Smokefree 2030

Andrew Gwynne Excerpts

Thursday 3rd November 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to speak in this important debate. It has been a small but, I think, perfectly formed debate, in which there has been a large degree of consensus throughout the House on our ambition for England to be smokefree by 2030.

I commend the hon. Member for Harrow East (Bob Blackman) not just for the work he has done on this subject over a long period, particularly in the all-party parliamentary group, but for the way in which he introduced the motion, which, as my hon. Friend the Member for Stockton North (Alex Cunningham) observed, enabled us to say, “We agree with Bob.” I congratulate my hon. Friend for his own work on the subject. I thank the hon. Member for Erewash (Maggie Throup) for her contribution, and also thank her for her time as the public health Minister: I used to enjoy our debates across the Dispatch Box, and I wish her well in whatever comes next.

The Health and Social Care Front Bench is a bit like a whirling dervish at the moment. We had the hon. Member for Erewash a few months ago, then the hon. Member for Sleaford and North Hykeham (Dr Johnson)—she was in post for just six weeks, and I want to thank her as well for the work she did in that short time—and now we have the new Under-Secretary of State for Health and Social Care, the hon. Member for Harborough (Neil O’Brien), whom I welcome. Let me also echo the words of the hon. Member for Harrow East in wishing my hon. Friend—indeed, my friend—the Member for City of Durham (Mary Kelly Foy) a speedy recovery after her hospital treatment.

It is now nearly five months since the release of the Khan review. Both the hon. Member for Erewash and I spoke at the launch, and I think the review was universally welcomed. It was generally agreed that we must move apace in ensuring that we meet the ambition of a smokefree 2030. In those five months we have had three different Health Secretaries, and we are now on our third Prime Minister. I do not blame the current Minister for all this chopping and changing, but it is little wonder that the Government have failed to find time to respond to the Khan review amid the endless changes. I hope that when the Minister responds to the debate, we will finally be given some clarity. I hope he will set out a timetable for when the Government will respond to the Khan review, and will outline which measures in the review itself the Government are currently considering. I also hope he will be able to reassure Members on both sides of the House that the Government stand by their commitment to create a smokefree England by 2030.

The importance of that smokefree 2030 cannot be overstated. Tobacco is the primary driver of health inequalities throughout the United Kingdom. In 2019-20, there were more than half a million hospital admissions and more than 74,000 deaths attributed to smoking. My constituency of Denton and Reddish straddles two local authorities, Tameside and Stockport in Greater Manchester. The public health charity Action on Smoking and Health—ASH—estimates that smoking costs those two local authorities about £172 million in lost productivity and health and social care costs. That is unsustainable.

Behind those stark economic figures, however, are individual lives that are being harmed or lost as a direct result of smoking. We know that more than 50% of people over the age of 16 who smoke say they want to quit—in fact, many say that they wish they had never started in the first place—and it is therefore imperative that the Government support them in their efforts to do so. Unfortunately, stop smoking services have suffered a 33% real-terms cut in their budgets since 2015-16. There is a drastic need for that to be reversed.

The Government have made a commitment to a smoke- free 2030, which is commendable. We support them, and we want them to succeed. However, a commitment alone is not enough: we want to see action to get there, and we need to see that action fast. The former Secretary of State had an interesting relationship with the tobacco industry, to put it mildly. She had previously accepted hospitality from the industry, and had voted against several sensible public health tobacco measures. During her brief but eventful tenure, it was reported that she had scrapped the Government’s proposals to publish a tobacco control plan, as well as the health disparities White Paper. I asked the Minister about the White Paper earlier this week during Health questions, and received something of a non-answer. I will therefore ask my questions again today, in the hope of getting some clarity. Are the Government planning to scrap the health disparities White Paper—yes or no? Are they planning to scrap the tobacco control plan—yes or no? We need transparency, as there seems to be an information vacuum in the Department of Health and Social Care. If the Government are indeed rowing back on their public health responsibilities, they should have the guts to say so, and face scrutiny for that decision.

By doing everything from inviting tobacco lobbyists into the heart of No. 10 to accepting gifts from the big four tobacco firms, the Government have shown themselves too willing to ally themselves to an industry that is damaging the health of the nation. However, the damage done by the tobacco industry is not confined to public health. Recent analysis conducted by The Daily Telegraph has revealed that the Russian Government have received almost £7 billion from tobacco companies in taxes since Putin’s invasion of Ukraine. That is despite several tobacco companies pledging to cut ties with Russia. I would be interested to know what the Minister makes of this revelation. Will the Government make it crystal clear to tobacco companies that they are expected to follow the lead of those companies that have ceased trading with Putin’s tyrannical regime?

Labour Members believe that if we want to ease pressure on our NHS and improve public health, we need to get serious about prevention. That means ensuring equitable access to smoking cessation services, and taking on tobacco companies that profit at the expense of public health. Smoking prevalence is not a problem that the Government can ignore and hope will magically go away. As a Greater Manchester MP, I have been really encouraged by Greater Manchester’s “Make Smoking History” strategy. If the Minister has not looked at that, I encourage him to do so, because it really is best practice. Indeed, it is cited as best practice in a case study in the Khan review.

Greater Manchester’s comprehensive approach to tobacco control means that smokers in Greater Manchester have more offers of support in quitting than ever before. Thanks to the scheme, smoking rates among people in routine and manual jobs have reduced faster in Greater Manchester than in any other region of England. If these strategies can work regionally, they can, with the political willpower, be scaled up to national level.

