Health Services: Southend West

Nigel Evans Excerpts

Wednesday 6th July 2022 Commons Chamber

[Anna Firth]

My right hon. Friend makes an important point. While ambulances wait in the hospital car park, another person is waiting at home with a broken hip or something similar and is unable to be picked up.

The 111 service in Mid and South Essex is run by Integrated Care 24, and the service answered 30,396 calls from patients in June. One of the most baffling things about the 111 service is that if a call has not been triaged by a clinician within an hour, an ambulance is automatically dispatched as a fail-safe. In June alone, 100 ambulances were auto-dispatched in Mid and South Essex, which is an average of 3.1 a day, due to delays in patients being triaged. In May, I met an ambulance crew who had been auto-dispatched to treat a 12 year-old child with tonsillitis as the case had not been triaged by a clinician within an hour. The ambulance crew were as surprised as the mother that they had been sent to attend a child with tonsillitis. On average, each ambulance call-out costs the taxpayer about £350. On those figures, we could be spending nearly £500,000 annually in Mid and South Essex alone on unwanted and unnecessary ambulance call-outs. Were that situation to be repeated at every hospital trust throughout the country, we would spend tens of millions of pounds on unnecessary ambulances. Will the Minister commit to reviewing the system that causes ambulances to be auto-dispatched?

Finally, I come to GP waiting times. GPs are at the heart of so much of our health system, and they have traditionally been the first port of call for people who have minor or recurring illnesses, but since the covid pandemic we have had a tsunami of complaints from people who are not able to see their GP. According to a poll by Survation, 47% of people in Southend West experienced problems booking a GP appointment in the past year—that is nearly 50% of people who are trying to see their GP. Every week, I am contacted by at least three constituents who are struggling to get a GP appointment. Generally, the complaint is that patients are in an endless loop of calling their practice in the morning and being told that there are no appointments available and they should call back in the afternoon, only to be told then to call again the following day—and they go round the buoy again. In one case, it took a constituent five weeks to get an appointment with his doctor. At West Road surgery, in my constituency, there are currently three-week delays for urgent blood tests. I have also received many reports of GPs delaying the return of medical forms to the Driver and Vehicle Licensing Agency and of delayed referrals to specialists. One constituent who had suffered a minor injury to his head and needed to see a GP for a check-up and bandaging had to call an ambulance and attend A&E because no appointment was available. This simply adds to the pressures I spoke about earlier in this speech.

Some surgeries in my constituency are attempting to innovate by bringing in an e-consult system, but they are doing so without writing and explaining the new system to their patients in advance—I am told there are no funds from the clinical commissioning group for such a letter. Not surprisingly, that is adding to the levels of frustration and anxiety. Besides, this online system is not suitable for many of the most elderly and vulnerable people in my constituency, who do not have access to the internet. Nationally, 54% of over-75s are not online, and the figure for the city of Southend is 8%, so we are talking about 12,000 people who have never even used the internet.

What my constituents need and deserve is to be able to visit their doctor, and that brings me to my final ask this evening. We can implement all sorts of clever systems to reduce waiting lists, but what we really need is more GPs and more appointments. Will the Minister please let me know what is being done to recruit more doctors in Southend, and what is being done to encourage them to increase the number of in-person appointments available?

I started this evening’s speech on a positive note by thanking our brilliant health workers, and I want to conclude on a similar one. We have some brilliant initiatives locally that are already making people in Southend West healthier. Southend University Hospital is piloting an innovative enhanced discharge service, a collaboration between Southend-on-Sea City Council, Southend clinical commissioning group and the hospital. This is helping people to get home when they have been in hospital, and it is a brilliant therapy-led assessment service that really puts people at the heart of ongoing care. I am delighted that the Government have praised the scheme, and I look forward to it being extended. I would like to take this opportunity to invite the Minister to come and visit the hospital; he and his ministerial colleagues—whoever they may be—are always welcome to come and visit.

My hon. Friend the Member for Rochford and Southend East (James Duddridge) would raise the case for a Shoebury health centre if this debate covered the whole of Southend, but I know the Minister is already aware of his passion and support for such a proposal. I fully support this endeavour and indeed would welcome one of these in Southend West as well.

To conclude, my main asks this evening are as follows. What is being done to recruit doctors in Southend, and what is being done to encourage them to increase the number of GP appointments available? What is being done to reform the 111 service to ensure ambulances are not auto-despatched needlessly? Most importantly, will the Minister please confirm tonight the release of the £8.4 million of enabling funding that is so vitally needed to improve the Southend emergency department?

[Mr Deputy Speaker (Mr Nigel Evans)]

As the Minister is a regular attendee at Adjournment debates, I would normally say that I am delighted to see him here today. After the events of the last 24 hours, however, I will say that I am relieved to see that he is here to respond to this debate.

Ambulance Waiting Times: Royal Cornwall Hospital

Nigel Evans Excerpts

Wednesday 29th June 2022 Commons Chamber

[Edward Argar]

I gently say to the hon. Gentleman that the hon. Member for North Shropshire (Helen Morgan) made the point about delays in respect of her county in March, so we are seeing significant challenges across the country. I have highlighted some of the specific points about Cornwall, such as the geography and the distances. It is also about demand, which, as I alluded to, does not abate even slightly in the summer. There is a range of factors—my hon. Friend the Member for Truro and Falmouth highlighted a number of them—and I have set out some of the measures that we are taking to address them.

Nationally, as my hon. Friend alluded to, a wide range of support is in place. Ambulance trusts receive continuous central monitoring and support from the National Ambulance Coordination Centre, and NHSEI has allocated £150 million of additional system funding for ambulance service pressures in 2022-23, which will support improvements to response times through additional call handler recruitment, retention and other funding pressures.

National 999 call handler numbers have been boosted to more than 2,300 at the start of May 2022, which is about 400 more than in September 2021, with further potential increases. We are also investing £20 million of capital funding in ambulance trusts in each of the three financial years to 2024-25, in addition to the £50 million national investment across NHS 111.

We continue to work closely, in terms of additional resources and system pressures, with the ambulance trusts in the south-west and across the country. I am grateful to my hon. Friend for highlighting this hugely important issue. Her constituents are lucky to have her representing them in this place. I will continue to work with her and other right hon. and hon. Members, and the system, to deliver the improvements that we all wish to continue seeing.

[Mr Deputy Speaker (Mr Nigel Evans)]

I, too, welcome Mr Foord to the House on his maiden intervention—if such terminology exists; it does now.

Question put and agreed to.

