(2 years, 6 months ago)
Commons ChamberI thank my hon. Friend for her support. Over the past two years, the number of clinicians in the NHS has risen by about 40,000. In the past year, we have 10,000 more nurses, 5,000 more doctors and more people in medical school than ever before, so a huge amount of record investment is going into the workforce. Recently, I also asked the NHS to put together a long-term 10-year-plus workforce strategy and I look forward to receiving it.
The elective care backlog is not the only crisis facing the NHS. Covid has affected the care being delivered by mental health services, primary care, emergency care, community care and social care. In the Health and Social Care Committee’s recent report on tackling the NHS backlog, we recommended that a broader national health and care recovery plan be published to set out a clear vision for how patient care will be improved. Will the Secretary of State confirm that that will be published before April, as the Committee recommended?
I thank the hon. Lady for her work on the Committee. She is right to raise the importance of mental health. Although today’s plan is focused on elective surgical procedures and diagnostics, she is right to talk about other types of care, especially mental health care. I know that she supports the huge amount of record investment going into the NHS for mental health care. Under the NHS long-term plan, it is an additional £2 billion a year. She is also right to raise the importance of patient care. I believe that there is a lot in this plan on patient care that she will support.
(2 years, 6 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
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I am grateful to the Father of the House, who once again brings his typical wisdom and experience in this House to our deliberations in the final point that he makes. He is absolutely right. I am happy to join him and his constituents in expressing gratitude to all those who work in the NHS for the work they have been doing throughout the pandemic and that they do every day, irrespective of the pandemic. I know that those on both sides of the House will share in that. The term “elective” is a technical term used within the NHS, but I take his point that it is easy for us in this House to use the technical terms used within our Departments or in the system, but that it is often helpful if we talk in rather more simple terms that mean something to all our constituents.
As a survivor of breast cancer that was treated in 2019, I was grateful to be seen within 10 days of the referral by my GP and to start treatment within a month. It is frightening that in the months between April and November last year over 90,000 women who might have breast cancer were not seen by a specialist within the target of 14 days of being urgently referred by a GP, and that this year half a million people with suspected cancer will wait longer than the supposed two-week maximum to see an oncologist. The Minister will know that an early diagnosis can be life-saving. What does he think the impact for potential cancer patients will be of the delay to the NHS recovery plan when waiting times are spiralling so much?
The hon. Lady and I often exchange views across the Dispatch Box, and she always asks sensible and reasonable questions. She is right to highlight the importance of cancer care, and that there are some illnesses and diseases like cancer where delay can have a significantly detrimental impact on the outcomes experienced by patients.
Between March 2020 and November 2021, more than 4 million urgent referrals were made for cancer, and over 960,000 people received cancer treatment. Thanks to the amazing work of NHS staff, we maintained cancer treatment at 99.7% of pre-pandemic levels in the latest month for which I have statistics, which is November 2021.
As well as looking to the future with the announcement of community diagnostic hubs and a range of other measures, the plan is not necessary for us to do the work, as we are already doing it. The plan is important for mapping out the future direction of care, but we are not waiting for the plan to improve services, to build back better and to tackle the waiting lists.
(2 years, 6 months ago)
Commons ChamberI am grateful to my hon. Friend. Far be it from me to suggest that hindsight characterises the approach adopted by Opposition Front Benchers, but he is absolutely right. I mentioned the shadow Chancellor, the hon. Member for Leeds West (Rachel Reeves). She also said in this place:
“Those who look after the sick and the vulnerable deserve our protection, and getting PPE to them is the priority of all of us.”—[Official Report, 4 May 2020; Vol. 675, c. 412.]
She was absolutely right and remains right, and that is why this Government did exactly that. Protecting the taxpayers’ pound is hugely important. Equally, so too is procuring the kit that protects lives. In the unique circumstances that we faced at the time in 2020, I believe that this Government made the right choices.
For context, £9 billion would have given every NHS nurse a 100% bonus on their salary or it could provide the funding needed to solve the issue of autistic people and people with learning disabilities being detained in inappropriate units because no funding is available to support them in the community. Instead, it is clear that large amounts were wasted on unused and unsuitable PPE, some of which, we understand, will have to be burned. I remind the Minister that we could have had a stockpile of PPE in this country if Exercise Cygnus in 2016 had been handled responsibly. Exercise Cygnus showed gaping holes in our emergency preparedness and we have to learn the lesson from that.
I am grateful to the hon. Lady; to be fair, we may not always agree, but she always makes thoughtful points and knows this subject well. However, many right hon. and hon. Members across the House have regularly said that Exercise Cygnus gave everyone everything they needed to know in how to manage this pandemic, which is completely not the case. That was a flu pandemic exercise with a number of preconditions, one of which was that, at a certain point, it was assumed that antivirals would become available within—I think, off the top of my head—nine weeks of the pandemic beginning. That was not the case, because we were dealing with a completely new virus, so although there are valuable lessons to be learned, we need to be very careful about drawing direct parallels.
