Women’s Health Strategy for England

Alec Shelbrooke Excerpts

Wednesday 20th July 2022 Commons Chamber

[Steve Barclay]

I thank the hon. Lady in particular for that tribute to the work Sir David contributed to this, and agree with her on the issue of same-sex couples having access to IVF. She is right about better research and how we highlight that; that is a key part of the strategy. It is also interesting from the comments of the health ambassador that services can be reconfigured in a way that gives better outcomes for the patient without leading to higher cost. By having centres of excellence where the woman’s voice is heard, treatment comes more quickly and that delivers better patient outcomes.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

May I welcome my right hon. Friend to his place and say how good it is that he has had direct experience with Kath Sansom and the work of Sling the Mesh? I also pay tribute to the hon. Members for Livingston (Hannah Bardell) and for Kingston upon Hull West and Hessle (Emma Hardy); the three of us have worked closely cross-party to bring these issues to the Floor in Westminster Hall debates and in this Chamber, which I think has played a big part in today’s strategy. I thank them across the House for that work.

Within the strategy there is talk of centres of excellence and mesh centres, but those must be carefully monitored, because we are getting a lot of feedback now that mesh centres are perhaps not working in the way we think they are. That must be carefully monitored, and data collections may not be working in the way my right hon. Friend would hope, so that will be important.

I welcome the strategy on listening to women. Anecdotally, too often the words “sexist” and “misogynist” have been used about the NHS’s attitude to women, and we need to move to a stage where those words are no longer used and it is not saying, “Go and take some painkillers,” patting them on the head and saying, “It’s all very normal.”

On that final point, will my right hon. Friend talk to our right hon. Friend the Education Secretary about teaching in school about diseases such as endometriosis? If people do not know a disease exists, how can they know they have it? That is an important point. Overall, I welcome this strategy as a massive step forward, but we must all recognise that we cannot give up. There is much more to do to ensure that what is in the strategy actually works.

[Steve Barclay]

I am grateful to my right hon. Friend, who I know has campaigned for many years on this; mesh is a particular issue that he and I have spoken about in the past. On the quality of data I am very happy to work with him on any specific examples, and indeed with colleagues across the House, because I know there are others who have worked closely on the mesh campaign, to see how we get the right consistency and the right analysis of data, because that is a shared interest of all of us in the House today.

In terms of the Department for Education, I am very happy to take the matter forward with my right hon. Friend the Education Secretary to look at what schools can do to raise awareness. That ties in with the wider point about ensuring that patients have the right information and that, where issues and concerns arise, they are not fobbed off but taken seriously.

Health and Care Bill

Alec Shelbrooke Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

I am happy to join my hon. Friend in paying tribute to Paula McGowan and all those who have campaigned for this and other amendments that the Government have been able to accept to the Bill. It is often easier to pay tribute to right hon. and hon. Members who have championed issues in this House, but often they are merely mouthpieces for those campaigners who have done so much to raise the profile of such issues.

The Government have also taken steps to extend the storage limits for embryos and gametes, removing an existing unfairness. Currently, legislation discriminates between those who have a medical need to freeze their materials and those who do not. Amendments 82, 98, 100 and 122 remove that distinction by introducing a new scheme consisting of 10-year renewable storage periods up to a maximum of 55 years for everyone regardless of medical need. Our proposals were welcomed unreservedly in the other place, and I hope that they will receive a similar reception in this House.

The Government have also tabled a number of amendments in the other place on transparency of payments made and other benefits given to the healthcare sector. Lords amendments 52 to 54, 93, 94 and 97 all deliver on a recommendation from Baroness Cumberlege’s independent medicines and medical devices safety review. They will enable the Secretary of State to make regulations requiring companies to report information about payments or other benefits that they have provided to the healthcare sector.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

I thank my hon. Friend for what he said, which, with the Cumberlege review, is very important. I urge him again to go further on that review.

--- Later in debate ---

[Fiona Bruce]

Please let me continue. I am sure the hon. Lady will have put in to speak. I thank Health Ministers for listening, and for recently cancelling this temporary emergency provision from August, fully in accordance with the Government’s intention at the outset of the covid pandemic, which was that the measure would be temporary. To delve a little deeper into the issues and concerns, having no in-clinic assessment means that gestational age is, and can only be, an estimate. Many women cannot be sure that they are within the legal—and, I presume, safe—limit of nine weeks and six days for taking such pills. Indeed, several women who have needed hospital treatment after taking an at-home abortion pill were clearly many weeks over that limit.

[Alec Shelbrooke]

Will my hon. Friend give way?

[Fiona Bruce]

I feel that I must be fair, and I have said that I will not take interventions—

[Alec Shelbrooke]

Just on this point?

[Fiona Bruce]

All right.

[Alec Shelbrooke]

I am genuinely grateful to my hon. Friend, and I am not intending to speak in the debate. I know that she has deeply held beliefs, which I respect very much. She is giving examples and details. Can she give data referring to the examples she is giving? I have been struck by the fact that in this debate, I have heard a lot of anecdotal evidence that has not been backed up by any reference to data, and I think that data is important for this debate.

[Fiona Bruce]

Yes; the organisation Right to Life, which is the secretariat to the all-party parliamentary pro-life group, has collated such data. Freedom of information data analysis also shows that one in 17 women taking abortion pills requires hospital treatment. That means that more than 14,000 women have been treated in hospital following the approval of pills-by-post abortion. A similar study of FOI data in February 2021 showed that every month, 495 women attended hospital with complications arising from abortion pills, and that 365 of them required hospital treatment. Thirty-six women every month are making 999 calls—that is more than one a day—seeking medical assistance because they are concerned about complications arising from taking abortion pills.

Women, especially vulnerable women, deserve the care and attention given in an in-person meeting with an experienced clinician before making such an important decision. Indeed, 74% of GPs have indicated concerns about women finding it distressing to terminate a pregnancy themselves at home. More than 600 medics signed an open letter to the Prime Minister in May 2021 calling for an end to pills-by-post abortion, and a clear majority—70%—of the respondents to the Government’s consultation on this subject said that the temporary measure of pills-by-post abortion should end.

However, whatever one’s views on abortion, the Government very recently made a decision to cease the authorisation of these pills from August this year, due to this being a temporary covid provision that was never intended to outlast the covid pandemic period. The Government—our Health Ministers—have made an informed, carefully considered, evidence-based decision. We should respect that, but once more, those pressing for an even more easily available abortion regime in this country are not willing to accept it. Instead, they are seeking to make a serious change to the law through an amendment, as is frequently their practice. That gives us far too little time to debate such fundamental issues. There is too little opportunity for us parliamentarians to scrutinise this serious issue, which is literally a matter of life and death. Whatever our views on abortion, that is simply wrong. I urge colleagues to vote against this proposal to make at-home abortion pills permanently available.

--- Later in debate ---

[Jess Phillips]

I agree 100% with every word that the Father of the House has just said. There is no expert opinion group that agrees with the view put forward by the hon. Member for Congleton, who cited the secretariat of a pro-life group. By the way, I am pro-life: I am pro the people who live being able to make choices. I am incredibly pro-life—I am just also pro-choice. I hate the terminology that suggests somehow one side is pro-life; what is the alternative?

[Alec Shelbrooke]

First, may I offer my condolences for what must be a very difficult time for the hon. Lady and her family?

There has been a lot of conversation in which people have said, “You’ve got no way of knowing that it is going to be less than nine weeks and six days.” Will the hon. Lady address that particular point, which is very important to how people have been trying to frame the debate?

[Jess Phillips]

I have heard similar framing, with some saying people will take the pills after 10 weeks. If we look at the actual data, we see it shows that the change increased from 25% to 40% the proportion of abortions happening before six weeks. Telemedicine has dramatically reduced the gestational period, making it much less. I am afraid to say that these are not a good faith arguments. They are based not on fact, but on the idea that women will lie. Women are concerned about their health. They are frightened about their health. We do not make decisions about our health in the hope that we will be harmed; we do what is best. We should not be treated like children; we should be treated like adults.

Cumberlege Report

Alec Shelbrooke Excerpts

Thursday 3rd February 2022 Westminster Hall

[Andrew Rosindell (in the Chair)]

Before we begin, I remind hon. Members to observe social distancing and to wear masks.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

I beg to move,

That this House has considered the Cumberlege Report.

It is a pleasure to serve under your chairmanship, Mr Rosindell. I have secured a debate about fulfilling the recommendations of the Cumberlege report because I do not feel that we are making enough progress. We had a debate on the Floor of the House in July and a written ministerial statement on 21 July. To stay in order, Mr Rosindell, I will only say that the Minister’s answer to the debate and the written ministerial statement were disappointing, in many ways. In my opening remarks, I will seek to address why I believe that to be the case and, fundamentally, ask for certain updates. We are talking about people whose lives have been destroyed. Many hon. and right hon. Members will bring their own examples about various parts of the report, whether they are about Primodos, sodium valproate or mesh, but I will focus my comments on mesh.

I will not spend too much time going over the examples I gave during the debate in July, which can be looked up in Hansard, but I will say that people were given an operation that many did not need, which many were convinced that they should have. Some people did not even know it had happened to them. It took many years for the problems that arose to become apparent, and so those people have effectively been dismissed.

Like many Members, I have constituents who have had their lives stopped, especially women, although I will mention how the issue affects men as well. One constituent, who I have mentioned before, was a physiotherapist in her 40s who had had a child. She had mild incontinence after giving birth and was told to have the mesh implant, which she went ahead and did. Her entire life has been destroyed by that. Trying to remove it was described to her as being like “trying to take hair out of chewing gum”. We should consider that image when we think about the difficulty of the operation. We must not forget that the NHS did this, and the NHS has a responsibility to deal with it. I will make that point several times.

I have been contacted by a lady who is a constituent of my hon. Friend the Member for Thornbury and Yate (Luke Hall). Her name is Paula Goss and both she and he have given me permission to talk about her case. She set up Rectopexy Mesh Victims and Support in March 2019 after she was unable to find much research or information about the meshes that she had had put in. The group now has over 1,100 members, as well as members who have sacrocolpopexy vaginal mesh and hernia mesh. She is the ambassador and advocate for rectopexy and hernia mesh on the Mesh UK Charitable Trust, which has a further 2,000 members.

She had rectopexy mesh in 2014 as she was unable to clear her bowels. She was ill-informed by the now dismissed surgeon, who, as she found out from her notes, inserted three meshes—in the bowel, vagina and posterior. She says:

“All mesh types don’t necessarily show complications straightaway. My Pre mesh insertion issues started again around 9 months after the op, in which I was passed from pillar to post by all medical professionals saying my issues were the menopause or in my head. This went on from 2015 until September 2018 when I was admitted to hospital with a blocked bowel and bladder and had to have enemas and catheters, still they would not connect this to the mesh, upon doing a CT scan at this time they also found a large ovarian tumour, it was then discussed by my gynae oncologist at the BRI and Southmead NBT to do a joint op to remove the tumour and the mesh, due to the incompetence and lack of mesh removal experience at Southmead I ended up having the ovarian tumour removal in January 2019. Thankfully, after testing it was a large benign fibroma, following up with Southmead they then stated that they wouldn’t remove my mesh but would do an op to give me a permanent stoma—again, brushed aside and fobbed off, I sought a second opinion in London privately, whilst we are by no means rich, you can’t put a price on your health...I had to pay £32,000 for my removal, it took over 10 hours and they could not get all of it…two protacks in particular sit very close to the bifurcation of the inferior vena cava on the left and the common iliac on the right. Pre mesh removal I was found to have a heart murmur and I suffered pericarditis quite a few times. My histology on my meshes showed that I was not a candidate for polypropylene and should not have this inserted again…When I discovered I had hernias again I was neglected by the local hospital who at first refused to do a scan, saying I must have an ulcer. it was thanks to my private mesh removal surgeon who contacted my GP and insisted that I was referred for a CT which then clearly showed two large incisional hernias.

The consultant at Southmead stated he would only fix my hernias with polypropylene mesh. After I told him that I couldn’t have that, there was no option but to again look down the private route. Thankfully, my colorectal mesh removal surgeon was able to do this and a date was set for 6 January 2020. However, my hernia started to strangulate and I was luckily rushed to London by my husband, and had this op done on 28 November 2019. This cost £43,000.

This operation was by far the toughest and took a long time to get over, due to ending up with a seroma and now a hiatus hernia due to the trauma to my abdomen.

My journey has not been, and is still not, plain sailing, but I am one of thousands.

Whilst vaginal mesh gets a lot of coverage, ours does not. Rectopexy affects men, women and children…All three main types of mesh need to be included and talked about—bowel mesh, vaginal mesh…sacrocolpopexy and colporrhaphy vaginal mesh and hernia mesh...One of our rectopexy mesh ladies found out that the surgeon who put mesh in also removed her ovary without consent, she sadly committed suicide due to this event.

One of our rectopexy patients was just 15 when she had her mesh inserted. She’s early 20s now and now suffers complications and doesn’t even know if she will ever be able to have children.

We have other ladies in their 20s and early 30s suffering, who may not be able to have children.

We have many rectopexy bowel men on our sites who feel they have nowhere to go and no one who will listen to them.

This is the same for all hernia mesh victims too.

There are many real victims’ journeys that need to be listened to and taken seriously.”

That is what the report did, and why it was so appreciated by the victims, as they were finally being taken seriously. That is where the report’s value lies. Today, I once again push for it to be implemented in full as far as possible, and for recommendation 3 about redress, recommendation 4 and recommendation 5 to be reconsidered.

Recommendation 1 was for an apology. That apology was received in July 2020, given by the Government, but, as good as it was, their actions depend on whether they can justify what they are doing on recommendation 9. Recommendation 2 is:

“The appointment of a Patient Safety Commissioner who would be an independent public leader with a statutory responsibility. The Commissioner would champion the value of listening to patients and promoting users’ perspectives in seeking improvements to patient safety around the use of medicines and medical devices.”

The Government accept recommendation 2, and I ask the Minister for the latest update on that appointment. On 2 December last year, in the other place, the noble Baroness Cumberlege asked Her Majesty’s Government

“when the process to appoint the Patient Safety Commissioner will commence; and when they expect the Commissioner to be in post.”

In response, the noble Baroness Chisholm of Owlpen said:

“My Lords, we are making good progress towards appointing the first patient safety commissioner for England. We expect the appointment of the postholder by spring 2022.”—[Official Report, House of Lords, 2 December 2021; Vol. 816, c. 1443.]

As I said, I would like an update on where we are in that process.

