A Plan for the NHS and Social Care

Neale Hanvey Excerpts

Wednesday 19th May 2021 Commons Chamber

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba)]

I want to begin by thanking NHS colleagues from University College London Hospitals and from services all the way up to Scotland, including in my Kirkcaldy and Cowdenbeath constituency, for the incredibly hard shift that they have put in over the last year. The warm words of the Prime Minister telling them that he knew how hard it had been for them must be replaced by swift action.

All that the nine words in the legislative programme demonstrate is that the Government fail comprehensively to understand the interdependencies of care services, from intensive and acute care to social, palliative and end-of-life care. In his first speech as Prime Minister on 24 July 2019, the right hon. Member for Uxbridge and South Ruislip (Boris Johnson) promised to

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

In his 2019 manifesto, he stated that his Government would seek cross-party consensus. In January 2020, he claimed that he would

“get it done in this parliament”,

yet in October last year, the Minister for Care could not give any commitment in Parliament to the Health and Social Care Committee about action on social care.

We must face the reality of a social care system that at the start of the pandemic was underfunded, understaffed, undervalued and at risk of collapse. Any response to covid-19, however fast or comprehensive, would need to contend with that legacy of political neglect. Despite the Government’s espoused commitment to improving the social care system and introducing proposals in 2021, there is nothing on how they will do so, never mind fixing the system. Integration is undoubtedly the way forward to make the system work, but that requires funding and services that are in good order before it begins. Without social care reform, a robustly funded and continuing cancer recovery plan, as well as core funding for palliative and end-of-life care, services will continue to struggle and people will suffer.

There is an absolutely foreseeable risk. Expecting integrated care systems to find the capacity to reorganise and find end-of-life care pathways with fragile resources is recklessly putting the cart before the horse. This all matters in Scotland. As ever, we are more reliant on Barnett consequentials. All the while, the UK Government find ways to squirrel money away, preventing them from triggering our share. The Alba party amendment to the Gracious Speech recognises unequivocally the recent majority for independence parties in Scotland, calling for immediate progress on independence. The fact that that sentiment has been dismissed by the UK Government comes as no surprise, but the fact that it has been neither echoed nor supported by the victors of that election will not go unnoticed at all.

Covid-19

Neale Hanvey Excerpts

Monday 22nd February 2021 Commons Chamber

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (SNP) [V]]

I begin by paying tribute to my NHS colleagues, every key worker, and every volunteer and vaccinator in my Kirkcaldy and Cowdenbeath constituency for their continued and tireless efforts.

Over the weekend, the Secretary of State dismissed the High Court ruling that he had acted unlawfully in his failure to comply with transparency rules by advancing the argument that the ends justify the means. Of course, everyone knows that this is yet more bulldog bluster, attempting to drape a cloak of acceptability over the cronyism at the heart of this Government’s procurement. As everyone across these islands knows, you can’t polish a cowpat.

Earlier today, the Prime Minister made it clear not only that he is willing to defend his Secretary of State’s unlawful conduct, but that he does so by pursuing the same flawed Machiavellian argument—that the ends justify the means. That should concern every Member of this place, because establishing that there has been

“No misuse of taxpayer money and no actual or perceived conflicts of interest”,

is a ministerial commitment authored by the Prime Minister himself, along with the

“precious principles of public life enshrined”

in his own ministerial code—

“integrity, objectivity, accountability, transparency, honesty and leadership in the public interest”—

which

“must be honoured at all times; as must the political impartiality of our much admired civil service.”

If this Government continue their refusal to disclose the names of companies linked to Ministers, hon. Members, peers and officials that were awarded preferential contracts via a high priority lane, and thereby conceal any material, financial or fiduciary relationship between those entities, that will amount to the most profound breach of the ministerial code possible. We can all make honest mistakes, but the wilful concealment of information that serves to confirm honourable behaviour or otherwise is clearly and irrefutably in the public interest. The publication as such should be of little consequence if there is indeed nothing to hide.

Standing by or surrendering our principles can be costly, but that choice only matters if they are of intrinsic meaning and value to the holder. Even the appearance of manipulating the means to serve other ends is morally and ethically hazardous, and an unwillingness to act with integrity and transparency risks a slip from democracy into authoritarianism. This Government have demanded that we back their plans under a pretence of collaboration, but when they dictate every step and close their ears to other voices, then they seek obedience and acquiescence. The Government must not block or otherwise interfere with the lawful scrutiny of Ministers by Parliament. By backing the unlawful conduct of the Secretary of State, the Prime Minister has made it clear how distant his relationship is with his own ministerial code.

Covid-19 Vaccine Update

Neale Hanvey Excerpts

Thursday 4th February 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful to the Chair of the Health and Social Care Committee for his question, and he is absolutely right. The manufacturers are already working on variants to their vaccine to take into account the mutation of the virus. Viruses will mutate to survive and this virus is no different. There are about 4,000 mutations now around the world, some more concerning than others. We have, in the United Kingdom, a genome sequencing industry that is a world leader—about 50%, or just under, of the sequencing has taken place in the United Kingdom. Not only are we working with the current manufacturers—Pfizer-BioNTech, AstraZeneca and Moderna —that have been approved, but we are also looking at how we can make sure that we make the most of the new messenger RNA technology, which allows the rapid development of vaccine variants that will then deal with the virus variants as rapidly as possible. When I spoke to the Science and Technology Committee a few weeks ago, I said that we were planning to have in place the ability to go from the moment that we can sequence a variant that we are really concerned about to the moment that we can have a vaccine ready in between 30 to 40 days, with then, of course, the manufacturing time.

