Independent Medicines and Medical Devices Safety Review

Philippa Whitford Excerpts

Thursday 8th July 2021 Commons Chamber

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

Along with other Members here, I took part in the debates on sodium valproate in 2017 and on vaginal mesh in 2018. I welcome the fact that Baroness Cumberlege’s inquiry covered both of these issues, along with Primodos, a hormonal pregnancy test that, like valproate, contributed to congenital abnormalities. At the time of our debates, it was clear that the same underlying issues had driven all three disasters and that there were four main features: a failure of licensing and regulation in the first place, particularly regarding implantable devices such as vaginal mesh; a lack of accurate information so doctors could discuss the risks of these drugs and devices and allow patients to give genuine, informed consent; a weak and poorly publicised system for doctors or patients to report adverse events that would result in action; and finally, the failure of doctors to listen to the affected women who were raising concerns.

The report makes nine recommendations, with two main aims: the need to provide remedial support and redress for the women and children affected; and how to prevent something similar happening ever again in future. The report also captures the experiences of women who have been campaigning on these issues for years, which are well summarised on the report’s contents page:

“‘No-one is listening’—The patient voice dismissed…‘I was never told’—the failure of informed consent”.

Considering the evolution of these disasters, I would perhaps reverse those two aims, as the problems started with the failure of regulators to ensure that these drugs and devices were safe and to provide accurate information on which women and their doctors could base treatment decisions.

I will focus my remarks on vaginal mesh, as there were additional issues associated with its licensing and use. In particular, the original trials comparing mesh with traditional abdominal operations did not have a long enough follow-up. This meant that while immediate surgical complications such as bladder injury were seen to reduce from one in 10 to one in 100, the later mesh complications were not identified. This led to the original vaginal mesh tapes being defined as low-risk devices and gynaecologists switching to this approach as it actually appeared safer for patients.

The whole issue was compounded by the fact that, after that initial research, the federal drug administration in America licensed all similar tapes without further trials, despite the fact that their design and how they were inserted at surgery changed significantly. The products that it passed then largely got accepted by the European Medicines Agency and the Medicines and Healthcare Products Regulatory Agency. Because late problems such as muscle or nerve damage were not recognised, gynaecologists did not even have the accurate information to discuss benefits and risks with patients.

The Scottish Government were the first to advise against routine use of vaginal mesh in 2014 and established a registry in 2017, but there have been no vaginal meshes inserted since 2018. They have accepted all the recommendations that are under devolved control and are in the process of appointing an independent patient safety commissioner. The UK Government have brought in the Medicines and Medical Devices Act 2021 but did not take the opportunity to establish a registry of all implanted devices to allow long-term audit and patient recall in future, if necessary.

There are risks and complications with any operation and they should be presented clearly and openly to allow patients to make an informed choice of what is important for them. Dr Wael Agur, a well-known gynaecologist involved in the mesh campaigns, works in Ayrshire and Arran, my local health board, and working closely with patient groups, he developed a Scottish patient decision aid for patients with incontinence, which was praised in the report. However, there is a need to get consensus on such decision aids and to ensure they are actually used routinely.

A lack of patient information was also central to the issue of sodium valproate. While it is an excellent drug to control epilepsy, a dangerous condition that kills over 1,000 people a year, sodium valproate has caused developmental delay in thousands of babies, and birth defects ranging from cleft lip to spina bifida. While the first case reports were published many decades ago, the connection was missed due to a lack of reporting. Even now, as we have heard today, women and their children are still in danger due to not being given the right information about their medication.

All three disasters highlight the failure of the yellow card system. The MHRA plans to introduce artificial intelligence in the future to recognise common patterns and themes, but adverse events need to be reported in the first place. It is about reporting any adverse event with a possible link to a new drug or any congenital defect in a baby whose mother has received medication during pregnancy. Publicity is also needed to inform patients that they, too, can complete a yellow card and report concerns directly themselves.

A year on from the publication of the report, we need to hear from the Government how they plan to take forward Baroness Cumberlege’s recommendations, particularly on the reform of the licensing and regulation of new drugs and devices, and the system to detect and act on adverse reports. However, the Government also need to lay out how they plan to support the women affected through the provision of removal or remedial surgery and financial redress for the women who have suffered so much. Without their forceful campaigning, even more women would now be suffering. Financial compensation is also crucial for families affected by the use of Primodos or sodium valproate, so they can provide long-term support for their children.

As highlighted by the right hon. Member for Maidenhead (Mrs May), at the core of all three disasters has been the failure of doctors to listen to women, or to patronise them and dismiss them when they raise concerns. Above all, these three medical disasters should be discussed in medical schools to teach student doctors, the doctors who will look after women in the future, the importance of actually listening to all their patients.

