Menopause (Support and Services) Bill

Ben Spencer Excerpts

2nd reading
Friday 29th October 2021 Commons Chamber

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I join Members from across the House in paying tribute to the hon. Member for Swansea East (Carolyn Harris) for bringing forward this very important debate and for the campaign she has been running.

I have a different experience of the issue. Obviously, I have not been through the menopause, but as a doctor working in mental health I have looked after several women who have come to me where their depression has been misdiagnosed as the menopause. So I have seen the issue the other way around. I completely get the point that has been made across the House by several Members that understanding and recognition in this area by clinicians is something that people have many concerns about and needs to be improved. One thing that I have really taken notice of is the strength of feeling around that and the medical profession needs to think about that. I should make some declarations. I am still a member of the medical profession. I am a member of the Royal College of Physicians and the Royal College of Psychiatrists, but, as I would say if I was a member of the Scientific Advisory Group for Emergencies, I am here speaking in a personal capacity today.

I want to talk about one of the statistics that has been put out, which is that 41% of medical schools do not have formal training on the menopause. I found that astounding—I had formal training on the menopause when I went to medical school—so it is worth unpicking that a little bit. I had a look in the briefing to see where that came from. My reading of it is that it is not that student doctors and GPs are not getting training; they are getting training. They are getting vocational training on placements with senior doctors who are teaching them, but some schools do not have formal modules in terms of didactic sit-down teaching on it. I think we need to be a little careful when we say there is no training on the menopause and to dig in a little bit. The reason that is important—as I say, I totally get the sentiment and agree on the need for improvement and better recognition —is that we need to be careful about issuing diktats for how the profession approaches its training programmes. If we carve off something for one disorder, the question then is, “Well, what about other things?” Eventually, the strength of the argument will start to diminish, because we will have all different campaign groups saying, “This needs to be separately cut out, and this, and this.”

[Carolyn Harris]

Can I just say, 51% of the population is a huge amount of people who are not getting appropriate care.

[Dr Spencer]

I thank the hon. Member for her intervention and for pointing that out, but I would argue that it is maybe not 51% of the population who are in that situation of needing that care and support. Although 51% will go through the menopause, that is different from saying that 51% of the population will therefore need medical intervention and medical discussions around this.

But like I say, I do not particularly want to get into a deep debate on this; I just wonder whether we could ask the profession what it thinks it can do better, rather than us telling it, top-down. Of course, I would say that, I am a doctor—yadda, yadda, yadda; declarations, etc.—but I just wonder what the profession would say in response to the hon. Member’s campaign about how it can improve things and whether we can hear a bit more about that.

My final point is that, in a sense, I find the fact that we are having to have today’s debate deeply depressing. It is a wider indictment of the problems we have in society with the role and position of women. We have got the Equality Act 2010 and lots of legislation and statute, but as we have heard, when it comes to cultures and attitudes, it is just not there. There really needs to be a step change, given the events of the past year and what we have seen with sexual harassment. I have loads of constituents who come to me and tell me about the disrespect experienced by women. I hear the points made by my hon. Friend the Member for Thurrock (Jackie Doyle-Price). It is frankly appalling that women’s health has been left behind. We need to think carefully about what we can do as leaders of our communities and society to change things and increase respect for girls and women and the position of women in society. On that note, I absolutely pay tribute to the hon. Member for Swansea East for bringing this debate forward and the campaign she is running.

--- Later in debate ---

[Mrs Flick Drummond (Meon Valley) (Con)]

May I also add my thanks to the hon. Member for Swansea East (Carolyn Harris) for this amazing debate and Bill?

When I was first in Parliament, I encountered the exact experiences in all the comments read out by the hon. Member for Luton South (Rachel Hopkins). I was incredibly worried about it. I am delighted that so many people are now speaking out about it in public, because none of that was happening when I was first in Parliament and going through the menopause myself. Other than knowing that hot flushes were part of the process, I had no idea about any of the other symptoms until I listened to “Woman’s Hour” in, I think, 2017 and literally everything became clear: the brain fog, the insomnia, which I am afraid has not gone away—it was in the middle of the night that I heard the programme—and the anxiety and weepiness and feeling that you couldn’t cope with what was happening to you. That was very much part of it. Weight gain is common in Westminster anyway, and a lot of men also gain the Westminster stone, so I cannot blame the menopause for that, but it is certainly something that we need to work on.