Recommendation 3 is that:

“A new independent Redress Agency for those harmed by medicines and medical devices should be created based on models operating effectively in other countries. The Redress Agency will administer decisions using a non-adversarial process with determinations based on avoidable harm looking at systemic failings, rather than blaming individuals.”

The Government do not accept recommendation 3. As set out in the Government’s statement,

“We have no current plans for a redress agency…We do not believe it is necessary to create a new agency for redress as it is already possible for the Government and others to provide redress for specific issues where that is considered necessary. Neither do we believe that creating an agency would succeed in making products safer as the report suggests, or that grouping existing redress schemes through a single front door would add value for harmed patients.”—[Official Report, 21 July 2021; Vol. 699, c. 72WS.]

I do not accept that it is already possible to provide redress where necessary, because my inbox, and I am sure those of several right hon. and hon. Members, suggests that that is simply not true. It is too vague and takes too long. When I talk about recommendation five, I will discuss where that issue comes to a head.

I come back to my point, which is that the NHS did this to people. I have said it before and I say it again: the problem is very similar to the thalidomide scandal. Eventually we got justice for thalidomide victims. People are just being fobbed off—I have many examples—and that is exactly what happened with thalidomide. Mr Rosindell, can you imagine living an active life, as we all do, and the NHS recommending something that means that you can no longer take part in what you were doing? Imagine being physically and mentally restricted and unable to fulfil your life’s ambitions. A full quango might not need to be set up, but at the very least we need a ring-fenced department in the NHS to bring those areas together.

[Sir Mike Penning (Hemel Hempstead) (Con)]

Baroness Cumberlege specifically states in her report that her terms of reference prevented her from talking about individual compensation and redress. Is my right hon. Friend suspicious, like me and probably many others, that that was specifically written into the plan so that she could not do what my right hon. Friend is asking for?

[Alec Shelbrooke]

That is where we have to dig into recommendation 4:

“Separate schemes should be set up for each intervention—HPTs, valproate and pelvic mesh—to meet the cost of providing additional care and support to those who have experienced avoidable harm and are eligible to claim”.

The Government do not accept recommendation 4. That is exactly the same situation as with thalidomide. One of my earliest campaigns in 2012 was to extend the grant to victims, and my hon. Friend the Member for North Dorset (Simon Hoare) took that campaign further to make it a permanent grant. People will not recover from what happened, whether it was drug-induced or operation-induced.

My constituent who has had mesh removed emailed me only today to say that four years down the line things are better, but they have not improved to the point where she can really live her life. She says she is mentally exhausted and does not want to go on. She had a thriving physiotherapy career that she cannot go back to. She is only in her 40s and has the rest of her life to live. The Government have a responsibility because the Government run the NHS. I interchange the words “NHS” and “Government”, but the NHS is the Government. That is where this situation falls on the Minister:

“While the Government are sympathetic to the experiences of those patients who gave evidence to the report, our priority is to improve the future safety of medicines and medical devices.”—[Official Report, 21 July 2021; Vol. 699, c. 72WS.]

Trying to prevent further catastrophe is obviously very important—that is one thing—but thousands of people will suffer for the rest of their lives thanks to this treatment.

I will draw the distinction between this surgery and breast-enhancement surgery. Many people have had that done privately and then when there have been complications, they have had the operation to sort it out on the NHS. There is often a lot of debate around whether that is right or wrong. That is not where I want to go today. However, if we are willing to do that for things that people have had done privately, why are we not willing to redress the issues of people who have had things done by the NHS?

We are talking about women from their teens all the way up. Some people think the problem is with the elderly end of the population, but we are talking about those in their teens upwards. As I said, we did recognise the situation with thalidomide. I know that costs come into it, but there is a moral responsibility to redress the situation.

[Hannah Bardell (Livingston) (SNP)]

The right hon. Gentleman is making a powerful speech. Does he agree that there is a moral responsibility? Once the Government—whatever Government that is and wherever they are—have committed to review such a profound issue, and have essentially marched people up to the top of the hill, giving them faith and hope, they must then follow through. Leaving people in a state of suspended animation for such a long time, when they have already suffered so much, is just not acceptable.

--- Later in debate ---

[Alec Shelbrooke]

I am most grateful to the hon. Lady for that intervention. She summarises the entirety of what we are trying to achieve. When I put in the application for the debate, I found no difficulty at all in getting sponsors who were one third Conservative, one third Labour and one third SNP. This is not about the colour of the Government. It is about the NHS, which will be managed through all colours of Government, and has been throughout its life. It is the responsibility of this place, and part of who we are, to do the right thing by people.

I ask the Minister to look at the thalidomide grant scheme and translate it across to those who, as a direct result of the issues raised, will not be able to fulfil their earning potential and will have to deal with physical restrictions and pain for the rest of their lives.

[Alan Brown (Kilmarnock and Loudoun) (SNP)]

As well as compensation, which I think is what the right hon. Gentleman was talking about with “redress”, the Scottish Government, at least, are now progressing with a Bill to set money aside for people to get mesh removed through private surgery, fully funded by the Scottish Government. Does he think that that should also be considered by the UK Government?

[Alec Shelbrooke]

Again, I am most grateful for that intervention, because people are having to turn to private care to get that surgery done—often by the same surgeons. There has always been a conversation about the NHS commissioning private medicine to help it, particularly when it comes to clearing the backlogs caused by the pandemic. That that is important. I will come on to that question in my comments about where we are going.

Recommendation 5 says:

“Networks of specialist centres should be set up to provide comprehensive treatment, care and advice for those affected by implanted mesh; and separately for those adversely affected by medications taken during pregnancy.”

The Government accept the first part of recommendation 5, on specialist centres for those adversely affected by mesh. I regret to tell my hon. Friend the Minister that it is not working. I have a document that I will read from Kath Sansom of Sling the Mesh. She sent me this information. These are women’s voices, in just January 2022. An 83-year-old says:

“I am disappointed. I was expecting help but just offered pain relief and physio. And I now have red inflamed abdominal inflammation. I wanted to know if all these problems were the mesh—the answer was that they don’t know.”

A 64-year-old says:

“Not sure about anyone else, my experience hasn’t been particularly good. For me the wait goes on and on. Offered pain management, didn’t get anything only offered physio. In 14 years I have had enough physio to last a lifetime. Latest offer yet another camera in the bladder, that makes 4 now. First removal 2019, been waiting ever since for stage 2. I feel the longer it goes on, they hope I will give up having surgery at 64 years old.”

Others say:

“After a very long wait to see a specialist in the mesh centre, having scans etc. was told no real problems”—

and—

“Mesh centres are a piece of paper over a cavernous crack!”

Another person says:

“I feel mesh centres are giving us false hope—and then the realisation that it’s all been pointless. They actually admitted at Nottingham that they would watch Leicester removing my mesh so that they could learn how to remove a TOT mesh! They looked disappointed when I said there was no way I was thinking of having it removed. I feel like I would have been an experiment. I’m scared.”

Another says:

“I waited 12 months from referral by GP for my first appointment, then it has taken 3 years of various tests and appointments to get on the surgery removal waiting list. I have been on that list for 15 months so far. In that time, I lost my job that I’d had for over 16 years due to sickness record, I’ve been on the waiting list for pain management for over 12 months, and I am gradually able to do less and less due to the constant pain.”

Someone else says:

“Nottingham mesh centre same pro mesh surgeons that put in mesh in charge of centre referring patients to nearby Leicester Hospital for operation—what’s all that about!! It’s OK having Specialist Mesh Centres, but these doctors need to be trained by surgeons that are doing good jobs.

I’ve been hurt once by these surgeons that put mesh in, I’m not letting anyone near me unless they have done lots of successful removals. the sad thing is, because only 4 or 5 great surgeons do removals, you have to pay private, because their waiting lists are so long.”

Others say:

“Kath, can you highlight the LONG waiting times please and referral to pain management, which has a long waiting list—we are talking years overall when all we want is this damned mesh removing sooner rather than later”

and

“Mesh centres, what mesh centres? Same doctors been under for years. No faith at all. Only know how to put it in, not take it out.”

Another person says:

“Been waiting 15 months, and still no appointment. Was referred to UCHL, which I have heard nothing from, even though the hospital referring has resent the referral a couple of times. Been told I have to go to my local now, which is Southampton which I have heard not one positive outcome from, so basically, funding it myself with credit cards as can’t put up with the pain anymore”

while another says:

“Suffered for years before I found out what it was. My GP referred me five years ago—doctor yawned in my face & denied it was plastic. Told me it was tape. Sent me round in circles for lots of tests and visited 8 different hospitals for mainly painful procedures before I was finally sent to St Mary’s (Manchester) 3 years ago for a translabial scan.

Was sent to Wythenshawe then back to St Mary’s & told I had to see pain management clinic before I could be offered a full removal.

Covid cancelled all appointments in 2020 then I had an SNS trial implant at Northern General Christmas ’21 for bowel control (it failed) & spinal fusion L4/5 year ago for stenosis then got wound sepsis, so back in DRI for two weeks in lockdown last March. Sure the mesh damage caused all this!”

Somebody else says:

“There is a stark contrast between NHS and private, it shouldn’t be like this. I saw Professor Hashim on 1st October, he examined me, confirmed issues and said he could offer me full or partial removal. If I had been able to cough up the money I would probably be getting removal February or March. I am in his area for the Bristol mesh centre so my consultant referred me straight to him after reading his report. I have not had any communication from Southmead Bristol yet, everything I am hearing about Bristol now is that I am going to have to go through the pain clinic and try steroids etc first. Why do we have to jump through these hoops with the same surgeon just because we can’t afford…£15,000”?

Another says:

“Gynaecologist was dismissive and stated that women like me are depriving other women from benefitting from it.”

[Caroline Nokes (Romsey and Southampton North) (Con)]

My right hon. Friend has made that point a number of a times during his speech, and it is worth highlighting. I know that my hon. Friend the Minister will do some great work on the women’s health strategy, but time and again my right hon. Friend has said that women’s voices are being ignored and dismissed. They are told that they are imagining things and that it is in their heads. It is not good enough.

[Alec Shelbrooke]

I completely agree with my right hon. Friend. In fact, I will later make a couple of points on what I have discovered about women’s health. The way women are treated is quite appalling.

Another person says:

“I had my TVT in Exeter 12 years ago. Exeter consultant in 2020 told me I couldn’t be referred to Bristol. He said he would refer me to UCLH but I never heard from them, I rang in 2021 to be told UCLH hadn’t received any referral but they then put me on their wait list from when I’d been told the referral was made. I then heard nothing from them for ages so I paid for a private consultant at Bristol to be told I could have been referred to Bristol on the NHS in the first place. Bristol requested NHS tests in Exeter which were done in August 2021 and they referred me back to Bristol in October, so I am now on Bristol NHS list for removal”.

Somebody else says:

“Took 4 years to be referred to specialist mesh centre, after a lot of pushing and pushing for it, referred to Royal Victoria Hospital in Newcastle upon Tyne. The mesh centre was no better, more lies, gaslighting and a really appalling treatment and total indifference, lots and lots of mistakes, cancelled appointments and no regard for any pain or suffering.”

Another person says:

“Told too dangerous to remove…left in agony...self-catheterising, lost job, pain management referral but they are behind 12 months …invisible and invalid is how I feel…is this my life at 54?”

Somebody else says:

“I went for a consultation for removal in 2020 had a scan then asked to contact his secretary when I’d had an MRI which I did in December 2020. Now still waiting for them to contact me. I leave messages and nothing happens.”

I could go on and on and on, and I am sure that many other right hon. and hon. Members will be raising similar cases. What I want the Minister to comment on in today’s debate is this. There is now, from the relevant royal colleges, the “Purpose Statement for the Mesh Complications Management Training Pathway”. That statement outlines several areas, but I will highlight just the “Mesh Complication Management credential”. Its subheading is “Professional Identity: Clinical Expert” and it states:

“The doctor has the knowledge, skills and attitudes required for clinical assessment of patients presenting with suspected mesh-implant complications…The doctor is able to investigate mesh complications, and interpret the results of tests, appropriately…The doctor is competent in non-surgical management of mesh complications…The doctor is competent to undertake mesh removal surgery as part of a multidisciplinary team”.

This is progress, but I think we can all understand that there is going to be a long time around that, so I say this to the Minister. Can the House please have regular updates on how this training process is going, within the royal colleges, for surgeons, because we need to understand what the process is and how long it is taking to try to deal with the main issue?

That brings me to the other parts of recommendation 5 in the report of the independent medicines and medical devices safety review. The written ministerial statement in response said:

“Recognising the need for enhanced data collection on pelvic mesh, the Government in 2018 announced the provision of £1.1 million for the development of a comprehensive database of urogynaecological procedures, including vaginal mesh, to treat pelvic organ prolapse and stress urinary incontinence. I can update the House that the pelvic floor information system has started to receive live data, including historical data from July 2017 onwards, with an initial focus on supporting specialist services to report every pelvic floor and comparative procedure to this national database.

The report of the IMMDS review also recommends that the information system is accompanied by a retrospective audit of mesh procedures, and by the development of a patient reported outcome measure (PROM) or patient reported experience measure (PREM). I am pleased to announce to the House today that the Government accept both these recommendations. NHS Digital has been commissioned to scope and deliver the retrospective audit. Subject to receiving high quality research bids, a new validated PROM for pelvic mesh procedures will be commissioned through the National Institute of Health Research in 2022.”—[Official Report, 21 July 2021; Vol. 699, c. 73WS.]

Again, I ask the Minister whether she can update us on progress in these areas and, after today’s debate, could she speak to her Department about ensuring, even if it is just through a written ministerial statement, that there is a regular update on the progress being made?

I will give a summary of the points that I have made. GPs are unaware of mesh complication centres and the referral process. Many patients are denied access and offered physio and pain management instead. They pay thousands of pounds for private care. They experience extremely long delays for appointments. Many women end up seeing their implanting surgeons, who then dismiss them. That leads to further deterioration in their physical and mental health. There is a lack of experience, particularly in mesh removal. There are only around four to five surgeons in the UK who can do mesh removal. There is no post-op aftercare.

More positively, on recommendations 6 and 7, the Government announced that the MHRA

“has initiated a substantial programme of work to improve how it listens and responds to patients and the public, to develop a more responsive system for reporting adverse incidents, and to strengthen the evidence to support timely and robust decisions that protect patient safety.”

Recommendation 7 was:

“A central patient-identifiable database should be created by collecting key details of the implantation of all devices at the time of the operation. This can be linked to specifically created registers to research and audit the outcomes both in terms of the device safety and patient reported outcomes measures.”