Covid-19 Update

Philippa Whitford Excerpts

Monday 5th July 2021 Commons Chamber

[Sajid Javid]

First, may I thank my right hon. Friend for his support for the measures? He speaks with great experience and I want to thank him for that. Regarding test, trace and isolate, he is right. There are many successes over the past year that we can be proud of, but there are also many improvements that can be made. I have already asked for such advice and I look forward to talking to him about that in future.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

This pandemic is very far from over, so, with cases soaring across the UK, I am surprised that the Health Secretary is planning to end all covid measures. The delta variant, which was allowed into the UK due to the failure of border quarantine, is twice as infectious as the original, and is infecting younger age groups, including children. It also shows significant vaccine escape, with only 33% protection against infection from the first dose. While receiving two doses of either vaccine dramatically reduces hospitalisation, the numbers are rising and only half the population are fully vaccinated. That means that the other half are not, and many will not have that opportunity until near the end of September.

The Secretary of State talks about the percentage of adults who are fully vaccinated, but he must know that that is not how herd immunity works. It is achieved by reducing the number of susceptible people in the whole population to stop onward spread of the virus. The UK Government’s failure to lock down last September allowed the alpha variant to emerge in the south-east of England and spread across the UK and, indeed, the rest of the world. If the Health Secretary is going to just let it rip, how does he plan to avoid generating yet another UK variant with even greater vaccine resistance?

With more than 150,000 people dead, why has the Secretary of State returned to the false narrative that covid is just like flu? Is it just wishful thinking? Why is he planning to end even simple measures such as mask wearing? He has suggested that people need to learn to live with it, but appears to be completely ignoring the risk of long covid, which is already affecting more than a million people, including children. How does he plan to avoid soaring cases of long covid in unvaccinated young adults and children? Does he consider them to be collateral damage, or just a price worth paying?

[Sajid Javid]

The hon. Lady started off well, but her contribution completely degenerated into political point-scoring. She should know much better than to engage in scaremongering among the Scottish people and the British people. She has no respect for what is happening, as we try to treat this whole issue with a degree of respect and seriousness. She used the phrase, “Let it rip”. If anything, the only part of the UK where cases could be described as “ripping” is in Scotland where the case rate is higher than in any other part of the UK. In fact, it has seven of the 10 highest hotspots in Europe in terms of its number of cases, and she should reflect on that.

The hon. Lady claimed that I had suggested that covid is like flu. I have never said that. It would be complete nonsense for anyone to suggest that covid is like flu. She should think about the millions of people across the world affected by this and the thousands of people who have died in the UK. How dare she even raise that—it is as if she is suggesting that it is like flu. In the same way that we have had to learn to live with flu, even though, sadly, in some years, we have had 20,000 deaths from flu, we will have to learn to live with covid. The hon. Lady should reflect on what she has said and stop playing political football with this serious issue.

Covid-19 Update

Philippa Whitford Excerpts

Monday 28th June 2021 Commons Chamber

[Sajid Javid]

First, I thank my right hon. Friend for his remarks, and I welcome the scrutiny that he and his Committee will provide. I am not sure about the seven hours bit, but I very much welcome the scrutiny and the intention.

On his question about preparing for future pandemics, a huge amount of work is already going on. Just yesterday, I met the chief executive of the UK Health Security Agency, which will work on much of that. As I think my right hon. Friend knows, in the best part of a year that I have been away from the Front Bench, I spent time as a senior fellow at the Harvard Kennedy School where my project was looking at potential future pandemics. I will put that knowledge, and everything I learnt through the process in doing that preparation, to use.

My right hon. Friend is also right to raise the importance of social care reform and the work that needs to be done, including on sustainable funding. He will remember how in the past we often worked together as Ministers. In these different roles, I look forward to working with him on that same issue of how we provide a long-lasting, sustainable solution to the social care challenge that this country faces. As I said to the right hon. Member for Leicester South (Jonathan Ashworth), that remains a huge priority, and I look forward to talking to my right hon. Friend and learning from him, too.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

In welcoming the new Secretary of State to his place and thanking him for advance sight of his statement, I would like to ask how he plans to review or modify current covid policy? The management of any epidemic is not rocket science but infectious diseases 101: avoiding the importation of dangerous variants through border control and quarantine; and stopping the virus spreading from one person to the next. Does he plan to revise the Government’s quarantine and traffic light system to avoid importing more variants, which, like the delta, would threaten the reopening of the domestic economy and society?

