NHS Dentistry: Waveney

Jo Churchill Excerpts

Tuesday 25th May 2021 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

First, I congratulate my hon. Friend and Suffolk colleague the Member for Waveney (Peter Aldous) on securing time for this important debate. I also congratulate my hon. Friend the Member for North Norfolk (Duncan Baker), who for the second time today has spoken about the challenges of dentistry that we have.

As my hon. Friend the Member for Waveney said, this is not a new problem; it was a problem and challenge pre-covid. The pandemic has definitely shone a light, and things have become much more challenging in the world of dental provision during the pandemic. Dentistry has been significantly impacted because of the risks associated with the aerosol-generating procedure that dentists do and, obviously, with the saliva generated when someone is carrying out a procedure on someone else’s mouth. In response, dental practitioners have been required to wear full personal protective equipment to keep them, their teams and their patients safe.

Public Health England is reviewing the current guidance on infection prevention and control. I mention this because it goes to my hon. Friend’s point on fallow time—the time between the dentist putting their instrument down and cleaning down their room, and then seeing the next patient. These things have been big constraints in trying to have a rapid throughput of patients through the consulting room. Fallow time now is as low as 10 minutes in many cases, although that does depend on material factors such as the ventilation and so on.

I am talking to NHS England about the use of ventilation and the ability to support dental practices in putting ventilation in, but I gently point out that what sounds easy in a sentence in this place is often challenging. The buildings are not always owned by the dental practices, and in order to put ventilation systems in we have to take the rooms being used to deliver care out. So there is that combination of challenges, but there is new research on ventilation and lighting, and we are constantly looking at these things to see how we can further support the profession.

An important step forward has been to reduce the amount of time between seeing patients, in order to facilitate more care for more patients, but we have taken the action we have because infection control sits at the heart of what we have to do. I stress that because, with the variant of concern in some of our towns and cities around the country, we have to very mindful that we are looking for progress as to how we proceed with dentistry. I agree with much of what my hon. Friend said about making sure we are looking for opportunities, but we have to be mindful of the fact that we are not yet clear of this pandemic, and that brings enormous constraints.

The thresholds that have been set for dental practices since the start of the year have been based on data on what is achievable while also complying with infection prevention and control. My hon. Friend alluded to the 45%, which was the level of dental activity placed on practices in the fourth quarter of last year. That figure is now 60%, and 80% through orthodontics. This is the tension that exists in this whole area. Sixty per cent is still 40% lower than what we delivered in pre-covid times—obviously. The challenge is to make sure that we are able to see the backlog, that we drive forward with looking after the most vulnerable and those with the highest degree of need, and that we do not lose ground on what has gone before, while also having to deal with complexities such as retirements and contracts coming back and so on and so forth. However defective the 2006 UDA contract is, it is not just a question of swapping one for the other.

The current thresholds are monitored on a monthly basis, and the new thresholds have been put in place for six months. Dental practices have been asked to deliver as much care as possible, prioritising urgent care, particularly for vulnerable groups. They are delaying planned care, ensuring that they are dealing on a needs basis with those in the most acute need.

In addition to these activity thresholds, NHS England has provided a flexible commissioning toolkit. I am very keen for the profession to get real-world examples of what can help deliver the service, based on the successes that have been achieved locally. Some of those successes have been achieved in our own particular area. Flexible commissioning is used to convert units of dental activity, or UDAs as my hon. Friend has referred to them, to activity that focuses on priority areas, such as improving access to urgent care, or targeting high-risk patients, which was exactly what he was asking us to look at in his speech. We are already doing that. It is good practice and regional commissioners can implement it. I am very keen to make sure that that practice is being used as much as it possibly can be. I am having very frequent discussions with NHS England to make sure that we are monitoring the use of these measures.

As well as flexible commissioning, support is also available to local NHS commissioners to put that capacity where we need it most. In the east of England, NHS England has developed the transformational dental strategy, the aim of which is to prioritise urgent care, prevention and inequalities. Despite our efforts to increase services, we know that patients are still experiencing acute difficulty in finding an NHS dentist—that is also true in my constituency.

A feature of the debates that we have had today is the availability of private provision in areas where there is no NHS provision. NHS England is charged with commissioning to the need in an area. Making sure that we commission to the need in an area is something that contract change, which I am very keen to see delivered by April 2022, addresses, but it is highly complex. I have met stakeholders in the UK. Some people suggest that the Welsh system is better. Others favour the French system or the one that exists in some of the Scandinavian countries. I have met members of the dental profession from all those places and, actually, no one has a perfect system. We are trying to take what is good about the various systems and ensure that we deliver in localities so that people can have access to care when they need it, with a particular focus on prevention.

We have a web-based programme in the east called service provider, which provides up-to-date information on dental services that are available. Patients experiencing difficulties are able to contact NHS England’s customer care centre and call 111 for help in accessing emergency dental care. All NHS dental practices in the east of England have been asked to reserve at least one slot per day for urgent dental care to improve capacity and, as my hon. Friend the Member for Waveney said, allow greater access. In addition, we have not stood down the 600 urgent dental centres that we had across the country during the height of the pandemic; we have left those in place, and we have a network of them across both Norfolk and Suffolk.

However, we know that information on NHS dentists is not always easy to access. Alongside increasing access for patients, it is crucial to support NHS dental practices and mixed practices—and, arguably, private practices—in order that we can start to have a more balanced approach. As my hon. Friends the Member for Waveney and for North Norfolk mentioned, part of the challenge that we have is retention. That is the case particularly in our area, but it is something that I have discussed with Cornish colleagues too; my hon. Friend the Member for St Austell and Newquay (Steve Double) and I have discussed at length how the problem is not unique to the east of England.

Practices have continued to receive their full contract payments minus agreed deductions, providing that levels of activity are met. An exceptions process has also been put in place for practices that have been disproportionately impacted by the pandemic. It is wrong to say that we want anyone to feel that they are not supported to deliver what they can. We have also made personal protective equipment available free of charge through a dedicated portal; and as of a week ago, we had delivered more than 367 million items free to dentists, orthodontists and their teams.

If it has done anything, the pandemic has continued to highlight the fact that transformation in dentistry is necessary, particularly if we want to make sure that we drill down on the oral health inequalities that exist across the country. I am meeting the chair of Healthwatch tomorrow, and I am sure that, among other things, we will discuss access to dentistry at some length. We need to develop a sustainable, long-term approach to dentistry that is responsive to the population. It needs to provide high-quality, urgent treatment and then restorative care where clinically necessary, but prevention must sit at its core.

The majority of oral health failures are preventable. My hon. Friend the Member for Waveney spoke about children. There is nothing more upsetting than a child being in acute pain and having all their teeth removed. That is a broader problem. Through flexible commissioning, we can ensure that we are doing supervised tooth brushing by encouraging local authorities to put that in, but we can also enable parents to do their part and ensure that they can help their children learn good habits right from the early days. Parents can encourage their children to look after their teeth by rubbing their gums before their teeth even appear, making sure that they understand how important it is.

In addition, any system that we design must improve patient access and oral health, and offer value for money for the taxpayer. It must also be designed in conjunction with, and be attractive to, the profession. NHSE is leading on dental contract reform work. Importantly, it is engaging with stakeholders, including the ADG, which my hon. Friend spoke about. It will be looking at what changes can be made to dental contracts in the short term to offer some improvements and some relief and respite to everyone, while details of the next stage of reform will be agreed by April 2022. Making NHS dental contracts more attractive to the profession will help with vital recruitment and retention, and I know that all my hon. Friends in the Chamber, particularly across rural and coastal areas, will welcome that.

Health Education England’s Advancing Dental Care programme has also been exploring opportunities for flexible dental training pathways and how we train our dental workforce to improve recruitment and retention. I am also very keen to make sure that we use the broader dental team as efficiently as we can, because dental technicians, dental nurses, hygienists and so on hold many skills that, particularly, could be used for prevention. However, with another hat in my portfolio on, I think of the obesity agenda and making sure that we all look after ourselves a bit better and have healthier lifestyles. Everything that we consume goes in through our mouths. Dentists are wonderfully placed, as are their teams, to help to encourage us to have a healthier lifestyle and to eat a little less sugar.

We remain committed to prevention and improving oral health, and I am pleased that my hon. Friend the Member for Waveney supports—I think, from his asks—the direction that we are trying to go in by changing the UDAs, concentrating on making sure that we have the skill mix right, focusing on prevention and looking at retention. As he said, however, this is a complex area. I am also having discussions with the GDC—he spoke about recognising dentists who have trained overseas and making sure that once we are assured of standards of education and so on, things are a bit simpler.

On making sure that we can expand schemes, subject to funding being secured and consulted on, I want to look at the expansion of fluoridated water. As my hon. Friend said, it is one of the simplest ways that we can improve oral health intervention, and we could significantly improve children’s health across the country. It is unacceptable in this day and age that young children have total dental clearances due to preventable tooth decay. The return on investment on fluoridation is very compelling and there needs to be a renewed focus on the investment in prevention.

We are committed to increasing dental access both in the short and the long term so that we can ensure equality of access no matter where in the country a patient lives. But this is complex. We are working hard at it. We are working with the profession, but we all need to double down both on prevention and making sure that we are all walking in the same direction to bring accessible oral healthcare to people.

Question put and agreed to.

Oral Health and Dentistry: England

Jo Churchill Excerpts

Tuesday 25th May 2021 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Ms Bardell. I congratulate the hon. Member for Bedford (Mohammad Yasin) on securing this important debate. We have heard during the debate that we all want better dentistry. I would like us to have that conversation in a constructive and positive manner going forward.

