Covid-19 Update

Rachael Maskell Excerpts

Monday 15th November 2021 Commons Chamber

[Sajid Javid]

Yes, I absolutely agree with my hon. Friend: the facts and figures now speak for themselves. He referred to the latest data from the UK Health Security Agency today that shows there is more than 90% protection when someone has had their booster dose; as he says, that is protection not just for that individual but for their loved ones.

[Rachael Maskell (York Central) (Lab/Co-op)]

The NHS is under severe pressure. Too many people, including those who are vaccinated, are sick and too many people are still dying. Why will the Secretary of State not meet directors of public health, who are tearing their hair out because although the Government have rightly put so much investment into the vaccine programme, they are not investing in other public health measures that would stop covid becoming a disease of inequality?

[Sajid Javid]

The hon. Lady will know that, as I said in my statement, the vaccines are absolutely central to protecting us against this virus, but it would be wrong for anyone to suggest that they are the only thing the Government are focusing on. There is of course a lot more; for example, I draw the hon. Lady’s attention to our recent announcements on antivirals.

Covid-19 Update

Rachael Maskell Excerpts

Tuesday 9th November 2021 Commons Chamber

[Sajid Javid]

I thank my right hon. Friend for his support. On the assessments that we have done, I have shared some information with the House, and there will be an impact statement followed by an impact assessment that will give him more information. It may be helpful for him to know that studies already in the public domain show that against the delta variant, the AstraZeneca vaccine is 65% effective and the Pfizer vaccine is 85% effective in preventing infection. The fewer people who are infected in these settings, the less spread there will be.

I think I have set out the Government’s thinking on flu, but it remains under review. There are many reasons why we have focused on the 1 April date, but the main one is to give those in the NHS who have not yet had a single jab—there are 100,000 of them—to make the positive decision to get vaccinated.

[Rachael Maskell (York Central) (Lab/Co-op)]

In York, vaccination rates are high at 87%, but transmission rates of covid are also extremely high, and transmission is happening in the community. As a result, directors of public health such as my own are absolutely despairing that the Secretary of State and others in the Department are not listening to public health experts who are asking for the tools to be restored to manage the virus. That is about moving contact tracing immediately into local authorities, where they got on top of the virus and locked it down. It is also about ensuring that greater public health measures are taken—hands, face, space needs restoring in all settings.

[Sajid Javid]

The hon. Lady is right to point to the high vaccination rates in York, and everyone involved is to be commended. When it comes to other measures that may or may not be taken, I think the plan A approach that the Government set out is the right one. There may be reasons to take a slightly different approach in certain regional areas, and that is also possible with the right evidence. This is something that we always keep under review.

Covid-19 Vaccinations

Rachael Maskell Excerpts

Thursday 4th November 2021 Commons Chamber

[Maggie Throup]

I can reassure my hon. Friend that there is no problem at all with the supply of vaccines; we have plenty of supply. He talks about schools. The vaccine programme in schools is being carried out by the school-aged immunisation service, which is very experienced in carrying out vaccinations for different conditions in schools. If there is a problem in his area, I will definitely look into it on his behalf.

[Rachael Maskell (York Central) (Lab/Co-op)]

I cannot accept that the deaths of 217 people yesterday and 293 the day before shows good management of this pandemic. The fact that so many people are now dying of this virus is a call on Government to take urgent action. With the Minister’s own confession that 5 million people are yet to be vaccinated and the fact that my constituents are not able to get access to the flu vaccine either, it is clear that we are heading for a real health crisis. Will she urgently take back the message that we need greater public health measures to be introduced in order to keep our communities safe?

[Maggie Throup]

No death is acceptable and my condolences go to everyone who has lost somebody in this terrible pandemic. Our best wall of defence is through vaccinations. Vaccinations do work, so my message is: get your booster. If people have not had their first jab, they should get their first jab and continue to build that wall of defence.

