Health and Care Bill

Martyn Day Excerpts

Consideration of Lords amendments
Monday 25th April 2022 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call the SNP spokesperson.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I will be brief, Madam Deputy Speaker.

Operational procurement is a devolved matter but, given our interest in trade policies, we welcome the progress on procurement to ensure that healthcare supply chains are not linked to modern slavery and human trafficking. We support UK Government amendment 48A in lieu of Lords amendment 48, and we also support Lords amendment 48B in lieu. It is perhaps worth reflecting on the fact that in Scotland half of all PPE is now produced locally and that the overall costs of pandemic procurement were a third less than those of the UK. Such measures can, then, be cost-effective and help to safeguard against global supply chain issues.

[Matt Hancock (West Suffolk) (Con)]

I rise to support the compromise measure on reconfigurations and to ask the Government to take forward the work on UK-wide statistics with vigour and gusto.

First, on reconfigurations, it is right and reasonable that the largest organisation in the country, which is funded by taxpayers through the taxes that every single citizen pays, should be accountable to Ministers who are in turn accountable to this House. Although that principle has been accepted in the Bill across the board and in general terms, the other place has decided that it should not apply in the specific circumstances of reconfigurations. It is vital that when a reconfiguration happens, not only the clinical voices but the voice of the local community should be heard. The two need to go together. The best way to make happen any reconfiguration that is needed on clinical grounds is to engage the local community and get it onside. If we are to save lives through a reconfiguration, we can win the argument, but only if we engage and make the argument. In my experience, too often a reconfiguration was put on the table, perhaps for good clinical reasons but without enough local engagement, and in practice the process just ran into the sand.

I welcome the six-month delay—I hope the Secretary of State will work quicker than six months most of the time, but it is a good backstop; I welcome the de minimis threshold, because relatively small reconfigurations happen all the time; and I welcome the removal of some of the bureaucracy in the amendment. To my hon. Friend the Minister, who has done a magnificent job on the Bill right from the start, before it even came to this House—I thank all his officials for their service—I say: let us take this compromise but say clearly to the other place, “Thus far and no further.” The principle of democratic responsibility for the NHS and for winning the argument with the public about its local design is at the heart of the Bill and it must stand.

In the final minute I have in which to speak, let me make a point about statistics. Those on the Treasury Bench have decided not to include in the Bill measures on the UK-wide measurement of health services and on the interoperability of data in the four nations of the UK, but I put on the record the importance—I hope the Minister reiterates this—of getting UK-wide measurements. In Wales, it was decided to discontinue the measurement of some aspects, especially in respect of A&E performance. A suspicion was raised—I am sure this could not possibly have been true—that those measurements were discontinued so that unfavourable comparisons with England could no longer be made. If that were true, it would be an outrage. I very much hope that it is not, but we should put it right anyway and measure NHS service delivery throughout the UK on the same basis, so that comparisons can be made, so that we can learn about and improve services across all four nations, and so that accountability can properly apply to the four different Governments who run the four parts of the one NHS, which operates across this United Kingdom.

Oral Answers to Questions

Martyn Day Excerpts

Tuesday 19th April 2022 Commons Chamber

[Mr Speaker]

I call the SNP spokesperson, Martyn Day.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

Thank you, Mr Speaker.

Integration and service improvement cannot be delivered without sufficient staff, and the only way to attract people to a career in social care is by valuing them. In Scotland, they are already paid better than those in England and Wales, and through the national care service the Scottish Government will improve terms and conditions for care workers, through the introduction of national pay bargaining. Have the UK Government considered following the Scottish Government’s approach and commitments?

[Sajid Javid]

Integration between the NHS and social care requires the right level and quality of workforce, both in the NHS and in adult social care. In the NHS in England, we have more doctors and nurses—more people working than ever before. In adult social care, we are recruiting at high levels, not least because of the huge recruitment campaign we ran with the sector, and some of the other changes we made, including the £400 million- plus of retention funding over the winter period. In addition, the support for the workforce more generally is making a real difference.

--- Later in debate ---

[Mr Speaker]

I call the SNP spokesperson.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

The Scottish Government have recently bought Carrick Glen, a private healthcare hospital, in order for it to become part of the national network of treatment centres, which once fully operational will have capacity for over 40,000 additional surgeries and procedures each year. In contrast, the UK Government have taken the path of further privatisation of the NHS, so what recent assessment has the Minister made of the impact on the workforce of further privatisation of NHS England?