I thank all members of the dental profession. This has been incredibly tough, but there is a reason. I very gently point out that dentistry uses aerosol-generating procedures. Dentists work very much around the mouth and nose, where there are saliva and droplets. The whole onus of what we did at the beginning was to keep people safe—the profession, their teams and their patients. It has been a very slow rebuild, and infection control still lies at the centre of that. I would like everybody to remember that, because it makes dentistry a uniquely challenging area to try to deal with.

I agree with everyone that dentistry was an incredibly challenging area before the pandemic. Certain parts of the country, including the east of England but also the south-west, already had systemic problems. The hon. Member for Bradford South (Judith Cummins) and I have had conversations about how we can improve this and drive things forward. The Healthwatch report published yesterday shows that demand for dental access remains high, and that many patients are experiencing difficulties. I am not shying away from the fact that there is a problem and that we need to work hard to fix it. However, there was an access problem prior to the pandemic as well. I very much welcome the Healthwatch report, and I look forward to meeting the chair of that organisation tomorrow.

The pandemic has had, and continues to have, a substantial impact on dentistry, and I am grateful to dentists and all their teams for their continued resilience and dedication in providing the best care for their patients under extremely challenging circumstances. They have had to adjust to working differently and responding to new challenges, especially around infection and control measures, which I know they find restrictive. My hon. Friend the Member for Mole Valley (Sir Paul Beresford) brought members of the profession and we discussed how difficult it is to work in the PPE and so on. We are looking, with Public Health England, at how we can provide them with that assurance. However, once again, at the heart of this lies the fact that my primary concern is to make sure everybody is safe. I would not be doing what I am tasked with if that were not the case.

Ventilation was bought up by several people. There are significant and practical financial and timing challenges in assessing and putting it in. Not every dentist owns their own premises, and not every dentist acts only in their own premises. However, I have asked NHS England what we can do in this area, what is practical and what can be achieved by working with the profession. The aerosol-generating procedures obviously involve high-speed drilling, creating a fine spray of saliva, which creates a heightened risk of transmission, as pointed out. In response to our usual high street dental practices, we required dentists to wear full PPE and to rest rooms early in the pandemic for up to an hour. That caused problems, and challenges with getting volume through. That caused problems, and challenges with getting volume through. With the new guidance, however, the time in many cases is down to as little as 10 minutes, depending on, as I have said, the level of ventilation and other things. That has been an important step forward in allowing greater throughput in practices and has helped to facilitate more care for more patients. But we are asking the profession to see patients on the basis of need. As everybody has pointed out, there has been an enormous backlog for some considerable time. We need to ensure that we are seeing the people who have the most urgent and essential need first. That is why people will not always get a routine appointment at the first time of asking.

Taking revised IPC—infection prevention and control—requirements into account, we have worked closely with NHS England in considering what levels of NHS dentistry can be delivered in the current environment. It is undeniable that the pandemic and the necessary steps that we have had to take to protect dental patients and staff have led to a reduction in the number of patients treated. That is self-evident, but we are continuing to work with dentists, the broader profession and NHSE to develop a road map, which is essentially what everybody needs in order to move forward.

I know that many across the House are concerned about the thresholds; the hon. Member for Nottingham North (Alex Norris), who is always constructive in these things, has said that they were introduced last year. But there is a fine line here. In the beginning, we supported the profession with 100% of payments for what it was delivering, but we now need to get that volume up. We cannot have no targets for delivery; we cannot have a drive towards giving more patient care but not ask the profession to deliver more. That just does not work. Dental practices have been asked to deliver more care, prioritising based on clinical need, and in that way we have sought to target available capacity at those who need it most. I am pleased to say that approximately 95% of practices exceeded the threshold for full remuneration set in the last quarter of last year, so up to March. The average performance in February was 59%.[Official Report, 7 June 2021, Vol. 696, c. 2MC.] The hon. Member for Bedford will be pleased to hear that 87% of his local NHS practices have already exceeded the threshold, and there is still time to submit the activity for quarter 4.

We have continued to monitor the levels of NHS care being delivered, and on that basis we have set the new threshold of 60% for dental activity and 80% for orthodontic activity between April and September. Sixty per cent. still means 40% of people who were seen before not being seen, and that was still not a system that was enabling everybody to be seen. That is why we have challenges throughout the system, but the thresholds were based on data. The accusation that they were not modelled properly and we did not look at them is actually not fair, because we have done that. I am terribly sorry, but I cannot remember who said that people were not doing NHS care but reverting to private care. I think it was the hon. Member for York Central (Rachael Maskell), or was it the hon. Member for Putney (Fleur Anderson)? It is still a patient in their chair; it is still activity; it is still volume. It is just a different way of charging.

Again, the thresholds were based on modelling. There is a need to lift capacity if we are to care for patients. We are monitoring on a monthly basis, and the thresholds have been put in place for six months to provide some stability to the system. To improve access for those who need it most, NHS England has also provided a flexible commissioning toolkit; it has been charged to do that. As the hon. Member for Bradford, South said, as my discussions with my hon. Friend the Member for Mole Valley have shown and as we discussed in the previous debate, which was initiated by the hon. Member for Putney, these things are in train. We need to effect change. The UDA—unit of dental activity—system, brought in by the Labour Government in 2006, is broken; we understand that it is broken, but these things take more than a month to put in place. To improve access for those who need it most, we are pushing on with flexible commissioning, focusing on those experiencing health inequality and on available capacity where it will impact oral health most. We are looking at and targeting those vulnerable groups who have been referred to by so many hon. Members.

The situation remains challenging, even as we see more and more people being vaccinated, and certainly in Bedford there are challenges. I spoke to the hon. Member for Bedford last week about surge testing and turbo-charging the vaccination programme in Bedford. We need to be aware that, when there are these challenges, we have to look at dentistry and be doubly careful that we are aware of variants of concern in some of these areas.

Many patients are still experiencing difficulties in finding an NHS dentist. NHS England’s customer care centre can help people, and patients with urgent need can also call NHS 111. I say to the hon. Member for Norwich South (Clive Lewis) that there are 10 urgent dental care, or UDC, teams across Norfolk. So, if anybody needs that number of teeth extracted or is in pain they should ring 111 and they will be directed to a UDC for urgent care.

Actually, we are seeing broadly the same number of patients through urgent care as we were pre-pandemic, showing that the current prioritisation is keeping numbers stable. However, the need for urgent care is not wavering and in all reality it will rise, because people have been waiting for a longer period of time.

I acknowledge that the Healthwatch report also highlights the fact that information on NHS dentist availability is not always easy to access. Again, I have tasked others with going away and making sure that patient information is more readily available. So, NHS dental practices will be asked to update their information online, because much of it is out of date, meaning that it is much harder for individuals to see what is available locally. The update will mean they can find the care they need.

I have also asked that we truly look at and identify where we have dental capacity and where we have dental deserts, as it were. That goes to not only where we target the workforce—we are working with the GDC very closely on overseas registration and so on—but how we actually deliver, because parts of the country have much greater access problems than other parts.

Throughout the pandemic, we have supported NHS practices, in addition to paying the full contractual value for the lower ends of activity. We have also provided free PPE from the dedicated portal. As of 18 May, nearly 7,000 dental providers have registered with the portal, which has shipped over 367 million items to dentists, orthodontists and their broader teams.

I will move on to contract reform. The pandemic continues to highlight the fact that transformation in dentistry is essential. If we are to address continuing inequalities, particularly in children’s oral health, I want to see a change in the way we approach dental services and oral health. We have much to build on, but it is time to move from research to action.

We are grateful to the prototype practices, whose commitment to the reform programme has been invaluable over the years, and their ongoing participation has enabled us to gather vital data, which will inform the next stage of the reform process. I have spoken to people with different systems, from as close as Wales—leading academics and practitioners—but also people from right across Europe. I have spoken to people who provide services that are totally free at the point of delivery and those who have a total charging system.

No country has a perfect system. Dentistry offers an incredible challenge. We have a mix of private, mixed and NHS services, and I would like to maintain that environment. We need to develop a sustainable, long-term approach to dentistry that is responsive to the population, providing high-quality urgent treatment and restorative dentistry.

There is an opportunity for the whole team to support improved population health. Everything we eat goes in through our mouths, so dentists are great in helping to advise in other general areas of health, such as obesity and so on. We have a profession that is eager to contribute more and enthusiastic to do so. High-quality prevention needs to be at the forefront, and I am determined that a transformation in commissioning will help us to achieve that.

I am beginning to run short of time, for which I apologise. A toothbrush costs 33p. Every parent needs to help us to care for their children’s teeth. Oral decay is preventable. We need to work together, so that there is more supervised tooth brushing but also more parental guidance, so that parents can help their children to have healthy oral hygiene.

I want to see water fluoridation, which has been in some parts of England for decades, rolled out. I heard my hon. Friend the Member for Isle of Wight (Bob Seely) argue that his constituency would be a good test place. A provision needs to be included in the upcoming health and social care Bill, to transfer responsibility to the Secretary of State, in order to expand schemes more easily. I am glad to see the unanimous support for that. Subject to funding being secured and to consultation with partners, that is something we need to work on together. I want to prevent the unnecessary pain and suffering each year of those 37,000 children in many of our constituencies. Water fluoridation offers the quickest return on investment, giving as much as £35 return for every £1 spent.

I hope it provides reassurance that I meet regularly with the profession. I am meeting the all-party parliamentary group for dentistry and oral health next week. We are committed to ensuring that patients can access NHS dentistry and supporting the profession. A substantial amount of work is going on, changing the way dental services are provided to improve the health of the population.