That is why this conversation is so important. There are 5.1 million women aged between 45 and 55, and it is estimated that 1.5 million will be going through the menopause at any one time, yet we are so embarrassed to talk about it. Husbands and partners are at a loss as to why their wives and partners are struggling, because the symptoms have been hidden from public knowledge. If I had known some of the symptoms before, I could have dealt with them better, and I am sure my husband could have as well. That “Woman’s Hour” programme was a saviour for me, because suddenly I understood what was happening, and if you understand what is happening, you are better able to face it.

Turning to HRT, I never take medication, apart from the odd pain killer, so taking something to control a natural process was something that I did not consider—probably mostly from ignorance, I should add—but I completely understand that others need medical help. The House of Commons Library briefing states that

“16,000 women were admitted to hospital in England in 2019/20 with conditions associated with the menopause.”

I had absolutely no idea, and I am sure that most of the public do not either.

The case on HRT has been well made, so I will not say more on that, but I do hope that we can consider how it can be made affordable, because, otherwise, it will become a postcode lottery. I am very grateful that a Member who represents a constituency in Wales is interested in looking after all of us who live in England.

I wish to comment on the second part of the Bill, because it is very important. I am really pleased that everything has been raised so publicly, but it is extraordinary that it is only in the past four years that people have been bold enough to speak out, when this has been happening to millions of women for centuries. The big change is that more women are in the workplace now than at any time over the past 100 years, and nearly half of all women are over 50. I am really pleased that we have the menopause workplace pledge, with so many employers leading the way. I hope that Parliament has signed up to it, too. Flexible working hours are essential, especially as lack of sleep is a big issue. Another thought is allowing women to come later into work if they travel on public transport, so that they do not have to crowd themselves in when they are feeling incredibly hot. I have come off the tube so many times absolutely drenched in sweat and incredibly embarrassed that I do not have a change of clothes when I get to my office.

The point about training GPs is crucial, too. I listened to what my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) had to say. I spoke to a doctor about this and found that the issue is barely covered in their initial medical training. For GPs, the clue is in the name—the name is general practice, which means that GPs have to cover a huge area in their curriculum, and it is not mandatory to have additional training for a condition such as the menopause in their professional development. I would very much like to see such training being seen as part of their professional development and it should be taken perhaps every year or every few years, so that they can keep up to date with every aspect, whether it be HRT or anything else on the menopause.

[Dr Spencer]

Does my hon. Friend hope that the chair of the Royal College of General Practitioners is listening to this debate today and responds to the hon. Member for Swansea East (Carolyn Harris) on what we are talking about on GP training?

[Mrs Drummond]

Absolutely, because it is incredibly important that people understand what we are going through—whether we are talking about men or women or people of any age. As someone who does not see the same doctor twice in their practice, although I have not been there very often, I do not have that relationship with a GP, so I would feel embarrassed about going to ask for something that I did not know much about.

On the peer-to-peer point, when I returned to Parliament in 2019, I looked around at the new intake and started approaching women of a certain age—I call them my WOCA group—to form a support group to help those going through the menopause. This has been a lifeline to us, and I hope that everyone else considers that as well. [Interruption.] I can see Madam Deputy Speaker indicating to me.

Finally, may I thank the hon. Member for Swansea East. She truly is a force of nature and I congratulate her on all the things that she is achieving in Parliament, and it is such a joy to work with someone on the Opposition Benches to make a real difference to people’s lives.

Covid-19 Update

Ben Spencer Excerpts

Tuesday 14th September 2021 Commons Chamber

[Sajid Javid]

I do understand the point the hon. Lady makes, but may I suggest that, if she has not yet, she should read the JCVI’s advice on booster vaccines? I think then she might better appreciate the importance of the booster programme.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I thank my right hon. Friend for his statement. I think we all hope that plan B is not activated, but may I follow up the question asked by my right hon. Friend the Member for Tunbridge Wells (Greg Clark) and ask the Secretary of State to lay out exactly what “unsustainable pressure” means? In his assessment of NHS capacity over winter, where does he see the bottleneck? Is it staff? Is it medication? Is it beds? What work is being done to enhance that capacity?

[Sajid Javid]

When I talked earlier about unsustainable pressure, it would be things like hospital occupancy, in particular in intensive care units, the admissions of vaccinated individuals versus unvaccinated individuals and the rate of growth in admissions. I know there is a lot there, but I think it is right that there is not one particular trigger and that we take a number of issues into account. I hope my hon. Friend agrees that the Government are right to plan for all contingencies.

