Health and Care Bill

Baroness Winterton of Doncaster Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Fiona Bruce]

My right hon. Friend makes exactly the right point.

Our law needs to be updated. The current 24-week limit was set over 30 years ago, in 1990. That legislation removed the previous time limit of 28 weeks. In 1990, 24 weeks was considered the point of viability outside the womb, but the scientific advances in those 31 years have been enormous. The latest guidance from the British Association of Perinatal Medicine establishes 22 weeks gestation to be the point of viability and enables doctors to intervene to save premature babies from 22 weeks. A study from a neonatal intensive care unit in London found that survival rates for babies born at 22 and 23 weeks gestation went from zero in the period from 1981 to 1985 to 19% in the period from 1986 to 1990, and then up to 54% in the years from 1996 to 2000. We would no doubt find that the figures had increased substantially since then, were those figures available. Just in the past few weeks, we have seen the incredible story from the American state of Alabama of the birth of a baby boy at just 21 weeks old. Weighing just 14.8 ounces, Curtis Means needs oxygen support and a feeding tube, but he is in good health. New clause 31 is a probing amendment, so I will not be pressing it to a vote on this occasion. However, I would welcome the Minister’s views and I look forward to a greater debate on this issue.

I also want to take a few moments to give my support to new clause 51, in the name of the hon. Member for Upper Bann (Carla Lockhart), which would clarify that abortion on the ground of the sex of the foetus is illegal. This relates to the truly awful exploitative practice whereby women can be pressurised into abortions based on the sex of their unborn child. I also support new clause 52, also in the name of the hon. Member for Upper Bann, which seeks to bring parity to the law in equalising time limits on abortions that take place on the ground of disability, so that they would be equal to the limits on most other abortions. The current law permits abortions up to birth if the baby is deemed likely to be born seriously handicapped. This is interpreted to include entirely non-fatal disabilities such as Down’s syndrome and easily surgically rectifiable conditions such as cleft palate and club foot. One of my sons was born with club foot, and I know how rectifiable it is. The law is plainly inconsistent with the disability discrimination legislation that applies after birth, and it sends a dreadful message to people who are living and thriving with disabilities about how little their lives are valued under abortion law. Again, I look forward to hearing the Minister’s views.

[Madam Deputy Speaker (Dame Rosie Winterton)]

In order to try to get as many people in as possible, I am going to put on a three-minute time limit.

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

Forced organ harvesting in China is one of the worst crimes against humanity of the 21st century. That is why I wish to speak to new clauses 24 and 25 in my name. It is a crime that no British citizens should be taking part in, and a crime that humanity has a duty to stop. New clause 24 aims to put a dent in the forced organ harvesting trade. It would prohibit UK citizens from receiving a transplant abroad without the clear consent of the donor. The forced organ trade is a big money business. The organs of a young healthy adult are worth in the region of half to three quarters of a million US dollars. That is money that people would, and do, kill for.

China started with political prisoners, with the religious Falun Gong group being the main source. Now it has moved on to Uyghur Muslims, some Christians and other minority groups. Evidence was heard at the China and Uyghur tribunals that mass DNA testing is taking place in the internment camps in Xinjiang, enough to compile a Uyghur organ database and bank ready for withdrawals on demand. The world might believe that China had an ethnical organ donation system based on the World Health Organisation’s assessment, yet that assessment from the WHO is based on a country’s self-assessment—in this case by the Chinese Communist party. It is a barbaric practice, and every democracy in the world should be looking at what it can do to stop it.

I am grateful to Members from every party across this House for supporting my new clause. It will not stop the trade, but it will show that we in Britain are doing our part and helping to influence other countries to do the same. I thank my hon. Friend the Member for Nottingham North (Alex Norris) for raising these new clauses in Committee. The Minister sympathised, but expressed certain concerns. He was worried that countries could have a deemed consent system in which everyone was automatically a donor. Deemed consent is acceptable only if people can opt out. Under a new provision, the Secretary of State will assess the deemed consent of each country. The Minister was also concerned that the recipient of an organ could face criminal consequences. It is the duty of a Government to ensure that people are aware of what is a crime, and supporting or funding a crime against humanity must be illegal.

New clause 25 would make imported cadavers require the same consent as bodies sourced from within the UK. The Minister claimed that a revised code of practice covered this, but a code of practice is not law. Surely the sanctity and dignity of the human body demand the power of legislation. I call on the House and this Government to step up and do their part to stop this crime against humanity.

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[Jim Shannon]

Does my hon. Friend share my concerns that a large number of people throughout the whole United Kingdom object to this? We have had hundreds and hundreds of emails from my constituents about this issue. I commend my hon. Friend and the hon. Member for Congleton (Fiona Bruce) and totally oppose new clause 50—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. That intervention is quite long enough.

[Carla Lockhart]

I will not push either of my new clauses to a vote. However, legal clarification on sex-selective abortion is urgently needed for the sake of women and the missing girls who are the victims of this abhorrent practice.

I commend the hon. Member for Congleton (Fiona Bruce). As evidence changes, so should the law, and 22 weeks’ gestation is the point of foetal viability. At heart, this is a debate about human rights, and the most basic human right is the right to life.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. Before I call the shadow Secretary of State, I should say that I will probably introduce a three-minute time limit after the shadow Secretary of State and that I am unlikely to call anybody who intervened on the Secretary of State during his opening speech.

Health and Care Bill

Baroness Winterton of Doncaster Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Edward Argar]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Dame Rosie Winterton)]

With this it will be convenient to discuss the following:

New clause 33—Support provided by the NHS to victims of domestic abuse—

“(1) Each Integrated Care Board must—

(a) assess, or make arrangements for the assessment of, the need for support for victims of domestic abuse using their services;

(b) prepare and publish a strategy for the provision of such support in its area;

(c) monitor and evaluate the effectiveness of the strategy;

(d) designate a domestic abuse and sexual violence lead; and

(e) publish an annual report on how it has discharged its duties relating to the provision of services to victims of domestic violence under the Care Act 2014.

(2) An Integrated Care Board that publishes a strategy under this section must, in carrying out its functions, give effect to the strategy.

(3) Before publishing a strategy under this section, an Integrated Care Board must consult—

(a) any local authority for an area within the relevant Integrated Care Board’s area;

(b) the domestic abuse local partnership board appointed by the local authority for an area within the relevant clinical commissioning group’s area under section 58 of the Domestic Abuse Act 2021; and

(c) such other persons as the relevant local authority considers appropriate.

(4) For the purposes of subsection (4), ‘local authority’ means—

(a) a county council or district council in England; or

(b) a London borough council.

(5) An Integrated Care Board that publishes a strategy under this section—

(a) must keep the strategy under review;

(b) may alter or replace the strategy; and

(c) must publish any altered or replacement strategy.

(6) The Secretary of State may by regulations make provision about the preparation and publication of strategies under this section.

(7) The power to make regulations under subsection (7) may, in particular, be exercised to make provision about—

(a) the procedure to be followed by an Integrated Care Board in preparing a strategy;

(b) matters to which an Integrated Care Board must have regard in preparing a strategy;

(c) how an Integrated Care Board must publish a strategy;

(d) the date by which an Integrated Care Board must first publish a strategy; and

(e) the frequency with which an Integrated Care Board must review its strategy or any effect of the strategy on the provision of other provision in its area.