On Friday, the National Audit Office released a report on the NHS Test and Trace system, which did not quite get the media coverage one would have expected. One year on, Serco is still reaching only 83% of contacts, while Scotland reaches 98% and Wales 95%. Both of them have used public health and health protection teams from the start. As covid restrictions are eased, a well-functioning test, trace, isolation and support system will be critical to detect and control small clusters and avoid future surges. Therefore, instead of awarding Serco a new contract for more than £300 million, should the opportunity not be taken to reform the system?

It is only isolation that stops the onward spread of the virus, and while the £500 isolation payment is welcome, it is less than the minimum wage, and many are excluded by the eligibility criteria. With no results at all registered for almost 600 million issued lateral flow tests, will the Secretary of State shift some of that funding to provide more generous and accessible financial support for those who are asked to isolate? While vaccines are reducing the likelihood of hospitalisation, cases are rising exponentially. Does he recognise that allowing the current surge to go unchecked would put pressure on the NHS and run the risk of even more infectious or vaccine-resistant variants emerging?

[Sajid Javid]

The hon. Lady first talked about the importance of border control, and she was right to do so. That is why the Government have already put in place the so-called traffic light system, with this Department working across Government with the Home Office, Border Force, the Department for Transport and others. The system absolutely needs to be kept under review to ensure that it is doing its job in protecting the people of this country from viruses, and especially from any new variants of covid-19 that may emerge. I can give her reassurance on that.

The hon. Lady also raised Test and Trace. She should know that the NHS Test and Trace system is the largest diagnostic exercise of its kind in British history. We have carried out more than 200 million tests, identified more than 4 million positive cases and found more than 7 million of their contacts. Every time that happens, whether in England, Scotland or any part of the United Kingdom, that breaks the chain of transmission and saves lives.

Covid-19 Update

Philippa Whitford Excerpts

Monday 14th June 2021 Commons Chamber

[Matt Hancock]

The goal is that the steps in the road map are irreversible; that is the goal, and I am sure it is a goal that my right hon. Friend agrees with. We have demonstrated repeatedly during this crisis our willingness to take difficult decisions if they are necessary and if they are needed by the data, but it is also important to try to take steps when we can have a good degree of confidence that we will then be able to deliver that irreversible route, as opposed to moving faster than that, which might lead to a reversal. I hope that that explanation is one with which my right hon. Friend and indeed the House can concur in terms of what we mean when we say that we seek an irreversible approach to the road map.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

While hospitalisations and ICU admissions are, thankfully, not increasing as fast as covid cases, they are both rising significantly, so this delay was inevitable. According to Public Health England, the delta variant appears to be about 50% more infectious and reduces the protection against infection from one vaccine dose to just 33%. As a single dose is therefore less effective, by what date does the Secretary of State expect all adults to be fully vaccinated with both doses and would that not be a more appropriate time for the removal of all restrictions, rather than setting another arbitrary date when younger adults will not be fully protected?

So how did we end up here? Having ignored the Scottish Government policy of all arrivals undergoing hotel quarantine, the Secretary of State then delayed adding India to the UK’s red list at the same time as Pakistan and Bangladesh. He previously claimed it was because of greater positivity rates among travellers from Bangladesh and Pakistan but that is not borne out by the published data. Between 25 March and 7 April the test positivity of arrivals from India was 5.1%, lower than Pakistan at 6.2% but significantly higher than Bangladesh at 3.7%. Was the delay not just because the Prime Minister was still clinging to his plan for a trade visit to India? The whole point of border quarantine is to protect the UK from variants that might be more infectious or show resistance to vaccine-induced immunity, so having allowed the delta variant to enter and become the dominant strain in the UK, does the Secretary of State not recognise that the Government’s border strategy has failed?

[Matt Hancock]

I thought that the right hon. Member for Leicester South (Jonathan Ashworth) on the Opposition Front Bench was Captain Hindsight, but, seriously, this argument is completely divorced from reality. The data that the hon. Lady has just recommended to the House is data about what happened between 25 March and 7 April, and she complains about a decision the Government took on 2 April because we did not know of the data up to 7 April; so she brings to this House information from after a decision was taken and asks why it was not taken into account for that decision, and the answer is because it had not happened yet.