I urge the Minister to take the brave decisions. They are sometimes tough and often very unpopular with a significant vocal minority of people, but taking those decisions is the right thing to do, as history often shows. Smoking has gone up among young adults aged 18 to 24 in the past three years. To put that in context, in 2007, around 41% of young people said that they had smoked. By 2019, that had fallen to just a quarter, but in the short space from 2019 to 2022, that increased to a third. That is going in the wrong direction. Between 2007 and 2020, smoking fell, as successive Governments really ratcheted up the regulation of smoking and introduced smoke-free laws. They increased the age of sale from 16 to 18; banned the display of tobacco products; introduced standardised packaging and large, graphic health warnings; banned smoking in cars with children; and, lastly, banned menthol in 2020. Those measures worked, but they have to continue, as does the pace of change, if we are to meet the goals of Smokefree 2030.

The last Labour Government implemented one of the biggest and most significant public health interventions in modern political history. I am most proud of it, but it was not popular in all quarters; I was almost banned from holding surgeries at Denton Labour club. It was the ban on indoor smoking. When we go abroad to countries that still have smoking indoors in public places—in bars, restaurants and cafes—we wonder how on earth we put up with that in our country until fairly recently. Absolutely nobody with a modicum of common sense would want to reverse that legislation.

When we were in government, we supported taking the bold steps necessary to protect public health, and many thousands of lives were saved as a result. That is why we want the Government to commit to Smokefree 2030. They will miss that target unless they up the pace of change, accept the recommendations of the Khan review, and legislate to put measures in place. For far too long, public health has been an afterthought, or a battleground on which to have ideological arguments. We have had obesity strategies scrapped, tobacco strategies binned, and health inequalities widened. This neglect cannot continue. We will support the Government in being brave on public health. We will give the Minister the majority he needs, if he does not have one, to pass the right measures in this House. Labour Members will do right by Britain, and encourage the Government to do the same. Be brave, and build a healthier, happier and fairer Britain; we will support you.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 1st November 2022 Commons Chamber

[Mr Speaker]

I call shadow Minister Andrew Gwynne.

[Andrew Gwynne (Denton and Reddish) (Lab)]

We know that, if poorer communities cannot afford to heat their homes, health inequalities will worsen significantly over the winter months and beyond. Despite the seriousness of this issue, the previous Health Secretary—that is the right hon. Member for Suffolk Coastal (Dr Coffey), in case Members are struggling to keep track—planned to ditch the Government’s long-promised health disparities White Paper. Does the current Minister intend to do the same? If he does, how will he seriously address the dreadful health inequalities that have widened after 12 Tory years?

[Neil O’Brien]

The hon. Gentleman implies that I disagree with him about this. In fact, the Government are working hard to clamp down on squalid housing. That is exactly what we were doing in my previous Department, DLUHC, and I have just mentioned some of the things that we are doing: the £37 billion we are spending to help people to meet the cost of living, the £15 billion of that that is targeted on the very poorest households, and the £12 billion that we are investing in making people’s houses easier to heat. We will continue to tackle health disparities across the board.

Draft Adult Social Care Information (Enforcement) Regulations 2022

Andrew Gwynne Excerpts

Monday 31st October 2022 General Committees

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Edward. I welcome the Minister back to her place in the Department of Health and Social Care. Hopefully, there will not be too many issues still on her desk from her previous time as a Minister; let us hope that those who served in between managed to clear the in-tray.

I am pleased to speak to this statutory instrument on behalf of the shadow Health and Social Care team. We see no reason to oppose the measures before us; it is sensible that adult social care providers will be required to supply the Department of Health and Social Care with important data. It is striking that prior to the pandemic there was no comprehensive national data from providers on workforce status, bed availability or the number of people in receipt of care. As the Minister said, having access to that crucial data will no doubt improve policymakers’ ability to judge risk in the care system, which we know to be under significant stress. Without the requisite data, they are unable to make those detailed assessments right now.

I am reassured by what the Minister said about the data being subject to GDPR restrictions, and the fact that data will be shared appropriately with local authorities and integrated care systems. It is right that when a provider is persistently in breach of its data obligations and has not made appropriate attempts to rectify them, financial penalties will be scaled to the provider’s type and size. That is common sense.

The Department of Health and Social Care has indicated that it will consider improving the accessibility of data available to providers and any opportunity to link the capacity tracker to other data sources. In her closing remarks, could the Minister provide a short update on that work and whether the capacity tracker data will be publicly available, so that the state of the social care sector can be robustly assessed in the public domain?

You will be pleased to hear, Sir Edward, that those are the remarks of the official Opposition. We do not oppose this instrument—indeed, we actively support measures to improve transparency in our social care sector.

Covid-19 Vaccines: Safety

Andrew Gwynne Excerpts

Monday 24th October 2022 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Roger. I, too, commend the way the hon. Member for Carshalton and Wallington (Elliot Colburn) opened the debate, and I thank him for his candid support for the vaccine programme.

At the start of September, we had a debate in this very Chamber about the covid-19 vaccine damage payment scheme. I want to begin my speech in the same way as I started my speech in that debate, by saying that the covid-19 vaccine is safe and effective and has saved countless lives. I and the entire shadow Health and Social Care team remain extraordinarily grateful to those who sacrificed countless hours to facilitate our vaccine roll-out.

We are here debating this petition because of the vaccine. Without it, we would probably still be dialling in from our homes—me in Denton, frantically trying to sort my dodgy wi-fi and battling my dog for custody of the study chair. Some 51 million people have been fully vaccinated, and more than 151 million doses have been given in the United Kingdom. Without the vaccine and the extraordinary work of scientists, volunteers and NHS staff, we would not have been able to reclaim the liberties that we were forced to forfeit over the course of the pandemic.

Members from across the House will be aware that all vaccines go through rigorous and ongoing testing procedures. The covid-19 vaccines went through several stages of clinical trials before being approved, and met strict independent standards for safety, quality and effectiveness.

[Andrew Bridgen]

Surely the hon. Gentleman is well aware of the much-publicised interview of a Pfizer representative by a committee of the European Parliament only a couple of weeks ago, when they admitted that they had done no testing whatever to see whether the vaccination prevented transmission of the virus.