(8) Before making regulations under this section, the Secretary of State must consult—

(a) all Integrated Care Boards; and

(b) such other persons as the Secretary of State considers appropriate.”

This new clause would require Integrated Care Boards to publish a strategy for the provision of support for victims of domestic abuse using their services and designate a domestic abuse and sexual violence lead.

New clause 55—Guidance for babies, children and young people—

“(1) The Secretary of State must publish guidance on how integrated care systems should meet the needs of babies, children and young people aged 0-25.

(2) Integrated care systems must act in accordance with the guidance in subsection (1).”

This new clause would require the Secretary of State to publish guidance on how integrated care systems should meet the needs of babies, children and young people aged 0-25 and would require integrated care systems to act in accordance with the guidance.

New clause 57—NHS England’s duty as to reducing inequalities—

“Section 13G of the National Health Service Act (duty as to reducing inequalities), is amended by the addition of the following subsections—

‘(2) NHS England must publish guidance about the collection, analysis, reporting and publication of performance data by relevant NHS bodies with respect to factors or indicators relevant to health inequalities.

(3) Relevant NHS bodies must have regard to guidance published by NHS England under this section.

(4) In this section “relevant NHS bodies” means—

(a) NHS England,

(b) integrated care boards,

(c) integrated care partnerships established under section 116ZA of the Local Government and Public Involvement in Health Act 2007,

(d) NHS trusts established under section 25, and

(e) NHS foundation trusts.’”

Amendment 47, in clause 6,  page 4, line 11, at end insert—

“(5) In paragraph 1(a) ‘relevant public body’ means a public authority listed under the title ‘Health, social care and social security’ in Part 1 of Schedule 19 to the Equality Act 2010 or an NHS Trust.”

This amendment provides that NHS England resources for supporting or assisting organisations that are providing or planning to provide health services may only be directed to public sector bodies.

Amendment 58, in clause 12, page 8, line 6, at end insert—

“(2) An integrated care board may not—

(a) delegate that function; and

(b) exercise that function to enter into an integrated care provider contract with any body other than a statutory NHS body.

(3) In paragraph (2)(b) an ‘integrated care provider contract’ has the same meaning as in Schedule 3A of the National Health Service (General Medical Services Contracts) Regulations 2015.”

This amendment is designed to ensure that an organisation carrying out the functions of an ICB on its behalf is a statutory NHS body.

Amendment 59, page 12, line 29 at end insert—

“(3A) Nothing in——

(a) the rules referred to in subsection (1),

(b) this Act, or

(c) any regulations made under this Act

(none) shall entitle any provider of health services to withhold provision of those services from any individual on the basis of the integrated care board to which that individual has been allocated.”

This amendment is to ensure that any providers of health services cannot withhold provision of those services from any individual because of the integrated care board that they have been allocated to.

Amendment 66, in clause 15, page 13, line 44, at end insert—

“(j) palliative care services.”

This amendment adds a requirement for the commissioning of palliative and end of life care services.

Amendment 21, page 14, line 43, at end insert—

“3AA Duty of integrated care boards to commission approved treatments

‘(1) This section applies where—

(a) a treatment has been approved by the National Institute for Health and Care Excellence, and

(b) an integrated care board has not arranged for the provision of that treatment under section 3 or 3A of this Act, and

(c) a clinician has recommended that treatment for a person for whom that integrated care board has responsibility.

(2) The integrated care board referred to in subsection (1) must arrange for the provision of that treatment to the person for whom it has responsibility.

(3) In subsection (1) “clinician” means a medical professional employed by or acting on behalf of an NHS Trust, NHS Foundation Trust or primary care service from whom the integrated care board has arranged for the provision of services.’”

This amendment would require an integrated care board to arrange for the provision of a NICE-approved treatment to any patient whose NHS clinician has recommended it, even if that treatment is not otherwise available to patients in that ICB area.

Amendment 48, in clause 19,  page 16, line 6, leave out “promotes” and insert

“secures the rights set out in”.

This amendment requires ICBs to act to ensure that health services are provided in a way which secures the rights set out in the NHS Constitution.

Amendment 99, page 16, line 34, at end insert—

“(2) In fulfilling their duties under this section, integrated care boards must have particular regard to the need to reduce inequalities between migrant and non-migrant users of health services.”

Amendment 49, page 16, line 37, leave out “promote” and insert “enable”.

This amendment, together with Amendment 50 provides that ICBs enable the involvement of patients, their paid and unpaid carers, and their representatives in decisions relating to the prevention or diagnosis of illness, care or treatment, rather than promoting their involvement.

Amendment 50, page 16, line 37, after “their”, insert “paid and unpaid”.

This amendment, together with the Amendment 49, provides that ICBs enable the involvement of patients, their paid and unpaid carers, and their representatives in decisions relating to the prevention or diagnosis of illness, care or treatment.

Amendment 22, page 17, line 4, at end insert—

“14Z37A Obligation on integrated care boards to ensure appropriate uptake of all NICE approved products according to population need

‘(1) Each integrated care board must promote uptake of all NICE approved medicines and medical devices in accordance with the need of the population it serves.

(2) An integrated care board must, in each financial year, prepare a report on the uptake of all NICE approved medicines and medical devices, including the number of patients that have accessed each product.’”

This amendment would require ICBs to ensure that all NICE approvals are available and promoted to their population, and report on this uptake annually.

Amendment 19, page 17, line 14, at end insert—

“14Z39A Duty to review latest innovations with a view to local commissioning

(1) Integrated care boards must review all new—

(a) medicines,

(b) medical devices, and

(c) other health care solutions that may benefit the local population.

(2) Integrated care boards must—

(d) appoint a dedicated innovation officer to their board, and

(e) develop and maintain a system to keep up to date with medicines and devices innovation and review suitability for patient usage, including engagement with the relevant—

(i) academic health science network, and

(ii) local pharmaceutical committee.”

This amendment would mandate integrated care boards to monitor and assess innovation for the benefit of the local population.

Amendment 16, page 17, line 19, at end insert—

“(2) Each integrated care board must each year prepare, consult on and adopt a research strategy for patient benefit which—

(a) meets local need;

(b) meets national research undertakings.

(3) In developing a strategy under subsection (2), an integrated care board must engage with—

(a) the National Institute for Health Research,

(b) academic health science networks, and

(c) all other relevant regional and national health research organisations.”

This amendment would require ICBs to establish a research strategy and other connected measures.

Amendment 91, page 18, line 18, after first “the” insert “physical and mental”.

This amendment will require Integrated Care Boards to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness replicating the parity of esteem duty as introduced in the Health and Social Care Act 2012.

Amendment 92, page 18, line 23, after first “of” insert “physical and mental”.

This amendment will require Integrated Care Boards to prioritise both the physical and mental health and well-being of the people of England and to work towards the prevention, diagnosis or treatment of both physical and mental illness replicating the parity of esteem duty as introduced in the Health and Social Care Act 2012.