Covid-19 Update

Ben Spencer Excerpts

Monday 6th September 2021 Commons Chamber

[Nadhim Zahawi]

I will absolutely join my hon. Friend in congratulating St John’s volunteers, who have done a phenomenal job. They really rose to the challenge when we contacted them and said that we needed them. They delivered in spades. I thank my hon. Friend for all his words: this has been a massive team effort involving the health service, the public sector and of course the private sector as well.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I would like to thank my hon. Friend for the incredible vaccine roll-out; many lives have been saved by it. My question is about domestic vaccine passports, and I have to apologise because I get a bit confused by the nomenclature of what is being proposed. On the one hand, we have what I understand to be vaccine-only passports, which say simply that someone has been vaccinated and that that is all that counts. Then we have covid status certification, which can also include negative testing and proof of recent infection. Crucially, this is not just about whether someone has been vaccinated, because as I understand it, a lateral flow test negative result is the best evidence that someone is no longer infectious. Is my understanding correct that the proposal for the end of September is for vaccine-only domestic vaccine passports? If that is the case, why has that moved from covid status certification?

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. Just before the Minister answers, I must point out that we need to finish this statement fairly shortly. Colleagues should keep their questions very short, and the answers should be correspondingly short.

NHS Update

Ben Spencer Excerpts

Wednesday 21st July 2021 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

I ought to conclude the statement here, because we are running way behind time. However, I appreciate that Members have important questions to ask and that the Minister will want to answer them. But I ask for much greater speed and brevity, because otherwise it is not fair to people who are waiting for us to come on to the next item of business. I call Dr Ben Spencer.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

Thank you, Madam Deputy Speaker. Before I ask my question, may I declare an interest, in that my wife works in the NHS?

I thank the Minister for her statement, particularly on supporting our workforce. When I speak to local health leaders they tell me that the workforce are tired—they have been dealing with covid for the past 18 months, and they are worried that they will have to lurch from covid into tackling 150% of the covid backlog. What reassurance can the Minister give health staff working in my constituency that there will be a sustainable transition from dealing with the pandemic to dealing with all the backlog and consequences as a result of it?

[Helen Whately]

My hon. Friend makes an important point, and it is why I am working closely with my hon. Friend the Minister for Health, who is leading oversight of the elective recovery work. We are very much discussing how we can make sure that, with the pressure of looking after people with covid, with winter approaching and with elective recovery, we are looking after our workforce through this period. Of course, looking ahead to the winter, it is important that people get not only the covid vaccination, if they are eligible, but the flu vaccination, so we can try to have as little flu as possible in what may be a challenging winter ahead.

National Health Service

Ben Spencer Excerpts

Tuesday 13th July 2021 Commons Chamber

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

Controversially, perhaps, I think that much of this statutory instrument is uncontroversial. The reason behind that is my own experience of being recruited to go through medical school. As part of the recruitment process, it was made very clear to me that I had to have hep B testing and I had to be vaccinated for hep B, and that going through and getting involved in becoming a medical student just would not happen if that was not the case. I think that is fair enough.

We expect our health staff to have vaccinations for a variety of conditions—not just hepatitis B but things such as chickenpox for people who have not been exposed, and rubella—because we know the impact that those things can have on the patients we look after or the people we care for. We know the huge impact covid has on the most vulnerable in our society. Its lethality—its severity—is linked to frailty, and one of the most frail groups are people living in care. It is important that people are vaccinated so that, when they have asymptomatic covid, they do not unintentionally pass it on. We know that vaccination rates are not high enough to give the protection necessary to protect people in care homes, and on that basis it is an entirely reasonable and sensible approach to bring forward measures saying that people have to be vaccinated to work in that setting. However, although that might be a reasonable approach I realise that it is different from my personal experience as I have just described, because that was a pre-recruitment process that I went through, whereas what we are talking about now is a process for people who are currently in post—people who might have been working for quite some time and have a lot of years behind them—and if they do not go through with vaccination, ultimately they will be without a job. That is a big deal. It is also important to recognise that those who may decide that they do not want to be vaccinated are not evil people who should be shunned; they are people who make decisions for whatever reason about vaccination, and that is important and should be respected.

