Oral Answers to Questions

Alex Norris Excerpts

Tuesday 12th January 2021 Commons Chamber

[Jo Churchill]

I can unreservedly say yes to that. The NHS is under huge pressure and there have been some instances where, for totally understandable and unavoidable reasons such as staff ICU capacity or the safety of patients themselves, treatment has been rescheduled. Any such decisions are always made as a last resort. However, we have changed the way we operate, making sure that we have covid-secure cancer hubs, consolidated surgery and centralised triage to prioritise those patients whose need is most urgent. We have utilised the independent sector, and will continue to do so, to increase capacity. These measures, and, as the hon. Member said, the tremendous efforts of our NHS cancer workforce and their teams, are helping to ensure that those who need treatment can continue without delay.

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

Throughout the pandemic we have been calling for a cancer recovery plan, so we were glad to see one published in December, but disappointed that it ran only for a couple of months. Events have clearly overtaken us since that publication, and the unprecedented demand on our NHS risks further delays to treatment and to people entering the system for treatment. These plans must now go much, much further. Will the Minister make a commitment today to work with the sector and interested parliamentarians to develop the recovery plan into one that properly addresses the backlog and builds improved treatment pathways for the future?

[Jo Churchill]

The cancer services recovery plan was worked on by clinicians and stakeholders, including the charities, to make sure that we had a robust plan for addressing the challenges that have come about throughout the pandemic. The levels remain high for referral and treatment, despite other pressures on the NHS. I assure the hon. Gentleman that I regularly meet Cally Palmer and Professor Peter Johnson, who lead for the NHS in this area. We have made it absolutely clear, since the beginning of the pandemic, that the continuation of urgent cancer treatment is a priority, as is its restoration. We are doing what we can to ensure that swift treatment is there for everybody. I regularly meet all-party parliamentary groups—indeed, I am meeting one on Thursday of this week—so I can assure the hon. Gentleman on that front.

Covid-19: Vaccinations

Alex Norris Excerpts

Monday 11th January 2021 Commons Chamber

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

I am grateful to the Minister for advance sight of his statement.

We meet today at a challenging moment in the handling of the pandemic. We have growing infection rates, we are in lockdown, businesses are shut and schools are closed, and tragically more than 80,000 people have already lost their lives to this awful virus. The vaccine provides us with a light, a glimmer of hope, and a way to beat the virus, saving lives and getting us back to normal.

The Government succeeded in the development of a vaccine—investing in multiple candidates has paid off handsomely—but a vaccine alone does not make a vaccination programme. Given the Government’s failures with the test and trace system and the procurement of personal protective equipment, it is right that we scrutinise the plans carefully.

The plan is quite conventional: aside from the new big vaccination centres, it uses traditional delivery mechanisms operating within traditional opening and access times. The Opposition have some concerns about that, as we believe that exceptional circumstances call for an exceptional response. At the No. 10 briefing earlier today, 24/7 access was said to be something that people would not be interested in, which surprised me; I would like to hear from the Minister the basis for that view.

Similarly, there is the mass deployment of community spaces and volunteer mobilisation unprecedented in peacetime. It is the Government’s prerogative to choose their approach, but I am keen to hear from the Minister assurance that the plan as written and set out today will deliver on what has been promised: the top four priority categories covered by the middle of next month. On a recent call, the Minister said that the only limiting factor on the immunisation programme would be the speed of supply. Will he publicly reaffirm that and confirm that this plan will make maximum use of the supply as he expects to get it?

I think we would all agree that our frontline NHS and social care heroes deserve to be protected. At the beginning of the pandemic, our staff were left for too long without adequate personal protective equipment, and we must not repeat that with the vaccine. Protecting them is the right thing to do, reflecting the risks that they face, but it is also pragmatically a point of emphasis for us, because we need them to be well in order to keep doing the incredible job that they are doing.

We are currently missing about 46,000 NHS staff for covid reasons. The health and social care workforce are in category 2 in the plan, but there does not seem to be a national-level emphasis on inoculating them immediately. There seems to be significant variation between trust areas. Will the Minister commit today to meeting our demand that they all get their vaccines within the next fortnight? We very much welcome the clear and simple metrics that he is going to publish each day so that we can follow the successes of the programme, but as part of that, will he commit to publicising the daily total of health and care staff vaccinated, so that we can see the progress being made against that vital metric, too?

It was reassuring to see pharmacies included in the plan. They are at the heart of all the communities in our country, they are trusted and they already deliver mass vaccinations. It was disappointing and surprising to see them having to take to the front pages of national newspapers last week to get the Government’s attention, but now, with them in the plan, will the Minister reassure the House that he is fully engaged with their representative bodies and that they are satisfied that they are being used properly? The number that has been trailed publicly is of 200 participating pharmacies, but given that there are 11,500 community pharmacies in England, can that really be right? Why are there not more involved, or is that number wrong? If so, could the Minister share with us what the number is? On social care, 23% of elderly care home residents have been vaccinated, compared with 40% of the over-80s more generally. Given their top prioritisation, is there a reason for this lag? What plans are there to close the gap? Is the Minister confident that all care home residents will be vaccinated by the end of the month, as promised?

Finally, there has been a high level of consensus across this place, and certainly between the Minister and me, on misinformation, and we will support the Government in whatever they think they need to do to tackle it. We will have a real sense of the impacts of misinformation as the programme rolls along, particularly as we look at who is and is not declining the vaccine. Will the Minister tell us what he will be monitoring in that regard, and what the early feedback is, perhaps from our own care staff, on who has been saying yes and who has been saying no and what that might mean for the future?

We welcome the fact that the Government have published this plan. We will back them when we think they are right but we will continue to offer constructive ways to improve the process, as I hope I have just done. I hope that the Minister can address the points that I have raised.

[Nadhim Zahawi]

I am grateful for the hon. Member’s backing and support. He asks a number of important questions, and I will attempt to answer them now. Suffice it to say that it would be sensible for us to recognise that test and trace now delivers 85% of those who are tested positive in terms of identifying their direct contacts and the indirect contacts at between 92% and 96%. Over 5 million people have been tested and isolated and are therefore not transmitting or spreading this virus, and 55 million people have been tested. That is a pretty major undertaking, with capacity now touching 770,000 and tests running at about 600,000 a day. From a standing start of about 2,000 a day back in March, that is a pretty remarkable achievement for NHS test and trace.

The hon. Gentleman asked about 24-hour provision. There are two priorities for the NHS, and we have looked really long and hard at this. Priority No. 1 is obviously to target very closely those four most vulnerable categories. Priority No. 2 is to try to get a vaccination to them as quickly as possible, which is about throughput. This is linked because if we were to go to a 24-hour regime, it would be much harder to target the vaccine at those four cohorts. Obviously, when we have limited vaccine volume, we do not want staff standing around waiting for people in centres that are open 24 hours. Also, many of those people are over 80, and we are going into care homes to vaccinate the residents of those homes. The decision to go from 8 to 8 was made because we want to ensure that there is an even spread and very close targeting.

That is linked to throughput—how many vaccinations can we get into people’s arms as quickly as possible? We do not want vaccines sitting in fridges or on shelves. That goes to the hon. Gentleman’s question on the 24 hours, but also the pharmacy question. All the 200 pharmacies that we are operationalising can do 1,000-plus vaccinations a week, so the focus in phase 1, certainly with the first four categories—and, I think, with the total nine categories—is very much on targeting and throughput. The 2,700 sites are the best way that we can target that. Obviously, primary care is very good at identifying those who are most vulnerable or over 80 and, of course, getting into care homes, hence why the NHS plan and the plan we have published today are very much based around those priorities.

As we enter phase 2, where we begin to want to vaccinate as many adults as quickly as possible, we want convenience of course. We want to be able to go into many more pharmacies, so people can walk to their local pharmacy, or GP, and get their jab, when we have limitless volumes of vaccines. We have clearly now got that optioned and it will come through in the weeks and months ahead. That is the reason for that. The hon. Gentleman is absolutely right: the limiting factor continues at this stage to be vaccine volumes. The NHS has built an infrastructure that can deploy the vaccine as quickly as possible, but it is vaccine volumes that will change. With any new manufacturing process, especially one where we are dealing with quite a complex process—it is a biological compound that we are producing—it tends to be lumpy at the start, but it very quickly stabilises and becomes much more even. We are beginning to see that, which is good news.

We are absolutely committed to making sure the health and social care workforce are vaccinated as quickly as possible, and of course we are committed to making sure the residents of care homes are vaccinated by the end of this month—January. I reaffirm that commitment to the hon. Gentleman.

I think the hon. Gentleman’s final question was on data. I am glad that he agrees that it is important, because the Prime Minister’s absolute instruction to us as a team is that we have to make sure we publish as much data as possible as quickly as possible, hence why we have moved to a rhythm of daily data and on the Thursday more detailed publication, which will have regional breakdowns. The NHS is committed as it builds up more data to publish more and more. The nation expects, and rightly wants to see, the speed and the targeting that we are delivering, but I am confident that the NHS has a solid plan. We have the volunteers and the Army—two great institutions of this country—delivering this campaign and with the support of Her Majesty’s Opposition I am sure we will do this.

Public Health

Alex Norris Excerpts

Wednesday 6th January 2021 Commons Chamber

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

Thank you, Mr Deputy Speaker. I put on record my thanks to you and your staff for what is now the second recall of Parliament for important business. I know that a lot of work goes into making that possible, and we really appreciate that, but it is important that we are here today. The daily figures that colleagues will have read while sat in this debate are sobering: 1,041 more of our countrymen and women have lost their lives to this horrible virus. It is a sobering moment, and with that in mind, we will support these regulations today. We do not think it is inevitable that we are in this situation, but it is clear that we are in a very challenging moment indeed, and in these dangerous times, with our NHS working at such high capacity, it is in the national interest to protect it and make these difficult decisions.

I say to people watching: if you are one of the very many people who have been excluded from Government support so far, or if you have missed out on self-isolation support, or if you are concerned about business support or reductions in welfare support going forward, I hope that you will have seen the support from our Benches, from my hon. Friends the Members for Walthamstow (Stella Creasy), for Leeds East (Richard Burgon), for Manchester, Withington (Jeff Smith), for Barnsley East (Stephanie Peacock), for Sheffield Central (Paul Blomfield), for Bristol South (Karin Smyth), for Sefton Central (Bill Esterson), for Blaydon (Liz Twist) and for Putney (Fleur Anderson), all giving you voice. Similarly, I hope that those very many clinically extremely vulnerable, who have so often felt ignored, saw in the contribution from my hon. Friend the Member for Lewisham, Deptford (Vicky Foxcroft) that they are not. The same goes for contributions on frontline staff made by my hon. Friends the Members for Worsley and Eccles South (Barbara Keeley) and for Liverpool, Riverside (Kim Johnson).