The Government accepted both recommendations. Again, I ask the Minister for an update.

Recommendation 8 states:

“'Transparency of payments made to clinicians needs to improve. The register of the General Medical Council (GMC) should be expanded to include a list of financial and non-pecuniary interests for all doctors, as well as doctors' particular clinical interests and their recognised and accredited specialisms. In addition, there should be mandatory reporting for the pharmaceutical and medical device industries of payments made to teaching hospitals, research institutions and individual clinicians.”

The Government said that they accepted the recommendation in principle:

“We agree that lists of doctors’ interests should be publicly available, but we do not think that the GMC register is the best place to hold this information”,

so “publications of interest” should be held by healthcare providers. Having approved the recommendation, how is that progressing and how easy is patient access?

Finally, we get to recommendation 9:

“The government should immediately set up a task force to implement this Review's recommendations. Its first task should be to set out a timeline for their implementation.”

The Government accepted the recommendation in part.

Having probed the recommendations to open the debate, I ask the Minister whether she and her Department are able to say positively that they are meeting recommendation 9. Are the recommendations being implemented properly and is she revisiting the recommendations rejected by the Department initially? We can all recognise from the examples that I have given that the mesh centres are not working, that people’s lives have been destroyed and that they will need to support throughout their lives. We cannot just draw a line, have a year zero and say that we hope such things do not happen again. We have to move forward.

Drawing on what my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) said and on my research, it is clear to me that the NHS is constantly failing women. During the pandemic, I read a report—unfortunately, I have not been able to reference this since, so it is open to challenge—stating that gynaecological surgeons were taken off their operating theatres for longer than any other surgeons, being kept on the frontline of the covid wards.

That says exactly where the problem in the NHS lies. That comes up not just in this debate, but next week, in another debate, on problems with endometriosis. It seems that the NHS is—I do not say this in a positive way—gender-blind to the needs of women and the complications that occur. It is an attitude, a built-in psychology, that we will have to address, and we can only start to do so if we take all the aspects of this report seriously.

Although men have mesh issues too, this debate is dominated fundamentally by women’s health. It speaks to that wider assessment of NHS priorities on women. We have to start doing something about that. We must stand up and say that we are not afraid to criticise areas of the NHS, because I am sure that as we go through the debate we will have example after example from which we can draw only one conclusion: women are being failed.

My hon. Friend the Minister, as a practising nurse, will know the importance and vocation of patient care. With her professional eyes, will she allow the NHS to ignore the plight of people who are suffering every day? To be blunt, her predecessor appeared to. I ask her to apply her considerable and dedicated professional expertise to get the Government to direct the NHS to adopt the recommendations, or at least to mirror them. That is the least we can do for the terrible and horrific damage that the NHS has caused to so many people. To finish: the NHS did this, so the NHS must fix this.

--- Later in debate ---

[Mrs Theresa May (Maidenhead) (Con)]

As others have said, it is a privilege to serve under your chairmanship, Mr Rosindell. I add my congratulations to my hon. Friend the Member for Elmet and Rothwell (Alec Shelbrooke) on having secured this important debate. We are here for a significant reason, which is, frankly, to hold the Government’s feet to the fire and press them on why they have not made more progress on this issue. As others have said, it was debated some months ago in the Chamber of the House of Commons, and the cross-party support for Government action was absolutely clear, as the presence here shows, yet we have had to come back to ask the Government why they are not making more progress.

The independent medicines and medical devices safety review was absolutely clear about the damage done by the three medical devices and medicines that it considered: Primodos, mesh—not only vaginal mesh—and sodium valproate. As my hon. Friend the Member for Elmet and Rothwell—

[Alec Shelbrooke]

Right honourable.

[Mrs May]

I am so sorry; that must have changed after my time. My right hon. Friend set out very clearly how people’s lives have changed. The hon. Member for Blaydon (Liz Twist) has just done that as well.

Lives have been not just changed, but significantly damaged. People have suffered physically, mentally, socially and, in many cases, economically. As well as suffering the direct impact of what was done to them and, in the case of Primodos, to the babies born with defects as a result of their mothers taking it, they suffered constant rejection by the state—by the NHS and the Government, the very bodies that should have been there to protect and support them. The longer it takes the Government to fully implement the recommendations of the Cumberlege report, the more rejection these people suffer. Every week that goes by is a further rejection, because the report was very clear: action needs to be taken.

I was pleased to set up the report, and I commissioned it largely out of the concern I had about Primodos, which had been raised with me by my right hon. Friend the Member for Hemel Hempstead (Sir Mike Penning), but also by our former colleague Seema Kennedy, who took up this issue as well. The aim of the review was not just to get to the truth, but to identify what needed to be done to redress the problems that had occurred, to provide support to those who had suffered, and to ensure that it could not happen again.

There are two glaring aspects to these issues. The first is that the natural reaction of the NHS and the medical establishment was—and, I fear, continues to be—to defend themselves, rather than to admit to mistakes, ensure that those who suffered were given the support they needed, and take action to ensure that those mistakes could not happen again. That is still happening.

I spoke to a constituent earlier this week who had an operation a number of years ago, and is still having operations to correct problems that arose from a mistake made in that operation. My constituent Hugh Whitfield, a former consultant surgeon who runs the Independent Medical Negligence Resolution, spoke to me before Christmas about the large sum of money the NHS spends on litigation and on trying to defend cases in court, when a better system would be to just accept that mistakes were made. I have constituents who just wanted an apology. They just wanted to know that somebody had accepted that something had gone wrong, and to be shown that it would not be allowed to happen again. Instead, the NHS spends significant sums of money trying to defend itself in court cases when there is a better solution. That is slightly aside from the main point I want to make about the Cumberlege review, but it shows that the NHS’s attitude is to defend itself, rather than accept that mistakes were made.

I want to pick up on a point made by the three Members who have spoken. Sadly, when we look at the three issues that the Cumberlege review considered, we see a patronising attitude towards women—a pat-you-on-the-head attitude. “There, there. This is the sort of thing you can expect. You’re in pain? Oh well. You’re a woman.” I am afraid that that was the attitude taken on some of these issues—and it was not just that: it was a female doctor, Isabel Gal—a woman who had survived Auschwitz—who first identified the problems with Primodos, but she was dismissed and ignored, and sadly her career was damaged as a result. She eventually left the medical profession. What comes through in the report is that there is an attitude of not being willing to listen to women’s voices, and of not accepting it when women say, “Actually, what you have done to me is causing me extreme pain and difficulty.” Instead of saying, “You know what? I do this, and I get it right. Go away, dear,” professionals should say, “Let’s look into this and find out exactly what happened, and whether we made a mistake.”

I come to three of the specific recommendations, one of which is to appoint a patient safety commissioner. Reference has already been made to this, and it is good that the Government have accepted the recommendation, although they needed a bit of a nudge in the House of Lords to do so. What concerns me is the need to ensure that this patient safety commissioner is not in hock to the Department of Health and Social Care.

My right hon. Friend the Member for Elmet and Rothwell spoke about the NHS. Yes, these are the actions of the NHS, but behind it lies the Department of Health and Social Care, which consistently resisted properly looking into these issues over a significant period. I do not want a patient safety commissioner to be taken over by the Department of Health and Social Care. It has to be somebody who can be independent and can genuinely give patients a voice.

On the recommendation to establish a redress agency, my right hon. Friend the Member for Hemel Hempstead is right that under its terms of reference, the Cumberlege review was not able to look at compensation for individuals, but it was asked to look at wider redress measures, and it proposed the redress agency—a proposal that, sadly, the Government have not been willing to accept. I know the Treasury will have heard the proposal as, “Ding, ding, ding! Pounds!”—I have dealt with the Treasury, and we all know what happens—but the agency would have a wider remit than that. The Treasury often thinks these things are just about funding and monetary compensation, but people who have suffered as a result of these issues need other sorts of support given to them—for example, support for children with special educational needs. Redress is wider than monetary compensation, which is often what Government think about.

Recommendation 9 is to set up a taskforce. The patient reference group is a good idea but, as the hon. Member for Blaydon (Liz Twist) said, where now? The taskforce would have the job of gripping this issue and pressing down on the accelerator for action. I ask the Minister: who in Government is gripping this issue and pressing the accelerator for action? As I am sure she will gather, most of us here think that nobody is doing that, and that the issue is being allowed to drift. It is important that these recommendations be followed up on.

My final thought is about levelling up—a term that some of us in politics like to use at the moment. The victims of these three issues need to have their lives levelled up with those of people who did not suffer as a result of this. Above all, NHS treatment given to women needs to be levelled up with that given to men, to ensure that women are not just patted on the head and told to go away.

--- Later in debate ---

[Maria Caulfield]

I want to reassure my right hon. Friend that changes have already been made. When women were experiencing these problems, particularly with sodium valproate, compensation was mainly run by NHS trusts and individual organisations, which was very difficult and cumbersome.

We have introduced the duty of candour, which a number of Members have raised this afternoon. That duty means that when a mistake happens, hospital trusts and GPs have to be up front, own that mistake and explain it to patients. Very often, women did not realise that the problem was the sodium valproate or the Primodos; they thought something else had happened. The duty of candour means that hospital trusts and GPs are up front, that that apologise and that the process of redress is started as soon as possible.

Now that NHS Resolution has been set up, the process is as easy as possible for anyone with a claim of clinical negligence to come forward. As a result of the new system, between 70% and 80% of claims—I will correct the record if I am wrong—are now settled out of court, which is quicker and helps patients get the compensation they need. They have a fundamental right to that if clinical negligence has happened.

[Alec Shelbrooke]

I am listening closely to what my hon. Friend is saying. Is that data independently audited, and will it be made available? The reality on the ground is that although these things are in place, there are plenty of examples of people who feel that that is not the case, and that doctors and professionals are carrying on doing the same thing and not feeding back in. I welcome what she has said, but could an auditable trail be published to show what is happening and those who perhaps are not taking any notice?

[Maria Caulfield]

There are absolutely processes in place, including bodies such as the Care Quality Commission, which audit and inspect to ensure that the processes that have to be in place are being used. NHS Resolution is clear about the work it does, and its chief executive also gave evidence to the Select Committee this week on how the process should work. Of course, if patients feel that it is not working for them, we need to hear about it. We set up these mechanisms specifically to make compensation easy, quick and representative of the needs of those who are claiming, to make sure that they get the compensation they need as quickly as possible. That has not happened in the past; we fully acknowledge that.

The Secretary of State will announce a consultation on wider reforms to clinical negligence very soon, because we recognise that the system has not worked for people. It has been too bureaucratic, and the legal position and fear of going to court has put many people off. It does not need to be like that. We want to make it as easy as possible for people, whatever their clinical negligence claim.

--- Later in debate ---

[Alec Shelbrooke]

I thank all hon. Members who have contributed this afternoon. Even though many Members have given me apologies for not being able to be present, we have covered the wide-ranging aspects of the review concerning Primodos, sodium valproate and mesh. I thank and congratulate the Minister, who showed in her response that she understands her brief. I will come on to some of the issues we disagree on, but she did not just read out what has been written for her. She has taken the issue seriously and has taken the debate on board. That is a refreshing change from her predecessor.

Let me move on to some of the specific comments. I welcome the hon. Member for Chesham and Amersham (Sarah Green), with whom I have not had the privilege of being in a debate before. She made an important point when she said that we need to listen to victims. That is the point of the report: the need to listen to victims. We have to be very careful about how we proceed. The report was trusted because the victims felt that they were finally and properly listened to. That is why it matters so much.

Let us be blunt: it does not matter which side we are on, we in this place are all getting a bit of a bad press at the moment. The report is an opportunity to show people that they can have faith in this place and trust it. When we go out, listen to victims, take their views on board and, as a Parliament, say, “The adversarial side of politics can be parked over there, because on these really important issues, we all get together and we can make things happen,” we can do things. I thank the Minister for the progress that she is making on the recommendations, and for giving us the update.

The hon. Member for Livingston (Hannah Bardell) gave us a shocking revelation. Records were destroyed, rather than people admitting the mistakes that had been made. That is why redress, the databases and all the other things that we want to introduce are so important.

We come back to this point. I thank my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for her reference to the analogy I gave her about the aircraft industry. The Minister used the word “whistleblower”, and that is the wrong word. We are talking about cultural change, and it follows on from what the hon. Member for Livingston and my right hon. Friend the Member for Romsey and Southampton North said. We have to develop a culture in which it is natural for anybody working in a system to feed in, “This is going wrong” or “There has been some evidence of this.” There should be no blame for anybody and no comeback for their careers.

I am a great fan of the TV programme “Air Crash Investigation”—my wife cannot watch it—especially as I spend my life in the air. It is absolutely clear when people watch that programme how the airline industry is now at a point at which it is really unusual for a plane to drop out of the air, because of the no-blame culture. If somebody leaves a spanner somewhere, that gets reported. The tiniest things are reported, which is how that industry’s safety has improved.

[Mrs May]

Will my right hon. Friend give way?

[Sir Graham Brady (in the Chair)]

Order. I am terribly sorry to interrupt the right hon. Lady, but we cannot have interventions during what should be a very brief winding-up speech.

[Alec Shelbrooke]

Thank you, Sir Graham. The most important point that I want the Minister to take away today is the following. I do not want compensation for people; it is not compensation that I am seeking. I want there to be grants, like the thalidomide grant. People will be subject to these injuries for life, and compensation is not going to cover it. We have a responsibility to deal with the problem, so I hope that my hon. Friend takes that away today. I say this to the Minister: we will keep coming back and keep coming back, and eventually there will be a votable motion on the subject on the Floor of the House and I do not think it will be able to be whipped.

Question put and agreed to.

Resolved,

That this House has considered the matter of implementation of the recommendations of the Cumberlege Report.

Public Health

Alec Shelbrooke Excerpts

Tuesday 14th December 2021 Commons Chamber

[Sajid Javid]

First, I think my hon. Friend, if I heard him correctly, talked about the “Government’s measures on lockdown”. I am not sure where he has seen these measures on lockdown, because they are certainly not being presented by this Government here today. On whether the omicron variant is milder, I will come to that issue very shortly.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

Building on the point from my hon. Friend the Member for North West Leicestershire (Andrew Bridgen), which my right hon. Friend says he is about to expand on, the question is: when will we know whether omicron gives severe or mild disease? If it is mild, how quickly could the decision be made that this would be an advantage to get rid of delta and to get herd immunity while it does not create strong disease?

[Sajid Javid]

If my right hon. Friend will allow me, I am about to come to precisely the point he raises.