Amendment 68, page 18, line 26, at end insert—

“(d) health inequalities.”

This amendment would modify the triple aim to explicitly require integrated care boards to take account of health inequalities when making decisions.

Amendment 17, page 18, line 38, at end insert—

“14Z43A Duty on integrated care boards to consider requests to engage in clinical trials, and patient participation

(1) An integrated care board must consider any request from the organiser of an authorised clinical trial for the ICB to engage in that trial.

(2) If such a request is accepted, the integrated care board must offer the ability to participate in the trial to any patient within their area who is eligible to take part.”

This amendment would require integrated care boards to consider any requests to engage in clinical trials and offer patients the opportunity to participate.

Amendment 20, page 18, line 38, at end insert—

“14Z43A Duty to update formularies to include all NICE-approved products

(1) Within 28 days of any medicine or device receiving market authorisation from NICE, an integrated care board must update its formulary to include that medicine or device.

(2) On receipt of notice of the market authorisation by NICE of any medicine or device, an integrated care board must immediately instruct providers of health and care services commissioned by the board to update their formularies in such a way that all NICE-approved medicines and devices are available to patients on the recommendation of a healthcare practitioner within 28 days of market authorisation.

(3) An integrated care board must report annually all medicines and devices that have been added and removed from their formulary over the previous year.”

This amendment would mandate integrated care boards and healthcare providers (e.g. hospital trusts) to update their formularies to include all NICE-approved medicines or devices within 28 days of market authorisation to ensure they are available for healthcare practitioners (e.g. physician or prescribing pharmacist) to make available for suitable patients.

Amendment 102, page 21, line 25, at end insert—

“(c) set out any steps that the integrated care board proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).”

This amendment requires the joint forward plan for an integrated care board and its partners to set out any steps it proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).

Amendment 51, page 22, line 23, leave out

“in a way that they consider to be significant.”

This amendment requires ICBs and partner NHS Trusts and NHS Foundation Trusts to consult on all revisions to their forward plans.

Amendment 52, page 23, line 42, at end add “on its website”.

This amendment is to require capital resource use plans to be made publicly available on the internet.

Amendment 53, page 24, line 22, leave out

“in a way that they consider to be significant”.

The purpose of this amendment is to require all revisions of capital resource use plans to be published.

Amendment 18, page 25, line 6, at end insert—

“(d) explain what research activity it undertook during the year, including

(i) research to meet local health issues, and

(ii) research to support national research projects.

‘(2A) The annual report prepared by the Secretary of State under section 247D of this Act must include a section which reproduces, and comments on, the sections of the annual reports of each integrated care board prepared under paragraph (1)(d).’”

This amendment would require integrated care boards to publish an account of their research activity, and require the report the Secretary of State must prepare and lay before Parliament under section 247D of the National Health Service Act 2006 to include a section which reproduces, and comments on, the research activity of all ICBs.

Amendment 23, page 25, line 14, at end insert—

“14Z56A Report on assessing and meeting parity of physical and mental health outcomes

(1) An integrated care board must annually set out in a report the steps it has taken to fulfil its obligations to deliver parity of esteem between physical and mental health to its local population.

‘(1) The report must set out—

(a) the number of patients presenting with mental health conditions,

(b) the number of patients presenting with physical health conditions,

(c) the number of mental health patients waiting for initial assessment,

(d) the number of physical health patients waiting for initial assessment,

(e) the number of mental health patients waiting for treatment,

(f) the number of physical health patients waiting for treatment,

(g) the number of mental health patients receiving treatment,

(h) the number of physical health patients receiving treatment,

(i) the number of patients readmitted to mental healthcare settings, and

(j) the number of patients readmitted to physical healthcare settings.

(2) The report must set out performance against nationally set standards in both physical and mental health.

(3) Each year the Secretary of State must lay before Parliament a consolidated report of all the reports made by integrated care boards under this section, and make a statement to each House of Parliament on the report.’”

This amendment would require an ICB to report on assessing and meeting parity of physical and mental health outcomes.

Amendment 15, in clause 20,  page 29, line 20, at end insert—

“(2A) The Secretary of State may by regulations make provision about representation of particular health, social care, and local interests, clinical fields, and types of health or care provision in the membership of integrated care partnerships.”

This amendment would enable the Secretary of State to make provision about the membership of integrated care partnerships.

Amendment 100, page 29, line 22, at end insert—

“(4) A member of the Integrated Care Partnership may not work for, be the representative of or hold financial interest in any private company delivering or seeking to deliver health and care services or services supporting the health and care sector or producing or seeking to produce health and care products, with the exception of general practitioners.”

This amendment seeks to ensure that Integrated Care Partnerships are made up wholly of representatives from public sector organisations and that private companies are not represented on them.

Amendment 1, page 29, line 45, at end insert—

“(c) fully integrate the promotion of everyday wellbeing, self-care for minor ailments and the management of long-term conditions into local health systems.”

This amendment would ensure that everyday wellbeing, self-care for minor ailment and management of long term conditions are integrated and promoted into local health systems.

Amendment 2, page 30, line 3, after “services” insert

“including services provided by pharmacists for minor ailments”.

This amendment would ensure that integrated care partnerships include in a strategy its views on how health-related services, including provision for self-treatable conditions, are integrated into health and social care services in that area.

Amendment 69, in clause 23,  page 35, line 32, at end insert—

“(5) NHS England must publish guidance on the means by which an integrated care board, NHS trust or NHS foundation trust which believes its capital resource limit or revenue resource limit risks compromising patient safety may object to the limit set.”

Amendment 114, in clause 25,  page 37, line 27, at end insert—

“(2A) The priorities set by the Secretary of State under subsection (2)(a) must include priorities relating to leadership, the integration of services and the quality and safety of services.”

The Secretary of State has the function of setting priorities for the Care Quality Commission in carrying out assessments in relation to integrated care systems. This amendment requires the Secretary of State to set priorities relating to certain matters.

Amendment 61, in clause 64, page 59, line 27, leave out from beginning to end of line 28.

This amendment is to ensure that a commissioner cannot also be a provider.

Amendment 62, in clause 69, page 63, line 30, leave out “may” and insert “must”.

This amendment makes it a requirement that regulations make provision in relation to the procurement by relevant authorities of (a) health care services for the purposes of the health service in England, and (b) other goods or services that are procured together with those health care services.

Amendment 63, page 63, line 36, leave out “may” and insert “must”.

This amendment makes it a requirement that regulations make provision in relation to (a) general objectives of procurement, and (b) procurement processes.

Amendment 64, page 63, line 39, leave out “may” and insert “must”.

This amendment along with Amendment 65 makes it a requirement that regulations make provision for the purposes of (a) ensuring transparency and fairness in relation to procurement, and (b) ensuring that compliance can be verified, or managing conflicts of interest.

Amendment 65, page 63, line 41, leave out “or” and insert “and”.

This amendment is to make it a requirement for regulations to make provision to ensure both transparency and fairness in relation to procurement.