[Edward Argar]

I am grateful to the hon. Gentleman, and had we been going further down the route of privatisation, his question might have had a little more resonance. What we are doing in the NHS in England is investing in our workforce and investing in our national health service, while of course working closely with the independent sector to maximise the use of its capacity in parallel to make sure we bring down waiting lists and waiting times.

Health and Care Bill

Martyn Day Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Fiona Bruce]

Yes; the organisation Right to Life, which is the secretariat to the all-party parliamentary pro-life group, has collated such data. Freedom of information data analysis also shows that one in 17 women taking abortion pills requires hospital treatment. That means that more than 14,000 women have been treated in hospital following the approval of pills-by-post abortion. A similar study of FOI data in February 2021 showed that every month, 495 women attended hospital with complications arising from abortion pills, and that 365 of them required hospital treatment. Thirty-six women every month are making 999 calls—that is more than one a day—seeking medical assistance because they are concerned about complications arising from taking abortion pills.

Women, especially vulnerable women, deserve the care and attention given in an in-person meeting with an experienced clinician before making such an important decision. Indeed, 74% of GPs have indicated concerns about women finding it distressing to terminate a pregnancy themselves at home. More than 600 medics signed an open letter to the Prime Minister in May 2021 calling for an end to pills-by-post abortion, and a clear majority—70%—of the respondents to the Government’s consultation on this subject said that the temporary measure of pills-by-post abortion should end.

However, whatever one’s views on abortion, the Government very recently made a decision to cease the authorisation of these pills from August this year, due to this being a temporary covid provision that was never intended to outlast the covid pandemic period. The Government—our Health Ministers—have made an informed, carefully considered, evidence-based decision. We should respect that, but once more, those pressing for an even more easily available abortion regime in this country are not willing to accept it. Instead, they are seeking to make a serious change to the law through an amendment, as is frequently their practice. That gives us far too little time to debate such fundamental issues. There is too little opportunity for us parliamentarians to scrutinise this serious issue, which is literally a matter of life and death. Whatever our views on abortion, that is simply wrong. I urge colleagues to vote against this proposal to make at-home abortion pills permanently available.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I come to this Bill rather late, so I pay tribute to my hon. Friend the Member for Central Ayrshire (Dr Whitford), who did most of the heavy lifting on it for the SNP. I have turned up for the fag end of the process. I hope the House will oblige me by listening to a few general comments before I address the Lords amendments.

Overall, this Bill is a missed opportunity for England to go back to a unified service, similar to the one we have in Scotland. Whatever system we have, I am sure each of us on these islands would wish to extend our gratitude and thanks to the staff who delivered such a focused patient care service in difficult times, throughout the pandemic. I also acknowledge the Government’s progress on recognising the need for consent from the devolved nations; that should have been included in the Bill from the get-go. Still, better late than never.

As we know, health is mainly a devolved matter. Following discussions with the UK Government, the Scottish Government were able to bring forward a legislative consent motion in December, further to which, in the light of securing acceptable amendments, the Scottish Government recommended consent to the Secretary of State’s power to transfer or delegate functions under clauses 88 to 94.

The UK Government made amendments to introduce two new clauses to the Bill—on hymenoplasty offences in Scotland, and on information about payments, et cetera, to persons in the healthcare sector—that also require legislative consent. The Scottish Government are content to recommend that the Scottish Parliament grants that consent.

In summary, the SNP supports Lords amendments 66 and 109 on the Health Services Safety Investigations Body to protect safe spaces and reduce any future harm to patients. These amendments largely rehash some of the amendments we tabled at previous stages, and I welcome the Government’s acceptance of the Lords amendment to remove coroners’ access in this regard.

A key health driver on which we can make a big difference is encouraging people to stop smoking, which is one of the best things people can do at any time of life. We support Lords amendments 85 to 88 on a tobacco products statutory scheme for the regulation of the prices and profits of tobacco manufacturers and importers, and they would require the Secretary of State to carry out a consultation on the scheme.

Although I understand that the Minister does not wish to prejudge the options for England’s tobacco control plan, we should remember that these would be UK-wide measures, and public health and smoking cessation are devolved to Scotland. The Scottish Government’s programme for government committed to a refreshed tobacco action plan built on the pillars of prevention, protection and cessation to achieve their target of lowering Scotland’s smoking rate to 5% or lower by 2034, which would put tobacco out of sight and out of mind for future generations. These Lords amendments, particularly on the “polluter pays” charge, would be beneficial in that regard, and Scotland’s progress should not be held back by decisions in this place.