The second thing about omicron that I want to share is that, although we do not yet have a complete picture of its severity, even if its severity is significantly lower, the much higher transmissibility of omicron means that it still has the potential to overwhelm the NHS. Let us take the current observed doubling time of two years—[Interruption.] Sorry. Let us take the current doubling time of two days. If, for argument’s sake, omicron is only half as severe as delta, after the lag between cases and hospitalisations has taken effect, that would buy us only two days before omicron hospitalisations reach the same level as for delta.

--- Later in debate ---

[Sajid Javid]

My hon. Friend did raise that point yesterday. It is being looked at very urgently. I am sure he will agree that if it is done, it should be done in a safe way that our regulators are happy with. I can confidently say that I expect an urgent update later today as soon as I leave this Chamber.

[Alec Shelbrooke]

I entirely agree with what my right hon. Friend said about the pressure on the NHS and the difficult problems that will occur if we have unvaccinated people blocking ICU beds. As he said, however, variants come along. He is making the case that, even if symptoms are only mild there will be exponential growth of cases in hospitals. What is the plan going forward? There is a set of measures today to deal with the situation now—fair enough—but if this is going to keep happening, how do we avoid being sat here in three months’ time, five months’ time or six months’ time debating the same thing? What is the plan?

[Sajid Javid]

That is a very fair question. I will say more about that in a moment, but I point my right hon. Friend to one of the things I have just mentioned, which is better and better vaccines. In the future, we will have poly-variant vaccines. Because of the orders we have already placed, we are at the front of the queue for such vaccines.

--- Later in debate ---

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

It is a pleasure to follow my hon. Friend the Member for Wolverhampton North East (Jane Stevenson).

As my hon. Friend the Member for Bexhill and Battle (Huw Merriman) said, our hospitals and intensive care unit beds are being filled up with unvaccinated people. It is a real problem in the hospitals in Leeds, and is having a huge impact on people who want to get vaccinated—people who want their lives to move forward and to be able to continue to do the things that we all want to do. As my right hon. Friend the Health Secretary said at the time, the reality is that there could come a point when people are not able to have the operation that they may need, because a bed might not be available. I have spoken to trained, highly-skilled surgeons, who have been in situations where the theatre is available and the theatre nurses are available, but the operation is cancelled because there is no bed to put the patient in, so they cannot do the operation.

What we have before us today is a set of really unfortunate measures. They do not sit comfortably with me: I do not like the things we are doing. However, they are balanced for this moment in time. I do not believe that they are measures for vaccine passports, as they have been described in the countless round robin emails I have received, and it has been made clear from the Dispatch Box that they are not. They are measures for a specific moment, in a very specific area.



I think we need to consider requiring everyone to have a lateral flow test before going into an area where there may be a chance of spreading the virus, because that is a way of protecting society. It is people’s right not to be vaccinated—I am totally opposed to mandatory vaccines—but it is my right, and the right of a great many of my constituents, to expect to be able to continue to receive services that we have paid for and used, when and where we may need them. That is what is overwhelming services at present, and it is going to lead to a simple choice, and a debate is going to be had.

At some point, we are going to have to work out how we are going to free up intensive care unit beds. Are we going to say that people must take lateral flow tests to ensure that they mix in an environment in which everyone has had one, if we do not want to introduce vaccine passports? In fact, I do not believe that vaccine passports would work anyway. Someone might have a partner who did not want to be vaccinated and could not attend an event, but the other person could. Because that person had a vaccine certificate, a test would not be required, and he or she might get covid and go home and give it to the partner, who might then end up in intensive care. So that is not really going to work. Lateral flow tests do work.

As I have said, I do not believe that what is on the table today is a vaccine passport, which is why, although I do not like this package of measures, I will be supporting it. However, there is a fundamental question, which is going to stir up a really hard debate in this country. Do we demand that everyone has a lateral flow test before they go anywhere? Do we find strains which may not cause a lot of disease and let them spread to try to defeat the virus? Or must we take the Singapore model, and say, “On your head be it if you need hospital treatment, and there will be financial consequences”? One of those three things will have to happen in the long run.

As we stand here today, we are faced with a very unfortunate set of measures, but I am backing them today because I think that what is sacrosanct at the moment, especially after last year, is the need to protect this Christmas season. People must be able to have that, and if it means a few sacrifices now, I think that that is a price worth paying.

Public Health

Alec Shelbrooke Excerpts

Tuesday 30th November 2021 Commons Chamber

[Steve Brine]

I do not think I would call directors of public health “activists”, although I understand that some of them play it very differently from us. It is the job of this place to get legislation and regulations right, and if we draft them in a way that makes them so wide, so loose and so flexible that any director of public health could be an “activist” if so minded, it will lie at this door, not that door. I should like the Minister, in summing up the debate, to define “suspected”, because I think there is an element of the Salem witch trials in this. What is a “suspected” case? I should like an answer from the Dispatch Box, please, before I am asked to vote for this measure.

I said in the House yesterday that the regulations, in and of themselves, were relatively mild. I have already talked about face coverings. What concerns me is the chilling effect that this is having on the rest of our society. The fact that No. 10 Downing Street, the centre of government, has taken to the national newspapers today to ask head teachers not to cancel nativity plays because of the announcement that we made on Saturday night makes me ask, “What on earth are we doing?”

We should think of the effect that this is having on confidence, on society and on hospitality. Those in hospitality have put everything into this Christmas in order to survive and to save their year. There is nothing in these regulations that says Christmas parties must be cancelled—unless, of course, Dr Harries is in charge—but there is everything in the language and the narrative coming out of the Government right now that is causing Christmas parties to be cancelled left, right and centre. I have seen organisations in my constituency cancel events that were due to happen within the next few weeks, on a “just in case” basis. These regulations will have a chilling effect, and we should not underestimate that just because it is not written in black and white.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

Does my hon. Friend agree that the Business Secretary should have been involved in these decisions? Does he share my concern about that? I have received several emails from travel companies in my constituency whose potential bookings have dropped off a cliff because of the cost of PCR tests. My hon. Friend mentioned a “chilling effect”, but it goes deeper than that: there is also a huge impact on business. If these regulations are to be implemented, it must surely be done hand in hand with the Chancellor and the Department for Business, Energy and Industrial Strategy.

[Steve Brine]

Having been a Minister of the Crown, I hope that the regulations have been through the right-round process, albeit an accelerated right-round process, but my hon. Friend is absolutely right. It will worry the travel industry that the regulations that have not been subject to a motion today are not being debated in the House—and yes, I am greatly concerned. I have to say that I agree with the Opposition about departure testing. Other countries, such as the Netherlands, have introduced it. I do not think that the Opposition have had an answer from Ministers about why they have not chosen to do the same, and I should like to hear an answer in the Minister’s winding-up speech.

--- Later in debate ---

[Daisy Cooper (St Albans) (LD)]

The Liberal Democrats will support the regulations, but we have grave concerns about whether the Government are doing enough to protect people, to protect the NHS, and to buy scientists the time that they need in order to learn more about the new variant.

We know that masks are effective. We know that they reduce transmission, and they are a small price to pay for the guaranteeing of all our other freedoms. They also allow the clinically extremely vulnerable to leave their homes, which many of them have not done for a very long time. They continue to shield, cut off from society, because they do not have the confidence even to enter a shop or board a bus. I am worried by the Secretary of State’s pledge to abandon masks in a few weeks’ time if omicron proves to be no more dangerous than the delta variant, because the delta variant is still dangerous, and the NHS is already on its knees before we go into the worst of the winter.

I wish there were more support for those in self-isolation. For too long, the support has been too stingy and too hard to access. We must create a sense among people that it is their civic duty to self-isolate if they are asked to do so, and if the Government ask people to self-isolate, they must step up and provide proper financial support. I would also like to see the reintroduction of the encouragement to “work from home if you can” from the Government. The colleagues have also mentioned ventilation, on which the Government have been far too slow to act. In schools right across England, people have been crying out for ventilation for months and months, but the Government have been dragging their heels.

[Alec Shelbrooke]

I want to pick up on the hon. Lady’s comment about working from home. I say gently to her that a great many of my constituents have businesses that thrive on footfall in the city centre of Leeds, and that the working from home encouragement had a devastating impact on their ability to earn a living. When people say, “Let’s just work from home again”, they must recognise that there would be a very large economic impact on a great number of my constituents if that were to happen.

[Daisy Cooper]

I take that point. We know that many of these measures often result in a lose-lose situation. A real problem over the past 18 months has been the way in which people have tried to frame this as public health versus the economy, because for me, having a strong and healthy workforce and a strong and healthy economy are two sides of the same coin. Notwithstanding that, I am encouraging the Government to ask people to work from home where they can, in order to strike the right balance that would reduce levels of transmission. I am not suggesting a blanket mandate for everybody to stay at home; I am suggesting encouraging people to work at home where they can, in a balanced way.

--- Later in debate ---

[Sir Christopher Chope]

I hope the hon. Lady accepts that people should be free to make their own decision on whether they wish to be vaccinated. I am therefore extremely nervous about backdoor proposals to require vaccine passports. I do not believe people’s freedom should be conditional on taking compulsory medication, which is why I am against the provisions in the Health and Care Bill on compulsory fluoridation. To that extent, I am probably on the same side of the argument as she is.

A mood of increasing intolerance is being engendered towards those who have a reasonable excuse for not wearing a face covering. Paragraph 7.8 of the explanatory memorandum makes it clear

“people do not need to show proof of this reasonable excuse”

but that is not being promoted by the Government. Regulation 5 says:

“For the purposes of regulations 3(1) and 4(1), the circumstances in which a person (“P”) has a reasonable excuse include”—

this is the important point—

“those where P cannot put on, wear or remove a face covering because of any physical or mental illness or impairment, or disability…or without severe distress”.

That is one reasonable excuse, but there are many others. The Government seem to be rather conflicted or muddled, because paragraph 7.8 of the explanatory memorandum says:

“Nobody who has a reasonable excuse and is therefore not wearing a face covering should be prevented from visiting any setting because of the requirements in these Regulations. Furthermore, people do not need to show proof of this reasonable excuse under the Regulations.”

In other words, people do not have to show a face covering exemption certificate, such as this one from Hidden Disabilities. I see quite a lot of people wearing these certificates but, as soon as people have to wear them, they are asked questions, “Well, what are your disabilities?” Most of my disabilities are well hidden, and I intend to keep them hidden. It is unreasonable that we should be creating an environment in which people are being challenged, and being encouraged to be challenged, on their personal and private health.

That brings me to the conflicting content of paragraph 12.3 of the explanatory memorandum. It may just be a misprint, but it says:

“The Department has also included a range of exemptions to ensure that this policy does not unfairly discriminate against those with protected characteristics. Furthermore, the policy will be supported by a communications campaign that will make clear that some people are exempt from these regulations and people should be challenged by members of the public for not wearing a face covering.”

Surely it should say “should not be challenged”. I do not understand it, because paragraph 15.3 says:

“Maggie Throup, the Parliamentary under Secretary of State”—

she is sitting on the Front Bench—

“can confirm that this Explanatory Memorandum meets the required standard.”

If it was indeed a misprint, the explanatory memorandum does not meet the required standard. If it is not a misprint, it is a serious contradiction within the explanatory memorandum and seriously undermines people’s freedom to go about their business without having impertinent remarks and questions put to them by busybodies acting on behalf of enforcement authorities.

[Alec Shelbrooke]

My hon. Friend has been a Member of this House far longer than I have. Is there a mechanism where that could be clarified before today’s vote?

[Sir Christopher Chope]

The mechanism is for the Minister to intervene on me, and I am happy to give way to her, to say that it is a misprint, or it is a deliberate confusion—it is to confuse the punters, so we can have it both ways. That might be the response of a Liberal Democrat, were there one on the Front Bench. I hope that the Minister will be able to respond to that serious point.

Obviously, people out there will be wondering about exemptions and reasonable excuses. The hon. Member for Sheffield South East (Mr Betts), who chairs the Select Committee on Levelling Up, Housing and Communities, drew attention in his intervention to the fact that young people are going around in shopping centres saying that they have a reasonable excuse for not complying with the regulations and for not wearing face masks. What is the problem with that? If people have a reasonable excuse for not wearing face coverings, let us not get too fussed about it. That is why these regulations are part of a scaremongering propaganda campaign on the part of the Government that is designed to try to stop or restrict social interaction between social animals who happen to be living in the United Kingdom. That is potentially the most damaging aspect of the regulations before us today: they are designed to suppress freedom of the individual and to suppress social contact and they are doing that through unreasonable fearmongering.

[Huw Merriman (Bexhill and Battle) (Con)]

Yesterday, I intervened on the Secretary of State and during his statement he repeated to me:

“we will not keep measures in place for a day longer than necessary.”—[Official Report, 29 November 2021; Vol. 704, c. 679.]

With that assurance in mind, I thought I would come to listen to this debate and speak on behalf of the transport sector, which relates to my Select Committee, willing to support these measures as proportionate measures in circumstances where we do not know whether the new variant will have an impact on transmissibility and on our vaccine effectiveness. On regulations 1340, on face coverings, I can get there in that regard because they expire on 20 December and they are well set out. I have concerns about the way the transport sector is somewhat singled out, albeit with retail, as perhaps being an unsafe setting, whereas hospitality is marked differently. If we put £10 billion into the rail network alone just to keep it going, sending out a message that it is a less safe setting than a pub or restaurant will not be the way to give people confidence to get back on to that network which we need to survive.

I also have concerns about what happens on the buses, given what I witnessed today. That may well have been because people had not tuned into this debate and did not realise that these regulations had already come into force. People are still getting on board without a face covering. Despite the powers given to drivers to ensure that they do not do so, there is no questioning and on they go. Not only does that wind people up, but it leaves others thinking, “What’s the point in bothering? If not everyone is wearing a mask, what’s the purpose of anyone wearing one?” However, I can get there on those regulations because of the unknowns that we need to deal with.

One of the wonderful things about coming into this Chamber is to be educated. I might make the point that my hon. Friend the Member for Winchester (Steve Brine) has made: perhaps more of us can come here and be educated. I have grave concerns about the issues around regulation 1338, on self-isolation. If the aim is for us to be covered for no longer than is necessary, why do they have no end date and default to 24 March? The impact of these regulations is even greater than our having to wear a face covering for longer periods because, as has been mentioned, we could well be back to “pingdemic” territory.