Amendment 9, page 64, line 1, at end insert—

“(3A) The regulations must provide that—

(a) there is a presumption—

(i) in favour of contracts being awarded to NHS trusts and NHS foundation trusts, and

(ii) that integrated care provider contracts will not be awarded to a body other than to an NHS trust or an NHS foundation trust, except for under the provisions of paragraph (b);

(b) if an NHS trust or an NHS foundation trust does not consider that it is able, or does not wish, to provide certain services under a contract, it must publish its reasons;

(c) if paragraph (b) applies, the integrated care board must consult the public if it proposes to award any contract for those services to any body other than an NHS trust or NHS foundation trust;

(d) a consultation under paragraph (c) must—

(i) set out the responses of the integrated care provider to the reasons given by the NHS trust or NHS foundation trust under paragraph (b),

(ii) specify the proposed parties to and the full terms and conditions of the proposed contract, and

(iii) specify that the terms and conditions for staff under the proposed contract must be at least equivalent to NHS terms and conditions.”

This amendment would make NHS trusts and foundation trusts the default providers of NHS services.

Amendment 72, page 64, line 1, at end insert—

“(3A) The regulations must make provision in relation to the procurement of the services referred to in paragraph (1)(a) (other than primary medical services, primary dental services and primary ophthalmology services) that before any contract for a service with an annual value in excess of £5m may be awarded to an organisation that is not an NHS trust or NHS foundation trust—

(a) the business case for the award of the contract must be published;

(b) any responses to the proposal in the business case must be considered and published;

(c) the process for awarding the contract must be open and transparent and non-discriminatory at every stage, including (but not limited to)—

(i) procurement strategy and plan,

(ii) invitation to tender,

(iii) responses to invitations,

(iv) evaluation of tenders,

(v) decision to award, and

(vi) contract awarded;

(d) the process for awarding the contract must demonstrate due regard to the principles established in the Public Contracts Regulations 2015 (S.I.2015/102) or any regulations which may supersede them;

(e) in any case where it is claimed that an emergency justifies an award without the process being used then the responsible body must within 14 days publish the business case for the award of the contract and the record of the decision.”

Amendment 101, in schedule 2,  page 125, line 26, at end insert—

“(3) Members of an Integrated Care Board may not work for, be the representative of or hold financial interest in any private company delivering or seeking to deliver health and care services or services supporting the health and care sector or producing or seeking to produce health and care products, with the exception of general practitioners.”

This amendment seeks to ensure that ICBs are made up wholly of representatives from public sector organisations and that private companies, their employees and representatives, and those with financial interests in them, are not represented on ICBs.

Government amendments 25 to 28.

Amendment 76, page 126, line 26, at end insert—

“(d) at least one member nominated by the mental health trust or trusts that provide mental health services within the integrated care board’s area;

(e) at least one member nominated by the Directors of Public Health that serve each local authority within the integrated care board’s area;

(f) at least one member nominated jointly by any NHS trust, NHS foundation trust and local authority that provides social care services within the integrated care board’s area;

(g) at least one member nominated by the trade unions representing the health and social care workforce that serves the integrated care board’s area;

(h) at least one member appointed to represent the voice of patients and carers in the integrated care board’s area.”

Amendment 77, page 126, line 26, at end insert—

“(2A) The constitution must prohibit representatives of GP practices with active Alternative Provider Medical Services contracts from becoming members.”

This amendment would mean that the only GPs able to participate in Integrated Care Boards would be those whose practices are on the standard General Medical Services (GMS) contract.

Amendment 78, page 126, line 26, at end insert—

“(2A) Representatives of private providers of healthcare services, other than general practitioners who hold a contract for the provision of primary medical services in the area, may not be appointed to NHS decision-making boards, integrated care boards, or any place-based committee or sub-committee of the boards.”

Amendment 81, in schedule 2,  page 130, line 14, at end insert—

“(7) An integrated care board may enter into an externally financed development agreement in respect of any Local Improvement Finance Trust relevant to the area for which it has responsibility and receive the income related to that agreement.

(8) An integrated care board may enter into an externally financed development agreement in respect of any proposed Local Improvement Finance Trust relevant to the area for which it has responsibility.”

This amendment would enable integrated care boards to participate in existing and future LIFT schemes and to receive the income that would come to the local area from the local investment in such schemes.

Amendment 79, in schedule 3,  page 132, line 28, leave out “person” and insert

“general practitioner, GP partnership or social enterprise providing primary medical services”.

This amendment would prevent an integrated care board from entering into or renewing any Alternative Provider Medical Services (APMS) contract.

Amendment 80, page 132, line 32, leave out “person” and insert

“general practitioner, GP partnership or social enterprise providing primary medical services”.

This amendment would prevent NHS England from entering into or renewing any Alternative Provider Medical Services (APMS) contract.

Government amendments 29 and 30.

[Edward Argar]

New clause 49 has attracted a slightly fuller House than my previous speech did. This additional clause relates to the cap on care costs for charging purposes.

On 7 September, my right hon. Friend the Prime Minister took the bold step of publishing “Build Back Better: Our Plan for Health and Adult Social Care”. Successive Governments over decades have failed to tackle the reform of social care. This Government are delivering a package—package is the key—of reforms that will not only tackle the wider challenges faced by the adult social care system but reform how social care is funded to ensure that everyone, regardless of where they live or their level of assets, is protected from catastrophic costs. Let me remove all doubt on this issue: no one will lose from these reforms, compared with the system we have now, and the overwhelming majority will win.

Underpinning the reforms set out in the plan is an additional £5.4 billion over the next three years. That funding will end wholly unpredictable care costs and include at least £500 million to support the adult social care workforce. The reforms will make a real difference to the frontline of adult social care, including care users and the dedicated care workforce who have performed heroics throughout the pandemic. A crucial element of the reforms in the plan are the proposals to reform the existing social care charging rules.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. It will be obvious to Members that a large number of colleagues want to contribute to the debate. I urge brevity, so that others can participate. I call the Chair of the Health and Social Care Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con)]

Madam Deputy Speaker, I think on this occasion I can oblige you, because I will be very brief. I wish to speak to amendment 114, which may seem a rather technical amendment—as is evidenced by the fact that, out of 650 colleagues, only one has actually signed it, and that is me—but it makes up in quality for what it does not have in quantity. It is about making sure that the new integrated care boards focus their energy on the safety and quality of care of patients. That is very important, because the new integrated care boards will have enormous power. In effect, they will be the local governing bodies of our NHS.

Although the statutory structures matter, what the people running those care boards focus their attention on is incredibly important to all our constituents. The amendment will make sure that when care boards consider their priorities, the things that matter to patients—the safety and quality of care—are put at the very top of their list. We know the way the NHS works. It is the fifth-largest bureaucracy in the world, and there is a plethora of internal NHS—

Giving Every Baby the Best Start in Life

Baroness Winterton of Doncaster Excerpts

Tuesday 9th November 2021 Commons Chamber

[Tim Loughton (East Worthing and Shoreham) (Con)]

I pay tribute to the hon. Member for Richmond Park (Sarah Olney) and the other colleagues who secured the debate. It is great to be having a debate about early years again; we are having a few of them these days. It never happened when I first became a Member of the House and has not for much of my 24 years here. It is really fantastic that such a relevant and important subject to so many of our constituents is now commonplace in the Chamber and that there is real, concerted action. We may disagree over the extent or detail of that, or the amount of money that is going into it, but I think we all agree about the direction and emphasis.

