Coronavirus

Alex Norris Excerpts

Thursday 25th March 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

This is a solemn moment. In the week when we mark the anniversary of our first lockdown and of this emergency legislation, we must start by reflecting with sadness on the loss of the lives of 125,000 of our countrymen and women: mothers, fathers, sons, daughters and friends. That is an awful lot of broken hearts, and our thoughts and prayers are with all of them.

Today, were are acting to protect the country as much as possible as we go forward, and in that spirit, we have had a really high-quality and interesting debate. I reflect particularly on the contribution from my hon. Friend the Member for Luton South (Rachel Hopkins), who talked about the disproportionate impact on black, Asian and ethnic minority individuals in our country. We should reflect on what that says about Britain. I also reflect on the contribution from the right hon. Member for Romsey and Southampton North (Caroline Nokes) about some of our most vulnerable people. We must hold them very much at the forefront of our minds as we act today.

I am in the slightly iniquitous position of agreeing with, but having to disagree with, a number of my own colleagues, but I do not think that it serves me, them or anybody else well to disagree with them and not say so. I agree with the points made by my right hon. Friend the Member for Warley (John Spellar) on hospitality, by my hon. Friend the Member for Leeds East (Richard Burgon) on low pay and support for those who need it, and by my hon. Friend the Member for Blackley and Broughton (Graham Stringer) regarding protest. I have a lot of sympathy with many of the provisions in the Bill introduced by my hon. Friend the Member for Brent Central (Dawn Butler), and I agree with everything my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) said about her desire to amend what is in front of us today. I also share the view of my right hon. Friend the Member for Islington North (Jeremy Corbyn) that it is wrong that this is a take-it-or-leave-it proposition. I agree with all those points, but I cannot agree that the answer is to vote against these measures today. I do not think that that is the right course of action, because we would lose all these provisions. I will reflect on them shortly.

I disagree, too, with what colleagues in the Liberal Democrats have said. The right hon. Member for Kingston and Surbiton (Ed Davey), the hon. Members for Twickenham (Munira Wilson) and for Westmorland and Lonsdale (Tim Farron) and the right hon. Member for Orkney and Shetland (Mr Carmichael) have completed the set today. On some points they have agreed with the proposals, on some points they have abstained and on some points they have disagreed. I do not think that that sort of going with the wind is what we need in a pandemic. We have been consistent: we support the Government on the restrictions we have needed to protect public health.

Reflecting on contributions from Conservative Members, I agree with everything the excellent Chair of the Procedure Committee, the right hon. Member for Staffordshire Moorlands (Karen Bradley), said regarding amendments. I slightly disagreed with the hon. Member for Winchester (Steve Brine)—although I agree with the spirit of what he said—about being hoist by our own petard. The right hon. Member for North Somerset (Dr Fox) talked about us being stuck with a take-it-or-leave-it proposition, but there is nothing inevitable about that. The Government could have brought forward amendable provisions today, and we would have been in a much better position if they had done so. I think I would have looked fondly on what the hon. Member for Wycombe (Mr Baker) said, and our amendment is also sensible. We could really have improved this legislation, and I hope the Government will reflect on what it is they are recoiling from when it comes to Parliament improving their laws.

There was a strong but, I would still argue, fringe line of argument from a group of colleagues that we need fewer not greater protections for the British people. It was well represented by the hon. Members for Broxbourne (Sir Charles Walker) and for Hazel Grove (Mr Wragg), the right hon. Member for New Forest West (Sir Desmond Swayne), the hon. Member for Wycombe (Mr Baker), the right hon. Member for Forest of Dean (Mr Harper) and the hon. Members for Christchurch (Sir Christopher Chope) and for Isle of Wight (Bob Seely). I believe, as I have said before, that those colleagues have been wrong at every turn and are wrong again today. It is wrong to look at the pain that this virus has caused and to continue to advocate weakening our tools to fight it.

I do not believe either that it is a question of liberty—I do not think it can be. Every one of those colleagues voted last week for draconian fetters on the right to protest.

[Sir Charles Walker]

On a point of order, Mr Deputy Speaker. You will be well aware that I was not able to vote in last week’s Divisions, because I am chairing the relevant Bill in Committee, so that is not a legitimate point of debate from the hon. Gentleman.

[Mr Deputy Speaker (Mr Nigel Evans)]

The shadow Minister will have heard the comments, and I am sure he would want to respond himself.

[Alex Norris]

I apologise to the hon. Gentleman. I am wrong there, and I would like the record corrected.

I would say that those colleagues—those who were present in previous Parliaments—also voted for the Transparency of Lobbying, Non-Party Campaigning and Trade Union Administration Act 2014 and for reforms to trade union rights. I also believe that most, if not all, of them intend to vote for what are pretty draconian reforms to our voting process, particularly regarding identification. So I am not here to take lectures on individual freedom.

I think this is about ideology and worldview. If someone spent the 40 years since Ronald Reagan became President telling people that the thing holding them back was Government and that the way forward was less Government, then this last year has been a problem. It has shown at home and abroad that Government do have a role in making sure that people have an income, do have a role in making sure that they have housing and do have a role in protecting their health, and that it is not always best to leave things to the market.

[Sir Graham Brady]

I am listening carefully to the argument the hon. Gentleman is developing. Is he saying that there is simply no limit to how long he would be willing to have these restrictions on people’s freedoms in place, should there always be some threat of another variant of covid?

[Alex Norris]

I am grateful for that intervention. That is not my position and I am going to develop that argument shortly. I would hope to hear from the Minister that, particularly with these provisions lasting into October, he intends to bring them down much more quickly than that and as soon as we can. The point that the right hon. Member for Staffordshire Moorlands made about 21 June being present only in the procedural motions was a very good one.

Let me make a couple of points about the specifics and substance of the Act. It is right that the opportunity is being taken today to sunset provisions in it—certainly ones that have not been used—and we support the Government where they have chosen to do that. However, I do wish to question the Minister on the three provisions that are suspended. On sections 22 and 23, which expire tomorrow, I would like clarity that, as they have expired rather than been formally turned off, they will not be revivable and there is no intention to revive them. On section 58, in relation to transportation, storage and disposal of dead bodies, why was that only suspended? There does not seem to be a foreseeable use for that.

I also wish to query a number of powers that the Government have chosen to neither turn off nor suspend. Why is section 14, on continuing healthcare assessments, not being turned off, given that its counterpart, section 15, is? Section 37, on the temporary closure of educational institutions and childcare premises, has never been used, and I do not think its use is foreseeable. On section 50, on the power to suspend port operations, I do not think there is any anxiety about Border Force’s resourcing levels to cover our ports. Why has that not been turned off yet? On section 52, which many colleagues have raised, on events, gatherings and premises, there are surely better tools in other bits of legislation and regulations that we could use.

I hope that we will learn from this crisis. In particular, the points made by colleagues about a public inquiry are important. It would be very difficult for the Government to get independent feedback about why we have one of the worst death tolls in the world and one of the worst recessions in the world, but we simply must learn the lessons for the future, no matter how hard it is for Ministers to hear them.

I want to reflect on a couple of things that are still missing in the approach and in the road map. It is a really significant gap. For all the good news in the Budget for self-employed people, so many—possibly millions—are still ineligible for that support. Those excluded continue to receive almost nothing beyond social security—and some of them are not eligible for that because they have been saving, for example, to pay off tax liabilities. That is wrong, it has been wrong throughout, and I cannot understand why Ministers have not moved more quickly on it.

