the part not just of medical professionals, but of patients too. We need to make sure that we have honest discussions about outcomes, what we need to do better, what we expect from everyone and what patients can legitimately expect from the NHS.

That was very much part of the discussion during the general election. I remember knocking on doors and being asked, “But can we trust you on the NHS?” I would reply, “Conservatives are not aliens from the planet Zog who never get ill. We depend on the NHS as much as anyone else. Why would we ever engage in an act of self-harm by not doing our best for it?” We can be clear that under this Government the NHS will have the investment that the country can best afford, and we will focus on making sure that it delivers the best service possible.

The biggest challenge facing the NHS is not money. The workforce remains a considerable challenge. While we carry on talking about imports and the need for more doctors and nurses, we will continue to feed perverse behaviours and make the labour market in the NHS dysfunctional. Medical staff know that they can earn more as locums, so we have a massive vacancy rate and sky-rocketing salary bills, because of the choices people make. We need to do more to address that issue.

Much healthcare can be delivered by those who are not medical professionals. We need to look at where the NHS can commission services from the voluntary sector and how that could work. It is not just about doctors and nurses: it is about a more holistic approach to wellbeing. I would really welcome it if we could move the political debate away from pounds towards patients.

My right hon. Friend the Member for South West Surrey (Jeremy Hunt) spoke passionately about patient safety. Again, we need to focus on outcomes, and no one did more than he did to meet that challenge. When he became Secretary of State for Health, my constituency had a failing hospital, but thanks to the measures that he put in to improve performance, we now have a hospital that provides the service that we deserve. We should not be shy about challenging poor performance. The excellent doctors, nurses and others delivering medical services know when things are failing and would welcome the challenge to the leadership of their institutions to make them better.

We need to do more to help more vulnerable patients. The public services do very well for the pointy-elbowed middle classes who are able to fight for what they want, but the test of a society is how we treat the most vulnerable. In that regard, I welcome the commitment to reform the Mental Health Act 1983. That Act was a product of an era in which people with mental ill-health were an inconvenience to be managed. I am pleased to say that we have moved on very far from that, and we will introduce reforms that will empower patients to look after their own recovery. We should be grateful to people who have been through detention and shared their distressing experiences to make things better.

I can see that you are rightly looking at the clock, Madam Deputy Speaker, but I want to mention one final challenge in an area where, as a Minister, I was disappointed not to be able to do more—the issue of people with autism and learning disabilities being detained in institutions that, frankly, are doing them harm. I was horrified to see a report on “Sky News” only this week that showed that we have lost 10 people in the past year in those institutions. That is a mark of failure of the state: families entrusted their loved ones to that care and then lost them. I hope very much that we will redouble our efforts to make sure that we are not putting people into inappropriate care settings and are giving them the tools to be able to live outside those institutions.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am delighted to call Florence Eshalomi to make her maiden speech.

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[Marion Fellows (Motherwell and Wishaw) (SNP)]

It will come as no surprise to you, Madam Deputy Speaker, that I intend to dwell on health and social care issues as they relate to my constituents in my own country of Scotland.

Before I do so, however, I should like to remind the House that just because edicts and statements are issued from the Government Benches, it does not mean that they are factually correct. Indeed, I must say that the pejorative language used by Conservative Members, including those representing Scottish seats, when discussing Scotland and its SNP Government, is unjust, mostly fallacious and paints a picture of healthcare in Scotland that neither I, my family nor my constituents recognise. In Scotland, the SNP Government are carrying on with the day job and have abolished prescription charges, which helps many folk in Scotland. To know that they can have the medication they need without worry is a fine thing, and it can save precious NHS resources further down the line.

Satisfaction with the NHS in Scotland remains high. In 2018, 95% of patients rated their overall experience of cancer care positively. [Interruption.] The hon. Member on the Government Front Bench may shake his head, but I can vouch for that, as my husband had cancer treatment in Scotland. Some 86% of patients rated their full in-patient experience positively, and 83% rated the overall care provided by their GP surgery as good or excellent. Scotland’s patient safety record is among the best in the world. Over the past five years there has been a decreasing year-on-year trend in the rate of MRSA and C. diff infection.

Scotland led the UK by introducing a mental health waiting times target. In the Scottish Government’s 2019-20 programme, the budget for mental health increased by £15.3 million, up by nearly 22%. This is the first Government in Scotland to have a ministerial post dedicated to mental health. The SNP is always looking to improve services for all Scots, which is why the Government are undertaking a review of mental health legislation in Scotland. The review aims to improve the rights and protections of persons who may be subject to existing legislation, and to remove barriers to those caring for their health and welfare.