Motion lapsed (Standing Order No. 10(6)).

Covid-19:International Travel

Jo Churchill Excerpts

Monday 24th May 2021 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve with you in the Chair, Ms Fovargue. First, I thank my hon. Friend the Member for Don Valley (Nick Fletcher) for raising this important issue on behalf of the Petitions Committee. I thank all Members of the House who have taken time for this wide-ranging debate: my hon. Friend the Member for Don Valley, the right hon. Member for Exeter (Mr Bradshaw), my hon. Friend the Member for Bexhill and Battle (Huw Merriman), the hon. Member for Ealing, Southall (Mr Sharma), my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill), the hon. Member for Richmond Park (Sarah Olney), my hon. Friends the Members for Cities of London and Westminster (Nickie Aiken) and for Bracknell (James Sunderland) Bracknell, and the hon. Member for Ellesmere Port and Neston (Justin Madders). The one thing it did absolutely perfectly was display the complexity of the area and how difficult it is to get to a perfect solution.

I will take from the debate that we all agree that people have made enormous sacrifices, both in the country and out of the country, and that the vaccine roll-out has been a tremendous success. However, I point out that we have not yet reached the under-30 age group. While everybody was lucid about allowing people who had had a vaccination to travel, nobody said anything about those who had not, or what the solution was for them. This debate has ranged from the travel industry to business travel and has covered the Department for Transport, jobs and a wide range of Departments, but at its heart is how we are dealing with family and friends.

The past 14 months have presented huge challenges for all of us, and it is only right that members of the public, like Ms Sinclair, should debate such issues of enormous interest to us. My heart goes out to everyone who, 14 months ago, did not want to spend the past year like this. However, many of the reasons why people make sacrifices, in this country and without, are well known to us all. Last Monday, we took an important move to step 3 of the Government’s road map, in that we removed the provision to stay in the UK. International and leisure travel is slowly—I repeat, slowly—starting again and there is a new traffic light system.

In essence, the petition asks whether family members and unmarried partners should be able to visit their families and partners abroad, specifically regarding the “stay at home” and “stay in the UK” measures, which were in effect until 29 March and 17 May respectively. Under “stay in the UK”, individuals had to have a reasonable excuse to leave the UK. As with all restrictions during the pandemic, no decision has been easy, and none has been taken lightly. Where international travel is concerned, we acted to control the spread of the virus and to reduce the risks of variants being imported and exported. It struck me as interesting that people assume that that is completely possible while exempting people in a whole range of different areas.

I have often argued against the party of the hon. Member for Ellesmere Port and Neston, which has said that we should have a more stringent managed quarantine system. Everyone cannot have everything; we have to have a balanced approach in what we are doing. At the heart of everything is protecting people. We are opening up, but we are going slowly. Where international travel is concerned, we do not want to export or import variants, as I said.

Infection rates have fallen back at points but, crucially, a large amount of the population are not yet vaccinated, so it is vital that we maintain additional restrictions while the programme continues through the cohorts and to counter the risk of import or export. I of course appreciate the desire to see loved ones. I sympathise with those who have not seen partners and family members for a long time. I, too, like everyone else in the Chamber, have constituents who have come to me with such challenges. I recognise how difficult it is for people with family and partners based abroad. The pandemic has presented unprecedented challenges. My thanks go to everyone for their contribution and to all those working in the health service. That is what has allowed us to arrive at where we are today.

Acknowledging instances of those with family members overseas, the “stay in the UK” regulations included a number of reasonable excuses—no one appeared to allude to them—to allow international travel in circumstances where visits could not be delayed. I have had constituents—[Interruption.] I will try to beat the bell. I have constituents who have used those exemptions, which include travel to support someone giving birth, to accompany someone to a medical appointment, to provide care or assistance to a vulnerable person, including those of 70 years or older, a woman who is pregnant or those with underlying health conditions, or to say your last goodbyes at the end of life. So, there have been possibilities; to say that there has been none is just wrong. People could also travel out of the UK to attend their own wedding or civil partnership, or that of a close family member if at least one of the persons getting married or entering the partnership lives outside the UK.

As part of the road map, however, the Government took the prudent decision, informed by the latest data and analysis, not to allow international travel to see family members and partners more generally, however hard that feels. It was not an easy decision. Indeed, it is one of the many tough but necessary decisions taken as we continue to follow the road map out of lockdown. It is about finding a balance between priorities, including the need to save lives and to mitigate another surge in infections, as well as to avoid putting pressure on the NHS.

Those restrictions have bought us time: time to establish the vaccine roll-out and reduce the spread of disease, time to vaccinate front-line staff and care staff, and time to vaccinate care home residents and the most vulnerable. We continue to make good progress. As of 22 May, over 37.9 million people have received their first vaccine, another 22.6 million people have received their second dose and a staggering 60.5 million covid vaccine doses have been administered across the UK, through the enormous efforts of our general practice teams, pharmacists and mass vaccination centres.

Public Health England reports that the UK covid vaccination programme has prevented about 12,000 deaths in those aged 60 or above in England. Furthermore, it has saved 33,000 hospital admissions for those over 65. Restrictions on international travel have helped us achieve these things and have helped protect people so we can move to step 3. It is important that we remain vigilant and continue to manage the risks, so that we do not lose the benefits gained through the efforts thus far. Step 3 includes a cautious, managed return to international leisure travel, which I hope colleagues across the House will embrace.

I will address some specific points raised by hon. Members. When we talk about opening up, it is important to keep in mind that we had the indication only this weekend that the Pfizer and AstraZeneca vaccines were both effective against the Indian variant, so asking us to see into the future is incredibly difficult.

On 17 May, we moved to a traffic light system that categorises countries based on their level of risk to public health and the potential effect of variants of covid-19 to limit the efficacy of the roll-out. Decisions on designating countries to red, amber or green lists and the associated border measures are under constant review, to ensure that we manage the risks. These risks are challenging. They are about the impact on people’s jobs, livelihoods and all those things, but they are predominantly about people’s health and wellbeing, and about protecting people.

The decisions are taken by Ministers, who consider the Joint Biosecurity Centre analysis, as well as wider public health considerations. As I have explained, decisions are under constant review so that we manage the risks. I was glad that the hon. Member for Linlithgow and East Falkirk (Martyn Day) outlined how rigorous this process is and how we are now in better lockstep with our friends across the border.

We are making progress as we journey along the road map, but we have to remain vigilant. Variants continue to pose a significant risk that we are monitoring closely, and action will be taken as necessary to stop the spread. Border measures, including testing and quarantine, continue to help manage the risks. That includes the requirement for international arrivals, except those from green list countries, to take a pre-departure test and isolate for 10 days, either at home or in a managed quarantine hotel if they have come from a red list country, and to take a post-arrival test on day two and day eight.

Several hon. Members talked about testing. From May 15, NHS Test and Trace reduced the cost of tests from £210 to £170, and day two tests for green list countries went down to £88. These costs include genomic sequencing if someone has a positive test. Other private providers are stringently tested to ensure quality, and they are available. PCR tests continue to fall in cost, to around £100 to £120 for a day two test. We expect green arrival tests to be somewhere between £20 to £60. As the market develops, that cost will keep dropping as prices become more competitive, but I gently ask, is the British taxpayer meant to pay for the test for leisure purposes and travel?

[Justin Madders]

I understand the point that the British taxpayer should not be expected to pay for these tests for leisure purposes. However, a person who goes on to the Government website now does not need to give a reason to receive a lateral flow test, and we know that for a number of sporting events that have taken place, the condition for entry has been tests, which have also been free. There is not any consistency here, is there?

[Jo Churchill]

As I say, these things are kept under constant review. The Department for Digital, Culture, Media and Sport is testing large-scale events involving large groups of in-country crowds. That is completely different from testing those people who are returning to the country. Measures for these international journeys are essential, and it is vital that we follow what restrictions remain in place.

It is also essential that offers of vaccination are taken up by everybody as soon as possible. We hope that the continued success of the vaccination roll-out, including increased testing capabilities, alongside falling infections and hospitalisations, will allow us to continue to lift restrictions. However, we have to protect our hard-fought gains made over the past few months, and we are taking a cautious approach to opening up international travel, given that the risk from those travelling back from countries with high prevalence or where there are variants of concern is not only to the individual, but to wider society.

Some Members brought up the difference between allowing us to enlarge business travel and travel to visit family, friends and so on. They are, in fact, completely different—I very rarely behave with family and friends as I might in a business meeting, so I would urge a little caution before drawing a comparison between the two. Like everybody else, I feel for travel agents and so on in this time of uncertainty. However, they are supported by Her Majesty’s Treasury and the different interventions that have been put in place. Those things will be ongoing after we open up on 21 June, so long as we keep on the road map, and there is some assistance for businesses going forward.

This is a first step, and more opportunities will come along. It is important to remember that, and to highlight that the Joint Committee on Vaccination and Immunisation looks at the outcome of vaccine programmes on reduced levels of infection, high levels of vaccination, and the transmission risk and variants of concern. I reiterate my sympathy for those who have not been able to visit family and partners, and my thanks to those who have stepped up. Getting to this point has taken remarkable perseverance and resolve, and I am grateful to everyone who has got us here. The collective effort has meant that we can reopen our borders, allowing us where possible to reunite families, loved ones and friends. We must continue this careful approach. It is a risk-based approach, informed by the latest data and scientific evidence and by the abiding need to protect the population’s health and wellbeing, and thereby the economy.