We have invested in Oxfordshire, in the Vaccines Manufacturing and Innovation Centre, and in the Cell and Gene Therapy Catapult Manufacturing Innovation Centre in Braintree—£127 million there and just shy of £100 million in Oxfordshire—to be ready to manufacture any vaccine that we would need. The Prime Minister, of course, also visited those making what I refer to as our seventh vaccine, the Valneva vaccine. That is a whole inactivated virus, so it does not just work on the spikes in the way that the two current vaccines that we are deploying work. It works on the whole of the virus, which is much more likely to capture any mutations from the spikes and therefore be incredibly effective. We have invested in that production facility in Scotland so that we can have that vaccine as a future-proofing of annual vaccination strategies or a booster in the autumn, if necessary.

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (SNP) [V]]

I thank the Minister for advance sight of his statement. I am glad to hear his recognition of the importance of adherence to the clinical categories of the JCVI, and I also give my thanks to vaccination teams in my Kirkcaldy and Cowdenbeath constituency, across Scotland and, indeed, these islands.

I urge the Minister, however, to think more lightly of himself and deeply of the world. Over recent weeks, the UK Government and their allies in Scotland have quite disgracefully been attempting to sow fear in the minds of our vulnerable communities that vaccine deployment is too slow. That narrative was completely debunked yesterday, yet the Prime Minister still claimed that we have today passed the milestone of 10 million vaccines in the United Kingdom, including almost 90% of those aged 75 and over in England, and every eligible person in a care home. Today, however, on “Good Morning Scotland”, the Minister was further pressed on how many vaccines had been given—not offered, but given to people in care homes in England. Even with 24 hours’ warning and following a detailed probing, he was not able to offer more than a vague 91% of those eligible in an ill-defined subset, before settling on “a very high number”, and suggesting that care home staff’s vaccination may not yet have begun in England. Can he tell us today what percentage of all care home residents and all care home staff have had their jab in England and, if not, why not?

To return to the JCVI clinical prioritisation, in a recent written parliamentary question to the Minister regarding the clinically extremely vulnerable, he chose to regurgitate JCVI guidance rather than answering the question. With the encouraging news that the Oxford vaccine and potentially others have a measurable impact on transmission, can he update the House on what steps he has taken to ask the JCVI to review current guidance for household members of the clinically extremely vulnerable, such as people with blood cancer or organ transplantation, and thus provide a vital layer of protection to those who may not be able to receive the vaccine themselves?

[Nadhim Zahawi]

I am grateful for the hon. Member’s question, albeit, dare I say, I do not recognise his description of our collaboration. We have, over the past two weeks, been working solidly. The British Army—the armed forces—have been working to deliver 80 vaccination sites in Scotland and to hand them over to NHS Scotland within 28 days, and that work began a couple of weeks ago. So I hope he recognises the effort the United Kingdom is putting in not just in supplying the vaccines for Scotland, Wales, Northern Ireland and England, but in the way we are trying to support the vaccine deployment in Scotland.

Of course, last weekend was our target to make sure that every eligible care home in England was visited, and over 10,000 care homes have actually been visited and received the vaccine. Only a handful of care homes, which were deemed to have an outbreak, were not visited. The NHS, quite rightly, celebrated achieving that target last weekend, so I am slightly saddened, in a way, that there is this politicking between ourselves about this issue.

We continue—as the shadow Minister, the hon. Member for Nottingham North (Alex Norris), asked me—to work very hard to make sure that staff in care homes are also offered the vaccine on those visits, and they also have an opportunity to be vaccinated in their primary care networks and, of course, in hospitals.

On the JCVI, those who are clinically extremely vulnerable are in category 4, and we will vaccinate them by mid-February.

Covid Security at UK Borders

Neale Hanvey Excerpts

Monday 1st February 2021 Commons Chamber

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (SNP) [V]]

Sadly, there are no shortcuts to dealing with covid. Between June and August 2020, Scotland almost eliminated covid, with minimal community transmission. At the same time, England and Wales were also doing well. That was a real opportunity to consider the impact of the slow response, such as in Italy, and what had worked across the world, including approaches in Asia-Pacific and New Zealand, which had experience of managing similar pathogens in the past. It was also an opportunity for cool heads and collaboration, and for dealing with issues such as the £45 billion allocated early on for testing—that testing, however, was slow to materialise. We know that only 30% of people who should self-isolate do so, given the financial implications of doing so. That amplifies community transmission, and people do not have the financial means to self-isolate. Instead of having porous borders, we could have spent time improving our border biosecurity. That was an early lesson from our friends in New Zealand.

Because we did not do that, we imported a soup of different strains, with limited transmission suppression across the country, which is precisely why new variants are emerging. That is how viruses mutate. Last week’s announcement by the Home Secretary was welcome, but those tougher measures at the UK’s external borders are months overdue and reflect what many other countries have had in place since the beginning of the pandemic. Despite having responsibility for public health, the Scottish Government cannot unilaterally close the border in Scotland.

That brings me to vaccine nationalism, which has been an emerging discussion point in recent days. Fourteen per cent. of the world has 83% of the vaccine stock. We urgently need to correct that, not just because it is unjust, but for the long-term management of covid, without which there will be no long-haul holidays and no meaningful aviation recovery, and while the JCVI and Governments across the UK work on vaccine deployment, that will be for nought if our borders remain porous.

On test to fly, many lateral flow test devices are insufficiently sensitive. That is accepted by the Scottish Government, but not by the UK, and it is a mistake in the making. The PM’s bulldog optimism has not stopped covid. Only by learning from others across the world, deploying corrective measures at our borders, and working to distribute vaccines equitably will we beat covid. The burden and the solution are shared across the world.