[Andrew Gwynne]

Yes, I heard that. Of course, the issue is that we were protecting the lives of those people who needed the vaccine to be able to get on with their day-to-day lives. The covid vaccines did go through several stages of clinical trials before approval and, as I am sure the Minister will make clear in her response, the MHRA continues to monitor the use of the vaccines to ensure that their benefits outweigh any risks. That is an important fact.

[Sir Christopher Chope]

I hear what the hon. Gentleman says, but if the vaccines were so safe, why was it necessary for the vaccine manufacturers to seek an indemnity against liability for negligence from the Government and the taxpayer?

[Andrew Gwynne]

I suspect that they wanted those assurances because of the rapidity of the roll-out. There is an ongoing process of testing the vaccines. These things are kept under review all the time by the scientists, the Government and the Department of Health and Social Care.

As the hon. Member for Carshalton and Wallington said, the MHRA operates the yellow card scheme to collect and monitor information on suspected safety concerns. A dedicated team of scientists review information daily to monitor the vaccine roll-out. For this reason, His Majesty’s Opposition and I do not view the ask of this petition—a public inquiry into covid-19 vaccine safety—as necessary.

Serious vaccine side effects are extremely rare, and catching covid-19 without vaccine protection remains overwhelmingly more dangerous than getting the vaccine itself. Where vaccine damage does tragically occur, it is right that individuals and their families can access the vaccine damage payment scheme, which I spoke at length about in September. We must ensure that this scheme remains fit for the future. I did raise some concerns about that in the previous Westminster Hall debate on this issue, because it is important that those who are eligible can access financial support.

The petition claims that there has been

“a significant increase in heart attacks and related health issues since the roll-out of the covid-19 vaccines began in 2021.”

I appreciate the strength of feeling of those who signed this petition, and I do want to understand more from the Minister about any investigations being undertaken by the health authorities and scientists.

[Andrew Bridgen]

Was the shadow Minister not listening to my speech? The report in Florida showed an 84% increase in deaths from cardiac arrest in men between the ages of 18 and 39.

[Andrew Gwynne]

I was indeed listening to the hon. Gentleman’s speech. He should have let me finish the sentence, because I was saying that I want to understand from the Minister what investigations are being undertaken by health authorities to ascertain whether this is actually the case, because there is conflicting information.

The hon. Gentleman talks about a study in Florida. It is important that we take into account all the information from across the globe. There is no data in this country from Office for National Statistics, the MHRA or any other public health body that actually backs that up. Therefore, it is important that all this data is kept under review and scrutinised. I think it is important that the Minister gives us assurances that that is being done.

As the Government made clear in their response to the petition, there have been rare reports of myocarditis and pericarditis. That has informed product information advice for healthcare professionals and patients, as the hon. Member for Christchurch (Sir Christopher Chope) pointed out. However, it is worth reenforcing just how rare these specific adverse reactions are. Across all vaccines used in the UK, there has been a reporting rate of just 0.01% for myocarditis and pericarditis. Even where this side effect has occurred, most cases have been mild and individuals have recovered.

There is an awful lot of misinformation regarding vaccine efficacy and safety, and it is vital that any debate about vaccine safety is led by the facts. Could the Minister set out what action she will be taking to tackle vaccine misinformation and to provide accurate reassurance to those who remain hesitant? How will she get robust data out there for proper and effective public scrutiny, so that we can reinforce that efficacy?

I hear a lot in my capacity as shadow Public Health Minister about concerns relating to yellow card reports. To that I reiterate the MHRA guidance, which clearly states:

“Many suspected ADRs reported on a yellow card do not have any relation to the vaccine or medicine”.

The yellow card reporting scheme allows individuals and health professionals to report any suspected reactions or side-effects, even if the reporter is not sure that they were caused by the vaccine. It is often the case that events recorded via the yellow card scheme would have happened anyway.

I feel passionately about tackling vaccine misinformation head-on, because the truth is that we are not in a position to be complacent. In the UK, people are still dying because they have not been vaccinated, and uptake among certain communities is still far too low, but the challenge is also global. More than 20 nations across the world have first-dose vaccine rates of lower than 20%. In Burundi, just 0.2% of people have received their first dose. The United Kingdom has an important role to play in ensuring that low-income countries can access vaccines, but also in making the argument, domestically and on the world stage, that vaccines are safe and effective. That will ensure that we remain better protected not only against covid-19 and potential mutations, but against future pandemics, where trust is a key tool in protecting people and communities across the globe.

This has been an important and wide-ranging debate, and one that I am glad we were able to facilitate. We in this House may have different views on this subject, but we also have a responsibility to protect the health of the people we represent, and that means using our platforms to make it clear that covid-19 vaccines are safe and effective—something that I am sure the Minister will wholeheartedly agree with.

NHS Dentistry

Andrew Gwynne Excerpts

Thursday 20th October 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I thank the Backbench Business Committee for granting this important debate, and congratulate the hon. Member for Waveney (Peter Aldous) and my hon. Friend the Member for Bradford South (Judith Cummins) on having secured it. We support the motion in the form in which it has been moved; there is nothing in it that we disagree with. If some of the political arguments are removed from the debate, I think there is consensus across the House as to what the problems are and what needs to be done.

[Sir George Howarth]

I am sorry to interrupt my hon. Friend so soon. I agree with him about the motion, but I did make the point that there were some short-term measures that could, and should, be taken within the three-month period that the motion envisages before the Government report back on progress.

[Andrew Gwynne]

My right hon. Friend is absolutely right. There is no reason why the Government cannot expedite action on the issues he mentioned in his contribution and get those improvements in place.