Fundamentally, this SI is about risk, and I see two risks here. One is the risk of covid to people living in care settings, and that risk is very clear: there is loads of data on that—loads of data on the impact and on fatalities, and also on the protection provided by vaccination for people at risk of covid and protection in terms of reducing transmission. So, that side of the equation is very clear, but the side that is less clear is the risk in terms of staffing, and that is a critical issue. Some people will decide that not being vaccinated is more important to them than working in the care sector. I am completely unclear as to how many people will make that decision and I do not think anyone knows what that population is going to be—what the numbers are going to look like. That is a concern as we already have staffing issues in the care sector and it has been a long-term problem.

Nevertheless, perhaps the only way to test this out is to bring it forward and see what happens. The 16-week run-in makes a lot of sense, but it is critical that it is monitored to see what happens with regard to staffing and retention, and if that is a big issue—if retention pressures start coming through—we will have to change course. When my hon. Friend the Minister sums up I would welcome her saying what she will do over the summer as this is being brought in to work with and engage with people in the social care sector on its impact. If there is a substantial impact, I hope that she will undertake to come back to the House after the summer recess with plans to mitigate this or change course.

Covid-19 Update

Ben Spencer Excerpts

Monday 28th June 2021 Commons Chamber

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I congratulate my right hon. Friend on his appointment and warmly welcome his return to the Front Bench. Does he share my concerns regarding this winter, when we predict that an increase in covid hospitalisations may be superimposed on normal NHS winter pressures? Can he confirm that plans and preparations are being put in place now to support our NHS in what may be a very difficult winter indeed?

[Sajid Javid]

My hon. Friend is right to raise this issue. I can absolutely confirm that plans are being put in place. A huge amount of work was done by my predecessor and, of course, I will continue that work—just yesterday, I had meetings on winter plans. I can give my hon. Friend the absolute assurance, not just on vaccinations but on dealing with the backlog, that there are plans in place, and in due course I will come to the House and set them out.

Covid-Secure Borders

Ben Spencer Excerpts

Tuesday 15th June 2021 Commons Chamber

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

We are an island nation, and we rely on our connections with the world for trade. I am sure that many Members would, like me, celebrate and congratulate the Government on the historic trade deal that was agreed today. We rely on our connections to get freight and to meet our friends and family. Many businesses and jobs rely on international travel. In my constituency of Runnymede and Weybridge, it is our lifeblood. We depend on our connections, both domestic and international, for jobs and to support businesses.

I therefore reject the premise of the motion that the Opposition have put forward today. They would have us isolate from the world as if we were some sort of zombie island—or maybe a zombie world, depending on how one views the analogy. For all the reasons that I have put forward, we cannot do so, because we are so dependent on our connections.

Our approach must be proportionate. It must be based on science, not on the false “no risk/high risk” dichotomy that has been presented. Covid is here to stay, and with new variants continuing to evolve, we need a system that is immune to them and that can adapt and evolve as the virus does. The Minister and I have had many discussions about the need for international safety standards and the fact that we can, should and must lead the world in supporting international travel—through whatever means, but fundamentally through the use of science and new technologies.

The Opposition’s proposal is backwards. It is built on a world where there are no vaccines and where there is no testing. Our plans have moved on. We have the science behind us, and our border plans are the foundation for safely bringing back international travel as things develop.

A Plan for the NHS and Social Care

Ben Spencer Excerpts

Wednesday 19th May 2021 Commons Chamber

[Matt Hancock]

Well, it did not actually, because after 2010 we then had to bring waiting lists down, and we brought them down. The 52-week waits came down to just 1,600 before the pandemic, and it is our task and our mission to make sure that we get them down once again. However, this will take time and it will take all the resources that are possible—yes, extra staff, and that is happening; yes, extra capital investment, and that is happening; and yes, extra diagnostics, and that is happening. We have to use all the capacity of everything that we can—north and south, revenue and capital, public and private. What people care about and what our constituents care about is whether they can get the problem fixed, and last year has demonstrated that without doubt. So on the Government side we will use everything in our power to support the NHS. It is only those on the other side of the House who have the ideological divisions, and that just demonstrates once again that we are the party of the NHS.

In March, we committed £7 billion for further funding for healthcare services, including £1 billion to address backlogs from the pandemic, and that has taken our additional funding for covid-19 to £92 billion. We are also helping the NHS to recover medical training, and today I can confirm to the House an additional £30 million for postgraduate medical training. The formula for beating this backlog is looking closely at the demand as we emerge from the pandemic, putting in the right resources to meet this demand and putting in place an ambitious programme of improvement in the NHS.