It is a great pleasure to follow the hon. Member for Newcastle upon Tyne North (Catherine McKinnell), and I agree with much of what she said. It is also a great pleasure—but a great challenge—to follow my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), who is such a guru on this subject that anything the rest of us say subsequently will pale into relative irrelevance, but I will give it a bash anyway.

I want to recount an episode that happened when I was Children’s Minister 11 years ago. I used to spend a week of the summer recess going out on the frontline with some of the workforce, without any fuss and without any cameras, just to see what their job involved at first hand. I remember my first time: I spent a week in Stockport going out with social workers, knocking on doors, seeing cases at first hand, manning the overnight emergency helplines, sitting in on morning meetings and liaising with police and others. It was a fascinating experience, which I recommend to any other Member. I think it should be compulsory for all Ministers and their officials to spend time with the professionals over whose regulations that Department has responsibility. That is where we find out the most. I used to find out most of my information from sitting down with groups of children in care, as the Minister responsible for children in care; that is where we find out what is really going on.

A really good social worker took me to my first case, and I think that she deliberately chose the most challenging case in the most run-down, depressing part of the town. We went into a house that was a complete mess. There was a young mum with three young boys. There were no carpets on the floor. There was virtually no furniture, other than what had been dumped in the garden. There was no food in the house—the fridge was bare—other than what the kids literally were eating off the floor. There were bare mattresses for beds and piles of dirty clothing.

One of the kids had had a really dire toothache for some weeks, and the social worker had gone on at the mum about getting the child some treatment for it. On the day that we visited, the mum had had a toothache problem. On the previous day, she had gone down to the emergency dentist and had her tooth fixed, but she did not have the presence of mind to take her son who was suffering from toothache along with her.

What does someone do with a family like that? Plenty of professionals had been going in and out of that house to offer different bits of help, but that mum required some serious support. She had been abused as a child, as is so often the case. The father was not on the scene and she had been subject to domestic abuse, as is so often the case. We all know, extraordinarily, that about a third of domestic violence starts during pregnancy. So there she was, highly vulnerable and desperately in need of support, but her life was not improving and the life chances of her children were certainly not. So what does someone do?

Those children could have been taken into care. They probably would have been split up, going to different families across the area and perhaps beyond. The mum would have been completely distraught at that prospect. Inadequate though she was, for whatever reason, in the care that she provided, she absolutely doted on those kids and they doted on her, so what was the solution? That is the sort of judgment of Solomon that our social workers have to make day in, day out when dealing with those really complex, challenging cases.

That case, which I will remember for the rest of the time that I am involved in these areas, encapsulates all the challenges that we face in children’s social care and all the challenges relating to the whole issue of the best start in life and the project that the Government have undertaken, thanks to my right hon. Friend the Member for South Northamptonshire. That is why it is so important. One of the answers is to have a joined-up approach locally, with all the different professionals working together as a team to encapsulate mum and family. It is about having somebody who can literally take her by the arm and march her down to a children’s centre to get family support and advice or march her down to the dentist with little Johnny to make sure that he gets dental treatment—somebody to take control of people’s lives and get them on the straight and narrow until they can fend for themselves and their family again. We need local professionals working as one, with a lead person who has responsibility, who has all the joined-up knowledge about what needs to happen, and who has the force and confidence to make it happen.

We also need the Government to be joined up at the centre. I remember that when we were trying to get the early intervention grant sorted, we were getting the run- around from officials because the fund would affect various Departments. We were told, “Oh, we can book you an appointment with the Minister in that Department in a few weeks’ time, and then perhaps you can have another meeting with that Minister.” In the end, the only way my co-Minister Sarah Teather and I got the problem sorted was by ringing up all the Housing, Health, Home Office and other Ministers responsible. We all had pizza in the Adjournment, agreed what the strategy should be, went back to our Departments the following morning and told our civil servants, “This is what we want to happen.” All the civil servants said, “That’s not the way we do things here, Minister,” to which we all said, “Tough. Do it.”

The problem is that government does not work in a joined-up way, which is why the approach that my right hon. Friend the Member for South Northamptonshire has taken is really pioneering. I pay tribute to her for the way she has brought things together, forcing Departments to sit down, work together and have a strategy that works as one. That is the only way we will sort the problem sustainably for the future, which is key to the whole approach.

The hon. Member for Richmond Park has set out the problems: the £8.1 billion that perinatal mental illness costs each year; the £15 billion that we spend each year in this country on child neglect, particularly in relation to younger children; the £6 billion that childhood obesity costs each year, which is likely to rise to £9 billion within the next few years. As well as the cost of domestic abuse and safeguarding, we are spending £20 billion to £30 billion-plus each year as the cost of getting it wrong for some of the most vulnerable children and their families. Spending a fraction of that on solutions to get it right will be absolutely transformational.

Let us look at some research from the Institute of Health Visiting. I will always speak up for health visitors; in my view, frankly, they are one of our emergency services. They have been diverted too often during the pandemic to other parts of the health service, and their absence has been greatly felt. There is a shortage of several thousand: the institute says that we need at least 3,000 additional health visitors over the next three years, and I completely agree. One of the great achievements of the Cameron Government was building up the health visitor workforce, which has since diminished, alas. A survey of health visitors shows that 81% have seen an increase in perinatal mental illness, 80% have seen an increase in domestic abuse, 80% have seen an increase in child behaviour problems, 72% have seen an increase in poverty affecting families and 71% have seen an increase in child safeguarding.

The hon. Member for Newcastle upon Tyne North is right, too. Research from Action for Children shows that

“only 57% of children from poorer backgrounds were ready for school at age five, compared to 74% of their better-off peers…82% of parents of 0-5s in England struggled, or were unable, to access vital non-childcare early years services…78% of parents who were unable to access a service were worried about potential impacts on themselves or their children. The most common concerns were children’s development, and parents’ own mental health and wellbeing.”

That is the cost of failure, and that is why it is so important to have a co-ordinated, joined-up approach. One statistic that has always stayed in my mind is that if a 15 or 16-year-old at school suffers from depression or some form of mental illness, there is a 99% likelihood that their mum suffered from some form of perinatal mental illness or depression—the link is that close. We should be spending so much more time and resources on looking at the pre-school period, particularly from conception to age two, because that is where it all goes pear-shaped. We see the consequences throughout childhood, and they so often carry on into adulthood and stay with the person for the rest of their life. So of course we should be doing more about this, and I am glad that at last the Government have recognised that that is where all the action—or a lot more of the action —needs to be focused.

On health visitors, I agree with the Local Government Association, which has said it is important for the Government to work

“on a children’s workforce strategy to support the development of a well-qualified, well-resourced workforce with the appropriate knowledge, skills and experience to work in a preventative way. This needs to be an integrated strategy between local authorities, health, education and community and voluntary sector partners, which links effectively with established programmes, such as Supporting Families, Sure Start and Family Hubs and puts the child’s journey at the centre.”

