Public Health

Lord Harper Excerpts

Monday 15th June 2020 Commons Chamber

[Jo Churchill]

I thank my hon. Friend for that. If he will allow me to go through what I wanted to say, I hope it will be clear why we have used that procedure.

The rapid and frequent amendments to the regulations have been critical to ensuring that the Government can respond to the threat from the pandemic and its impact. The use of the emergency procedure has enabled us to respond quickly, begin a cautious return to normality and reopen the economy as soon as possible. I recognise that there may be frustrations that we have had to run parliamentary process in parallel during these unprecedented times, but I believe that we have demonstrated the advantages of our flexible constitution. I wish to make it clear that these are extraordinary times and measures, and we are definitely not setting a precedent for how the Government engage with Parliament on other matters and in more usual times. I am very grateful to all hon. Members for their patience and continued support during these difficult times.

[Mr Mark Harper (Forest of Dean) (Con)]

May I just pick the Minister up on the point made by my hon. Friend the Member for Hazel Grove (Mr Wragg)? The thrust of the amendment No. 4 regulations—I accept, if you will give me a little latitude, Madam Deputy Speaker, that they are not the ones that we are debating, but I think the Minister referred to them in her remarks—was announced on Tuesday or Wednesday last week. I do not see what would have prevented a draft of those regulations being laid for debate on Thursday, so that the House could have taken a decision on them before they came into force. Would that not have been better, particularly because they are legally quite complicated in how family support structures are translated into law? That would have been better for our legislative process.

[Jo Churchill]

I thank my right hon. Friend for those remarks. I will certainly take that back and feed it in, because I know that he is not alone in feeling that we could improve the time sequencing slightly, in order that we get to a place where these matters are debated fully. I reiterate, however, that these are unprecedented times, and being able to debate complex differences between the timings needs to be thought about.

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[Jo Churchill]

It is my belief that they can stay over if they are within the guidelines of the social bubble—that is, if they are a single person. There are several distinct areas and I am happy to discuss them with my hon. Friend, or to write to him to clarify them. They are clearly laid out in the regulation of what is or is not applicable.

The Government continue to work on the process of gently easing restrictions as it is safe to do so, in line with the ambition set out in the road map. Working alongside scientists and experts, we must act swiftly to respond to current infection levels and our assessment of the five tests that have been set out previously. I am sure that we all support the aim to protect and restore livelihoods by only keeping in place restrictions that are proportionate and necessary. We of course remain ready to reimpose restrictions if the need emerges in the future, although we all hope that that will not be the case.

[Mr Harper]

I am grateful to my hon. Friend for giving way. In asking her a question, may I respond to my hon. Friend the Member for Broxbourne (Sir Charles Walker)? The reason for the confusion goes back to the point that I just made. My hon. Friend asked about what has been called the “bubbling” of households, the putting of households together, which was announced at one of the press conferences last week. It has been turned into legislation, which was laid before this House on Friday, but we are not yet debating it. So we are debating one set of amendments, but a new set has already come into force and the reason for the confusion is that we are not yet debating it. I think that rather proves my point that we should really have debated that legislation in advance of it coming into force. I hope that my hon. Friend’s confusion, and he is not a man easily confused, demonstrates the point about why that is important.

[Sir Charles Walker]

I thank my hon. Friend.

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[Mr Harper]

For the benefit of the House, I understand that that particular point about participation in legislative debates is currently being considered by the Procedure Committee. I think the Government have indicated that if the Procedure Committee can come up with a sensible way of including colleagues who need to participate remotely in legislative debate, that is something that the Government will look at favourably. I hope that is helpful to the House.

[Justin Madders]

I thank the former Chief Whip for his intervention. I would certainly welcome that development. I have not heard anything from the current Leader of the House to explain why we can take part remotely in some debates but not in others. I will not take any more interventions, because I know we are up against time.

Turning to the regulations themselves, they include, as the Minister outlined, some relaxations including the reopening of some outdoor retail as well as various outdoor sporting activities. They also make provision for elite athletes in anticipation of the return of professional sport, including the Premier League later this week. I am sure we are all looking forward to that, although anyone who has witnessed the Arsenal back four this season may consider the definition of an elite athlete to be a triumph of hope over reality.

It is not all one way, however, and for the first time, the regulations include a list of venues that must now close. I fail to see any logic, coherence or consistency in respect of the Government’s approach to these venues and, critically, there has been no impact assessment on those venues. The first set of regulations, despite their sweeping nature, had no impact assessment at all. We understand, of course, why that was not possible in the first instance, but we have made it clear that we do not want that to become the norm, because we know that the impact of these regulations will be huge. We are now on the third set of regulations, 12 weeks after the lockdown started, and we have still had no impact assessment. How can the Government continue to issue new laws with such sweeping powers when they cannot tell us what their impact is?

Is there a document the Minister can point us to that sets out the Government’s own assessment of whether they have met the five tests they set themselves for relaxing the lockdown? Certainly, there is concern that the threshold for relaxation has not yet been met. Only yesterday, the World Health Organisation expressed concern that we may be coming out of lockdown too early. According to a recent University of Oxford study on each country’s level of readiness for easing lockdown, we are now fourth from bottom in the entire world.

