(2 years, 5 months ago)
Commons ChamberMy hon. Friend is campaigning passionately for primary care services in his constituency, and he points to some fantastic practices. I congratulate all the people involved in delivering that and support him in his work with his local commissioners to make sure that they are getting even better local primary care.
Does my right hon. Friend recognise that the crisis in NHS dentistry, which affects my constituency as it does his, well predates the pandemic, and indeed goes back to at least 2006 when the then Labour Government changed the way in which dentists are paid? Will he undertake to look at the units of dental activity system, which disincentivises dentists from providing dental work particularly in the most disadvantaged communities?
My right hon. Friend is absolutely right in his analysis, and I can give that undertaking. I will say a bit more about that in a moment.
If the hon. Member for Ilford North wants to talk about funding for the NHS, I am happy to oblige. Under the last NHS long-term plan, before the pandemic, we made a historic commitment of an extra £34 billion a year. Because of the pandemic, we then necessarily put in £92 billion of extra funding. At the last spending review, we increased funding still further so that the NHS budget will reach £162.6 billion by 2024-25, supported in part by the new health and social care levy.
We have made sure the NHS has the right level of resourcing to face the future with confidence, but we must also be alive to the consequences. The British people expect every pound spent to be spent well, and they expect us to be honest with them that every extra pound the hon. Gentleman calls for will be a pound less spent on education, infrastructure, housing and perhaps defence. I believe in a fair deal for the British people, and especially for our young people. We will be making plenty of changes alongside this funding.
(2 years, 5 months ago)
Commons ChamberThe place-based working that the hon. Gentleman talks about is also at the heart of the integration White Paper that the Government presented recently.
I welcome Gordon Messenger’s review, but does the Secretary of State not agree that in the history of the national health service, reorganising senior management has often been a distraction? Will he prioritise the area that would make a real change to health and care—the interface between the two—and focus on career progression and development for care workers in particular, who hold the key to unblocking the awful problems that we have in both sectors?
I know my right hon. Friend speaks with experience, and I appreciate that he will not have had time to look at the report in detail yet, but I think when he does read it he will find that it is precisely what he has just asked for. This is not a reorganisation; it is all about strengthening management, and the report sets out in quite some detail how that can work.
(2 years, 9 months ago)
Commons ChamberI agree with the hon. Gentleman about the importance of the workforce, especially in the context of specialisms, and pathology is a really good example. That is why we are putting record amounts of investment into the workforce and training. It is also one of the reasons why, to get a more joined-up plan in health, I have decided that Health Education England should be merged with the NHS. This will enable more joined-up thinking and much better planning for the future, especially in specialist areas.
I declare my interest as a doctor. Will the Secretary of State look again at how we structure doctors’ pay and remuneration? At the moment, we are training lots of doctors—more and more of them—which is a great thing, but typically they leave in their late 50s, so we are losing a whole decade of productive medical time. That cannot go on. Will he look again to see how we can disincentivise early retirement of medical professionals?
My hon. Friend speaks with great experience and raises a really important issue. The short answer is yes. We have fantastic doctors throughout the NHS and more in training in medical schools than ever before, but we should also focus on retaining talent throughout the NHS. I assure him that that work has already begun.
(2 years, 11 months ago)
Commons ChamberI of course understand the importance of my right hon. Friend’s question; as he said, he asked it yesterday and, understandably, has asked it again today. I hope he will understand that I am not able to give that commitment alone; it would not be a decision for me and my Department alone, but I know the Government would consider it together seriously.
Might the Secretary of State consider going a little further? Since the data is changing all the time—almost by the minute—it is inconceivable that in a week’s time and a week after that we will be in the same place that we are in today. This House needs to consider the information available to it in near real time, so will he go away and consider whether it would be appropriate now to ensure that the House is able to consider these matters for sure next week and the week after that?
I will consider that. My right hon. Friend is right to point out that this is a fast-moving situation and it is right that the Government continue to monitor it and respond when necessary, but I hope my right hon. Friend will agree that right here and now the matter being debated and the regulation before the House is the best possible response that can be given by this Parliament today.
(2 years, 11 months ago)
Commons ChamberI declare my interest as a vaccinator. I support the level of ambition that the Secretary of State has articulated, but does he distinguish between being offered a jab and actually getting a jab? Someone can be offered a hip replacement, but it does not mean they will get it any time soon.
First, I thank my right hon. Friend for being a vaccinator and for all the work he has done personally to help this country get through the pandemic. Of course there is a distinction—he is absolutely right. The NHS can offer an individual a jab—they might receive an email or a text saying, “Please come forward. Either book or walk in. You are eligible.”—but the individual has to come forward and take up that offer. That is why a huge amount of effort—even more effort than before—will go into persuading people to come forward.
(2 years, 11 months ago)
Commons ChamberOur NHS is not being overwhelmed by covid, nor is it likely to be, but if the Health and Social Care Secretary really believes that it will come under pressure, what is he doing to ensure that novel antivirals, such as sotrovimab and molnupiravir, are freely available now to treat people, as we know that they will reduce hospitalisation and death by up to 80%?