I pay tribute to my right hon. Friend and to my hon. Friends the Members for Blackburn (Kate Hollern) and for Bootle (Peter Dowd), as well as the hon. Members for Bath (Wera Hobhouse), for Mole Valley (Sir Paul Beresford), for Berwickshire, Roxburgh and Selkirk (John Lamont), for Gloucester (Richard Graham), for Salisbury (John Glen), for North Devon (Selaine Saxby) and for Loughborough (Jane Hunt), for their contributions.

I welcome the Minister to his place. I am not sure how long he is likely to be at the Department of Health and Social Care, but I hope he is there long enough to implement some of the changes. I am all for a bit of stability in the Department. He is a good person and a good friend, and I wish him well. However, when he comes to the Dispatch Box, he will no doubt seek to deflect from the situation that has been described my Members across the Chamber by saying that we are here today because of the pandemic.

The backlog has not helped—we all acknowledge that; it goes without saying—but the Government’s spend on general dental practices in England has been cut by more than a third over the past decade, with the number of NHS dental practices in England falling by more than 1,200 in the five years prior to the pandemic. My hon. Friend the Member for Bradford South (Judith Cummins) raised that, and it cannot be ignored. It creates the regional imbalances and dental deserts we have heard about. This is not a rural-urban thing; it is a rural and urban thing, sadly. My right hon. Friend the Member for Knowsley (Sir George Howarth), the hon. Member for North Devon (Selaine Saxby) and the right hon. Member for South Holland and The Deepings (Sir John Hayes) spoke about those dental deserts, which are very real.

The Minister’s next line of defence, if I were to guess what the officials have put in his red folder, will be, “It’s all because of the dental contract.” There is some truth in that. It is 16 years since that dental contract was introduced, and it was introduced for a perfectly good reason. There was no golden age of NHS dentistry before it. There is a reason why people of my age have a mouth full of fillings and my children do not. It is not because I did not brush my teeth as much as my children do, and it is not because I ate more sweets than my children do. It is because the emphasis for paying dentists prior to the introduction of the changes was on early treatment that was perhaps not necessary—“drill and fill” is what they called it. We recognised in 2010 that the contract had not worked in the way we hoped it would, and we proposed changes. Of course, we lost that election, but after 12 years of this Government, I am afraid the line will not wash that it is solely the contract, because they have had plenty of time to make changes to that contract and have not.

We hear about the ABCD plan, and I certainly welcome the “D” in it; at least there is a recognition of dentistry. However, like my right hon. Friend the Member for Knowsley, I worry that this kind of “Sesame Street” strategy does not come close to tackling the scale of the emergency that is gripping dental care. All we have heard from the Secretary of State is sticking-plaster solutions that tiptoe around the edges while failing to address the root cause. That is apparent in the Government’s “hit and hope” approach to dentistry. The £50 million of emergency funding announced earlier this year is a prime example. As my hon. Friend the Member for Bootle said, it is a time-limited, inaccessible pot of money that has done precious little to improve access. In fact, figures obtained by the British Dental Association showed that just 17.9% of that funding was drawn down. This is indicative of a sector that has completely lost faith in the Government’s ability to act, and to be frank, I do not blame them, because when we do see action, it does not meet the scale of the crisis, and in some cases it makes things worse.

As we have heard, the geographic, ethnic and socioeconomic disparities affecting access to NHS dentistry are becoming starker by the day. What does the new Health and Social Care Secretary do in response to that problem? She scraps the health disparities White Paper. It is beyond bizarre that in the face of such overwhelming evidence, the Government will not even consider possible solutions—let alone implement them.

I fully support what the hon. Member for Waveney and other hon. Members on both sides of the House have said about education. Dentistry in schools, a prevention strategy and an emphasis on good oral health is absolutely crucial. We would support the Government in implementing that—hopefully sooner rather than later. The consensus and mood is there to get that done, so I hope the Minister will take that up and get going on that opportunity.

As for many issues facing our NHS, much of the problem with NHS dentistry can be traced back to one thing: workforce. Several hon. Members raised that point. Any hope of an NHS recovery must be underpinned by a comprehensive workforce strategy. Where is that strategy? Was it accidentally shredded with the mini-Budget? I am sure the Minister will hail the fact that NHS stats show an increase of 539 dentists practising in 2021-22, compared with the year before. When we drill down beneath the surface, however, there is not much to be positive about.

Those stats are rendered worthless by the fact that a dentist performing a single check-up on the NHS in a 12-month period is weighted the same as one with a full cohort of NHS patients. BDA survey data shows that for every dentist leaving the NHS altogether, a further 10 are significantly reducing their NHS commitment. No matter how much Ministers might try to fudge the numbers, they simply do not add up. We cannot afford more bluff and bluster. We need action, which the Opposition will support.

The outgoing Prime Minister said that dentistry was in her top three priorities for her first 90 days. That now seems rather optimistic given that she is Liz of 44 days, but we really want the Government to act on that commitment. Can we have an update on how things are going?

The Labour party will fund one of the biggest NHS workforce extensions in NHS history. We will double the number of district nurses qualifying every year, train more than 5,000 new health visitors and create an additional 10,000 nursing placements every year. We will fund this transformative expansion by abolishing non-dom tax status. We will give dentistry the staff, equipment and modern technology it needs to get patients seen on time. Labour has a plan. Where on earth is the Government’s?

Motor Neurone Disease

Andrew Gwynne Excerpts

Thursday 20th October 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I congratulate the hon. Member for Northampton South (Andrew Lewer) and my hon. Friend the Member for Newport East (Jessica Morden) on securing this debate; I thank the Backbench Business Committee for granting it and I welcome the Minister to his place. I also pay tribute to the MND Association, the My Name’5 Doddie Foundation and MND Scotland for their tireless campaigning to improve the lives of people affected by MND.