That strategy, it adds, needs to be properly resourced. Well, we are having a lot of extra resource. We could all argue that it is not enough, and the more Opposition Members argue that it is not enough the more I will welcome that, because we could always do with more money; but I think this has been a good start.

Let us look briefly at some of the action areas. One of them is the provision of seamless support for families. As my right hon. Friend the Member for South Northamptonshire has said, we need to have a lead person who knows all the facts and history of the family involved, and who has the power to say, “This is what needs to happen for that family”, and make sure that it happens. Then there is the welcoming hub for families. I can answer the earlier question from the hon. Member for Newcastle upon Tyne North by saying that 75 family hubs have been identified, in about half the number of local authority areas. I hope very much that the other 75 will follow very quickly, so that there is at least one per authority.

Can we get away from the idea that these hubs are a challenge to, or in place of, children’s centres? They are building on the experience of children’s centres and are complementary to them, but they are not just about bricks and mortar; they are about services. I think that in the past we have been too hung up about the amount of bricks and mortar that we have rather than the quality of the services provided, whether as outreach or within children’s centres, and, most important, the outcomes that they are creating for the children for whom they exist and their families.

It is important to ensure that families have the right information at the time when they need it. When people are reluctant to cross the threshold of a children’s centre or a family hub, as my family in Stockport were, they need to have other ways of obtaining that information. It may be a night-time call line, or it may be online, on the internet. It may mean having another professional to call on, or even volunteers—even members of another family who are looking out for vulnerable families. What those people need is a trusted source of information that they can access, rely on and then act on to their benefit.

I think we have all learnt in the past that a top- down approach, with all the geeks in the civil service coming up with whizzy new schemes and trying to impose the same scheme in Newcastle as in a village in South Northamptonshire or a coastal town like Worthing, rarely works. We need national frameworks and national quality thresholds, and we need local design and local implementation. We need to hold people’s feet to the fire. Every local authority needs to come up with a best start in life plan. That local plan needs to meet the thresholds for children’s outcomes, and then the centre needs to ensure that authorities go ahead with those plans and achieve those outcomes. In that way we can have local ownership, local design and local flexibility that are in the best interests of children and their families.

I welcome the “best start in life” programme, and I congratulate all who have made it possible. This has been a huge joint effort. It has been a false economy not to look at those initial few pre-school years, because that is when we can have the biggest impact on the nurturing value of parents and the attachment that is so essential between a parent or parents and their children, when a child’s brain is growing exponentially—and will be impacted on for the rest of his or her life. At last we have a programme that realises that. Let us ensure that we make it a success for our future generations.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Before I call the next speaker, I must tell the House that we have another debate following this one in which 11 Members have put in to speak so far, so we must be conscious that there are slight time pressures.

--- Later in debate ---

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call Sarah Olney for a very brief wind-up.

Health Incentives Scheme

Baroness Winterton of Doncaster Excerpts

Friday 22nd October 2021 Commons Chamber

[Scott Benton (Blackpool South) (Con)]

As the Prime Minister pointed out at the Conservative party conference, life expectancy in Blackpool is 15 years lower than it is in some areas just a few miles away. This scheme will help to reduce those disparities. Does the Minister agree that Blackpool would be the ideal location for this pilot scheme?

[Madam Deputy Speaker (Dame Rosie Winterton)]

Just say yes.

[Maggie Throup]

I am not going to give a one-word answer on this occasion, but obviously the location will be chosen carefully and will be announced in due course.

[Maggie Throup]

Obviously we will be looking at ways in which we can engage people, and ensure that they are fully aware of the pilot and have ready access to it.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I thank the Minister for her statement. We now return to the debate on the Bill.

Covid-19: Government Response

Baroness Winterton of Doncaster Excerpts

Thursday 21st October 2021 Commons Chamber

[Maggie Throup]

I thank the hon. Gentleman for his question. I reassure him that a lot of investment is being put into the health service, as I am sure he is aware, to ensure that we can tackle the backlog that has been created because of the pandemic.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I gather there may be a point of order. Did somebody wish to raise a point of order? We need to move on. There should be a statement from the Secretary of State.

[Emily Thornberry (Islington South and Finsbury) (Lab)]

On a point of order, Madam Deputy Speaker.

[Madam Deputy Speaker]

Ah—a point of order!

[Emily Thornberry]

Can you advise me how best to deal with the stress levels created by this morning’s timetable? I do not mean to complain—I am a big girl—but, quite frankly, I had departmental questions this morning, we heard on the grapevine that there was going to be a statement on the Trade and Agriculture Commission, for which we have been waiting for more than six months, and we also heard last night that there was going to be a deal with New Zealand.

I got a copy of the Government statement on the deal with New Zealand at six minutes past 10 this morning, when I was obviously on my feet dealing with departmental questions here. I do not complain about where my office is, as I have a wonderful office, but it does take quite a long time to get to it. I need to get to it, pick up the statement that has been given to me by the Government, read it, write what I am going to say, make sure that it is only half the length of the statement and then come back.

I also want to make reference, of course, to the Trade and Agriculture Commission, which the Government have said is a really important part of any future deal that they negotiate, because of the grave concerns that farmers have about their future business, to which the TAC is supposed to be part of the remedy. We got a written ministerial statement, which I received 20 minutes ago while running back from my office. [Laughter.] I got a ministerial statement at six minutes past 10. We have to put all those things together. Although in many ways it is funny, if I was a frontline farmer I would not find this funny at all.

[Madam Deputy Speaker]

I thank the right hon. Lady for that point of order. I very much suspect that the Secretary of State should also thank the right hon. Lady for that point of order. We have had some examples this morning of the way in which not to do business in this House. It is vital that Secretaries of State ensure that they are here in good time for their statements. I think that expresses the opinion of all in this House. Stress levels have been raised by this, so the best thing now is to move on as quickly as possible. I am sure that the International Trade Secretary will want to apologise—I call her to make her statement.

Coronavirus Act 2020 (Review of Temporary Provisions) (No. 3)

Baroness Winterton of Doncaster Excerpts

Tuesday 19th October 2021 Commons Chamber

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

There is a limited amount of time for this debate, which needs to finish at 4.31 pm, and I want to give the Minister 10 minutes to respond. There are more people standing than indicated to the Speaker’s Office that they wanted to speak, which means there is even more pressure on time. I ask hon. and right hon. Members to confine their speeches to five minutes.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Rosie Winterton)]

In order to be helpful, I will impose a five-minute limit. If colleagues take less than that, we will definitely get everybody in.

[Chris Green (Bolton West) (Con)]

We are in a profoundly different place from where we were 19 months ago when we entered the pandemic and went through a series of lockdowns. The medicines that doctors use and prescribe and the procedures that are in place are all profoundly improved. The vaccination programme has been a revelation thanks to the quality, the range and the roll-out of the vaccines. We must recognise that, today, we are in a profoundly different situation from where we were right at the beginning. We just have to look at the third wave that we are going through at the moment and at the connection between infections, hospitalisations and deaths. Those rates are fundamentally different from those in the first and second waves, so we should be taking a profoundly different approach to dealing with this virus.