With all this in mind, I believe we have good reason to feel optimistic, although there will be new and unexpected challenges, and there will be some setbacks as well. I have not hugged some of my children for 14 months, and they all live in this country—we have a large family. It is tough, and I get that, but we are doing what we are doing for the right reasons. We are better protected and better prepared to take on those challenges than we have ever been.

Alcohol Products: Labelling

Jo Churchill Excerpts

Tuesday 27th April 2021 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I am grateful to the hon. Member for Liverpool, Walton (Dan Carden) for securing the debate and for the measured way in which he has approached this issue. He set out how we want to move forward, how alcohol has a broader cost—a cost to lives, to people’s health and to society—and how, fundamentally, this is about education; it is about helping people to make informed choices and make the right choice. For that, I thank him.

While the debate focuses on the labelling of alcohol products, I want to start by making a few points on alcohol consumption and misuse, which it is extremely important to address. While the majority of people drink and do so responsibly—I am sure the whole nation will be cheering at the fact that the hon. Gentleman does not want to take the fun out of us all enjoying a responsible drink and getting together with friends and family—we know that there are people who drink at harmful levels, with that alcohol misuse leading to significant harms in not only their lives but the lives of those around them. It has large impacts on society that have a cost to health, to productivity and to quality of life.

Excessive consumption is the biggest risk factor to which early mortality, ill health and disability are attributable among 15 to 49-year-olds in the UK—those are young people’s lives—and is considered to be the third largest lifestyle risk for preventable disease after smoking and obesity. Alcohol harms are not experienced equally across all groups. Those with a lower socioeconomic status show the greatest susceptibility to alcohol harms and have a much higher likelihood of death or suffering a disease relating to their alcohol use, be it cancer, liver disease or a plethora of other things.

In recent years, we have seen an overall decrease in the number of people drinking. However, a review undertaken by Public Health England shows that during the pandemic, we have seen an increase in those drinking at dependent and higher-risk levels. While numbers may have gone down at the more moderate end, we have seen an increase of more than 16% in alcohol-related deaths for the first three quarters of 2020 compared with 2019. During that period we were largely limited to off-sales, because places where we might normally enjoy a social drink were closed.

We know that most people who drink alcohol do so responsibly and enjoy doing it on social occasions, but the covid pandemic has shone a spotlight on the impact of general poor health on our ability to fight off the virus. That is why we need to be aware of the risks of excessive drinking and how much heavier the impact is on those who have risks and challenges in that part of their life. It has underlined the need to take action, which was the thread running through the hon. Gentleman’s speech. We are improving the public health response and addressing a number of challenges, including obesity, smoking and drug misuse, and we will continue to monitor the impact of alcohol during the pandemic and as we come out of it, considering further action in the forthcoming addiction strategy.

Drug and alcohol treatment providers have continued to support and treat people through the pandemic, but there have been challenges. There have been some brighter sparks. I have spoken to people who have delivered group sessions, and it has been easier at times to connect and communicate, but for others, the journey during the pandemic has been a lot more disconnected. At this point in the debate, I would like to encourage, as I am sure the hon. Gentleman would, anybody who is worried about their consumption of alcohol to reach out and seek help at the earliest possible opportunity.

Alcohol labelling, which is what we are largely discussing this evening, is an important part of the overall work on reducing alcohol-related harms. The Government believe that people have the right to accurate information and clear advice about alcohol and the health risks that may be associated with it, to enable them to make informed choices about their drinking and what they consume. As people return to socialising and drinking this summer, it is increasingly important that they are educated not just about alcohol and its harms, but about how they can enjoy alcohol responsibly and have fun with other people in a manner that saves on some of the other costs of drinking too much.

The UK chief medical officer’s low-risk drinking guidelines were published back in 2016. The intention is to help people understand the risks that alcohol might pose to an individual’s health and to make decisions about consumption in the light of those risks. The guidelines are based on evidence of risk and benefit, including the most up-to-date international and UK-specific data. The guidelines give a clear recommendation to limit alcohol intake to 14 units a week, to limit daily intake to reduce immediate risk, and not to drink if pregnant or planning to become pregnant due to the effect on the unborn child.

Over the past years, we have worked with the alcohol industry to ensure that alcohol labels reflect the UK CMO low-risk drinking guidelines, and the industry has committed to comply with that requirement. We are monitoring, carefully and closely, the progress that is being achieved. The British Retail Consortium—I would like to congratulate it on this—led the way in this area, with most own brands, such as Marks & Spencer and Aldi, now displaying the CMO guidelines. That shows that it can be done and that some are doing it. We were also pleased that in 2019 the Portman Group, which the hon. Gentleman mentioned, and its members committed to include the guidelines on their products. We fully appreciate that the pandemic has delayed those plans and that the hospitality industry has been severely impacted, but I would like to think that we can now refocus. I am really looking forward to seeing rapid progress and top premium brands increasingly displaying the guidance on their labels. As the hon. Gentleman said, the Portman Group acts as the socially responsible element of the industry, and what can be more socially responsible than helping to educate people so they can make an informed decision?

Post covid, we know that more must be done to look after our health. However, making healthier decisions without all the information is actually quite a challenge. For people to make informed decisions about the drinks they are purchasing, they need to be able to understand what is in that product and what it means for their health. We know that excessive alcohol consumption can be a contributing factor to obesity. I think the hon. Gentleman totted up the daily figures I am going to give and rounded them up to a week’s worth of figures, which equated to an extra day’s calories. Adults, on average, consume 200 to 300 extra calories per day. Of those who drink, 7% to 8% of that calorie intake comes from alcohol, because it is highly calorific. However, the evidence shows that the public, as he articulated, are largely unaware of those invisible calories. Many adults cannot accurately estimate the calorie content of an alcoholic product.

In 2019, less than half of alcohol brands provided calorie information on labels, so as part of the Government’s latest obesity strategy we are committed to consult on the introduction of mandatory calorie labelling on pre-packaged alcohol and alcohol sold in the on-trade sector. We hope that the provision of calorie labelling on alcohol will encourage reformulation, because there are market opportunities for lower-calorie versions that will further help adults to reduce their calorie intake from alcohol. This consultation will be launched very shortly.

The Portman Group, as I said, is the social responsibility body and regulator for alcohol labelling, packaging and promotion. It operates its codes of practice to ensure that alcohol is marketed in a socially responsible way only to those of 18 and over, and in a way that does not appeal to those who are particularly vulnerable to its appeal. The codes are supported throughout the industry, with over 150 code signatories, including producers, importers, wholesalers, retailers and their trade associations. I am absolutely committed, as are colleagues across Government, to working with the industry to address concerns over irresponsible labelling, packaging and promotion allied to labelling, and the concerns that the industry has, because I am sure that it is much easier if everybody is doing a similar thing, and then people can easily and swiftly find the information that they need, as the hon. Gentleman laid out.

[Dan Carden]

Will the Minister give way?

[Jim Shannon]

Will the Minister give way?

[Jo Churchill]

My goodness—stereo!

[Dan Carden]

As we know of the increasing harms from alcohol across society, which are slightly different from what will be covered in the addiction strategy, and there has been an increased focus on the drug strategy, does the Minister see the argument now for a proper review and strategy to deal with increasing alcohol harms across society?

[Jo Churchill]

Now is a great time to focus on making sure that we enable people to make the healthier choice as the default choice, and that we work to ensure that people have the right information for them. All I am willing to say at this stage is that nothing is off the table. There are a lot of strategies. Rather than making any blanket statement, the important job now is to refocus and to deliver on some of the commitments that we would like to see, and to make sure that the consultation is rolled out so that we can have that dialogue and make sure that we are doing the right thing for individuals but also across the industry.

[Jim Shannon]

I thank the Minister for outlining very clearly a strategy to address the issues that the hon. Gentleman is referring to. Minister, I know that it is not technically your responsibility, but I think perhaps—

[Jim Shannon]

Apologies, Madam Deputy Speaker. One massive issue has been the promotion of drink at cheap prices so that people can get drunk cheaper. Would the Minister be sympathetic to discussing this issue with the industry—the Portman Group has been referred to—to try to address it?

[Jo Churchill]

I think the hon. Gentleman refers to minimum unit pricing. As I say, we are refocusing on making sure that we are having a broad range of discussions. As he pointed out at the beginning of his intervention, this is not something that sits within my responsibility. However, I have heard, and I am sure others have heard, his plea for that work, which does go on in other parts of the United Kingdom.

Alcohol labelling is one part of wide-ranging cross-Government work to address alcohol-related health harms and their impact on life chances. The Government are committed to supporting the most vulnerable at risk from alcohol misuse. We have an existing agenda on tackling alcohol-related harms, including an ambitious programme to establish specialist alcohol care teams in the worst-affected 25% of hospitals, because I do recognise some of the challenges within the workforce that the hon. Member for Liverpool, Walton mentioned. We continue to support the children of alcohol-dependent parents—a situation that wreaks such havoc.

As part of the prevention Green Paper, we are committed to increasing the general drinking population’s direction of travel towards lower-strength alternatives when they have moderate drinking habits. We are working with the industry and other stakeholders to create more consumer choice and availability in the low-alcohol and no-alcohol sector. They are often very palatable alternatives, particularly for those who are driving or who may have a reason to want a clear head the following morning. The more choice that we can give people in that area, the better.

The Government have committed to publishing a new, UK-wide cross-Government addiction strategy that considers the full range of issues, including drugs, alcohol and problem gambling. While each of those comes with its own set of issues—as the hon. Gentleman said, the second part of Dame Carol Black’s review is due shortly—there is also much common ground and many benefits to tackling addiction in a complete, comprehensive and joined-up way. The scope of the addiction strategy is still being developed, so I consider this debate and his calls most timely as we consider what more can be done to protect people from those alcohol-related harms.