Similarly, we are letting down our nation’s carers. We clapped for them but now refuse to make a meaningful recognition of their contribution. The derisory 1% pay offer for NHS staff is a real-terms cut and completely unacceptable under these circumstances. Also we should not leave out of the conversation social care workers, working in the homes of some of our most vulnerable people, meeting the health needs of people who really need it, but putting their own at risk. What is their reward for that? A clap on a Tuesday and then a pay freeze in the Budget. That will mean that, for the 10th year in a row, their pay will be squeezed. That should be an enormous source of shame for the Government. I hope the Minister could reflect, and perhaps give us some good news on that when he stands up to speak.

To conclude, we will support this. We do not do so without reservation or with much pleasure, but it is the situation we find ourselves in today. There is nothing inevitable about it. The virus has been a problem for every country, but we have struggled particularly. So we need these measures so we can cautiously move forwards and make this lockdown our last.

UK Rare Diseases Framework

Alex Norris Excerpts

Wednesday 24th March 2021 Westminster Hall

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Mrs Miller. I congratulate my hon. Friend the Member for Blaydon (Liz Twist) on securing the debate, and on the case she made and her inspiring work championing those with rare diseases through the all-party parliamentary groups that she has chaired, currently the APPG on rare, genetic and undiagnosed conditions and previously the APPG for phenylketonuria. She set out a very strong case. She started by saying that we have been here before. If we followed some of the suggestions that she made, it would make sure that we are not here forever.

I want to pick up on the point around childhood screening. I hope the Minister will address the points on the report and the outcome of the strategy. That learning is really important.

It is hard not to be struck by the wide range of conditions that colleagues raised—NF1, raised by the hon. Member for Thirsk and Malton (Kevin Hollinrake); thalassaemia, raised by my hon. Friend the Member for Enfield, Southgate (Bambos Charalambous); motor neurone disease, raised by the hon. Member for Northampton South (Andrew Lewer); and muscle wastage, raised by my hon. Friend the Member for North Tyneside (Mary Glindon). The right hon. Member for Kingswood (Chris Skidmore) and the hon. Members for Gedling (Tom Randall) and for Darlington (Peter Gibson) raised PKU, as did my hon. Friends the Members for Neath (Christina Rees) and for St Helens South and Whiston (Ms Rimmer). They made important points around welfare reform and the accessibility of Kuvan.

I hope that the Minister will also cover the more general points around NICE, made by the hon. Member for Peterborough (Paul Bristow) and on the life sciences sector deal, made by my hon. Friend the Member for Cambridge (Daniel Zeichner).

The debate tells us that while rare diseases are rare individually, collectively they can affect up to one in 17, so they are not rare at all. That is more than 3.5 million people in the UK. We will all know someone with a rare disease and we will all have constituents for whom we need to advocate. Rare diseases can be life-limiting and life-threatening. As was mentioned, three quarters of them affect children, and sadly more than 30% of children with a rare disease die before their fifth birthday. That is a truly heartbreaking statistic. With that in mind, we welcome the Government’s plans, but I want to test some of the detail.

On the first priority relating to diagnosis, I am keen to know what the Government’s plans are in greater detail. Will the scope of newborn screening in the UK be increased? Many countries screen for more than 20 conditions; indeed, Iceland and Italy screen for more than 40. Here in the UK, we screen for nine. Will that be revisited? How do the Government intend to measure success in diagnosis more broadly?

On the second priority, awareness, we need to skill up our wonderful healthcare professionals. I find that, whoever I speak to—especially those whose diseases were not diagnosed at a very young age—lack of awareness often prevented diagnosis and access to the correct treatment and care pathways. A couple of weeks ago I met a wonderful group of people from the Pernicious Anaemia Society who do great work for people struggling with pernicious anaemia. As we went around the room—virtually, of course—it was striking that everybody had been diagnosed with something different at some point, and often multiple things, incorrectly. What will we do about that? Do the Government intend for rare diseases to have a larger part in undergraduate courses? Will they be part of continuous professional development for already qualified medical professionals? More importantly, because there is no new money with this strategy, from where will the resourcing come to increase training and develop additional tools?

I want to touch on priorities three and four on improved co-ordination and access to care treatment and drugs. I will lean less on the latter, which was covered by others, but, on priority three, well co-ordinated care is crucial to patients and their families. Last year, a Genetic Alliance UK report found that more than 70% of respondents were responsible for their own or a family member’s care. That means reduced work—or giving up work—and reduced education and other opportunities that the rest of us take for granted. We need a family-centred holistic and equitable approach to care. It would not change everything, but it would make their lives much better. Again, I know the Government have committed to that, but how will they measure progress?

Finally, on understanding the action plans, health is devolved and it is important that we take the different nations approach, but when do Ministers intend to hear back? When do they think they will hear back? What will we do to ensure that the care pathways are properly co-ordinated?

I will finish there to give the Minister a chance to address all the points raised. This has been a great debate, and hopefully those with rare diseases, who do not always think their voices are heard, will feel that today they have been heard and not missed or forgotten. If we come together, we can do something really special in this space.

Botulinum Toxin and Cosmetic Fillers (Children) Bill

Alex Norris Excerpts

Report stage & 3rd reading
Friday 12th March 2021 Commons Chamber

[Laura Trott (Sevenoaks) (Con) [V]]

I am very grateful to have reached this point today. This is an important Bill that will protect young people. We are short on time, so I will cover the substance of the amendments quickly. On amendment 1, consequential provisions are essential to ensure consistency with other legislation. On amendment 2, six months will enable the necessary changes to be made to the human medicines regulations under the consequential provisions that were just discussed.

[Alex Norris (Nottingham North) (Lab/Co-op) [V]]

I have been reassured by the answers given to the promoter of the Bill, the hon. Member for Sevenoaks (Laura Trott), so I do not intend to support either amendment or delay proceedings any further.

[The Minister for Patient Safety, Suicide Prevention and Mental Health (Ms Nadine Dorries) [V]]

I congratulate my hon. Friend the Member for Sevenoaks (Laura Trott) on the outstanding work that she has done in introducing the Bill, and I reiterate the Government’s support for the legislation. I believe that everyone has the right to make informed decisions about their bodies, but our role in Government is to support young people in making safe, informed choices where necessary to protect them from the potential harm that cosmetic procedures can do to their health. The increasing popularity of cosmetic procedures and the pressures on our young people to achieve this aesthetic ideal are well documented, and I believe that the Bill is an important step in putting those necessary safeguards in place.

I acknowledge the intentions behind the amendment tabled in the Public Bill Committee by the hon. Members for Swansea East (Carolyn Harris) and for Bradford South (Judith Cummins) to introduce a medical necessity test on the face of the Bill, and I hope that they have taken assurances from the explanation by my hon. Friend the Member for Sevenoaks of the work that she has done to explore this. The standards set by the General Medical Council already require doctors to consider the best interests of the patient to cover the ethical treatment of under-18s.

It has been an absolute pleasure to work with my hon. Friend to take this step towards greater regulation of the cosmetic procedure industry. I look forward to the Bill’s successful passage through the Lords.

--- Later in debate ---

[Ms Dorries [V]]

I have nothing further to say due to the shortage of time. I just reiterate that it has been an absolute pleasure to work with my hon. Friend the Member for Sevenoaks (Laura Trott) to take these steps forward to the conclusion of the Bill, and I commend it to the House.