I emphasise that the regulations mean that, regardless of a vaccination having been given, one has to self-isolate for a period of time if there is a suspicion that one has been in contact with someone who has the omicron variant. Right now, and perhaps for the period up to 20 December, I can understand that the suspicion would perhaps be linked, as the transmission rates are slower to build—one would hope that would be so for the next few weeks—to whether one had been in contact with someone who had been in South Africa, or something on those lines. If, however, we move to 24 March and the variant has spread fast but, as we hope, it has not had a negative impact on the vaccine, we could see the default option being, “I have come into contact with somebody who has covid. I did not know whether they had omicron or not, because that does not tell me that. Therefore, I must be cautious, as we are always told to be. Therefore, I must self-isolate.” Then we could see the whole country being pinged again, as it has been before.

The situation could even be worse than that. If it turns out, as is currently being discussed in South Africa, that although the strain may transmit quickly it may not have the same impact as even the delta variant, stopping people being out and about may make things worse, because they will not get the antibodies that we want them to get. Surely those on our Front Bench are aware of that. The beta variant was a variant of concern, and the amber-plus regulations were brought in, as there was a concern that beta would have been worse against the vaccine than delta. It turned out that one dose of AstraZeneca was more effective against the beta strain than two doses of it were against delta. So variants of concern can quickly turn out not to be a concern at all.

That is why we must make sure that our legislation stops and is flexible and nimble, yet these regulations will roll on until 24 March. That is what our job in this place is about; I can agree in principle that there is a need to take measures, but I cannot vote for legislation that does not actually do what I believe the Government intended it to do. There are options, and they can be used right now. The Minister could stand at the Dispatch Box and find a way to reassure those of us who have the same concern. Alternatively, the default option for me is to vote against this legislation, not because I disagree with the principle, but because I disagree with voting for legislation that I know to be poor, badly drafted and not to meet the intention. Surely we should not be stubborn and pig-headed when legislation does not work; we should fix it or we should vote against it.

I have one last point to make in relation to a motion that I thought would be before us but is not—one that deals with the restrictions on travel and the introduction of PCR testing. Yesterday, the Secretary of State also reassured me that PCR testing would not be expensive and that we would not be at the mercy of unscrupulous providers, as we saw happen during the summer. A wise person just told me about an incidence of a three-hour PCR test, which many will need to take in order not to have to self-isolate—that is good for the economy—costing more than £200. Why are these regulations being laid under the negative procedure? We need to be discussing that legislation and finding the pitfalls, as we have with the regulations before us—I applaud my colleagues for doing so this afternoon—yet they are not even being brought forward.

[Alec Shelbrooke]

I wish to return to the point I made earlier, and I wonder whether my hon. Friend shares my genuine concern. As he said, we are here today because of a variant that has been discovered. More variants are going to be discovered and the cost of the PCR test will make people think carefully about going abroad, and that is going to have a devastating impact on the high street, travel agents and holidays. Does he agree that this issue has to be taken as a whole, and that it cannot be separated out so that every time there is a variant we say that we have to shut everything down?

[Huw Merriman]

I do agree with that, and it is a good point for me to end on. Let us look at not just the consumer, but those who work in aviation. Some 5,000 jobs have been lost on a monthly basis since February 2020 in that area; this has been an absolute disaster for the aviation and international travel sector, and for those who want to trade around the world. We had just started to see the easing of restrictions, with no damage to public health at all. My right hon. Friend is right to say that we need to learn lessons. It is okay for us to take tentative steps perhaps this once, on a limited basis, but we cannot keep shutting down parts of the economy every time there may be a variant of concern. Otherwise, to quote the Prime Minister, we will never “live with” this virus.

Covid-19 Update

Alec Shelbrooke Excerpts

Monday 29th November 2021 Commons Chamber

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

Why don’t you learn food mechanics then?

[Mr Speaker]

Order. Mr Shelbrooke, I thought you might have been going on the NATO delegation, and I do not want to hear that you have missed out on it.

--- Later in debate ---

[Sajid Javid]

Most people in that situation will be contacted either by letter or directly by their GP, but I understand the importance of the question. The hon. Gentleman may have heard earlier that one piece of advice from the JCVI that I have accepted is that the severely immunocompromised who have received three doses as part of their primary course will now be offered a booster dose—a fourth dose—so long as there has been a three-month gap since their third dose. In many cases, if an individual is unsure, the best place for advice is their GP. If the hon. Gentleman would find it helpful to meet the vaccine Minister to get more information, I can set that up.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

I thank my right hon. Friend for his statement. He mentioned reviewing the evidence as quickly as possible. Will that include evidence from countries that had the variant before it got here?

Many health academics have said that the virulence of flu is growing with social distancing, the wearing of masks and so on, and that our immunity is not what it was because we are not mixing. With attention rightly being given to covid, are we looking at other viruses such as flu? What plans will be put in place if a very virulent strain takes hold?

[Sajid Javid]

Work is being done on this variant not just in the UK but by our friends across the world. At the G7 meeting I attended earlier today, we all agreed to co-operate and share whatever information we get. My right hon. Friend is right to mention the importance of the flu vaccine, and I am glad he has reminded the House that, although we have understandably been talking about the importance of the covid vaccine, and of the booster vaccine in particular, the flu vaccine remains vitally important this winter. That is one reason why we have the largest flu vaccination programme this country has ever seen.

Independent Medicines and Medical Devices Safety Review

Alec Shelbrooke Excerpts

Thursday 8th July 2021 Commons Chamber

[Emma Hardy]

I thank the hon. Lady for her intervention and I agree with her absolutely, which brings me on to the point about the redress agency, which is one of the recommendations in the report that has been rejected. Instead, the Government have said:

“The government and industry have previously established redress schemes without the need for an additional agency.”

That goes to the point that she made, because this puts the burden of redress in entirely the wrong place: on the victims, not on those responsible. Seeking redress requires enormous effort on the part of those who are already suffering, not just financially but emotionally, as was set out in Baroness Cumberlege’s report. It recommends that without waiting for the establishment of a redress agency:

“Separate schemes should be set up for each intervention…to meet the cost of providing additional care and support to those who have experienced avoidable harm”.

Sadly, no such moves have been made, so I would be interested if the Minister gave an indication of the progress on such schemes.

The report also recommends transparency on payments to clinicians, with a UK-style Physician Payments Sunshine Act 2010 to require the mandatory reporting of all payments made to doctors, teaching hospitals, research institutions and charities. The Government’s interim response said that they would “consider” this recommendation, in discussion with other parties, including the General Medical Council. I understand that there are suggestions that this could be done by expanding the voluntary system of reporting, but, as we have seen, voluntary systems simply do not work.

By way of a quick example, a high-profile academic recently admitted that he had failed to declare £100,000 from the manufacturer of one of the types of vaginal mesh implants that he was assessing. He has now published a correction, but this is almost seven years after he first did his report and it came only after a complaint was made about him. A section 60 order in the Health and Care Bill would allow for legislation to cover this, because transparency is vital to patient safety. There should be no opportunities for payments made by industry to introduce bias into prescribing or the scientific literature that is used to inform our National Institute for Health and Care Excellence guidelines. This report recommended creating a database to record which device was used when, in which person, and what the outcomes were in terms of safety and patient feedback.

The roll-out of the medical device information system has begun, but questions are arising as to what data is being collected. This is really important. To give an indication of that, let me raise the case of Kath, an extremely fit and healthy woman who used to be interested in skydiving. She had mesh implants and afterwards was in such pain that she was unable to move or get out of bad. This completely changed her life forever. However, her procedure was recorded as a success because she no longer had incontinence and that was the measure being looked at. We need to be looking at all patient outcomes when we are recording that data in those data sets.

That brings me on to my next point, which relates to the current moratorium on using mesh, as recommended in the report. Kath has said that there is no way she would ever have had this procedure had she had any indication of the risk of harm. I understand that there is pressure from some of the surgeons to reintroduce mesh, but I do not believe we can do that without fully informed consent, and we can have that only if patients are fully aware of all the risks. They can be fully aware of all the risks only if all the data is collected and recorded accurately. Until that is done, we cannot have informed consent and we should not consider lifting the moratorium on the use of mesh implants.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

I am grateful to the hon. Lady for joining me to help to secure this debate. I will be speaking later, but I wanted to touch on this specific point about the pressure we are coming under. Does she agree that nothing has changed from a clinical point of view in the past 18 months, yet the clinician pressure is to stop the suspension? Does that not represent the pressure we are under coming from the clinician side of this argument?

[Emma Hardy]

I completely agree and thank the right hon. Gentleman for bringing this debate forward and championing it from the other side of the House. He correctly says that we need to have all that evidence so that people can give that informed consent.

Finally, the report recommends establishing specialist treatment centres

“to provide comprehensive treatment, care and advice”.

Some of these care centres are being established, which is good news, but again there are concerns about the data collection on patient outcomes after mesh removal and not all women are having all their mesh removed—some of this is only a partial removal. Again, what questions are being asked and what data is being collected? I have submitted numerous written parliamentary questions to the Department but have yet to receive a clear answer on exactly what data will be collected.

There are also important questions to be answered on the competence of surgeons to undertake removals. I know that my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson) has a very difficult story on this issue. The Department says that it is for individual trusts to decide which surgeons to use for removals, but I do not share that view. How can it be fair to ask a woman to return to the same surgeon who put the mesh in, causing her all that harm, in order to have it removed? I really think we need to look at this issue again.

--- Later in debate ---

[Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)]

I thank my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) and the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) for securing this very important debate. As we have heard, today marks one year since the independent medicines and medical devices safety review was published. I was speaking virtually that day and I have to say that I am thrilled to be able to speak in the Chamber today; thankfully, it is starting to feel a bit more normal. I wholeheartedly thank Baroness Cumberlege and her team for their excellent work; it is great to see her with us today. I also thank the right hon. Member for Maidenhead (Mrs May) for commissioning the review in the first place. It was a brave and bold thing to do—and the right thing to do, as she has so often done in this place.

The problems with the medicines and medical devices that the review reports on—Primodos, valproate and vaginal mesh—have been ongoing for much, much longer than just the past year, as we all know. I have had the privilege of working with campaigners over many years on these issues; I pay tribute to Janet Williams, Emma Murphy, Marie Lyon and Kath Sansom, to name just four, for their dedication and expertise. They are normally with us for these debates, and it is sad that they are not able to be here.

I first spoke in this House about surgical mesh implants in October 2017, as shadow Minister for public health—there were always lots of debates in that brief, as my hon. Friend the Member for Nottingham North (Alex Norris) will know. My mam always likes to see my speeches, so one Saturday, while I was making lunch, I showed her that speech and said “Oh, thank goodness you’ve never had any of this awful mesh put in.”

That was when our world was turned upside down. She said, “No, no, I only had a bit of tape put in a few years ago, before all my troubles started”—the “troubles” she refers to being numerous health problems that appeared one after the other. She had had scans and cameras everywhere, with no diagnosis. Obviously there was no solution that could be found. Does that sound familiar to those who have had constituents with mesh problems get in touch?

Fast-forward three and a half years—coming up to four now—from that first debate, and my mam still has all sorts of complications. She is now in constant pain all the time. She is 76 this year. She has all sorts of autoimmune reactions and she just wants her mesh removed, no matter her age. She was very healthy and had a great life before, and her life now is a shadow of its former self. She wishes constantly, every day, that she had never had it put inside her.

She is not alone. I know that there are tens of thousands of women in exactly the same position, so I support all the recommendations of the excellent Cumberlege review. Recommendation 5 calls for specialist centres to be established, which is excellent; it has happened, they are open and I think some have actually started to do some of their work. But therein lies the issue that I want to specifically mention today—I am pleased that my hon. Friend the Member for Kingston upon Hull West and Hessle and the right hon. Member for New Forest East (Dr Lewis) have already raised it, so I am not alone in being concerned.

The issue is that the very surgeons who implanted this awful, life-devastating mesh are in most cases the very same ones now offering to remove it. As the right hon. Gentleman said, after gaslighting women and telling them that their pain was in their head or that they just had to learn to live with it—or to lie back and think of England when they tried to have sex, as was once mentioned in Westminster Hall—they are the very same surgeons these patients, including my mam, are expected to trust again to remove this mesh. That trust is, unsurprisingly, all gone.

[Alec Shelbrooke]

I am most grateful to the hon. Lady; I really appreciate all the work that she has done on the issue alongside us. To take what she says one step further—she may be coming on to this point—does she agree that the other problem is that the evidence we have had in APPG meetings is that the very same surgeons still think that this is the best cure for women? They are not actually accepting some of the problems that are blatantly obvious.

[Mrs Hodgson]

The right hon. Gentleman makes a very good point; I was not moving on to it, so I am glad he has made it. They are very keen to start reimplanting and reusing the mesh; they still say that it is great and that it transforms 90% of women’s lives. For the 90% whose body can tolerate it, that is great, but for the 10% who cannot, it devastates their lives. It transforms their lives in a devastating way; in many cases it can leave them crippled and unable to work.

Not all these women are of pensionable age like my mam, who is 76 this year. Some are still of working age and have all the problems associated with trying to get recognition in the benefits system when so little is still known, not just by GPs but by the Department for Work and Pensions people who are dealing with them. The last thing we want to do is create more victims of this terrible medical device. Mesh-injured women are between a rock and a hard place: either they have their mesh removed by the very same surgeon who implemented the mesh, often—in the case of my mam as well—after it was widely known that it was devastating some women’s health, or they do not have it removed at all. This should never be a choice, so I call on the Minister to work with NHS England to reconsider that and put patients first by giving them a genuine choice about where they go for their mesh removal and who removes it. There are only eight of these centres, so this is not often as easy as saying, “Oh well, you can go to Manchester or London,” as was said to my mam; obviously, I will bend over backwards to enable that to happen, but some women just will not have the wherewithal. There must be a way for surgeons from other parts of the country to travel to where those women are, so that they do not have to face and deal with the surgeon who put the mesh in them.

I want to briefly mention valproate and Primodos. Since the review was published a year ago, very sadly 10 members of the Association for Children Damaged by Hormone Pregnancy Tests have died, still suffering with the enormous guilt of feeling, even though it was not their fault, inadvertently responsible for the damage to their babies. This has been an ongoing battle for them since 1978 and we have heard and will hear further this afternoon how devastating this drug has been for those who took it in all innocence, with full trust in their doctors to do them no harm.

On valproate, I have huge respect for the noble Lord O’Shaughnessy. When he was the Health Minister responsible he put in train excellent guidance and safeguards and tried to help more than anyone before him, yet shockingly still around 400 babies are born per year who have been exposed to valproate—even now, after all we know and all that the noble Lord put in train. That is truly shocking. Some 15,000 women in England alone are prescribed valproate in their child-bearing years with the majority still not receiving the pregnancy prevention programme or given a change of medication should they seek or want to become pregnant. This is without even beginning to estimate the additional tragedies of stillbirths, miscarriages or terminations that are due and necessary because of valproate.