Many points were made earlier today about schools, which I will not emphasise any further, other than to mention the contributions from my hon. Friends the Members for Eltham (Clive Efford), for Sheffield Central, for Luton North (Sarah Owen) and for Cambridge (Daniel Zeichner). Important points were made about the border by my right hon. Friend the Member for Normanton, Pontefract and Castleford (Yvette Cooper) and my hon. Friend the Member for Cardiff South and Penarth (Stephen Doughty), which I will reflect on shortly.

Many Opposition colleagues—including my hon. Friends the Members for Wirral West (Margaret Greenwood), for Hartlepool (Mike Hill) and for Sheffield South East (Mr Betts), my right hon. Friend the Member for Warley (John Spellar) and my hon. Friend the Member for Cardiff South and Penarth—referred to the vaccine, as did many Government Members, including the right hon. Member for Berwick-upon-Tweed (Anne-Marie Trevelyan) and the hon. Members for Bridgwater and West Somerset (Mr Liddell-Grainger), for South Leicestershire (Alberto Costa) and for Middlesbrough South and East Cleveland (Mr Clarke). In particular, the hon. Member for Winchester (Steve Brine) and the right hon. Member for Forest of Dean (Mr Harper) made contributions about the Government committing to publish a schedule of precisely what vaccine is going to be received and when, and how that will be rolled out, and I think the Government ought to do that.

Important contributions were made by Government Members about the exit plans and support for business, as well as children and early years. Contributions were made by the right hon. Members for Chesham and Amersham (Dame Cheryl Gillan) and for North Somerset (Dr Fox), the hon. Members for Altrincham and Sale West (Sir Graham Brady), for Poole (Sir Robert Syms), for Bromley and Chislehurst (Sir Robert Neill) and the right hon. Member for Wokingham (John Redwood) about oversight, and we as an Opposition would support a further review, in shorter order, of these regulations and further debate to make sure that they are as effective as possible.

The right hon. Members for East Antrim (Sammy Wilson) and for New Forest West (Sir Desmond Swayne) and the hon. Member for Romford (Andrew Rosindell) all made points about the scientists. I would perhaps fall on Margaret Thatcher’s maxim, “Advisers advise, Ministers decide”. Ultimately, if those colleagues are dissatisfied with the actions of the Government, it is for Ministers alone to account for them rather than the scientists, who are giving their best endeavours, even if we do not agree with them.

I thought it was interesting that not a single colleague mentioned that we are exactly where we were one week ago. I was in this place, the Minister was in her place and you were in your place, Mr Deputy Speaker, as we were discussing regulations. That failed. That seems funny, but actually, it is not funny at all when we think about it. I asked the Minister three times to say that the Government thought that their final attempt to salvage the tier system would work. I had no such commitment made, so perhaps it is not a surprise that it fell over, even if it is a surprise that it fell over as quickly as it did. That is a characterisation of a failure to grip this virus, as my hon. Friend the Member for Ilford North (Wes Streeting) said. The Government have been just so slow and always short, trying to do the bare minimum and never, frankly, doing enough.

In a similar vein, it was quite disappointing that the Secretary of State’s contribution—his 23 minutes—could have been an intro to a general debate on vaccines, because that was all he spoke about. Of course, the vaccine is important and is our way through this, but actually, it is a failure to grasp at ministerial level that there are many things other than the vaccine, that they have control and say over and that they simply have not done well enough on.

This lockdown, which we will no doubt support tonight, will not make our problems go away. Lockdowns do not solve anything. They buy us time to solve things, so in the limited time remaining, I will highlight some of those that I think that the Secretary of State ought to have referred to, and I hope that the Minister will in her winding-up speech.

On economic support, again, there was not a word for those many millions excluded from support so far. They have gone a long time now without support. They deserve more than the glib comment that they had from the Prime Minister this morning. I hope the Minister might do a little bit better. The Chancellor should be here giving us a chance to scrutinise those plans. He was very keen to at the beginning, but we have not seen him now for a very long time.

Test, trace and isolate remains a significant gap in our fence. What fools we all look now given that, when the virus was at its lowest ebb in the summer, that system was not sorted out. Instead, while the testing number at the beginning of the system remains a very good one, turnaround time does not hit its targets, tracing never hits its targets and we know that not enough people isolate because the support for them is not good enough. The fact that we have failed to fix those problems reflects very poorly on the Government.

On the border, I am always loth to make international comparisons, certainly beyond Europe, but our daily death total today is more than the entire death total during the pandemic in Australia. There are ways in which we are similar and ways in which we are different from them, but I think we should reflect on the fact that on 20 March, they closed their border. Anyone returning home during that time had a two-week quarantine, but that was it. Now, we are still talking about test to release and other such measures at the border. It is an extraordinary failure.

To finish, I will make a couple of points on vaccination. The development and procurement of vaccine has been a success of this Government—I have said that multiple times in this place, and will continue to do so—but whether they have a successful vaccination programme remains to be seen. There is frustration on both sides of the House that we do not yet have the sense that this will be a 24/7 service, or that we are unleashing all those people who have volunteered to contribute. It is surprising to see pharmacies on the front page of national newspapers—that is the length that pharmacies feel that they have to go to get the attention of the Government. If the Government are sure they do not need that extra support and will still deliver on time, they should be clear about that.

May I have some particular clarity from the Minister? We have been hearing the Secretary of State and the Prime Minister now saying—they have changed their form of words in the past three or four days—that everyone in categories 1 to 4 will be “offered” the vaccine by the middle of February. What does that mean? What does it mean for the modelling? Before, we thought that by the middle of February we wanted everyone in those categories to be vaccinated—within, of course, the limits of people choosing not to take it up. What this cannot be is a paper exercise; it has to be the fullest—

[The Minister for Care (Helen Whately)]

indicated dissent.

[Alex Norris]

The Minister seems to dispute that, so I hope that she will take the time in her contribution to do so.

The vaccination programme represents a deal with the British people. We are asking the British people to ensure significant hardship for a significant period—that is the British people’s side of the bargain. The Government’s side of the bargain is an effective, safe and timely vaccination programme. They have to deliver on that.

I will finish in that spirit, with a simple message to my constituents and constituents across the country: stay at home, protect the NHS and vaccinate Britain.

Public Health

Alex Norris Excerpts

Wednesday 30th December 2020 Commons Chamber

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

I hope you had a good Christmas, Madam Deputy Speaker, and I wish you and all colleagues a happy new year. I take this moment to express our gratitude for the work of you and the staff to ensure that we could sit today. I also associate myself with the Minister’s comments regarding this country’s outstanding health and social care workforce, who have made Herculean efforts over Christmas and new year. They are greatly appreciated.

There is something very 2020 about discussing covid regulations three hours after a subsequent set of regulations were introduced, but it is nevertheless important that we do so. I will cover each of them, perhaps making some cross-cutting points as I do so.

With regard to SI No. 1611, we discuss these regulations today because we are obliged to do so following their introduction on 20 December. However, we are compelled to do so because the failures of the restrictions announced on 2 December. At some point in the next few parliamentary days, we will debate the restrictions announced from the Dispatch Box earlier, and we are compelled to do that because of the failure of restrictions that we talk about today. This episode is a perfect encapsulation of the failings of the Government’s handling of the pandemic: slow and always falling short.

The Government have now had three goes at a tier system. The first two have failed, and today’s announcement marks the final attempt to salvage a third go. We must hear from the Minister today a clear commitment that, based on the best scientific guidance available, the Government firmly believe that these restrictions will halt the rise in the infection rate and, indeed, start to reduce it. We must have that commitment today, because otherwise we will be back here time and again. When the Minister hopefully makes that commitment, there ought also to be a commitment to publish the guidance that the judgments are based on, so that we might begin to repair damaged trust.

The stakes are high. We cannot afford failure. Our national health service is experiencing dire pressures. A major incident was declared in Essex this afternoon. Elsewhere, exasperated doctors are taking to social media to report that oxygen is running out. An internal incident has been declared at the Queen Elizabeth Hospital in Woolwich. London hospitals are asking their counterparts in Yorkshire for support. Rates of sickness in our care facilities are increasing. Right hon. and hon. Members had a call this afternoon with Stephen Powis from NHS England, and it was clear not only that the pressures are significant, but that we can expect multiple weeks of growing demand. If the Government dither and delay again today, the price will be significant indeed.

We are considering a bundle of five different regulations. I do not intend to labour too much on SI No. 1533 or SI No. 1572, as they exclusively deal with moving specific geographies into specific tiers and are now significantly out of date, as was elegantly demonstrated by the hon. Member for Christchurch (Sir Christopher Chope).

SI No. 1611 creates tier 4, something that nearly 80% of us will now need to get used to. I shall cover that shortly, but it also deals with Christmas. Although that is of course now in the past, it is worth reflecting on briefly. The change was announced on 19 December, turning the nation’s plans upside down at a stroke. Of course, some allowance must be made for the changing nature of the virus; I accept that. We are in very fast moving times. However, it was clear many days before the announcements were made that the initial Christmas plans would not be sustainable. That was regrettable, but it was clear. On 16 December, the Leader of the Opposition asked the Prime Minister from this Dispatch Box to look at it again, and the Prime Minister replied characteristically with bluster and bluff. Later that day, he said that it would be an “inhuman” thing to do, but of course he had to. He delayed, he dithered and, eventually, he had to do it anyway. Again, these things matter because they chip away at public confidence bit by bit to create a sense that the Government do not really have a handle on the crisis.

We will all have been cheered—the Minister majored on this in her speech—to wake up this morning to the news of the approval by the Medicines and Healthcare Products Regulatory Agency of the Oxford-AstraZeneca vaccine. This is an extraordinary scientific success and a vindication of the Government’s backing of multiple vaccine candidates. We should be exceptionally proud of Britain’s role in this vaccine and others. It is a great success story for our country and our place in the world after such a significant day today.