[Alex Norris [V]]

I add my congratulations to the hon. Member for Sevenoaks (Laura Trott). I know that this has been no mean feat, especially during the current challenging times, and there has had to be a lot of patience, but it has been rewarded today. It is important that we act to protect our young people, especially with the pressures that they face. This is one of those great bits of legislation where I think if we stopped our constituents in the street and asked them about it, they would think it was already like this. This is a common-sense, practical and proportionate way to protect our young people, and we give it our full support.

[Sir Christopher Chope]

I, too, support this Bill. I notice that it was first canvassed as a possibility in the 2017 Conservative manifesto, which contained a commitment to ensure the

“effective registration and regulation of those performing cosmetic interventions.”

I had not realised the extent to which children had been able to access botulinum toxin and cosmetic filler procedures without a medical or psychological assessment; nor had I realised that practitioners did not need to be medically qualified to perform the procedures and that there are no mandatory competency or qualification frameworks related to their administration. Obviously, this Bill will help to avoid the potential health risks of such procedures, which include blindness, tissue necrosis, infection, scarring and psychological impacts.

It seems to me that my hon. Friend the Member for Sevenoaks (Laura Trott), so early on in her obviously very promising political career, has been able to identify an issue on which there is a lot of enthusiastic support. I congratulate and thank her for bringing the Bill forward, and I hope that it makes successful progress in the other place after its passage here.

Covid-19: Community Pharmacies

Alex Norris Excerpts

Thursday 11th March 2021 Westminster Hall

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is an honour to serve under your chairship, Sir Graham. I thank the hon. Member for Thurrock (Jackie Doyle-Price) for securing this important debate through the Backbench Business Committee, as well as for her leadership of the all-party parliamentary group on pharmacy. We are very lucky to have her commitment and her expertise in this area, and we can tell by how subscribed the debate has been and the high quality of it just how important community pharmacy is to Members of Parliament of all political persuasions. This is a very well-timed opportunity to talk about this important subject. As a Nottingham Member of Parliament, I know that Boots has been putting us on the map for 170 years now, so I am always very enthusiastic to talk about pharmacy.

The hon. Member for Thurrock made a number of important points, a couple of which I double-underlined. First, that sheer volume of work is indicative of the capacity, ability and creativity of our pharmacies, but also just how popular they are with our constituents. Secondly, she made a particularly important point about cross-funding, which is what pharmacy is built on at the moment. We have to get to a place where pharmacy, and the provision of what are, however we think about them, NHS services, is not cross-subsidised from selling Dairy Milks as well. That is the situation at the moment, and we need to do better.

The contributions from colleagues were really great, and it was really interesting to hear just how much commonality there is. I will start with my hon. Friend the Member for Coventry North West (Taiwo Owatemi), because of her special expertise in the NHS as an oncologist pharmacist. The points she made about how pharmacies stayed open and the financial pressures that they face today were shared by my hon. Friends the Members for Bootle (Peter Dowd), for Halifax (Holly Lynch) and for Birmingham, Selly Oak (Steve McCabe), but they were also echoed across parties, in the contributions of the hon. Members for Bolton West (Chris Green), for Harrogate and Knaresborough (Andrew Jones), for Isle of Wight (Bob Seely) and for Southend West (Sir David Amess), as well as by the hon. Member for Barrow and Furness (Simon Fell), who left us with the sobering reality that his community has lost a pharmacy during this crisis. That is a big gap in the high street.

The hon. Members for Henley (John Howell) and for Carshalton and Wallington (Elliot Colburn) made very good points about vaccinations, which I will draw on shortly. The hon. Member for Strangford (Jim Shannon), as ever, brought his insight from Northern Ireland, which I thought was interesting. In particular, his points about medicine supply remind us that, without the right supply, we can have all the best services in the world but we will be unable to meet need. Finally, I was delighted that the hon. Member for Winchester (Steve Brine), the former Minister, raised the issue of hub and spoke. This is going to be such a seismic change to pharmacy that is going to affect all of our high streets, and I will make a couple of points about that in my conclusion in a moment.



Throughout this pandemic, we have had many heroes working on the frontline—doctors, nurses, dentists and other healthcare staff, as well as others in other professions, such as teachers, retail workers and many more. They have all adapted to fight the impact of the pandemic on the frontlines. They have had to adapt the way in which they operate, as has everybody in some way, whether it is working from home, working with social distancing measures or being on furlough. We ourselves are meeting in an extraordinary Chamber today, and we are very lucky to have the staff to deliver this for us.

However, one profession that has carried on very much as normal on the frontlines is community pharmacy. My local chemist in Bulwell has been open for me to pop in to pick up essentials, to get face-to-face advice and healthcare, and to pick up prescriptions. Now he is starting up as a vaccine centre—Raza, we are very lucky to have you. That has been the case all over the country, and although the hon. Member for Thurrock and I have obviously had similar briefings on this, I will reiterate the numbers, because they are really something. As well as dispensing the annual 1 billion prescription items, pharmacies have delivered healthcare advice at a rate of more than 48 million consultations a year. More than 600,000 people have sought advice from English pharmacies on medical symptoms each week, with a further 185,000 regularly needing help with an existing medical condition.

Pharmacies are acting as a buffer for the NHS, sharing the load when it has been most desperately needed. Thanks to community pharmacies, half a million GP appointments and 57,000 A&E walk-in centre appointments every week have been avoided. This has been a massive help for local communities and kept our NHS going. We should feel very fortunate to have these services available to us throughout the pandemic, but we must therefore show our gratitude in a meaningful way.

On 8 March last year, the Chancellor said that the NHS would have whatever it needs. Well, like the hon. Member for Harrogate and Knaresborough (Andrew Jones), I count community pharmacy very much as NHS—absolutely—and they should be covered by this too. That extra work and the extra costs of providing a safe environment have cost them money, and we have an obligation to meet those costs. That is not just my view, but the view of the Prime Minister on 10 February at the Downing Street press conference. He promised reimbursement as soon as possible, but pharmacies are still waiting. Those must not be empty words, to go along with empty claps for carers who have done so much for us but whose justice is a real-terms pay cut. We cannot see that happen again.

In a written answer to my hon. Friend the Member for Luton North (Sarah Owen) published on Tuesday, the Minister said that negotiations about this issue are ongoing. I hope the Minister can update us on progress and give us some good news. I am very mindful that, whatever we think about the recovery in dentistry, it was not satisfactory that negotiations between NHS England and the dentistry negotiating bodies collapsed before Christmas, meaning that the new arrangements were imposed on dentists. That has left a lot of ill feeling and anxiety. We should not repeat the same in pharmacy.

In that reply, the Minister also discussed advance payments as part of Government support for pharmacy, but we know now that the Government want those emergency cash-flow loans to be paid back. We should not be selling this as money given to the sector, when it is indeed a loan. That repayment of £370 million—an average of £32,000 per community pharmacy—is a real burden. I would be keen to know from the Minister what assessment she has made of the impact, because this could well harm patient care. It is impossible not to see, certainly because of the elegance of the figures, that that is exactly 1% of what we will spend on Test and Trace. Given what the Public Accounts Committee said about the effectiveness there, community pharmacies, which are getting a 100th of the funding, have probably had 100 times the impact.

This has been an ongoing situation in recent years. Pharmacy finances were marginal prior to this pandemic. A study by the National Pharmacy Association last year found that 28% to 38% were in financial deficit already, that this number would more than double without funding changes and that we have lost 400 pharmacies since 2016—disproportionally in the poorest communities, as the hon. Member for Barrow and Furness said. That has a significant impact on communities: patients travelling further, people waiting longer for appointments with overstretched GPs, and people suffering in pain with their minor illnesses and ailments or overloading our A&E departments. Communities lose the benefits of prevention, tackling health inequalities, early identification of disease, tackling obesity and other health conditions, and, of course, the vital administration of vaccinations.