The questioning comes not just from outside bodies but the Government’s own joint biosecurity centre, which has not reduced the threat level—still level 4—and says very clearly that only when the threat reduces to level 3 can there be any relaxation of restrictions. I implore the Minister to set out exactly why the Government feel they can depart from the opinion of their own joint biosecurity centre.

All these concerns matter not only because of the enormous impact of the regulations but, frankly, because the Government appear to be winging it in respect of which regulations they choose to apply. Take the new category of venues to be closed in schedule 2—model villages, zoos, safari parks, aquariums and so on. Clearly, that was an oversight in the original regulations, but we have seen a rapid U-turn on parts of the regulations so that, as I understand it, zoos and safari parks are no longer required to close. How have the Government got themselves into such a mess that we are debating on the Floor of the House regulations that they do not fully support? How can it possibly be consistent with the rule of law for the Government to present us with regulations and say, “Actually, we’re going to pretend that bits of this are not there”? It is an absolute shambles. To preserve the rule of law, it is vital that people do not act outside the law, but how can we expect it to be enforced properly if the Government say that bits of the regulations do not need to be followed? The changes come to us late, without any assessment of their impact, and after some of them have been pulled. That does not inspire confidence that the Government are in control of the situation or following any kind of plan.

As we know, the WHO, the Association of Directors of Public Health and some of the Government’s own scientific advisers have said that the easing of lockdown should not occur until the testing and tracing system is proven to be more robust, but the reality is that the system is in chaos. The Government have not been able to publish the number of people tested each day for more than three weeks now. How can testing and tracing work properly if we do not know how many people are tested each day? A third set of data from the test and trace system shows that it needs a lot more work. Just over 8,000 people were tested, but only two thirds of them were contacted. Missing out a third is not what I would call an effective and robust system.

And what of the app? It seems that the world-leading, game-changing, virus-busting app is not as important as it once was. That is a fate that probably awaits us all in here, but the app has suffered a downgrade before it has even been launched. Last month, the Secretary of State said it would be crucial and that downloading the app would be a public duty. Now we are told that it is not vital; it is more of a cherry on the cake. Which is it? Will the Minister explain how it is safe to open non-essential retail if people who might come across someone who is infected cannot be traced because there is no working app in place?

The Government have been too slow on testing, too slow on social care, too slow on personal protective equipment, and too slow on the lockdown, and now it seems they are too slow on tracing. The Prime Minister promised a world-beating system by 1 June, but that date is long gone. Newspaper reports suggest that we may not get a fully operational system until September. When pressed in debate on the last set of regulations, the Minister could not give us a date when it will be ready.

This matters because the restrictions are being lifted now. The Government must demonstrate that they have got a grip of the testing and tracing strategy in order to restore public confidence in their handling of the pandemic and to ensure that we do not risk another catastrophic spike of infection that will lead to a second lockdown, with all the damage that will bring. The Government have taken the decision to lift the restrictions. It is for them to demonstrate that they are listening to the experts and publish the full scientific evidence behind the decisions that have been taken.

We want the Government to succeed and remain committed to working constructively with them, but that is a two-way street. I have now spoken three times on these regulations. On each occasion I have stressed the importance of the Government operating within the rule of law, following due process and providing us with a full evidence base supporting the decisions they take. On each occasion the Government have failed to listen to those concerns. They have failed to demonstrate that they are following the science, they have failed to show that they are assessing the impact of their decisions, and they have failed to show that they grasp the importance of accountability. This Parliament and this country deserve the full picture, so I hope next time we debate these issues we get just that.

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[Mr Mark Harper (Forest of Dean) (Con)]

It is a genuine pleasure to follow the hon. Member for Westmorland and Lonsdale (Tim Farron), because my area, like his, has a number of tourism and hospitality businesses. I have met a number of those businesses virtually, and they too will be waiting to see the guidance on how they are able to open their businesses in a way that is profitable and sustainable. They no doubt look forward to seeing that guidance.

I want to cover two things. The first is the process of how the Government make these regulations and the House debates them. The second is the amendment to regulation 7, on gatherings, and pertains specifically to an event proposed in my constituency.

My first point relates to one that I touched on in my interventions on the Minister and in response to my hon. Friend the Member for Broxbourne (Sir Charles Walker). I note that on social media, one of our colleagues has clipped my remarks and used them as an explainer for the rather complicated set of amendments that we are debating. I have not yet had a chance to look at it, because that would have been inappropriate and difficult in the Chamber, but I will see whether my explanation has clarified things.

It is worth reminding ourselves that this set of regulations are the biggest restrictions on the liberties of British people since the second world war, and potentially even including some of the wartime restrictions. The first set of regulations were made on 26 March and came into force immediately. They were clearly very significant, and they were made under the emergency provisions. Although the regulations were made under the Public Health (Control of Disease) Act 1984, the substance of them had been debated quite fully as part of the debate on the Coronavirus Bill, which got Royal Assent that week. To be fair, although the original regulations themselves had not been debated, the substance of them had been debated at length by the House as part of the passage of the Coronavirus Act 2020, so they were properly debated in the House. Since then, though, they have been amended by the different sets of amendment regulations—I shall not trouble the House by reading out all the titles.