The Health Secretary said today that the vaccine is the way out of the pandemic, so for us today the vaccine must be the way to end the regulations. That is nearly right, because actually it is a vaccination programme that is the way out of this. Of course, a vaccine is the most vital component of such a programme, but now that we have that it ceases to be so much a question of science and becomes a much more rudimentary and basic exercise in logistics.

The Government have faced two such major logistics challenges in this pandemic. The first was the effective and urgent procurement and distribution of personal protective equipment and the second was the roll-out of the test, trace and isolate system. Both have been significant failures. The PPE roll-out was a farce for at least the first two months, and the test and trace system has not delivered, even on the Government’s own metrics, since its introduction. At the root of both these failures has been the same slowness that has characterised the Government’s response to the pandemic. They have been slow to respond and slow to grasp the scale of the challenge—this cannot happen again with the vaccine.

I have an awful lot more confidence in a programme that will be delivered by the NHS than in one delivered by one of the companies that the Government seem to default to even though they do not tend to deliver for them. There are still some questions, however. NHS staff are in category 2 of the initial prioritisation, but we are still hearing that there has not yet been a full roll-out. Can the Minister let us know when she anticipates that all of our NHS heroes will have had their jab? Of course, that is the least they deserve, but we have heard today from the British Medical Association that NHS staff absence is at 10%, so it is a pragmatic necessity that, as we deal with increasing demand, we have a resilient workforce to do that.

We saw a significant change of direction in the administration of the vaccine this morning. Previously, we were administering it in pairs about a month apart, and that was seen as the best way of delivering it effectively. Now, the Government have made the judgment that they will go to a first shot, with a second shot to come three months or so later. I assume that this reflects the best advice of the Joint Committee on Vaccination and Immunisation, and if so we will support it, but will the Minister publish that advice and, crucially, the roll-out plan?

We know now that we have enough vaccines for everyone who wishes to take the offer up. We know that we have a national health service and different ways of dispensing it through our GPs and our hospitals. We know all the components, but we now need to know the timetable. That is important so that it can be scrutinised and perhaps improved, but also so that we can build public confidence in this crucial plan. People are rightly looking at this with great hope, and it is right that they know that there is a proper process behind it. In the meantime, however, the way out of the tiers as constituted in SI Nos. 1611 and 1646 remains to reduce the five metrics on which the Government say the tiering decisions are based.

As a constituency MP, I have to say that this is a Kafkaesque process. Like you, I suspect, Madam Deputy Speaker, I have met Ministers, Government scientists and NHS leaders, both national and regional, and I still do not believe that there is a particular criterion for going up and down tiers. It is more that you kind of know it when you see it. To an extent, that is understandable. This is a complicated mix of infection rates, healthcare capacity and their associated trajectories and direction of travel, and then you kind of cook them all up altogether, so it is never going to be one number at one time at one moment. However, it is a significant issue for us as local leaders that we cannot build confidence in regulations by answering the basic question from constituents. I have had this multiple times, as will other hon. and right hon. colleagues. Constituents are saying, “I accept that we are in the tier that we are in, and it is important that we are. I wish that we were in a lower one, so that I could do more of the things that I enjoy doing. What do we need to do in order to achieve that?” Frankly, as a local leader, I cannot answer that question and I doubt that anybody, including the Minister, could answer that question either.

What we did not hear from the Health Secretary from the Dispatch Box earlier, and what we did not hear from the Care Minister in her contribution just now, is that the reality is that you are in your tiers now, especially in tier 4, until the vaccine is rolled out. However, we have heard from the Prime Minister on that, hints on that from Robert Peston and hints on that in a reply after the Downing Street briefing. If that is the case, it is time for the Government to be honest about it. The one thing that we know after the year that we have had is that the British people can take it. They can take that level of honesty. What they hate is when plans are changed at the last minute. What they hate is being told that, if they push down the infection rate in their community, they will be able to get back to doing the things that they love doing, and then finding out that it is no longer that but the percentage of positive tests. We have been through that in Nottingham; it is horrible and it is chipping away at confidence. It is time for a bit more honesty.

We support the introduction of these tiers. We withheld our support from the three-tier system. We did not believe that it would work and it did not. This goes further, so we are willing to support it, but two things need to be resolved with regulations that flow from today’s announcements, but also relate to the regulations we are discussing today. First, on the support for business, the £1,000 for wet pubs was an insult—£30 a day for the busiest time of year. Tiers 3 and 4 mean a shuttered hospitality sector. Viable businesses, jobs and livelihoods that are closed for very good reason must be better supported.

Similarly, tier 4 restrictions were introduced 10 days ago. We have worked throughout this pandemic on the principle that as restrictions increase, so does support for businesses, jobs and communities, but we have heard nothing since then. Where is the Chancellor? His slow and shorthanded response in his winter economic plan meant that, in the end, he had to have four different versions of it. Frankly, we might need another one because, otherwise, these restrictions will mean significant damage to our economy and to lives. This means action, finally, for those who have fallen between the various schemes on offer. We could dispute all day how many have been excluded, but we cannot deny their existence. I would give the Government significant latitude in understanding that, as you make up a furlough scheme and a self-employed scheme out of nowhere for the first time, there will be gaps between those schemes. It is entirely obvious that that will happen. However, what we must do is do something about it and close those gaps. It has been months and months, and now the Government really have to do it.

Secondly, a fundamental gap remains the test, trace and isolate system, which is fundamental to breaking the chains of transmission. The Prime Minister promised 100% of results within 24 hours nearly six months ago. At the moment, that figure is 19%. If we allow for next day, rather than 24 hours—because it is still the Christmas season—that figure rises to 37%, which is pathetic. On tracing, things have got better, with the greater improvement of local authority teams. However, the one way the Government have made significant inroads in their testing statistics is by defaulting to the canniest tactic in the book; they have changed the way this is counted. Generally, that is not a good sign about how things are going. Again, progress here has been pathetic.

Crucially, we come to isolation payments. All colleagues will have heard stories of constituents making that impossible choice between feeding their families and doing the right thing for the national effort. The £500 payment was too slow to come forward and does not adequately replace lost income. The scheme is still so full of holes and very much depends on how the system picks you up. Self-isolation should be automatic and we have failed communities by not creating conditions for it to be so. Ministers will want to blame the new strain for covid’s continued spread, but the reality is that they did not have control of the virus prior to this and they still do not have an adequate test and trace system to subdue and control it anyway. In the course of such a defective system, we have managed to spend £22 billion—dearie, dearie me.

Finally, on regulation No. 1518, we are happy to support the reduction of the self-isolation period from 14 to 10 days, assuming, again, that it is based on the best scientific evidence. Will the Minister commit to publishing this?

To conclude, we are at a crucial point in this pandemic. Today, with profound sadness, we hear of the passing of a further 981 of our fellow countrymen and women. The total directly who have lost their lives from covid alone is over 70,000 but, in reality, it will be many, many more. Those are big numbers but behind every one of them is a life, a person missed, a grieving family. Today, we have heard that the way out of this is in sight. However, we have also heard that things are poised to get much, much worse before they get better. In recognising this, the Government’s response is another system of tiers. These have failed every time so far. They must not fail now and we must hear from them why they believe they will work. We must also hear more clearly what they are going to do to deliver on other crucial aspects—on the vaccine and on test and trace. Failure to do otherwise will cause extraordinary harm.

--- Later in debate ---

[Alex Norris]

This has been an excellent debate. We have heard lots of different views and perspectives about how to wrestle with this knotty crisis—the great national question of the day—but I do not mistake the disagreement and points of difference for a lack of faith or a lack of love of community or country. All hon. Members and right hon. Members have attacked the question with a commitment to wanting the best for our country, even if sometimes we disagree on the conclusions.

That is particularly important today. Today has been a momentous day and the past 12 hours and five minutes of parliamentary business will be remembered—perhaps that is one for your book, Mr Deputy Speaker, and please be kind if I do anything to earn a place in there. Who knows how I could do that? There will be some for whom today is a day of great joy, and there will be some for whom today is a day of pain. Whatever people feel about what has happened here today, we have to come together. We have had four years—longer, really—of significant disagreement and division and what we have seen in the pandemic is that the UK is at its best when it is united and comes together. I hope that we will move forward from today in that spirit, and tackling the virus reminds us why we ought to do that.

Let me reflect on the contributions from colleagues. My hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) made the point about ensuring that NHS staff are vaccinated. As I said in my opening speech, that is important because it is the right thing to do and because of the sacrifices they make and the risks they run on our behalf, but also because of the need for a resilient workforce.

My hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) made a very important point: when the right support is not in place, whether that is for the individual to self-isolate or for businesses to shut their doors in challenging times, it undermines people’s confidence and faith in the overall process. That is why the Government’s economic support package needs to move hand in hand with increased regulation to protect public health.

My hon. Friends the Members for Hackney South and Shoreditch (Meg Hillier) and for Birmingham, Selly Oak (Steve McCabe) both referenced an important theme about honesty. I will reiterate what I said to the Minister—the British people are ready for candour. If we are in tier 4 from now until the vaccine, now is definitely the time to tell us.

I am not going to itemise all the Government Back-Bench colleagues who spoke—there were too many. We really ought to do something about that at the next election; at least I can commit to that. I particularly want to mention the speech made by the right hon. Member for South West Wiltshire (Dr Murrison), because he referred directly to my speech and suggested that when I talked about SI No. 1646 I was a bit churlish. I do not think I was; I was a bit saddened by that. I shadowed the right hon. Gentleman when he was a Minister for international development and I was never churlish then, and I was not churlish now. My point about SI No. 1646 was that we were concerned—and said so at the time—that the three-tier restrictions would not go far enough, but in that SI in particular it is not clear how to get out of a tier. I have not heard anything in the subsequent speeches, and I doubt we will hear anything from the Minister, that gives a clear set of criteria even around the five metrics for exiting tiers. That remains a significant problem for public confidence in the process.

I wanted to pull out two quick themes from Government Back-Bench contributions. The first is about tiers. In the contributions from the right hon. Member for New Forest West (Sir Desmond Swayne) and the hon. Members for Bolton West (Chris Green), for Thirsk and Malton (Kevin Hollinrake) and for Buckingham (Greg Smith), they all put admirable scrutiny and pressure on their Minister, as I have heard them do before, and I know that she will be keen to respond. I would be keen to enlist that support for matters beyond tiers. Tiers are a symptom, not a cause, of the challenges of the restrictions of liberty we are making today. Tiers are put in place when we lose control of the virus. Some of that can be accounted for by the mutant strain, which is 56% more potent, but the issues existed before then. We needed tiers before that, and tiers that constantly increased in strength, because we do not have the fundamentals right, particularly on test and trace. I implore those Members to apply that level of scrutiny and pressure on their Ministers on that, too, because it would make a real difference.

