Public Health

Bob Seely Excerpts

Tuesday 30th November 2021 Commons Chamber

[Bob Seely (Isle of Wight) (Con)]

It is pleasure to follow my hon. Friend the Member for Wycombe (Mr Baker) and my right hon. Friend the Member for Forest of Dean (Mr Harper). I thank them for their fantastic leadership on this issue.

I want to develop one point specifically: I believe that Government must take a balanced view. I accept the argument made by various people, including the hon. Member for St Albans (Daisy Cooper), that the precautionary principle is good. I think we can be criticised for potentially not acting quickly enough at the beginning of the pandemic two years ago, but overreaction is not good. We have had a damaging obsession with a very narrow view of what we perceive to be health. The poorer you are and the younger you are in this society, the higher the price you have paid, and that is not acceptable.

I look at this debate and this motion in the context of some dreadful forecasts and dreadful assessments that have driven Government’s nervousness. I want to explore them and put them on record because I believe it is in the public interest, but I do so within the terms of the motion. I want to look particularly at Imperial College and Professor Ferguson. I have a great deal of respect for them and I will be careful how I phrase this, but I am concerned that some of the forecasting we have had has had a track record in, frankly, getting it wrong repeatedly. In 2001, Professor Ferguson predicted 150,000 human deaths from foot-and-mouth; under 200 died. In 2002, he predicted between 50 and 50,000 deaths from BSE; in the end, 177 died. In 2005, he said that 150 million people could be killed by bird flu; 282 died. In 2009, a Government estimate based on his advice said that a “reasonable worst-case scenario” for swine flu would lead to 65,000 British deaths; in the end, 457 people died. I am happy to be corrected on any of those points, but that is the publicly available information.

Moving forward to covid, Ferguson predicted 85,000 deaths in Sweden; in fact, 6,000 Swedes have died. Anders Tegnell, Sweden’s chief epidemiologist, said in September 2020:

“We looked at the”

Imperial

“model and we could see that the variables that were put into the model were quite extreme...Why did you choose the variables that gave extreme results?

I love experts—don’t get me wrong; I know we sometimes have our issues with them—but it is helpful if they are right, if only very occasionally. Johan Giesecke, Sweden’s former chief epidemiologist, said that Ferguson’s models were “not very good”. The Washington Post quoted Giesecke as saying that Imperial’s forecasts were “almost hysterical”. This is the forecasting that has been, in part, driving Government action.

In this country, oncology professor Angus Dalgleish, in this country, described Ferguson’s modelling as “lurid predictions”. He said that Ferguson and his colleagues were getting it “spectacularly wrong”. He said:

“Unfortunately, we have a Sage committee advising a government that is devoid of any scientific expertise, on speculative concepts such as the R number”—

which we now all know is the reproductive rate—

“and the need for everyone to stay indoors, even though the evidence strongly suggests that people are less likely to catch Covid-19 outside.”

So some of the scientific evidence may have actually driven the rising covid rates in the same way that going into hospital may have been the place that people caught covid and died from it.

Viscount Ridley has criticised Ferguson’s modelling. Lund University has applied Ferguson’s models and found a massive difference between his predictions and what actually happened. Professor Michael Thrusfield from Edinburgh University said that Ferguson’s previous modelling of foot-and-mouth was “severely flawed”.

[Sammy Wilson (East Antrim) (DUP)]

The hon. Gentleman is absolutely right in highlighting the predictions that are wrong, but the unfortunate thing is that politicians then jump on to them and quote them. For example, the Health Minister in Northern Ireland, on the basis of Mr Ferguson’s predictions, talked about deaths “of biblical proportions” and scared the life out of people.

[Bob Seely]

The hon. Gentleman makes the point most eloquently. Politicians then become fearful. They think, “What if the worst-case scenario is right?”, and lose faith in more balanced predictions.

John Ioannides from Stanford University said of Ferguson’s modelling that

“major assumptions and estimates that are built in the calculations seem to be substantially inflated”.

He is a serious customer, Professor Ferguson, and Imperial has an impeccable reputation. I pay respect, overall, to their work, and I do not seek to criticise for the sake of it; I want to highlight that bad forecasting and bad modelling drives bad Government decisions that then become illiberal and intolerant of other people who have more balanced views.