Smoking Cessation: Prescription of E-cigarettes

Rachael Maskell Excerpts

Monday 1st November 2021 Commons Chamber

[Maggie Throup]

I thank my hon. Friend for his question. I am looking forward to our debate in a couple of weeks’ time. As I mentioned earlier, the NHS already has measures in place through the long-term plan to help those who are pregnant to stop smoking. That is important. Should e-cigarettes be licensed as a medicinal product, it will be a gateway for those smokers to stop smoking through that method and hopefully stop smoking completely.

[Rachael Maskell (York Central) (Lab/Co-op)]

What investment will the Government put into research into the long-term use of e-cigarettes, so that we can understand the impact that will have? Will the Minister also commit to invest in health checks, so that we can screen people for public health issues, such as smoking and other forms of harm, and get the right interventions at the right time and address these issues?

[Maggie Throup]

This Government are determined to level up, and as part of that we are levelling up for health, as well as some of the issues that the hon. Lady mentioned. Our Office for Health Improvement and Disparities will play a big role in moving forward with this issue.

Endometriosis and Polycystic Ovary Syndrome

Rachael Maskell Excerpts

Monday 1st November 2021 Westminster Hall

[Taiwo Owatemi]

I thank the hon. Gentleman for making an important point, but I think what that highlights is the need to ensure that endometriosis and PCOS are included on the medical curriculum for GPs and healthcare professionals. That is why funding is so important: to make that difference.

[Rachael Maskell (York Central) (Lab/Co-op)]

I rise to support the petition as well. My constituents have also written heartfelt letters about their experiences; it took one constituent 11 years to receive a diagnosis. Is not the crux of the issue that we need a diagnostic framework to get on top of the conditions quickly so that they do not reach the severity that many women experience?

[Taiwo Owatemi]

I thank my hon. Friend for making that important point. I agree, and I will come on to that issue in my speech.

To add insult to injury, funding for symptoms such as excess facial hair and chronic acne has decreased over the years. Endometriosis can cause chronic bowel and bladder-related symptoms and depression, yet I have heard from countless women that, after finally being diagnosed with endometriosis or PCOS, they are told by their GP to come back when they want to get pregnant and are then sent on their way, without targeted treatments.

It is extraordinary to think that there are the same number of women in the UK who have endometriosis as there are people diagnosed with type 2 diabetes. Nobody would suggest that a person suffering from diabetes come back when they decide to get married, so that they can manage swelling in their fingers before buying a wedding ring—that would be absurd. One in 10 people in the UK suffers from asthma, yet it would be completely unthinkable to tell someone with asthma to come back when they decide they want to run a marathon. Endometriosis and PCOS are about so much more than having difficulty conceiving.

Dame Carol Black’s Independent Review of Drugs Report

Rachael Maskell Excerpts

Wednesday 27th October 2021 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve with you in the Chair, Ms Fovargue. I congratulate my hon. Friend the Member for Liverpool, Walton (Dan Carden) on securing today’s debate, and I thank Dame Carol Black for putting forward such strong recommendations: 32 in all that must be adopted in full.

Some 3 million people have used drugs in the last year—an indicator of why the issue is so urgent. As we have heard, in the last year 4,561 people have lost their lives, including a young boy in my constituency. That brings it home how important it is to tackle the issue and move it into a public health framework. We know that it preys on people whose lives have been afflicted with trauma and many complex needs, but it can also be indiscriminate. That path is not inevitable. Things can change, and the report describes a pathway for bringing about change.

I was struck by the call for a change in governance and ensuring that there is a central drugs unit. That should be a priority for No. 10 and a sub-committee of the Cabinet in order to bring together Government Departments to bring the laser-like focus that is needed. When money, time and people are focused, it can shift agendas. We need leadership. We need to build an evidence base and to invest in research on the best treatments and early intervention. If we take a half-hearted approach, we will not shift the dial. That is why the Minister should step up and make it possible to bring about change.

We need to see diversion as well so that people are not sucked into the criminal justice system, but brought out of it through diversion and ensuring that, for instance, young people are not arrested but pushed down the line of education, giving them a pathway out into apprenticeships and work, and giving them the chances in life that they have never had. We need to invest in and mentor young people so that their future goes a different way. Many of the people dealing drugs are being exploited by criminal gangs, and they too deserve a future that is very different from the paths that they are on.