I note that although the amendment No. 2 regulations were debated in a Delegated Legislation Committee, as the Minister said, they are going to be approved by the House only today—they are on the Order Paper—and we are now debating the coronavirus No. 3 regulations which, as set out in the exchanges, have in some cases already been superseded by the No. 4 regulations, which were laid before the House on Friday and in some cases came into force almost immediately afterwards, with some regulations coming into force on Saturday.

My hon. Friend the Member for Broxbourne put his finger on it when he noted that the regulations are actually quite complicated and not everybody will understand them in great detail, but because they are the law a breach of them is actually an offence. We are creating criminal offences here, and when we do that it is important that we let people know what the offence is and how they can make sure that they remain within the law. I suspect that if we were to do a survey among Members of Parliament, even they probably would not get all the regulations correct. They are quite difficult to follow, given that they start off with a set of regulations that is then amended over and over again. It is quite a challenge to work out what the current legal position is. Given that sanctions are involved, that is difficult.

If I were to explain to the public—who are, after all, the people we represent and the reason why we are here—why they should care about what might seem like a piece of esoteric processology, I would say that it is because we are debating laws that they have to live under and that place enormous restrictions on their liberty and how they live their lives and, as my hon. Friend the Member for Broxbourne said, have really quite significant impacts on their livelihoods, as was clearly illustrated by the hon. Member for Westmorland and Lonsdale when he recounted the impact on his local tourism sector, as there has been an impact on mine. The regulations include detailed provisions about what businesses can trade, how they can trade and how they can make money or not make money, so it is important that we debate them seriously.

It is worth my briefly going through how we have ended up with these regulations. As I said, the first set of regulations were in effect debated as part of the debate on the Coronavirus Bill. There were then some amendments that were largely minor and technical, so people could probably live with the fact that they were not debated in detail. The second set of amendments—those that are not being debated by the House today, because they were debated in Committee, but will, I suspect, be approved by the House today—contained some important changes and significantly increased the maximum penalty from £960 to £3,200. Admittedly, that is the maximum after a number of offences, but it is a significant penalty increase, and they have not yet—until this evening—been approved by the House. So far, that criminal offence or sanction has been imposed only by the stroke of a Minister’s pen, not by the approval of the House.

The amendment No. 3 regulations, which we are debating, contain some significant changes. They changed fundamentally the structure of the regulations from restrictions as to whether we could leave our homes and the reasons why we could do so towards in effect saying that we could leave our homes whenever we liked but just could not stay away overnight. That is a significant change in the way the regulations are structured and, again, that has not been properly debated by the House until today.

The other significant change in the regulations was that they altered the rules about gatherings. Originally, more than two people were not allowed to meet in a public place. These regulations change the rules on gatherings to cover both public and private places and put a restriction on gatherings to be of no more than six. I will come onto that a little later in my remarks, because it is relevant to my particular constituency case.

The final thing that these regulations do that I want to focus on—the Minister touched on this in her remarks—is to extend the review period from 21 days to 28 days. I am not sure I quite follow the logic that the Minister set out, because I was happy with the shorter period on the basis that the regulations are very significant restrictions on liberty, and therefore I think reviewing them more frequently is better. On the Minister’s point that the length of time for the review has been extended to allow changes to come into force and an assessment to be made of the impact of those changes on, presumably, the R number and the level of infections before we make another set of changes, I understand the logic behind that, but that does not really seem to be exactly what we are doing. The review period as set out in the regulations is 25 June, which is nine days before the point in the Government’s plan at which we will potentially open up the leisure, tourism and hospitality sectors. That nine-day gap will not leave people a lot of time to prepare, because 25 June is only 10 days after the very significant and welcome changes to open up the non-essential retail sector, which have only taken place today.

If those changes today were to have an adverse impact on the spread of the virus— I do not think they will, because businesses are operating in a covid-secure way—we probably would not know about that in 10 days’ time because of the period that the virus takes to show up and feed through into the data. So we would not be in a position on 25 June to know whether the changes that have taken place today have had any impact. We would not know, therefore, when we were potentially going to announce the opening up of the hospitality, leisure and tourism sectors, whether the changes today have had any impact or not, and whether we need to make a course correction. I am not sure that the extension of 21 days to 28 days for the review period makes a lot of sense, because we are not debating the regulations at the time when they come into force or ahead of that, so the timetables are completely out of kilter.

My final point before I come to the specifics of the regulations is on the amendment (No. 4) regulations, which deal with linked households. I will touch on them only briefly, because they are not the regulations we are debating today. I have read those regulations, and they are quite complicated. There is such a level of detail about family structures and the rules on which households can link to other households means, and I am not really sure that trying to put that level of detail into the law makes a lot of sense. That is both because it is complicated—I am not sure how anybody makes head or tail of it—and because realistically I cannot see how anyone can practically enforce the regulations. I do not see how a police officer, without carrying out the most extraordinary amount of surveillance, can possibly know whether various households are appropriately linking to each other, particularly if one of the households has multiple adults in it.