More recently, in July 2021, Ferguson predicted 100,000 cases, saying that it was “almost inevitable”. Yet we got nowhere near there. The US forecaster Nate Silver, who is very good at predicting US elections, said:

“I don’t care that the prediction is wrong, I’m sure this stuff is hard to predict. It’s that he’s consistently so overconfident.”



The political scientist Professor Philip Tetlock agreed with Nate Silver, adding:

“Expect even top forecasters to make lots of mistakes…When smart forecasters are consistently over-confident, start suspecting”

other factors in play, such as

“publicity or policy-advocacy games”.

I make no such allegations.

More recently, I understand that this summer Professor Ferguson predicted upwards of 100,000 cases. They topped at just over 30,000. In an interview with The Times, the good professor said that his prediction was off because the football messed up his modelling. That for me comes to the essence of the problem with forecasting. When someone can predict 100 million deaths and no one dies but someone gets a sore thumb, they can say mitigations were taken by Government. When a forecaster’s work becomes verifiable, we can see when he predicts and gets it wrong. When that forecast comes up against reality, reality kicks in and makes a fool of the forecast and sometimes, sadly, a fool of the forecaster. Every time Professor Ferguson’s forecasts have been verifiable, they have been seen to be very badly flawed, and this is a serious man and a serious university.

To sum up, if we look at the forecasts made about covid, just like the forecasts for so many other things, reality changes those forecasts and very often undermines their credibility, so we need another set of factors to guide us. Members on the Opposition Benches and on this side have said we need principles. We need a precautionary principle, but we need a sense of balance so that we do not overstep the mark, damage our society, damage our young people and damage poorer people by seeking to control when we need to learn to live with this. My final question to the Minister is: will the Government look into forecasting and perhaps hold an inquiry into the success of forecasting and what we can learn from it, so that we do it less badly in future?

Finally, going from the theoretical to the very practicable, and on a point related to the Isle of Wight, we are not getting the boosters in the Riverside Centre. My hon. Friend the Member for Winchester (Steve Brine) raised a specific point about his constituency, and in the same way, will the Minister please look at getting more booster jabs to the Isle of Wight and our Riverside Centre?

[Mr Deputy Speaker (Mr Nigel Evans)]

The last contribution before the Minister responds is from Dr Andrew Murrison.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I record my interest as a practising doctor. I agree with my hon. Friend the Member for Isle of Wight (Bob Seely) that there appears to be a problem with the availability of slots for vaccinations, and that was before the Government announced this week that we were to expedite the booster programme. I am concerned about that, and I hope the Minister, who has commented briefly on that already, can confirm she has a cunning plan to ensure that people who need to be vaccinated are vaccinated and in particular that those vaccines reach the elderly and the vulnerable. At the moment, I have severe concerns about the availability of those slots, if not the vaccines themselves.

I will be supporting SI No. 1340 today on face coverings. I am mindful that we have to rely on the best available evidence. The evidence for a lot of these non-pharmaceutical interventions is more common-sense than actual. It seems to me to be a minor imposition to ask people to wear a face mask, particularly given the evidence published by The BMJ last week on this matter, which we have referred to already. The hon. Member for Central Ayrshire (Dr Whitford) in particular spoke about it.

I am more concerned about SI No. 1338 for two reasons. While SI No. 1340 expires on 20 December—or, at least, Ministers can decide whether to continue it on that date—there is no such luxury contained within SI No. 1338. That seems to be illogical. When pressed earlier, I regret to say that the Minister, who was very good at taking interventions from hon. and right hon. Members, did not address that point. She needs to explain to my satisfaction, and that of other Members, why 20 December stands in SI No. 1340, but it is 24 March for SI No. 1338. It seems that there is an appetite in the House to return here, if necessary, to reconfirm or refute the need for these measures to continue into the new year. I hope that the Minister has heard that loud and clear.

I for one would be more than happy to be here well past the time at which we rise, and right up to Christmas if necessary, and the reason for that is this: the things we have been discussing today touch heavily on the liberties and livelihoods of our constituents. These things are not trivial; they are of vital importance, and all actions have consequences. I am worried about things like this because of the messaging it gives off. It will be very difficult for businesses deciding whether to invest. They will look at SI No. 1338 and think, “Good gracious me, this will go on and on and on.” While they have been happy to go along with some of the impositions that we have had over the past 18 months, they are now coming to the point where they are thinking, “This could basically be the new normal. This will go on and on, and on what basis will we continue to invest in our businesses if every few months we have these kinds of things and goodness knows what else that may follow?” I am worried about that.