We need investment in treatment, as has been articulated, not only for mental health but for physical health as well. We need to build stability, too, with a housing first approach so that people have a house. When people leave the criminal justice system, they need a house, a treatment plan, a bank account, and also a job to move into if that is appropriate. We should look at the person and not just the issue.

We need to go further, so I urge the Minister to look at how we can create drug consumption rooms where people can engage with services, while recognising that it will take people six or seven attempts on average to move out of a life on drugs. Also, I want the Minister to look into heroin-assisted treatment so that we can take a different approach to break the cycle of substance misuse. There is a real opportunity ahead of us, and I trust the Minister will step up and deliver.

GP Appointment Availability

Rachael Maskell Excerpts

Tuesday 26th October 2021 Westminster Hall

[Joy Morrissey]

I thank the hon. Lady for her contribution. I agree that the problem has a trickle-down effect throughout the NHS. We will see more people presenting at A&E and perhaps with more advanced stages of disease, because they have not been seen in person. Encouraging GPs or creating a covid incentive programme for them to see people in person will decrease the amount of hospital admissions and lead to earlier diagnosis for cancer and heart disease. These things can really only be done in person. If someone is healthy and just needs a phone appointment, that is fine, but certain things cannot be seen unless a person’s vitals—their heart pressure—can be physically checked. Only a GP can do that and really only in person. If we want to reduce the overall burden on the NHS this winter, finding a safe and secure way for more residents to see their GP will reduce the overall pressure long term on the NHS. I know we have an aging population, and that GPs are under huge amounts of pressure and strain, but I believe there is a way we can work together to find a solution.

[Rachael Maskell (York Central) (Lab/Co-op)]

The hon. Lady said that only a GP can check someone’s blood pressure. We know that many people can undertake many of the different clinical functions that a GP is asked to undertake. Is it not right, therefore, to look at a multidisciplinary clinical team and how to deploy it better, rather than just to focus on the GP?

[Joy Morrissey]

The hon. Lady is stealing my thunder, but I agree with that comment. With the multi-disciplinary approach, even nurse practitioners and others could be recruited into a GP surgery structure, to help with many of the ailments that people are presenting at A&E with or asking for an appointment about. There is a wide range of healthcare professionals who could help and support GPs, and I think this is an important issue that needs to be further discussed and debated.

When this matter came before the House in July, several relevant questions were raised. One of them was about NHS England and NHS Improvement, or NHSEI, which leads the programme of work support practices, using digital and online tools to widen access. I would just love to hear what progress has been made since this topic was debated in July. Also, what is the progress of NHSEI’s independent evaluation of GP appointments? Again, I would like to see whether we have had any progress on that independent evaluation. Finally, what is being done by the NHSEI access improvement programme to support practices where patients are experiencing the greatest access challenges, such as drops in appointment provision, long waiting times, poor patient experiences or difficulties in embedding new ways of working related to covid-19, such as remote consultations as part of triage? I would really welcome any updates on those questions.

We could perhaps discuss today how we can provide GPs and their surgeries with some kind of in-person patient incentive during covid. Perhaps that could come from existing regional funding streams. Perhaps each time a GP sees a patient in person, they could receive an extra payment, or they could receive an additional payment for visiting someone in their home. That would mitigate the additional cost of PPE and also the additional risk posed to the GP themselves by having to see people in person during covid or high levels of winter flu.

Some GP surgeries are already receiving additional funding for cervical cancer and diabetes screening, and we have seen uptake increased in those areas very successfully, so this type of programme has been modelled in the past. It would help to mitigate the risk and burden for GPs, while still getting as many of our constituents as possible into in-person appointments if they need them.

The NHS claims that it would like more patients treated at home rather than having to stay in hospital for extended periods of time. This model could be enhanced if GPs were given the financial incentive to carry out in-home treatments for patients who traditionally would have remained in hospital. Obviously, this allocation would have to be set by the integrated care system in each region and it would be decided on within regional NHS structures, but it is worth considering.