In conclusion, I draw Members’ attention to the Cancer Research briefing:

“Implementing a ‘Smokefree Fund’ would require tobacco manufacturers to pay for the harm caused by tobacco but without letting them influence how the money is spent. It would provide much-needed investment in evidence-based measures such as public education campaigns and Stop Smoking Services, without further squeezing the public purse.”

Who could argue with that?

[Several hon. Members rose—]

Covid-19: Impact on Social Work

Martyn Day Excerpts

Wednesday 23rd March 2022 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am managing not to laugh; I will do my best.

I am grateful to the hon. Member for Lancaster and Fleetwood (Cat Smith) for securing today’s debate, which has been thoughtful and consensual. It is a worthy topic and I start by expressing my own gratitude to social workers for their outstanding work during these difficult times. They have continued to work tirelessly to support children, families, individuals and communities across a range of specialisms and services throughout the covid-19 pandemic.

I am grateful for the comprehensive and measured manner in which the hon. Member for Lancaster and Fleetwood outlined and opened the debate. It is a timely reminder to us all that, sadly, lives can be at risk when things go wrong, so it is vital that things do not go wrong and that social workers play a major role in helping to sort out people’s lives.

There are around 11,000 social workers registered with the Scottish Social Services Council. They are part of a social services workforce of over 209,000 people and are aligned to, but a different profession from, social care professions. Most work in local authority settings, across adults, children’s and justice social work. Registered social workers are also employed by the independent sector and may be self-employed independent social workers. They were all classed as key workers and admirably carried out their roles within the additional pressures of the pandemic climate. However, 77.7% of social workers interviewed by the British Association of Social Workers strongly agreed that working under lockdown had increased concerns around being able to safeguard children and adults. Concerns for the safety of women and children experiencing domestic abuse heightened over the pandemic. In some cases, lockdown and social distancing exacerbated already high-risk situations. It is deeply concerning that referrals to domestic abuse services increased during that period.

The Scottish Government are working tirelessly to ensure that frontline services continue to support adults and children experiencing gender-based violence, with £12 million allocated to tackle violence against women and girls. At the beginning of the pandemic, the Scottish Government allocated an additional £5.75 million to various organisations, including Women’s Aid and Rape Crisis Scotland, to support those providing frontline services to people experiencing the violence of domestic abuse, and to ensure that services could meet increased demand. Services, including national helplines, remained open during the pandemic, so that anyone who needed help could access them.

The Scottish Government have also committed to review the funding and commissioning of special services, with an additional twin focus on domestic and sexual abuse services. They recently launched the Delivering Equally Safe fund, inviting applications from public bodies and third-sector organisations. The fund provides up to £13 million a year from October last year to combat violence against women and girls.

Following the Scottish Government’s commitment in the 2020-21 programme for government, they published revised national guidance for child protection on 2 September. The guidance, which incorporates learning from child protection cases, supports improved cross-agency working and outcomes for children at risk. Local implementation of the guidance has been supported by a national group that is chaired by the deputy chief social work adviser. Chief officer groups oversee local public protection arrangements and the assessment and response to risk, vulnerability and protection across the 32 local partnerships.

The Coronavirus (Scotland) Act 2020 provisions were also developed to improve capacity and flexibility of local child protection processes and prioritisation of children at greatest risk. A local authority and Police Scotland data return, collected since April 2020, continues to be key to understanding how the pandemic is impacting on Scotland’s vulnerable children and young people.

While the Scottish Government have worked to protect social workers and those they serve, the UK Government’s requirements for mandatory vaccination of those working in care homes has forced valuable workers from the sector. The British Association of Social Workers issued a statement at the time warning of the dangers of the UK Government’s approach and expressing opposition. In my opinion, the UK Government should have followed the Scottish Government’s “educate and inform” approach to vaccination of care and social workers.