Now is a good time to talk about the covid vaccine supply. With vaccine supply doubling this week, and with community pharmacy being so keen to do more, could the Minister tell us how we might get up from the few hundreds to perhaps the majority of the 11,500 pharmacies in England being part of the programme?

I want to finish by talking about hub and spoke dispensing. I am not against it, or particularly in favour of it. It still seems a bit like a solution in search of a problem to solve. I have met with pharmacy big and small—pharmacy representative bodies, independents and massive multiples—and everyone is always pretty nonplussed by it. It is never in the top few things that they want to talk about. That gives me some cause for concern. There will be thorny issues around the regulatory framework relating to the Medicines and Healthcare Products Regulatory Agency and the General Pharmaceutical Council over issues such as refrigeration and those differences that will need to be ironed out. Similarly, there are issues about finances and where risk and reward relating to the dispensing margin will lie in the system.

Despite the ambivalence on hub and spoke generally, there is a lot of interest in how it is going to proceed. I echo much of what the hon. Member for Winchester said. I hope the Minister will say today when we can expect the consultation on hub and spoke and critically— I have been asked this question multiple times—whether the Government see it happening before the NHS Bill, at the same time as the NHS Bill or after the NHS Bill. I understand that information sometimes cannot be shared, but knowing that would be of great importance to organisations that are planning their responses to both things and that want to know what their priority should be.

The Minister has made welcome commitments about consultation, but what is coming back to me from the sector is a desire for a really deep, proper technical consultation about this. I hope she can commit to that, because this is one of those strange circumstances where some people are already doing these things: we can build on their expertise and understand what hub and spoke does and does not do.

Pharmacy is a critical part of our health service. It has delivered for us in the most testing of times. We do not want to repeat the mistake that was made with dentists. We do not want broken commitments such as those that have been made to NHS staff. Pharmacy deserves better than that. I hope that today we can hear good news from the Minister about negotiations and get a sense of where we are going in the future.

Covid-19 Vaccine: Take-up Rates in London

Alex Norris Excerpts

Tuesday 9th March 2021 Westminster Hall

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Sir Christopher, and it is a pleasure, too, to be back doing Westminster Hall. These debates are a crucial way of airing important topics. I am grateful to the staff for the clearly extraordinary efforts they have made to make this happen. Facing a wall of pictures of one’s colleagues in this way is possibly the closest I will get to being on “Saturday Night Takeaway”, so I am grateful for that, too.

I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing this debate and his leadership of it. His argument was very much based around three themes: data, supply and the impact on take-up in diverse and poorer communities. It is remarkable that all the contributions that followed basically fitted within that framework. It is clear that this is a strongly held view and a commonly shared experience in London, so I hope the Minister will address the points raised. I was particularly interested in what my hon. Friend said about the catch-up point and using local authorities to contact those who have chosen not to take up their vaccine yet, or who have been unable to do so, and encourage them to do so. I know that, as a former leader of a council, he shares my enthusiasm for the ability of local authorities to cut through and connect with their constituents. That is a very good model and is certainly one that has succeeded for us in Nottingham.

Just to pick up briefly on some of the things colleagues have said, my hon. Friend the Member for Westminster North (Ms Buck) made the point about granular data, and as my hon. Friend the Member for Hammersmith says, we always want more data, but it is for a purpose. I think it is really clear that we need granular data about the vaccine because, as my hon. Friend the Member for Ealing Central and Acton (Dr Huq) said, we started off thinking this would be a great leveller, but actually in terms of both covid deaths and vaccine take-up, we know that it is not a great leveller and the experiences are not common to everyone.

That chimes very much with the point that my hon. Friend the Member for Hornsey and Wood Green (Catherine West) made about the tale of two cities, which is a very elegant way of explaining it. Similarly, my hon. Friends the Members for Bethnal Green and Bow (Rushanara Ali), for Putney (Fleur Anderson) and for West Ham (Ms Brown) all talked about the inequalities that exist within London, and that difference between inner and outer London. We have to match our policy response to that. In that spirit, the point that the hon. Member for Harrow East (Bob Blackman) made about different ethnic minorities and not grouping them collectively, which I will talk about in a second, was very interesting, too.

The critical point that my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh) made about access was so well put. It can be easy to say, “Hang on a minute, we just know that in certain groups of the population take-up is lower and that is kind of how it is.” But, as the care law she mentioned says, if that is then overlaid with access and where facilities are, we are baking in and causing that conclusion ourselves. Again, I hope that is something that can be addressed.

All colleagues were at pains to talk about good news, and I think that is right. It is wonderful that over 22 million people have now had at least one dose. That is about one in three of all of us in the UK, and about 40% of the adult population. People are getting those first doses at a rate of about 300,000 a day, which is a real success and an extraordinary effort by all involved. I am grateful to the Minister for his leadership and for his constant availability to me and to all colleagues, and, of course, to the staff who have delivered this. It is working; we are seeing a decline in hospitalisations and cases. Of course, lockdown is a significant part of that, but the vaccination effect is a major part. It is wonderful news and provides that light at the end of the tunnel.

Today’s spotlight on London reveals a challenge for our capital, but also other similar communities. While the regional data is a little bit older—about 10 days’ old—in London just over 2 million doses have been delivered, which is about 29% of the adult population, so a significant drop from the 40% nationwide. My hon. Friend the Member for Hammersmith made it very clear that he did not want this to be special pleading. It is not special pleading; there is something different going on and therefore we must react in a different manner. That is true among boroughs, too. In Tower Hamlets, with the highest poverty rate in the capital, by my maths 16%—the BBC have it at 14%—of the adult population have had their first dose. In Newham it is 20% and this is the same across the capital. With Bromley, where there are some of the lowest rates of poverty, the percentage is close to 40% and in Richmond upon Thames the figure is about one in three.

London is not alone. Vaccination rates are lowest in urban areas in general, with Birmingham and Manchester also reporting lower take-up than the rest of England. These regional variations really matter and have a significant impact on local health systems. In London, the rate of decline in covid hospital patients is now the slowest in the country, with a weekly rate of decline of just 15% compared with twice that in the midlands, where I live, and nearly 40% in the south-west. That means more people in hospital suffering from covid but also less capacity for other treatments. I noted that in January, King’s College Hospital NHS Foundation Trust had to cancel all priority cancer operations—that is all those that need to be carried out within 28 days. I am keen to know what assessment Ministers have made of the impacts of such decisions and what plans there are to try to catch up.

Yesterday, YouGov released polling that might help pick away at some of the disparities. In the study, 19% of people who categorised themselves as black said they would not take a vaccine and 18% who said they were Pakistani said the same. That is compared with 6% of people who look like me or 5% who said they were Asian. Again, as the hon. Member for Harrow East demonstrated, that is a reminder of the limits of the term BAME as a collective, and that we should not lose the individual experiences of different communities by using that term. It should give us all cause for concern, because those groups who have said they are less likely to take the vaccine are also the groups who are most likely to have died from covid. That is a sobering paradox.