I emphasise the Government’s commitment to ensuring that alcohol labels provide the information that people need to make informed choices about the products that they are purchasing. I stress, probably for my husband and children mostly, that we are not saying, “You can’t enjoy a drink.” What we are saying very clearly is that we would like to encourage the nation’s drinking to be responsible, and to help people not to be one of those statistics that wreck lives.

We believe that people have the right to accurate information to help them to make decisions about the products that they purchase, and we are committed to ensuring that the labelling on alcohol provides that. Progress has been made in relation to the UK CMO’s low-risk drinking guidelines and other information on alcohol products, but we are not complacent. We will continue to actively monitor the position and keep it under review, and ensure that we level up so that people, no matter what drink they choose, can get accurate information from the product.

We await the consultation to ensure that we take everyone with us, because it is important that we do things in a measured but directed way in order to bring the benefits to the most people. I thank the hon. Member for Liverpool, Walton for introducing this Adjournment debate and for everything that we have discussed. Let us hope that we can get there.

Question put and agreed to.

Public Health

Jo Churchill Excerpts

Monday 26th April 2021 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I agreed with the right hon. Member for Torfaen (Nick Thomas-Symonds) when he thanked the scientists for their unfailing work to get the vaccine, the Army for its efforts to help to deliver the vaccine, and the NHS workers up and down the country for getting the vaccine into arms. From that point onward, however, there was not a great deal with which I could agree.

On 15 February, we introduced the managed quarantine service as a proportionate approach. From that date, arrivals from countries on the red list were subject to additional measures, including a requirement to quarantine in managed hotels. We have put in place a proportionate system, which allows those with residence rights and British and Irish nationals who live in the UK to return home, but manages the risk of importing new covid variants. We have signed contracts with 29 hotels to provide accommodation for those in quarantine; as and when demand increases, we can bring on additional hotel capacity. I visited one of the hotels—the Radisson Blu—and was reassured by what I saw. To make the scheme effective, we have introduced specific and limited exemptions to manage the quarantine, and those are for the continuation of essential services, but also in very limited compassionate and medical circumstances—for example, for those visiting a dying relative or with medical evidence that they cannot safely quarantine for 10 days in a hotel. I recognise the significant impact that requiring quarantine in hotels has on individuals, not least financially.

[Mr Steve Baker (Wycombe) (Con)]

Quite apart from the expense, my British Muslim constituents from Wycombe —one family in particular—who found themselves in a hotel were served bacon. That is obviously not halal food, and they found it difficult to get halal food. This of course is Ramadan, and they found it was difficult to be fed at the appropriate times for Ramadan. Will the Minister confirm that this is not the Government’s policy, and that the hotel should be doing much better for people at this time?

[Jo Churchill]

I would be happy to confirm to my hon. Friend that it is incumbent on hotels to support Muslim guests during their time there, but particularly at this time of Ramadan to be aware of their needs. Hotels will arrange for halal and vegetarian options to ensure that people’s needs are catered for, and if they are observing fasting during Ramadan, hotels will arrange to provide meals at suhoor and at iftar. They are also quite happy to support individuals who want to take their tests at an appropriate time of day as well—once fasting is broken, for example—and to provide extra clean towels in order to pray. I would be happy to speak to my hon. Friend afterwards and make sure that we can raise these matters immediately. However, I would urge his constituents and anybody else who is failing to get their requirements met to raise the matter, because it is important that we deal with them when people are in managed quarantine. This is a service, and our aim is to make it easy as possible for individuals.

[Sir Charles Walker (Broxbourne) (Con)]

Will the Minister give way on testing?

[Jo Churchill]

Yes, I will, but then I would like to make a little progress.

[Sir Charles Walker]

Can the Minister explain to the House, when testing is done in hotels—there is now quite a good sample or quite a good group of people—what percentage of those tests over the 10-day period are picking up traces of covid, and when covid is identified, what percentage of those cases are the South African variant, the Indian variant or the Brazilian variant?

[Jo Churchill]

I will come on in my speech to how we are picking those up, and the fact that we have world-renowned genomic sequencing actually helps us in that. We have identified, in recent days, 132 cases of the Indian variant of interest. Obviously with those, as when we pick up any positive test on day 2, we are genomic sequencing them to ensure that we have the correct information, so that we can make sure that we are following up and contacting people if they are in quarantine at home. In a red list scenario, people are in a managed quarantine facility, and their period of isolation will be expected to start from then. For the exact differences, I will be happy to write to my hon. Friend, because I do not have all the different numbers for all the different variants on me at the moment.

As I have said, to make the scheme effective, we have made limited circumstances where exemptions can be had. On the impact financially, for those who need it there are deferred payment plans. Alongside managed quarantine, we have also introduced mandatory testing, meaning travellers are required to pre-book tests before they travel. Testing takes place on day two and day eight, and allows us, as I have said, to use our world-renowned genomic sequencing expertise to better track any new cases that might be brought into the country and detect new variants.

Travellers will have to have had a pre-departure test within 72 hours of flying, and carriers should not let individuals board without a correctly filled in passenger locator form, so that we know where people are travelling onward to, and when from a red list country, that they have booked their place in a managed quarantine facility or hotel. If the carrier does not do this, they will face fines via enforcement.

Each of the measures we have introduced adds another layer of protection against the transmission of the virus, reduces the risk of a new and dangerous strain being imported and keeps people safe. However, we do not take lightly adding any country to the red list, but keep things under constant review. In India, for example, there has been an extremely rapid rise in cases detected throughout April. Normally there is a high volume of travel between India and the UK. We have already seen 132 cases of the variant under investigation appear in the UK, and that is why we have acted. As the Prime Minister said:

“We stand side by side with India in the shared fight against COVID-19”,

and our thoughts and prayers are with them at what is the most incredibly difficult time.

These decisions are based on risk assessments produced from the Joint Biosecurity Centre, which monitors the spread of variants of concern internationally. The risk assessments cover a range of factors for each country, including surveillance, genomic sequencing, in-country community transmission, evidence of exportation of new variants and travel connectivity. Informed by evidence, including JBC’s analysis and other relevant public health input information, decisions are taken by Ministers.

It is important to note—this probably goes to the comment made by my right hon. Friend the Member for Forest of Dean (Mr Harper)—that countries are also removed from the list under our particular proposals. Portugal and Mauritius, for example, have been removed from the list to allow travel to commence following evidence showing that the risk of importing a variant of concern from those areas has reduced.

Speed of action where variants of concern are found in the community, with urgent tracing and investigation, can identify and rapidly control further transmission and the variant. We believe that the combination of strong border measures, managed quarantine, testing and enforcement remains the best way to effectively reduce the public health risk of importing variants of concern, as public safety is the driving force. We recognise that the additions to the red list have meant challenging times for the airport sector—a crucial sector to the economy—and businesses across the industry can draw on the unprecedented package of economic measures that we have put in place to support them.

I am grateful for the continued efforts of individuals, airline carriers, quarantine facilities, border forces and others to help us tackle the global pandemic by helping everyone follow the rules, protecting each other and saving lives. The Government objective is to see a safe and sustainable return to international travel for business and pleasure. The current border regimes will remain in place for the time being, as will the restrictions on outward-bound international travel, because at the moment we should not be going anywhere.

The global travel taskforce is developing a framework that will facilitate greater travel when the time is right. There is no single measure that mitigates the risk entirely, and each layer we have introduced helps to reduce the risk. The managed quarantine service is complemented by testing, and those measures have been put in place for all arrivals. The mandatory testing regime improves the efficacy of the post-travel isolation period for preventing onward transmission of those imported cases.

Given the incredible progress made on the vaccination programme, as well as the hard work of British people to bring down the rates, it is more important than ever that we continue to protect people with a strong approach. As the House knows, there are restrictions on travelling abroad from England, and the individual must have a justified reason, but there are those who feel we have not gone far enough and those who feel we have gone too far. That probably indicates that we are where we need to be.

However, our rationale for this policy remains clear: we must continue to be alert and able to take swift action to mitigate any negative impact on vaccine effectiveness from the risk of variants of concern and broader public health challenges. That also includes at airports. The right hon. Member for Torfaen asked me about keeping people separated. Every step is taken to reduce risk to minimise potential for passenger interaction, including tests before departure, social distancing, mandatory mask wearing, the cleaning of facilities and specific lanes to minimise any interaction between those who have come from red list countries and those who have come from amber list countries. A number of airports, including Britain’s busiest airport, Heathrow, have introduced additional measures to separate passengers from the red list ahead of the immigration hall in order to stop them mixing, so it is not fair on those who have been working so hard to produce a system that we can live and work with to say that they are not doing anything. I know this is difficult for families who have been impacted by the introduction of hotel quarantine. However, they are part of the national effort. While we learn more about variants of concern and potential new strains, it is right that we continue to take a cautious approach, allowing us to continue with the road map and move closer to a more normal, yet covid-tinged life.

--- Later in debate ---

[Jo Churchill]

There were a considerable number of questions from my right hon. Friend the Member for Forest of Dean (Mr Harper). I will try to cover those that I heard, but he will forgive me if I write to him on the matters for which I do not have the immediate answers. Let me say as a slight cover-all that many of the things to which he alluded will be brought forward by the global travel taskforce when it starts to lay out the approach to restarting international travel safely, aligned with the domestic road map. I appreciate that he said he felt that this was his last chance to raise this issue while the House was sitting, because, given the dates, it is highly likely that that will happen while we are prorogued or shortly after. However, this is live and dynamic at the moment, and I can give him few answers on the specific questions he raised on the global taskforce and what it will say in three weeks’ time about future travel arrangements. Although I apologise for that, there is really nothing I can say to pre-empt that set of instructions as to how and when we are going to lift restrictions, and the use of a traffic light system, where countries will be categorised as red, amber or green, and how we deal with people in that space.