Oral Answers to Questions

Philippa Whitford Excerpts

Tuesday 8th June 2021 Commons Chamber

[Matt Hancock]

My hon. Friend is quite right. The NHS is one of Britain’s proudest achievements. It operates across the whole of Great Britain and co-operation is ingrained in the DNA of the NHS. I am absolutely determined, as the UK Secretary of State for Health and Social Care, to ensure that, wherever people live in this United Kingdom, they can access the very best of care. If a constituent of my hon. Friend’s in Aberdeenshire needs a treatment that is only available in England because it is so specialised, they should have absolutely every right to that treatment, in the same way that a constituent of mine in Suffolk or a constituent in north Wales should. We have one NHS across these islands, and it is one of the things of which this country is most proud.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

I am sure the Secretary of State is well aware that the Scottish NHS has been separate since 1948 and has been under direct Scottish Government control for the last 20 years, so there are actually four NHSs. Perhaps I can ask him about some of his decisions that have made it harder for the Scottish and other devolved Governments to fight covid. Last September, he refused to follow Scientific Advisory Group for Emergencies advice for an urgent lockdown, and the six-week delay allowed the more infectious B117 Kent variant to emerge and spread across the UK, driving a second wave more deadly than the first. He has repeatedly claimed to follow the science, so can he explain why he did not follow scientific advice last September?

[Matt Hancock]

Just on this point, this attempt at division within the NHS is deeply regrettable. It is not what people want. It is not what people want in Scotland. It is not what people want anywhere across the country. The NHS is an institution we should all be very proud of. Of course it is managed locally—it is managed locally across parts of England and it is managed under the devolution settlement in Wales and Scotland, as are health services in Northern Ireland, and rightly so—but it ill behoves politicians to try to divide the NHS. It is a wonderful institution that should make us all proud to be British.

On the specific question that the hon. Lady asked, of course we are guided by the science and take all factors into consideration. These are difficult judgments based on uncertain data, and we make the best judgments that we can. That is still the process we are going through, in the same way that the Scottish National party Government in Scotland have recently opened up parts of the rules in terms of social distancing, despite the rise in cases.

We face a challenging decision ahead of 21 June, but that decision is made easier by—indeed, the decision to open up is only possible because of it—the UK vaccination effort. Today marks six months to the day since Margaret Keenan in Coventry was the first person in the world to receive a clinically validated vaccine—the same day as Scotland, the same day as Wales. Since then we have delivered—

[Mr Speaker]

Order. It is not a statement, but an answer that we require. I call Dr Philippa Whitford to ask her second question.

[Dr Whitford]

I think the Secretary of State would find that most people in Scotland were rather glad that their NHS did not come under the Health and Social Care Act 2012 fragmentation. Having ignored the Scottish Government’s call in February for all arrivals to undergo hotel quarantine, he then delayed adding India to the red list. This allowed the more infectious Delta variant, which one dose of the vaccine is less effective against, to enter and become dominant in the UK. Is he not concerned that, if he removes all social distancing completely in the near future, the variant will cause a covid surge among those who are not fully vaccinated?

[Matt Hancock]

As I was saying, Mr Speaker—

Covid-19 Update

Philippa Whitford Excerpts

Monday 7th June 2021 Commons Chamber

[Matt Hancock]

On the latter point, I am very happy to look at how the case of my right hon. Friend’s constituent Laura Wilde can fit with the exemptions that already apply for travel for medical purposes, along with the testing regime, to ensure that that is done in a safe way. I am happy to talk to colleagues at the Home Office about allowing that to happen.

On my right hon. Friend’s first point, it is reassuring that there is such a clear breakage of the previously inexorable link from cases through to hospitalisations. That is very good news, and it is why we have this race to get everybody vaccinated as soon as possible. If I can address those people in their late 20s who will be able to book a jab from tomorrow and others who might feel that, in their age group, they are unlikely to die of covid, the honest truth is that the best way for us to get our freedoms back and get back to normal is for everybody to come forward and get the jab. It really matters that we all come forward and do this, because that is the safest way out.

On my right hon. Friend’s specific question about our thinking on the 21 June step 4, not before date, the honest answer, which I will give to any question about this, is that it is too early to say. I tried to give a studiously neutral answer on the TV yesterday, which some people interpreted as gung-ho and others interpreted as overly restrictive. That is the nature of uncertainty, I am afraid. It is too early to say. We are looking at all the data, and the road map sets out the approach that we will take, which is that there is step 4 and then there are four distinct pieces of work, which are reports on what should happen after step 4 on social distancing, international travel, certification and the rest. We will assiduously follow the road map process that has been set out with the five-week gap—four weeks to accumulate the data, then taking a decision with a week to go. The Prime Minister will ultimately make those decisions and announce them in a week’s time.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

I note that the Secretary of State is still considering ending all social distancing measures on 21 June, but does he not think that that would be dangerous in the face of rising cases of the significantly more infectious delta variant? Would it not be better to adhere to the Government’s mantra of being guided by data and not dates?