Long Covid

Neale Hanvey Excerpts

Thursday 14th January 2021 Commons Chamber

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (SNP) [V]]

Thank you, Madam Deputy Speaker. I commend the hon. Member for Oxford West and Abingdon (Layla Moran) for securing this important debate. Long covid is a prevalent and growing concern that is every bit as important as community transmission rates, excess mortality rates and the consequential impacts on other life-saving services, such as cancer services. It is evident in my Kirkcaldy and Cowdenbeath constituency. Bailey-Lee Robb, an 18-year-old student from Lochgelly, tested positive in October. He was isolated originally in his university accommodation, but he has now returned home to recuperate. He told me:

“Due to Long Covid I’m on painkillers as I have bad lower back and knee pain; I still have a loss of smell; shortness of breath; short-term memory loss; insomnia; and some of my body randomly breaks out in rashes. While I try to lead a normal life, some days I can’t leave bed because I’m that sore and exhausted. It’s horrible!”

He felt that the impact on young people is important. Even if fewer young people are dying from covid-19, long covid could be with them for a lifetime. There is a pressing need for Governments to raise public awareness of long covid, to urge lockdown compliance and to limit community transmission.

Research suggests that 10% of the infected population will suffer from long covid and, in line with other post-viral syndromes such as ME, it may become a chronic, potentially lifelong condition. The president of the British Society for Immunology has said:

“As the pandemic has gone on, it has become clear that…Covid-19 is more far reaching than affecting just the respiratory system”.

They went on to note that this may be a consequence of a generalised systemic inflammatory response, mediated by the body’s “cytokine storm” against covid. Shortness of breath can lead to pulmonary fibrosis, and circulatory, cardiovascular, renal, neurological and mental health impacts, and very real survivorship challenges, including depression and suicidal thoughts.

The British Heart Foundation, the British Lung Foundation and others also recognise the role that inflammation plays in the disease’s progression. Anyone working in an intensive therapy unit knew long before covid that such a systemic inflammatory response can lead to multi-organ failure and death.

Long covid is real, and it also affects young people such as Bailey-Lee. There is limited empirical evidence on how to diagnose, support, treat and rehabilitate sufferers. In Scotland, we advocate an holistic approach, and we are currently considering the organisation of services. More than 70,000 Scots will be provided with free vitamin D, which is recognised as having a role in prevention and moderation of morbidity. This week, Food Standards Scotland launched a vitamin D campaign for the general public. The Scottish Chief Scientist Office recently concluded research calls into the long-term effects of covid-19, with funding totalling £2.5 million being recommended for nine projects across Scottish universities. In addition to that funding, the Scottish Government are supporting an ongoing study on the longer-term lung health of covid-19-related acute respiratory distress syndrome survivors, and they are also supporting Scottish participation in the UK-wide post-hospitalisation covid-19 study.

Of course, it is also key to listen to those living through the condition, such as Long Covid Scotland and the Post Covid Syndrome Support Group. That is vital to improve understanding of the longer-term effects and develop effective clinical interventions to support recovery and rehabilitation. Post Covid Syndrome Support Group founder Louise Barnes has called for a shift to effective treatment after she made contact with a clinical team in South Africa regarding a peer-reviewed study looking at the use of a six-vitamin stack protocol. Despite being sceptical, Louise felt that she had nothing to lose so participated in the trial. Within three days, she saw notable improvement:

“I felt within days almost back to normal”.

That study is promising, as we know from leukaemia treatment the valuable role that vitamins or micronutrients can play. Of course, a six-vitamin stack will not suit big pharma unless they develop an analogue of the vitamin stack that they can patent. I have not looked into the detail of the study, but it is very positive and deserves serious consideration.

What is the UK Government’s strategy? It is clear that we must take action now. We must properly record, research and develop means to defeat the mechanisms of long covid. Otherwise, we are creating further resource and financial burdens for the NHS well into the future. Will the UK Government develop appropriate additional support and funding for the NHS to meet these challenges, however they are to be delivered? Will the Government now accept the pressing need for continuation of the £20 universal credit uplift and its extension to legacy benefits, in the light of long covid?

We also need action on sick pay rates. The UK has one of the lowest sick pay rates in the OECD. The SNP has continuously called on the UK Government to increase SSP in line with the real living wage. It is a disgrace. The UK Government’s meagre £95.85 rate of SSP is poverty pay in comparison with Ireland, where the rate is £266, and other countries such as Germany and Austria, where it is more than £280. Long-term, meaningful economic support must be put in place for long covid sufferers. Will the UK Government immediately increase SSP, so that long covid sufferers have financial support? Most importantly, will the UK Government match the Scottish Government’s ambition and fund research into post-covid syndrome, allowing sufferers hope that their new normal is not post-covid syndrome or long covid?

Oral Answers to Questions

Neale Hanvey Excerpts

Tuesday 12th January 2021 Commons Chamber

[Helen Whately]

We absolutely recognise not only the importance of self-isolation, which is critical in breaking the chains of transmission, but that it is not always easy for people to do. We recognise, for instance, the cost of self-isolation, and that is why we introduced a payment of £500 for those who are on low incomes and unable to work from home while isolating. We will continue to make sure that people have the support they need to self-isolate.

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (SNP)]

What the evidential basis is for the use of Innova lateral flow tests for covid-19 in the asymptomatic population.

[The Secretary of State for Health and Social Care (Matt Hancock)]

The Innova lateral flow tests for covid-19 identify a substantial proportion of those who are shedding viral load due to their covid-19. We of course identify, analyse and publish the evidential basis for the use of these tests, as with the other tests that are used in the national testing programme.

[Neale Hanvey [V]]

I would like to thank the Secretary of State for that answer, and I thank him also for his helpful response to my questions in the Select Committee last week. In that spirit, he will know that I have been pursuing the use of lateral flow tests since early November, when concerns were first raised. Unfortunately, some of those concerns continue to persist—not least when they were underscored by a communication from his Department as recently as 11 December, which stated:

“We are not currently planning mass asymptomatic testing; swab testing people with no symptoms is not an accurate way of screening the general population, as there is a…risk of giving false reassurance. Widespread asymptomatic testing could undermine the value of testing, as there is a risk of giving misleading results.”