The hon. Lady rightly talked about the sum of money and highlighted the impact. She is right that £8.7 billion is a very significant sum of public money, but she also must acknowledge that that £8.7 billion was not wasted, because the PPE exists. This is an accounting point about what the purchase price was compared with the value now, with a stable marketplace for that. Only a very small fraction of that stockpile has been deemed not fit for use and, in those cases, we continue to investigate, through contractual mechanisms and elsewhere, what we can do to recover that money.
(2 years, 7 months ago)
Commons ChamberI do agree with my hon. Friend. That is why, as part of our continued response to the covid-19 pandemic, on 2 December last year NHS England asked local systems to consider ways to increase patient flow out of acute hospital settings. That includes surge capacity in care homes, identifying unused hospice capacity and, in some cases, repurposing hotel accommodation where appropriate. NHS England is reporting to me on this regularly, and it is something that we will closely monitor progress on.
The Government’s own impact assessment of discharge to assess in the Health and Care Bill, which was published almost two months after the Bill was voted on, expects unpaid carers to have to give up working hours and bear the financial burdens of the discharge to assess policy. In the light of that assessment will the Government provide greater support to unpaid carers, or will they actually reconsider this policy?
Throughout the pandemic especially we have been providing more and more support, quite rightly, across the care sector, including for domiciliary care in care homes and unpaid carers. We have made £3.3 billion of extra funding and support available since March 2020.
(2 years, 8 months ago)
Commons ChamberMy hon. Friend will understand that there has been a huge surge in demand for lateral flow tests, perfectly understandably of course. The situation at present is that the warehouses of the UKHSA have plenty of stock, but the distribution channel has been limited, although it has added to that significantly in recent days, including building on the channels it has with Royal Mail, Amazon and other suppliers, and also opening up more access points other than direct ordering online so that people can pick up tests from far more pharmacies, for example, than they currently can. It is being worked on, and whatever the current situation is, it will be improved very, very quickly. I hope that reassures my hon. Friend.
The Secretary of State is making some vital points about testing and self-isolation, but yesterday I raised a point with him about PCR testing that I would like to come back to. Although the supply of lateral flow tests is important, so is the PCR testing, which is a more reliable gold standard. Today there was a point when it was reported on social media that there were no PCR testing slots available in any region of England. Yesterday I asked him if he would authorise each director of public health across the country to have a float stock of 500 PCR tests they can use to disrupt covid outbreaks and to slow the transmission of omicron. This is a really important point. Only nine directors of public health have that float stock at the moment. Will he take this vital step and authorise it for all the other directors of public health?
I hope I can reassure the right hon. Gentleman that it will not be a case of saying to people, “If you don’t take up the jab, that’s it—you’re out.” There will also be the opportunity for redeployment to other roles where vaccination would not be mandatory. I hope that gives him the reassurance that he needs.
My hon. Friend is handling his speech in just the right way. There is a balance of rights here, and patients have a right to be treated by staff who are fully vaccinated to protect them. I have a constituent who is clinically extremely vulnerable. She contacted me to say that she was not willing to go to her necessary hospital appointments once she realised that the hospital staff were not fully vaccinated. Does my hon. Friend agree that we have to think of that pretty large number of clinically extremely vulnerable people in this country?
My hon. Friend is absolutely right.
We have heard the arguments in outline: this is about protecting staff and patients; it is not a new precedent; and there is a professional obligation, which makes it slightly different from the experience in the social care workforce. I will come on to talk about what the Government need to do. Those are broadly the arguments—
(2 years, 8 months ago)
Commons ChamberFirst, I very much agree with my right hon. Friend on the importance of never losing sight of potential unintended consequences. He points to an excellent report by the Centre for Social Justice, which looked at this in the light of past actions. That is certainly not lost on me or my colleagues in Government, but he is right to highlight that to the House once again. I hope he agrees, however, with the messages we have set out so far. They are measured and they are proportionate. The focus should be on the booster campaign because that is our way out of this. On the 15-minute wait, it is being very actively looked at, and I am sure that I will have something more to say on that very shortly.
The Secretary of State says that there are millions of tests available, but only nine local authorities out of the 153 across England have access to a float stock of 500 PCR test kits to use at their discretion, using local knowledge, to tackle covid clusters before they become significant outbreaks. This is very important to disrupt outbreaks and slow transmission, but it is not available outside those nine pilot local authorities. Given the importance of slowing transmission of the omicron variant, will the Secretary of State agree to authorise the same float stock of 500 PCR test kits to every director of public health and every area, to give them the tools they need to fight this variant?
I was referring to lateral flow tests earlier, but I think the hon. Lady asked me about PCR tests. I will look into what she said.