While it is welcome that half of adults are fully vaccinated, and Scotland has already started vaccinating those over 18, the Secretary of State must be aware that one dose of the current vaccines only provides 33% protection. Does he accept that that means we cannot rely on single dose vaccination to control this variant without social distancing measures? I and many other MPs repeatedly called for hotel quarantine to be applied to all arrivals in the UK to prevent exactly the situation we now face. He repeatedly claimed that home quarantine was working, but does he not accept that the importation and now dominance of the delta variant shows that is not true? With the current rise in cases of the delta variant threatening the progress made during almost five months of lockdown, does he regret the decision to delay adding India to the red list?

In light of the disruption caused by the shambles of changing Portugal’s classification this week, does the Secretary of State recognise that it has done neither holidaymakers nor the travel industry any favours? Will he now get rid of the traffic light system and tighten border quarantine policy so that we can avoid importing more vaccine-resistant variants and safely open up our domestic economy and society?

The Secretary of State talked today about the UK vaccinating the world, so can he say how many doses the UK has donated to COVAX? Does that mean the Government will support the sharing of intellectual property and technology and the trade-related intellectual property rights—or TRIPS—waiver so as to increase global vaccine production?

[Matt Hancock]

There is quite a lot that needs sorting in that. The first thing I would say is that the hon. Lady complains that I acted on Portugal when we saw the data, yet she complains that I did not act on India before we had the data. She cannot have it both ways. She asked me to follow data not dates, but then asked me to prejudge the data by making a decision about 21 June right now. I am a bit confused about that one, too, because I notice that the Scottish Government have themselves been reopening. That is a perfectly reasonable decision for the Scottish Government, but it is a bit rich then for the SNP spokesman to come to this House and have a go at us for deciding to look at the data over the next week, rather than prejudging that decision. It is quite hard to listen and not respond to explain what is actually going on.

The third point I will make is on international vaccination. Absolutely this country has stepped up to the plate. Of the 2 billion doses delivered around the world, half a billion have been the Oxford-AstraZeneca vaccine, which was developed by AstraZeneca and Oxford, with UK taxpayers’ money. It is, as I put it in my statement, a gift to the world. Of course we do not rule out donating excess doses as and when we have them, but only when we have excess doses, and I am sure the hon. Lady will accept that position is agreed not only by the UK Government, but by the devolved Administrations, because we all want to make sure that the people whom we serve get the chance to be vaccinated as soon as possible. That is our approach.

Finally, when it comes to intellectual property, we support intellectual property rights in this country. We could not get drugs to market in the way we manage to without support for intellectual property, because it is often necessary to put billions of pounds into research in order to get the returns over the medium term. What we did, more than a year ago, was agree with Oxford and AstraZeneca that there would be no charge for the intellectual property rights on this vaccine right around the world, and I am delighted that others are starting to take the same approach. Last month, Pfizer announced that in low and lower middle-income countries, it will not charge intellectual property, but we have been on this for more than a year now, so it is a bit rich to hear a lecture from north of the border.

Covid-19

Philippa Whitford Excerpts

Tuesday 25th May 2021 Commons Chamber

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

Can the Minister explain if the new restrictions for areas such as Bolton are only advisory? Will hospitality companies affected still be eligible for financial support? Why was the Public Health England report on variants snuck out at 11 pm on Saturday, during the Eurovision final and minus the promised data on school outbreaks? The B.1.617.2 or April 02 variant appears to be 50% more infectious and is affecting even younger children, so can the Minister explain why on earth the Government have ended the wearing of face coverings in schools? It is good that two doses of the vaccines still provide good protection from the variant, but testing shows that one dose is only 33% effective. The gap between doses has been shortened from 12 to eight weeks, but with less than half of those between 50 and 65 years of age having had their second dose, are there plans to close the gap further?

[Nadhim Zahawi]

I am grateful for the hon. Lady’s question and just remind her that Public Health England makes those decisions for itself: it is not up to the Minister when it releases its data.

On pubs and hospitality, indoor areas of venues—cafés, restaurants, bars and so on—can reopen. In any premises serving alcohol, customers will still be required to order, to be served and to eat and drink while seated. Venues are obviously prohibited from providing smoking equipment such as shisha pipes. It is just to make sure that we do everything we can to limit the ability of the virus to infect others. Within that, reducing social contact is incredibly important. Some businesses, such as nightclubs, must remain closed and follow the restrictions. It is very much about making sure that we work together to control the B.1.617.2 variant, exercising the common sense that the Prime Minister spoke about. The guidance is there to do that. People on the whole have been following the guidance.