That brings me to the third thing I want to talk about, which is how we are going to build back better. The Queen’s Speech outlines improvement in almost every area of healthcare, applying vital lessons that we have learned from the pandemic, including from the successful vaccination programme, when the whole health and care system has worked as one in the face of challenge and adversity. The vaccination programme brought a jigsaw of academics, the private sector, volunteers, the NHS, civil servants and many more, and put this together, revealing a bold picture of what is possible in this country when we pull together. That is the spirit and the energy that will underpin our reforms, and all of them have a common thread, which is to improve the health of the nation, based on the principle that prevention is better than cure.

Turning to our health and care Bill, as outlined in Her Majesty’s most Gracious Speech, one of the lessons of the crisis is the importance of integrated working. We knew this before, but it has come right to the front of mind. For years, people in the NHS at all levels have called for stronger integration within the NHS, and between the NHS and others they work so closely with, such as local authorities. The Bill will allow for a more preventive, population health-based approach to how we spend NHS money, helping people to stay healthy in the first place, and that is at the core of our Bill.

The right hon. Member for Leicester South asked about the new integrated care systems. They will bring together decision making at a local level between the NHS and local authorities to ensure that decisions about local health can be taken as locally as possible. The Bill will tackle much of the bureaucracy that makes it harder to do the right thing and free up the system to innovate and embrace technology as a better platform to support staff and patient care.

Her Majesty also set out our commitment to reform adult social care, and we will bring forward proposals this year to give everyone who needs care the dignity and security they deserve. Throughout the pandemic, we have sought to protect the elderly and the most vulnerable, and this will remain our priority as we look to end the care lottery and ensure that people receive high-quality, joined-up care.

This country understands the importance of the NHS and social care, but I also think that there has never been a greater appreciation of the importance of public health. Never have the public been more engaged, and never have we learned quite so much in such a short space of time. We must capture the lessons of the pandemic on how we do public health in this country and put that together with the innovations of the last decade—in data, genomics, population health, science and research.

One of the lessons that we have had to learn quickly is that health security and health promotion each need a single-minded focus. The people who get up in the morning and think about how we increase healthy life expectancy must be different from the people focused on fighting novel pandemic threats. Each is important and each needs dedicated focus. We have split these functions into two purpose-built organisations so that we are better at both.

The new UK Health Security Agency will have a dedicated focus on responding to the current threats, planning for the next pandemic and scanning the horizon for new threats in good times as well as bad. Of course, pandemics do not respect administrative boundaries. The UKHSA’s role is specifically to promote and protect the security of the United Kingdom as a whole.

Next, the job of our new Office for Health Promotion will be to lead national efforts to improve and level up our health—addressing the causes of ill health, not just the symptoms, such as through our plans to tackle obesity and make healthier choices easier and more accessible, and through supporting our colleagues in primary and community care. General practice, after all, is at the forefront of all population health measures and GPs are the bedrock of the NHS. General practice will be central to our levelling up the health of the nation because we know, and they know, that prevention is better than cure. A greater proportion of our efforts will now be directed at preventing people from becoming patients in the first place.

All of that brings me to mental health reforms. To truly level up health and reduce health inequalities, we must level up every part of our health, including mental health. I am determined to see mental ill health treated on a par with physical ill health, and to ensure that support is in place for those struggling with their mental wellbeing. We have provided record levels of funding for mental health services, especially to meet the additional burdens of the pandemic, but we need a better legislative basis—a mental health Act fit for the 21st century.

We are modernising the Mental Health Act to improve services for the most serious mental illnesses and support people so that they can manage their own mental health. The new Act will tackle the disparities and iniquities of our system and improve how people with learning difficulties and autism are supported. Ultimately, it is going to be there for every single one of us if we need it.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I know that my right hon. Friend shares my passion for legislative reform of the Mental Health Act. We go through this process every 20 years or so. I was wondering whether he could unpack how this will go forward, bearing in mind the need to get the law right while delivering it very quickly so that patients get the benefits.

[Matt Hancock]

My hon. Friend has enormous expertise and wisdom in this area. He is right to make the argument that we need to support everybody’s mental wellbeing, but that we also need a specific focus on very serious mental ill health, much of which has been, in many cases, exacerbated by the privations that have been necessary during the pandemic. He says that this is a process that happens once every 20 years, but it is almost 40 years since we had a new mental health Act. We want to do this with stakeholders on a consensual basis—I am very glad to hear the reiteration of cross-party support just now from the right hon. Member for Leicester South. Our goal is to bring forward a draft Bill in this Session and a Bill potentially in the next Session, so that we ensure it is legislated for during this Parliament. That is a timetable on which we have worked with the many experts who have informed the process, led by Sir Simon Wessley, of course, whose report sparked off this work. I look forward to working on that with him and the Minister with responsibility for mental health, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries).