Given those ongoing concerns, I would be most grateful if the Secretary of State committed to a meeting to consider those concerns in a bit more detail—

[Mr Speaker]

Order. I think the Secretary of State can take an answer off that.

Covid-19

Neale Hanvey Excerpts

Tuesday 12th January 2021 Commons Chamber

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (SNP) [V]]

I do not think it is controversial to say that we are not in a place where any of us would choose to be right now. It is not a time for taunts about U-turns or to respond with personal or flippant remarks; our constituents need grown-ups in the room.

The Secretary of State requests that the House get behind his decision, but if he is to achieve that his approach must change. There needs to be less personal attack and greater clarity. We all need to listen more carefully to voices whose opinions differ from ours, from the frontline to the experts and all Members of this place.

I am as determined as the next right hon. or hon. Member to see the back of the pandemic. With more than 7,000 excess deaths since March 2020 in England alone, not one of us should want to prolong this tragic loss of life. But without a realistic and determined strategy, we risk continued failure to contain the threat. If all Members are to truly get behind any such strategy, it must be forged with as broad a consensus as possible—cross-party and respectfully with the devolved Governments. I firmly believe that that is the only way we can move towards an end to this crisis and the elimination of community transmission.

Such planning should encompass all relevant areas of Government, ensuring that disbursement of financial support always results in equitable consequentials. There must be some movement from the Government to address the devastation inflicted on the 3 million who have been excluded from support; repeatedly telling them how generous the Government have been to everyone else only serves to pour more salt on their wounds and lacks any semblance of humanity. The compelling case for the retention of the extension to legacy benefits, the £20 universal credit uplift, is a move supported by 60% of people across the UK. Indeed, there is a well-trodden shopping list of issues that some in this House would argue a case for, and I believe that they do so for the most honourable of reasons.

The most pressing of matters, of course, is our direct response to the threat of the virus to life. We know that we cannot firefight our way out of this current position, if that is how we got to this place. Vaccines are welcome, but the science has yet to bear out their impact on the transmission of coronavirus. As the virus remains prevalent and circulating in the community, the risk of further mutation remains.

NHS England chief executive Sir Simon Stevens said that this has been “the toughest year” that any staff member “can remember”, and that NHS England is back in the “eye of the storm” that it faced earlier last year. The handclapping on the doorstep and the warm words of appreciation ring hollow without recognition and proper reward. The resilience of cancer services has again been severely tested, and Parliament must consider, monitor and scrutinise the short-termism of the cancer recovery plan. We need a plan for the future, and it needs to be one with consensus.

Covid-19

Neale Hanvey Excerpts

Wednesday 18th November 2020 Commons Chamber

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (SNP)]

This global pandemic has shaken the lives of so many. The pain from the loss of loved ones, friends and colleagues has been compounded by redundancy or business failure, as support for key sectors has failed to materialise or people have found themselves excluded from the UK Government schemes. As we now pin our collective hopes on the brightest and the best delivering promising vaccine candidates into clinical use, we must turn our minds to our recovery and how we choose to build a better, greener and fairer future for our communities.

I would like to take a moment to pay tribute to those who have contributed to the spirit of community across my Kirkcaldy and Cowdenbeath constituency. First, I pay tribute to Tricia Marwick, the chair of the NHS Fife board, and to its members, to Dr Chris McKenna, the medical director, and Helen Buchanan, the director of nursing, and to every single member of staff on the frontline, to whom we owe so much.

I would also like to pay tribute to the local media outlets—the Fife Free Press, the Central Fife Times, K107 community radio and Kingdom FM—all of which have helped my constituents stay informed and updated and have kept us all safe. I pay tribute to the many community lifeline groups, such as the Cottage Family Centre, which aims to ensure that no child or family goes hungry, cold or without presents this Christmas; Love Cowdenbeath, whose online presence has been supporting the local community and retailers; and Linton Lane Centre, which sadly, like other groups across my constituency, had to cancel its annual Christmas day meal for seniors, but will aim to distribute 100 hampers to those who would have attended.

There are so many other examples that I simply do not have time to mention, but the spirit of community that has emerged from this dreadful pandemic is built on hope and an aspiration to do better by our neighbours and, like much of my constituency, is bursting with vision, ambition and confidence that a better future is possible.

Such a future is possible, but it is imperilled by decisions made in this place, led by a Prime Minister who considers our considerable achievements in government and our shared aspirations a mistake and does not see a case for further consideration. I put it to the House that, in our recovery from covid-19, it is the independent countries that will do better. By following the path of regaining democratic control of our own country, our people will be richer, our influence for good greater and our future brighter.

However, the PM’s unguarded words have undermined even article 19 of the Acts of Union, which he purports to uphold. He poured scorn on Scots’ ability to make their own laws while, in his words,

“free-riding on English taxpayers”,

describing it as “simply unjust”. I would be interested to know if the Minister genuinely thinks that the people of Scotland believe that a Government with such an appalling track record—of austerity, welfare cuts, the two-child cap, the bedroom tax, benefit sanctions and the unfair manner in which the Women Against State Pension Inequality have been treated—are uniquely benevolent when it comes to Scotland. Of course she does not, and the facts expose the mendacity of that obtuse notion.

It is a matter of record that in each of the 30 years prior to the introduction of “Government Expenditure and Revenue Scotland”, Scotland generated more tax revenue per head for the UK Treasury than the rest of the UK. If the Minister believes that with 8.2% of the population Scotland creates between 50% and 60% of the UK deficit, will she please direct me to where that money was spent and by whom? Will she also tell me why the people of Scotland should have any confidence in this place to help Scotland build a better future post covid? I can provide the Minister with the answer: they do not.