This has been a short and small, but perfectly formed debate. I particularly thank the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) for his kind words of tribute to Gordon Aikman. I also thank the hon. Members for Coatbridge, Chryston and Bellshill (Steven Bonnar), for Berwickshire, Roxburgh and Selkirk (John Lamont) and for Strangford (Jim Shannon), and the hon. Member for Linlithgow and East Falkirk (Martyn Day), who leads for the SNP on these matters.

We know that MND impacts up to 5,000 adults across the whole UK at any one time. Tragically, MND kills one third of people within a year of diagnosis and more than half of people within two years. Many people have experienced the tragedy of motor neurone disease in their own families and communities; I know I am not alone in that. My cousin’s husband tragically died in his late 40s from amyotrophic lateral sclerosis, as it is known in the United States. He and my cousin moved there to live their dream, but sadly the dream was shattered by this dreadful disease.

Last year, my hon. Friend the Member for Leicester West (Liz Kendall) spoke on behalf of the Opposition in a Westminster Hall debate on MND. She rightly called on the Government to turbocharge investment and reform in MND research, bringing together industry, the public sector and charities to ensure the best possible outcomes for those affected by the condition.

The moral case for investment in research is clear, to help to find treatments to transform the lives of those affected by this condition, but the economic case is just as strong. Treatments in the late stages of MND are up to nine times more expensive than early intervention. Investment into research that enables earlier treatment leads to better outcomes for the NHS and better value for the taxpayer. Investment in MND research also has the huge economic benefit of building on our world-class research and science sector, delivering the high-skilled, well-paid jobs we so badly need.

In November 2021, the Government made a welcome announcement of £50 million of ring-fenced funding into MND research over the next five years. However, almost a year since the promise was made, we still have a long way to go to achieve the progress we need to support those living with MND. Unsurprisingly, given the uncertainty around the future of our economy and the future of our Government, there is also uncertainty about what the future holds for MND and those affected by it.

I will start briefly with the future of MND research. First, when the Minister rises, will he confirm that the pledge of £50 million of ring-fenced money into MND funding is still Government policy? If it is still policy, when will it be delivered? We will support him in turbo- charging that roll-out.

Will the Minister also give assurances about the wider future of R&D spending? As he knows, there are worries in the sector: we are being told that, at the current Chancellor’s forthcoming fiscal event, we can expect cuts to public services and public funding. Should we expect cuts to R&D spending, as many in the science community fear? I hope that is not the case. As the Minister also knows, soaring inflation means that funding counts for less, and the devalued pound means that the cost of the imported equipment and technologies that are crucial to running research laboratories is rising. What assessment has the Minister made of that issue?

Investment in research is crucial to treating MND, but it is not the only thing that matters: if we want to invest in a better future for those with MND, we must also invest in a better future for our NHS and social care system. If we look at the workforce, there are 132,000 vacancies in the NHS and 165,000 vacancies in social care. Given those chronic shortages, it is hardly surprising that, according to the MND Association, more than a third of people with neurological conditions such as MND have reported waiting more than a year between first experiencing symptoms and getting a diagnosis; that only 44% of adults with neurological conditions ever have an appointment with a specialist nurse; and that only 26% of people living with MND receive social care support. Those figures are further proof of the desperate need for a workplace strategy, which this Government have not yet delivered. I hope to impress on the Minister the urgency of that matter. Will the Government listen to the MND Association’s calls for a recovery and respite plan for family carers? As the Minister knows, the enormous stresses that those people are under anyway have been compounded by the impact of the pandemic. Again, if the Government produce such a plan, we will support it.

Finally, providing housing that meets the accessibility needs of people with MND is a vital part of making sure they can maintain their dignity, independence, and the choice to stay in their own home for as long as possible. A guiding principle of Labour’s approach to social care is “home first”, because the vast majority of people want to stay in their home for as long as possible, yet too many struggle to get even the basic support for home adaptations that makes that possible, with a quarter of housing authorities describing their need for accessible homes as severe. Investment and reform in research, the NHS, social care and housing are the steps needed to ensure a better future for those with MND. Labour is committed to delivering that better future, and to supporting this Government to deliver it while they remain in office. Please, let’s just get on with it.

Vaccine Damage Payment Scheme: Covid-19

Andrew Gwynne Excerpts

Tuesday 6th September 2022 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Edward, for this debate on covid-19 vaccines and the vaccine damage payment scheme. I commend the right hon. and learned Member for Kenilworth and Southam (Sir Jeremy Wright) for setting out such a compelling case for reform. As he said, the application process is painfully slow and the level of disablement is really hard to assess. Setting the level at 60%, and having a limit for compensation, really does penalise so many people who ought to benefit from the scheme. It seems crazy that the COVAX scheme is three times more generous than the scheme that we have in the United Kingdom.

I thank the right hon. and learned Gentleman for setting out those facts to Parliament, and I hope the Minister has taken them on board. I also thank him for setting out the case of the Scott family, particularly Jamie Scott—one of a number of people who have been affected by the covid-19 vaccination, whose voices absolutely have to be heard in this Parliament. Hopefully, we can address some of the concerns that he set out.

This issue is very important, and it is equally important that facts remain at the heart of the debate. From the outset, I want to make it clear that the covid-19 vaccination programme has saved countless lives and enabled us to reclaim many liberties that we were forced to forfeit over the course of the pandemic. Nearly 51 million people have been fully vaccinated in the United Kingdom and, for the overwhelming majority of people, the vaccine is safe and effective, and it protects against covid-19. However, we are here today to talk about the small number of people for whom the vaccine has had devastating consequences.

The data has consistently shown that, by comparison with the unvaccinated, the rates of death from covid-19 are lower for the fully vaccinated in all age groups. In August 2021, just eight months after the first vaccine had been administered in this country, the UK Health Security Agency estimated that over 90,000 lives had already been saved in England alone thanks to the vaccination programme. Covid vaccines went through several stages of clinical trials before being approved and met strict independent standards for safety, quality and effectiveness.