I know there is a lot of interest in this issue, so I would say for people who are watching, of course it is okay and it is natural to be hesitant about what you put into your body. However, we see all the misinformation that is circulated, whether on WhatsApp or online, and it is frustrating because much, if not all of it, has simple explanations. If someone watching today is unsure, I hope they will ask their doctor, their pharmacist, their Member of Parliament, or their faith leader—whoever they trust, please will they ask those questions?

With supplies set to double and, hopefully, able to tackle many of the supply issues that colleagues raised, we are at a crossroads. Will the inequalities widen or can we to use this moment to close them? I have a few questions that I hope the Minister will address this morning. What different steps are being taken to mop up segments of cohorts that the roll-out has moved past? What is being done to provide more local vaccination sites in communities that are being left behind? I am conscious that often, in politics—we all know this—sometimes we cannot change the message, but we can change the messenger. A community pharmacy, for example, is a trusted alternative in the heart of every community, on every high street, which can help reach a different group of people. How can we use those to try to close this gap? On a similar note, in Nottingham, we are using mosques as vaccination sites now. Are similar approaches being supported in the capital?

Before I conclude, I want to make a point about the staff delivering this tremendous vaccination programme. Their efforts have been incredible and are inching us out of this awful period, a day at a time. It is shameful that their reward for this is a real-terms pay cut and then to be told, as they were over the weekend by a Minister, that they are lucky to be getting anything at all.

Similarly, local authorities are playing a pivotal role in the logistics of the roll-out, as they did in resurrecting test and trace. Their reward is an even greater real-terms pay cut. As well as being a shoddy way to treat these people, this is also bad for the collective, as we seek to rebound from the impact of covid. Where do these healthcare assistants or leisure centre cleaners spend their money? It is in our local economies.

We have just finished a decade of disaster economics and all it did was lead to anaemic growth and an erosion of living standards that has weakened our communities, which has meant that the poorest communities were most vulnerable to covid. The Office for Budget Responsibility says that we have the same ahead of us again. It is crucial that we do not keep making the same mistakes. Simply put, those who clapped on their doorstep should not be voting to cut NHS pay this evening.

There is much to be pleased about with the vaccine roll-out, and it is giving the nation hope. However, we are seeing widening inequalities among already unequal groups. We must act now to tackle that.

Oral Answers to Questions

Alex Norris Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Jo Churchill]

I thank the hon. Gentleman for his question. The latest official data for December, as I say, suggests that two-week wait GP urgent referrals were 7% higher than for the same month last year, 62-day GP urgent referrals were 6.7% higher, and urgent referrals for cancer were 151% higher than in April, showing the month we were most impacted. As I say, we are straining every sinew to make sure that cancer services not only recover but go on and are better to deliver more care for patients.

[Alex Norris (Nottingham North) (Lab/Co-op)]

Going into this pandemic, staff shortages were already causing increased waiting times for cancer treatment. Despite being short-handed, our wonderful NHS cancer staff have done a heroic job maintaining services while fighting this virus, but given the size of the backlog, cancer services will need to go above and beyond pre-pandemic levels for a significant period of time—straining every sinew, as the Minister says. They need extra resources to be able to do so. Next week’s Budget must contain these resources. Has the Minister asked for them?

[Jo Churchill]

Cancer has been prioritised with funding throughout the pandemic. It is, as I say, a key priority. Not only have we invested in radiotherapy equipment to the tune of some £325 million but there is a £160 million initiative to provide covid-friendly cancer treatments that are safer for people. We still have the same objective in the long-term plan to diagnose more cancers early, and appropriate funding, such as the billion pounds targeted at the NHS to drive down cancer backlogs and to ensure that people can access care, is part of that strategy.

Covid-19

Alex Norris Excerpts

Monday 22nd February 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to close this debate for the Opposition.

There have been very good contributions on both sides of the House; I cannot cover them all, but want to highlight a few. First, on this side of the House, my hon. Friends the Members for Easington (Grahame Morris), for Pontypridd (Alex Davies-Jones), for Worsley and Eccles South (Barbara Keeley), for Kingston upon Hull West and Hessle (Emma Hardy), and for Bethnal Green and Bow (Rushanara Ali) made excellent points about the inequalities in our country that covid has highlighted, and I will cover that in my contribution, as I will isolation pay, which was mentioned by my hon. Friends the Members for Weaver Vale (Mike Amesbury) and for Wirral West (Margaret Greenwood).

Excellent points were made about exams and education by my hon. Friends the Members for Newport West (Ruth Jones) and for Birmingham, Selly Oak (Steve McCabe). There was welcome cross-party consensus about the need to extend and improve business and tourism and travel support from the hon. Member for Cumbernauld, Kilsyth and Kirkintilloch East (Stuart C. McDonald), my right hon. Friend the Member for Warley (John Spellar), my hon. Friend the Member for Warwick and Leamington (Matt Western), the hon. Members for Bolsover (Mark Fletcher) and for Totnes (Anthony Mangnall), the right hon. Member for Elmet and Rothwell (Alec Shelbrooke), and the hon. Members for Windsor (Adam Afriyie) and for North Devon (Selaine Saxby).

Colleagues on the other side of the House also made important points about the NHS: the hon. Members for Runnymede and Weybridge (Dr Spencer), for Congleton (Fiona Bruce), and for East Surrey (Claire Coutinho), as well as the hon. Member for Ipswich (Tom Hunt), latterly regarding children with special educational needs.

It is a feature of today that the Prime Minister has rather stared down the caution to the wind group on his own Back Benches, and there were contributions from some of those colleagues—the hon. Member for Wycombe (Mr Baker), the right hon. Member for North Somerset (Dr Fox), the hon. Members for Bolton West (Chris Green), for Broxbourne (Sir Charles Walker), for Hazel Grove (Mr Wragg), for Mid Derbyshire (Mrs Latham), for Thurrock (Jackie Doyle-Price) and for North East Bedfordshire (Richard Fuller)—again with some sort of agreement, but generally pointing at the fact that they do not agree, and frankly they have been wrong the rest of the way so what is one more to complete the set? Finally, the hon. Member for Rushcliffe (Ruth Edwards) made the excellent point that a new, improved and exceptionally promising vaccine is being developed at the University of Nottingham, showing once again that things are just that little bit better in Nottingham.

On the day on which the Prime Minister has outlined the future road map, there is rightly a sense of optimism, but in that context we cannot forget the terrible toll this last year has had on our country. Across the UK, over 120,000 people have lost their lives to covid-19; that is a tragically high number of lost loved ones, and the impact is felt everywhere across every community. That is an awful lot of empty places at the table and lots of grief that will last a lifetime.

The roll-out of the vaccine is a beacon of hope and a source of national pride. It shows once again the strength of our national health service. I thank everyone involved in that programme—we are very lucky to have them—and it stands in contrast, I am afraid, to the failures of the test and trace system, which has had to be propped up in recent months by the interventions of local authorities. These two events together show us that a decade of selling off public services is not what we needed in the past 10 years and is certainly not what we are going to need in the next 10 years.

However, even following a long statement and a four-hour debate there remain a few points to resolve. The Opposition have a number of constructive ideas that we think would strengthen the nation’s efforts, and I hope the Paymaster General will be able to address them in her closing remarks.

Sick pay and isolation support need to be fixed. Without that, the Government’s plans to roll out millions of lateral flow tests as we reopen will be useless. The news that only three in 10 people who have a positive diagnosis self-isolate should scare us all; imagine how much more quickly and effectively we could manage this virus if that figure was 100%, or even somewhere in the middle. Again, the lack of news today from the Prime Minister on this was a glaring miss and a significant hole in the fence. I hope that there might be more news from the Paymaster General.