The second theme was vaccines. Many colleagues, including the right hon. Member for Forest of Dean (Mr Harper) and the hon. Members for Mid Derbyshire (Mrs Latham), for Runnymede and Weybridge (Dr Spencer), for Dudley South (Mike Wood), for Aylesbury (Rob Butler), for South Cambridgeshire (Anthony Browne) and for Newcastle-under-Lyme (Aaron Bell)—everyone, in fact, but particularly those Members—expressed joy about the plan. The right hon. Member for Forest of Dean made a particularly detailed and powerful case for the levels he felt that the Government should be aspiring to. I hope the Minister will engage with that directly and say whether it is realistic. If it is not, can she say why not and what a more realistic level is?

I want to reiterate the point on schools that was made by a number of colleagues. Not that Members would ever look at social media during a colleague’s contribution, but if they did, they will have seen that there is significant anxiety as a result of the announcement by the Secretary of State for Education this afternoon. It just will not do to say that some schools will be open and that some schools will not be open and then not to publish the list, and then when the list is eventually published, it is incomplete. This has caused a significant amount of anxiety. We must not forget that we are—what—five days away from those schools opening. Parents need to know. Schools need to know. It really will not do and I hope the Minister might be able to give some clarity on that and, if not, a sense of when the Government will return to finish off that job.

I just want to finish by reiterating three key questions to the Minister. I know that she will have an awful lot to cover, so I wanted to make sure that I left her the lion’s share of the winding-up time—whether she will thank me for that I do not know. First, we do need to hear the Government say with both clarity and commitment that, based on the best scientific evidence available, they believe that the tier system is sufficient to control the spread of the virus. This is their third go at a tier system. The first two failed and we are here today because the third one is not working either. We need to hear that explicitly, because otherwise we will have to take more significant action later. We might as well be honest about that now.

Secondly, when will we see the roll-out plan for the vaccine so that we can help to build confidence and perhaps to improve it through parliamentary scrutiny? The plan should include NHS staff as a priority, but, in general, it needs to ensure that we get through the entire population. It is a wonderful and joyous moment to know that we will have access to enough vaccines for everyone who wants one. It is a wonderful moment. Now our responsibility is to demonstrate that we can get them out for people in the quickest and safest possible manner.

Finally, there should be no extra health regulations without extra support for business. Where is that support package? When will we see it? When asked that question earlier—I think by a Back-Bench colleague of mine—the Secretary of State for Health said, “Well, I’m not a Treasury Minister, I am a Health Minister.” Nobody thinks that that is how it works here. We cannot afford for it to work in that way. The two need to move in lockstep, so can we have clarity about when we will see that support package? I will sit down now, Mr Deputy Speaker. It has been a very good debate, but I hope that the Minister can now give clarity on the points that I have raised.

Healthcare Support Services: Conception to Age Two

Alex Norris Excerpts

Tuesday 15th December 2020 Westminster Hall

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

It is an honour to serve under your chairship, Sir Christopher. I congratulate the right hon. Member for South Northamptonshire (Andrea Leadsom) for securing this debate. She really is one of the leading parliamentarians on this issue, so we were very pleased to see her appointed as the early years healthy development adviser. She has shared with us a lot of insight from her 20 years as well as from the current review. I look forward to hearing those findings and recommendations from that first phase. I hope that we will have a parliamentary opportunity, whether here or the main Chamber, to discuss them further. Hopefully, they will really turbocharge this debate and lead to a renaissance of early intervention at the very forefront of public policy in Britain. I very much hope that will be the case, and I think this is a key moment.

The right hon. Lady’s point about brain development was so interesting; I cannot hear these points enough. Like many colleagues here, I have been involved in early intervention type activities throughout my time in Parliament, but we have been really reminded of the physical impact of emotion in the early stages and how profoundly responsible it is for whether young people—even babies—learn that the world is a good place. The hon. Member for East Worthing and Shoreham (Tim Loughton) said that these things have been well rehearsed, and they have, but I do not think they can be heard enough as they are very important.

The phrase that I underlined twice was “indisputable”; I completely agree there. The evidence for early intervention is indisputable. However, I am struck by the Royal Foundation research with Ipsos MORI that says that only one in four of our constituents understands that. We have a real job to do in taking something about which we are in such profound agreement in this place out to our constituents, so that they understand why it is such a good investment for the individual and for us all as a whole. That is something I am going to return to. The right hon. Member for South Northamptonshire’s points about the lockdown were extremely well made, and I look forward to the Minister’s response to them.

I turn to the contributions of other Members. I was glad that the hon. Member for Glasgow Central (Alison Thewliss) referenced her tireless work on breastfeeding and the importance of support services for that; I will reflect on the public health grant in England shortly. On what the hon. Member for East Worthing and Shoreham said, I make no comments about “old or very old”—I leave that only to the Member in charge. But I recall from his time as a Minister and our time serving together on the Home Affairs Committee his strong commitment to getting all children the best start in life. I thought his contribution was very much in line with that. I loved what he said about health visitors. That is such an important distinction in understanding. Health visitors are the best at getting uniformed services over the threshold for some of the hardest families to reach in our communities. That has to be an important part of our public health response.

The comment he made about all the big spending we do on getting it wrong is at the nub. I will expand on the point shortly, but we have to work it out. We know we are spending the money, but we also know that the old argument we make about what a difference it would make, if only we had a fraction of it invested, does not work with the Treasury. That has not worked with successive Treasuries of whatever political persuasion. We have to try to answer that question of how to do it in a way that is “cashable”, for want of a better word, and deliverable on a timeline that the Treasury will accept.

I will repeat what I said to the hon. Member for Strangford (Jim Shannon) when he and I were here in the late debate last night. In the early debate this morning, his contribution, as always, comes with a burden of empathy behind it. That is at the root of the issue: understanding the impact of empathy on the development of a young person. The reason that matters is because it is important for public finances, of course, but we are all here because we care about people. We do not want anybody to have their potential and outcomes curtailed before they have even had a chance. That is the importance of a source of empathy.

I will take great interest in family hubs and their development, having listened to the hon. Member for Congleton (Fiona Bruce). I recognised a lot of what she said from Sure Start. The loss of Sure Start is a real sadness, but I look forward to reading and hearing more as those other ideas develop.

I will finish by congratulating the hon. Member for Truro and Falmouth (Cherilyn Mackrory) on the anniversary of her first year here. I am sure it has gone in seconds. I know that colleagues and those watching will appreciate her work and her bravery in sharing her personal story of baby loss. That makes such a big difference to people listening and watching. Her points about continuity of care were really important and I hope the Minister will reflect on that.

I will make a few points of my own. Early intervention is the best gift we can give ourselves. It is brilliant for the individual, transforms lives and is great for the collective, not least financially. We saw that with Sure Start under the previous Labour Government, which made a tremendous difference, especially in the most disadvantaged communities such as mine. I see that work and its legacy close up in my community today, as I saw it when I was lead for health and social care on Nottingham City Council, prior to coming to this place.

Nottingham has a proud history in this area. My predecessor, Graham Allen, the previous Member for Nottingham North, was a real leader in the area of early intervention. It is 10 years next month since his first report, “Early Intervention: The Next Steps”, was published, and almost eight years since the founding of the Early Intervention Foundation, following his second report. He has played a formative role in my development on this issue, in politics and in life more generally, so I know he will not mind if I run out his ideas. He texted me on my way to this debate with a quote reminding me that the best early interventions we can make start 100 years prior to a baby’s birth, but I will start at conception, because that is what the right hon. Member for South Northamptonshire chose to do. I am sure he will forgive me for that.

We have good examples of the impact of failing to make these early interventions. I will draw on the Department for Education’s Wave Trust report of 2013 that provided the foundation for the 2014 cross-party manifesto, which was so important and provides a theme I hope we can return to in this decade. Disadvantaged mothers are more likely to have babies of low birth weight and low birth weight is associated with raised blood pressure, coronary heart disease, as well as reduced educational attainment, qualifications and employment. Optimal infant nutrition, especially breastfeeding, increases children’s chances of leading a future healthy life. By age five, according to analysis from the Millennium Cohort Study, breastfed children were already one to six months ahead of those who never were.

Those are little examples of the difference that one thing at birth or in the first two years makes for the rest of a life. We could also have drawn on stress and smoking during pregnancy, trauma, language inequalities and communications. I could go on and on. We know what is at the root of this. Those households in the lowest socio-economic groups have significantly worse health outcomes. If levelling up is the term of the day, this is the crucial piece of levelling up.

This is not a theoretical exercise. As colleagues have said, we are in significant agreement but not just in theory. We have seen excellent early-intervention models working over the past decade. I have talked about Sure Start but there is the Family Nurse Partnership, which has supported young parents and their babies for 13 years and is now in 60 areas across England, including my constituency. My friends at Roots of Empathy have reached over a million children around the world, and their Seeds of Empathy programme is incredible. I have joined in with that, and it helps young children learn by watching a baby’s development. It is a wonderful programme. Those sorts of things make such a big difference, and we can do more to champion them.

The Government have to do their bit. Over the last decade, early intervention grants were reduced by almost two-thirds: £2.8 billion to £1.1 billion. The public health grant has been exceptionally distressed over the last seven years. From my three years stewarding that grant in Nottingham, I know that after demand-led services such as drug, alcohol and sexual health services have been dealt with, there is not an awful lot left. Sometimes, some of those services with longer term impacts—such as early intervention services—are the ones that can get forgotten. It is a prime example of that. Similarly, local authority children’s services departments have been forced to cut back children’s centres—family support services that make such an impact—because of their finances. I do not know what Ministers think they have saved in the last decade by making those cuts, but the cost to the country’s finances in years to come will significantly exceed the savings. It is the falsest of false economies.