[Mr Harper]

Let us assume, based on the timings that have been announced, that the results of the global travel taskforce are going to be announced when the House is not sitting. May I get an assurance from the Minister, then, that on the first day after the state opening of Parliament that it is permitted to have a statement there will be a statement at that Dispatch Box by a Minister, so that we are able to ask questions about the results of the global travel taskforce? Will she assure me that that will take place at the earliest possible opportunity?

[Jo Churchill]

I thank my right hon. Friend for that. I assure him that I will take that request back. As he knows, I cannot commit to that at the Dispatch Box.

My right hon. Friend asked which ports of entry people can fly into, why we have chosen those ports, whether we are extending them and what happens if someone from a red list country is booking in to arrive at a non-designated port. If someone has a pre-existing booking to a non-designated port, it is the individual’s responsibility to change it to a designated port. Carriers are not permitted to carry anyone who has been in a red list country in the previous 10 days to any port of entry other than those that are specified. Currently, those designated ports are clearly Heathrow, Gatwick, London City, Birmingham and Farnborough.

I ask the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy) to write to me, but I gently say to her and to the hon. Member for York Central (Rachael Maskell)—I cannot discuss the specifics of the case of her constituent, for whom I have the greatest sympathy—that the challenge here is that their Front-Bench team are asking for stricter restrictions the whole time, across the piece. If all we then do is build more and more exemptions into the system, we will have a looser system than the one we are endeavouring to make sure is proportionate, delivers in a way that manages the arrivals from red zone countries, and has a degree of flexibility to ensure that as the system changes we can build countries back into travel and restrict others where there may be a flare-up.

It is right, as I have explained, that all these measures are kept under constant review. The combination of quarantine requirements for all international arrivals means that those arriving from countries presenting with the highest risk are asked to use the Government-approved hotel quarantine facilities. There is a robust testing regime prior to departure and then again on arrival. Enforcement is put in place if required. As we still have more to learn about the virus and, as my right hon. Friend said, more understanding to acquire, we must make sure that our approach is based on the best evidence, and that it is proportionate. That is the responsible approach to take to safeguard progress in defeating the virus and to make sure that we can all get back to some degree of normality.

[Mr Harper]

Before my hon. Friend sits down, may I press her on one further point? I accept that she cannot set out answers to my detailed questions until the global travel taskforce has presented its outcome and Ministers have made their decisions. The central question I did ask though requires a fairly wide policy decision. It may be that that will be decided by the global travel taskforce as well. Fundamentally, is our travel regime and how much protection we are going to have based on the extent to which we have vaccinated the British public, which is obviously proceeding at pace and suggests that we would be able to relax these measures sometime during the summer, or will it be based on the extent of the virus globally, which suggests, listening to some of the best voices on this, that we will be looking more towards the end of next year. That does not seem to me to depend on what the global travel taskforce is deciding. It possibly does, but perhaps she could furnish the House with an idea.

[Jo Churchill]

I do hate to disappoint my right hon. Friend, but I will have to do so once again. The answer to that question will appear with the global taskforce as we move into the coming months. In addition to that, there is a package that is linked to the work of the Chancellor of the Duchy of Lancaster on passport certification. We want to have a coherent integrated system that provides a proportionate response as we move forward.

[Mr Steve Baker]

On this point of coherence, I know that my hon. Friend cannot comment on the outcome of the taskforce, but does she agree that it is very important that, for all of these decisions on red listing, the evidence is clearly presented to the public so that they can see that countries are being treated fairly? Diasporas do bring with them some of their politics, and she will understand that, in particular, pairs of countries need to be seen to be treated fairly without any particular geopolitical preference. She will understand the point I am making, so can we always present to the public the evidence for the red listing?

[Jo Churchill]

We always try to make sure that we present the evidence with the rationale behind what we are doing. Ultimately, the driving force behind what we are doing is to make sure that we keep our residents safe and that we help other countries to keep their residents safe. The way that I will finish is that, as we all know, until everyone is safe, none of us is safe.

Covid-19 and Health Inequalities: West Yorkshire

Jo Churchill Excerpts

Wednesday 21st April 2021 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under you, Mr Hollobone. I congratulate the hon. Member for Hemsworth (Jon Trickett) on securing time for this important debate and showing that one reason why Westminster Hall is important is that it enables us to discuss the local as well as the national.

I very much associate myself with the hon. Gentleman’s thanks to those who have worked so hard to keep us safe through an unprecedented time for our country. I agree that we come from different communities, but the underlying issue is that none of us is safe until everyone is safe; I keep that in mind as I respond to his points.

In case we run out of time, I should say that I will of course meet the hon. Gentleman again because some of his points relate to key things that we want to work on. I know that directors of public health and his local authority have been doubling down on this issue because it is very important that we suppress. Although we are on a downward trajectory, we are all going to have to learn to live in a covid-tinged world, so we need to be aware of the things that he has highlighted.

Covid-19 has highlighted health inequalities across the country. As the hon. Gentleman said, his constituency was a mining community and some disease types are particularly prevalent among men there. We often see higher rates of smoking in areas such as the one that he represents. All have been a keen focus for me during the past 18 months or two years, and also for the Office for Health Promotion going forward, because all these things need to be looked at in the round.

I emphasise that as we rebuild from the pandemic, we are committed to tackling the long-term problems and levelling up. People should have the right to good healthcare, a good life and good life expectancy, wherever in the country they live. The NHS has committed to inclusive recovery from the pandemic and has set out eight actions to reduce inequality in the restoration of services. I do not cover hospital services, on which the hon. Gentleman spoke at some length, but he is free to write to the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), who looks after those. Reporting on providing services to the poorest in our areas is one of the actions.

My focus has been, and remains, tackling inequalities through the health and social care system and promoting health among disproportionately disadvantaged groups, because targeting everybody often only enlarges the gap. The hon. Member for Hemsworth highlighted several issues, and targeting and focused approaches work better.

The best way to improve life expectancy and reduce health inequalities is to prevent health problems from starting in the first place. Prevention is one of the top five areas for the health service and it is my focus, going forward. In March, we announced that the Office for Health Promotion would lead the national effort in improving and levelling up public health. That will enable a more joined-up, sustained approach and action between the NHS and national and local government. The hon. Member talked in the end about how we drive these interventions to address the wider determinants of health, ensuring that we have longer, better quality years and that we drive down health inequalities through the health and social care policy.

The West Yorkshire and Harrogate Health and Care Partnership supports some 2.7 million people and takes a place-based approach, which is totally right, to highlight the strengths, capacity and knowledge of those involved. Wakefield clinical commissioning group has developed a health inequalities prevention pathway and housing for health network—as we know, some of the determinants do not always sit within health; they sit in other areas, such as the quality of work that people have, and the homes in which they live—to support the reduction of barriers to services and deliver the recommendations from our ethnic minorities review.

That collaborative work has led to good practice being shared that saves lives and prevents illness. That includes the Healthy Hearts project, which the hon. Member for Hemsworth probably knows well. It originated in Bradford, but has been scaled up right across West Yorkshire and Harrogate, aiming to prevent 1,200 heart attacks and strokes over the next 10 years. The partnership also launched a new targeted prevention grant fund worth £100,000 to help reduce the gap in health inequalities across the area, supporting targeted, community-level preventive interventions that reduce harmful health behaviours, improve health outcomes and support those disproportionately affected by covid-19.

I wonder whether there is some targeting, because on some of the things that the hon. Member mentioned, such as people travelling in cars—I know exactly what he is alluding to, as my background is in construction—it is about ensuring that we all reinforce the messages: “If you are sharing a car, do not sit next to somebody; sit with a distance between you. Keep windows open and wear face masks.” All those things are important.

We will build on action that we have taken to limit the impact in West Yorkshire. The local teams, with national support, have managed outbreaks in many kinds of settings, and have done a brilliant job, including in care homes, meat factories, bed factories and general practice surgeries and within the professional football team. I know that covid-19 has affected some groups disproportionately. The Public Health England review last July identified age, occupation and ethnicity as particular risks. We therefore built up the community champions scheme, providing nearly £24 million to local authorities and the voluntary sector to improve communication for those most at risk.

The scheme is investing nearly £1.4 million to support ethnic minority groups across communities and faiths in Bradford, Kirklees, Leeds and Wakefield. We have mobilised 700 volunteers and are training 300 residents locally. In Wakefield, we have developed specific covid-19 and vaccine messages, working with English for speakers of other languages tutors, and community leaders such as mosque and black African church leaders. Community champions have contributed to the successful vaccination programme, as has the rolling out of information in different languages. That may also be something that we need to look at doing more effectively, but we have done a great deal of work on it. We can take that up at a further meeting.

The NHS has met the target for offering everyone in the cohorts their first vaccine by mid-April. More than a million people in West Yorkshire have received their first vaccination, in line with the national uptake rate. Vaccines were distributed fairly across the UK. It was a mammoth job. Somebody always has to be at the top and somebody not so near the top, but there is now much more balance. We have targeted the top nine groups. They are those at most risk from dying if they catch covid. That is the strategy that the Joint Committee on Vaccination and Immunisation, Jon Van-Tam and the Secretary of State have spoken about many times, explaining that we are protecting the most vulnerable.