This Minister’s lasting legacy could be to right these historical wrongs once and for all. We must ensure that everyone in the healthcare system is protected and treated with care, and when there are failings, as will happen—they cannot all be prevented, much as we would like it to be so—the Government must take action to ensure that those harmed are treated with respect and given proper healthcare and restorative surgery where possible and are, if they can be, properly compensated. But mostly we need to ensure that this sort of harm from medicines and medical devices never happens again.

--- Later in debate ---

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

I thank the Backbench Business Committee for allowing this debate in my name and that of the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy).

When the hon. Lady and I met to discuss the progress that may or may not have been made, we felt it was important to hold this debate today because it is one year since the publication of the report. Everybody in this House, and I am sure a lot of people around the country, understands that the past year has created a set of circumstances that was always going to put some aspects on the back burner and not move them forward. So today’s debate is not designed to criticise and have a go at the Government—I have a great deal of respect for the Minister and the Department—but merely to say, “Please don’t forget about this report.” It is one of the most important reports on health matters that has come before this House in many years.

What is important today is that none of us loses sight of the people we are talking about. Hon. and right hon. Members from across the House have already raised issues relating to the people themselves—real stories about real people. The hon. Member for Washington and Sunderland West (Mrs Hodgson) has done enormous amounts of work on this and speaks with passion and from the heart of the effect it had personally on her family and her mother. I can only wish her and her family the best and hope that those matters can be resolved.

This first came to my attention when a constituent came to see me. I know that some hon. and right hon. Members will have heard this story before—in fact, the hon. Member for Washington and Sunderland West touched on it—but it is worth telling again. The constituent was a very, very brave lady. She was in her 40s. She had had a child. She was a physiotherapist for the NHS. She was fit and healthy. She stood in front of me and could not sit down. She was having to bend her body into a position to feel as comfortable as she could. She sweated throughout the entire surgery because she was in crippling agony.

I knew nothing about this subject when my constituent came to see me and explained what had happened. What was even more terrifying was that it was an operation she never needed. She had had her child. She continued to have a full, loving and sexual relationship with her husband. But every now and again she had some urinary leakage, and she was told, “Don’t worry, we’ve got a cure for that. It’s a great cure. We can put some mesh inside you. We’ve done it for years. You’ll be fixed and there’ll be no problem.” She went ahead and had the operation done.

About eight years later, things started to go wrong. The fundamental problem is the time between having the operation and problems becoming apparent. That is why the recommendation of a proper database is so very important. As the hon. Member for Kingston upon Hull West and Hessle said, inserting the mesh is being recorded as a successful operation, but what happens afterwards is not recorded. To be blunt, thalidomide was successful in what it was supposed to do because it stopped morning sickness. Nine months later, the consequences were horrific. We do not class that as a successful drug that was administered. Indeed, we could talk about other drugs today, such as sodium valproate and Primodos, which raise a very important point in relation to this report. However, I am going to focus on the vaginal mesh issues.

One reason why I will focus on vaginal mesh is that my jaw hit the floor at some of the stories that my constituent told me. First, let me get rather graphic, because I think it is important. She described to me how during sexual intercourse, her husband’s penis was sliced. That is not a successful operation in anybody’s book. She then went through several operations, where, to be blunt, she was butchered to the point where she has no sexual stimulation whatever. She was told, “On the bright side, you now have a designer vagina.”

In what circumstances does anybody feel it is appropriate to comment on the perceived attractiveness of somebody’s genitalia, especially when they are suffering the pain and agony that my constituent is going through? I am afraid that that comment alone shows the arrogance of clinicians that we are up against with this issue. It is appalling, and it is one of the reasons why, as I said to the hon. Member for Kingston upon Hull West and Hessle, and indeed to the hon. Member for Washington and Sunderland West, we have to push back against clinicians saying, “We want to stop the suspension of the use of mesh because it works in so many circumstances.” I am sorry, but there is too much information out there about patients simply not being listened to.

It took two and a half years for Baroness Cumberlege to put the report together. The review went around the country. Indeed, the constituent I am speaking about sat and spoke at a table with my noble Friend. She said to me afterwards, “It is fantastic. I was really listened to.” Normally when a Government set up an inquiry, you think, “Yeah, yeah, yeah, they will take some hearings and everything else”, and you get, “You’re my Member of Parliament, can you feed in?”, and so on. She said to me afterwards, “I was really listened to.”

When that report came out, women felt that they had finally been listened to and things were moving forward. I have to say that the Minister, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), performed brilliantly that day when she stood at the Dispatch Box and first of all issued the apology. My constituent said to me she had nothing but praise for the Minister. I hope the Minister knows that the comments I am making today are in no way directed towards her; they are more directed towards what is going on in the NHS and the clinicians. Obviously the driver of this debate today is making sure, as we come out of this global pandemic and all the strains that have been put on the health service, that we reinvigorate these reports and say that they must, must, must be at the forefront of what happens.

I am afraid there is a pattern forming. One of the things that struck me when we had the debate about vaginal mesh in Westminster Hall, which I believe was around 2017, was when I described what I have just described to the House about my constituent’s sex life. In that debate—it is in Hansard—I used the word “clitoris”. It is incredible how much notice was taken of what I had said because a man used that word. I am afraid there is a blunt truth to this debate: it appears to be that only when men talk about women’s issues do people perk up and listen. It seems to me that there appears to be a huge gender blindness in the NHS to how it approaches the health issues of women.

It simply cannot be right that a woman goes time and time again to a doctor and is just dismissed out of hand. As my right hon. Friend the Member for Maidenhead (Mrs May) clearly outlined in her speech, we hear, “There, there. You will get over it.” I have heard that so many times.

Today’s debate does not include endometriosis—that is a different debate, but many in the House will know that I feel very passionate about it, and the hon. Member for Kingston upon Hull West and Hessle works very hard on it alongside me. To deviate for one minute, if you will allow me, Madam Deputy Speaker, endometriosis is a crippling disease that affects 10% of women in this country, yet there is still an eight to 10-year diagnosis period before anything is done. That again shows the problem. Why are women not being listened to? Why does it take a male Member of Parliament to say these things and get noticed? It is not good enough. The reality is that the recommendations in Baroness Cumberlege’s review need to be implemented.

As I bring my comments to a close, I want to focus on the issue of redress. Redress is not about compensation culture. It is about the fact that my constituent— a healthy and active woman in her 40s who was a physiotherapist and worked for the NHS—as a result of an operation she never asked for, has seen her marriage break down, her career disappear and her life destroyed. The destroying of her life has meant that she can no longer operate as a physiotherapist. She physically cannot do the job. To a certain extent, she has had sick pay and has been looked after, but that is not the point. The point is that the NHS did the operation, said it was all fine and ignored her. She had to take out a loan and go privately to have the mesh removed because of the waiting list. It got to the point where, after she had the operation and was still not getting better, she had further scans that revealed that the mesh had intruded into her bones. Someone commented, “It’s like trying to remove hair from a piece of chewing gum.”

My constituent cannot work. She will never, ever return to the life that she had. Not to mention the breakdown of her marriage, she will never return to the profession that she trained for. She has a caring attitude. She always points out to me, “Alec, you’re too fat. Your knees are going to collapse. I see it all the time.” In fact, I bumped into her in Wetherby market square about two weeks ago, and she said, “Well, at least you’ve listened and lost a bit of weight, but there is still some way to go.”

My constituent was part of the caring profession. That is who she is, but she cannot work again. That is why redress is important. It is important that we are able to look after the people the NHS damaged. She did not need the operation and was damaged. This is not about compensation culture; it is about looking after such people. As my right hon. Friend the Member for Maidenhead made clear, the NHS is an all-encompassing caring body and society. We cannot just pick out parts of it and say, “That was the care, but now we are going to ignore you.” We either believe in what it was set up for and what it is meant to do or we do not; it is as simple and black and white as that.

I believe that everybody in this House believes that; I certainly know that my hon. Friend the Minister does. I read her comments in the Daily Mail this week about women’s pain being ignored and about the idea that women can just accept a bit of pain—I think it was about the implanting of the contraceptive coil. It is high time that we start to recognise the institutional picture that that paints. The first step, and the reason why I wanted to speak in this debate—I know my hon. Friend the Minister is absolutely dedicated to these causes—is to bring this as high as we can in the public spotlight. We must move as quickly as we can to implement the nine recommendations, because we are destroying people’s lives. We have destroyed people’s lives, and although we will never rectify the situation, we have a responsibility as a society to do everything we can to support the people who have suffered.

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[Dr Julian Lewis (New Forest East) (Con)]

I must say it is quite hard to speak unemotionally after hearing the tragic story that the hon. Member for Ayr, Carrick and Cumnock (Allan Dorans) has relayed to the House. How much more difficult must it have been for Baroness Cumberlege to hear dozens, if not hundreds, of such stories of individual human suffering? She came up with a truly magnificent report and the House of Commons had what I thought was one of its best days for a long time when we discussed it, in no small measure due to the Minister for Patient Safety, Suicide Prevention and Mental Health, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries) and her response to the report. We would all have felt quite justified in thinking that, at last, there was real light at the end of this horrible, terrible, awful tunnel, but it does not seem that we have got to the end of it yet.

I took from Baroness Cumberlege’s report one particular area of hope, and that was the establishment of the specialised mesh centres, and I wish to focus in my contribution on three questions. First, are the mesh centres truly dedicated and comprehensive one-stop shops offering all the types of treatment likely to be needed and all the types of investigation likely to be required, if not under one roof, then at least within a single footprint, or are they merely specialists hubs in name only?

Secondly, there is another problem related to the centres. Are we seeing a situation in which surgeons who could have been described as mesh problem deniers are now reinventing themselves as mesh problem remediators? I do not think they are qualified to hold that role. I fear that there is an attitude of mind that says, “Well, it’s not that easy to find people who specialise in this area, and therefore, even though these are the people who put the mesh in, maybe they are the people who are best qualified to take the mesh out.” I absolutely refute that. Not only did those people put the mesh in, but when the patients came along time and again to say what terrible problems they were suffering, those were the people who refused to listen to them. They were the people who, in some cases, insisted on putting more mesh in, and they were the people who, in other cases, refused to let the patients have a referral to figures such as Miss Sohier Elneil in London or Professor Hashim Hashim in Bristol, who are—or were at that time—the true, and possibly the only, specialists in mesh removal.

When I was thinking about what to say in the light of what had gone before, I was debating whether I should use the word “butchered”, but my right hon. Friend the Member for Elmet and Rothwell (Alec Shelbrooke) did use it in his most powerful speech and I will use it as well. The idea that someone who has butchered your body is an appropriate person for you to go back to, after all that, and that they could then say they are going to take the mesh out, when that person may well have stood in the way of your perhaps going to see Miss Elneil or Professor Hashim, who could have done something for you, is unconscionable.

My third question is: what research is being undertaken on new methods of safe removal? If indeed it is the case that an argument is going to be made that there might be some future use for mesh in safer ways, what research is being done to see whether or not something could be developed that would not run the risks of this disaster?

I shall say something very fanciful now, and it is probably nonsense, but the thought occurs to me, hearing about the way in which the flesh grows around the mesh, the mesh fractures and it becomes so very difficult to remove: has anybody ever thought that it might be possible to develop a future type of mesh, if this is not possible with the mesh that has already been put inside people, that might conceivably be harmlessly dissolved within the body if something went wrong, by the addition some sort of chemical? That may be absolute nonsense, but the point is that unless specialist research is carried out, this sort of botching and butchery is going to continue.

As a result of the three constituency cases that I originally cited in a debate on—it is hard to believe that it is more than three years ago—19 April 2018, I have received certain amounts of information and concerns from Kath Sansom, who does such wonderful work with the Sling the Mesh group. I conveyed a message to her and basically said, “If you were standing up in this place today, what points would you like to put over?” She said:

“The debate is calling for all Cumberlege recommendations to be implemented without further delay, including financial redress for women and sweeping reform of the healthcare and regulation framework. Women are losing hope that they have been properly listened to. They need urgent financial redress for the many losses they have suffered. They want to know also when they go to a specialist centre that it is not a postcode lottery of care. To date the specialist centres are special in name only.”

In other words, is there really a new centre, or are people being sent from pillar to post for all the different parts of the investigations and having to wait months between each particular appointment for each particular type of investigation?

Kath also said:

“There has been no national training programme and no agreed way to measure success—they haven’t even agreed on outcome logging measures to standardise the data capture.”

She also made the point, which I think I have made strongly enough, about some of the centres

“being run by pro mesh surgeons who have denied mesh is a problem”.

[Alec Shelbrooke]

I said this in my speech, but it is worth emphasising again. We are talking about what needs to be done and what is happening, but we must also come back to people; as my right hon. Friend says, people are very important. Women are killing themselves. They are killing themselves. Look at the suicide rates for women with mesh problems and endometriosis. Women go through crippling pain, and dozens a year are taking their own lives. Does that not make the point that my right hon. Friend is making—that we have to move more quickly on this?

[Dr Lewis]

It totally does. I shall share a little something with the House. Although it does not compare with the agony of what these women are going through, I lost a year and a half of my life when I was given some inappropriate treatment that resulted in my being unable to read for a year and a half during my early 20s. What really made it worse was the knowledge that, if I had not asked for a particular treatment to try to improve my tired eyes because I was studying, none of it need have happened. How much worse must it be for these women, many of whom are not only undergoing all this suffering, but are undergoing it because they were told it was a minor procedure and they thought, “Oh, well—maybe I will have it, then.” If only they had known, they would never have gone within a mile of it. They must be saying that, over and over again. To expect them to go back to the same surgeons who did not tell them what the consequences could be is inhumane and totally unrealistic.

The issue of some people having a financial interest in promoting certain products has been touched on. We are obliged to declare our interests in this House and perhaps something like the Physician Payments Sunshine Act would be the equivalent for people in this context.

Finally, Kath draws attention to what she calls a black hole in official statistics. She says, for example, that according to hospital statistics, in the year 2008-09, 1,038 women were readmitted to hospital with problems within 30 days of a mesh sling having been implanted. In comparison, data derived from surgeons says that only 104 women were admitted to hospital—that is something like 10% of the total. Some 934 women have somehow gone missing from the surgeons’ data.

These are strange and disturbing features. This House has shown itself at its best in condemning what happened. The Government need to build on that and put in place the measures recommended by the report to make it far less likely that it could happen again.