Well-implemented preventative services—along with early intervention in the foundation years and in the long run—deliver economic and social benefits, as well as being likely to do more to reduce abuse and neglect than would reactive services. Social return on investment studies have shown a return of between £2 and £9 on every £1 invested when there are well-designed early year interventions. The return could possibly be even greater. But that is easy to say. Similarly, the Royal Foundation says that its figure for late intervention was £17 billion each year. It is easy—certainly in Opposition—to say, “If only the Government were enlightened enough to hive off 10% of that and invest it. They would save all that money.” That is true but that is the argument of fixing an aeroplane in flight, so we must have a real conversation. I would be interested to hear the Minister’s reflections on that. The Treasury does not buy that argument and says that it is for idealists and daydreamers who do not understand the reality of public finances. But as the hon. Member for East Worthing and Shoreham says, we are spending an awful lot to get it wrong.

What do we have to change? How do we have to recalibrate that investment conversation to get the Treasury to move on the issue? Colleagues who are more enlightened on the issue than I am have been trying to do that year after year after year, and it does not happen. What is stopping us here? I have reflected—as have colleagues—on the Royal Foundation, now led by the Duchess of Cambridge, which has now spent nine years on early childhood experiences. That is wonderful political leadership, and has highlighted the fact that only one in four people in this country think that it is a priority. The royals would, hopefully, be good people for leading the conversation and helping to grow that figure, but we must also play our role and talk about the successes. We would be keen to do that in a cross-party manner because it needs helium in the public conversation so that we have greater public space to invest in it. We would all be better off if we did so.

I will not repeat points made by colleagues on the pandemic about the impact of isolation. The impact of covid will be the subject of longitudinal studies for the rest of my life. I want to raise the issue of the impact on local authorities, which is significant. That worries me because my local authority—and, I suspect, the vast majority of the 150 authorities in England—will be doing in-year budgets. They are a bad way to run public finances, because twice as much has to be cut to get the half-year effect. The public health grant, in particular, is likely to be distressed and squeezed by that. We will lose early intervention type activities from that. The Government need to look at that and to back-fill that public health grant loss from the previous seven years, not just from this year. That is the big prize. Dealing with covid and dealing with Brexit are vital. It is right that we spend these weeks and months doing that. As for getting our country where we want it to be—a country in which everybody can reach their potential and flourish—it is about those early interventions we make in the life course. I am glad to see the complete and cross-party agreement we have on the issue. We now need to translate that into more action.

Covid-19: Vaccination

Alex Norris Excerpts

Monday 14th December 2020 Westminster Hall

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

It is a pleasure to serve under your chairship in this debate, Sir David. Over 300,000 people have signed the e-petition that we are debating, which shows the strength of feeling on this matter, and I am very grateful to the hon. Member for Carshalton and Wallington (Elliot Colburn) for his leadership of this debate and for having taken it on on behalf of the Petitions Committee. It was the anniversary of his election to this place a couple of days ago, and he has made a significant impact over that year, although he will forgive me if I do not look back on that date with quite the same level of enthusiasm as he might. However, I thought he made an outstanding case about how detailed the process of a vaccine coming from conception to usage is. I hope those who are listening will have taken that on face-value terms, because it should give us all a lot of comfort.

Similarly, the word that I double-underlined was “marvel”. We should marvel at vaccination, and we should also marvel at the role of Britain in vaccination: whether in 1796, 1996 or 2020, and whether that is brilliant British scientists or enlightened British Governments of all persuasions. The thing I particularly reflect on is Britain’s role in vaccinations around the world, through the Global Vaccine Alliance and through our own bilateral aid arrangements. Hundreds and hundreds of thousands of deaths have been prevented because of our role in the process of vaccinations, and we should take a lot of pride in that. It is a real British success.

The hon. Member for Strangford (Jim Shannon)—we are a bit warmer than we were in this Chamber together last Thursday—made a poignant contribution, with a reminder about loss. We can sometimes get wrapped up in the figures behind all this, but each one of the people whom we have lost this year is a person with a family and a story. His contribution was also very poignant when it came to the vagaries and variances in all of our experiences, as well as the range of vaccines, a point that was also made by the SNP spokesperson, the hon. Member for North Ayrshire and Arran (Patricia Gibson). I hope that the 300,000 people who signed this e-petition, or those who choose to listen to this debate, will understand this vaccine as part of all vaccines, rather than anything distinct or different. Although it is the story of the day, it fits very much within the suite of things we think collectively are good for people, and it has gone through all the tests that have been described. I hope, again, that is something people will take comfort from.

I was very pleased to see the hon. Member for Wycombe (Mr Baker) in this debate. As the hon. Member for Strangford said, I always follow his contributions closely. Before becoming the shadow public health Minister, I was an Opposition Whip—I do not know what I had done, but I was an Opposition Whip for some time—and the major upside of that role, if there is one, is that Members get to sit in the Chamber and hear from colleagues of all persuasions—ones whose contributions they might not otherwise look out for. They hear about Southend being a city—I have never been there, and the only thing I think about with Southend, Sir David, is you talking about city status.

The hon. Member for Wycombe made what I think was my favourite speech this year, certainly from the Government Benches, on 30 January—I do not remember the date of everyone’s speeches; I have a good memory, but it is not that good. It was the day before we left the European Union, and the hon. Gentleman made a speech in the general debate on global Britain. I have to say, I thought the scheduling of that debate was difficult, because feelings were very strong and running very high. Some people were in Parliament Square celebrating; others were at home, commiserating. The hon. Member made a very important speech about the need for victors to be gracious and for the vanquished to look forward. I think that everybody could take something from that. I am not sure, 11 months on, whether we are quite there yet, but I hope so, and I think that we all, as leaders, have a role to take on.

[Mr Baker]

I am honoured by the hon. Member’s words, and am very grateful.

[Alex Norris]

I have not finished yet. The hon. Member concluded his speech that day with lots of references to Ronald Reagan, which sent me down a reading rabbit hole that I have not yet finished. I still cannot get the attraction, but the merits of Reagan are perhaps a debate for another day. However, I thought the hon. Member made a very strong case on both the pragmatic and the moral arguments. I will come back to some of the implied coercion points that he made.

I welcome the Minister to his place. This is certainly the first time I have opposed him. We all enjoyed William Shakespeare being one of the first to get the vaccine, but no one made the Stratford connection to him as Minister. I thought that was a missed opportunity. I will make a few points, and hopefully draw him out on a couple of them. We know that many basic freedoms have been curtailed over the last year, and we all want that to end as soon as possible. We know that there is a strong desire for things to get back to normal, but these significant measures and restrictions on freedom are necessary, and we have seen yet another reminder of that today.

Vaccines are the most effective public health intervention, either in relation to coronavirus or health in general, so the progress that has been made should cheer us. It is therefore important that a significant proportion of people take up the vaccination, especially those with the greatest vulnerabilities. The last time we debated the covid-19 vaccine in this place was just over a month ago. It was the day after the Pfizer/BioNTech vaccine had achieved success in phase 3 studies. Similarly, since then both the Moderna candidate and the University of Oxford AstraZeneca vaccine have achieved similar success.

That is a remarkable story in terms of time. We saw wonderful pictures of people receiving their first dose last week, and I understand that this week the vaccination programme is being extended to GP surgeries. It has been a whirlwind month, and I commend the Government for what they have achieved. It is no small feat, and I know that the Minister will take my attempts to seek clarity in that spirit. I am not seeking to throw rocks at the success, but we want some answers.

I am particularly keen to know the Minister’s assessment of the take-up required for the programme to be effective. I submitted a written question on that and received a holding answer, but he might indulge me today. If the Government are not keen to be drawn on what the figure is, which I can understand, perhaps he could explain why they do not think sharing it is helpful. In my head, I would have a totaliser. When we are fixing the community centre roof, and we need to raise money, we colour it in every time we receive another hundred pounds, but that might well not be the right approach, and I would be keen to know why.

The vaccine is one thing; a vaccination programme is another. We have rightly been very critical of the big logistical challenges for the Government both in the roll-out of personal protective equipment and the implementation of test and trace. We cannot afford a situation where vaccines complete the set. I recognise that the early signs have been positive, but I wish to pick up on a couple of bits. We have been made aware of some care-home and hospital staff being at risk of missing out due to requirements of the IT system. Have those loopholes been closed yet? Has that been clarified?

Similarly, GPs have raised concerns with us about the new rules being brought in late in the day, so that vaccinations will take twice as long, as patients need to be observed for 15 minutes. Again, that might be on very good public health grounds, but I am keen to know from the Minister what they are. We know that general practice per designated site has to deliver at least 975 vaccinations over a seven-day period. I did not receive a convincing answer when I raised this last month with my opposite number, the Minister for Prevention, Public Health and Primary Care, but what is the assessed impact on other GP services and how will we ensure that practices can meet their normal case load? I would be very keen to hear those points addressed.

Turning to the substance of what these 300,000 people have asked us to discuss, at the root it is about vaccine hesitancy. It is very easy to talk about the anti-vax elements. I am glad that colleagues have not majored on that, because to an extent that is a straw man. Multiple hon. Members made contributions about just how thin the basis for those conspiracy theories or anti-vax sentiments are. We could spend all day deconstructing them and never lose the argument, but that concerns only a very small proportion of the British people.

We know from polling, and from our constituency mailbags, that those people are a very small group indeed. There is a much more significant and noticeable chunk of people—though far from a majority—who are vaccine-hesitant, and entirely reasonably. Some might simply not want to have it, as the hon. Member for Wycombe said, and we ought to respect that. Others might not want to do so because of safety concerns—something I have heard from lots of constituents. They want to know that any vaccination, be it for covid-19 or anything else, is safe, so we as political leaders have a really important role in giving constituents the confidence that they seek. That will hopefully come from people observing the debate, and from our public engagements in general.

I know people will be watching this debate. I do not always think that about the debates we have; I suspect my 30-minute Adjournment debates do not pull in the big numbers. My message to people watching is that if they are unconvinced by what we are saying, which is perfectly reasonable, they should ask, ask, ask. If they get a question answered and are still not happy, they should ask the next one. I would certainly say that to my constituents. We will seek to get them information through all the available channels, if that is what it takes for them to feel confident about receiving the vaccine.

I agree with a number of hon. Members that the sentiment of the petition slightly misses where we are at the moment. There is a pretty broad political consensus against compulsion, coercion or inconveniencing people into submission. I know what our position is as the Opposition, but no one studies what the Government say more closely than we do, and I have never detected a desire for mandatory vaccination in what they are saying. We all want to have confidence, and to know that the roll-out has been done through the proper process, rather than in any other way, and like other hon. Members who have spoken, I hope that business will take the same view. The Government might have a role in that, and I would be interested to know the Minister’s reflections on the contribution from the hon. Member for Wycombe. I would say gently to businesses that compulsory vaccination will almost certainly not do what they want it to do. It is therefore important to take some time and have a cool head on this issue.