In my own personal experience with my mother-in-law, she has been at home all the time 24/7. She is now completely disabled and needs 24-hour care, but the most difficult challenge was the out-of-hospital care provision—getting the GP, the hospital and the council to co-ordinate the care effectively. It is a full-time job for someone to co-ordinate that care. If we can make those pathways of care and co-ordination easier for everyone, then, as was said earlier in the debate, it would reduce the overall pressure on the NHS.

--- Later in debate ---

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve with you in the Chair, Mr Robertson. I thank the hon. Member for Beaconsfield (Joy Morrissey) for calling today’s important debate. Let me set out the challenge, and how Government can make a difference.

York Medical Group has 44,000 patients on its books. In a single calendar month, it received 41,000 calls from people who needed to see a clinician—unprecedented demand, with higher acuity, co-morbidity and complex needs. When patients get through to the call-handling system, they are triaged and, when urgent attention is needed, that is followed up by a clinical conversation. Appointments are allocated, tests are ordered, referrals are made, and prescriptions are issued.

Of course, people are also applying to see a practitioner through the internet or are turning up at the surgery. That is managed by exceptional staff, who are really pulling out all the stops to support their local community. However, this logistical agility to meet the serious demand is outstripped by the pressures placed on it. When spending time embedded in the system—as I did, spending time with call handlers and with GPs—I saw how relentless they were in trying to meet that demand, but that demand is continuing to put pressure on them.

[Alex Sobel (Leeds North West) (Lab/Co-op)]

My constituency is only 25 miles from my hon. Friend’s. A constituent came to see me last week; they could not get an appointment with their GP, but were told to go to the accident and emergency department in Leeds. It took two hours at the A&E to be triaged, and they were then told it would be a further six to seven hours to see a doctor. They ended up going home because it was too cold at the hospital to wait. Does this issue not impose pressure right across our health system, to the point that it is near collapse? Winter has not even properly started yet.

--- Later in debate ---

[Rachael Maskell]

My hon. Friend hits the nail on the head. We cannot look at part of the health service without looking at the entire health service, and the pressures that are brought to bear. As we have heard, many people do go to their A&E or urgent care centre, because that is the only way that they know they can confidently access the service, which puts more pressure on those parts of the service. We must look at the whole.

However, when it comes to trying to engage with our community practitioners—that is what primary care is all about: people who would traditionally have known the patient and the family—medicine has changed so much, yet we have not caught up with where it is. I saw both the call handlers and the GPs facing burnout. They are reducing the number of sessions that they are working because, we must remember, a session then extends right through into the night, as they are catching up with paperwork, ordering tests and following things through. Individuals are just saying “If I don’t step back, it will have a serious impact on my own wellbeing.” We have got to protect the wellbeing of GPs. They are a precious resource in delivering our healthcare services.

[Margaret Greenwood]

My hon. Friend is making an excellent speech. Does she share my concern about the shortage of GPs? The Government have committed to having an extra 6,000 GPs by 2024 or 2025, I think. The pressures GPs are under is a direct consequence of the failure to address the issue.

[Rachael Maskell]

My hon. Friend raises the next point in my speech. We are in this mess because for over a decade we have had failed workforce planning across the system. We have seen that most acutely in primary care. The pandemic continues to be mismanaged, which I want to stress. The Government may be looking at the numbers when it comes to intensive care and hospital admissions, but as people are less sick they instead go to see their primary care physician. That puts more pressure on them. We need to see more measurements and data on the pressure that has been put on primary care during the pandemic. In addition, we have long covid as well. In York there are around 3,000 cases. It is not coded, so can the Minister get that sorted urgently? We need to look at the support that people with long covid require.

[Mohammad Yasin (Bedford) (Lab)]

In the Bedfordshire, Luton and Milton Keynes clinical commissioning group area, there is only one GP for every 2,500 people, making it one of the worst hit by GP shortages in the country. The number of GPs employed in the area also has fallen by 12% to 390. Does my hon. Friend agree that we need an urgent independent review of access to general practice, not a “name and shame” league table that will only drive more overwhelmed GPs away from their profession?