This Tory Government aim to emulate Scotland by abolishing parking charges at hospitals. Since 2008, when the SNP Government abolished charges in NHS car parks, patients, visitors and staff have saved over £39 million.

The Nuffield Trust, an independent health think-tank, has said that although the 3.2% increase in NHS England’s budget is welcome, it must not detract from the reality that the English health service cannot adequately function or improve without significant investment in NHS capital and the workforce. Perhaps NHS England, through adequate Government funding, could emulate NHS Scotland and offer the same bursary to student nurses as we do in Scotland, where from next September nursing students will benefit from a £10,000 bursary, which is double the proposal for nurses training in England.

Of course, nursing students receive free tuition in Scotland. The benefits of this policy are easy to see, with nursing student numbers in Scotland increasing for seven years in a row. Compare that with a 30% drop in applications in England. How difficult will it be for this Government to achieve their promise of 50,000 extra nurses, or is it actually 19,000 fewer nurses? I am not sure; I am a bit confused about that figure. Perhaps I am not the only one.

On the question of social care, in 2011 the Scottish Government became the first in the UK to pay the real living wage to staff, including all NHS workers. In 2002, free personal care for the elderly was introduced by the Labour-Lib Dem Executive, and I give them credit for that, but that was against the wishes of the Westminster parties, which used it to cut social security funding for older people in Scotland—as ever, Westminster never misses an opportunity to cut Scotland’s budget. [Interruption.] Now the SNP, in government, has extended free personal care to all those under 65 who need it, and from the next Parliament the Scottish Government will work to abolish social care charges. [Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The hon. Lady must be heard. There are indeed a lot of Members here this afternoon, but we will have no noise.

[Marion Fellows]

Thank you, Madam Deputy Speaker.

The Westminster Government would do well to look at and emulate many of the forward-looking, fair, equitable and progressive policies that originate in Scotland. One example is that, through the Social Care (Self-directed Support) (Scotland) Act 2013, everyone who uses social care services can now control their individual care budget.

The Prime Minister promised to

“fix the crisis in social care once and for all … with a clear plan we have prepared”.

The UK Government have failed to propose a Bill, a clear timetable or costings in their manifesto to address the social care crisis in England. The Tories have been in government for a decade and overseen the social care crisis. According to Age UK, there has been a £160 million cut in public spending on older people’s care in the last five years, despite rapidly rising demand. About 1.2 million people over the age of 65 did not receive the care support that they needed, and cuts have increased the pressure on unpaid carers.

I encourage the Secretary of State to look to and adopt the innovative measures that the Scottish Government have introduced in Scotland, to benefit those who live in England and use its NHS and social care provision.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am delighted to call Dehenna Davison to make her maiden speech.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. It gives me great pleasure to call Dean Russell to make his maiden speech.

[Dean Russell (Watford) (Con)]

Thank you, Madam Deputy Speaker. It is wonderful to see you in the Chair. I am incredibly humbled to be here. As a working-class lad, to be sitting on these Benches is an enormous honour, but to be sitting among so many other working-class Conservatives is just as fabulous. I must thank the people of Watford for putting me in this wonderful place and for giving me the honour and the opportunity to hopefully make a change in this country.

First, however, I want to pay tribute to my predecessor. Everyone who knows him will know that he works tirelessly and is a true gentleman: Mr Richard Harrington. When I first became a candidate, people would say to me, “Dean, you’ve got big shoes to fill.” At first I thought it was a dig at my height, but I soon found it was because of Richard’s amazing legacy and the work he has done for the people of Watford. Today’s debate focuses on health, and there are so many things I could talk about—from his jobs fairs to the work he has done on social housing and tenancies—but I will specifically pay tribute to his work to ensure that Watford General Hospital and the local NHS got additional funding. I am proud that Watford will get one of the six new hospitals in the coming months and years, as was alluded to in a previous speech. Richard was a true champion for Watford, and I hope I can fill his shoes in the coming years. I will work tirelessly to do so, although my height may not change.

As you know, Madam Deputy Speaker, Watford General is on Vicarage Road, right next to the legendary, most fabulous Watford football club, which famously once had Elton John as its chairman. I would like to steal one of his song titles and say that I would like to be the first rocket man of Watford as we soar to the stars.

Sadly, to be totally honest, Elton John was not actually born in Watford—I cannot do anything about that—but we do have an incredible wealth of world-famous Watfordians. We have our very own Spice Girl in Geri Halliwell. [Hon. Members: “Hear, hear!”] You have to give a whoop for that. We have our own boxing heavyweight champion of the world in Anthony Joshua. We have our own political heavyweight, too, in the dearly departed Mo Mowlam. And we have the England football manager with the best waistcoats in the world, Mr Gareth Southgate.