Covid-19: Contracts and Public Inquiry

Alec Shelbrooke Excerpts

Wednesday 7th July 2021 Commons Chamber

[Ian Blackford]

My hon. Friend is quite correct. There have been a number of occasions on which all the devolved Administrations have sought support from the UK Government for borrowing, and have been frustrated in that, but for friends of the UK Government, it is a case of “Come in, there are contracts to be had.”

Let me give a few examples. There was the neighbour and local pub landlord of the former Health Secretary, the right hon. Member for West Suffolk (Matt Hancock), who supplied tens of millions of vials for covid-19 tests despite not having had any previous experience of providing medical supplies: off the street, no experience whatsoever, but he was a friend of the Government. There was the small Stroud-based company which, despite making a loss in 2019, was awarded a £156 million contract for PPE. Wait for it: the company was run by a Tory councillor, and no evidence—none whatsoever—was ever found of its supplying PPE previously.

[Alec Shelbrooke (Elmet and Rothwell) (Con)]

rose—

[Andrew Bowie (West Aberdeenshire and Kincardine) (Con)]

rose—

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[Ian Blackford]

My hon. Friend is quite correct. I am delighted that we have an opportunity today to shine a light on all this, but it demonstrates that we need to get on with the public inquiry. The public deserve to know what has been happening with this Government as we have come through the pandemic.

We have heard excuses from the Prime Minister and the former Health Secretary that some of these contracts were fast-tracked because there was no time to be wasted in such urgent circumstances. Well, some basic due diligence might have been useful. Perhaps unsurprisingly given the lack of expertise of some of those securing the covid procurement contracts, there have been numerous issues with the orders.

As reported by the BBC, 50 million face masks bought in April 2020 could not be used by the NHS because they did not meet its specifications. The use of 10 million surgical gowns for frontline NHS staff was suspended because of how the items were packaged. Millions of medical gowns were never used, having been bought for the NHS at the end of the first lockdown for £122 million. A million high-grade masks used in the NHS did not meet the right safety standards and have been withdrawn. What a waste of taxpayers’ money. What a shambles. At the same time, 3 million of our constituents have been left with no financial support. Those are the warped priorities of the Government.

[Alec Shelbrooke]

Will the right hon. Gentleman give way?

[Ian Blackford]

There are, of course, numerous further examples of Tory sleaze in the Government’s response to the pandemic, of which we are all too aware. There was David Cameron’s lobbying of Cabinet Ministers to benefit Greensill Capital, of which he was a shareholder. We had Dido Harding, wife of a Tory MP, put in charge of the disastrous and costly Test and Trace despite a lack of experience in public health. And of course there is the issue of the £37 billion that has been spent on it. Where is the value for money? Money wasted. [Interruption.] I suggest to the right hon. Member for Elmet and Rothwell (Alec Shelbrooke) that this is a debate where he is permitted to put in to speak, but—[Interruption.]

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[Jo Churchill]

I thank my hon. Friend and constituency neighbour. The right hon. Member for Ross, Skye and Lochaber referred to his leader, who early on in the pandemic spoke about elimination, yet now the World Health Organisation says six out of 10 of the highest rates across Europe are currently in Scotland. That is why I think that if selective lines are picked out, and people are used as battering rams against each other rather than us looking sensibly at the facts, that means that we do not get the perspective we need to make sure that we come through this and that we stand shoulder to shoulder with the population and deliver the vaccine programme.

As I said, I am proud of the work that the UK Government have done in driving the vaccine. At the beginning of the pandemic we were told this would be a 10-year process; we got there in a year. That is utterly phenomenal, and there were great academics from Scotland who joined in; there were academics from across the world. We can deliver this, and the NHS is getting on with the job of vaccinating and allowing us that road to freedom.

[Alec Shelbrooke]

I am grateful to my hon. Friend for giving way. Does she agree that, because of the investment the UK Government made in the AstraZeneca vaccine and the Government’s worldwide collaborations and investment, not only have we been able to produce the vaccine in 10% of the predicted time but we unlocked technology that will serve the health service and people of this country for many years to come?

[Jo Churchill]

I could not agree more. The vibrancy and quality of the life sciences industry, the pharmaceutical industry and the academic ecosystem in Scotland, in Wales, in Northern Ireland and in the UK really does unleash a bright future for us. It is thanks to that joint working that we have been able to procure at speed vital goods and services, such as ventilators and PPE, which have been so critical to our response in the pandemic. To date, every patient who has needed a ventilator has had access to one. I am sure that the right hon. Member for Ross, Skye and Lochaber will celebrate the jobs that have been created—I think it is 450 of them—at the Honeywell factory in Motherwell, producing PPE for the frontline. We now have a home-grown industry that provides 70% of all PPE, apart from gloves, and we are working hard to find the right materials so that we can have a glove industry as well. That is what I call a success story, from a standing start back in April.

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[Fleur Anderson]

I agree with the hon. and learned Lady. This is not about the processes and whether they have been followed, but about what undue weight was given to the resulting contracts that came out of those processes. Some of them have been taken up in court, so there are questions to be answered.

For over 12 months now, my colleagues and I in the shadow Cabinet Office team have been asking some very simple questions again and again of the Chancellor of the Duchy of Lancaster and Minister for the Cabinet Office, the right hon. Member for Surrey Heath (Michael Gove), and his team over their procurement policy during the pandemic. Every time, we have been met with deflection and non-answers. Those questions have not been getting an answer, so I will try again today. That is not very impressive for the Department responsible for increasing transparency across Whitehall, and it is transparency that we are talking about today. But it is not only about transparency. Were those contracts given to the right companies to save lives at the right time? Without question, we needed speed. Without question, we needed the best companies to be chosen. The question is, when it comes to another emergency, pandemic or crisis, do the Government throw due transparency out of the window and just start talking to their friends?

[Alec Shelbrooke]

The hon. Lady said that shadow Cabinet Office Ministers have been asking the Chancellor of the Duchy of Lancaster questions about the things going on. However, I warn the hon. Lady—I say this to draw us back to where we were 12 or 15 months ago —that the then shadow Chancellor of the Duchy of Lancaster, the hon. Member for Leeds West (Rachel Reeves), wrote to the Chancellor of the Duchy of Lancaster saying that he was not awarding PPE contracts quickly enough, and that he should be bypassing the system to get them out there. She then gave a list of companies in my city of Leeds that had offered support, and they included a football agent, an historical clothing company, an events company in Surrey and a private legal practice in Birmingham. All I say to the hon. Lady is that there are lessons to be learned, but in terms of what she is trying to say, please do not think that Opposition Members were all innocent and that the Government were guilty and need to follow some lesson, because the reality is that the then shadow Chancellor of the Duchy of Lancaster put it in writing.

[Fleur Anderson]

Of course there are questions to be asked, and that is what we are doing—we are asking these questions. I hope that there is a real-time review going on right now, and I hope that all the questions we are asking will be in the public inquiry to come. All these questions need to be looked into.

I have 15 questions for the Minister today, which I hope she will be able to answer. Question 1: what assessment has she made of the accuracy of the Prime Minister’s official spokesperson’s statement on 28 June 2021 on the conduct of ministerial Government business through departmental email addresses? The Parliamentary Secretary, Cabinet Office, the hon. Member for Hornchurch and Upminster (Julia Lopez), said, only two hours after the statement that day, that

“a huge volume of correspondence was coming to Ministers via their personal email addresses”.—[Official Report, 28 June 2021; Vol. 698, c. 33.]

The Minister will have seen the leaked minutes from the Department of Health and Social Care meeting on 9 December, confirming that. So was the Prime Minister’s spokesperson not telling the truth, or just wrong, and will the Prime Minister be correcting the record? The use of private email addresses, how it all came to be and the murky times around that time need to be opened up to transparency.

It is hugely welcome news that the Information Commissioner’s Office will be investigating that point. The Government must co-operate fully. It is not just about freedom of information law and data protection law, important as that is; it is about taxpayers’ money being dished out secretly on private emails. Labour expects the Government to ensure that they come clean on private email use in other Departments, and that anyone found to have acted unlawfully or inappropriately in ministerial office faces the consequences.

Question 2: in her response to last week’s urgent question, the Parliamentary Secretary said that 47 offers of PPE supplies were processed through the Government’s priority mailbox. The Government have said that the details of all contracts will be published, but have refused to name the 47 companies. Who are those 47 companies, why are they not being named, and will those names be published now?

Question 3: can the Minister tell us which Ministers formally approved contracts awarded under the emergency procurement process during the covid pandemic? The Minister will have no doubt read the Public Administration and Constitutional Affairs Committee’s recent report on decision making during the pandemic, and it has a whole slew of other questions. It concluded:

“Ministers have passed responsibility between the Cabinet Office and Department of Health and Social Care”.

So who was responsible for actually signing off those contracts?

That leads me to question 4: which Minister made the decision to award a contract to Public First for contact focus group testing in March 2020? The Cabinet Office has stated that the Chancellor of the Duchy of Lancaster did not personally sign off the decision, so if he did not, who did?

Question 5, which was raised earlier in this debate: what role do the army of non-executive directors currently employed across Whitehall have in influencing the award of contracts? Did they have a say in the process or the decisions behind the award of those contracts? For instance, how can the Minister explain the fact that Kate Lampard, the lead non-executive director on the Department of Health and Social Care board, is also a senior associate at the consultancy firm Verita, which in May was awarded a contract by the same Department, worth £35,000, to assist Public Health England? It is not just about how people vote when they are awarded these positions. It is not about their voting tendency. It is their closeness to Ministers and others, and their closeness to some of the contracts being given out, that the public need to know more about.

This brings me nicely on to question 6. What steps were taken by the Department to identify and address conflicts of interest in relation to the contracts awarded through the VIP lane? Is the Minister confident that all meetings between Ministers and companies that were awarded contracts have been fully disclosed and added to the transparency data? Can we be assured of that today?

Question 7: I mentioned the leaked minutes of the December meeting of the Department of Health and Social Care. In that meeting the second permanent secretary used the term “sub-approval”. Can the Minister enlighten us on the sub-approval process? What does it mean in relation to Government covid contracts? The public have so many questions about what was going on in the contracting last year.

Question 8: the Parliamentary Secretary, Cabinet Office, the hon. Member for Hornchurch and Upminster, spoke in a Westminster Hall debate on Monday 21 June, which I attended, about the market conditions facing suppliers in China. There have been questions about links with China. In that same debate, I referenced evidence uncovered by the Good Law Project that showed officials in the Department of Health and Social Care were aware that an agent working for PestFix, the pest company that got a covid contract, may have been bribing officials in China. The point was not addressed by the Parliamentary Secretary, Cabinet Office, in that debate, so I ask the Minister to comment on it today. Is she aware of this allegation? Does she agree that, no matter how difficult market conditions were at the time, it warrants urgent investigation?

Question 9: I also asked in that debate whether the Cabinet Office would commit to auditing in detail all the contracts identified by Transparency International as raising red flags for possible corruption, and to commit to publishing the outcome of that audit. This would go a long way to restoring public trust. If it cannot be done, why not? What do the Government have to hide? I am afraid this is a question to which I did not receive an answer in that debate, so I hope to receive an answer this afternoon.

Question 10: the Parliamentary Secretary, Cabinet Office, said she believes there are cases where clawback is taking place, and other Ministers have mentioned it, too, but we do not know when it has happened and what was in the contracts for those that failed, by millions of pounds in some cases. Is the Minister in a position to provide more detail?

In the past 12 months, the Government have awarded £280 million of contracts for masks that did not meet the required standards, at a time when we were crying out for PPE that would save lives. I presume those masks had to be mothballed. I do not know where they are.

The Government spent £100 million on gowns without carrying out technical checks, so they could not be used. It is incredibly important that as much of this taxpayers’ money as possible is retrieved as soon as possible. Perhaps the Minister can explain to the nurses facing a pay cut, and to the 3 million who have been excluded from any help, that the money has gone to boost the profits of the firms that received these contracts, rather than coming back to the public purse.

Similarly, my eleventh question is about how much money the Government have spent defending themselves in court against the unlawful decisions that have been made.

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[Alec Shelbrooke (Elmet and Rothwell) (Con)]

As a comprehensive schoolboy, that privilege really runs right through me! However, let us be serious. First, let me say that we are dealing with a subject that has cost hundreds of thousands of people their lives. Millions of people around the world have died from a disease that nobody had even heard of, because it probably did not exist, two years ago. In that short time, we have had to do things, in the developed world and across all of the world, including in this country, that nobody would ever have dreamed of. We had to react very quickly to those things.

It is worth taking a step back to where we were, because short memories do not serve us well for the future. As I mentioned to the hon. Member for Putney (Fleur Anderson), at that time several people were coming to MPs, from all over, with suggestions, and not to make a quick buck; a lot of them answered the call to help out in the crisis the country and the world were in—one that not only affected this country, but created a worldwide shortage of the very equipment and supplies that the world needed. Of course, what has come out of this pandemic is a look at the global supply chains and how they have to change, and that is tearing up the convention that has existed for many decades across many parts of the world. It took the crisis to say, “When we stretch out your supply chains like that in a world crisis, they are not going to work in the best way possible.” The pressure for personal protective equipment was enormous.

Again, I make the point about the letter that the shadow Chancellor of the Duchy of Lancaster sent to the Chancellor of the Duchy of Lancaster, which covered two aspects. First, it said, “All these people are offering you PPE. Why haven’t you bought it? Why are you taking so long to buy it?” That is there in black and white, in an official letter sent to the Chancellor of the Duchy of Lancaster. The letter then listed other companies that had come to the shadow Chancellor of the Duchy of Lancaster and said that they could supply things; as I said before, there were football agents, historical clothing companies, events companies and private legal practices in Birmingham. I am not saying that in a sense of mockery; I am saying that to make the point that Members of Parliament from all parties—from across the House—received several emails and representations from those trying to supply PPE to deal with the crisis. It was the responsibility of Members of Parliament to pass those emails and those contacts into the system to see what would happen.

I equally understand that the shadow Chancellor of the Duchy of Lancaster had a frustration about the length of time it was taking for those contracts to be awarded, because we were all desperately trying to solve a problem that the world was facing to get PPE to where it needed to be. Of course we can name contracts that went wrong. We can do that in any walk of life and for any contract. It does not mean there was an endemic failure. Things were happening in a very short space of time and certain procurements did not meet the standards, but the last figure I heard showed they amounted to less than 1% of all the PPE that was procured. That is not a bad hit rate when there was not time to fill in the paperwork.