[Rachael Maskell]

Absolutely. My hon. Friend speaks for himself. We need a shift from a sickness service to a health service. The Government scrapped the health checks that were vital in picking up ill health. We need to see prevention at the front of the queue, and we need to see investment in public health, which is currently being cut by local authorities. We need to make sure proper preventive measures are put in place.

The fact that the Government are not moving to plan B right now shows that they are escalating the challenges on general practice rather than diminishing them. They are putting the vaccine responsibility on GPs when it can be done elsewhere in the service, as it was by Nimbuscare. We need to look at how not only health professionals but volunteers and the Army, even, are working together to deliver healthcare. We need to think about the broadest team available. Pharmacy also plays a crucial role in making sure that we are protecting the health service.

Looking at prevention, we do not necessarily need to move towards an individual, one-on-one health system for everybody. We can socialise and communitise health, so that people can get health support in active communities. Peer support is vital in managing disease and ensuring that people can support one another through ill health. Occupational health services can make those early interventions in workforces, often where mental health problems show up when there is stress in the workplace. There are real opportunities to expand those services and look at deploying early intervention and education to turn around this system. It will only happen if proper investment is made and proper workforce planning is put in place. The Government have got to get to grips with the figures on staffing and ensure that investment is in place.

Staff are exhausted, tired and downtrodden. The trauma of covid is hitting right now. We need to ensure that staff are properly rewarded through their pension scheme and with a decent pay rise. Get it sorted.

--- Later in debate ---

[Maria Caulfield]

We are committed to increasing GP numbers, as in our manifesto commitment. However, that does not stop us increasing the numbers of other healthcare professionals. We need to get the message out to patients that seeing a nurse, physio or paramedic at the GP surgery is not second best. These are highly qualified, experienced and educated professionals who often are better placed—though I do not want to upset the shadow Minister—to see a patient than a doctor. They can make a considerable difference, but very often patients feel they are being fobbed off or seeing the second best. We need to do a lot of work to reassure patients on that.

We have already recruited 10,000 of the additional 26,000 staff we stated in our manifesto would be working in general practice by the end of 2023-24. We are strengthening our plans to increase the number of doctors in general practice. To reassure Members, so far we have filled a record number of GP speciality training places this year, with the latest data showing that there are already 1,200 more full-time equivalent doctors in general practice than two years ago. It is a challenge; I am not going to say it is not, but we are making progress.

I feel particularly passionate about the use of community pharmacists. In many other countries, the pharmacist is the first port of call for minor ailments. They are highly qualified professionals with over five years of clinical training who are able to assist patients. Over 800 practices have already signed up to participate in the community pharmacist consultation service, which enables patients to see a pharmacist, on the same day in many cases, to deal with minor conditions. That will not only help patients, but it will free GPs up to see the patients that really need to see them for clinical conditions.

[Rachael Maskell]

Will the Minister also ensure that the funding goes into community pharmacies in the right way if they are to be utilised? Likewise, with the voluntary sector involved in providing support for people through different forms of wider health support, will she ensure that it too gets proper funding?

[Maria Caulfield]

I thank the hon. Lady. The spending review tomorrow may have further updates on that, so I will not comment on the funding for now. NHS England and the Department of Health and Social Care have asked the Royal College of General Practitioners to provide GPs with more guidance on how to blend face-to-face with virtual appointments. We do need a mix of both going forward, and the comms, as has been said so much this afternoon, will make a difference, so that patients know where to go, what is available and who they can see for their particular condition.



The issue of abuse has featured heavily this afternoon. The hon. Members for Batley and Spen and for Linlithgow and East Falkirk (Martyn Day), my hon. Friend the Member for Bracknell and for Waveney (Peter Aldous) and others have mentioned the impact of abuse. When patients have been waiting a long time to see a GP, cannot get through on the phone and are feeling unwell in very distressing situations, they often take it out on practice staff. It is unacceptable, and we all have a role in this place to say that we have zero tolerance for that.

We know as MPs what it is like to face a torrent of abuse. If it is not acceptable for us, it is certainly not acceptable for them. My message to general practice staff is that we are four-square behind them on this and will support them. As part of the winter support package, there is £5 million to facilitate extra security, be that CCTV, extra screens or door entry systems—whatever practices feel will make their staff more secure, that funding is available to them. That is not the only solution, and they should not face abuse in the first place, but we are taking it extremely seriously.