(2 years, 8 months ago)
Commons ChamberI very much agree with my hon. Friend. He is right to point to the huge importance, more than ever, of the pharmaceutical defences—let us call them that—against this pandemic. Top of the list are the vaccines, and especially the booster programme. Although it is already the most successful in Europe, there are a lot more people whom we want to boost. I hope he will agree with me that in doing so, it is not just about the quantity, although that is hugely important; it is about getting through to the most vulnerable people first and making sure that we prioritise them. I should also point out that, as I said in my statement, the antivirals are hugely important pharmaceutical defences. Building on all these things—whether it is the vaccinations with the new hubs, the 10,000 new vaccinators we are hiring, the use of the military or the use of pharmacies more than ever before—will really help us to turbocharge access to those pharmaceuticals.
I want to raise the vital issue of public trust in restrictions during the pandemic. People across this country have followed the rules, even when that meant being separated from loved ones at the end of life, and families not being able to be together at funerals. Does the Secretary of State agree that the people of this country have the right to expect the Government to follow the rules as well? The measures he has just announced rely for compliance on people having trust and confidence in the Government, and that has been shattered by the news of the Downing Street party. How is he going to restore it?
Of course everyone should follow the rules—no one is above the rules. The hon. Lady refers to the exchange that took place earlier in Prime Minister’s questions; the Prime Minister set out the Government’s position in that exchange.
(2 years, 8 months ago)
Commons ChamberI fully understand my right hon. Friend’s point about the impact on the travel sector; that should not be lost on anyone. We all understand why the action has been taken, but we must not forget that the sector is hugely important to the economy, and that it has been hit hard again and again. Next week’s update—the review point—will be important to provide more certainty. As I said to the hon. Member for Wallasey (Dame Angela Eagle), we cannot guarantee that we will have all the answers to our questions, but that information will certainly help to provide more certainty.
I have a constituent whose mother has been fast-tracked for end-of-life nursing care in a local care home. However, my constituent was told that she would not be able to visit her mother at Christmas, despite this being her last Christmas. The reason that the care home gave for suspending visits on Christmas day was to make it easier for the staff, because the covid
“testing would be too time consuming”.
That flies in the face of Government guidance, which says:
“Visits at the end of life should always be supported…in the final months and weeks of life…not just the final days or hours”.
Will the Secretary of State issue guidance to care homes, emphasising the importance of visits at Christmas, particularly for people at end of life?
Yes, I most certainly would like to help with that. I am sorry to hear about the hon. Lady’s constituent. As she says, visits at end of life should always be made available; there should be no excuses. I would be happy to look into the case that she has mentioned, if she provides me with more details. I will also check the general guidance.
(2 years, 8 months ago)
Commons ChamberOn the latter point, I cannot say much more at this point, but a White Paper is being developed and will be available early next year. My right hon. Friend is absolutely right that that is another key part of making sure that councils can deliver on the obligations in the Care Act 2014.
The levy raises £12 billion a year, more or less. For the three-year period, the majority of that sum will go towards catching up with electives in our NHS. There are now 6 million people in urgent care, so that is the right thing to do. However, we know that we will need an increasing share of that fund as we go beyond the three-year period. Many of the reforms in the White Paper and many of the things that we will be working on will help to inform the discussions with the Treasury.
Social care is a vital service that has been in crisis for a decade. What we need is reforms to bridge the funding gap so that unmet needs can be met and more care packages can be delivered; a dramatic improvement in pay and conditions for care staff, to halt the exodus out of care work; and decent support for the 11 million unpaid carers who have done so much extra caring during the pandemic. Sadly, what the Minister has announced falls far short of what is needed. Does she actually believe that these half-hearted measures in any way match up to what the care sector needs to survive?
This is a big reform that needs to take place, and it is based on demographic changes in the population all over the world. It is complex, and it will take a lot of time: it is a 10-year vision. I know that the hon. Lady has not had the chance to read our White Paper yet, but I am sure that she will see that there are a lot of things in it.
If we are actually looking to fix something—if we are looking to put a sustainable system in place that offers independence, choice, a great place to work and a great career—we need to fix a lot of solid foundations. I know that the Labour party always wants to throw money at the problem, but actually we need to make sure that the foundations are in place and that proper and sustainable funding is in place. That is what the White Paper delivers.
(2 years, 9 months ago)
Commons ChamberMy hon. Friend makes a very important point. I know he rightly takes a close interest in this; we do want to minimise any impact on our excellent transport and travel sector. He is right to raise the importance of making sure that PCR tests are available, the pricing is correct and the Government website where providers are listed is properly monitored so that anyone who breaks the rules is delisted.
Although the measures taken so far are welcome, now that we have community transmission of omicron in Brentwood and in Scotland, we need more protective interventions. Mask wearing can obviously play an important part, so can the Secretary of State say whether he agrees with the call from the British Medical Association to extend it to all indoor and enclosed settings? Will he also consider measures to increase ventilation in enclosed settings, encourage working from home and give proper sick pay to those who need to isolate?
I think we have been clear about why we have set out the new rules on masks, and I think our response is the proportionate one. The hon. Lady is right to raise the importance of ventilation. That is why it is very clear in the guidelines, and many places are following that. When it comes to sick pay, it is right that we have kept the rules in place that allow people, should they test positive or have to self-isolate, to claim sick pay from day one.