According to the latest gold-standard Scottish social attitudes survey, 61% of people say they trust the Scottish Government to work in the national interest, but just 15% trust the UK Government to do likewise. The gulf is even wider when it comes to leadership. First Minister Nicola Sturgeon’s approval rating in Scotland is 100 points above that of the Prime Minister, with one commentator—a Unionist, as it happens—stating today that

“that is the good news”

for the Prime Minister, since he suspects that he has

“not yet reached rock bottom”.

That distrust will only grow as the cronyism at the heart of this Government continues to be exposed. Today the National Audit Office released its damning report on the UK Government’s procurement practices during the pandemic, which confirms what we have been saying for months about a Government failing to manage conflicts of interest, doling out public money to clearly unsuitable companies and improperly avoiding scrutiny.

[Tim Farron]

I think the hon. Member will probably agree with me that what is galling for so many people is the £10.5 billion of contracts given out without proper tender processes and without transparency, if we contrast that with the 3 million people in this country—people who have been self-employed for a short time, company directors of small limited companies and many others—who have been completely excluded from support. A small fraction of that amount of money would have kept food on their tables and a roof over their head.

[Neale Hanvey]

The hon. Gentleman makes the extremely important point that the avarice attached to these contracts undermines any sense that the Government are putting their arms around anyone, let alone the whole country. I would be interested if the Minister could indicate whether the Prime Minister will heed SNP calls—in fact, cross-party calls—for a full public inquiry into the cronyism at the heart of this Government. Convincing answers are urgently needed as to why so many Tory friends, relatives, donors and prominent lobbyists were awarded jobs and privileged access to UK Government meetings and decision making.

The National Audit Office has exposed and confirmed the existence of VIP lanes in which unsuitable companies were often placed by the private offices of Ministers, and they were more than 10 times as likely to win a contract as other suppliers. Recent weeks have seen reports that £1.5 billion of taxpayers’ money has gone to companies linked to the Conservative party. Concerns have also emerged over the weekend about privileged access for lobbyists with links to the Conservative party, without any public process or announcement.

With so much suffering across these islands, it is vital that there is full transparency and that the public have confidence in the manner in which the UK Government spend taxpayers’ money fighting coronavirus. As we heard last week from the hon. Member for Sefton Central (Bill Esterson), rather than support experienced and established UK-based PPE providers, the Government chose 12-week-old businesses with no experience or capacity to provide PPE. How can UK-based companies survive when their Government cut them off at the knees? If everything is above board, surely the Minister will have no issues indicating her support for an inquiry.

Yet that is not the only economic vandalism of this Government during the pandemic. Despite the promises to wrap their arms around everyone, support remains poorly targeted and offers no relief for people who have become self-employed more recently or to businesses in my Kirkcaldy and Cowdenbeath constituency such as RG Construction, which was denied £64,000 of furlough support on a technicality it could never have predicted or met. Will the Minister undertake to ask the Treasury to review these entry requirements to open up support to self-employed people and other businesses that have so far been excluded?

The Government sprang into action to provide countless contracts for their wealthy friends, but that sense of urgency is sadly lacking when it comes to taking action on social care reform, pay awards for frontline NHS staff or addressing the poverty of carers. This week on the Health and Social Care Committee, we heard evidence that healthcare assistants were not being provided with the same standard of PPE as more senior staff, leading to stress, anxiety and burnout. This risk of burnout is all the more concerning when it comes to how we recover the delays in cancer treatment precipitated by the pandemic. The King’s Fund has described an already existing problem of chronic excessive workload in the NHS. This week we heard expert evidence that that, in combination with the culture that demands ever more, can lead to serious mental health problems. What action is the Minister taking to address these pressures and challenge such an unhealthy culture in the NHS?

I would like to pay tribute to Macmillan lead cancer nurse Denise Crouch for her valuable evidence highlighting the pressure cancer nurses have been facing before and during covid-19. Macmillan has highlighted serious shortages in the cancer workforce, in which 2,500 specialist cancer nurses are needed to meet current demand, rising to 3,700 by 2030. I say with genuine sensitivity that this pandemic has thrown into even sharper focus the fragility of our NHS workforce and the need for fast-paced and substantial action. I would be interested in what action the Minister has taken to secure additional capacity in the NHS beyond March 2021 and to invest in the cancer workforce as part of next week’s comprehensive spending review.

Work-related stress is also being amplified elsewhere. Where is the urgency or action addressing the deeply immoral exploitative practice of firms firing workers only to rehire them on significantly reduced terms? This fire and rehire practice has sadly emerged in many sectors, most notably in aviation. Those are not the only threats to our ability to build back better after covid. To pile misery on misery, the Government are persisting with their plan—I use that word in the loosest of terms —with no regard to the consequences or the views of the people of Scotland.

What of the £20 uplift to universal credit? With so many now facing redundancy, this must be made permanent and extended to legacy benefits. These calls are backed by the Joseph Rowntree Foundation and Save the Children. Can the Minister not see the need for this support and the positive impact that such support could have on health and wellbeing? If the UK Government are as keen they claim to be on protecting people, why is it that their own workforce in the Department for Work and Pensions, already equipped to work from home as part of a pilot, are being forced to work in an office one day a week in the face of covid clusters occurring among their colleagues?

In Scotland, we see things through a different lens. As a small country, we ascribe more value to the view that intangible infrastructure such as education and healthcare form the backbone of a country. The Credit Suisse country strength indicator places six small countries in the top 10. Small countries make up more than half of the world’s top 30 countries, with Scotland showing higher scores on the UN human development index than the UK as a whole.

Scotland must build back better, and that is only possible with the full powers of an independent nation. A new YouGov poll across Britain revealed that 85% of respondents from Scotland think that the UK Government are doing badly at handling the UK’s exit from the European Union. An expert study from Warwick University earlier this year revealed that Scotland is already £3.9 billion worse off as a result of Brexit, losing £736 per head of population, with Aberdeen the worst hit at £9,000 per head. Separately, Scottish Government analysis revealed that Tory plans to end the transition period in 2020 could cut £3 billion from the Scottish economy in two years on top of the impact of coronavirus. It is no wonder then that 14 polls in a row now show a majority of support for independence in Scotland, with the most recent poll by Panelbase showing support at 56%. I know that my focus on Scotland and the interests and aspirations of my constituents tire some on the Government Benches, but there is a simple and obvious solution available to them.