Access to GP Services and NHS Dentistry

Nigel Evans Excerpts

Tuesday 21st June 2022 Commons Chamber

[Several hon. Members rose—]

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. As Members can see, there is a great deal of interest in this debate. I am not imposing a time limit now, although I—or whoever occupies the Chair after me—will obviously be free to do so later, but some discipline in this regard would be very useful. We will start with Paul Blomfield.

Childhood Cancer Outcomes

Nigel Evans Excerpts

Tuesday 26th April 2022 Commons Chamber

[Several hon. Members rose—]

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. The last speaker on four minutes will be Taiwo Owatemi, and we will drop the time limit to three minutes thereafter.

--- Later in debate ---

[Taiwo Owatemi]

I agree. My hon. Friend makes an important point. We need more funding for cancer research across all cancers.

His medical team did everything they could to save Ben but, in the end, decades of circumstantial neglect of RMS patients failed him. With Ben in mind, I just wish to make two brief points today. The first is that this Government must do better to encourage research into cancers that primarily affect children, not just adults. Parent-led charities and special named funds such as Pass the Smile are fundraising at grassroots level, but it is not right that the burden of raising funds should fall on the shoulders of bereaved parents. Secondly, we must treat the issue of childhood cancer outcomes with more urgency. We regularly call childhood cancers “rare”, but we must not lose sight of the fact that cancer is the disease that most commonly kills children.

Finally, I wish to thank Ben’s parents, Sarah and Scott, for allowing me to share Ben’s story, for their bravery and, above all, for their desire to ensure that no other family goes through what they have been through. I hope that the Government will listen to the stories that Members have shared today, and take the necessary steps to encourage greater awareness and improve research into cancers affecting children.

[Mr Deputy Speaker (Mr Nigel Evans)]

Thank you. There is now a three-minute time limit.

--- Later in debate ---

[Dame Caroline Dinenage]

I thank all hon. Members from both sides of the House who have supported this debate. In some cases, they have shared their own experiences and, in other cases, they have shared the incredibly sad and touching stories of their constituents. Other hon. Members wanted to be here to raise their own cases, including my hon. Friend the Member for Moray (Douglas Ross), who wanted to talk about Abbie’s Sparkle Foundation.

The stories have been incredibly difficult to listen to, but as hard as they are to hear, they are infinitely harder to go through. Families up and down the country who have been supporting children with cancer go through that every single day. I would like this debate to be a tribute to those children. The hon. Member for North Antrim (Ian Paisley) said that we have to be the voice of the voiceless, which is what we are all here for. It is not enough to pay tribute or say that we have listened. Actions speak louder than words.

The Government’s 10-year plan for cancer is a once-in-a-generation opportunity to move the dial on children’s cancer outcomes. It is a chance to shine a spotlight on this often devalued and much neglected area of medical research. The Minister talked about the research that is ongoing, but it is nowhere near the research that is going on in many other forms of cancer. It is a Cinderella and a backwater of research, which is not good enough.

The 10-year plan is a chance to introduce the mission on childhood cancer, which could really make a difference and save lives in future. It is a chance to introduce Sophie’s mission, Rayhan’s mission, Ebony’s mission, River’s mission, Alice’s mission—a mission for every single child whom we have heard about today and all the others yet to come. We have to stop failing children like this.

Question put and agreed to.

Resolved,

That this House has considered childhood cancer outcomes.

[Mr Deputy Speaker (Mr Nigel Evans)]

We will pause momentarily while hon. Members leave the Chamber.

Ambulance Response Times: Shropshire

Nigel Evans Excerpts

Thursday 31st March 2022 Commons Chamber

[Edward Argar]

I am grateful to the hon. Lady, and I will turn to her specific asks in a moment.

However, I will turn now to the Bill introduced by the hon. Member for St Albans (Daisy Cooper), which I am aware of. I have to be honest and say that we do not consider that the Bill would necessarily be the most appropriate way of achieving what she wants. The challenge with that legislation is that, at a time when we wish trusts to be focused on the delivery of frontline services, it is another administrative process of data collection. I would add that trusts of course operate at trust level, not at an individual station or county level, and trusts may cover a number of counties. So while I am aware of her legislation, it is not something that I believe would achieve the outcomes or be practical in the way she wishes, and she and I regularly have a to and fro across the Dispatch Box about a number of issues when she speaks for her party on health and care matters.

There is strong support in place to improve performance. At the national level, as the hon. Member for North Shropshire generously recognised, there was £55 million of investment last summer, in advance of the winter, to help increase ambulance staffing capacity to manage pressures. All trusts received a portion of that funding to expand capacity through additional crews on the road and additional clinical support in control rooms as well as extending hospital ambulance liaison officer cover at the most challenged acute trusts.

On overall staffing, which includes frontline clinical staff and the clinical support staff who work with them, our ambulance service has seen about a 38% increase since 2010—the Liberal Democrats can quite rightly take some credit for that from their five years in government—and, indeed, in the last year we have seen an increase of about 500 frontline staff. So we have increased staff and continue to increase available staff.

The £55 million was supported by an additional £4.4 million in capital investment—these are still national figures, but I will turn to her specific local circumstances—which helped to keep an additional 154 ambulances on the road during winter over and above normal levels. Call handler numbers, which are equally important, are being boosted with more than 2,400 on target to be in place by the end of March—the end of today. That is about 500 more FTE—full-time equivalent—staff compared with September 2021, with potential for services to increase in capacity further during the coming financial year.

NHS England and Improvement is also providing targeted support to the hospitals facing the greatest issues with delays in the handover of ambulance patients, helping them to identify short and longer-term interventions to reduce delays and get ambulances swiftly back out on the road. She is right that that is hugely important, and even more so in areas with large rural populations because of the distances involved. Trusts also receive supportive continuous central monitoring and support by NHSEI’s national ambulance co-ordination centre.

With clinical support in control rooms, the ambulance service is closing just over 11% of 999 calls with clinical advice over the phone, which is an increase of three quarters since before the pandemic. That helps to save valuable ambulance resources to respond to more urgent calls, with that clinical input ensuring that the advice and decisions are right.

The hon. Lady will be pleased to hear that significant local support is in place to improve response times in her county. The West Midlands Ambulance Service is working with community partners to help avoid conveying patients to hospital where there is no clinical necessity, providing alternate treatment and care at home or in the community and helping to avoid unnecessary trips to hospital, thereby freeing up resources and hopefully providing a more pleasant experience for those patients.