However, that lack of support has been the reality for all those 3 million people who have been excluded from the Government’s financial support all year. It is worrying, surprising and quite hard to understand that the Chancellor has still to heed their calls and make the simple creative amendments necessary to plug the gaps in these schemes and relieve their anxiety. I understand that as these schemes needed to be created at pace there may have been gaps, but I cannot understand, a year on, why we have not acted to close them. Again, the message was wait for the Budget, but they have been told, “Demand, demand, demand” for a long time. They have real-life costs to meet and are stretched to their limits, so I hope that there will be good news for them shortly.

I hope the Minister can clarify something for indoor hospitality. We are told that that will be opening up, but not before 17 May. That will be a month after business rates resume and two weeks after furlough. Will there be news for them about how that gap will be bridged?

Of course, the big and welcome news is the reopening of schools. That is a collective priority across this place. We now must use the time available to do this as safely as possible. It is a shame that the Government resisted our calls to vaccinate teachers; however, in the absence of that, will the right hon. Lady at least commit to working with the sector to deliver a credible plan for getting all the pupils back into school, with mass testing, better ventilation, Nightingale classrooms where possible, and reviewing financial support for covid adaptations? Our schools have done an incredible job throughout this pandemic. They have never actually shut—they are open as we speak—and they have had to do that by being very creative, but we should not ask them to be creative alone; in order to get things back to normal we have to help them. Those are immediate steps that, if taken, would lead to a significant improvement in our country’s attempt to beat this virus, and I hope the right hon. Lady will take them in the spirit intended.

Multiple references were made to the alarming news that the Health Secretary broke the law earlier in the pandemic. The Prime Minister seemed to have no concern about this, which in itself is quite worrying. I will not rehash that point, but I will ask the Paymaster General, as a minimum, in the interests of decent government and in line with British values, to commit to publishing the details of the VIP lane schemes and how they are used. The Prime Minister has total confidence that everything is appropriate, so I think it might be time to share that information so that we might all have some of that confidence.

As we seek to safely navigate these next few months, we have to learn the lessons not only of the past 12 months but of the previous decade. Covid has thrived on the deep inequalities and injustices in our country. Building back is not what we need; we need to be genuinely different. The pandemic has shown that profound inequality is not just bad for those on the sharp end of it, but bad for everybody. It has shown too that some communities in our country have thrived while others have struggled to get by. People who live in one of the poorest communities are twice as likely to die, and people from minority ethnic groups have an increased risk of 50%. We could also say that about their access to decent housing and about whether they have to leave their community to access better employment chances. These inequalities exist across our lives, and that is the legacy of 11 years of choices made by this Government. These groups have paid the real price for the 2008 economic crash, which they did not cause. As we face the future and choose what comes next, we must not repeat those mistakes, so I hope to hear from the Minister today that there will be a break from the past decade and that that will be replicated in the upcoming Budget.

Covid-19 Vaccine Update

Alex Norris Excerpts

Thursday 4th February 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

Thank you, Madam Deputy Speaker. I am grateful to the Minister for advance sight of his statement and for his kind words about my birthday. Of course, the gladdest tidings is the news that more than 10 million people have received their first dose. Once again, our incredible national health service has delivered for us. I visited a site in Nottingham earlier in the week, and that team of the NHS, armed forces, local councils, volunteers and many more coming together was an uplifting and incredible sight.

We welcome today’s announcement about the new clinical trial. It is clear that we will live with covid-19 and its mutations for a long time, so this is the best way to get out in front of it. We were glad also to hear the study results regarding the Oxford-AstraZeneca vaccine reducing transmission and maintaining protection over 12 weeks. As the Minister said, it is clear that vaccines are the way out of this pandemic. Daily cases are beginning to fall, but it is vital that the Government do not repeat previous mistakes and take their foot off the gas just as things look to be getting better. Could the Minister update us on whether he expects similar trial data to be published for the Pfizer vaccine?

The Government seem to be on track to deliver on their promise of vaccinating the top four Joint Committee on Vaccination and Immunisation priority groups by the middle of this month. We really welcome that, and I commend the Minister’s work in that regard, but in a spirit of co-operation, I need to press him on a couple of points about what comes next.

First, regarding data, we are all concerned about the reports of lagging take-up among black, Asian and minority ethnic communities, as well as poorer communities, and I associate myself with the comments about the brilliant work done by our colleagues to fight that. We know that these groups have been worst affected by the pandemic, and we need them to take up the vaccine, but I am conscious that much of what we hear is based on anecdotal stories, rather than hard data at a community level, split by ethnicity. Can the Minister say what data he has on that and when colleagues can get council ward-level data, so that we can all be part of the effort to drive up take-up? As the first phase is coming to an end, can the Minister update us on the number of care home staff who have received their first dose and perhaps what the plan is to encourage those who have not done so to take it up on reflection?

When we get to the beginning of April, those who have had their first dose will be expecting and needing their second one. Can the Minister give an assurance that there will be enough supply to ensure that everyone who is due their second dose gets it, as well as, obviously, to manage those who are due their first? The Foreign Secretary would not offer that commitment on behalf of the Government recently. I hope the Vaccine Minister will be able to.

Colleagues have raised with me the fact that constituents who have received a national letter and called 119 to book are not routinely being offered local primary care network-based options. Can the Minister confirm that that should not be the case and that he would welcome hearing examples of where that is happening so that we can change it?

The Opposition fully supported the Government in prioritising those at greatest risk of dying—those in the first four categories—but as we move to categories 5 to 9, it is reasonable to ask the JCVI about including key workers. Data has shown that those who work closely with others and are regularly exposed to covid-19 have higher death rates than the rest of the population. By prioritising those workers alongside the over-50s and 60s, and people with underlying health conditions, we can reduce transmission further, protect more people and keep the vital services that they provide running smoothly, which includes reopening schools. Putting the politics of this to one side, we raised this suggestion over a week ago now. Will the Minister say whether he has had those conversations with the JCVI, or whether he will at least commit to asking it to look at how that suggestion might work?

It is HIV Testing Week. Those living with HIV are in category 6. If their doctor knows their HIV status, they will have their opportunity as planned. However, some choose, perfectly legitimately and for some profoundly important reasons, to access their healthcare through other means, such as an HIV clinic. Their doctor might therefore not know their status and they may well be missed. In this specific case, will the Minister commit to looking at a possible workaround? Allowing HIV clinics to connect those individuals directly would be one way, but we would support any effective way of doing that.

Finally, given that it is World Cancer Day, what consideration has the Minister given to vaccinating household members of the clinically extremely vulnerable, to give another layer of protection to blood cancer patients and other CEV people, an argument strongly supported by the reports that transmission is reduced by these vaccinations?

To conclude, this programme really is the light at the end of the tunnel. Our NHS has delivered, and we must support it to continue to do so by making the right policy decisions.

[Nadhim Zahawi]

I am grateful to the hon. Gentleman for his constructive way of engaging with the vaccination deployment programme. On trials, we have two running currently, both with Public Health England. The Vivaldi trial is testing residents of care homes, who were in category 1 of the JCVI categories. The second is Siren, which is testing frontline health workers, who are in category 2. As Jonathan Van-Tam, the deputy chief medical officer, has said, we will know the infection and transmission data from those trials in the next few weeks. Of course, the Oxford data is very promising—it needs to be peer reviewed—but those trials will also capture the Oxford vaccine, because obviously that came on site in January.