I am also deeply worried, as other hon. and right hon. Members have pointed out, about this “suspected of” bit. That seems to me to be rather clumsy and I am not comfortable with it. Presumably, anybody showing any coronavirus symptoms could be “suspected of” having the omicron variant.

The World Health Organisation touched on a potential solution to that at the weekend, which is the Thermo Fisher PCR test. I assume that it relies on the detection of the S-gene dropout that has been referred to, which could expedite the diagnosis of omicron as opposed to straightforward coronavirus. I wonder whether the Minister could reflect on that and say whether her understanding is that such a test would be the basis on which we would decide whether somebody was suspected of having it, because that could shorten the length of time that people are required to be out of action and might make No. 1338 slightly more palatable for those of us who have concerns about it.

I disagree with some hon. Members about what will change in three weeks’ time, because I think a great deal will change, as a number of international authorities have made clear. Indeed, the doctor who first found the variant, Angelique Coetzee, seemed to be of that view in her upbeat assessment of how it is affecting her patients, as is Dr Anthony Fauci, the adviser to the President of the United States. Many international authorities are saying that in two weeks’ time, we should be a lot further along the journey of understanding how the variant behaves.

That makes sense because, in two weeks’ time, if the variant is a problem, we will presumably see an uptick in hospitalisation at least among the vulnerable population. It is wrong to suggest that everybody in South Africa is young and vibrant; of course it has its fair share of elderly, vulnerable and frail people and of people with comorbidities. In two weeks, I expect there will be at least some indication of whether it will be a problem. We should also keep in mind that it might be part of the salvation, rather than the problem, because we do not know how the virus will behave. Some viruses mutate downwards and others mutate upwards. We must hope for the former not the latter, but at the moment we simply do not know, which is the basis of my support for No. 1340.

There is an assumption that perhaps southern Africa is not sophisticated in healthcare terms, but I gently make the point that the Republic of South Africa certainly is sophisticated. It has been the victim of its own generosity in having invested heavily in sequencing. It is a bit like the UK in relation the Kent variant: if we look, we will find. We need to be careful about suggesting that other healthcare economies are not up to spec, because I do not think that is necessarily the case for South Africa.

I also observe that yesterday, 25 deaths were attributed to covid-19 in South Africa and the seven day average is 35 deaths. Many of us are captivated by the covid graphs; I check them daily. I confess that I do not generally obsess about South Africa, but recent events have made one focus on its graph, which is bumping along the bottom. We are in no way seeing a wave as yet, although we may yet do so, but we need to be careful about suggesting it will be a major problem, as Angelique Coetzee and others have been.

The Government are right to be cautious—of course they are—but we also need a sense of proportion. We need to understand that everything we do in this place with regard to regulation has a consequence for liberty and livelihoods, for the economy in general and for young people in particular. I made that point in connection with the apparent suggestion of the hon. Member for St Albans (Daisy Cooper) that it was a no-cost measure. We need to be careful about the impact that it all has on young people and especially on mental health.

[Bob Seely]

Does my right hon. Friend share my frustration that we have all these charts about covid, but we have never had them in context—how many people are born, how many people die, how many people die of flu, how many people die of other illnesses—so we have become fixated by something when there are many other causes of death in this country that, frankly, claim many more people, and by taking this out of context we create unnecessary fear?

[Dr Murrison]

Yes, I absolutely agree with my hon. Friend. The point about that is of course that the national health service at the moment is running very fast to catch up because for the past 18 months, necessarily, it has not been doing a lot of the elective work in particular that it would have wanted to do. That is actually going to be a problem, I think, for years to come. What I would say is that there seems to me to be very little likelihood of our NHS being overwhelmed this winter. There are always pressures at this time of the year, and an overwhelmed NHS was the absolute cornerstone of Government policy towards this particular public health emergency at the start. Those things are not there now, and I think that we just need to contextualise a lot of what is going on.

Of course we need to reduce the number of admissions to the NHS, particularly to ITUs, for covid-19. It is a huge burden for the NHS, and it prevents us from doing other things, but we are certainly not in the position now that we were in this time last year. So while I will certainly be supporting No. 1340, I am afraid that I will not be able to support the Government in respect of No. 1338, because of the lack of a sunset provision similar to that enjoyed by No. 1340 and also because I am very concerned about “suspected of” and what that might mean in terms of a chilling effect on schooling, the economy, liberty and livelihood.