Social work relies very strongly on a human rights regime, which the Scottish Government have championed through working to enshrine the UN convention on the rights of the child and the UN convention on the rights of persons with disabilities in Scots law. The UK Government’s shameless attempt to prevent the enshrining of the UN convention on the rights of the child does nothing to protect the rights of children, and their plans to overhaul or overturn the Human Rights Act are a direct threat to social work, as has been highlighted in the British Association of Social Workers’ briefing. The UK Government should commit to supporting human rights and end their attacks on the Human Rights Act.

There can be no doubt that poverty is a driver of the need for social work interventions. As I have repeatedly called on the UK Government to make the £20 increase to universal credit and working tax credit permanent, it was disappointing that that was not done. The September cut to the £20 uplift has meant that millions of claimants suffered a £1,000-a-year cut, with only tapering to soften the blow. That cut is estimated to have pushed 60,000 people in Scotland into poverty, including 20,000 children.

[Cat Smith]

I am very much enjoying the hon. Gentleman’s contribution. I am glad he has raised the issue of poverty; that is one of the things I did not include in my contribution, but not because it is not important. Does he agree that it is important to understand the link between poverty and families needing support through social work, and that eradicating poverty would go a long way in easing many of the issues that we wish to address through social work?

[Martyn Day]

I agree entirely with the hon. Member. I am bringing my remarks to an end, and she has helped amplify my point, for which I am very grateful. On poverty, the British Association of Social Workers has commented in its briefing that

“it cannot be ignored that poverty will have wider repercussions, such as on social work.”

I will leave that thought as my final remark. I hope it helps focus the Minister’s response.

Oral Answers to Questions

Martyn Day Excerpts

Tuesday 1st March 2022 Commons Chamber

[Maggie Throup]

As far as I am aware, and I am pretty sure I am right, the Scottish Government already have tax-raising powers, so perhaps they could use them in this instance.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

The Department of Health and Social Care asked the Treasury for £5 billion to continue testing, which was refused, yet it has been revealed that the UK Treasury has effectively written off £4.3 billion given to fraudsters during the pandemic. Does the Minister think it is wrong to write off losses that have enriched fraudsters while refusing to support the continuation of free testing?

[Maggie Throup]

I assure the House that the Treasury has not written off anything.

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[Sajid Javid]

My hon. Friend is absolutely right to raise this. NHS England has already given clear guidance to all GP practices that they must provide face-to-face appointments alongside remote consultations. Patients’ input into the type of consultation they want should be sought by all practices and their preferences should be respected.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

The Scottish Government have now confirmed their initial aid for humanitarian support to Ukraine of £4 million, as well as medical supplies. They are keen to work with aid agencies and other UK nations to get support to where it is most needed as soon as possible. What discussions has the Secretary of State had with his Cabinet colleagues on boosting urgent medical equipment provision to Ukraine from the UK and on guaranteeing access for doctors to the country?

[Sajid Javid]

The hon. Gentleman raises a very important point, and he will be pleased to know that the UK was one of the first countries in the world to provide medical aid. As I mentioned a moment ago, one flight left on Sunday night and one left this morning, and there will be many more, I hope. I welcome the work of the Scottish Government and their offer, and we will certainly work together in making sure that aid reaches the people who need it.

Government Contracts: Randox Laboratories

Martyn Day Excerpts

Thursday 10th February 2022 Commons Chamber

[Maggie Throup]

I appreciate my hon. Friend’s recognition, remembering where we were barely two years ago, of how we have moved on since then. We have put in place a test and trace programme that is renowned across Europe and across the world, and we have a world-leading vaccination programme as well as the amazing work done on therapeutics and antivirals. Coming together in the national effort has been vital, which is why I make no apologies for my Department’s looking at every opportunity to ensure that everybody could get tested who needed to be tested, that everybody could be jabbed who needed to be jabbed, and that the right therapeutics were in place to keep people safe.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

These secret communications reveal that Paterson corresponded directly with the then Health Secretary, the right hon. Member for West Suffolk (Matt Hancock), in January 2020 about the services that Randox could provide. Then, without competition, Government contracts were issued to provide Randox with equipment if it struggled to get it, offering loans of equipment that were drafted on the same day as the emails were exchanged. Nice work if you can get it, eh? In the exchanges, Paterson repeatedly noted that he was a paid consultant to Randox, but the Government seemingly overlooked that fact for months until The Guardian revealed he had lobbied for Randox to get the contracts. Internally, Paterson then asked the Health Minister to kill the story once and for all. Can the Minister explain to me how that is not institutional corruption? Nobody trusts this Government. They are rule breakers and system cheaters. Does this whole case with Randox not just prove that the Government are interested only in helping their friends?