On transmission and the effectiveness of the two doses—the hon. Lady’s question on accelerating the vaccination programme—the whole idea of us following the Joint Committee on Vaccination and Immunisation guidelines and advice on vaccination is to be able to vaccinate at scale. We have two big weeks ahead of us and we will continue to focus on the second dose. When people get that text message or the call to bring forward their second dose, they should please take that up, because it is incredibly important in controlling the variant.

A Plan for the NHS and Social Care

Philippa Whitford Excerpts

Wednesday 19th May 2021 Commons Chamber

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

I rise to speak to amendment (i), which stands in my name and those of my colleagues. At the start of my speech, I wish to pay tribute to all health and social care staff, right across the UK, for everything they have done this past difficult year. Although there are real concerns about the rise of the Indian variant in multiple areas, we are all hoping that we can continue, slowly, to open up our society. Our attention is therefore now turning to patients who have been waiting many months for treatment or who have not yet even come forward with their health concerns. All four health services are working on recovery from the covid pandemic, and the Scottish Government have put in place their 100-day plan, to utilise some of the innovations used in the past year to increase the diagnosis and treatment of both elective and cancer patients.

However, the wellbeing and recovery of NHS staff must also be put front and centre, otherwise we will simply lose staff who are worn out. Especially after Brexit, the UK already faces workforce challenges. All NHS staff have worked above and beyond over the past 15 months, and the public have shown how much they value them, by clapping on their doorsteps and sticking rainbows in their windows. It has to be said that the derisory 1% pay rise for NHS staff in England is not exactly making them feel valued; you can’t spend claps in the supermarket. For NHS staff, this feels like a kick in the teeth. Many feel disrespected and are considering whether they will stay in their profession.

By contrast, in Scotland, where our NHS staff were already higher paid, they will get a 4% pay rise, the largest since devolution. Our nurses still get a bursary of £10,000 a year and do not pay tuition fees. That means that the Scottish Government invest £20,000 a year in every student nurse, so that they do not start their careers £50,000 to £60,000 in debt. NHS staff in Scotland have faced the same horrendous pandemic year, but we are trying to say thank you with a simple bonus of £500 and by focusing on their wellbeing and support services during recovery. The four national health services across the UK are not about hospitals or machines; rather, this is about the NHS staff who diagnose us, treat us and care for us, and now it is vital that we look after them so that they can recover.

There can be no NHS recovery without allowing staff to recover. It is only by supporting staff that they in turn will be able to look after patients and contribute to the huge task of treating those who have had to wait because of the pandemic and those who come forward now. Clearing the backlog of cases will take many months, but it will also require significant investment, yet the additional covid funding in England has already started to be removed since April. Although English trust debts were wiped last year and the NHS was told it could have whatever funding it needed, analysis by the King’s Fund shows that the core health and social care budget actually fell by £1.7 billion.

The main piece of health-related legislation in the Queen’s Speech is the health and care Bill, which, less than 10 years on, will repeal some aspects of the Tory-Lib Dem Health and Social Care Act 2012. It was that policy that brought me into politics. I had been following the proposals since 2011, in sheer disbelief that anyone could think that breaking up the NHS in England would somehow make it work better. Although I and others will be glad to see the back of section 75, which forced GPs to put services out to tender, this Government’s management of the covid response does not suggest that they are any less keen on outsourcing.

Exactly how commissioning will work is not at all clear, and that is causing concern for key community services such as dentistry and community pharmacies. Although the Secretary of State rightly highlights that prevention is better than cure, public health in England was decimated by funding cuts and reorganisation before covid hit and even went through further upheaval at the height of the pandemic. With regard to the White Paper and the Bill, the devil will be in the detail. Personally, I am concerned about how the United Kingdom Internal Market Act 2020 is reversing devolution, and particularly about how the procurement Bill might be used to undermine our integrated public NHS in Scotland.

Overall, it is easier to talk about what is not in the Queen’s Speech than what is. The most glaring omission is the long awaited social care Bill. That is in keeping with its complete absence from the Budget in March, but it is unforgivable. Not only has the pandemic highlighted the vulnerability of the social care sector, particularly those living in care homes; it also brought home to all of us the important role played by care staff, whether in care homes or looking after people in their own homes.