Covid-19 Update

Bob Seely Excerpts

Monday 29th November 2021 Commons Chamber

[Sajid Javid]

Yes, of course. We want to make sure that we are helping people who are immunosuppressed in every way possible, including with access to any tests that might be clinically required. The hon. Lady may have noted that in the JCVI advice that I referred to, there is a recommendation, which we have accepted, that those who are immunosuppressed and are able to benefit from the vaccine to some extent should be offered a booster dose on top of the third primary dose. The antivirals are also very important for that group of vulnerable people, and it is good that the UK has procured them.

[Bob Seely (Isle of Wight) (Con)]

Will the Secretary of State, on behalf of the Government, reassure me that the Foreign Office and its consular service will be doing all they can? I am already receiving calls from Islanders stuck in southern Africa who are worried about their ability to get back.

[Sajid Javid]

Yes, I can give my hon. Friend that assurance. We have been working closely with colleagues in the Foreign Office, and that will remain vital work so that we can help people—UK citizens or Irish citizens—who might be stuck abroad to come back.

Health and Care Bill

Bob Seely Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Edward Argar]

I fear that I do not have time to cover the other amendments in the four minutes that I have left.

Although I appreciate that my right hon. Friend the Member for Maidenhead and my hon. Friend the Member for Broxbourne will continue to press this matter, may I offer them a meeting with me and the Mental Health Minister to discuss further what they are proposing in advance of the Lords stages? I cannot make any promises or say anything beyond that, but I will meet them to further discuss the sentiments that sit behind their amendments.

Let me turn to my hon. Friend the Member for Aberconwy (Robin Millar), who made his points powerfully and eloquently, as he always does. As a Government of the whole United Kingdom, we have a duty of care to all citizens in the UK, which is why I welcome the clauses already in this legislation that will bring benefit to residents across the UK.

[Bob Seely (Isle of Wight) (Con)]

Will the Minister take my intervention?

[Edward Argar]

If my hon. Friend can do it in 10 seconds.

[Bob Seely]

Please, Minister, do not forget the unavoidably small hospitals, of which there are 12 in isolated communities.

[Edward Argar]

My hon. Friend has made his point. He has made it to me before. I will not forget either him or unavoidably small hospitals, particularly in the Isle of Wight.

On the point made by my hon. Friend the Member for Aberconwy, we do recognise the importance of making sure that health and care data can be shared safely and effectively across the UK to support individual care and improve outcomes for people across the UK.

--- Later in debate ---

[Bob Seely]

Let me start by thanking my hon. Friend the Member for Waveney (Peter Aldous) for that superb speech. We have a huge problem with NHS dentistry on the Isle of Wight, and also with independent pharmacies. I have written to the Health Minister about that several times, and there is an ongoing conversation, for which I thank him very much.

In the short time that I have, I want to speak about fairness and equality. The Secretary of State spoke eloquently—as he always does—about equality between the four nations. I want to see equality between isolated and non-isolated communities as well, specifically in relation to unavoidably small hospitals. There are about a dozen in England and Wales, and for obvious reasons they tend to be in isolated areas. The most isolated of those hospitals is St Mary’s on the Isle of Wight, which has a 100% isolation factor because it is separated from everywhere else by sea. Such areas tend to have populations of less than 200,000.

Unavoidably small hospitals find it difficult to achieve the economies, and the economies of scale, that are possible elsewhere in the NHS, because they do not receive tariff payments. They have to provide baseline services at a certain cost, but they do it for many fewer people. It is therefore likely that fewer people will use the services of that particular surgeon or those particular nurses, and as a result they are under permanent pressure. On the Island, our additional costs are estimated, at 2019 prices, to be some £12 million a year. That covers acute services, ambulances—including helicopters, for us—and travel to other destinations, which may involve ferries.

The NHS long-term plan—pre covid, back in January 2019, almost a lifetime ago—set out a 10-year strategy, stating that it would develop a standard model for delivery for smaller hospitals. May I ask the Secretary of State and the Health Minister what has happened to that plan and to the community services formula, which we hoped would support unavoidably small hospitals?

I am, however, delighted that, thanks to the excellent work of Maggie Oldham, the superb chief executive of the Isle of Wight NHS Trust, St Mary’s Hospital has been taken out of special measures and is now good. I would welcome either of the Ministers if they came to see us on the Island, not only to congratulate Maggie but to understand the pressure that one of the 12 unavoidably small hospitals in the United Kingdom is under, so that they can work with me to provide a better funding model for it and the other 11.