We have secured, I believe, some 180,000 doses of new antivirals. There are two main antivirals that are specifically designed to work against covid-19. As I mentioned earlier in my statement, we are starting a national study that will help us to roll these out and make them targeted and effective. For those who are immunosuppressed and have a positive PCR test, we will be able to use them very shortly.
(2 years, 11 months ago)
Commons ChamberIt is important that there is easy access for everyone to get vaccinated. The hon. Lady has given a really good demonstration of why that is so critical for every part of our community. If it is helpful, the Vaccines Minister will be pleased to meet her, as chair of the APPG, to see what more we can do.
Vaccines are clearly our way out of this, but does the Secretary of State agree that treatments are also important, and they have come on in leaps and bounds? Sotrovimab reduces the incidence of death or hospitalisation by 80% and molnupiravir got its approval last week. Does he agree that while we are very good at R&D we are less good at rolling out these extraordinary therapeutics? Will he do everything in his power to make sure that the NHS has access to those drugs as soon as possible since they reduce considerably the problem that covid and its associates will pose in terms of mortality and serious illness?
Yes. I know my right hon. Friend speaks with experience and I agree with him absolutely.
(3 years ago)
Commons ChamberMy hon. Friend makes a very important point and he speaks with deep experience. What I can tell him is that we will shortly be publishing an integration White Paper, which, given what he has just said, I am sure he will welcome.
I declare an interest similar to that of my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter). Does the Secretary of State agree that there is an opportunity with integrated care boards and panels to ensure the end of the awful spectacle of people at end of life and frail elderly people coming towards the end of their days being expected to live out those days in an acute hospital ward, when they should be looked after in more homely settings in the community? That has gone on for too long and consecutive pieces of legislation have failed to address it. We have an opportunity here, probably with the help of the other place, to sculpt the measure we are considering today to ensure that stops. It must stop now, so that our frail elderly can have a future that does not involve an end as grisly and as sad as so many are forced to endure.
I absolutely agree with my right hon. Friend, who also speaks with deep experience. I very much agree with what he has just shared with the House.
On bureaucracy, we are removing the rules and regulations that make sensible decision making harder. On accountability, our healthcare must be accountable to democratically elected Members of this House. We spend well over £140 billion pounds of taxpayers’ money on our healthcare system, so it is right that there is more accountability to this place.
In closing, the unprecedented challenges of the pandemic have only deepened our affection for everyone working in health and care. They have been the very best of us. It is on us in this place, and on everyone who can make a difference, to give them the best possible foundation to work together to meet the challenges of the future. The Bill does that and a lot, lot more.
(3 years ago)
Commons ChamberI listened carefully to what the hon. Lady said and I will take that away, but let me give her some reassurances. We work very carefully on the vaccination programme with GPs, local authorities and others. Obviously it is vital to ensure that costs and payments are covered, and we keep that constantly under review.
Pandemics are by definition international, and the UK—along with France, Germany and the World Health Organisation—has rightly called for an international pandemic treaty. Can my right hon. Friend say what form that treaty will take, and within what sort of timeframe? Will it cover, for instance, the availability of personal protective equipment in a timely fashion to those who need it, and the avoidance of the use of vaccines to exert diplomatic leverage, which we have seen in the case of AstraZeneca and the threatened use of article 16 of the Northern Ireland protocol?
(3 years ago)
Commons ChamberI gently say to the hon. Lady that she really should not try to play politics with the story that she is perpetuating about the Prime Minister on a hospital visit yesterday. As the hospital trust said, and as I am sure she knows, the Prime Minister and his team followed all the rules that they were required to follow, whether they were about face masks or otherwise, in that hospital. Something tells me that she knows that, but sadly she has decided that she wants to play politics with such an important issue.
As for information on vaccination rates in Bristol, the hon. Lady knows that every region of England has a director of public health. She probably knows who hers is, and they will be able to supply a lot of information. If she is having any difficulty getting that information, I will certainly help her in any way that I can.
I declare my interest as a vaccinator. I support the Government’s position, but will my right hon. Friend the Secretary of State tell us what assessment he has made of the risk of transmission of coronavirus from an apparently healthy person to a vulnerable person? As with hepatitis B, the only justification for the measure must be that there is a significant risk of transmission.
Furthermore, will he reassess his position on flu following the comments of his two predecessors, which I support? Will he ensure that we do nothing to trespass on the rights of individuals unless it is absolutely essential to keep vulnerable people safe? Finally, will he say why he has gone for 1 April? If this has to be done, it is better to do it quickly. By the spring, we will clearly be past the winter pressures that we are all concerned about.