Coronavirus

Ben Spencer Excerpts

Thursday 25th March 2021 Commons Chamber

[Dr Ben Spencer (Runnymede and Weybridge) (Con) [V]]

This past year has been incredibly difficult for all of us, and I would like to start by paying tribute to the people of Runnymede and Weybridge for their boundless resolve and community spirit, and remembering those who have lost their lives as a result of the pandemic.

Many of my constituents are hurting. The pandemic and lockdown have hit us hard. Many have lost their jobs and many are desperate to see their loved ones. The road map and the fantastic vaccine roll-out bring those most valuable of commodities, certainty and hope—something to look forward to that life will get better. I want to go faster, but I also agree that the need for irreversibility and certainty weighs heavy. I will therefore support the regulations we are voting on today, but I must reiterate that every day we have the restrictions in place they are causing great harm. The Government should move heaven and earth to lift them as soon as possible.

In the brief time I have in this debate, I want to talk about the broader provisions of the road map. As with all discussions on the coronavirus regulations, they are only half the story. We talk a lot about the new normal and the return to normal life after the pandemic. The road map charts out the plan for the lifting of legal restrictions, but not the return to normality. Covid has changed many aspects of life and I have been calling for a long-term plan for living with the virus. I am pleased that the road map starts to tackle that through the four reviews on: large events, covid certification, international travel and social distancing.

Those four reviews will do all the heavy lifting. They are critical to setting out what our post-pandemic covid world—our endemic covid world—will look like after June. When legal restrictions lift, the impact of the recommendations will still be felt. They will have a far longer lasting impact than what we vote on today. They will form the basis of what the new normal will be on a huge range of issues that impact on daily lives, from social distancing requirements in pubs and restaurants to the wearing of face masks, self-isolation and contact tracing.

I ask the Minister, in his closing remarks, to clarify that we will get to debate in the House the outputs of those critical reviews—the Government’s endemic covid road map, as it were—and that we will be able not just to vote on any resulting legislation, but to approve any formal guidance and provisions resulting from it.

Covid-19: Government’s Publication of Contracts

Ben Spencer Excerpts

Tuesday 9th March 2021 Commons Chamber

[Edward Argar]

The right hon. Gentleman highlights quite accurately the 94%, which was cited in the subsequent judgment and the order that flowed from it, of the contracts that were late in publication. We accept that that is a statement of fact. The Department has published 100% of the CANs that it is obliged to publish that are related to this matter. He talked about a percentage that were procured without following a normal competitive tendering process—I think he referred to 58% as the percentage that were procured. That is entirely appropriate under regulation 32, recognising the situation we faced at the time and the priority of this Government to make sure that, at pace, we got the PPE that our frontline needed to keep it safe.

On his final two points, I do not see in the judgments in this case or in any of the other scrutiny of this issue by Committees of this House or other organisations anything that asserts or finds that inappropriate conflicts of interest influenced how these contracts were awarded. I am proud to serve in a Government led by a Prime Minister who leads from the front and has done whatever is necessary to make sure this country gets through this pandemic.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

This time last year, there was a desperate need to secure PPE urgently when, almost overnight, it became one of the most hotly sought-after commodities globally. I congratulate the Department on its Herculean efforts to keep my residents safe and get them the PPE they needed when the shortage hit. Of course, delays to publication are not ideal, and I am glad that the Department is urgently trying to resolve that. Does my hon. Friend agree that, as part of the review into the pandemic, we need to look at how procurement procedures can be improved when responding to a national crisis or, indeed, future pandemics?

[Edward Argar]

I pay tribute to my hon. Friend for his work on this issue; he is a strong and vocal champion for the NHS and those who work in it. The context he sets is absolutely right. I will quote from the summary of the NAO report without making a value judgment on it. It highlighted in paragraph 2:

“Demand for PPE rocketed in England from March…There was also a surge in demand in other countries. At the same time, the global supply of PPE declined as a result of a fall in exports from China (the country that manufactures the most PPE) in February.”

That is a statement of fact, and it highlights the context in which we were operating.

My hon. Friend is right: all Governments should rightly look at what they have done and what lessons they can learn, to ensure that they are well prepared for future events.