During the 2019 election, the Prime Minister claimed to have his fully prepared social care plan, but maybe he was mixing it up with the oven-ready Brexit deal that he was boasting about at the same time. Far from being ready to go, it has yet to see the light of day. Various Ministers have recently tried to blame delays on Opposition parties taking too long to sign up to a cross-party approach. Well, I have certainly never seen it, and I note that the shadow Care Minister, the hon. Member for Leicester West (Liz Kendall), has said the same. I do not know why the Government are finding it so difficult to make contact with us; our email addresses are all in the parliamentary directory.

We have not just been waiting since December 2019 or even last July; a Green Paper on social care has been promised since 2017—four years ago. During that time, social care in England has been allowed to wither on the vine, with the gap between what is funded and what is needed growing to between £8 billion and £10 billion. The Scottish Government spend 43% more per head on social care, which allows us to provide free personal care, letting people stay in their own homes for longer, which is something that all of us would prefer.

After the experience of the covid pandemic last year, the Scottish Government commissioned the independent Feeley review, which has proposed a human rights approach to social care—valuing and enabling participation in society, rather than always looking on care support as a burden. The report outlines the route to establishing a national care service, with Scotland-wide service standards, staff training, and national terms and conditions.

Another key element missing from this Queen’s Speech is any real detail about rebuilding a better society and economy than the one that was driving poverty and inequality before the pandemic brought life to a shuddering halt. We all know that we need a different economic model ahead of 2030 if we are not to burn or consume the planet. With the added economic damage of Brexit, it will take the investment of time, energy and money to recover from covid. We therefore have a choice about what kind of society we want to rebuild: one that exacerbates inequality or one that focuses on the wellbeing of everyone who lives here.

Wellbeing is not about healthcare or the NHS. It is much more than an absence of physical or mental illness. It comes from having a decent start in life, a warm and safe home, enough to eat, and fair opportunities at school and beyond. Scotland already has a broad range of wellbeing policies for all ages, from the baby box to welcome newborns, through to free personal care to support our older or vulnerable citizens. The Scottish Government are founders of the Wellbeing Economy Governments group with Iceland and New Zealand. They have already committed to a wellbeing and sustainability Act to ensure that every level of Government and every public body in Scotland puts the health and wellbeing of local people at the heart of all policy decisions.

We have seen the impact of covid on those in low-paid and insecure jobs, who, without decent sick pay, simply could not afford to isolate when they tested positive. Failing to properly support people to isolate has been one of the biggest mistakes in the UK Government’s covid response, yet we see no evidence that any lessons have been learned and no proposals for change. Where is the employment Bill that we heard about? Where is the plan to tackle child poverty, which has been driven up right across the UK since the first welfare cuts in 2012 and exacerbated by the benefit freeze and heartless policies such as the two-child limit and the rape clause?

There is nothing in this Queen’s Speech about genuine levelling up for the most vulnerable. That is just a slogan for blatant pork barrel politics. In Scotland, the Government pay the bedroom tax and are providing the Scottish child payment to help fight to child poverty, but more people are beginning to recognise the effort and money that is spent just trying to mitigate the policies of Tory-led Governments that repeatedly put the heaviest burden on the weakest shoulders.

Poverty is the biggest driver of ill health, and a decade of Tory austerity has been the biggest driver of poverty, but the Chancellor has already stated that the uplift to universal credit will be cut in September, signalling the start of yet another decade of Tory austerity. The people of Scotland certainly aspire to something better—a fairer society that looks out for those who need support. As we rebuild from the pandemic, we need to move away from an economy based on relentless growth in consumption to a more sustainable one that values people rather than just GDP.

That demonstrates the clear blue water between the UK Government’s plan for yet more austerity, poverty and inequality, and our vision for a fairer, healthier and more sustainable independent Scotland. The people of Scotland have the right to choose between those two visions. In Scotland, more people are beginning to recognise that we need the full powers of a normal independent country to be able to direct our recovery from covid and build the better country we want to live in and pass on to our children and grandchildren.

Covid-19 Update

Philippa Whitford Excerpts

Monday 17th May 2021 Commons Chamber

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

Covid cases in India began to soar at the start of April, so why were Pakistan and Bangladesh added to the red list at that time but not India? Was it because of the Prime Minister’s planned trade visit? After India was finally added to the red list on 19 April, the restrictions did not take effect until 23 April. How many people arrived from India in those days, trying to escape having to go into hotel quarantine? When I previously raised the issue of applying hotel quarantine to all travellers, the Secretary of State claimed that the current system was protecting the UK; does he now accept that the entry and community spread of the Indian variant shows that that simply is not the case and that having a negative test does not rule out the possibility that travellers are carrying covid?