All variants of concern are defeated by our vaccines at the moment, and we have every expectation that that will continue to be the case into the future. By maintaining the Coronavirus Act 2020, but with perhaps a limited number of provisions, we maintain the fundamental approach to dealing with this virus. Society as a whole and the civil service more narrowly are still looking at this challenge in the same way, and there is not, in that sense, a change of mindset.

We are approaching what will be a tough winter. No matter what happens, we will have a very difficult winter. That may be due to the coronavirus itself or to influenza, but it will also be due to the very significant build-up in waiting lists and in conditions that should have been investigated 18 months ago. We know that these cases are building up and that it will create a huge amount of pressure on the national health service.

I want to focus today on the care sector. Some 18 or 19 months ago, we would have had cross-party consensus on the fact that the care sector needed fundamental reform. That is far more true today than it was back then. It is clear that the care sector needs far more resources today than it needed then. There is a shortfall of about 100,000 carers. With the compulsory vaccination approach that has been taken in the care sector, the Government are expecting another 40,000 carers to leave. That will create huge problems not only for the carers, but for the residents themselves.

In my constituency, the care sector is already under tremendous pressure. Some people are leaving because of the pressure that they are under, and some because they choose not to be vaccinated. Some of them are finding employment in the national health service. They are leaving the care sector and going into the national health service to provide care there, but at some point we may be imposing vaccinations in the national health service as well. We do not know how many will leave the NHS at that stage, but if vaccinations in the NHS stand at about 90%, we could be looking at a loss of more than 100,000 people.

We have concerns about people being transferred out of care in the national health service and into the care sector. We know that the situation is going to get substantially worse as we go through the winter and more carers leave the care sector, but we do not yet know when the same approach will be imposed on the national health service. I therefore ask the Minister: what is the Department’s thinking at the moment? When will we impose compulsory vaccination on the NHS, just as has been imposed on the care sector, and what impact will that have?

We need a fundamental reset in our approach to dealing with the coronavirus. The circumstances are fundamentally different now, because of medical advances and so many other things. We have the opportunity to reverse the decision on the care sector. We want to keep carers caring where they want to be caring. We ought not to be imposing this decision now, because in a couple of weeks it is going to be too late. I am concerned about plan B and the possibility of ID cards or covid passes—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. We need to move on.

[Dawn Butler (Brent Central) (Lab)]

Today really feels like groundhog day. The Government are again pushing through the Coronavirus Act with no scrutiny from Parliament. I do not know what it is about this authoritarian Act that the Government love to push through. Some 18 months ago, the Bill was nodded through—understandably, in a way, but it was never, ever proportionate. As the Secretary of State said, it was fast-tracked legislation. It contained really draconian powers, including the powers to postpone elections, close borders, detain people not suspected of a crime, ban gatherings and remove safeguards for disabled people. This is the mother of all Parliaments and we should always have the opportunity to scrutinise Government legislation. That is what we are elected to do. This all-or-nothing approach does not wash; it is wrong.

As a parliamentarian, I want to get my control back. I want to get back my powers to scrutinise the Government. The Government should not be the sole decider of legislation. We live in a democracy, not an autocracy. The Government should not be making all the rules themselves. That said, I am pleased that some of the most draconian parts of the Act have now been expired. I had a meeting with the Minister and am pleased that she listened to my concerns. Section 51 and schedule 21 —the powers relating to potentially infectious persons—have now been removed. As has been said, every single charge under schedule 21 was wrongful. Those 292 charges were incorrect, and that meant 292 distressed people who were already distressed during the pandemic.

We have to make sure that the Bill is fit for purpose, and ultimately it is not. It therefore needs to be scrapped and there needs to be a new Bill. I am already the sponsor of a Bill that has been presented to the House: the Coronavirus (No. 2) Bill. If we were to vote down this Act today, we would have 21 days to bring forward a new Bill. There is already one that is ready—oven-ready, some might say. [Interruption.] You liked that, did you? My Bill is properly ready to go.

This Government have proved time and again that they cannot be trusted. It is one rule for them and one for us. The latest person that we found had broken the rules was the Prime Minister himself, as his wife’s best friend went around to theirs for Christmas dinner, while other people dined alone throughout Christmas. As I have said, if we voted down this Act, we would have 21 days to bring a new Bill to the Floor of the House. We can do that and we can do it quickly.

I congratulate the Secretary of State on his new role and I appeal to him to consider one more vital change. I urge the Government to review every fixed-penalty notice issued under the coronavirus and public health regulations, and to establish an appeals mechanism, because people cannot appeal at the moment. Between March 2020 and June 2021, the police processed 117,213 fines. Let us not forget that we had no chance to scrutinise provisions when the Government raised fines from £960 to £10,000. The Guardian revealed that people of colour were 54% more likely to be fined than white people. I say to colleagues in all parts of the House that we should never be forced into an all-or-nothing approach when it comes to legislation. That is not our job. We are parliamentarians and we need to scrutinise legislation. Twenty-one days is enough time to consider better legislation. As we have the Coronavirus (No. 2) Bill, based on Liberty’s “Protect Everyone Bill”, I say to every single Member of this House that we can do that.

I am clear that we need to repeal and replace the Coronavirus Act not just because it is dangerous with regard to our rights and our liberties, or because it served the purpose that it was meant to 18 months ago, but because we must do better. We must learn the lessons. I am part of the Science and Technology Committee and there is a joint report that says that this Government have failed on so many occasions. This is an opportunity where we can do better and where this Government can do better. Let us do better, not just for us but for the country.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I am going to reduce the limit to four minutes but it should stay at four minutes if I do it now.

--- Later in debate ---

[Maggie Throup]

I will take the hon. Lady’s comments on board. The progress that has been made with regard to unlawful convictions has been really helpful.

We have come so far in our fight, but we still have a long way to go. This pandemic is not yet over, and the steps we are proposing will give us the support we need to continue our fight against the virus while restoring yet more of our precious freedoms and the important experiences that we really love.

I commend the motion to the House.

[Madam Deputy Speaker (Dame Rosie Winterton)]

The question is Motion No. 4 as on the Order Paper. As many as are of that opinion, say Aye. [Hon. Members: “Aye.”] Of the contrary, No. [Interruption.] Could I have the Noes again?

[Sir Desmond Swayne]

No!

[Madam Deputy Speaker]

I am afraid I fear the mood of the House is not to have a vote. The right hon. Gentleman would have to rustle up a few more people to really get the sense that we required a vote—

[Sir Desmond Swayne]

The just shall live by faith.

[Madam Deputy Speaker]

I am sure they will. The Ayes have it.

Question put and agreed to.

Resolved,

That the temporary provisions of the Coronavirus Act 2020 should not yet expire.

Baby Loss Awareness Week

Baroness Winterton of Doncaster Excerpts

Thursday 23rd September 2021 Commons Chamber

[Cherilyn Mackrory]

rose—

[Madam Deputy Speaker (Dame Rosie Winterton)]

If the hon. Lady wants to take a break, we can take another speaker and come back to her if that is what she would like.