I am aware of various barriers to vaccine uptake, but we have focused on that gap and driven it down, and it is now diminishing. We are working across Government to consider how we best support people and produce tailored outreach services, providing materials in a variety of languages and formats. We have also used outreach to approach targeted areas and communities.

There is a duty of care on workplaces to their employees to ensure that workplaces are covid-secure. It is only by us all working in lockstep that we can give everybody the same opportunity to have long, healthy lives wherever they live, wherever they work and whatever their background. Learning from the ways in which things have been done—the different deliveries—will help us going forward. I am happy to meet with the hon. Member, but the Department and I are determined to tackle both the long and short-term health inequalities that remain in Yorkshire, and to ensure that we help people.

Motion lapsed (Standing Order No. 10(6)).

Stroke: Aftercare

Jo Churchill Excerpts

Wednesday 21st April 2021 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is a pleasure to serve under your chairmanship, Sir Edward. I thank my hon. Friend the Member for Bromley and Chislehurst (Sir Robert Neill) not only for giving us all the opportunity to discuss this issue, but for sharing his and Ann-Louise’s journey and experience. I wish her well in her future recovery, but he articulated very well what some of the challenges are, as did many other Members.

The debate has made clear how stroke touches so many lives. I can feel an APPG coming, and I would welcome it, because the Stroke Association is a fantastic charity which does great work, and I am sure that they will be listening and keen to support an APPG. I thank all those at the Princess Royal and all those—in Stockport and throughout the country—who work in stroke services in the acute sector and out in the community. As has been articulated, it is a team game to give people the proper, consistent support so that they can achieve the optimum recovery.

I am so pleased that the friend of the hon. Member for Stockport (Navendu Mishra) made a fully recovery, but as hon. Member for York Central (Rachael Maskell) explained clearly, using her vast expertise, why it is a different journey for different people. Some people need a much more needs-based approach, which is obviously where we hope to head. That will hopefully be music to the ears of my hon. Friend the Member for Beaconsfield (Joy Morrissey). I hope to assure the hon. Member for North Norfolk (Duncan Baker) that we, too, are driving services in his area.

I do not have many minutes to speak, so if there are further questions I will be happy to go over them with individual Members. We have made enormous progress but, as many hon. Members said, that progress still needs work. We need to do better and we need to go faster. One of the ambitions of the long-term plan is the inclusion of a national stroke programme that looks to improve services, including better rehab services and increased access to specialist stroke units through a flexible and skilled workforce. We heard more than once about the challenges on the workforce front.

The prevention and treatment of stroke is a key priority for the NHS. Despite the many challenges presented by covid, the stroke programme has continued to support regional delivery. In some areas, we have accelerated implementation because it is such an important area. As of 1 April, there are now 20 integrated stroke delivery networks operating to support the national stroke service model. Those networks have patient voices and public voices, which it is quite important to let everybody know, because this does need to be patient-driven, and people need to know that they are being heard. ISDNs bring together key stakeholders in stroke to deliver a joined-up, whole pathway transformation through the integrated care systems.

I am sure that my hon. Friend the Member for Bromley and Chislehurst knows that such an ISDN is now operational in his constituency. They will be responsible for delivering optimal stroke pathways based on best evidence, which he referred to. They will ensure that patients who experience a stroke and, so very often, quite debilitating outcomes from it, receive excellent care from pre-hospital, through to rehabilitation and then life after stroke.

There is good evidence that stroke units delivering hyper-acute stroke care 24/7 enable the NHS to achieve ever-improving outcomes. Receiving high-quality specialist care in well-equipped, well-staffed hospitals is the optimum, and 90% of stroke patients will receive care in a specialist stroke unit. More patients will have access to disability-reducing treatments of mechanical thrombectomy and thrombolysis; combined with increased access to rehabilitation, that will, hopefully, deliver long-term improvement and a more seamless pathway.

As we heard from my hon. Friends the Members for Bromley and Chislehurst and for Beaconsfield, navigation of all the different systems is really part of the challenge as well. My hon. Friend the Member for North Norfolk will be pleased to hear that Norfolk and Norwich is one of the new pilot areas for non-neuroscience centres that will work towards the delivery of thrombectomy.

Delivering the right treatment quickly will lead to the best outcomes. We see that with ischemic strokes: busting the clots has become increasingly effective using the right drugs and treatments. All stroke units in the UK can deliver intravenous thrombolysis. Early diagnosis by stroke specialists, followed by early thrombolysis, has been transformative in stroke care.

Thrombectomy is a procedure used to treat some stroke patients, and there is evidence that, where used appropriately, it will reduce the severity of disability. Thrombectomy is available in 22 centres, with two further non-neuroscience centres under development, of which the Norfolk and Norwich centre is one. The expansion of these services is in the long-term plan, with plans to increase the workforce who are able to perform the procedure. Owing to training requirements, that is currently restricted to neuroradiologists, which is a challenge, so we have worked with the General Medical Council to develop a credentialling programme. That will hopefully enable the acceleration of training to a wider cohort of medical professionals, such as radiologists, cardiologists and neurosurgeons.

On rehabilitation services, if the stroke patient has had a hyper-acute treatment they will need early therapy, as we have heard from so many hon. Members. That needs to be delivered by physio, speech and language therapist specialists, and should be accessible within 24 hours. We have heard of the challenges. Long-term rehabilitation is also best undertaken locally, so that people do not face the challenges of chasing around for the service—that also supports the family, who are often vital in a patient’s journey—and to enable the assessment of the appropriateness of homes by occupational therapists and others. We do not want reviews every six weeks, every six months and annually. We want reviews to be patient-led, which I think is what the hon. Member for York Central was driving at.

The integrated community stroke service model has been developed by clinicians, experts and charities, whom I thank for the help that they have given us. To ensure that evidence-based care is being delivered, we have worked with them to address the variation across the country, which is a problem. The stroke rehabilitation pilots mobilised in 2020 are implementing an integrated community stroke service that will enhance care path- ways, including psychological support and vocational rehabilitation. Recognising that everybody’s needs are different is very important, as is delivering personal, needs-based stroke rehabilitation to every stroke survivor, in their home or place of residence.

We have funded the Stroke Association during the pandemic to provide the Stroke Association Connect service. Stroke rehabilitation pilot sites are also testing improved data collection.

The hon. Member for Stockport will be pleased to hear that we have turbocharged research, calling for more research into stroke areas, because evidence-based research is really important. Building on the rehabilitation pilot initiative, we will launch the new stroke quality improvement for rehabilitation later in 2021. Working closely with integrated stroke delivery networks, that will help address variation. Combined with funding for quality improvement projects and expansion of community data, we will then expand. In addition, the national stroke service model, due for publication in late spring, will support that service. The Government have initiated the biggest recruitment drive for allied health professionals in decades, including speech and language therapists and occupational therapists.

I want to give my hon. Friend the Member for Bromley and Chislehurst a couple of minutes to respond, but in conclusion, I hope I have demonstrated that this is a serious issue. I know the stroke community will have heard our discussion. I would welcome the opportunity to discuss the subject more fully, when there is time for me to go over some of the developments and ambitions we have to ensure that we impact the lives of people with strokes. We can give them significant benefits, we can benefit the NHS and, as my hon. Friend said, we can bring people back the best way that we can.

Non-devolved Provisions of the Coronavirus Act 2020: One Year Report

Jo Churchill Excerpts

Monday 19th April 2021 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

On 22 March 2021, the One-Year Status Report on the non-devolved provisions in the Act was laid in Parliament. The report provided a thorough assessment of whether the provisions within the Act remained necessary and proportionate to support the response to the pandemic.

The report highlighted an intention to expire 12 provisions and suspend a further three. The cautious expiration and suspension of these provisions reflects the progress made in tackling the pandemic. Progress along the roadmap and continued success with the vaccine rollout, show we are moving in the right direction towards the national recovery.

Following the publication of the One-Year Status Report, the Government identified that it contained a factual error. This relates to text on pages 14, 30 and 31 of the report, regarding section 24 of the Act, which covers Home Office responsibilities relating to the retention of biometrics—fingerprints and DNA profiles—that are being retained for national security purposes. I would like to apologise and address the error.

The report, laid in Parliament last month, stated that the regulations made under section 24 would expire in March 2021. However, it emerged that the second regulations made under this power, Coronavirus (Retention of Fingerprints and DNA Profiles in the Interests of National Security) (No. 2) Regulations 2020, are extant and will continue to have effect until 24 September 2021. This does not affect the substance of the report because the Government will shortly bring forward regulations to expire section 24, alongside other provisions set out in the One-Year Report.

We have taken the appropriate steps to rectify this error, and the corrections can be found at the end of this statement. An un-numbered Command paper will be laid before Parliament and published today setting out the changes. The published One-Year Report will also be updated on www.gov.uk to reflect those changes.

Since gaining Royal Assent on 25 March 2020, the Coronavirus Act has been an essential legislative tool in the Government response, enabling effective action to reduce the impact of the pandemic. The Government remain committed to keeping the powers in the Act under review and to retaining powers only where they continue to be necessary and proportionate.

This table highlights the changes made to the One-Year Report. The bold text represents additional text in the report compared to the previous version.

Oral Answers to Questions

Jo Churchill Excerpts

Tuesday 13th April 2021 Commons Chamber

[Rosie Cooper (West Lancashire) (Lab)]

What proportion of NHS trusts are in compliance with the requirement to collect data on all new diagnoses of recurrent and metastatic breast cancer.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

The National Cancer Registration and Analysis Service works closely with hospital trusts to determine sources of data that can be used to complete the cancer outcomes and services dataset. It also works with the software suppliers of cancer-management systems to ensure that data items can be recorded. Compliance with data standards is monitored by local CCGs, but I recognise that that is not enough, as data is incomplete after some eight years.