I thank my right hon. Friend for his support. On the assessments that we have done, I have shared some information with the House, and there will be an impact statement followed by an impact assessment that will give him more information. It may be helpful for him to know that studies already in the public domain show that against the delta variant, the AstraZeneca vaccine is 65% effective and the Pfizer vaccine is 85% effective in preventing infection. The fewer people who are infected in these settings, the less spread there will be.
I think I have set out the Government’s thinking on flu, but it remains under review. There are many reasons why we have focused on the 1 April date, but the main one is to give those in the NHS who have not yet had a single jab—there are 100,000 of them—to make the positive decision to get vaccinated.
(3 years, 1 month ago)
Commons ChamberIn our response to the pandemic, we have set out clearly our plan for the autumn and winter; I have certainly done so in the House. We certainly expect more pressure as we head into winter. We have been very open about that; it is why the covid vaccination booster programme and the flu vaccination programme both remain important. However, there are provisions in the Act that I believe are still necessary and proportionate to help with the pressure that my hon. Friend refers to, such as the registration of healthcare and social care workers and the power to discontinue healthcare assessments for people being discharged from the NHS. I think that it is wise—especially as we head into the winter, when we do not know just how significant the pressures will be—to have that flexibility.
Would my right hon. Friend go a little further? As a medical support worker, I can tell him that there has been very little effort to follow through on a programme begun last year to encourage people to return to being patient-facing. They need to remain engaged; the Act is a good start in that process, but it does not appear to have been developed in any way. I agree absolutely that my right hon. Friend needs to keep those provisions in the Act, but he needs to develop them more than has been done so far—particularly because if we face a bad winter and possibly the resurgence of this or another virus, we will need those people. They need to remain engaged.
My right hon. Friend is right to draw attention to that point. We need to keep working on it, but it might be helpful to know that under section 2 of the Act, the Nursing and Midwifery Council has been able to register temporarily some 14,000 nurses, midwives and nursing associates in England, and the Health and Care Professions Council has been able to register more than 21,000 temporary paramedics, operating department practitioners, radiographers and other professionals. That has certainly helped the NHS and the care system.
We have already allowed 13 of the 40 temporary non-devolved provisions in the Coronavirus Act to expire, and at the most recent six-month review we deemed a further seven provisions and part of an eighth suitable for expiry. Last month, as we published our autumn and winter plan, I came to the House to set those out.
Some of the provisions that we are recommending for expiry are some of the most stringent aspects of the Coronavirus Act. They include section 51, which relates to potentially infectious persons and which has been used only 10 times and not since October 2020; section 52, which gave powers to issue directions relating to events, gatherings and premises, and which has never been used; section 23, which relates to time limits for urgent warrants under the Investigatory Powers Act 2016 and which is no longer proportionate to this stage of the pandemic; and section 37, which allowed for the disruption of education for children and young people with special educational needs and disabilities, and which continues to be unused.[Official Report, 22 October 2021, Vol. 701, c. 8MC.]
(3 years, 4 months ago)
Commons ChamberThe hon. Lady will know that we have in place financial support for those who need it and who are asked to self-isolate. It is something that is important. It continues to be important, and it is something that we will keep under review.
Thanks to jabs and far better treatment, the case fatality rate is now 0.085% and falling. Had it been so a year ago, is there the remotest possibility that jurisdictions would have embarked on restrictions of the same breadth and scope? Does it not follow that now is the right time to move to step 4 and release burdens on people, so that we can get society going? Will the Secretary of State please caution the Opposition on their undue reliance on masks? They are not the solution; vaccinations are.
My right hon. Friend is absolutely right to raise the importance of vaccination. That has been the key to getting us to where we are on our road map, which is why we cannot emphasise enough the importance of continuing with the programme. That is why we have set out that we plan to have a booster programme in September.
(3 years, 4 months ago)
Commons ChamberThe hon. Gentleman is right to point out that there is no risk-free way forward. For the whole world, this pandemic is unprecedented, and leaders across the world are having to balance risks and take the approach that they think is right. He is also right to raise the challenges created by the pandemic and our response to it that are not directly linked to covid itself, such as the increase in mental health issues we have seen across the nation, including in Northern Ireland. We have provided much more funding for mental health, but we need a long-term, sustainable plan to deal with mental health challenges, which have, sadly, increased.
I very much welcome the statement and I welcome my right hon. Friend to his place. It emerges that the AstraZeneca vaccine made in India—particularly batches 4120Z001, 4120Z002 and 4120Z003—may not be recognised by the European Medicines Agency, despite being recognised by the Medicines and Healthcare Products Regulatory Agency. This has implications for the digital covid certificate that will enable many constituents to travel to Europe this summer. Can the Secretary of State clarify the negotiations with Europe on this, and say whether regulatory bodies in other jurisdictions, notably the Food and Drug Administration, are taking a similar line to that of the EMA?
I can tell my right hon. Friend that the AstraZeneca-type vaccine being used in India is, I think, referred to as Covishield. We have not used Covishield in the UK, and we are in intensive discussions with our European friends to ensure that they have the facts to hand and that they can respond accordingly.