In closing, the difference between the independence regularly celebrated on the Government Benches and the one that Scotland will choose soon is that Scotland wants independence to join the world whereas the real separatists sat on the Government Benches have sought separation to be an isolated and rudderless state. It is no wonder that support to abandon the UK separatists is growing, and growing in the majority of Scotland.

[Mr Deputy Speaker (Mr Nigel Evans)]

The time limit is reinstated.

Breast Cancer Diagnosis and Services: Covid-19

Neale Hanvey Excerpts

Thursday 12th November 2020 Westminster Hall

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (SNP)]

I thank the hon. Member for North Warwickshire (Craig Tracey) for securing this very important debate, and I congratulate him on his compassion and lucidity in presenting his case. I start by paying tribute to all the NHS, research and charity staff who have been working on the frontline in their respective disciplines to ensure that we move through this challenging time and continue to meet the challenges of breast cancer.

Breast cancer is the most common cancer, with one in seven women affected, and the impact of covid-19 is most keenly felt by those women and has the greatest potential to affect the lives of so many because of its prevalence. Covid has had an impact on almost every aspect of our lives. We have heard that 1 million women have missed their breast cancer screenings, but the covid pandemic has affected all aspects of the cancer pathway, from screening and diagnosis to treatment and follow-up care.

The reasons are varied, and include concern and fear over attending, cancellations due to re-deployment and the impact on the wider NHS services, radiology, surgical, medical and clinical oncology. All of those aspects of the treatment pathway have felt the impact, including, as I mentioned earlier, the capacity for clinical trials and research. In that spirit, I led a cross-party letter to the Chancellor asking for the Government to consider the establishment of the life sciences charity partnership fund to support the charities that have been significantly affected by the covid pandemic.

The design and success of cancer treatment is absolutely reliant on early diagnosis, as it allows rapid progress to treatment, prompt surgical intervention in the case of breast cancer, and onward to radiotherapy or chemotherapy, or indeed both. As such, it maximises the efficacy of those interventions, whilst allowing tissue and immune systems to recover. However, there are challenges.

The Royal College of Radiologists has highlighted that there has been a reduction in referrals for symptomatic breast cancer within the two-week wait standard and a reduction of clinical capacity. There have been some innovative moves, where appropriate, for a hyperfractionation of radiotherapy treatment schedules. The royal college also noted that radiologists are having to deal with attendance anxiety. It has, however, also noted innovative changes to the configuration of services, which have enabled some of the softer aspects of cancer care to continue where possible.

The impact on the challenges that were already present prior to covid also needs to be considered. I remember—more years ago than I would like to mention—when I was involved in peer reviews with a London cancer network there was already a shortage of radiologists within the cancer pathway. That problem has, sadly, not gone away. It is not a problem unique to the English system at all. There is at least one consultant vacancy in clinical oncology. Another important issue to consider is that the attrition rate for consultant posts is greater than the ability to recruit. Thus, there is a pressing need to move these challenges forward.

The new ways of working—telemedicine, Hospital at Home, and other innovations—need investment. There is also a need to reassess the skill base of the workforce and acknowledge chronic excessive workload, which has been highlighted by The King’s Fund. According to Macmillan, there is a need more generally to recruit around 2,500 cancer nurses alone—of course, other disciplines, from GPs to radiographers, also need consideration for recruitment.

The post-covid recovery plan must include significant investment in diagnostics and treatment, radiology, recruitment and training in specialist allied disciplines. Effectively, the covid pandemic has landed a narrow aperture at the point of diagnosis for many cancers and, because of its prevalence, breast cancer is a significant cohort. To widen that aperture, there is a real and pressing need for funding to come forward in the comprehensive spending review; it must deliver an expansion of service to support innovation, fund the NHS plan and support social care.

It is important to acknowledge that staff in hospitals have been working incredibly hard throughout the pandemic, but there is only so much that we can squeeze out of them, and we cannot rely on a never-ending supply of goodwill and extraordinary resilience. My suggestion echoes a plea from my hon. Friend the Member for Central Ayrshire (Dr Whitford), who is a breast cancer specialist herself: clinical audit and quality improvement standards need to be at the heart of the drive forward. That work has been commended by the Nuffield Trust in its “Learning from Scotland’s NHS” paper.

We need to support getting it right first time, while making great strides to enable clinical outcome data to be captured and the impact to be fully understood. In short, substantial investment is no longer optional, and I hope that in the spending review the Government make the necessary investments, as called for by the hon. Member for North Warwickshire, to ensure that that is brought forward.

Covid-19

Neale Hanvey Excerpts

Wednesday 11th November 2020 Commons Chamber

[Neale Hanvey (Kirkcaldy and Cowdenbeath) (SNP)]

Despite its dreadful impact, the coronavirus pandemic has brought out the very best in people, from Captain Sir Tom Moore’s inspiring fundraising efforts to volunteers in communities across my Kirkcaldy and Cowdenbeath constituency who have mobilised to ensure that the vulnerable among them receive food and medicine as they shield from this deadly virus. I would like to pay tribute to some of them today: Fife Voluntary Action, Benarty emergency response team and the many “Scotland Loves Local” high street heroes award winners to name but a few. But of course I would also add my thanks to all the key workers who kept us all going throughout lockdown.

The pandemic has also, however, laid bare the opportunism of some: a profiteering cronyism that runs through the heart of this Westminster Government—what Canadian author and social activist Naomi Klein calls “disaster capitalism”. In her award-winning book “The Shock Doctrine”, Klein presents a convincing narrative of a political strategy that exploits large-scale crises, such as this pandemic, to push through neo-liberal policy that systematically deepens inequality while simultaneously enriching the already wealthy with connections to those in power.