[Maggie Throup]

Once again, I make no apologies for the Department working to look at every opportunity to make sure that we had the right mechanisms in place to keep our country safe. As I said earlier, Randox was a recognised company in the diagnostic industry. The hon. Gentleman talks about how he perceives the Department working. The fact is that we have released all the documents. As I said earlier, the 11,000 documents were looked at to identify what was relevant. We have been very open in putting that information in the House of Commons Library and responding to the Humble Address.

Integration White Paper

Martyn Day Excerpts

Wednesday 9th February 2022 Commons Chamber

[Edward Argar]

My right hon. Friend speaks with typical wisdom and common sense on these issues. I will briefly address each of his three points in turn.

On pooled and shared budgets, I have to say that I think section 75 of the National Health Service Act 2006 has worked well. When I was cabinet member for health and adult social care at my council—I had more hair then, and it was not grey—I also sat on a primary care trust board as a non-executive member. I had a senior director of that PCT on my management team; we forged a common purpose, recognising that there would be some areas in which NHS moneys were greater than those put in by the local authority and vice versa, but the shared goal was achievable only when we worked together. I think that there is genuinely something to build on, and the ICSs, ICBs and ICPs at the upper level will be the vehicle to move the process forward. When I was doing it, there was a degree of personal relationship moving it forward, rather than necessarily a systematised approach, but I genuinely think that there is a willingness and a recognition of the need for this.

On public access to electronic records, my right hon. Friend’s central point is absolutely right: it is important to recognise that such data is our data and individuals’ data. We must always be wary about doing something to someone, as opposed to in partnership with them. That principle will underpin our approach in this space.

Finally, my right hon. Friend referred to a single responsible professional—not a single point of contact, but someone who brings together an individual’s care. He is right to highlight the importance of general practitioners. May I put on record my gratitude to GPs not only for all their work over the past two years, and for all they do day in, day out, but for the wisdom and care that they bring to addressing their patients’ needs?

Since my right hon. Friend’s time as Secretary of State, there has been a continual drive to increase the number of doctors in our health service. Not all will become general practitioners, but we need to continue to make general practice accessible and to encourage people to choose it as an incredibly exciting and rewarding career. One of the key elements of making what he describes work is building up a body of general practitioners who are able to perform such tasks. I pay tribute to his work; we are continuing that work and building on his foundations. I am grateful for his questions and for his contributions.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am grateful to the Minister for advance sight of his statement. I think it fair to say that England is late to the integration game; Scotland and Wales have been legislating and moving in that direction for 20 years. The Scottish Government are pushing forward plans for a national care service to ensure that social care is fit for the 21st century, and have developed the NHS Pharmacy First Scotland scheme to spread the burden of frontline care and make pharmacies the first port of call for patients when GP and hospital visits are not necessary.

What lessons have been learned from the devolved nations? Any new plan for the NHS will not change the reality of the challenges facing the NHS organisation across all four of our nations, including that of vacancies. While Scotland’s workforce has grown by 20% under the SNP, Brexit is still hampering our ability to recruit from EU nations. Will the Minister discuss loosening Brexit and immigration controls with his fellow Ministers to help alleviate that situation?

[Edward Argar]

I saw the hon. Gentleman’s final point coming. To his original point, we are always happy to speak to the devolved Administrations and learn from their ideas, just as I am sure they occasionally look to England to see what they can learn—that is part of being a member of this Union. I speak regularly to the hon. Member for Central Ayrshire (Dr Whitford), including about such matters. To his final point, all I would say is that since 2010 we have seen around 30,000 more doctors and 38,000 more nurses in the English NHS—I have highlighted the role that my right hon. Friend the Member for South West Surrey (Jeremy Hunt) played in that—so I think we are doing a pretty good job of continuing to grow the workforce. There is much more to do, but we have a plan and we are delivering on it.