On the priority list, the JCVI looked very closely at both black, Asian and minority ethnic and, of course, other considerations, including by profession, and came down clearly on the side of age as the deciding factor in people’s risk of dying from covid. This is a race against death, hence the nine categories, which we are going through, and we will continue to do so. A number of professions will be captured in those categories. Of course, those with extremely severe illness will be captured in the category for the severely extremely vulnerable, and others will be captured in further categories down the phase 1 list.

I certainly think it would be wrong to change the JCVI recommendation, because categories 1 to 9 account for 99% of mortality. When we get into phase 2, we would welcome a debate and, of course, will ask the JCVI about including professions such as teachers, shop workers and police officers, who through their work come into contact with much greater volumes of the virus than others do, and it will advise us accordingly.

On BAME and ethnicity, the NHS now collects such data, and we are publishing it. We are doing an enormous amount of work not only across Government, but with the NHS, to ensure that we bring in local government so that we can begin to share data. I would welcome us working much closer with local government and the NHS so that we can identify, to the individual level, the people we need to protect as soon as possible.

I put it on the record that I want clinical commissioning groups to share data with MPs. Several colleagues—[Interruption.] Including you, Madam Deputy Speaker; I can see you nodding away vigorously. CCGs should and must engage with local politicians, because MPs get a lot of emails and telephone calls from concerned constituents in the top four most vulnerable categories. Of course, the NHS has plans to publish CCG-level data very soon.

As for care home staff, we had a fantastic response through the care home vaccination programme, which is category 1, and we continue to do more with staff to encourage them to be vaccinated, because we make four visits into care homes. Visit one is for the first dose, visit two is to try to vaccinate those who may have been infected the first time, because people cannot be vaccinated until after 28 days, visit three will be for second doses, and so on. We are getting greater traction with care home staff, but the hon. Gentleman is right to mention that. There is a big focus on helping them to go to hospital hubs and, of course, their primary care networks.

On the second dose, everyone who has had a first dose of Pfizer will get a second dose of Pfizer within that 12-week dosing period. That will begin in March in the usual way that the NHS does vaccinations. Everyone who has had a first dose of Oxford-AstraZeneca will get a second dose of Oxford-AstraZeneca within 12 weeks as well.

The hg is right to ask about people wanting the option of going either to a national vaccination centre or to the PCN. If right hon. and hon. Members have particular cases, please point them to us and we will do everything we can to ensure that that is facilitated.

The hon. Gentleman rightly highlighted HIV clinics. I will take that matter away and see whether there is a workaround for those who want to have that information remain private from their GP. We will see what we can do.

This is World Cancer Day, and there is now real excitement in the scientific community in the UK about the messenger RNA vaccine, because people can begin to think about vaccines for cancers as well. However, the hon. Gentleman raises an important point about those who care for the clinically extremely vulnerable, and we want to ensure that we deliver the JCVI phase 1 and then very quickly reach the rest of the population.

Medicines and Medical Devices Bill

Alex Norris Excerpts

Consideration of Lords amendments & Ping Pong & Ping Pong: House of Commons
Wednesday 27th January 2021 Commons Chamber

To finish, the Bill has gone through with a great deal of well-informed, well-intentioned debate and changes. I am pleased that the constructive discussions that we had before it left us have continued. The other place has brought something back to us that I hope we can agree delivers for UK patients and the UK life sciences industry, which is vital and enables us to build a stand-alone regulatory system for the UK for the future and one that has patients absolutely at its heart.

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to resume proceedings on this Bill, and we are now very close indeed to the finish line. For us and, I think, for all Members, this has always been about patient safety and about making sure that people of the United Kingdom have the best access to medicines and medical devices. The exchanges so far have been of a high quality in both content and tone. As the Minister has characterised, the Bill started as a skeleton, but it is certainly thin no more. There is much in there that will make a significant difference to our country.

I have been proud to take the lead for the Opposition since the Committee stage, and I thank my predecessor in the earlier rounds, my hon. Friend the Member for Washington and Sunderland West (Mrs Hodgson), for setting the tone for us. I am also grateful to the Minister for her level of engagement and for giving us generous access to her officials and the Government in general throughout this process. The stages of the Bill through the Commons were of a high quality, and clearly considerable progress has been made in the other place, which we consider today. 

I welcome the Government’s concessions on the Bill, and I congratulate my colleagues in the other place, particularly Baronesses Thornton and Wheeler and Lord Hunt, on their hard work on and dedication to securing these vital amendments. That hard work will ensure that the Bill will promote patient safety and privacy, as well as proper consultation and scrutiny. I might even be mischievous enough to say that I tabled a number of these amendments in Committee, but I was unable to get them accepted at that point. I am therefore delighted to see them accepted at this stage.

We will support the Lords amendments where the Government have indicated their support, and where they have tabled amendments in lieu we will accept those as a reasonable compromise. I therefore do not intend to divide the House this evening. Similarly, I do not intend to speak to all 56 amendments, but I might cover a few of the pertinent major themes.

The Minister was right to say that in previous exchanges I challenged her to demonstrate that safeguarding public health and, critically, patient safety was uppermost, and that is reflected in Lords amendments 4 and 5. I knew from the outset that that was the Minister’s intention, and I think the amendments improve and make the Bill clearer, as well as future-proofing it for future Ministers and—dare I say it?—future Governments. It is important that that was done, and we appreciate that.

On Lords amendment 1, it is welcome that the Government have heeded the second recommendation in the Cumberlege review, and legislated for an independent Patient Safety Commissioner. We were lucky to have a review as seismic as that one, which crystallised many decades of suffering and pain for lots of people who had been crying in the darkness and ignored for a long time. That report was a cathartic moment, but it cannot remain just a report, and the fact that we had primary legislation that was the perfect vehicle for the independent Patient Safety Commissioner was a real blessing. I am pleased we were able to find a way to include that.

[Mark Tami (Alyn and Deeside) (Lab)]

Does my hon. Friend agree that many of the people he said were in the dark often felt that they were on their own, and it was only when groups were set up that they realised otherwise? Many doctors were telling them there was not a problem.

[Alex Norris]

Yes, and I met as many of those groups as I possibly could. That commonality in the story of people often being ignored and left alone, or told that they were wrong, lying or making it up, added insult to the significant injuries that they had suffered. That collective action was a big part of people getting their salvation and securing that review which then vindicated them so strongly. That is so important. The presence of the independent commissioner will ensure that patient wellbeing is prioritised and there will be a voice for those citizens. That is an essential step forward to ensure that our wonderful national health care system is responsive and hears challenging messages, even if perhaps it does not always want to. That will give people a voice, which is important.

We welcome the amendments on transparency and accountability, and I pay tribute to the hon. Member for Central Ayrshire (Dr Whitford) for her leadership at other stages of the Bill. Frequent reporting will ensure that the system is monitored and accountable, which is good. With Lords amendment 31 the Bill will provide for the establishment of the independent statutory device expert advisory committee, to ensure that the regulation of devices is transparent, and that decision making is better structured and more accountable. That can only be a good thing. Making urgent regulation subject to positive affirmation, as in amendment (a) in lieu, will allow the regulatory system to respond to changing situations, while ensuring proper accountability and scrutiny.

As the Minister says, amendment (b) in lieu sweeps up and replaces the Lords amendments that relate to sunset clauses and clauses on the super-affirmation procedure. It was not quite what I was after, but I think it is a pretty fair deal. It is certainly more than I thought I would get—perhaps I should not say that before the amendments have been made. As a former trade union negotiator, I always thought that going in and getting 60%, 70% or 80% for our members was a pretty good outcome, so we will certainly take that. The five-year review is a good thing as it gives the Government more time—those arguments were well made by the Minister, and on reflection I think they are right.