In raw numbers, the West Midlands Ambulance Service conveyed over 600 fewer patients to hospital in February based on the clinical advice this year compared with two years ago. It has also introduced a clinical validation team of advanced paramedics who work in control rooms and clinically triage lower urgency cases and, where appropriate, signpost patients to other services, as I alluded to. In February, that team reviewed 967 cases in Shropshire, of which 61% of were not sent an ambulance, 14% were treated on the scene and just 25% were conveyed to hospital. That was based on the clinical triage, which I am sure the hon. Lady agrees should be central to any decisions made. That has played a significant part in helping the service to tackle the pressures.

Other practical solutions include hospital ambulance liaison officers—HALOs—who are paramedics who work with bed managers to smooth out the flow of patients coming to an A&E department. They can provide a constant flow of information about capacity to the strategic command cell at the ambulance service headquarters, escalating any issues and avoiding queueing where possible. There is also joint work to cohort ambulance patients at A&E sites, where a single ambulance crew takes responsibility for three or four patients. That releases crews to respond to outstanding calls in the community more quickly.

A new same-day emergency centre—SDEC—has been opened at the Royal Shrewsbury to divert patients, as clinically appropriate, away from A&E, improving handover times. In the two and a half years that I have been a health Minister, I have discovered that there are probably almost as many acronyms in health as in the Ministry of Defence. Surgical SDEC capacity at the Royal Shrewsbury has also been expanded and all SDEC units receive ambulances directly for suitable patients.

The hon. Lady rightly mentioned hospitals, and I am grateful that my hon. Friend the Member for Telford (Lucy Allan) is here and made an intervention. During her seven years in the House, she has been a regular and vocal advocate for her local hospital in Telford. I pay tribute to her, because it was due to her campaigning and tenacity that there is an A&E locally at Telford. That is still seeing patients and helping to alleviate the pressure in Shropshire. She should rightly be proud of that, having successfully campaigned for it.

Action is being taken locally to improve the patient flow through hospitals by discharging patients more quickly to create bed space. The aim is not only to increase the number of discharges a day, but to bring more discharges forward to earlier in the day, when it is clinically safe to do so, to allow the effective discharge and transition back to care at home or in a care home. Health and care system partners locally are looking to create additional community and social care capacity to support timely discharge, create bed space to take patients from A&E and reduce ambulance handover times.

At a national level, we have set up a national discharge taskforce. As a Minister, I get almost daily statistics about where we are on delayed discharges across the country. It is a complex picture, with a variety of reasons behind delayed discharges. The hon. Member for North Shropshire is correct that some are about delays in getting into care homes or getting domiciliary care packages or rehabilitation packages at home. Some are also down to delays in the hospital in sign-offs and procedures, and there is more that we continue to do to drive those delays down.

Construction is also under way on a new modular ward at the Royal Shrewsbury site, with 32 additional beds in service by spring 2022. That is alongside a £9.3 million upgrade of the emergency department at the Royal Shrewsbury, delivering additional cubicles, a new and improved majors department, a new designated emergency zone for children and young people and a new clinical decisions unit. The first phase of that work is complete and all areas will be finished by spring 2022.

The hon. Lady raised a number of other issues, including the Future Fit model. We have been clear that funding of £312 million was allocated for that project, and that remains allocated. The challenge we face is that, thus far, the trust has not proposed a solution that meets that budget. We continue to work with the trust and to encourage it to do so. I hope that it will so that we can continue to drive that important project forward.

I will very gently push back on what the hon. Lady said about there being £10 billion of PPE that is not fit for purpose. She will know that that is not correct. In the statement that was made about write-downs, not write-offs, the amount was about £8.7 billion, and it was not all PPE, by any means, that was not fit for purpose. Only a tiny proportion of that was the case. A significant element of that was essentially due to over-ordering at the height of the pandemic to make sure that the frontline had the PPE that it needed. We were buying at the height of the market, and there is currently a glut of PPE, so its value has inevitably declined. Not all of it will be used, because we got more than we needed to make sure that clinicians and others on the frontline were not exposed.

The hon. Lady touched on local ambulance Make Ready stations and the changes to them. Decisions on reconfigurations and changes to that are made locally by the trust; it consults, but it makes those decisions. The Government do not have any power over those matters. The Health and Care Bill, which we debated yesterday, would give the Secretary of State greater power over such reconfigurations in the way that she asked, but her hon. Friend the Member for St Albans argued against that. I gently say that that is a matter for the local trust and the usual NHS processes on reconfigurations.

The hon. Lady touched on, I think—forgive me if I am wrong—asking the CQC to look into this issue. It is entirely open for her or others to raise it with the CQC, and the CQC will make a decision or a judgment on whether it believes that it is appropriate or otherwise to look into the matter.

In the few seconds that I have left, before Mr Deputy Speaker calls me to order, I say that I recognise and do not in any way diminish the significance of the issues that the hon. Lady raised. I hope that I have given her some reassurance that we are working through these issues and that we continue to put the support in place to help her constituents in Shropshire and more broadly.

Finally, the hon. Lady requested a meeting, and I am conscious that she has raised the issue of correspondence. I have asked for that; I believe that that has happened since Christmas, as the Department works through the backlog. There is still a delay in correspondence, but I have pulled that out and asked for it, and I am happy to meet her and her fellow Shropshire MPs, together with the ambulance trust, to discuss their collective concerns or reflections that they would like to put to me as a Minister.

I conclude by wishing the hon. Lady a very happy Easter and by thanking her for bringing this to my attention and the attention of the House.

[Mr Deputy Speaker (Mr Nigel Evans)]

On behalf of Mr Speaker and the entire Deputy Speaker team, I wish a happy Easter and a good recess to all who work here.

Question put and agreed to.

Health and Care Bill

Nigel Evans Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Several hon. Members rose—]

[Mr Deputy Speaker (Mr Nigel Evans)]

A lot of people want to contribute to this debate, and this first group must come to an end at 10 minutes past 5. Those who make long contributions really are doing other people out of an opportunity to speak.

[Greg Smith (Buckingham) (Con)]

I will be as quick as I can, Mr Deputy Speaker. The point underlying my amendments to Lords amendments 123 to 127 is relatively straightforward and simple. I heard what the Minister said in his opening remarks, but I feel that if we act in a way that impacts an industry—in this case, UK broadcasters—as severely as the advertising restrictions will, and we are talking about a £200 million a year loss to our great British broadcasters, it is a matter of fairness and equity that we should give them enough of a lead-in time, enough notice and enough ability to adapt, remodel their services and find a way of surviving, to put it bluntly.