[Cherilyn Mackrory]

Thank you, Madam Deputy Speaker, for your words and my hon. Friend the Member for Cities of London and Westminster (Nickie Aiken) for intervening.

Today, I wish to extend my sincere condolences to anyone who has experienced the loss of a baby. To anyone to whom this has happened, despite what they may see, I say that the sun will shine again. It does not feel like it now, but one day it just does. For me, the dark clouds of shock, anger, guilt and dreadful, dreadful sadness do eventually dissipate—

Covid-19 Update

Baroness Winterton of Doncaster Excerpts

Tuesday 14th September 2021 Commons Chamber

[Mr Alistair Carmichael (Orkney and Shetland) (LD)]

Pages 23 and 24 of the autumn and winter plan specify that, as part of plan B, the Government will introduce vaccine passports for all nightclubs, for indoor settings of 500 people or more, which presumably would include this Chamber of 650 Members, for outdoor settings of 4,000 or more, and for anywhere—that is a very big place—where there are 10,000 people. How does the Secretary of State square that with his assertion in reply to the shadow Secretary of State, the right hon. Member for Leicester South (Jonathan Ashworth), that the evidence on the usefulness of vaccine passports is just not there? If the evidence is not there, why are they part of plan B? The Government’s document also says that plan B could be brought into force at very short notice, so can the Secretary of State give the House some assurance that that will not happen without a vote?

[Madam Deputy Speaker (Dame Rosie Winterton)]

We need short questions and short answers.

[Sajid Javid]

We have made huge progress as a country in fighting this virus, and that is why we do not need certification; we do not need the plan B measures that the right hon. Gentleman has just set out. As I made in clear in my statement, while we can keep other measures in reserve, what matters is what we are actually doing, and if we keep making progress against this virus in the way that we are, we will not need any of the things he talked about.

Covid-19 Vaccinations: 12 to 15-year-olds

Baroness Winterton of Doncaster Excerpts

Monday 13th September 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful for my right hon. Friend’s important question. We have received interim advice from the Joint Committee on Vaccination and Immunisation, which we have published, and it has now received the Cov-Boost data. The interim advice was about vaccinating the most vulnerable with a booster for covid and for flu. It is advising a two-stage process, and stage one is to offer the booster vaccines to those in the old 1 to 4 cohorts plus the immunocompromised, and then to groups 5 to 9. That is the right way to proceed. We have not yet received its final advice.[Official Report, 14 September 2021, Vol. 700, c. 8MC.] It could be different to the interim advice, but boosting preparations are well under way. Clearly that final advice is predicated on which vaccine delivers the highest level of protection and durability.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I call Sammy Wilson.

[Sammy Wilson (East Antrim) (DUP)]

rose—

--- Later in debate ---

[Nadhim Zahawi]

My right hon. Friend raises a really important question. Of course, it was the CMOs who led the further work that took place and who made the announcement today. Health is devolved, as he knows, so the chief medical officer for Scotland will take that on in ensuring that the system—whether it is primary care or other parts of the system—understands the advice in full. The school-age vaccination programme is the major element of this particular part of the vaccination programme. It is very well versed in working with parents and teachers, and of course with young people to make sure that they have all the information they need to be able to take it back to their parents, get the consent and get their vaccination on time.

[Madam Deputy Speaker]

I call Sammy Wilson.

--- Later in debate ---

[Nadhim Zahawi]

The best way for parents and families to make that decision is through the tried and tested process of the school age vaccination programme, and through schools sharing information and having a consent form that parents have to sign and return before the vaccination programme is scheduled.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I thank the Minister for his statement.

Covid-19 Update

Baroness Winterton of Doncaster Excerpts

Monday 6th September 2021 Commons Chamber

[Dr Luke Evans (Bosworth) (Con)]

Will the Minister give way on that point?

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. This is a statement, so the hon. Gentleman can bob up later if he needs to.

[Nadhim Zahawi]

As ever, whatever the clinical decision from the JCVI, the NHS will be ready. We will proceed with the same sense of urgency we have had at every point in this campaign.

Vaccines remain our most important line of defence, yet they are not our only line of defence. Regular testing continues to play a crucial part in returning this country to something that feels a bit more like normal. PCR tests remain freely and easily available, and anybody with symptoms should make sure to get tested. Children are returning to classrooms across these islands. I am sure all hon. Members welcome that, as did the Secretary of State for Education at questions this afternoon. They return to an immeasurably better set up: no more home schooling, no more bubbles, teachers vaccinated, and all 16 and 17-year-olds offered a first dose before returning. That matters because we know that face-to-face education is the best place for children and young people.

Rapid testing can uncover hidden cases of the virus at the start of term. Whether it is our constituents or our children, we must encourage people to do it. On their return to school and colleges, students should take two rapid tests on site three to five days apart. They should then continue to test twice weekly at home. To university students, I would also say this: make every effort to get fully vaccinated before going back. It has never been easier to drop in and get a vaccine and the necessary testing. These are straightforward steps, but they are essential in stopping the spread.

Finally, I am sure the whole House will join me in welcoming the additional £5.4 billion cash injection we are putting into the NHS. This investment will go straight to the frontline, supporting our covid-19 response over the next six months. The funds include £1 billion to help to deliver routine surgery and treatments for patients, and tackle our backlog. The funds take the Government’s total support for health services in response to covid-19 to over £34 billion this year alone.

We are widening and deepening our wall of defence. We are getting jabs to more people and getting some people more jabs. We are getting the NHS what it needs. The ask of our NHS colleagues continues to be complex and challenging, yet they rise to it day in, day out. I pay tribute to everyone involved in these lifesaving efforts. We must keep going, and I commend this statement to the House.

--- Later in debate ---

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I would like to thank my hon. Friend for the incredible vaccine roll-out; many lives have been saved by it. My question is about domestic vaccine passports, and I have to apologise because I get a bit confused by the nomenclature of what is being proposed. On the one hand, we have what I understand to be vaccine-only passports, which say simply that someone has been vaccinated and that that is all that counts. Then we have covid status certification, which can also include negative testing and proof of recent infection. Crucially, this is not just about whether someone has been vaccinated, because as I understand it, a lateral flow test negative result is the best evidence that someone is no longer infectious. Is my understanding correct that the proposal for the end of September is for vaccine-only domestic vaccine passports? If that is the case, why has that moved from covid status certification?

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. Just before the Minister answers, I must point out that we need to finish this statement fairly shortly. Colleagues should keep their questions very short, and the answers should be correspondingly short.

[Nadhim Zahawi]

I am grateful to you, Madam Deputy Speaker, and to my hon. Friend for his question. I guess the reason for the shift by the end of September, when all 18-year-olds will have had the opportunity to get two jabs, is that testing provides a limited protective assurance and allows for the potential for self-testing fraud. The effectiveness of testing-based certification can also be undermined by a single incursion into a setting. Transmission, serious illness and hospitalisation are reduced using vaccination-based certification, even with incursions, so that is the thinking behind this. I reiterate that nobody does this lightly. We do not curtail people’s freedoms lightly; this is purely so that we can keep industries and sectors open and not have to close them down again if there is a super-spreader event.