People’s unwillingness to take the covid-19 vaccine has a knock-on effect on vaccine hesitancy more generally. In fact, this is probably the FA cup final of vaccine hesitancy. Last year, vaccine hesitancy was in the World Health Organisation’s top 10 threats to global health—it was up there with a future pandemic. It is something that we have to address, whether it is related to covid-19 or not. In Denmark in 2013, false claims in a documentary about the human papillomavirus vaccine led to a decline in uptake of around 90% among some cohorts. Similarly, between 2014 and 2017 in Ireland, vocal attacks on the HPV vaccine from the anti-vaccine lobby led to a drop in uptake from 70% to 50%. These things matter.

What we see through those developments, and through our experiences in this country, is that the best method of countering those views is through proactive, positive health-promoting campaigns. I know that is something the Government are doing, and it is very welcome—we will support them in that. It is almost certainly too early to have enough data to be able to talk about the efficiency of such things, but we want the Government to keep pushing hard on this issue. That is what our constituents want us to do—to explain and, as I say, make ourselves available to answer any questions that they have.

We have had an extraordinary year fighting the virus. There is now clearly a path for us to take—a light at the end of the tunnel, or however people want to characterise it. We need to pursue it with the same vigour with which we attacked the previous year. If we do, we might just get out of this thing.

Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2020 Draft Health Protection (Coronavirus, testing requirements and standards) (england) Regulations 2020

Alex Norris Excerpts

Thursday 10th December 2020 General Committees

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

It is pleasure to debate these draft regulations under your chairship, Ms Rees. As we have heard, the two sets of regulations combine to replace the CQC registration requirements for covid-19 test providers with end- to-end accreditation through UKAS. The explanatory memorandum states that the change

“will allow testing providers to qualify for COVID-19 testing and analysis quickly and simply, allowing the market to expand more rapidly….it will also accredit a far wider range of COVID-19 testing-related activities”,

and will be cheaper. I have seen from the Government consultation feedback from stakeholders that that has been positively received, and have not heard of any strong reservations, so we do not intend to oppose the change; indeed, we support it. It is a good thing to do. It takes something quite complicated and newly emerging and makes it quite simple and effective.

I have points on which I seek assurance from the Minister. I am conscious that I tend to pepper my speech with these questions; it may be that not all of them can be addressed today, because some of them are granular, so I would appreciate it if those were followed up in writing.

As the Minister said, certain test providers were out of the scope of CQC regulation. If the service provider was taking blood samples via pinpricks or from veins, and the sample did not need lab analysis, it was out of scope; the same would apply if it was taking blood samples or external tissue with a swab, or just analysing or reporting such samples, and was already registered with the CQC for something else. There is quite a gap there, and an uneven playing field; it is possibly quite confusing.

With the market growing, and a growing number of technologies, a universal system is welcome. It also makes sense to broaden the system to cover all parts of these activities, end to end. That can only be of benefit, from a regulatory standpoint. Do the regulations mean that the end-to-end process will cover all entrants, and that all those undertaking those activities will be treated similarly? I wrote my speech before hearing what the Minister said; I think I heard her confirm that, but I want to make sure.

The staged process makes sense, in terms of ensuring quality at the beginning, and making sure that we do not have to wait long periods for providers to enter the market. Providers entering the accreditation process have to meet a range of standards, which include meeting Departments’ minimum standards for private testing, having a clinical director and meeting requirements under the Medical Devices Regulations 2002. I understand that the requirements were updated in November, a month after they were initially published. Is this the final list, or does the Minister intend to update them again?

Existing providers will need to achieve stage 1 by the end of the year. After that date, new providers must achieve stage 1 before they can deliver testing. Will the Minister give a sense of how long it will take a new provider to enter a market? Stage 2 will require existing providers to meet UKAS’s requirements to ensure that they are progressing towards full accreditation by the end of January, or new providers within four weeks of completing stage 1, if that is later. The 13 key requirements include having carried out a gap analysis in relation to the relevant International Organisation for Standardisation standard; having access to relevant clinical expertise; and having demonstrated meeting technical performance characteristics consistently. Can the Minister confirm that, having talked to providers, she feels that four weeks is adequate time to meet those requirements, particularly for new entrants to the market? What will happen if they do not? Will they get more time? Do they re-enter the system from the beginning? I would be interested to know what happens in the case of failure.

Stage 3 is full accreditation to the relevant ISO standard, whether for lab-based or point-of-care testing. Stage 3 must be met within four months or by 30 June next year, whichever is later. Of course, achieving the standard is really important, and goes a long way to assuring us about fundamental standards of quality and safety, but in such a fast-moving market, if the process takes about six months in total, that is quite a significant window.

Will the Minister share her assessment of the likelihood and the impact of testing providers entering the market at stage 1 or 2, and then failing to achieve stage 3? Are those stage 1 and 2 tests, in her judgment and that of the Department, robust enough to ensure that a risky product will not be out there for months? What safeguards prevent an unscrupulous or low-quality provider from re-entering the stage 1 process with a slightly different product, with no good-faith intention of ever achieving stage 3?

I have no doubt that those in the CQC will be the people who are most cheered by this. I suspect that, given the significant burdens on their time, they will not miss these responsibilities at all. Of course, every action has an equal and opposite reaction, so the regulations will bring more responsibilities to UKAS. Again, I wonder what assessment has been made of the capacity for UKAS to effectively deliver this scheme—certainly at the beginning, a lot of people could be making applications—and of the resourcing implications of ensuring that UKAS can act effectively, in terms of the business interests, and safely in all our interests.

I am conscious that I have peppered a good dozen questions into my remarks, as I always do. These are important points of clarity, however, because this is such an important area. As the Minister says, we all hope and pray for the vaccine every morning, but in the meantime testing is the significant aspect. It is right, as we wish to do more things, that private businesses—the Minister used the example of businesses—want to do testing, for staffing purposes. However, it is important that we proceed in an effective manner. This is a market that is growing and has little precedent. Even a year ago, we had no idea that we would now need such a market in this country. Risks can come with that. What the Government are doing today to put a shape around that is very sensible; we just need to make sure that it works.

[The Chair]

Minister, would you like to respond to those peppered points?

Childhood Cancers: Research

Alex Norris Excerpts

Monday 7th December 2020 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Mundell. I commend the petitioners for securing this important debate about childhood cancer. As my hon. Friend the Member for Ilford North (Wes Streeting) said, it is hard to get the required signatures for these debates, and it happens only when the issue is as significant as this. I hope that the petitioners will see that their efforts have been rewarded with as full a House as we can have in the context of covid-19 and with the high quality of this debate.

I echo the comments commending Fiona Govan, who set this petition up following the tragic death of her grandson Logan in 2017. I am sure that many of the over 100,000 people who joined her in signing it have been touched personally by this issue. I say to Fiona and all those watching that the way that she and they have turned their grief into action is an incredible feat of bravery, which has had a powerful, important impact on all of us as legislators and has pushed us to drive change more quickly. I know that is what they want. I also thank Brain Tumour Research, which has been a phenomenal driving force in this area with the petition, the debate and all the other work that has gone on.

This debate has been an important reminder that, while we were elected by voting-age people almost a year ago today, we represent all of our constituents, including children. MPs have spoken today for those children: Logan from Ayrshire, Izzy from Islwyn, Daniel from East Renfrewshire, Georgia from Buckingham, Isla from Bosworth, Benny from North Norfolk, Kaleigh from Ilford, Grace from York, Cameron from Upper Bann, Atticus from Winchester, and Bradley from Easington. Their stories have been told by their representatives today, and their names will live on in the record for as long as this Parliament stands. I know that will not bring those children back to their families, but I hope that they can take some comfort from it. As we make progress in this place—we will make progress—I hope they can also take comfort from the fact that their children have been an integral part of this story. I am sure we all want to send our prayers to Eva from Wrexham and her family as she goes through her treatment.

We heard contributions from my hon. Friends the Members for Gower (Tonia Antoniazzi) and for Easington (Grahame Morris), as well as from the hon. Member for St Ives (Derek Thomas), who all provide leadership through their relevant all-party parliamentary groups, which do really important work in keeping this at the top of the inboxes of busy Ministers. I know they will continue to make significant efforts to turn today’s discussion into activity and change.

I must talk about a few numbers, because we have to discuss this at a global level. But before I do, I want to say, as all colleagues have, that behind every number is a child who has had their life taken before they have had the opportunity to really live it, and their family, who have to live with this extraordinary pain. As a country, we must strive to do our best for children who are afflicted by cancers, as if they were our own. We must take the efforts of parents, which we have heard about today, and act with that level of urgency. As colleagues have said, covid-19 has shown what can happen when we join together in common purpose and are properly resourced to meet great challenges.

Cancer remains the most common cause of death in children, with around 240 aged 14 and under dying each year. Research has made significant inroads. Mortality has decreased by around 70% since the 1970s. The five-year survival rate for retinoblastoma is now 99%. There are recent examples, too, with a clinical trial for acute lymphoblastic leukaemia improving survival rates by a quarter, thus offering promise for the future. However, as colleagues have said, that picture is inconsistent. The incidence of childhood cancer has risen by about 15% since the 1990s, and there are many cancers for which the five-year survival rate remains devastatingly low: it is 67% for neuroblastoma, 65% for bone cancer and 32% for atypical teratoid rhabdoid tumour.

Then, of course, there is DIPG, which Logan Maclean suffered from, as have many others, as has been mentioned today. When I spoke to people at Brain Tumour Research about DIPG, they labelled it the monster of all monsters: there is no cure, the two-year survival rate is less than 10% and the five-year survival rate is zero. As to treatment, surgery is rarely an option. Radiotherapy is the preferred option, but it is suboptimal, providing a temporary positive response but not a curative one. Chemotherapy has been trialled, but that is all. The only way out today —and the only way out for our collective energies—is through research. That is how we will make the difference for DIPG and for cancers in young people on a wider scale.

At the moment only about 20% of childhood cancer research is funded by the Department, with the rest funded by charities—most significantly Cancer Research UK. What assessment has the Minister made of how the gearing could be improved and what the results of that would be? Similarly, on brain tumour research, I know that the Minister will refer to the welcome £40 million that the hon. Member for Winchester (Steve Brine) spoke about, which was announced in 2018 as part of the Tessa Jowell Brain Cancer Mission. Two and a half years later, I understand that only about £6 million of that has been allocated. Will the Minister confirm that and set out what the plan is for the other £34 million? That money needs to be put to use for the things we want it to be used for.