I have spoken before in the House about the fact that I do not agree with the nanny state and telling advertisers what they can and cannot advertise. The Lords amendments that we are considering, and my amendments to them, are very much about the implementation of a policy, and about giving British broadcasters—public service and fully commercial ones alike—a fighting chance. It would be much fairer to give broadcasters at least a year to comply from the point at which Ofcom publishes its guidance and puts it in the public domain. Broadcasters and advertisers will have to go through a lot of processes once this Bill receives Royal Assent, and that cuts the time that they have to put in place new policies, compliance checks and mechanisms to comply with the legislation. Two months on from Royal Assent, Ofcom will not even have got its statutory powers in this regard, and so will not even be able to start work with the Advertising Standards Authority and other bodies on the detail, and the ways and means of implementation.

--- Later in debate ---

[Dr Johnson]

No, I am going to continue. The other problem with giving tablets—[Interruption.] The hon. Lady spoke for 16 minutes, which is considerably more than a fair share, given the number of Members who want to speak, so I will keep going.

The other problem is who will take the tablets. If someone is prescribed something of such severity over the telephone, the clinician does not know who will take the tablets. Will they be taken by the woman speaking to the clinician on the telephone? Will they be given to somebody else? Are they going to be sold to somebody else? Is somebody else going to be forced to take them? The reality is that we do not know and we cannot know, and that is another safety issue.

I will summarise my concern by saying, as a woman— I have not had an abortion, but I guess in the future I could become pregnant and not want to be—if I were having an abortion, I would rather have the inconvenience of having to go to a clinic than the worry of knowing that some women are having abortions without going to a clinic. Essentially, for me this is an issue of whether we want to make things more convenient for the majority of women, or we want to protect the women who are the most vulnerable, the most marginalised and the most at risk.

[Mr Deputy Speaker (Mr Nigel Evans)]

I intend to call the Minister at 5 o’clock to give him 10 minutes to wind up. We have not got long, so will Members please keep their contributions as short as they can?

[Jim Shannon (Strangford) (DUP)]

Thank you for calling me, Mr Deputy Speaker, to speak in this debate. I am pleased to follow the hon. Members for Sleaford and North Hykeham (Dr Johnson) and for Congleton (Fiona Bruce). I thank them both for the contributions.

It will be no surprise to the House that I am here because I abide by the absolute view that both lives matter—the unborn child and the mother. I know that many people believe that if someone is anti-abortion, they are anti-woman. I am not—I never have been, never will be and it is not the case. I believe in life and helping people. My career and all my life have been based around that, and I will continue as long as God grants me the strength to do so.

The Minister referred in his introduction to the fact that the regional devolved Administrations will make their own decisions. They can make that decision in Scotland and Wales, but we cannot make that decision in Northern Ireland, because the Government made it here. They took that decision away from us, and I am particularly concerned about that.

I have several concerns about the approach adopted during the pandemic in relation to so-called telemedicine to access abortion, which was recognised at the time as short-term. Without a face-to-face appointment, there is no confirmation of how many weeks pregnant a woman is, which makes a difference to the experience of an abortion at home. As reported in the summary of consultation responses, women who had experienced an abortion said that information should be provided on

“how inaccurate dating of pregnancy may mean increased pain and bleeding”.

A woman whose pregnancy is later than 10 weeks could find herself unexpectedly passing a mature baby at home, which could lead to significantly more complications. I understand that those advocating for the Lords amendment argue that complications have decreased since the pandemic, but I question the evidence, given that the Government and the Minister’s Department say that

“data on complications is incomplete”

and they are working on reviewing the system of recording abortion complications.

I am also persuaded by the concerns about the increased possibility of a woman finding herself pressurised at home to have an abortion that she does not want, as other hon. Members have said. There is a well-known link between abortion and domestic violence. Indeed, the BBC published a survey a few weeks ago reporting that 15% of those surveyed said they had felt pressured into ending a pregnancy. How are we protecting those women? How can doctors know that they are really speaking to a woman who is voluntarily calling about an abortion, or even that they are speaking to the right person at the other end of the phone?

There are many differing and strong views on this subject on both sides of the House, but I question whether the women who find themselves coerced into an abortion from their home, or who have found themselves bleeding unexpectedly at home or having an abortion much later in their pregnancy than they expected, would agree that telemedicine abortion is a positive step in women’s health. I doubt that they would.

I have recently been vocal regarding the need for face-to-face GP appointments. I have been inundated by constituents who simply have no confidence that a diagnosis by picture or telephone call is safe. I have constituents whose cancer has been undiagnosed because the GP was unable to see first hand what would have been clear in a face-to-face appointment. I believe that face-to-face appointments should be available.

I find it difficult to understand how pills to end life—to take away life—in a painful manner for the mother can be given without seeing someone to assess what cannot be seen on the phone. The signs and movements that an experienced GP can see that point to a deeper problem cannot be discussed in the two minutes allocated to such phone calls and I am fearful that the duty of care that we are obliged to discharge will continue to be missed. I am diametrically and honestly opposed to this legislation, because as I said at the outset, both lives matter. Lives could have been saved if abortion had not been available on demand.

I will vote against the permanent extension of this ill-advised scheme today and urge hon. Members on both sides of the Chamber to join me. It is a step backwards rather than forwards in providing adequate support and care for women, and it further normalises the practice of abortion as a phone call away rather than as a counselled decision under medical care, which is what it deserves to be. I, my constituents and my party are clear that this is a massive issue. I fully and absolutely oppose the Government in what they are putting forward today, for the safety of both mothers and the babies, because I am about saving lives, not destroying lives.

--- Later in debate ---

[Several hon. Members rose—]

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Three Members are standing and I want to get you all in, so we will have a four-minute time limit.

[Sir Edward Leigh (Gainsborough) (Con)]

Obviously, abortion is a deeply emotional issue and we probably all know where we stand, but this is not a debate about abortion. At-home abortions were brought in as a purely temporary measure to defend women’s health. It was always the understanding that the measure would continue just as long as the pandemic continued.

There are many different arguments about this issue. I could go through the statistics that have been given to me that some people might deny, but it is undoubtedly the case that more than 10,000 women who took at least one abortion pill at home provided by the NHS in 2020 needed hospital treatment. There is therefore an issue around safety and women’s health and we need a proper debate. This amendment was brought in in the House of Lords at night-time. Barely a seventh of the Members of the House of Lords actually took part in the Division. We need a proper, evidenced debate on this issue. There is nothing more important when a human life is at risk.

Of course, we all support telemedicine; I chaired a meeting yesterday on atopic eczema and we are making wonderful steps, but as important as curing atopic eczema is, it is nowhere near as important as a situation where a life is at stake. I know that there are different views about coercion, but surely the whole point of the Abortion Act, for those who supported it, was to get abortions into a safe medical location and to get them away from the backstreets. People surely did not want them to be done at home, where there is risk. The hon. Member for Upper Bann (Carla Lockhart) spoke about the case of the 16-year-old girl who delivered a foetus who, apparently, was 20 weeks old. That is why, as my hon. Friend the Member for Congleton (Fiona Bruce) said, the National Network of Designated Healthcare Professionals for Children welcomes the Government’s stance, and why children and young people will be provided with protections.