In the few minutes that I have left, I want to say that there are two main issues here. There is the short-term covid issue, which has seen a tsunami of patients whom we need to support as we come out of the covid period. There is the £250 million winter package, and there is support around opening up community pharmacies and enabling other healthcare professionals to see patients, which will take some of the bureaucracy away from GPs while we support them to get through the period. However, there are some longer-term solutions as well. General practice and primary care were creaking before covid, and we need to ensure that they are supported in the long term going forward.

I thank my hon. Friend the Member for Beaconsfield for securing this afternoon’s debate. She has raised some really important points. On Thursday, I am holding a cross-party call for MPs to raise some of their constituency GP issues. I urge them to feed back to me as the Minister where it is working well, because there are some brilliant examples out there. Where it is not working so well, it is not the fault of GPs. There are some fundamental solutions that we can help them with, but it is important that we hear about the problems so that we can support them. If Members have specific issues from their constituencies, they should join the call. We are hoping to hold such calls on a regular basis, if that is needed by colleagues, and I am keen to work with everyone across the House to support general practice, because that is the only way we will support patients in the end.

NHS England Funding: Announcement to Media

Rachael Maskell Excerpts

Monday 25th October 2021 Commons Chamber

[Edward Argar]

For a brief moment, I thought my hon. Friend was not going to mention the new hospital at Kettering. Yes, I am very happy to have that conversation with NHS England colleagues as I continue to discuss the new hospital in his constituency with them at regular intervals.

[Rachael Maskell (York Central) (Lab/Co-op)]

Workforce planning failures have brought us to this point, but many of the patients on the elective waiting lists will be showing up in primary care, and with greater acuity as they wait longer for their treatments. What additional support will the Minister give primary care to manage people on all these waiting lists?

[Edward Argar]

The hon. Lady is right to highlight that primary care and GP practices are often the front door for the vast majority of these people on the waiting lists, and I pay tribute to the hard work of GPs up and down the country over the past year and a half to two years. She will have seen the announcement a few weeks ago by my right hon. Friend the Secretary of State, in which he set out further support that would be made available to help GP practices.

Covid-19: Government Response

Rachael Maskell Excerpts

Thursday 21st October 2021 Commons Chamber

[Maggie Throup]

First, let me say a huge thank you to everybody who came forward to take part in clinical trials. Without those volunteers, we would not be where we are today, having the amazing vaccines that are helping to save lives. To ensure that I have the absolute up-to-date information, may I write to the hon. Gentleman on the latest with regards to those specific trials?

[Rachael Maskell (York Central) (Lab/Co-op)]

The problem is that the Government have put all their eggs in one basket with the vaccine when they should also be implementing public health measures and providing clear leadership on that. They should also restore the contact tracing that local authorities were doing with great success in locking down the virus. The Government took that right away from them, so will the Minister restore contact tracing to local authorities?

[Maggie Throup]

The Government have a range of measures. We have vaccines; we are world leading on antivirals; and we have lots of other measures. As I go about my constituency, I see many people blipping into venues, wearing their face coverings when they are shopping and lots of different things. It is important that people have that choice and make decisions based on the current circumstances.

Covid-19 Update

Rachael Maskell Excerpts

Thursday 21st October 2021 Commons Chamber

[Maggie Throup]

As I have mentioned on numerous occasions, we are in plan A. There is guidance for wearing face coverings as part of that plan.

[Rachael Maskell (York Central) (Lab/Co-op)]

I am sorry, but this is just not good enough. In my constituency, hundreds of children are off school, hundreds of people are not in work today, and, sadly, people are dying. As a result of that, rather than have a politically led strategy, will the Minister meet with the Association of Directors of Public Health to ensure that they take a lead on how we will manage the crisis in the coming months?

[Maggie Throup]

We are in a pandemic. The hon. Lady says that children are getting infections, which is why we have opened up the opportunity for 12 to 15-year-olds, as well as those 16 and above, to get their vaccine. That is important. They are protecting themselves and protecting other people.