At the root of this, the Secretary of State is acquiring significant powers, and it is right to review that as well as to have scrutiny down the line, and an opportunity for right hon. and hon. Members to determine whether the system might need consolidating or restructuring. That is vital to improve the quality of the regulatory system. I am really pleased that we got there, and with where we have arrived. I welcome the opportunity in Lords amendment 8 for the use of human tissue in medicine to be further regulated, thus preventing the NHS from being compromised by the trade in harvested organs, including those from ethnic minorities and political prisoners in authoritarian states. My hon. Friend the Member for St Helens South and Whiston (Ms Rimmer) will be pleased with that inclusion. It is her hard work that made that happen, and I commend her for it, as she battled away. She feels strongly about this, and what has come out is very positive indeed. As I say, I commend her greatly for that.

Covid-19: Dental Services

Alex Norris Excerpts

Thursday 14th January 2021 Commons Chamber

[Alex Norris (Nottingham North) (Lab/Co-op)]

Thank you, Mr Deputy Speaker. I join colleagues in commending my hon. Friend the Member for Putney (Fleur Anderson) for securing this important debate. Timing is everything in politics, and this is well timed indeed. I will cover the point that she made about imposed targets shortly, but I do not want to miss the contributions that she made about health inequalities and cancer, which I thought were really important.

I do not think that it is a great surprise that there was cross-party coverage and, frankly, a lot of consensus. Concerns about the targets were expressed by my hon. Friends the Members for Portsmouth South (Stephen Morgan) and for Bradford South (Judith Cummins), the hon. Members for Loughborough (Jane Hunt) and for Don Valley (Nick Fletcher), my hon. Friends the Members for Luton North (Sarah Owen), for Luton South (Rachel Hopkins) and for Sheffield Central (Paul Blomfield), and the hon. Members for North Norfolk (Duncan Baker) and for Totnes (Anthony Mangnall). I must say, though, that a spirited case for the defence was made by the hon. Member for Mole Valley (Sir Paul Beresford).

I was glad to hear dental labs brought up by my hon. Friend the Member for Brent North (Barry Gardiner). I will address them myself, but they are too often lost in this conversation. I also thought that important contributions were made by the hon. Members for North West Norfolk (James Wild), for North Cornwall (Scott Mann), for Waveney (Peter Aldous) and for Edinburgh West (Christine Jardine) about the pre-covid status quo not being what we should aspire to. Again, I shall address that myself.

Dentistry, like every industry, has had to battle its way through this pandemic—closed at first, worried for jobs and livelihoods, reopening desperate to address growing need, and innovating to do that as safely possible in challenging circumstances. We should be very grateful for the work that dentists and their staff have done and are doing, but even with that work 20 million appointments were lost between March and November. That is a backlog that we will live with for many years.

Although the dental profession has adapted well to provide urgent care through covid, the crisis has highlighted the need to do things differently and to do things better. As we rebuild post covid, we have a unique opportunity to not return to business as normal but instead shift the focus of dentistry in this country from the short term to the long term, and from the reactive to the preventative. I strongly believe that a more prevention-focused approach is something that many dentists across the country want for the benefit of their patients. I know that the chief dental officer is a big advocate of prevention being at the heart of NHS dentistry.

[Jim Shannon (Strangford) (DUP)]

I spoke to the hon. Gentleman beforehand. There are some 6,000 registered dental technicians who provide dental implants such as crowns and bridges to 80% of UK patients. It is predicted that 1,000 of them will lose their jobs by July 2021. If that happens, we will be unable to address the issue of dentistry in the future.

[Alex Norris]

I completely share that perspective, and I will cover that in my final points.

On prevention, I hope that the Minister will make a commitment that the Government want to move towards a preventative model. If she does that, the Opposition will work with her to deliver it.

Of course, there is a more immediate issue at hand. On 17 December, as colleagues have said, NHS England imposed new activity targets on NHS dental practices, which took effect at the beginning of this month. At the beginning of the pandemic the Government were right to step in and offer dentists their full contract for a much smaller proportion of their usual activity. We supported that then and we still do. It is also right to seek to increase capacity to help tackle the backlog, and avoid NHS patients being pushed into the private sector. However, what has followed is a mess, with negotiations between NHS England and the General Dental Practice Committee breaking down, and so targets being imposed on the sector, with practices needing to hit 45% of their pre-pandemic activity targets in the first quarter of this year.

Allowing negotiations to break down like that, rather than intervening to ensure that an agreement was found, is a failure of leadership by this Government. Where have they been on this issue? Whether we think that dentists are right or wrong in their perspective, and whether we think the figure should be 45%, 55% or 35%, surely we would agree that an imposed target is a failure of leadership.

It simply will not do that such a crucial part of our health service has working arrangements that discomfort it so greatly. NHS England would never pursue a work pattern that is dangerous, but there are reasonable questions about how practical it is. It is not just dentists raising that; we have had public pronouncements of concern from the faculty and the colleges. There should have been a negotiated deal that found common ground. I know the Minister is a consensus builder and I enjoy working with her. I hope she will say that she will step in to build consensus and fix this, and Labour will support her in that venture.

In the meantime, I hope the Minister can offer some reassurance on areas of concern relating to this: first, if practices do not hit that 45% of pre-covid activity, and instead land at between 36% and 45%, any reduction will be proportionate to the full payment; it will be downscaled in ratio. However, below 36%, a practice will drop off the cliff edge and not get its contract. That is concerning because in November that would have applied to 40% of practices. Those targets were put in prior to the third wave of the pandemic gripping, and we know that is having an impact. Eight in 10 practices have seen increased cancellations or missed appointments, and three quarters of practices have experienced staff absences this month alone.

Will the Minister therefore reassure the House that she will look again at that element to ensure that dentists have a fair chance of meeting targets and are not unfairly penalised if they do not, through no fault of their own? I know there will be a regional analysis of whether there are extraneous factors. I hope the Minister will endorse and double underscore that today.

Secondly, will the Minister offer reassurances that the use of units of dental activity will not incentivise just the treatments that fit in a little more easily—for example, check-ups that do not require fallow periods—while disincentivising more urgent complex care, and care that does not count towards the target? Thirdly, I am concerned about the wellbeing of dentists and their staff, because 45% of UK dental professionals feel that their mental wellbeing is worse compared with the start of the pandemic. What steps are in place to support our workforce? We have a duty of care towards them.

I will conclude with a point about dental laboratories. They make the crowns, bridges, dentures, and more, on which dentistry relies. While the Government acted quickly to protect the dental industry—as I said, we supported them on that—there has been nothing for dental labs, which have seen their orders collapse. Many have shuttered and will never reopen. People are leaving that skilled profession, but we are going to need them again, and in greater volumes as we catch up. Instead, we will now buy those products from the continent and beyond, all around the world, and we will have lost skilled work because we let it wither. I hope that the Minister will use this opportunity today to announce relief for that.

Dentistry is a vital part of our NHS. Dentists and their staff have fought valiantly to keep the industry going in unprecedented times. Now they are at a crossroads and need political help. The Government must step up and resolve the contracting issue, and work with dentists to build a new exciting future for dentistry, preventing ill health, rather than chasing it. If they meet the moment, we will support them, but if they do not we will call them out.