I urge hon. Members, whatever their view, to think, to consider the evidence and not to rush in. The amendment goes completely against the whole spirit of the Abortion Act. Whatever we think of that Act, the amendment would be a huge new step that I believe would put more women’s health at risk and possibly lead to coercion—we need more evidence on that. I therefore support what the Government are doing today.

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[Edward Argar]

I beg to move, That this House disagrees with Lords amendment 11.

[Mr Deputy Speaker (Mr Nigel Evans)]

With this it will be convenient to discuss the following:

Government amendment (a) in lieu of Lords amendment 11.

Lords amendment 51, Government motion to disagree, and Government amendment (a) in lieu.

Lords amendment 80, Government motion to disagree, and Government amendments (a) to (n) in lieu.

Lords amendment 81, and Government motion to disagree.

Lords amendment 90, Government motion to disagree, and Government amendment (a) in lieu.

Lords amendment 105, Government motion to disagree, and Government amendment (a) in lieu.

Lords amendments 1 to 10, 12 to 28, 31 to 41, 49, 50, 65, 83, 102 to 104, 106 and 107.

[Edward Argar]

Let me repeat, quite legitimately, what I said in opening the debate on the previous group of amendments. It is a pleasure to serve opposite the shadow Minister, the hon. Member for Bristol South. It was also a pleasure to serve opposite her in the Bill Committee. She was not the shadow Minister then, but she brought her expertise and, as I said earlier, her forensic knowledge of these areas of the Bill—occasionally to my slight discomfort—and, overall, a degree of informed deliberation to our proceedings.

The amendments in this group relate to integration, commissioning and adult social care. The Government’s amendments strengthen our expectations of commissioners, especially in relation to mental health, cancer, palliative care, inequalities and children. Lords amendments 1, 25, 27 and 49 strengthen our approach to mental health. Amendment 49 makes it clear that “health” refers to both physical and mental health in the National Health Service Act 2006.

Ambulance Services in England

Nigel Evans Excerpts

Thursday 10th February 2022 Commons Chamber

[Justin Madders]

In my constituency, the British Heart Foundation has told me that it is concerned about reports from the North West Ambulance Service that patient flow in and out of emergency departments is currently very slow, with ambulances being held for long periods, which has the knock-on effect, of course, of causing higher category 1 and category 2 stacks. Worryingly, we have heard reports of delays of up to four hours in these queues.

I am sure these figures, as shocking as they are, will not surprise hon. Members who, like me, have probably had many emails of concern and complaint from worried constituents. Behind these statistics are tens of thousands of seriously unwell people in dire need of help. As the chief executive of the Patients Association said:

“Going to A&E can be frightening. To then be stuck in an ambulance unable to get immediate medical help once you get there must add to the trauma of an emergency visit.”

I think we can all understand where they are coming from. The Royal College of Nursing’s director for England also points out:

“Having to wait outside in an ambulance because A&E is already dangerously overcrowded is distressing, not just for patients but also for staff, who can’t provide proper care.”

It must be so frustrating for those staff, knowing there are other urgent calls they could be going to, that they cannot leave their current patient because the hospital is already at capacity.

I agree with those comments. Not only does having an ambulance stuck outside A&E as it waits to offload a patient mean that it is unable to answer 999 calls, which leads to slower response times, but it means we lose ambulance hours. We lost 8,133 ambulance hours in the last week of January due to crews having to wait outside busy A&Es. That is an incredible statistic.

As NHS Providers points out:

“safety risk is being borne increasingly by ambulance services.”

We know that people are dying in the back of ambulances or soon after their admission to hospital because of these long waits. We heard from ambulance chiefs in November that 160,000 patients come to harm each year because ambulances are backed up outside hospitals.

The shocking report from the Association of Ambulance Chief Executives, which is based on NHS figures, did not report how many patients die each year because of ambulances stuck outside hospitals, but it did say:

“We know that some patients have sadly died whilst waiting outside ED”—

emergency departments—

“or shortly after eventual admission to ED following a wait. Others have died while waiting for an ambulance response in the community.”

The report acknowledges that, whether or not those deaths were inevitable

“this is not the level of care or experience we would wish for anyone in their last moments.”

The report also highlights that around 12,000 patients suffered serious harm because of delays, sometimes with a risk of permanent disability. In the same month, more than 40,000 people in England who called 999 with a category 2 condition such as a stroke or heart attack waited more than one hour and 40 minutes for an ambulance. Of course, the NHS target is to reach them within 18 minutes.

Just last week, NHS figures revealed that thousands of people are dying because ambulances are taking too long to answer emergency calls. The official statistics show that only three of England’s 32 ambulance services are reaching a majority of immediately life threatening call-outs within eight minutes. In fact, the latest available NHS England data for December 2021 shows that the average ambulance response time for category 2 emergencies —suspected heart attack and stroke patients—is 53 minutes and 21 seconds: three times the 18-minute target. Those are incredibly worrying figures.

The British Heart Foundation also reports that there were 5,800 excess deaths from heart and circulatory diseases in England during the first year of the pandemic alone. Although it acknowledges that these excess deaths were driven by a multitude of factors across the entire patient pathway, it also says it is very plausible that some of the deaths could have been prevented if these people had been able to access urgent and emergency care in a timely manner. If we are to avoid more preventable deaths and disability from heart conditions, it is vital that the most critically ill patients can access the care that they need when they need it.

Perhaps the Minister will be able to say what action has been taken to address the dangerous impact on emergency heart attack and stroke care and the victims whose lives are being put at risk, what conclusions the Department has reached as to why so many trusts are failing to reach the targets that have been set for them, and what steps are being taken to reduce waiting times for responses to 999 call-outs and ambulance waits. We know that these delays matter. If 90% of 999 calls were answered in time, 3,000 more heart attack victims could be saved each year.

I have reeled off a lot of statistics. Now I want to give a couple of constituency examples to show what this means for people who have experienced long waits. Thankfully neither case ended in tragedy, but these were clearly difficult and distressing times for those involved.