The Scientific Advisory Group for Emergencies has stated that evidence shows that the B1617.2 Indian variant is up to 50% more infectious than the Kent variant and has advised that, as in Scotland, areas with rising numbers of cases should remain under covid restrictions. The Indian variant has been doubling every week despite lockdown, so why is the Secretary of State ignoring SAGE advice and opening up areas like Bolton that have exponential growth?

Thankfully, the Indian variant does not show significant vaccine resistance, but the Secretary of State must know that it is not possible to outrun the virus through vaccination alone. As those aged up to 35 are not eligible for surge vaccination, that leaves a large pool of unvaccinated people among whom the variant can spread. It will take two to three weeks before even those who receive a vaccine in the coming weeks are protected. Does the Secretary of State not accept that the variant is in danger of surging and that without local travel restrictions it will spread to other areas? It is good news that fully vaccinated people are not ending up in hospital, but just letting the virus spread among young adults could allow the evolution of yet another UK variant.

[Matt Hancock]

I answered those questions in response to the right hon. Member for Leicester South (Jonathan Ashworth). The truth is that when we put Pakistan and Bangladesh on the red list, positivity among those arriving from those countries was three times higher than it was among those arriving from India. That is why we took those decisions and, of course, they were taken before the Indian variant became a variant under investigation, let alone a variant of concern. It is striking that the Scottish Government took the decision to put India on the red list at the same time as we in the UK Government did. It is all very well to ask questions with hindsight, but we have to base decisions and policy on the evidence at the time.

When it comes to how we are tackling the virus in the UK, the hon. Lady is quite right that it is good news—albeit early news—that the vaccines do appear to be effective against the B1617.2 variant. I am obviously pleased about the evidence we have seen but we are vigilant about that. I am glad that the approach we are now taking in Bolton and Blackburn worked against the South African variant in south London. We always keep these things under review, but I think that as a first resort, surge testing, going door to door, ensuring that we find and seek out the virus wherever we can spot it, and putting in the extra resources with the armed services who are supporting us, are the right approaches while we keep this under review. The numbers thus far nationally are still relatively low and, thankfully, we have a very good surveillance operation across the UK so that we can spot these things early and take the action that we need to.

Covid-19 Update

Philippa Whitford Excerpts

Monday 19th April 2021 Commons Chamber

[Matt Hancock]

We will certainly consider that. I have seen the letter. We have discussed the question. I would add that we have a record number of doctors in this country, in part thanks to the work that my right hon. Friend put in place when he was in my shoes. We have a record number of nurses—more than 300,000 for the first time in the history of the NHS. We do need, of course, to look to the future and ensure that we are preparing for it, as the letter suggests. We also need to ensure that we keep driving the project of delivering 50,000 more nurses in the NHS over this Parliament. I look forward to giving him a more substantive response, but I hear his encouragement to ensure that we take steps in that direction.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

While the vaccine programmes across the UK are going well, vaccine-resistant variants remain a major threat. I welcome that the Prime Minister has now called off his visit to India due to its devastating surge in covid. Cases of the B1617 Indian variant in the UK are still very low, but they have been doubling every week, despite lockdown, suggesting that like the Kent variant it is much more infectious than the original virus. I therefore welcome India’s being added to the red list to reduce further importation.

Will the Secretary of State not now consider extending hotel quarantine to all arrivals, as travellers from red list countries can currently avoid it by coming via a third country? We have already seen increased numbers of the South African and Brazilian variants in European countries, from where travellers are not placed in hotel quarantine, and more infectious or vaccine-resistant variants could emerge in any country. We simply would not know about it until it was too late.

The pandemic is still accelerating, and as well as causing appalling suffering and death in other countries it clearly poses a threat to the people of the UK. Does the Secretary of State not recognise the need for a more co-operative, global response to covid if we are to bring the pandemic under control and allow a safer return to international travel and commerce?

[Matt Hancock]

I certainly agree with the hon. Lady on her final point, on international collaboration and working together, which, along with the Foreign Secretary and the Prime Minister, we are working incredibly hard on. We are using the UK’s presidency of the G7 and the enthusiasm of the new Administration in Washington to try to drive international collaboration, in particular collaboration among like-minded democracies in favour of an open and transparent, science-led response to pandemics. I hope that she will concur with that approach.

On the new variants of concern, it is important when looking at the numbers to distinguish between community spread and spread connected to travel. By taking the action that I have just announced to put India on the red list, we are restricting yet further the likelihood of incursion from India of somebody with a new variant. However, the majority of the cases that we have seen already in this country have been picked up by the testing that we have in place now for every single passenger entering this country. That is a sign of the system working, and it is now being strengthened.