In the crisis we face today, ordinary people are focused on the daily challenge of survival, yet in parallel we have repeatedly witnessed new private companies springing up to profit directly, greatly assisted in those efforts by a political class prepared to make strenuous efforts to line the pockets of many with close links to the party of government. As my hon. Friend the Member for Gordon (Richard Thomson) incisively said of this phenomenon, people across these islands are in the grip of a cronyvirus at the heart of this Government that may be every bit as deadly as the coronavirus

[Laura Trott (Sevenoaks) (Con)]

Does the hon. Gentleman accept that the private sector has played a role in helping tackle the virus, and specifically that Pfizer, as a private company, has only got the money to invest because of its profit and share nature?

[Neale Hanvey]

I do not dispute the role of private companies in meeting the challenge of the coronavirus. I will go on to discuss the transparency and the appropriateness of how contracts have been awarded by this Government during the pandemic.

We only have to look at the PPE fiasco to see how this has been brazenly put into action, with large contracts awarded to small firms with little to no experience in the relevant field but with numerous links to the Conservative party. How on earth did the Government find them? In what amounts to a covid bonanza for these tiny companies, Government contracts worth more than £10 billion have been awarded in this way since March. Under the cover of the pandemic, the standard rules have been put aside, enabling contracts to be issued in extreme urgency with little to no oversight; I refer to the comments made by the right hon. Member for North Somerset (Dr Fox) about scrutiny.

With the emergence of promising vaccine candidates, we collectively hope that there is light at the end of the tunnel. However, the darkness of our journey through this pandemic must not be allowed to obscure our important public duty to act in good faith and with financial probity. We simply cannot emerge from this experience with the dismissive “at any cost” excuse deployed from the top of this Government down. We must ensure that the burden is shared equally together.

Enormous amounts of public money have been dished out in the absence of any tendering process, value for money assessment or assessment of whether any of these companies have relevant experience. We have all heard stories of UK businesses with expertise whose offers of help went unanswered by this Government. Why? On PPE, £108 million went to a tiny pest control company with net assets of £18,000. Another £108 million went to a modestly sized confectioner in Northern Ireland, while a third contract worth £252 million was awarded to an opaque private fund owned through a tax haven. The more that Members and external interested parties scratch the surface of this Government’s contract profligacy, the more serious are the questions that arise.

It is not just PPE. Under the fast-track rules, private firms have been handed a total of 843 direct contracts, including those that administer covid-19 tests and provide food parcels and medical supplies. Then, of course, there is the disastrous £12 billion test and trace failure, led by Conservative peer Baroness Harding. In yesterday’s joint Select Committee hearing, a possible reason for that was revealed. In July, the CMO claimed in a Select Committee that the ability to ramp up testing was “significantly strained”. Yesterday, Professor Sir Chris Ham gave evidence that increasing capacity over the crucial summer months was too slow, yet Baroness Harding claimed that testing capacity was increasing throughout the summer. What is the truth of the matter? Unfortunately, that was not the only incongruity, as Baroness Harding did not show a clear command of her brief, failing to answer or, in some cases, understand what was being asked.

The global pandemic is an absolute disaster for so many, with an unimaginable loss of life, yet the brightest and best of humanity have been working tirelessly on effective treatments and a vaccine. Rightly or wrongly, the appointment of Kate Bingham has proven controversial. There are no doubt questions to be asked about the absence of any clear recruitment process, but when she appeared before the Health and Social Care Committee recently, she was impressive. She was clearly on top of and in command of her brief.

However, that does not vacate the responsibility of this Government and any appointees to act ethically and in good faith and, most importantly, to account transparently for their actions. There are concerns about Kate Bingham’s astronomical public relations bill and claims that she shared sensitive information with investors. Further concerns emerged in The Guardian yesterday—in simple terms, how can a job be considered unpaid when the postholder has a position of influence or control in the process of awarding a £49 million investment in a company in which they remain a managing partner and from which they will surely benefit? Whatever the Prime Minister’s bluster, these matters must be fully scrutinised.

Sad as the pandemic is, what saddens the most is that these conditions are seen by some as an opportunity for Governments and corporate interests to implement political agendas that would otherwise be met with great resistance and opposition. The Government are on notice that, despite the disorientation of the public health crisis we are living through, these matters are being pursued.

This chain of events is not unique to the current crisis; it is a blueprint that neo-liberal politicians and Governments have been following for decades. Many thought that the meltdown of the global financial system in 2008 would prompt a comprehensive rethink of the principles underlying global capitalism, but in reality it was exploited to implement austerity and defund public services and social welfare provision on a grand scale. Covid illustrated that no more keenly than in respect of social care.

The 2018 report on social care from the other place pointed to a gap in service for 1.4 million people. This year, the Independent Care Group suggested that 1.5 million people are already living without the care that they need. The number keeps growing. One and a half million vulnerable and elderly people throughout England—husbands, wives, parents, grandparents, brothers and sisters; each and every one deserves much better from their Government. The Government are presiding over a social care system that is close to collapse.

Sir Simon Stevens, chief executive of the national health service, told the BBC that the covid-19 crisis had shone “a very harsh spotlight” on the “resilience” of the care system. The truth is that it comes down to priorities and political choices. To reform social care to pre-austerity levels will now cost more than £14 billion. That is a large sum, but it is £9 billion less than the bank bail-outs of 2007-08, which cost the public purse £23 billion overall. The annual operating costs of Trident nuclear weapons come in at £2 billion—far short of the £14 billion we need to repair the economic vandalism of austerity but, according to the costs worked out by Skills for Care, enough to recruit and train almost 550,000 new social careworkers every single year.