We may have reached the point where the Government should think—particularly because there has been such high compliance with even the parts of the rules that are guidance only—about whether we want to set out our thinking, publish the advice and guidance to people, and allow them to implement it themselves without having legal sanction underpinning it.

These regulations expire at the back end of September anyway. It may be worth the Minister saying what the Government are doing: whether they are going to keep the legal framework in place until then, or whether, at an earlier point, there may be some sense in moving to a model where we deal with this through guidance and advice, not the power of the criminal law. That would be a tribute to the British people. They have largely followed the rules very, very fully and the evidence is that they can be trusted to follow the guidance pretty comprehensively, even if it is only guidance and not backed by criminal sanction.

On the specifics in the regulations we are debating today—this is my final point, Madam Deputy Speaker—regulation 7 makes it very clear that a gathering of more than six people outdoors is unlawful and that somebody attending such a gathering is committing an offence. I mention that because there is a proposal in my constituency to hold a demonstration this coming weekend on the subject of black lives matter. Now, I am very firm in my view that I abhor racism of any kind. In normal circumstances, I would welcome people demonstrating that they, too, were against racism of any kind. I hear people say we have a right to protest in this country, and normally we do. However, under the regulations, which I suspect the House will approve this evening, we actually do not have a right to protest if there are more than six people—it is an offence. The Home Secretary made it very clear that it is an offence. She was very clear, in her exhortations this past weekend, that people should not come to London and should not protest, because the regulations are in force because we are trying to deal with a pandemic.

That is very much the view of most of my constituents about this particular demonstration. My own view is that I would welcome such a demonstration to take place in the future when the coronavirus regulations are no longer in force and we are no longer trying to deal with the pandemic, but it would be an offence at the moment. There is a decision taking place this evening. The local trust that runs the recreation centre is having to make a decision about whether to approve the demonstration. I have been very clear that people attending the protest would be committing a criminal offence, which is punishable by a fine, and it should not take place. If it were to take place, my advice to people would be not to turn up but to express their views in other ways—there are plenty of ways that people can express their views on social media and so forth—and to hold over a protest until it is lawful.

In any other circumstance, if a Minister proposed abolishing the right to protest, people would be outraged. We would think that this House would absolutely have to vote, debate and decide on such a provision, but that right to protest was effectively extinguished by the stroke of a Minister’s pen and has been significantly changed in the regulations again by the stroke of a Minister’s pen. It is only today that the House will take a decision. I would say to Ministers that it is in their interests to bring the measures to the House, have them debated and then have the House give its backing, so that it is Parliament that has approved them and not just them. Until the regulations are approved, the ban on protests is purely on the basis of the signature of the Secretary of State for Health, as the Minister said. I am sure that he does not really want to have all to himself the fact that he personally has abolished the right to protest in England. That is actually what he has done without the sanction, yet, of this House, because the regulations have not yet been approved.

[Craig Mackinlay]

As ever, my right hon. Friend is making a forensic analysis, particularly of the timeline, to which I think we will all refer over the days ahead. He makes the very good point that we are considering regulations that are backed up by criminal records and fines, and that we are doing that rather rapidly and belatedly. Would he hazard a guess as to how many people will actually be fined for having a barbecue with seven people next week, when they see that there will be no fines or sanctions for big gatherings of people who are passionate about what they stand for? I wonder if he might hazard a guess.

[Mr Harper]

My hon. Friend has a point. The reason why I have been clear in the view that I have expressed in my constituency about these protests is that I fundamentally believe that we live in a country governed by the rule of law, and one thing about the rule of law is that it applies to everybody in the country. Of course, one of the arguments that many of the people attending these protests are making is that they want everyone in our country, whatever their race, to be treated equally under the law. We already have laws in this country that protect the way people are treated and guarantee, under equality legislation, that we treat people of different races the same. It is difficult for someone to argue that they want the law to be applied to protect people of different races and guarantee their rights if, at the same time, that person is conducting a protest that in itself breaks the law. It is not a very consistent position to have.

[Sir Charles Walker]

I understand the point that my right hon. Friend is making, and it is very important that people act safely, but I find it rather wonderful that people in this country believe that the right to protest belongs to them and not Ministers. Whatever the rights and wrongs of protesting while there is a lockdown, looking ahead to the strength of the democratic right in this country, the fact that people believe the right to protest belongs to them and not Ministers should, in future, give us all hope for our democracy.

[Mr Harper]

I broadly agree with that sentiment, but I have a concern, for this reason. I think that we live in a country governed by law and I want the law to be respected, so the difficulty, if we get large-scale of breaches of that law—particularly if there is no sanction—is that all the millions of people in our country who, as my hon. Friend the Member for South Thanet (Craig Mackinlay) said, have been faithfully obeying the law, following the rules, not meeting members of their family and putting themselves through considerable hardship and difficulty then think it has all been rather pointless, and they do not quite understand why there appears to be a different set of standards. That is why it is important, if we are going to make rules such as this, that they apply to everybody, and that is very much the sentiment in my constituency. It is also important because if these things are the law, they are presumably the law because Ministers have determined, on advice from the chief medical officer and the chief scientific adviser, that allowing these gatherings would allow the virus to spread more widely than it would otherwise. In that case, allowing such protests to take place is going to put people’s lives at risk.