It is important that we bring these issues out in these debates, but why we do that is being lost in this one. There are, quite rightly, calls for an inquiry, but do we want it so that the country can learn, move forward and understand how to tackle things in the future, or is it for cheap political points? What I have heard so far is, pretty much, “If we had independence, we wouldn’t have any problems.” From almost the first sentence that came out of the mouth of the right hon. Member for Ross, Skye and Lochaber (Ian Blackford) there was the argument for independence, and it has gone on and on. We have heard, “If Scotland was independent, it would be different.” Well, it would not be that different, because Scotland would not be in the EU and it would not have had a chance to take part in the UK-wide procurement that supplied the vaccine programme. Let us not forget that the British armed forces have also contributed a huge amount to the fight against the pandemic. There has been a UK-wide force—the strength of this Union—delivering for every adult in the country. It does no service at all to try to make what has happened in the last 18 months into an argument about independence. It should stop this afternoon.

[Richard Thomson (Gordon) (SNP)]

Since the right hon. Member has taken us on to the Union, why did the Government seek to poll Scottish attitudes to it if its benefits were so self-evident throughout? Why were public funds that were intended for covid procurement misdirected to pay for that polling?

[Alec Shelbrooke]

I despair. I literally just said that we are supposed to be examining the procurement of PPE and when the inquiry comes, and yet we go back to those allegations. I am sure that my right hon. Friend the Paymaster General will once again give the answers that were given previously. Stop it! Grow up! The reality is that we are dealing with an issue that has caused the deaths of millions of people across the world, including tens of thousands of people in this country. Today we need to explore where things went wrong—that is important —why the inquiry should wait and how it should take place.

By profession I am a mechanical engineer and, as somebody who flies around the world, I have an interest—a morbid interest, I suppose—in the programme “Air Crash Investigation”, which my wife will not watch under any circumstances, given her fear of flying. Aircraft safety has improved immensely in the past decades, and that is because there is a no-blame culture. That ties straight in with the report published this week by the Health and Social Care Committee on deaths in natal care and having a no-blame culture. We may want to get to the analysis of what went wrong and why it went wrong, but we cannot do that from a position of wondering, “Am I covering my political back? Am I covering my professional back? Can I have an honest conversation?”

We have to understand what went wrong. Things did go wrong. There cannot be a single person in the Chamber or indeed across the country who felt that everything went really well and was fine. Nobody says that. Nobody believes that. It is self-evidently not true that everything went fine. We do have to learn lessons, and it is important that we learn them though the matrix of what went wrong. As we have said, plenty of preparation was done for a flu pandemic, but that turned out not to be able to handle this pandemic. It is therefore important that we analyse the pressures caused by different diseases that can come forward. [Interruption.] I heard things from a sedentary position, but I did not notice what was said.

Ultimately, we have not had any sense of the SNP taking responsibility where they have responsibility—indeed, it was noticeable that the leader of the SNP just dismissed the intervention from my hon. Friend the Member for South Suffolk (James Cartlidge), mocked it and tried to put the blame back on the UK Government. Quite simply, if people are really taking notice of this debate this afternoon, they will think that it needs to be a lot more mature and serious than it has been so far.

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[Angela Richardson]

I thank the hon. Gentleman for his intervention, but as I said, I am going to speak to the motion that his party has tabled today for discussion.

The Prime Minister has already confirmed that an independent inquiry into the handling of the pandemic is expected to begin in the spring of 2022. This inquiry will be on a statutory basis, with full powers under the Inquiries Act 2005, including the ability to compel the production of all relevant materials and take oral evidence under public oath. Every part of the state pulled together to tackle this virus, and as we recover as one United Kingdom, we must learn the lessons together in the same spirit. That is why the Government will consult the devolved Administrations before finalising the scope and details of the arrangements of this inquiry.

Given the scale of the inquiry and the resources required to carry it out, from identifying and disclosing all relevant information to giving that oral evidence, launching an inquiry would place a significant burden on our NHS and scientific advisers at a time when focus must still be on the fight against the virus. We are still rolling out the vaccine project; we have booster jabs to get into arms in the autumn; we will have winter pressures on the NHS; and, as we have discussed in recent days, we are rightly focused on addressing all of those missed appointments for other health concerns. Our deputy chief medical officer has said that an inquiry now would be an unnecessary extra burden that would distract the NHS from the vaccine roll-out:

“Personally, would an inquiry be an unwelcome distraction for me personally, at the moment, when I’m very focussed on the vaccine programme and the vaccine programme we might need in the autumn? Who knows, I think it would be an extra burden that wasn’t necessary.”

[Alec Shelbrooke]

Does that really not just make the point that what the inquiry needs to do is learn lessons so that we can move forward and be better prepared next time, rather than just scoring cheap political points?

[Angela Richardson]

I agree with my right hon. Friend: as always, he makes an excellent point.

We have acted at pace to protect our NHS and save lives, by delivering more than 11 billion items of personal protective equipment to our key workers and helping to protect all those working on the frontline in our fight against the virus. From the onset of the pandemic, we have acted at pace to secure the PPE that we all need. We purchased over 32 billion items for the whole of the UK, three quarters of which will now be provided by British manufacturers—that is massive upscaling at speed—and we have distributed over 11.7 billion items of PPE across England since February 2020.

We have talked about the success of the vaccine roll- out, but what was amazing was securing those 507 million doses of the eight most promising vaccines through our vaccine taskforce for every corner of our Union. We can be incredibly proud not only of that but of the investment in the COVAX project.

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[Angela Richardson]

My hon. Friend is absolutely right. Those therapeutics have made a huge difference to people who are unfortunately hospitalised. In my local hospital, the Royal Surrey, the doctor who led the covid ward was seconded from treating cancer, and he has learned many things by being involved in running that ward that will be beneficial not only for the pandemic but for anything coming down the line.

The right hon. Member for Ross, Skye and Lochaber (Ian Blackford) is no longer in his place, but in his speech he gave several examples of companies that had no previous experience in the production of something but had turned their hand to helping us to source things that we needed for the pandemic. I would ask the right hon. Member, if he were in his place, what he would say to all the whisky distilleries in Scotland that turned their hand to making hand sanitiser. What message is he giving to them today? I would like to take this opportunity to thank all the gin distilleries in my constituency and neighbouring constituencies that got in touch with me. They had made hand sanitiser and wanted a contact to speak to at my local hospital so that they could gift that hand sanitiser to it.

The Opposition would like us to take a trip down memory lane. Well, I am quite happy to do that. I was newly elected in December 2019, and I still have my training wheels on. I think a lot of us still feel like that. I had barely given my maiden speech before we were locked down and put into this situation. When you start as a new MP, you build your team from scratch. It is not there already waiting for you. At the most difficult time, I had about 1,500 emails a day coming into my inbox, and there were three of us dealing with them. We were trying to triage them and help as many people as we could. At the same time, I was receiving emails from people I had never met. I am an immigrant, and I went to a state school, so I am not connected in the way that the Opposition like to suggest about Conservative Members. It is a complete farce to talk like that, especially about a lot of those who have come in in the new intake—

[Alec Shelbrooke]

Discrimination!

[Angela Richardson]

It is. But I was receiving those emails and I knew it was my duty and responsibility, as my right hon. Friend the Member for Elmet and Rothwell (Alec Shelbrooke) has said, to pass on every single one of them, because I did not know which one would make a difference. That was not up to me; my job was to pass them on. I did not know most of those people from Adam, but I knew I had a responsibility to do that. I did not know about the eight-step process that civil servants were looking at for awarding contracts. I did not know whether any of them would be successful, but I hoped they would be. I hoped that many of the companies and individuals who put forward good ideas would have some success, because that is what we needed to tackle the pandemic.

We are at risk today of politicising this and going back into the Westminster bubble. We are at risk of not acknowledging the true heroes of the pandemic. Not us politicians, as we were just doing our job, but the businesses, schools and individuals in my constituency that suddenly came up with an idea or turned their hands to something. They were so proud of creating PPE for our local hospital, and they did an amazing job. We must remember, as we look back over the pandemic and as we consider our lessons learned, the trust spirit of communities coming together. I would wager that not just in constituencies in England, but in all four corners of the nation—in Scotland, Wales and Northern Ireland—there were people in the community who were making a difference. We have so much more in common than that which divides us, and that is how I would like to finish my speech.

--- Later in debate ---

[James Cartlidge]

I have great respect for the right hon. Gentleman and that is a fair question. My own view is that to most of my constituents the question of how soon the time comes when, for instance, they can sing in a choir in a church or go to a nightclub or gather inside with family and friends and loved ones without fearing that they are breaking the law, is more important than how soon the Westminster bubble can get excited about something that will take months and months and months and be pored over by legal people and many others.

[Alec Shelbrooke]

rose—

[James Cartlidge]

I was going to conclude, but I cannot resist my right hon. Friend; he spoke so well earlier, so as a prize I will let him intervene on me.

[Alec Shelbrooke]

Well there you go—everybody is a winner. Just to expand on the point that the right hon. Member for Orkney and Shetland (Mr Carmichael) has just made, I entirely agree with my hon. Friend that now is the time that we should come out of the restrictions, and things are moving to a close, but they are not over yet, because we have to get the autumn booster programme right. I would rather that that was properly in place before we move on to inquiries.

[James Cartlidge]

My right hon. Friend makes an excellent point. I hope he will be writing to our brilliant new Health Secretary to make that point to him.

Let me conclude by saying this. We ask ourselves when those freedoms will return and when the Government will do their part of the social contract and say, “The worst has passed, so it’s fair that you should now be able to do those things you used to do in normal life.” The answer is when those first contracts have delivered—the ones we signed with those companies, such as AstraZeneca and Pfizer, that have delivered this amazing vaccine programme that has benefited every part of the UK and every part of the world.

Every country in the UK has played a role in that. It has been a true feat of the Union, and we should be proud of it, because we are stronger together as a Union. Instead of falling back on narrow nationalism and bitterness, we stand together with a positive agenda. We have done the right thing. We have delivered an amazing vaccine programme. We have brought freedom, we have brought hope, and we look forward to better times ahead.

Covid-19

Alec Shelbrooke Excerpts

Monday 22nd February 2021 Commons Chamber

[Alec Shelbrooke (Elmet and Rothwell) (Con) [V]]

I greatly welcome my right hon. Friend the Prime Minister’s statement today setting out a clear path as to how we end this national/international nightmare, but for some industries it will not end when it does for others, and I want to focus on the travel industry.

Nearly two pence in every pound spent in this country is spent in the travel industry, which employs almost a quarter of a million people. I was glad to hear the Prime Minister say today that we will help everybody for the duration of the pandemic, but for the travel industry the pandemic will last beyond 21 June.

The review taking place into international travel is important, but we must recognise that we may not have control over where people can go. Countries may keep their borders shut, as is happening in the USA at the moment and, of course, in the EU. Whether we need a covid vaccination certificate to go to these countries will very much be up to them.

The industry therefore needs support to carry on. At the moment, its biggest concern is that if it reopens when all the non-essential shops reopen, that is well and good, but it will not have anything to sell. Let me give the example of just three travel agents from my constituency. One has gone from a £4 million turnover to zero, one has gone from a £2.3 million turnover, with £310,000 gross profit, to a £7,000 loss, and the other has gone from between £1 million and £1.2 million turnover, with a 15% profit, down to a £4,000 loss. Yes, staff have been furloughed, but there are still the fixed costs. What is often also overlooked is that the actual business owners are not earning a single penny but still have their costs going forward. We should remember that this sector employs more people than the automotive sector, but businesses are struggling to get coronavirus business interruption loan scheme loans because they have no revenue coming in to meet the banks’ criteria.

We really have to ensure that we support businesses in this sector and carry on with business grant support, business rate relief and the furlough scheme, because it could be three to four months after June before they are actually in a position to earn a living and sell products. Travel is a massive industry in this country, and it employs tens or hundreds of thousands of people, and we need to extend the support a little further. I hope that my right hon. Friend the Paymaster General will take these comments back to my right hon. Friend the Chancellor as we prepare for the upcoming Budget.

Finally, I have mentioned the hospitality industry before, but I hope that we are not going to suddenly cut the legs off pubs that may have the ability to serve outside but that would not be financially viable doing so. We must ensure that the support packages in all these areas remain until businesses are financially viable and can stand on their own two feet.

Public Health

Alec Shelbrooke Excerpts

Wednesday 6th January 2021 Commons Chamber

[Alec Shelbrooke (Elmet and Rothwell) (Con) [V]]

I want to start by praising the Prime Minister for the way in which he has taken the decisions. I would rather have a Prime Minister who leaves no stone unturned before restricting our liberties and who makes closing schools the very last thing that he wants to do. Ultimately, these measures have a real effect on people’s lives, and the decisions that we make today are a heavy burden. I also thank the BBC for what it is going to do to help with education; that is a real public service broadcaster.

I welcome the £4.6 billion that is being made available. This week I spoke to the landlord of a pub who told me that this is a vital injection of resources for him to use. I urge my right hon. Friend the Chancellor to consider a slight extension to the rates holiday, because the hospitality sector will be one of the vital tools in our recovery. People are desperate to go out and every time they go out, the Government will get revenue because every drink sold has a duty on it. It is a golden goose of the economy, so please do not cut its head off. Let us see whether we can do more to help that industry.

I have concerns about teacher assessment for examinations. A top grade can be given to a child for what they have been taught, but there will be a lot of stuff that they have not been taught and I fear that they will suffer the consequences of that later on by having that lack in their knowledge. Personally, I would like to see exams moved to Christmas this year. That is a radical solution, but this is an unprecedented situation. Curriculum delivery is absolutely vital, as is examination. Exams are not just an academic test, but a pressure experience and part of our human development that prepares us for later life.

I am concerned about nurseries and feel that they will need more financial support. Many parents will not send their child to nursery if they are at home. Why would they spend the money on that? That means that nurseries could well go bankrupt, so I urge my hon. Friends in the Treasury to look at that matter very quickly.

I want to finish on the issue of reporting. Many people have asked to be shown the number of injections that have been carried out each day. I am not sure whether that in itself is helpful. What would be helpful is a tracking graph of what happens three weeks later when people are immune. A series of levels would show the restrictions that could be undone when so many people have been immunised in the demographic that they represent. In that way, the public will be able to see how we are progressing towards the target of being able to come out of these restrictions. That will give a clearer roadmap and a clearer way of getting the proper buy-in that we need to get out of this situation as quickly as we can. It gives people hope and shows a real timeline in what it means to people.

Finally, on businesses that have put money aside for tax returns that they cannot access, I urge the Government to establish a furlough scheme so that they can access that money and not have to pay tax on it.