According to Age UK, 167,000 older people and their families throughout England now have to fund their own care because of the means test for free or subsidised support. Older people who are obliged to buy their own care have spent more than £7 billion in the 12 months since the Prime Minister took office and promised to fix social care. Every single day in England, 14 people exhaust their assets paying for care.

The reality is that the social care system that entered the pandemic was underfunded, understaffed, undervalued and at risk of collapse. Any response to covid-19, however fast or comprehensive, would have needed to contend with this legacy of political neglect. Government policies to support social care have faced major and widespread problems, not least the PPE crisis, which has led to a lack of protection for some people using and providing adult social care. Local authorities report that additional Government funding has been insufficient to cover the additional costs.

As has become all too clear throughout the recent crisis in England, protecting social care has been given far too low a priority. When the Minister for Care appeared before front of the Health and Social Care Committee last month, despite admitting that

“the social care system needs fixing”

and making a commitment to do so, she was unwilling to give any date for when the disinvestment of austerity would be rectified. If not now, when?

The UK Government do not even need to look far for inspiration: although challenges remain, they could learn much from Scotland’s approach. The story north and south of the border is very different, as is evident in our approaches to social care post covid. The Scottish Government have established an independent review to look at the creation of a national care service for all. As the Nuffield Trust points out, Scotland’s reforms are

“the most advanced of the countries…having set out an ambitious and comprehensive vision for a social care service.”

Because free personal care has been in place in Scotland since 2002, two thirds of those receiving social care support in Scotland do so in their own homes.

A further lesson from Scotland is the introduction of Frank’s law in April 2019. Under this legislation, free personal care was extended to all adults. Despite all these significant advances being made in Scotland, the system continues to struggle because we are part of the UK. Let us take funding, for example. The simple truth is that, without independence, we are limited in our funding options. Hoping for Barnett consequentials anytime soon seems unlikely, given the UK Government’s timidity towards social care reform in England. Then there is Brexit. While the Government celebrate the end of freedom of movement, the loss of its opportunities is lamented in Scotland. The Migration Advisory Committee is entirely right that this poses a stark risk for social care, given that the services are dependent on EU nationals. UK policy delivers to Scotland a triple threat: a lack of reform to tackle the many pre-existing issues; the Government’s irrational and ideological approach to the EU; and an immigration policy that refuses to acknowledge, never mind accommodate, the specific needs of Scotland.

I had a fleeting hope in March that covid would raise this Government’s eyes to injustice and the value of those in healthcare. I felt sure that honouring all the heroes in our NHS and care sector would naturally follow, but no. With the weekly clapping now a distant memory, many do not feel valued or do not feel that their efforts are properly recognised. Campaigners are calling on Ministers to boost nurses’ pay without delay. The Scottish Government are currently delivering the highest pay award in the UK for NHS Agenda for Change staff of at least 9% over the three years from 2019. They also gave an immediate 3.3% pay rise to social care workers and have just announced £50 million for the social care staff support fund for those who contract covid-19.

This Government sprang into action to approve countless contracts for their wealthy friends at the start of the pandemic, but that sense of urgency is sadly lacking when it comes to taking action on nurses’ pay or addressing the poverty of carers. The Prime Minister demonstrated yet again today that his ears are made of cloth. He ignores repeated calls for the £20 uplift to universal credit to be made permanent and extended to legacy benefits, which is backed by the Joseph Rowntree Foundation and Save the Children, and he defended his Government’s refusal to feed children in poverty during the summer holidays, yet brags about Marcus Rashford’s campaign this winter. It was support grudgingly given through shame.

We are seeing a return to the lack of compassion of the 1980s, but what we are witnessing now casts minds back further still, not just to the Thatcher years but to Dickensian Britain where great wealth and extreme poverty existed cheek by jowl, conjuring images of barefoot children with empty bowls and a population without access to medical or social care. This is the stark reality of Tory Britain: poverty, a pay-to-access suboptimal social care system, an assault on employment and working conditions, and the exclusion of the self-employed. Coronavirus must not be allowed to cover for the crony virus at the heart of this Government. Some say that Scotland gets too generous a settlement, but that is a false narrative. These policies exist in Scotland because—

[Richard Graham (Gloucester) (Con)]

On a point of order, Mr Deputy Speaker. This debate is about covid-19, the pandemic in our constituencies right now, but the hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey) is taking us back into the 1980s. Is that as it should be?

[Mr Deputy Speaker (Mr Nigel Evans)]

I am not responsible for the hon. Gentleman’s speech, but I know that he will be conscious of the number of people who wish to contribute to this debate. I know him to be a fair man and we are coming now to exactly the same timings of the other Front-Bench contributions, so if he could come to a conclusion, that would be really useful.

[Neale Hanvey]

It may not be the perception of the hon. Member for Gloucester (Richard Graham) that this is important to covid, but it is in Scotland and I am speaking to the people in Scotland.

The policies that exist to support us exist in Scotland because people vote for parties that campaign for these political choices. Prior to the 2014 referendum, Business for Scotland analysis revealed that, in each of the 30 previous years, Scotland generated more tax revenue per head for the UK Treasury than the rest of the UK. The subsidy myth was well and truly busted. The Prime Minister or Conservative Members talk of the generous handout from this Government, but it is not a handout; it is our money. It is our money that they are giving back to us. Scotland’s economy, when benchmarked against similar-sized independent nations that, quite frankly, would love to have Scotland’s economic advantages and natural resources, illustrates vividly the dreadful impact of Westminster’s continued economic mismanagement.

In closing—[Hon. Members: “Hurrah!”] Conservative Members might not like it. Vice-President-elect Kamala Harris recently referenced the following quote:

“Democracy is not a state. It is an act”.

To those aspiring for statehood in Scotland, I say this: it is time for democracy and it is time to act like a state.

[Mr Deputy Speaker (Mr Nigel Evans)]

There is now a five-minute limit.