One constituent told me that she had waited more than 10 hours for an ambulance, having first called 111 at about 10.15 am, when she was advised to call 999. When she called 999, it took a few minutes for the call to be answered. The call handler confirmed that an ambulance would be coming, before asking if it was OK for her to hang up and go on to the next call. About an hour later, having seen no sign of the ambulance, my constituent called 111 again and was told to call 999, but was then told that the ambulance waiting time was about eight hours. At 2.30 pm she was forced to call 999 again, as her husband’s condition was becoming noticeably worse. By that stage he could not move or talk because he was in so much pain. The call handler took the details again, but advised my constituent only to call if the condition worsened further.

Another three hours passed, with my constituent’s husband in absolute agony. When she decided to call again at 5.30 pm, she waited more than five minutes for the call to be answered. The call handler asked if the patient was breathing, and said that an ambulance could only be sent if a patient was not breathing, as it was a busy day, although he did also confirm that the request for an ambulance had been prioritised after her call at 2.30 pm—which, by that stage, was three hours earlier.

The ambulance eventually arrived at 8.45 pm, 10 and a half hours after the initial call. Unsurprisingly, my constituent told me that the paramedics were lovely and could see immediately that her husband needed to go to hospital. When he arrived there, he was scanned and treated, and operated on within 24 hours. It was clear that he needed urgent medical treatment; in fact, he probably needed more treatment than he would have needed had he been seen at the right time. However, in the long run, no serious harm has come to him.

That is just one example of a person who waited longer than they should have. It was not an isolated incident; we know that this is happening week in, week out throughout the country. Another constituent told me that he called an ambulance after his wife collapsed at home. They are both pensioners. My constituent called 999 at 11.45 am, and was told that an ambulance would not be able to attend for at least nine hours. He cancelled the call.

The Minister will no doubt be aware of the tragic case of Bina Patel, which has received considerable media coverage, and has been raised by my right hon. Friend the Member for Ashton-under-Lyne (Angela Rayner). Anyone who has heard the calls that were made requesting an ambulance, and the clearly urgent nature of those calls, cannot fail to be concerned about what is happening in our ambulance services. As I have tried to emphasise, these are not one-off incidents; they are part of a wider pattern, and symptomatic of a system unable to cope with the demands placed on it.

Targets are not being met and people are being put at risk or worse, but NHS England’s response is a proposed new standard contract which contains a “watering down” of several waiting-time targets, with standards lower than those that were in place before the pandemic. The proposals include scrapping the “zero tolerance” 30-minute standard for delays in handover from ambulance to A&E and setting it at 60 minutes, and introducing the additional targets that 95% of handovers must take place within 30 minutes and 65% within 15 minutes. I do wonder how performance can be improved if targets are loosened. The pandemic should not be used as a cover for this, as performance across the system was getting worse before the pandemic. Indeed, it is nearly seven years since the normal targets were met. By scrapping standards for delays in handover, the Government are trying to normalise those longer waiting times. My hon. Friend the Member for Ilford North (Wes Streeting) asked the Secretary of State earlier this month whether he really thought it should take an hour just to be transferred from an ambulance into a hospital. It should not take that long. Does anyone really think it is acceptable for people ringing 999 to be told they must make their own way to hospital?

I am sure the Minister is aware of reports in the Health Service Journal last month that several trusts, most notably the North East Ambulance Service NHS Foundation Trust, advised people calling 999 with symptoms of a heart attack or stroke to take a taxi or a lift with family or friends rather than waiting for an ambulance. I am sure the Minister will want to comment that that is not what we want to be hearing from our ambulance services.

The British Heart Foundation told me that it recently reviewed two calls to its heart helpline that highlighted instances where patients with suspected heart attacks called 999 and paramedics did attend, but then asked both to have their family drive them to hospital for further tests because the ambulance services in their area were under so much pressure. Neither person actually went to A&E, which is most unfortunate: one did not want to bother their family and the other thought that, if the ambulance was not taking them, their situation must not be urgent enough, which of course was not the case.

In short, those two patients did not access the care they needed because of the message being sent out about the burden they were placing on the system. That is completely wrong and certainly not the message we should be giving people who are clearly in urgent need of treatment.

A recovery plan has been announced this week, which, if we are honest, does not really address the issues of the wider NHS and social care pressures. It does not have any real plan for this particular area. The recovery plan, such as it is, is one part of the much wider system overhaul that is needed.

The Secretary of State said this week that approximately 10 million people represent missing referrals who did not come forward for treatment during the pandemic. I am afraid they may well end up becoming urgent referrals because they have not been through treatment and been spotted and helped at an earlier stage. I do not know whether the Government have given any thought to whether those 10 million missing referrals will lead to increased pressure on emergency services and A&E attendances.

What about those people whose care was not managed to target? The British Heart Foundation estimates that up to 1,865,000 people with high blood pressure were not managed to target last year, which could mean more than 11,000 additional heart attacks and more than 16,000 additional strokes across England over the next three years if those patients do not get support. Of course, that will again increase pressure on urgent and emergency care services in the longer term.

I appreciate there is quite a lot of ground to cover here, but when the Minister responds I would be interested to hear his analysis of the situation, whether he believes the examples I have given are part of a wider pattern of concern or isolated incidents, and what he believes must be done to put the ambulance service on a sustainable, safe footing for the long term. Are those images that we have seen of ambulances queuing up outside hospitals a temporary feature of a very difficult winter, problems with the ambulance service in particular, or symptoms of a wider health and social care system that is under incredible pressure?

[Mr Deputy Speaker (Mr Nigel Evans)]

Back-to-back appearances at the Dispatch Box by Ed Argar.

Dementia Research in the UK

Nigel Evans Excerpts

Thursday 10th February 2022 Commons Chamber

[Debbie Abrahams]

Let me start with some thank-yous. I thank all the speakers who contributed to today’s debate on dementia research, which is absolutely essential for the reasons that many of us have discussed. I am very grateful to every Member who shared their personal stories and experiences.

This is not something that will go away. We will see an increase in people with dementia, but it does not need to be that way. Before I go on to what we need to do and comment on the Minister’s winding-up speech, I pay tribute to my constituency, where we have 3,000 dementia friends. I was the first MP to train as a dementia friends champion; I deliver sessions on the subject across my constituency, and our youth council has taken part in this, too. It is an important way that we can drive up awareness, because so many people have personal experience of the effects of living with dementia. We have an annual memory walk, and many of our retailers have undertaken training, so that when someone gets to a checkout but does not know what they are there for, or what money they need to pay for the goods, there is understanding, rather than tut-tutting.

I worked hard with the Minister over a number of years when he was co-chair of the APPG. There is absolutely unanimity here—my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) referred to it. Members on both sides of the House need to do more. Unfortunately, what has happened so far is not enough. We need to ask the Government to stump up for the commitments that they made in the 2019 general election.