As with many medical interventions, there are, sadly, instances of serious side-effects and, in extremely rare cases, death. According to the Official for National Statistics, 49 deaths in England have had the covid vaccine mentioned on the death certificate since 2020. Although that is incredibly low, given the scale of the vaccine roll-out, every single one of those deaths is a profound tragedy, and I can only extend my utmost sympathy to individuals and their families who have been affected by rare vaccine side effects.

Although no amount of money can bring back a loved one or reverse physical damage, it is only right that those who have developed health problems, or who have lost a relative as a result of vaccination, can access a financial payment. As we have heard, the vaccine damage payment scheme was created back in 1979, and Members of all parties will agree that its principle is important and necessary. However, I have been concerned by reports of operational delays and inadequate support given to those who have suffered from rare vaccine side-effects. While I fully appreciate that identifying the causal link between covid-19 vaccinations and damage is a complex task, it is disappointing that the first vaccine damage payment related to the covid-19 vaccination programme was only made in July 2022—a full year after similar payments had been made in other countries such as Norway.

In November last year, the VDPS was administered by the Department for Work and Pensions alongside the Department of Health and Social Care. Since then, its management has been transferred to the NHS Business Services Authority, working exclusively on behalf of the Department of Health and Social Care. Given that the scale of the covid-19 vaccination programme is likely to increase applications to the scheme, can the Minister reassure colleagues that the NHSBSA and its contractor Crawford & Company will have the requisite capacity to process applications in a timely manner?

Further to that point, I note that in response to a written parliamentary question in December last year, the Minister for Health, the hon. Member for Lewes (Maria Caulfield), stated that the NHSBSA will

“review the Scheme’s processes to improve claimants’ experiences through increasing personalised engagement, reducing response times and providing general support.”

She also stated:

“The NHS Business Services Authority will also work with the Department on service improvements and further digitalisation, including an online claim form to increase accessibility.”

I would therefore be grateful if the Minister responding to today’s debate could outline how that work is progressing and what recent discussions she has had with her departmental colleagues on streamlining the VDPS. I would also appreciate it if she could set out the current average processing time from when a claim is made to when it reaches its conclusion, and whether there are any plans to improve on that average processing time.

As the Minister will no doubt be aware, payment levels for the VDPS have not been reviewed since 2007, when they were increased under the previous Labour Government. In a recent response to a written question from my hon. Friend the Member for Ealing Central and Acton (Dr Huq), the Minister stated:

“There is currently no formal plan to review the payment amount for the VDPS.”

Can she clarify whether that is still the Government’s position and, if so, what assessment her Department has made of the current level of support for those who are experiencing lifelong severe side effects, especially considering the evidence presented during the debate regarding the support available in countries that are part of the COVAX initiative?

I reference in particular a recent BBC report about Hamish Thomas. Hamish suffered from extremely rare side effects after a polio vaccination, and remains paralysed to this day. He rightly received a payout from the VDPS. However, Hamish says:

“In the grand scheme of things, especially for someone’s entire life span,”

the VDPS

“won’t cover the vast amounts of medical expenses that are needed to be paid for and the NHS unfortunately can’t provide.”

What assessment has the Minister made of stories such as Hamish’s, and will she commit to meeting campaigners to ensure that those who require support can access it, either through the VDPS or by other means?

It is vital that the VDPS is protected, but it is also vital that it is fit for purpose and has the confidence of the public at large. There is a right way of dealing with this, which the right hon. and learned Member for Kenilworth and Southam has set out, to avoid the litigation and the mistakes we have seen with other scandals, in particular the contaminated blood scandal. It is a public health imperative that people appreciate that vaccines are overwhelmingly safe and effective, but the public also deserve to know that in extremely rare cases where an individual experiences harm or damage, suitable and proportional support is available.

I want to take this opportunity to thank the Minister. Reshuffles are difficult to predict, but I wish her well in whatever comes out of the new Prime Minister’s decisions on who’s who in the Government. As this might be our last face-to-face, and I do not know what the future holds for her, I thank the Minister for her work and for the courtesy she has shown to me as I have shadowed her from the Opposition Benches. I wish her the best of luck in whatever the Prime Minister dreams up for her new Government.

Heart and Circulatory Diseases (Covid-19)

Andrew Gwynne Excerpts

Thursday 23rd June 2022 Commons Chamber

[Andrew Gwynne (Denton and Reddish) (Lab)]

I thank the hon. Member for Strangford (Jim Shannon)—I call him my hon. Friend because he is my friend—not only for securing the debate but for his skilful, seamless segue from Westminster Hall to the main Chamber. I join him in paying tribute to all those who work in our health and care system—from doctors and nurses through to porters, cleaners and cooks. They all keep our health and care system going, and we thank each and every one of them for the work they do.

As we heard from the hon. Members for Strangford and for Motherwell and Wishaw (Marion Fellows), who leads for the SNP on these matters, the issue of health inequalities cannot be ignored. The hon. Gentleman talked about postcodes and the workforce not being spread equally, and those health inequalities are not spread evenly across the UK. The hon. Lady mentioned some endemic health inequalities in parts of Scotland, and the same is true of every part of the UK. The maps of deprivation, of certain black and minority ethnic communities, of income levels, of education levels, of obesity and of smoking prevalence can almost be overlaid, and directly correlate, with those for the conditions that we are talking about. Those health inequalities and how we tackle them must be at the heart of everything we do, whether we are talking about the UK Government and their health policy for England, or the devolved Governments across the nations of the UK and the work they do to tackle these same health inequalities in the communities we represent. Health prevention must be at the core of what we do, and I am grateful for the insight the hon. Lady gave on the work of the NHS in Scotland and the insight that the hon. Gentleman brings on the work of the NHS in Northern Ireland. I am a big fan of the Marmot way of looking at health inequalities and how we tackle the social determinants of health. If we get that prevention policy right, we tackle the very conditions that we are talking about.