I am very fortunate that in my constituency we have had a relatively low incidence of coronavirus and a relatively low number of people have died, although every death is, for the family and friends of that individual, a tragedy. The incidence has been relatively low and I do not want to see that change, which is why I think it is important that we obey these rules.

In conclusion, although I support the regulations—I am certainly very happy to support them this evening—the Government need to think about the way they bring these sets of regulations in front of the House, the way they are debated and the way they are explained to people. They also need to look, over the coming days and weeks—as we hopefully are able to continually ease the restrictions—at the point at which it makes sense to move from the law and a legislative underpinning of these rules to advice, guidance and trust in the very good sense of the British people to follow the rules and continue driving the virus out of our community, so that we can all get back as close to normal life as possible until we develop a vaccine or a treatment.

Public Health

Lord Harper Excerpts

Monday 4th May 2020 Commons Chamber

[Mr Mark Harper (Forest of Dean) (Con) [V]]

It is a great pleasure to follow my hon. Friend the Member for Witney (Robert Courts) and relatively close geographic neighbour, because what I want to stay chimes with the sentiments that he has just set out. I fully support the regulations in front of the House, but it is worth emphasising what an enormous restriction on our liberty they are—the greatest restriction on our liberty that there has been in British history. That restriction is there for a very good reason, but in a democratic country such as ours, where we have to have consent, it is the Government’s task each time they bring forward such regulations to remake the case as to why we are doing it. It is also worth saying that with each of the review periods, it is not for others to justify the regulations going away; the Government must rejustify why they have to remain in place so we do not consider that they become the new norm.

In that spirit, and I hope that the Minister will address this when he winds up, I request that before any changes to these regulations come into force —indeed, there has already been one set of amendments—any amended regulations are brought forward and debated and decided on by the House. I understand why that did not take place when the regulations were first brought in, but any subsequent amendments should be debated by the House. I was pleased that the Opposition have taken that view. I would prefer the process to remain consensual, but it will only if the Government behave in that way. Scrutiny is important because, as we have already seen with the current regulations, there has been confusion and debate about the guidance that the Government set out and the meaning of the regulations—that is, the law and what has therefore been interpreted by the police.

The Prime Minister confirmed last week, when he addressed the nation on his return to Downing Street, that he was in favour of the greatest transparency as we debate these measures. I therefore say to the Minister that it was disappointing that the seven documents that have been created to set out safe ways of working—the guidance for employers—have reached the public domain, whether that was through leaks or briefing. I think that those documents should have been published by the Government. They could have been published in draft form for discussion. That would have been a better way of conducting the debate than to have those documents reach the public in the way that they have. If we want to take the public with us, the more open and transparent we are about the trade-offs and the difficult decisions that we have to take, the better.





The final point that I want to make is about this House. When I spoke in the House last week, I said that we should pay great tribute to Mr Speaker, the House staff and those who have supported the ability to get the House up and running in this virtual way. It is clearly better to have the House back in virtual form than not at all, but we do lose something. Ministers are not under the same pressure or same level of scrutiny that they are when we are in the Chamber—[Interruption.] I can see that the Minister is laughing in his seat. The sooner that we can work out ways to enable the House to function with more of us physically present, albeit in a more socially distant way, the better. I urge the Government to consider ways in which we can do that.

The Prime Minister has set a decision point this week: for the regulations that we are debating today to be considered, and for the Government to take decisions about whether they wish to continue with them in force or to make changes. Either decision—keeping them in force unchanged, or making changes—is very significant, and has an impact on everyone in the country and on businesses around the country. I think that that statement should be made in Parliament so that Members of Parliament can ask questions, not our own behalf, but on behalf of all those whom we represent. I hope that the Government will bear that in mind when they are making those decisions.

Covid-19 Update

Lord Harper Excerpts

Tuesday 24th March 2020 Commons Chamber

[Matt Hancock]

Yes, it is acceptable. It is right that volunteers in that sort of work, for example Samaritans, should travel to do it.

[Mr Mark Harper (Forest of Dean) (Con)]

The Secretary of State will know that, following the Prime Minister’s statement yesterday, all tourism and leisure providers have closed. I commend those in my constituency that closed before the advice was given, in order to protect people. However, those who take lots of deposits are obviously being pressed by our constituents to return that money, and that may put them in financial distress, but equally our constituents need the money back given their financial circumstances. I accept that the Secretary of State may not have an answer for me now, but will he at least commit to take the issue away and see whether an answer is forthcoming, perhaps with the support of the Treasury?

[Matt Hancock]

Yes, I will get my right hon. Friend an answer from the Department for Business, Energy and Industrial Strategy.