As a science fiction fan myself, it is particularly exciting that we have our very own member of Doctor Who’s time-travelling Tardis team in Mr Bradley Walsh. Many Members will know that Bradley Walsh hosts a famous game show called “The Chase”, in which he battles with “The Beast” Mark Labbett. As a Conservative, I feel that in this election we battled our own “Chase” and our own beast—the beast of socialism—and we won. We defeated that beast.

One of the most world-famous parts of Watford is a magical place, and it was mentioned earlier in a brilliant maiden speech: Warner Brothers studio and the Harry Potter tour. Given his love of buses, I would like to invite the Prime Minister to visit the studio, because we have neither a boring single-decker bus nor a boring double-decker bus; we have the world-famous Harry Potter triple-decker “Knight Bus.” Who can beat that?

Watford is not just a hub for entertainment. We are also a massive magnet for investment and business. We have several UK headquarters. We have Hilton hotels, so people have somewhere to sleep. We have TJX, the home of TK Maxx—looking around the Chamber, I am sure everyone has recently bought their clothes from there. We have a place to drink in JD Wetherspoon, and we have a place to win millions and to help millions more in Camelot and the lottery. We also have our very own pharmacy, a fabulous business called Sigma Pharma. Of course, every Member will want to visit our incredible market, our high street and the Intu centre for a most delectable day out.

Madam Speaker—sorry, Madam Deputy Speaker; I promoted you—at heart I am really just a family man, and it is my family who inspire me. My working-class roots may have defined who I am, but my family are the ones who drive me forward. I give credit to my parents and my sister for all the work they have done over the years and for the support they have given me. I am sure it is the same for many Members. Our families make such a difference to our lives and keep us grounded. In that sense, my wife and my daughter truly are my beating heart and soul.

However, not everyone in society has a family or even friends to support them, and, through no fault of their own, they may feel that they are on their own. That is where community comes into play. Let us all be role models to support people who feel as though they have no one. That is the role of a Member of Parliament: not just to make laws, but to help those around us. We must let everyone know that opportunity has no gender. Opportunity should have no race and it should have no age. Whoever someone is, wherever they are, they should be able to be the best version of themselves. I believe that my party is helping to represent that.

Community is very important to me, which is why I worry about modern times. Mental health has been a big issue today, but so, too, is loneliness. We used to talk about being lonely in a crowd, but today there are so many who are lonely in the cloud. The digital world, modern life and social media mean that probably more people are aware of the names of the Kardashian family than they are of those of the neighbours on their own street.

For many years, I have felt that we need to bring the world back together, to be less divisive and to try to tie those threads together. I have had a daily philosophy for many years, and it goes like this: HOPE is an acronym and it stands for Help One Person Everyday. If we all do that in our own lives, in a way that changes people’s lives, we will have a better world. I feel honoured to be in this place as a Conservative, to enable that on a much bigger scale. We may be able to effect laws and change legislation, but changing people’s lives is surely why we are here.

In the past few years, we have seen lots of divisiveness, but let us have an age of decisiveness. Let’s not just get Brexit done—let’s get stuff done, to make people’s lives better. I believe that our manifesto and the Queen’s Speech have shown that that is our goal. As we enter 2020, let us lead the world in relentless positivity, optimism and can-do-ism, and turn this into the soaring 20s. As I complete my speech—I may be going over time; I apologise—I just want to thank people for electing me to be on this Bench and tell them that I will work tirelessly for the people of Watford, and with all Members here, to make the world a better place.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank everyone who is speaking today but not making a maiden speech for their kindness towards the maiden speech makers, who are being given a lot more leeway. That means that we will now have to impose a time limit of four minutes on people who are not making maiden speeches and still one of six minutes or so for maiden speeches. There is no point in people looking shocked; there are only so many hours in a day and that is where we are.

The National Health Service

Baroness Laing of Elderslie Excerpts

Wednesday 23rd October 2019 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. We will begin with a time limit of seven minutes, but I would expect that to reduce as the day goes on.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I am very sorry, but after the next speaker, the time limit will have to be reduced to five minutes. If Members who wait to the end are annoyed about that, they will have to speak to all those who intervened on the Minister and the Front-Bench spokespeople at the beginning of the debate; I do not blame the Minister or the Front-Bench spokespeople.

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[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. We now have a five-minute time limit.