The pandemic piled massive pressure on the NHS, and indeed the motion is on the impact of the covid-19 pandemic on people with heart and circulatory diseases. But these problems did not start with the covid pandemic. They have been exacerbated massively by it, but I am afraid that we are now seeing the consequences of 12 years of Conservative Government in England: soaring waiting times, an acute staffing crisis and the worst levels of patient satisfaction since the 1950s. We went into 2020 with the NHS in crisis, and the pandemic ruthlessly exploited and exacerbated the failures. As the Culture Secretary recently admitted, a decade of Conservative rule left our NHS “wanting and inadequate” before covid hit. That is nowhere more apparent than in cardiac care. At the start of 2020, 30,000 people were waiting more than 18 weeks for cardiac care. That was already an unacceptably high figure, but it has ballooned by an unbelievable amount in the last two years. Now, 319,000 people are on an NHS waiting list for cardiac care—that is 319,000 individuals anxiously awaiting essential care, worried for their future, worried about their health and worried about their lives.

Cardiac care is time-sensitive. For example, patients with severe aortic stenosis—I will put my teeth in to say that—who are treated within two years have a 50% chance of survival, but that falls to 20% after five years. Every day that the Government fail to act, more patients face worse outcomes. About 15 million adults in the UK have high blood pressure and about 270,000 people over 65 have undiagnosed atrial fibrillation. What does that mean? It means we are sitting on a ticking timebomb, and unless we pre-emptively support people to manage cardiovascular risk factors, the system will come under even more pressure. I urge Ministers to work relentlessly to get a grip on this crisis. They need to come to terms with the fact that, on their watch, cardiac care has been allowed to falter. It is maddening that in these circumstances the Government have not set out a robust strategy for cardiac care and how they plan to address these really important issues. When the Minister comes to the Dispatch Box, will she commit to a timeline for that strategy, or will we hear more warm words with precious little action?

I want to reiterate concerns raised about urgent and emergency care. We now know that the average response time for a category 2 emergency, such as a heart attack or stroke, is more than double the target of 18 minutes. In some parts of the country, it is far, far worse than that, as we heard from my hon. Friend the Member for Wirral West (Margaret Greenwood) . Does the Minister agree that no one suffering from a heart attack or a stroke should have to wait 40 minutes or more for an ambulance? If so—I am sure that she does, as we all do in the House; nobody wants to see those failings—what discussions have she and her colleagues had to sort it out? This is a crisis on multiple fronts, and I am afraid that we need action rather than words.

From the moment a patient dials 999, they are being systematically failed. As we know, our NHS staff are heroes. Without them, the system would have buckled under the weight of incompetence and indecision during the pandemic, but they are fighting an uphill battle and the Government are letting them do it alone. That needs to change.

There is also a failure to acknowledge the role that prevention plays with health and social care. The Government have cut public health budgets here in England—that happened before the pandemic, and it is just not acceptable—and it means that only half of adults over 40 are attending regular health checks, which were introduced by the Labour Government in 2009. Those health checks have provided crucial evidence for spotting diseases early on, not least cardiovascular disease. With the fall in health checks, many opportunities to spot avoidable problems are being missed, especially among people from disadvantaged communities as I and the hon. Member for Motherwell and Wishaw outlined earlier. Indeed, the disproportionate impact of covid-19 showed starkly just how unequal a country we have become in health terms.

We also have huge numbers of people reporting difficulty in accessing primary care, as the hon. Member for Strangford referred to in his contribution. Some 40% of surveyed heart patients or those at risk of cardio- vascular disease had their appointments cancelled or rescheduled more than once. In 2019, the Prime Minister promised the British public that he would deliver 6,000 extra NHS GPs. Instead, numbers have gone down—another broken promise to add to the never-ending list of broken promises that define this Tory Government. Will the Minister explain to the House why the target is not being met and explain to patients why they are waiting longer than ever before?

We know from the Getting It Right First Time national cardiology report that the NHS needs 760 new cardiac physiologists and almost 100 consultant cardiologists to meet anticipated demand. Again, I reiterate the concerns raised about urgent and emergency care, because we need those staff in place. We need that workforce.

[Mrs Drummond]

The hon. Gentleman makes an interesting point, but how does he then account for the fact that in Labour-run Wales the waiting lists are even longer? I think 21% of the population are now on the waiting list, and that has extended dramatically, far more than in the NHS in England.

[Andrew Gwynne]

As we discussed at the start of the debate, the NHS is four systems that work together. We are here in the UK Parliament to hold the UK Government to account for the NHS in England. In terms of the NHS in Wales, the Welsh Government receive a block grant, as indeed do the Scottish Government, and they decide how to spend that money themselves.

There are some great things about the Welsh NHS, not least its leading the way on public health issues across Wales, and we can learn things from there, but I want to ensure that the promise about GP access that the hon. Lady’s Government made to the people in my constituency in England is kept. That is why I posed that point to the Minister. Again, we need the Government to outline how they plan to fill those vacancies and whether the workforce plan, when it finally materialises, will include speciality-level data and strategy to fill those gaps.

We in the Opposition have been clear. Labour would put patients first and sort out the mess that the current Government have left our NHS in. The last Labour Government brought waiting lists down from 18 months to 18 weeks, and we would do that again—[Interruption.] The Comptroller of Her Majesty’s Household, the hon. Member for Nuneaton (Mr Jones), chunters from the Front Bench, but I remind him that, while patient satisfaction is worse today than it has ever been and our waiting lists are some of the highest in NHS history, when we left office, patient satisfaction was the best it had ever been and waiting lists were among the lowest in NHS history. That is our record and I am proud of it.