[Rosie Cooper [V]]

Currently, women with metastatic breast cancer are counted only when they die. That is despite the fact that, since 2013, it has been mandatory for trusts to collect data such as the number of women involved, how long they have survived and whether there are any health inequalities. It cannot be acceptable to count only the dead, not the living. Will the Minister commit to ensuring that the 2013 mandatory requirement to collect data on women with metastatic breast cancer is enforced?

[Jo Churchill]

Yes. As I explained in my earlier answer, one of the challenges is that there is not a consistent way of capturing the data. We need to sort that out: we need to make it simple; we need to make people understand what data we are collecting; and we need to make sure that, for both breast cancer patients and all metastatic cancer patients, we know where they are and that we are helping them with this disease as effectively as we can.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

What assessment he has made of the effect of the covid-19 outbreak on bereavement services.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

We are continuing to work with the NHS and the wider scientific community to understand better the long-lasting effects of covid-19 infection and the potential treatments. We are committed to supporting patients suffering from long covid. Specialist NHS assessment services have opened across England, and the “Your COVID Recovery” website contains support and provides a personalised programme for people recovering from covid-19, following a clinical consultation. More than £30 million of funding has already been committed to research projects and a further £20 million was made available on 25 March.

[Paul Holmes [V]]

I pay tribute to all NHS and military staff who are administering vaccines across the UK, including to my mum and dad last week. The Minister knows of the debilitating and lasting effects of long covid. She has just outlined the funding elements that she proposes to put forward. Will she tell us whether she might set up a specific taskforce to look at more research into the damage that long covid causes and the effects that it has on so many people?

[Jo Churchill]

We are already taking strong action in this area; we have already worked hard and are taking long covid seriously. We are listening to patients, taking a patient-first approach, working with the NHS and the wider scientific community, and engaging with the Royal College of General Practitioners to better understand the disease, which is physiological and neurological. It is different for different people, and therefore treatments need to be different for different people. We are working on ensuring that we have the best post-covid assessment care and the best pathways.

[Andrew Bowie (West Aberdeenshire and Kincardine) (Con)]

What steps he is taking to support covid-19 vaccine roll-out in Scotland.

--- Later in debate ---

[Craig Whittaker (Calder Valley) (Con)]

What steps he plans to take to ensure a level playing field between online and mainstream broadcasters in the implementation of the proposed advertisement ban on foods high in fat, sugar and salt before 9 pm.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

We have made clear our intention to end the advertising of high fat, salt and sugar products on television before 9 pm. We recently held a short consultation on how to introduce advertising restrictions for online and we will publish our response soon. A level playing field, however, is important. I want to make it easy for everyone to be healthy.

[Andrew Selous [V]]

Does the Minister agree that ending junk food marketing online is hardly an outrageous assault on our freedoms, would remove 12.5 billion calories a year from children’s diets, and would allow advertisers and food companies to make plenty of money from producing and marketing healthy food?

[Jo Churchill]

Indeed I do. We are not banning food. It is very important that we make the environment right to ensure that people can make the healthy choice as a default option and enjoy a healthy balanced diet where they have the full knowledge and understanding of what they are purchasing. I think this is actually a great opportunity for companies.

[Craig Whittaker [V]]

May I send my deepest condolences, thoughts and prayers to the hon. Member for Tooting (Dr Allin-Khan) and her family?

It is good to hear the Minister say that there will be a level playing field in this area, but it has been reported on national media over the past few weeks that the Government seem to be dropping plans to ban ads online for foods high in fat, sugar and salt. On that basis, surely she will agree that when half of 10-year-olds and 83% of 12 to 15-year-olds own a smartphone, with 86% of those children using video on demand, it would be absolute nonsense to ban advertising on mainstream broadcast TV where children watch very little.

[Jo Churchill]

I agree that making sure that there is a level playing field is the right thing to do. If we were currently doing so well, we would not have the number of children and young people overweight or living with obesity, so we must work on making sure that we do everything we can so that every child can be a healthy weight. But my hon. Friend will not get me to pre-empt the consultation that we will be reporting on shortly.

--- Later in debate ---

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

What discussions he has had with the National Institute for Health Research on increasing the number of research grants for the treatment of brain tumours.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

It is essential that we increase the amount of research to treat brain tumours, which is why in 2018, through the NIHR, the Government announced £40 million over five years for brain tumour research as part of the Tessa Jowell Brain Cancer Mission to increase the number of applications and grants allocated. The NIHR released a highlight notice that encourages collaborative applications to build on recent initiatives and investment already made in this area, as well as working with the Tessa Jowell Brain Cancer Mission to fund workshops for previously unsuccessful researchers in order to support them in submitting higher-quality applications.

[Ruth Cadbury]

Like many across the country, my constituent Greg has a family member with a brain tumour; in his case, it is his young nephew. The £40 million of funding is certainly welcome, but only £6 million of it has been delivered, and there are still difficulties for those trying to get grants for this urgently needed research. Will the Minister commit to taking a more proactive approach to this—for example, by ensuring that brain tumour experts sit on the grant panels for research bids?

[Jo Churchill]

I thank the hon. Lady and would like to extend my good wishes to Greg for this treatment. There has been £8.8 million committed so far based on the NIHR programme and academy spend. The important thing is the quality of the applications. Brain tumours are invidious, and we need to do more and we need to go faster. I will look at her suggestion, but I am aware that there are already experts sitting on the panel.

[James Daly (Bury North) (Con)]

What steps he is taking to tackle obesity among (a) adults and (b) children.

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

Helping people to achieve and maintain a healthy weight is one of the most important things we can do to improve our nation’s health. That is why we published our healthy weight strategy last summer. We are taking forward actions from previous chapters of the childhood obesity plan, as well as further measures to get the nation fit and healthy, protect against covid-19 and protect the NHS. Question 25 on the call list is grouped with Question 26.

[Mr Speaker]

Yes, but unfortunately Jonathan Gullis is not here. You managed to jump in before James Daly could speak. Not to worry. We will go to James Daly.

[James Daly]

Thank you, Mr Speaker. Encouraging an active lifestyle is a crucial part of tackling the obesity challenge that our country faces. Does my hon. Friend agree that local authorities, working with partner agencies, should invest in iconic community venues such as Gigg Lane in my constituency to house a wide range of public health services and provide inspirational settings for young people to take part in sport, no matter what their background or personal circumstances?

[Jo Churchill]

I agree wholeheartedly that we should encourage all children to make sure that they can take part in sports and enjoy the outdoors. Regular physical exercise is important for the health and wellbeing of young people, and the local community has an important role to play in developing facilities. That is why the Government launched a £150 million community ownership fund, to ensure that communities across the UK can benefit from the local facilities and amenities that are most important to them. That includes community-owned sports clubs and sporting and leisure facilities that are at risk of being lost without community intervention, and I urge my hon. Friend to work with his community to ensure that he has those facilities locally.

[Jim Shannon (Strangford) (DUP)]

What plans the Government have to ensure an adequate number of nurses in the cancer workforce to deliver the targets for cancer set out in the NHS long-term plan.

Early Years Healthy Development Review and The Best Start for Life: A Vision for the 1,001 Critical

Jo Churchill Excerpts

Thursday 25th March 2021 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

In summer 2020 the Prime Minister commissioned the early years healthy development review. Chaired by my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom), the review looks across the “1,001 critical days” from conception to the age of two, ensuring babies and young children in England can be given the best start in life.

The focus on these 1,001 critical days from pregnancy to the age of two is important. They are a unique period of time, when the foundations for an individual’s cognitive, emotional and physical development are developed and set. It is also a period of time when babies are at their most vulnerable and susceptible to, and influenced by, the environment around them.

It is for these reasons, and many more, that I am pleased to share the first publication from the early years healthy development review entitled: “The Best Start for Life: A Vision for the 1,001 Critical Days”.

This comes at a timely moment for our nation as we reflect on the impact of the coronavirus pandemic and begin to turn our focus on building back better. As we do this, we must place our youngest citizens at the centre of our ambition.

Our vision sets out an ambitious programme of work to transform how we support families across England throughout these 1,001 critical days. It sets out six action areas to ensure that families have access to the services they need, when they need them. We want to enable the parts of the system to work even better together to provide this support.

Action area 1: Seamless support for families. Our vision is for seamless support for families, with local areas encouraged to publish a start for life offer. The offer should explain clearly to parents and carers what services they are entitled to and how they can access them.

Action area 2: A welcoming hub for the family. All families need a welcoming space to access services. Our vision is that family hubs are a place for families to access start for life services.

Action area 3: The information families need when they need it. All families need to have access to trustworthy information at the times they most need it. This includes digital, virtual and telephone services designed around the needs of the family.

Action area 4: An empowered start for life workforce. Our vision is that every family will be supported by a range of professionals and volunteers, each of whom brings skills, knowledge and empathy to interactions with families. From their first appointment, every parent and carer must feel that they are heard and that they can ask for help.

Action area 5: Continually improving the start for life offer. We want every parent and carer to have confidence that the services and support in their area will help them give their baby the best start for life. A brilliant start for life offer will continuously improve with better data, evaluation, and proportionate inspection.

Action area 6: Leadership for change. Leadership is critical to the success of the vision. There must be local and national commitment and accountability.

This is just the beginning of our work, and the early years healthy development review will continue with a second phase where we will focus on the implementation and delivery of these six action areas.

[HCWS896]