Vaccination: Condition of Deployment

Martyn Day Excerpts

Monday 31st January 2022 Commons Chamber

[Sajid Javid]

My right hon. Friend speaks with great experience, and I have the utmost respect for him, especially given the many years he spent successfully running this Department. I understand what he says, and I hope he will understand, having listened carefully to the statement, that when the facts change, it is right for the Government to review the policy and determine whether it is still proportionate. Many things have changed in the past couple of months with respect to covid, but the one big thing that has changed is that since this policy was originally implemented, we have moved from 99% of covid infections being delta to 99% being omicron. That is why we have had to change approach.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am grateful to the Secretary of State for his statement and for advance sight of it. I welcome the intention to U-turn on vaccination as a condition of employment. I have never supported mandatory vaccination for workers—a policy that, I am pleased to say, Scotland has avoided going down. Adding a further 70,000 or more vacancies to the existing 100,000 in NHS England would be a serious act of self-sabotage.

Vaccines remain one of the best defences against covid-19, as they reduce the likelihood of infection and therefore break the chain of transmission, and are something we should all continue to encourage. The Scottish Government have pursued an “educate and encourage” strategy in their vaccine roll-out, which has resulted in a higher vaccine take-up to date through entirely voluntary means. The five most vaccinated areas in the UK are all in Scotland.

Why are the UK Government taking so long to drop their damaging policy and adopt the Scottish practice? When will the consultation conclude and a decision finally be made? The UK Government’s vaccination mandate may have alienated many NHS staff, so what will be done to repair relations and encourage continued voluntary vaccine take-up?

[Sajid Javid]

The hon. Gentleman is right to draw the House’s attention to the importance of vaccination, as other Members have done. As was reflected in his remarks, it is the UK’s first line of defence against covid. Thankfully, the UK has put in place many other defences, such as the antivirals that are used across the UK and our testing and surveillance regime, but vaccines are the first line of defence. He is right to talk about encouraging as many people as we possibly can to take up the vaccine if they have so far not done so, whether they work in health and social care or otherwise. He is right that the best general approach is to educate and inform, and that is what we will continue to do.

Oral Answers to Questions

Martyn Day Excerpts

Tuesday 18th January 2022 Commons Chamber

[Edward Argar]

There is local flexibility to allow residents to be safely admitted to a care home during outbreak restrictions, following a risk-based approach that takes into account the size of outbreaks, who is affected, care home size and layout, rates of booster vaccination and current Care Quality Commission rating. The CQC supports risk-based decisions made on admissions to support the discharge of people with a negative covid test result, but, of course, we must continue to ensure the safety of those in care homes.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

The workforce are absolutely central to growing NHS capacity. The advice in a Migration Advisory Committee report was to amend migration policies, make

“Care Workers and Home Carers…immediately eligible for the Health and Care Worker Visa and place the occupation on the Shortage Occupation List.”

When will the UK Government start listening to their advisers and change migration policies to alleviate the pressures facing our NHS?

[Edward Argar]

I am grateful to the hon. Gentleman for his question and for the tone of his question. He is absolutely right to highlight the importance of the workforce. The workforce are the golden thread that runs through the heart of everything we do in our NHS, which is why we have already taken a number of steps to increase our workforce. We are well on target to meet our target of 50,000 more nurses. As I mentioned in my initial answer, in August last year we had over 20,000 more clinically qualified staff compared with August 2020, so we continue to grow the workforce.

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

My hon. Friend gets to the nub of the problem. The 2006 contract, which was introduced under the last Labour Government and is dependent on UDAs—units of dental activity—creates perverse disincentives for dentists to take on NHS work. We are already starting work on reforming that.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

We will not globally defeat covid if large proportions of the global population do not have access to vaccinations. The UK is one of a small number of countries blocking the TRIPS— trade-related aspects of intellectual property rights—waiver. Will the UK Government stop blocking the vaccine intellectual property waiver, and allow nations to manufacture the vaccines themselves?

[Sajid Javid]

The hon. Gentleman is right about the importance of helping the whole world to acquire these life-saving vaccines. That is why the UK can be proud of the more than 30 million vaccines that it has delivered to developing countries already. We will meet our commitment to increase that to 100 million by June, but we do not agree with the suggestion about the TRIPS waiver, because it will make future access to life-saving vaccines much more difficult.

Sickle Cell Treatment

Martyn Day Excerpts

Wednesday 8th December 2021 Westminster Hall

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am grateful to the right hon. Member for Wolverhampton South East (Mr McFadden) for securing this important debate, for the manner in which he opened it and for the work of the APPG that he chairs. He said we should all be concerned by the lack of understanding of sickle cell disease. I think we all agree with that fact. This has been a consensual debate and a valuable reminder that this issue is about the pain and loss that impacts on many families. That pain was well demonstrated by the personal testimony of the hon. Member for Vauxhall (Florence Eshalomi), who spoke so movingly of her mother’s experience. I am in full agreement that the increasing diversity of our communities amplifies the need for greater awareness of the disease.