That progress has been undone by this Conservative Government. Again, we are on standby to step in and protect our NHS. But we would focus on prevention. That prevention would improve outcomes and guarantee access to GP services for those who need them. We would publish a robust and comprehensive workforce strategy, and transform pay and conditions in the process. As part of that, we would support the hundreds of thousands of cardiovascular patients who are anxiously awaiting treatment. We would support health and social care staff who are shattered and demoralised after carrying us through the pandemic, and we would build an NHS that was resilient, accessible and fit for the future.

At the heart of that is a public health agenda that will seek to resolve the health inequalities that are endemic in too many parts of the country, where those health conditions are holding back the life chances of the constituents we represent and causing misery, poverty and pain. That is why a holistic approach to public health, and within that a strategy to deal with heart and circulatory diseases, is crucial. I hope the Minister understands the real importance of that. We stand ready to support her while she is in Government to get the strategy right, but getting that strategy right is crucial.

Community Pharmacies

Andrew Gwynne Excerpts

Tuesday 21st June 2022 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure to serve under your chairmanship, Sir Gary. I add my congratulations to my hon. Friend the Member for Bootle (Peter Dowd) on securing the debate, and I congratulate him and Members across the House on putting forward a compelling argument for supporting our community pharmacy sector and increasing its role in the provision of localised community healthcare.

We have heard from Members from across the House that community pharmacies are the cornerstone of our local areas. For many people, community pharmacists are the most accessible healthcare professionals in the NHS, and their work is invaluable. We have heard that more than 89% of the population is estimated to have access to a community pharmacy within a 20-minute walk, but, as my hon. Friend rightly pointed out, access is significantly higher, at 99%, in areas of the highest deprivation.

We have always known that community pharmacies are important, but it was felt acutely during the pandemic. Community pharmacies helped to administer 24 million covid vaccines and were at the forefront of our response to the virus. In 2020-21, they delivered more than 4 million flu vaccinations—an increase of 75% on the year before. Indeed, as the hon. Member for Southend West (Anna Firth) pointed, community pharmacies carried us through the pandemic and reacted with extraordinary speed to a virus that shut down the rest of the country. It is therefore essential that we not only protect this vital community resource but equip it for the future.

As has been noted throughout the debate, there are two broad areas of concern within the sector, and I would appreciate the Minister’s assessment of them. The first relates to resources. Despite the additional demand for services, there has been no increase in funding for the pharmacy network since 2014, and there have been cuts of around £200 million since 2016. The current framework, agreed in 2019, has not been adjusted, despite the covid-19 pandemic, and we have seen central Government’s failure to adapt. This has resulted in pharmacies being unable to meaningfully invest in staff and has been detrimental to infrastructure development as well as innovation.

What is perhaps most worrying, however, is that an EY study in 2020 found that 40% of the large pharmacy chains sampled were operating at a loss. That is not sustainable, and unless action is taken, we could see pharmacies shut and that vital point of access for people close. I think there is consensus across all parties, including from the Minister, that we want to avoid that, so I would be grateful if she could outline what steps the Government are taking to better support community pharmacies and what assessment her Department has made of the potential impact of fiscal pressures on the sector. Furthermore, has the Department of Health and Social Care made any assessment of the additional pressures that the pandemic has placed on pharmacies? Will that inform the next community pharmacy contractual framework?

The second issue I would like to focus on is strategy and workforce. That will not come as a surprise to the Minister, given the Opposition day debate in the main Chamber earlier. There has been a distinct lack of overarching Government strategy when it comes to workforce planning over the past decade, including in relation to community pharmacies. The community pharmacy model that the NHS needs has drastically changed, as have the needs of patients. As far as I am aware, there has not been any strategy outlining the Government’s ambitions for the sector. Instead, we have seen short-term thinking, a real-terms funding decline and radio silence on the future of this vital resource. That needs to change, and I impress on the Minister the urgency of working with her DHSC colleagues to develop a strategy for community pharmacies that is fit for the future. Crucially, it needs to address the workforce issues that have been reported by parts of the sector, particularly in rural areas, where the increase in patient demand is putting pharmacies under more pressure.

I understand that the Government will argue that extra resource is going into the NHS, but we must not get into the trap of taking community pharmacies for granted, and we need to build a resilient, innovative and adaptive service for the future. We must utilise community pharmacies to tackle the key issues of our time. For example, many pharmacies already offer a range of services geared towards tackling health inequalities, but the local commissioning structures mean that access is not equal throughout the country. There is a real opportunity for central Government to step in and to ensure that no matter where people live, they can access weight-management services, emergency contraception, smoking-cessation services and much more.

Community pharmacies are already embedded in communities. They are trusted by local people. We need, therefore, to ensure that the Government give full support to the sector. Every Member who has spoken would wholeheartedly support the Minister to make sure that happens.

[Sir Gary Streeter (in the Chair)]

I kindly ask the Minister to leave 30 seconds for Mr Dowd to speak at the end.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 14th June 2022 Commons Chamber

[Mr Speaker]

We now come to shadow Minister, Andrew Gwynne.

[Andrew Gwynne (Denton and Reddish) (Lab)]

More than 2 million people are affected by the backlog in cancer care. Smoking is the leading cause of cancer, and we know that a key component of tackling the backlog is prevention. Given that, can the Secretary of State assure the House that no current or former tobacco lobbyist working in or with No. 10 will have any influence on the Government’s tobacco control plan, prevention strategy or planned response to the Khan review?

[Sajid Javid]

As the hon. Gentleman will know, all decisions are rightly made by Ministers. I agree about the importance of tackling smoking. The Government are committed to a smoke-free 2030, which is exactly why I commissioned the independent Khan review. I welcome its findings and we are carefully considering them.