Oral Health and Dentistry: England

Bob Seely Excerpts

Tuesday 25th May 2021 Westminster Hall

[Bob Seely (Isle of Wight) (Con) [V]]

It is a pleasure to serve under your chairmanship, Ms Bardell, and I thank the hon. Member for Bedford (Mohammad Yasin) for organising the debate. The Minister knows that I have spoken on these dentistry issues on several occasions, and I have written to her as well. As discussed with the Minister, I will be writing to the Treasury on these issues this week, because the Minister is a champion of public health, dentistry, pharmacy and other issues, as she rightly points out, but there is a cash problem here as well. I am aware that she is doing her best in difficult circumstances, and covid presents a unique set of circumstances. I agree with my hon. Friend the Member for Mole Valley (Sir Paul Beresford) that we are seeing an improvement under the Minister—or we should see an improvement once covid gets lifted.

Islanders are facing issues, however, in relation to dentistry. It is, frankly, just very difficult—nig,h-on impossible in some parts of the Isle of Wight—for families to find an NHS dentist. I thank the Minister for the extra money to soak up some of the outstanding appointments, but that money was reasonably limited and it went very quickly. Some Islanders who are getting a new dentist are now having to go to the mainland for treatment. That is incredibly inconvenient, especially given that, with the most expensive ferries in the world, some kids on the Island have never seen a dentist in their life.

The Healthwatch England report found that 7 in 10 people find it difficult to access an NHS dentist. The same body published data in 2019 showing that 85% of dental practices across the country were closed to new patients. That is absolutely reflected in my constituency. As well as the inconvenience and the damage to the nation’s dental health, it will cause us problems in the longer term, as suggested by my hon. Friend the Member for Mole Valley. That is because we know that there will be a significant rise, potentially, in cancer cases: one of the side effects of a lack of dental appointments is that we will not be able to spot cancers like mouth cancer, and ill health, when they show themselves in people’s mouths. We know, also, that gum disease is associated with heart disease, so there is a knock-on effect on other bits of the health service.

As I have discussed with the Minister, my worry is that—as with pharmacies—because we have a cash-flow problem in these areas, that problem will exhibit itself as greater, and frankly more expensive, problems further down the line. Dental practices were clearly facing issues before covid. The challenge is, in part, a workforce one. The British Dental Association found that 75% of dental practices are struggling to fill vacancies. Over half of newly-qualified NHS dentists under 35 are thinking of leaving the NHS in the next five years, with many going into private practice. It is good that they are staying in dentistry but bad that they are leaving the NHS, because the NHS is where we now need the acute dentistry support.

Dental schools are not producing enough dentists. The nearest dental school to us is in Portsmouth. These problems seem to be exacerbated in coastal, rural, isolated areas. We are isolated by being cut off from the mainland by the Solent, and we are also coastal and pretty rural. We are experiencing these factors on the Island more, arguably, than many other parts of Britain. We also have an issue on the Island with dentists retiring or leaving early, and that is specifically the case among several of them. That will put our system under even greater threat, not only for NHS dentists but also specialists working in dental labs on the Island and indeed elsewhere. I have talked about that on numerous occasions.

There is no easy fix to these problems, but there are some potentially reasonably quick wins. I want to mention a few now, to see if I can interest the Minister in them. The initiation of a dental training scheme on the Island would be incredibly helpful and would deal with one specific hotspot. If someone trains here on the Island, there is nothing to stop them then going back to the mainland, so we would not only be training dentists for the Isle of Wight—it would be good if we were—but if we have an overflow of dentists there is no reason why they cannot go back to the mainland after their training.

Can we have a simplification of the process for qualifying as a training practice, and then a boost to the funding for interns’ salaries? We are not talking about significant amounts of money here, but these measures will pay dividends in the long run. According to people who are clearly much more expert on these matters than I am, it is important to make changes to the contracts to incentivise remaining in the NHS. It is also important to separate laboratory fees from dental fees, which will help laboratories to survive as well.