Coronavirus

Lord Harper Excerpts

Tuesday 3rd March 2020 Commons Chamber

[Mr Mark Harper (Forest of Dean) (Con)]

The Secretary of State will know there are two confirmed cases in Gloucestershire, and I put on record my thanks to the public health professionals who have dealt with those cases in a professional, calm and considered manner.

My specific question is about the action the Department for Work and Pensions will take for those members of the public who, whether because of business downturn or because of self-isolation, have to access the benefits system. Will frontline DWP staff and systems accommodate the fact that self-isolation, as the Secretary of State says, should be treated as an illness and that no inappropriate sanctions should be applied?

[Matt Hancock]

We are absolutely clear that that is the rule, and I frequently talk to the Secretary of State for Work and Pensions about this matter.

Health and Social Care

Lord Harper Excerpts

Thursday 16th January 2020 Commons Chamber

[Sir Desmond Swayne]

rose—

[Mr Mark Harper (Forest of Dean) (Con)]

rose—

[Jonathan Ashworth]

I give way first to the right hon. Member for New Forest West (Sir Desmond Swayne) and then I will make some progress because I know that many Members want to speak.

[Jonathan Ashworth]

We have long argued for a cap on care costs, but of course the Government, as the right hon. Gentleman says, dropped their support for this policy.

On the issue of social care, the Prime Minister said at the Dispatch Box yesterday that he wanted cross-party talks, although in his BBC interview the day before he said that he had a plan that he would bring forward in the next 12 months. The Government want a consensus. I say to the Government that the Labour party has proposed free personal care. We have a version of free personal care in Scotland. There is a similar version of it in Northern Ireland. There is a version of it in Wales. The House of Lords Economic Affairs Committee, which includes Thatcherites such as Michael Forsyth and Norman Lamont, alongside the former Labour Chancellor, Alistair Darling, has proposed free personal social care. There already is a political consensus. It is the Secretary of State and the Prime Minister who stand outside that consensus. If the Secretary of State wants to engage with us on that basis, then my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) is happy to do so. I will now take the intervention from the former Chief Whip.

[Mr Harper]

Given that the hon. Gentleman’s party is undergoing a leadership election and that will clearly mean—[Interruption.] No, I am trying to say this helpfully. If the Secretary of State has made a commitment to start the process of cross-party talks within the next 100 days, that will obviously be before that leadership election is concluded. So my serious point is that if we wish to engage on a cross-party basis on whether to implement the Dilnot proposals, as my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) mentioned, or on the basis that the hon. Gentleman just said, is he in a position to start that engagement with the support of his current party leader so that we can make progress urgently? The social care problems in the country are not going to wait, frankly, for another Leader of the Opposition to be elected. That is meant as a really serious and cross-party point.

[Jonathan Ashworth]

It is a serious point, and I am grateful for the way in which the right hon. Gentleman has put it. Of course, we are very happy to engage. My hon. Friend the Member for Worsley and Eccles South, who sits in the shadow Cabinet and leads on social care, is happy to sit down with Ministers at any point.

I am suggesting to the Secretary of State, rather gently, that there is a degree of political consensus on free adult personal social care. The House of Lords Committee, which includes Michael Forsyth and Norman Lamont, not socialists red in tooth and claw by any means, alongside Alistair Darling, has proposed it. We, as a Front-Bench team, have proposed it. There are forms of it in some of the devolved nations. It is the Secretary of State who is standing outside that consensus. If he wants to engage with us on those terms, and on the point about a cap as proposed by Dilnot, then of course we are prepared to have those levels of engagement.

There is also a degree of consensus around the need for better integration between health and social care, and better co-ordination of health and social care. That is why we are intrigued by the Secretary of State’s proposal to consult on the NHS Funding Bill.

--- Later in debate ---

[Matt Hancock]

The cash boost that we are giving now is bigger. I think today is the anniversary of Prime Minister Tony Blair sitting on the couch of a TV show, talking about increasing funding for the NHS, which was opposed by Gordon Brown, who was Chancellor of the Exchequer at the time. We will not take any lectures.

I am thrilled that the public comprehensively rejected the Labour party’s baseless scaremongering, which was repeated through the election campaign and worried some of the most vulnerable people who rely on our NHS. I lost count of the number of times I had to debunk some politicised nonsense put about by the Opposition across the country because they had nothing positive to say. The hon. Member for Leicester South was at it again yesterday and in his speech. He said that the settlement in the NHS Funding Bill is a cap, although clause 1 states that it is a minimum. Clause 1(1) states:

“In making an allotment to the health service in England for each financial year…the Secretary of State must allot an amount that is at least the amount specified”.

Did the hon. Gentleman even read the Bill? Did he get to clause 1? I am not sure he bothered reading it.

Let us look specifically at the amendment. It calls for reform of social care and for the Government to bring forward a plan, and that is precisely what the Queen’s Speech provides for. It also calls for additional funding for the NHS, which is what we are legislating for. The long-term plan is fully funded by the largest cash injection in the history of the NHS, and I urge Members across the House to support it fully. We can only fund the NHS with a strong economy, and that is exactly what we will do.