Charities, as I have said, are playing a crucial role in research, but their fundraising avenues have been severely hit by covid, so research funding is in danger. Sue Farrington Smith, the chief executive of Brain Tumour Research, put it bluntly:

“The stark reality is that charity-funded research into brain tumours could stop and the vital progress we have made will be lost.”

What are the Minister’s views on that? What assessment has the Department made of the resilience of research funded by charities and of how we are, at least in the short term, going to fill the gap that covid has created?

I want to finish by majoring on the points that the petitioners asked us and the Government to focus on in moving towards solving childhood cancer. First, transparent data classification systems, coming through from the National Institute for Health Research, could be dealt with relatively simply and quickly, so I hope the Minister will support that. The petitioners also ask for the ring-fencing of funding for research on childhood cancers. Finally—this is important for rare cancers and rare diseases more broadly—they want the incentivising of research in these areas, where the incentives will not, clearly, be financial. Taking those steps would make a significant difference for future children and families, who will not know that we are having this discussion. I would like to hear the Minister’s assessment of those asks. Will she let us know more broadly what steps the Government will take to reach those goals?

The debate has been a poignant and moving one, but those who signed the petition and triggered it want action. They have set out what those actions might be. It is time for us to pull together and get on with it.

Covid-19: Access to Cancer Diagnosis and Treatment

Alex Norris Excerpts

Wednesday 2nd December 2020 Westminster Hall

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

It is a pleasure to serve under your chairship for the first time, Ms McVey, and I commend the hon. Member for Westmorland and Lonsdale (Tim Farron) for securing the debate. When he opened it, he said he thought this was an issue on which we could work through consensus and in a collegiate fashion, which is absolutely right. The tone that he set, and that other hon. Members have followed, reflected that. He also said that he was direct in his contribution, which he was. He was right to be direct, because these are life and death issues, and we in this place need to be really focused on them in the most direct fashion.

I was lucky to meet the hon. Gentleman in July, alongside representatives from the secretariat of the all-party parliamentary group on radiotherapy, to discuss this issue. Of course the situation is not exactly the same as it was in July, but the crux of the issue is the same. It is great to go beyond virtual meetings and the back-channel conversations that we have in Parliament, and to get the subject on to the Floor of the House in order to have a public conversation about what is a very public and important matter. I particularly agreed with the hon. Gentleman’s point about “back to normal” not being good enough, because “back to normal” will not help us clear the backlog. Actually, we do not want to go back to where cancer services were in January. Hon. Members have touched on many ways to make services better—I will do the same later—and we should seek to do so. I share the hon. Gentleman’s anxiety about the gap between some of the rhetoric that we have heard from the Secretary of State, and the reality of what the numbers tell us about where we are at the moment.

Cancer touches us all at some point, as the hon. Member for Strangford (Jim Shannon) said yesterday and again today. For me, it was 33 years ago: I lost my father just before my third birthday. You come to terms with it and learn to live with it, but it is something that you carry around with you every day for the rest of your life. One of my major reasons for wanting to be a Member of Parliament is that I want there to be as few families like mine as possible. We can beat cancer to the best of our ability, so that people need not live their life in the shadow of cancer. I know that the Minister shares that aspiration. That is part of the consensus that we can build on this important issue.

The speeches this morning have been really good. The hon. Member for Warrington South (Andy Carter) started with Helen’s story, which was a really important thing to do. Lots of numbers have circulated—I will be guiltier than anyone else of throwing tens of thousands here and there—but each one of those statistics is a person and a life. That is what really matters. I strongly share the hon. Gentleman’s recognition of the creativity of our NHS.

I nodded and agreed when my hon. Friend the Member for Gower (Tonia Antoniazzi) made the point about undiagnosed cancers. I worry sometimes that when the Secretary of State talks, he is talking about the backlog and dealing with treatment for those who have a diagnosis. That is of course absolutely crucial, but it is only part of the problem that we are dealing with.

My hon. Friend the Member for Easington (Grahame Morris) has been a very good friend to me ever since I was elected in 2017, but particularly in my Front-Bench role over the past eight months. I am grateful to him for his counsel and guidance, and for constantly sharing his information with me to enrich my work. He was right to say that we have to understand the performance picture a year ago—frankly, covid was a very distant and small threat, and we had not really grasped how it would change our lives. We were not happy with cancer performance or with the direction of travel over the last decade. Certainly, as the Opposition, we were very concerned about that. We have to see the current situation in that context.

The hon. Member for Strangford was yesterday the Member in charge of a brilliant debate on cancer in children and young people. Collectively, we raised and analysed really important issues, and I know that the Minister took an awful lot away from that. The hon. Gentleman’s contribution today was very much in the same vein. It was about an holistic approach, across the four nations, all of which are represented today, which is really nice. As the hon. Member for Angus (Dave Doogan), who speaks for the SNP, said, this is of course a devolved issue. But we need to tackle it collectively.

I will make a few points of my own. In yesterday’s debate, I touched on the impact that covid has had on cancer diagnosis and treatment in children and young people—a demographic that is often both reluctant to visit the doctor and diagnosed slowly; it often takes multiple visits for that to happen. We will need to do things differently to tackle the pre-existing issues such as that and to catch up in relation to where we are.

Of course it was right that we prioritised covid during the first wave and have continued to make tackling the pandemic an important priority. We should take real pride in the fact that our NHS has taken such a strong punch to its capacity and stood there; that was not inevitable. We have seen other health services around the world overwhelmed, so we should be really proud of ours. It is a real testament to the institution that it has stood firm.

Nevertheless, we know that we now have an undiagnosed and untreated backlog of cancer. It is hard to estimate its true size because it is unknown. However, working off the best estimates of experts in the field—I shall use many of the numbers that the hon. Member for Westmorland and Lonsdale did in opening the debate—we are talking about a backlog of about 100,000 patients, which it would take about two years, working at 20% higher capacity than pre-covid, to capture. We cannot do that just by wanting it to be better or wanting people to put their shoulders to the wheel even more, after a year in which the NHS has been working flat out. We will have to do things fundamentally differently. If not, the price will be preventable deaths. Every four weeks of delay in starting treatment can cause an increase of up to 10% in the risk of death. The estimate is that the backlog could cause between 30,000 and 60,000 deaths, which starts to become of the same order of magnitude as the number of deaths from covid itself. That is how serious the situation is. As we emerge from the pandemic, we need to tackle cancer with the urgency and focus with which we have tackled covid.

There is particular concern about missed screenings. Cancer Research UK estimates that 3 million screenings were missed over the last year. Also, we know that fewer people went to the GP with symptoms during that time, because they were worried about other issues or capacity issues. As a result, about 350,000 fewer people were referred between April and August than we would normally expect, and there was a consequent 39% drop in the number of key diagnostic tests undertaken in that period.

I was really glad to hear yesterday from the Minister that the numbers of GP referrals are now back around pre-pandemic levels. That is a good sign. Actually, there were more referrals in September 2020 than in September 2019, but the two-week wait target of 93% is not yet being met, so there is definitely some context for that.

We need to understand that this issue will still not apply evenly throughout the population. Cancer does not know who we are when it grows in our bodies, but different demographics are affected differently—yesterday we talked about young people—and there are issues about different cancers, too. The points that the hon. Member for Strangford made about pancreatic cancer were well made.

The scale of the problem is exceptional and it calls on us in this place to make it a real focus and to have really strong, robust plans; so, now that I have talked about the problems, here are my suggested solutions. For me, this goes across four phases—planning, resourcing, new treatments, and workforce.

In August, the Secretary of State said that he very much hoped that the backlog would be cleared

“within a matter of months”.

Since I assumed my role, I have used three out of four sessions of Health questions to ask about cancer and try to get the Government on the record on that, which is why it is so great that we are having this debate. My heart sank when the Secretary of State said he thought the backlog could be cleared within a matter of months, because there is a problem; I do not think it is rude or unkind to say so. It has been recognised, during the pandemic, that some of the rhetoric that comes out of the Department is wishful and not grounded in reality. We are always told that things will be “world-class” and that things will be done “by the end of next month”. People’s hopes are got up and then dashed. We do not need exaggerated rhetoric here; we need exaggerated action.

I cannot see how anybody thinks that we can clear the backlog—the real backlog, which includes the lack of diagnosis as well as delayed treatment—within a matter of months. I do not think it helps anybody to talk in those terms. However, in October, at the Health questions before last, the Secretary of State gave me a categorical assurance that he has a cancer recovery plan that will drive down waiting lists each month for the rest of the year. I welcome that. That could be done and I am keen to hear the Minister reflecting on progress on that.

Similarly, at the most recent Health questions, the Minister for Health, the hon. Member for Charnwood (Edward Argar), said that there was greater capacity to deal with these things.

[Grahame Morris]

I cannot dispute the answer that my hon. Friend received from the Minister. It was an obvious answer, but the waiting lists have reduced because people are not presenting. There are fewer screening programmes, people are finding it harder to see their GP and things have become more and more difficult, so there is bound to be a reduction in waiting times, but that does not reflect the true picture of the backlog.

[Alex Norris]

Those points are very well made and get to the heart of what we as an Opposition want, what all Back Benchers want—and in fact, everyone. We do not want to beat cancer on paper and in statistics; we want to beat it in reality. We are not making this an issue of politics. It has to be an issue of coming together, as the hon. Member for Westmorland and Lonsdale said in opening the debate, with new and challenging things. Critically, at the heart of this, there is an indication of a plan, so I hope that today the Minister will commit to publishing it, give us greater detail on what is in it, update us on its progress in recent months and tell us whether it works through the full pathway, from symptoms to treatment, or whether it is just a diagnostics plan. To what extent is it being maintained in the second wave, and, with the national cancer recovery plan expiring next March, will there be a longer-term successor? I know that is a peppering of questions, but this is our best opportunity to ask, so I hope the Minister will take that in the spirit intended.

On resources, there was £1 billion in the spending review to tackle backlogs. Will the Minister clarify how much of that will go to cancers? Although the money is welcome, it is less than all the health experts have called for. The Chancellor has promised to give the NHS what it needs, and this is a “what it needs” issue, so resources are important.