The money that has gone on neurodegenerative diseases research covers a much broader spectrum of diseases than those that contribute specifically to dementia. The early career researchers fund covers all diseases, not just those specifically focusing on dementia. The families of people with dementia deserve better. They deserve delivery on a promise that was made to them more than two years ago. The impact that dementia is having on people’s lives cannot be underestimated.

There is a lot more that can be done. We can have screening programmes, like those that we have for breast, cervical, prostate and bowel cancers, for people in their early 20s and 30s. Diagnostic tools have been developed to enable diagnosis to happen sooner, rather than later, so that dementia does not have an impact on people as they grow older and it is picked up early. It is not good enough for the Government to say, “This is what we are doing.” They really need to deliver.

I hope the Minister will take this message back to the Treasury, so that there is an announcement in the spring statement. I know the Minister is personally committed to this issue, but the Government need to back him up.

[Mr Deputy Speaker]

As the Minister said, this has been a significant debate on the last day before the week’s recess. I have been an MP for 30 years and I remember that one of my first surgery cases was a lady who came to see me. Her husband had a very senior position and was well respected throughout the community but he had succumbed to the cruelty of dementia. She broke down in tears as she told me how she had had to put post-it notes all around their home in order for him to know where the cups were and things like that. My eyes welled up listening to her story. It is such a cruel condition, and we wish everybody working in dementia research in the UK and throughout the world well in order that they can protect lives in the future.

Question put and agreed to.

Resolved.

That this House has considered dementia research in the UK.

Midwives in the NHS

Nigel Evans Excerpts

Monday 17th January 2022 Commons Chamber

[Siobhan Baillie]

I thank my hon. Friend for all the campaigning that he has done—as has my hon. Friend the Member for Rutland and Melton (Alicia Kearns), who is not in the Chamber this evening—and he is absolutely right. Birthing partners not only provide that immediate bond and that precious time with the baby; they provide support for the mother and support for the team, and have the important ability to spot what is going on. A mother who is taking quite a lot of gas and air might need someone else to have a couple of conversations when she cannot do so herself.

We are making changes in schools so that we do not see restrictions and closures again, and I think that if we are ever faced with the need to introduce further covid restrictions, we cannot do that in maternity services. The restrictions have had a knock-on impact on midwives as well: seven out of 10 RCM members have experienced abuse about visiting restrictions. That abuse may well have come from very worried and well-meaning people, but there is no doubt that it has contributed to their wish to leave their jobs.

The campaign group Pregnant Then Screwed did a great deal of work on this, and 98% of respondents to its survey said that the possibility of further covid restrictions on maternity services was causing them anxiety. There is enough for pregnant women to be worried about without their having to worry about that. Mothers reported rushing their hospital care during the pandemic, and seeking early discharge so that they could get home to be with their partners. As was mentioned earlier by my right hon. Friend the Member for South West Surrey, women-centred care is the ethos of midwifery. and continuity of carer is the national recommendation. It is the right approach, but at no stage have the current staffing levels and the impact of covid been taken into account to assess the viability of a new system. The vaccine mandate continues to cause concern, and the potential loss of more staff is adding to the pressure-cooker effect.

We in Stroud are hugely proud of the facilities that we have. In the past, Stroud constituents have come together and fought to save the maternity unit, and that fight was so strong that I do not think anyone would dare to try to close it down again. We have also recently instigated an important campaign to deal with mental health and birth trauma. Between 25% and 40% of women view their experience of giving birth as traumatic—I am probably in there somewhere—and one in four have experienced sexual abuse. Such issues often have a huge impact on fears for pregnancies and future births. The campaign and the dedicated mental health team that Gloucestershire is setting up will change perceptions and conversations surrounding birth from the off. Our minor injuries unit across the road from the maternity unit has received a welcome £2 million for refurbishment purposes. I was at the hospital recently for my scan, and it is really buzzing. Although I have raised some serious matters, I do not want expectant mums to be worried about the care that they will receive at Stroud or anywhere else, as professional maternity teams will look after all of them.

One midwife told me that midwives do not speak out because they are always trying to put the women in their charge at ease, but unfortunately it has reached the point at which they feel that they must do so, which is why they have sent me here today. That said, although a Minister will respond tonight, the issues raised are clearly not just for the Government to address. NHS trusts, their human resources teams, managers, and all of us as patients in society need to think about how we behave, how we use the NHS, and how we can improve it. Making the NHS a political football, claiming that more and more money is the only way to fix issues, or putting the NHS on a pedestal so that there can be no criticism or open scrutiny, will not help a single midwife in this great country. I believe that the men and women of our maternity services deserve better. They literally hold new life in their hands, along with all the hopes, dreams and responsibilities that come with that job.

I leave the final words to a midwife who told me:

“I love my job. I love supporting women and the team. But I too feel that maybe this is as far as I can go. I have never suffered with mental health concerns prior to this last year. Anxiety has crept into my normally happy life due to work issues.”

I think that that is quite a stark way in which to end the debate, and I genuinely think that we can do better. I look forward to hearing from the Minister, who I know cares deeply about this issue, and I am grateful for the time that I have been allowed tonight.

[Mr Deputy Speaker (Mr Nigel Evans)]

The hon. Member for Stroud (Siobhan Baillie) and the Minister have agreed that Taiwo Owatemi may make a short contribution. I ask her please to allow the Minister some time to sum up.

--- Later in debate ---

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

I thank my hon. Friend the Member for Stroud (Siobhan Baillie) for securing this debate and wish her well with her “vested interest” and her pregnancy. I am sure that her experience with her midwife, Jan Partridge, will be positive.

I want to thank all midwives and maternity teams up and down the country. For the past 18 months to two years, they have gone above and beyond their duty. I have visited maternity units, spoken to midwives and heard how difficult it has been, particularly with covid. Being on a maternity ward, particularly a labour ward, is a busy enough experience anyway, but if there are women there with covid, the added infection control measures bring extra pressures. With staff isolating and being off sick, it has been an incredibly busy time, and I have heard at first hand many of the experiences that my hon. Friend raises.

I say to midwives that I fully recognise the pressure that they are under. Sometimes there are not enough staff on the wards, and they are dealing with more complex cases. I hate to use the term “geriatric women”, but we are seeing women becoming pregnant much later in life, with the risks and complications that that brings. We are also seeing babies being born much earlier. The expertise and skills that a midwife brings to those situations mean that we all see the incredible work that they do.