[Mr Harper]

The Secretary of State will have heard my earlier exchanges with the shadow Secretary of State, which I hope were helpful. He will be aware that more than half the budget for adult social care in England is spent not on older people but on those of working age, as we try to enable people to be more independent and to work. Will he confirm that the social care plan that he plans to discuss with other parties, and which he will bring forward this year as the Prime Minister committed to do, will cover older people and those of working age, and will probably entail different solutions for those two groups?

[Matt Hancock]

The proposals that we are working on include solutions for the provision of social care for older and retired people as they decline in the later years of their lives, and for people of working age. Part of the point about consensus building is that we must be open to options and look right across the piece. It was a disappointment that the Labour party proposals that came out in the autumn only covered older people and not working-age adults, and that point must be addressed. I hope we can do that in a spirit of cross-party discussion, and that those on the Opposition Front Bench will engage positively with that. We will engage right across the House when trying to bring forward a solution.

Learning Disabilities Mortality Review

Lord Harper Excerpts

Wednesday 15th May 2019 Commons Chamber

[Caroline Dinenage]

This is not a mess; the Department of Health and Social Care requested that NHS England commission the whole LeDeR programme. The report is an independent document, which is very important because we are talking about people’s lives and about deaths that could have been prevented. It is really important that the work is done by an independent group and that it is carefully scrutinised, and that that scrutiny and work to look at the recommendations—[Interruption.] If the shadow Minister would like to bob up and ask some questions, I will happily answer them, but if she is going to keep murmuring from a sedentary position, I will not be able to address anything that she says.

It is so important to do this process in an independent way, because we are talking about people’s lives. NHS England says that the LeDeR report has not been published yet because it contains some serious recommendations, as have other such reports, and NHS England needs to make sure that the correct people will be responsible for implementing those recommendations and that the document can be scrutinised in the correct way before it is published. I understand that the shadow Minister is always keen to get things published as quickly as possible, and not always with the benefit of their being done as thoroughly as possible, but in this case we will not be pushed. This is an independent document and I cannot control when it will be published, but the shadow Minister can rest assured that when it is published, I will be happy to answer any questions that arise from it.

Members will feel, as I do, that recent press reports are a clear indication that we need to do more on this, and I assure the House that we recognise that. The LeDeR programme confirms how seriously we take the issue of premature mortality and differences in life expectancy. We will continue to work with partners across Government and throughout the health and social care system to consider any recommendations that improve care for people with learning disabilities and autism and address the shameful inequalities that they experience. Everybody has a right to expect effective, compassionate and dignified care. If someone has a learning disability, their expectations should be no different.

I have already stated that I do not intend to comment on the specifics of the leaked bits of the document, which is independent and has not yet been published. However, like other Members, I am particularly concerned about any suggestion that doctors have recorded learning disability or Down’s syndrome as the reason for a “do not attempt cardio-pulmonary resuscitation” order—a DNACPR, as they call it. People with a learning disability have exactly the same right to enjoy a meaningful life as everyone else, and their disability should never, ever be used as an acceptable reason for a “do not resuscitate” order. We are taking immediate steps to ensure that doctors are reminded of their responsibilities and avoid any form of discrimination. [Interruption.] The shadow Minister says from a sedentary position that doctors should not need reminding. That is the whole point of commissioning the LeDeR review. Sometimes there are systematic or cultural ways of going about things in everyday life, whether in the medical profession or anywhere else, that mean people are not treated with the dignity and respect that they deserve. The whole point of the LeDeR review is to learn from every single preventable death and to make sure that no one else suffers in the same way.

The LeDeR programme published its second annual report in May 2018, and the Government’s response, which we published in September 2018, set out a range of actions for the Department of Health and Social Care, NHS England and other national partners to help to reduce premature mortality and improve outcomes for people with learning disabilities. Many of those actions have now been completed—for example, we recently closed our consultation exercise on plans to introduce mandatory training in learning disability and autism awareness for health and care staff, and we will set out plans to move forward on that later in the year.

The latest report will no doubt reinforce what we already know: that the Government and our health and care system need to do more to ensure that people with a learning disability receive good-quality, informed and safe care. There has been a significant improvement—there has been a tenfold increase in the number of LeDeR review cases that have been covered, the backlog has improved, and in 2018-19 NHS England invested an additional £1.4 million to support the local teams to accelerate the process, as well as to train 2,100 experts to carry out reviews. The process is new, but we are pushing forward and putting in the necessary resources to make sure that we deliver on time. The LeDeR programme is there to help to achieve what we have set out, which is to make sure that those with a learning disability should never expect to receive worse health outcomes. We will respond to the full version of the report as soon as it is published.

[Mr Mark Harper (Forest of Dean) (Con)]

I share the concern of the hon. Member for Worsley and Eccles South (Barbara Keeley) and the Minister about the fact that it appears that at least 19 patients had “do not resuscitate” orders specifically because of their learning disabilities. I welcome the fact that the Minister has made it clear that there will be an immediate notice to remind clinicians that that should never be a reason to not resuscitate a patient. May I ask her to go further, though? My understanding is that doctors should make “do not resuscitate” decisions only after a full discussion with their patient. It appears that, in these cases—without wishing to prejudge them—a doctor has made that decision without having had that discussion. Will the Minister also make it clear in her communication that the assumption should be that someone with a learning disability is just as capable of making these difficult decisions as everyone else? Their lives are worth as much as everyone else’s. That should be the assumption of everybody working in the national health service.