On innovation, I am lucky enough to have lots of innovative companies contact me to talk about their treatments. It cheers the spirit to hear about developments in chemotherapy that will make it possible for drugs to be tailored to individuals. That is remarkable. However, I will make a point about radiotherapy because of the hon. Members between me and the door; I will not get out unless I do. Radiotherapy is safe to deliver in a pandemic, is significant in 40% of cures and is cost-effective. That is an area where we can make a real impact. Will the Minister commit to follow what my hon. Friend the Member for Easington said and publish the delayed radiotherapy dataset? That would be a nice step forward.

Macmillan has raised concerns that the long-term plan for the NHS will not be matched by the workforce available. It thinks we need a further 2,500 specialist cancer nurses. Where are we up to with that?

The most important message that any of us can send today is to a person listening to this, watching this or following the coverage who has a hacking cough, a lump or bump or blood in the stool, and has previously used the pandemic—as perhaps many of us would—as a reason not to access care. I ask them to please not do that. The NHS is there for them. We need them to access it. It will be there.

[Esther McVey (in the Chair)]

I am about to call the Minister, but am mindful that Tim Farron needs time to wind up.

Cancer in Teenagers and Young Adults

Alex Norris Excerpts

Tuesday 1st December 2020 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank the hon. Member for Strangford (Jim Shannon) for securing this important debate. He works hard through the Backbench Business process to get important debates either on the Floor of the main Chamber or here in Westminster Hall. I think he has chosen very wisely in this one.

I know that all Members in the room have a personal commitment to this issue. My childhood experience of cancer was the death of my father just before my third birthday, and that stays with me and my family, 33 years on. I am here to speak up for my community, but also to fight on this issue so that across the country, there might be fewer families like mine. We are well served in that regard with the Minister, and her personal commitment to this issue is something that we all look to.

Similarly, when it comes to the Scottish National party, it always great to see the hon. Member for Glasgow East (David Linden) in his place. We always learn from his contributions, and also from those of his colleagues, such as the hon. Member for Central Ayrshire (Dr Whitford); with her enormous professional experience, she always adds to the debate. The hon. Gentleman mentioned his colleague and friend the hon Member for East Dunbartonshire (Amy Callaghan). I am sure she is watching, and I know the hon. Member for Glasgow East will pass our best wishes on to her. We can see that across this Chamber, there is a high level of commonality in our views about what must be done for young people. Between us, I am sure we can move forward on this important issue and make an impact.

I agree with so much of what the hon. Member for Strangford has said that throughout my speech, I will be reiterating the points that he made. Unlike him, I did not have a point to make on schooling, which is very important. Whatever challenges our children face in their lives—because of their socioeconomic background, their health, or whatever makes them different from their peers; everything makes a child different in some way—we must ensure that we are no less ambitious about their educational outcomes. We must meet their health needs in the short term, and then be ambitious about their futures so they can reach their potential. That is a cross-party theme; no one has ownership of it. It is important that we remain ambitious about the broader outcomes of children and young people who are suffering from cancer, so that—fingers crossed, and all that wonderful support willing—we can help them to resolve their health challenges and they can go on to live really full lives.

I refer to the poignant personal experiences described by the hon. Member for Wakefield (Imran Ahmad Khan). If he is still in touch with Daniel’s family, I hope that they can take comfort from the fact that Daniel’s story has been heard and his life recognised. The hon. Gentleman’s moving contribution will stand as a testament to Daniel in Hansard for centuries, and I hope that the family get to see it. I agree with what the hon. Gentleman said about early diagnosis, and I will refer to that theme shortly.

On covid-19, the hon. Gentleman said that the cure must not be worse than the disease. I understand that, but if we do not put restrictions in place and we do not control the virus to the degree to which we are able, our NHS will not be able to do anything else because it will be overwhelmed. I do not think that treating cancer and treating covid are in tension, and I hope we do not lose sight of that in the debate that we will have later today.

The hon. Member for North East Fife (Wendy Chamberlain) made points about cashlessness. We are all looking at how covid will change British life and our own lives. I was thinking about cashlessness only this morning as I beeped on to the tube. I have had the same £10 note in my wallet for months, and it is hard to think when we will use cash again. I have to say that such change makes me a little anxious—that might just be something in me—especially when I think about my constituents. For me, beeping in is great and doing stuff on apps on my phone while watching the telly is brilliant, but for lots of people in my community, cashlessness would be their worst nightmare. We tend to think about it in those terms, but the hon. Lady talked about how we might embrace the opportunity to get better outcomes, and how we might all take into these new times the spirit of putting money into charities’ collection boxes. Those points were well made. Importantly, I am sure that those whom she works with at Toby’s Magical Journey will have seen that their contributions and their wonderful work have been recognised today. I will come back shortly to the point about getting an early diagnosis.

I have spent eight months as shadow public health Minister, and it has has been a non-stop procession of virtual calls. The fact that it has been eight months may remind you that it feels simultaneously as though this pandemic has been going on forever, and as though it only started yesterday. The sense of time and space is strange. Sometimes, the virtual meetings can blend in together—I think I can say that without that sounding rude—but one really stood out, and that was when I was lucky enough to meet the Teenage Cancer Trust youth advisory group. I heard from four incredible people who had all experienced cancer at a young age, and they shared with me their unique and personal experience of this horrific disease. What they said was eye-opening and quite hard to hear at times. It was so inspiring that those four young people, who have fought or are fighting cancer, have chosen to use their experiences to fight the greater fight for others like them. That has had a great effect on me and informed my work.

Those young people talked about the scale of the problem that we are dealing with. We know that every year, 2,200 15 to 24-year-olds will be diagnosed with cancer. Lymphoma will be the most common—about a third—the next most common will be carcinoma of the thyroid, cervix, ovary, bowel or breast, at a little bit less than that. Survival rates are improving. That is something we should recognise, and we should be pleased and optimistic about it. We know that 82% to 85% of teens or young adults diagnosed with cancer will now survive for at least five years, but that is still in the context of the fact that nearly once a day a young person will pass away from cancer. That is the level of seriousness of this debate. Cancer in young people is rare, thankfully, but it is the biggest killer by disease, and the 2,200 15 to 24-year-olds diagnosed each year face mammoth challenges. We in this place cannot make that go away, although we wish that we could, but we have a responsibility to make sure that the best services are in place to meet their health needs directly and to provide support. I know that we are all committed to that.

The hon. Member for Strangford talked about the wide variety of challenges our young people face; everyone goes through them, even if they do not have to deal with this disease. I am just about young enough to remember some of them, whether social, emotional or physical. The idea of combining them with the physical and mental burdens of dealing with cancer is quite unimaginable. As we know, the normal challenges faced by young people are not sidelined in that situation; dealing with cancer just adds to and compounds them.

The experience that the TCT youth advisory group shared with me highlighted one of the biggest issues that young people with cancer face, and that is diagnosis. As multiple hon. Members have said, that is something that those young people face before they even know they have cancer. Cancer is often not the first, second or even third suggestion for what their healthcare challenges might be, and we know that young people are the most likely age group to present three or more times before they are diagnosed. That is backed up by studies that show that rarity can lead to doctors being unfamiliar with some of the symptoms that are presenting. A compounding factor is that, as the hon. Member for Strangford said, this age group is the least likely to take to a doctor concerns about their bodies. That can often go on for more than a year. Although the challenges that we face are understandable, we should not accept them. Rarity is not an excuse for us to not be really focused on the issue, and to want to do something about it.

I know the Minister will want to do that, and I look forward to hearing her contribution. I hope she can address a couple of issues. I am particularly keen to understand what steps the Government can take differently to increase awareness of cancer, not just among young people, but also among healthcare professionals, doctors and the wider healthcare system. We know those people are doing their best, so what can we do better to make sure they have the right information and awareness to recognise it more quickly? The hon. Member for North East Fife mentioned Childhood Cancer Awareness Month, and I think we could all do more during that month.

I am keen to hear the response to the question asked by the hon. Member for Strangford about what can be done to get waiting time statistics broken down by age, and I will explain in a second why that is particularly personal. The current situation masks the true extend of the problem and restricts our ability to understand it.

That leads on to my point about the impact of the coronavirus. I have raised this at three of the last four Health questions. Dealing with the cancer bubble of delayed diagnosis and delayed care is critical to improving our health services and making sure we do not add to the terrible loss of life from covid a series of other lives lost to cancer. Young people are particularly at risk in that regard.

In the short term, I cannot even imagine how scary it must be to deal with cancer at a young age during this period of time, because all the support systems that would normally be there are more difficult to access, and they must be accessed virtually rather than person to person. That is really challenging. The long-term issue is around waiting times. In the first lockdown, referrals dropped dramatically, as people stayed home to protect themselves and others. That means that lots of undiagnosed cases of cancer are out there, many of which will be among young people, who were already less likely to seek medical attention or be diagnosed quickly. That is a potential added factor that may make outcomes for young people worse. As cancer services are restored, we really need a sense of what we are doing differently to deal with the bubble for young people in relation to those extra factors.

[Jim Shannon]

The hon. Gentleman is making some important points. There is a build-up of young people, children and young adults who have not had a diagnosis or the chance to get treatment because of covid-19. Does he think that in the Government’s policy and strategy decisions, resources must to be set aside to address the long list of people who need diagnosis and treatment, and that resources must be in place for staffing as well?

[Alex Norris]

I agree with the hon. Gentleman. We will have to do something differently to catch up. When we talk about restoring cancer services, that does not mean restoring them to how they were in January. I know there will be a debate tomorrow morning on ways in which we can make those treatment pathways better. I think the wise thing to do is to focus on those groups on whom the impact is worse, and young people are one of those groups. Before I finish, I ask the Minister for her assessment of what the second lockdown has done to referrals and waiting times. When that was discussed at Health questions the week before last she was relatively optimistic about it, but I would be keen to know more. Particularly, we had a period between lockdowns where services will have been getting back to normal. Do the Government feel that we have learned any lessons from that about restoration of services, particularly for young people?

I want to conclude by saying, as have all Members who have taken part: if any young person, or indeed anyone at all, who is watching this is worried about possible symptoms, such as hacking cough, blood in the stool, or a lump or bump that they do not recognise—whatever it is—they should please not think that we are distracted by fighting the coronavirus and that they should therefore not present in the normal way to the health services. Do it—ideally this morning, or, if not, this afternoon or tomorrow morning. Whatever the earliest opportunity is, please do it, because the services will be there for you.