There are three areas that I think we need to address. The first is staff numbers, an issue that the hon. Members for York Central (Rachael Maskell) and for Coventry North West (Taiwo Owatemi) and my hon. Friend the Member for Stroud all raised. I reassure hon. Members that we are trying to get on top of staffing levels. Health Education England undertook a survey based on the Birthrate Plus midwifery workforce planning tool to assess the numbers of current midwives in post, current funded posts and recommended funded posts to try to bridge the gaps between the three. Following that, NHS England invested £95 million to support the recruitment of 1,200 more midwives and 100 more obstetricians and to support multidisciplinary teamwork. There is also £450,000 for a new workforce planning tool at a local level, so that maternity units can calculate their own staffing level requirements.

We are trying to increase the number of midwives in practice. Returners are being encouraged to join Health Education England’s Return to Practice programme, where a payment of £5,000 is given to employers to support returners. Funding is given to the students to pay for their fees and their Nursing and Midwifery Council tests of competence, and they get a stipend while they are learning.

My hon. Friend is right about new students. We have increased student training places to 3,650. We are also recruiting from overseas. Early this year, we are advertising and interviewing for between 300 and 500 overseas midwives to join the NHS in the next 12 months. We are also recruiting extra maternity support workers to support the work of midwives.

We are also trying to improve the environment and to bring in a positive working culture. Some £52 million has been brought in to accelerate the digital maternity programme, so that the burdensome paperwork and paper records that midwives are having to work with will hopefully come to an end. Improving that documentation will improve the outcomes for mums and babies, too.

There is so little time to express how much we are doing. We are trying to bring in a positive working culture; it is not right that midwives are having to go without toilet breaks or are unable to drink during shifts. That is completely unacceptable, and it creates a vicious circle: because working conditions are so tough at the moment, we are losing experienced midwives, which makes trying to recruit and retain more staff even more difficult.

The debate we have had this evening is just the start, and I want to work with Members across the House to ensure that we support midwives as much as we can. We are serious about increasing staffing numbers and improving the working environment for midwives, because that is how we improve the safety of maternity care.

[Mr Deputy Speaker (Mr Nigel Evans)]

The Speaker and his team send their congratulations to the hon. Member for Stroud (Siobhan Baillie).

Question put and agreed to.

Covid-19 Update

Nigel Evans Excerpts

Thursday 13th January 2022 Commons Chamber

[Wes Streeting]

I am not sure that is in order, but what I said from a sedentary position is that the Prime Minister is not fit to lick the boots of NHS staff in this country.

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. We will not have that again, please. No interventions like that, please.

[Sajid Javid]

Again, the hon. Gentleman had another fresh opportunity to thank the NHS staff for the enormous work they have been doing not just throughout the pandemic but in December, and especially for everything they have done to boost so many people, but there was not one word of thanks from him.

I was pleased to hear the hon. Gentleman welcome the new self-isolation policy. He asked whether enough tests are available. He might have heard me say earlier that we have quadrupled the number of lateral flow tests available this month to approximately 400 million, which is more than four times the original pre-omicron plan. I was confused by his response to that, because he seemed to be suggesting that we should be subcontracting our covid policy to the US Centres for Disease Control and Prevention. If I heard him correctly, he was suggesting that just because another country—in this case, the US—has changed its policy, we should automatically follow suit and do what it does.

We have just taken back control from the EU. We have just left the European Medicines Agency, and here the hon. Gentleman is, just months later, suggesting we subcontract our policy to another state. That tells us all we need to know about the Labour party’s approach. He suggests we take the same approach as the US, and he of all people should know that while the US might have an isolation period of five days, they have no testing. I do not know whether the hon. Gentleman heard me earlier, but let me remind him: the UK Health Security Agency data shows that approximately 30% of people are still infectious at the end of day 5. That is why we require two tests.

The hon. Gentleman was suggesting that we should have the same policy as the US, which requires no testing, and for everyone to leave isolation at day 5, regardless of whether they have tested or not, and wear a face mask for the last five days. The hon. Gentleman has to decide whether he wants these decisions to be made here in the UK, based on expert UK advice from some of the best advisers anywhere across the world, or to subcontract them to another state.

Finally, the hon. Gentleman talked about the NHS and capacity. He will know that as a result of the omicron emergency, it has sadly been necessary for the NHS to make changes. Of course that has had an impact on electives. The most urgent electives such as cancer care will be protected, and he heard me talk earlier about the deal that has been done at least for the next three months with the independent sector. I hope he supports that and the measures that the NHS is taking to protect capacity.

--- Later in debate ---

[Sajid Javid]

I thank my right hon. Friend for his support for today’s measures and for being a volunteer vaccinator. People like him up and down the country have come forward in their thousands, especially in the past few weeks as we have made the call for the booster programme. Those volunteers are working alongside the NHS, helped by the soldiers and the military, with whom my right hon. Friend also has direct experience.

I listened carefully to my right hon. Friend’s suggestion, which I think is a very good one. It is not something that I had given any thought to, but I think it is absolutely right that we contact those organisations and see whether they would like to be helpful to our army of vaccinators across the country. It is a very good suggestion; I thank him for it, and we shall try our best to act on it.

[Mr Deputy Speaker (Mr Nigel Evans)]

I call the incredibly patient Matt Western.

[Matt Western (Warwick and Leamington) (Lab)]

I add my voice to the congratulations to Jonathan Van-Tam and all those across our universities and science sectors who have contributed so much. I hope that others will be similarly rewarded.

The Secretary of State is aware of the shortage of testing kits. He mentioned in his statement that the 120 million have now increased to 300 million. As my right hon. Friend the Member for Leicester South (Jonathan Ashworth) said, the Opposition are desperately keen for businesses to stay open and for young people to remain in education. I am aware that there are separate supply lines to universities for testing, but there is concern about supply in future weeks. Can the Secretary of State confirm—guarantee, perhaps—that in the coming weeks there will be no issue with the supply of testing kits to our higher education sector?

[Sajid Javid]

The hon. Gentleman is absolutely right to thank not just JVT for his service, but those across our academic sector who have supported the Government, people and the NHS throughout the pandemic. I am privileged to work not just with JVT, but with so many of them, and I see every day the value they add and how they are helping us all to get through the pandemic.

The hon. Gentleman is right to raise the issue of testing. It is not 300 million; the 300 million lateral flow tests were in December, but for the month of January we have planned at least 400 million, which is four times as many as in the original pre-omicron plan. That makes us confident that we have the lateral flow tests we need. The university sector and the education sector more broadly, including schools and colleges, rightly have a separate supply line. It is still run through my Department, but we work very closely with the Department for Education to make sure that the sector has the supply that it needs.

[Mr Deputy Speaker]

I thank the Secretary of State for his statement and for responding to questions for an hour.