The hon. Member for Lewisham East (Janet Daby) used the term “ignorance and neglect”, which summed things up pretty well, given that deaths from sickle cell disease are pretty much avoidable. She also highlighted the cost of sickle cell medicines—a point I will return to. The hon. Member for Streatham (Bell Ribeiro-Addy) also gave a personal account of her experience of the disease and spoke strongly about the institutional racism that has been experienced. This matter should concern all of us from all parts of the country. I commend her for her action on blood donation—something, I must confess, that I have always been too frightened to do myself. We all need to consider the importance of giving blood.

Like the hon. Member for Strangford (Jim Shannon), I was impressed by the APPG’s report, “No One’s Listening”, published in November 2021 with its stakeholder group, the Sickle Cell Society. The report found that sickle cell patients too often receive substandard care; that community care for sickle cell patients is generally inadequate or non-existent, which leads to unnecessary admissions to hospital; and that awareness of sickle cell disease is low, as we have heard repeatedly.

The right hon. Member for Tunbridge Wells (Greg Clark) highlighted the differential impact of geographic factors, even within the same hospitals. That is an important point that I had not properly considered, although I had thought about the race element affecting different parts of the country differently. The hon. Member for Edmonton (Kate Osamor) highlighted the fear of sufferers even of attending hospitals, particularly in areas with a high population susceptible to sickle cell disease. Again, that is a point I had not thought of, so I am grateful for that commentary.

Sickle cell disease overwhelmingly affects people from particular heritage backgrounds, and the report highlighted the role of racism in diagnosing and treating sickle cell patients. People from African, Asian, Caribbean, eastern Mediterranean and middle eastern backgrounds are more likely to have sickle cell disease or to carry the gene, and it is therefore impossible to debate this subject without considering race and the failings to adequately provide equality of treatment within the existing system. It is particularly concerning that many sufferers believe that racist attitudes affect healthcare providers’ perceptions of the disease. A number of Members highlighted the systematic racism that appears to exist.

Sickle cell disease is a genetic blood disease. There are treatments to manage it, but it is a lifelong condition. These disorders are inherited, with the only cure being transplants. Approximately 5% of the world’s population carries trait genes for inherited blood disorders, and around 15,000 sufferers in the UK have sickle cell disease, which affects how the body produces red blood cells. Normal red blood cells around the red blood cells affected by sickle cell disease harden and become sickle-shaped, like a crescent moon. This causes the red blood cells to die too quickly and block blood vessels, leading to symptoms that are often painful, as we heard in a number of testimonies.

The Scottish Government are committed to improving the availability of treatment services in order for patients with sickle cell disease to receive the care they need. The Scottish Government’s NHS recovery plan for 2021-26 sets out the plan for healthcare over the next five years, including investment of more than £400 million to create a network of 10 national treatment centres across Scotland, increasing capacity for diagnostic care. The plan also sets out the Scottish Government’s £155 million investment to provide general practices and their patients with support from a range of healthcare professionals in the community. The plan includes the recruitment of further pharmacists to help with patients’ repeat prescriptions and medicine reviews and of community nurses to assist with the diagnostic tests and chronic disease management.

It is vital that we design and develop services that meet the needs of everyone, with a focus on those experiencing health inequalities, and we have heard much of those inequalities today. The UK Government should follow the lead of the Scottish Government in the provision of free prescriptions to those who suffer from sickle cell disease and beyond. Sickle cell disease usually requires lifelong treatment, and a medicine called hydroxycarbamide—I probably spell it worse than I pronounce it—may be prescribed by a patient’s doctor to manage episodes of pain. Patients are usually told to take it as a capsule once a day.

In Scotland, we abolished prescription charges in 2011, but in England the current charge is £9.35 per item. There is a live petition—e-petition 588355—to encourage the UK Government to add sickle cell to the prescription charge exemption list. They responded on 6 August that they have

“no plans to make changes to the list of medical conditions exempting patients from prescription charges”.

That petition has a few days left for people to sign it. I encourage the Minister to reconsider the position on prescription charges and to support the recommendations detailed in the excellent all-party parliamentary group report.