Learning Disabilities Mortality Review

Lord Harper Excerpts

Tuesday 8th May 2018 Commons Chamber

[Caroline Dinenage]

It is sad that the hon. Gentleman has sought to politicise this issue. It is nothing to do with funding cuts or cost-saving measures. We have actually invested more money into this programme. We are the first Government in the world to publish a learning from deaths programme so that healthcare trusts are held accountable and have to publish their data on people who die unnecessarily in their care. Making short-sighted party political points is therefore very unfair and does not get to the heart of the issue, which is about supporting people with learning disabilities and making sure that their health outcomes are the same as those of the population as a whole.

[Mr Mark Harper (Forest of Dean) (Con)]

The all-party parliamentary group on learning disability, which I have the honour to chair, will be looking at this area of policy later this year. Mencap, which provides the group’s secretariat, has a Treat Me Well campaign, which is about improving the position, and I know it is keen to work with the NHS. Drawing on some of the other questions, may I ask the Minister what she can do to get the NHS and all the providers to act with a real sense of urgency in making improvements in this regard with the speed that we would like?

[Caroline Dinenage]

My right hon. Friend is right to raise the Mencap report, because in many cases it reflects the recommendations that have been put forward in this particular report. The mandate to NHS England requires a reduction in the health gap between people with mental health problems, learning disabilities and autism and the population as a whole, and requests support for them to live full, healthy and independent lives. That is something that NHS England has a mandate to deliver, and we of course support it in doing that.

Breast Cancer Screening

Lord Harper Excerpts

Wednesday 2nd May 2018 Commons Chamber

[Mr Hunt]

I thank the hon. Lady for her comments. We have many other occasions to have a broader discussion about resourcing of the NHS, but I recognise what she says: in the specific situation we are in now, with the people who will need additional scans and additional treatments over and above what the NHS would have otherwise done, we will need to find additional resources to make sure others are not disadvantaged.

[Mr Mark Harper (Forest of Dean) (Con)]

May I add my words of support to the Secretary of State for the way he has approached this issue, and to Opposition Members for their approach too?

On the scope of the independent review, will it look at other screening programmes? It might be the case that this particular issue is not replicated, but I think people will want assurances about other screening programmes. Also, as the NHS looks to use IT as a powerful way to combat illness and disease, will the Secretary of State make sure that appropriate checks are in place so that there are proper assurances in the system and these kinds of problems do not arise in the future?

[Mr Hunt]

My right hon. Friend is absolutely right, and I assure him that the review being done by Lynda Thomas, one of the most senior cancer campaigners in the country, and Professor Gore, one of the most senior oncologists in the country, will look at what lessons can be learned for the entire cancer programme, and not just at the specific issue of why this particular IT problem occurred.

Oral Answers to Questions

Lord Harper Excerpts

Tuesday 20th March 2018 Commons Chamber

[Caroline Dinenage]

The hon. Gentleman is right to say that the integration of health and social care is vital, and I think that the renaming of the Department is a symbol of how seriously the Government take our commitment to it. I am keen to talk to him about funding, given that the figures for Liverpool show that it is raising £7.4 million from the social care precept and has received approximately £21 million in grant from the Government.

[Mr Mark Harper (Forest of Dean) (Con)]

I agree that the social care system needs more funds. In recent Budgets, the Chancellor of the Exchequer has found those funds and put them into the system. May I urge my hon. Friend, as she looks at the Government’s proposals in the Green Paper, to ensure that the Dilnot proposals are included? Those proposals, for which we have already legislated, will give us the best chance of a sustainable system in the current Parliament.

[Caroline Dinenage]

The Secretary of State was with Andrew Dilnot yesterday, and we are looking carefully at his proposals. My right hon. Friend is right: although 81% of adult social care providers are registered as good or outstanding, it is unacceptable for levels of care to fall below the standards that we would expect, and in preparing the Green Paper, we will look closely at how we can improve the system.

Oral Answers to Questions

Lord Harper Excerpts

Tuesday 6th February 2018 Commons Chamber

[Mr Hunt]

Public money is public money, and Members have a right to know how it is being spent, so we will absolutely ensure that those contracts are signed in a fair way.

[Mr Mark Harper (Forest of Dean) (Con)]

As the Secretary of State carries out his social care funding review, I urge him to look carefully at whether we should look again at implementing the Dilnot commission’s proposals. Given that we legislated for them, they are the only way that we are going to tackle the issue with the sufficient urgency.

[Mr Hunt]

At the heart of the Dilnot proposals was the idea of risk pooling—that there is a randomness in the illnesses that affect us in the later years of our life that we would want, as a society, to do something about. I will confirm what the Prime Minister said in the election campaign: we will consult on a cap on social care costs.