Finally, on fluoridation, which my hon. Friend the Member for Mole Valley raised, I think this is a no-brainer. It is very difficult to make a case against it. The Minister was kind enough to grab coffee with me, last week or the week before, to talk about public health schemes. If he is looking for a test case, fluoridation is a scheme that could be very easily introduced to a large area of the UK that is highly measurable because it is separated by sea from the mainland—clearly I am talking about my constituency. We are self-contained and have only one local authority and one water authority to deal with, so if there was a desire to introduce another fluoridation pilot scheme or pilot a roll-out, that could be done very successfully on the Island. Given that we are seeing dental problems and have a shortage of dentists on the Island, may I respectfully suggest, if there is to be a move to fluoridation, as my hon. Friend the Member for Mole Valley rightly suggested, that it please start where it is arguably most needed—on the Isle of Wight?

Coronavirus

Bob Seely Excerpts

Thursday 25th March 2021 Commons Chamber

[Bob Seely (Isle of Wight) (Con) [V]]

It is a pleasure to follow my hon. Friend the Member for Meon Valley (Mrs Drummond).

I will start with some positives. The success of the vaccination programme is a fantastic achievement; Katie Bingham is a national hero. The Secretary of State has also worked tirelessly, as have many other Ministers. I thank again everyone involved with the vaccination process on the Isle of Wight, including the NHS teams in primary care and secondary care.

However, I am not happy with the Government’s plans today and I think they are unbalanced. In the next couple of minutes, I will explain why. First—this has been echoed by others—the Government have said that they will base their response on data, not dates, but it has become clear that the data has changed quicker than predicted and the dates have not changed. As my right hon. Friend the Member for Tunbridge Wells (Greg Clark) just said, Government action is now based on data that is old and negative—too old and too negative. I have yet to hear a credible explanation as to why. Where is the new updated data that we should be using if we have fresh, new data? I fear that, yet again, science is being used gently to lead the debate, rather than to frame it with the evidence necessary for us to make decisions.

Secondly, basing lockdown on cases, not deaths, is not good enough. I was listening to Professor Van-Tam briefing Members a couple of days ago. He is clearly a very impressive man, but his presentation was clear: lockdown was being justified on cases. But cases are not deaths or hospitalisations. I felt as though I was almost being misled, and I say that with great respect to him. He was saying that we have to continue this way because we have cases, despite the Government saying that we cannot eliminate covid from our society and we have to live with it. We have been under house arrest for nearly a year now. Justifying continued mass house arrest based on cases, not deaths or hospitalisations, frankly felt like very thin gruel from the Government.

Thanks to the miracle of vaccination—and it is a scientific miracle, as this is the first time in human history that a pandemic is being defeated with science, which is an extraordinary event in the history of humanity —the link between cases, hospitalisation and death has been broken. Yes, we need to be mindful of cases, but cases are not deaths. The continuation of these draconian measures, now based on a “not quite sure” approach, is not normal. As my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady) said, we should not be normalising this response, because our liberties belong to us, not to the Government. Continuing in this way now, when we have broken the link between death, hospitalisation and cases sets a dangerous precedent.

Covid-19: Community Pharmacies

Bob Seely Excerpts

Thursday 11th March 2021 Westminster Hall

[Bob Seely (Isle of Wight) (Con) [V]]

It is a pleasure to see you in the Chair, Sir Graham, and also to follow a very knowledgeable former Public Health Minister, my hon. Friend the Member for Winchester (Steve Brine). I am grateful to my hon. Friend the Member for Thurrock (Jackie Doyle-Price) for securing this debate and for the lot of good work that she has been doing on the all-party parliamentary group on pharmacy.

I will be brief, as we are all saying pretty much the same thing. I hope that at the end of the debate the Minister will suggest some concrete measures that can make a difference, and specifically answers the questions that I will put. I have also written today to the Secretary of State and the Chancellor about support for pharmacies, and I am grateful for the conversation that I had with the Minister the day before yesterday about them.

First, we are attending this debate because we know what an important service pharmacies perform for communities, which they are embedded in. Pharmacies, especially independent pharmacies, are a friendly, valued and, above all, trusted voice. For the NHS and the nation, they take pressure off accident and emergency departments, GPs’ surgeries and other parts of the health service. At a modest cost, they deliver very significant benefits, and they are a critical part of primary care that pays significant dividends, as well as alleviating pressure elsewhere.

I have six independent pharmacies in my constituency and they are all highly valued: Yarmouth; Freshwater; Seaview; Ryde; and Regent, which has branches in both East Cowes and Shanklin. I talk to all the pharmacists regularly. Despite pharmacies’ significant role during covid, by remaining open they have incurred nationally costs of £370 million in staffing and other costs. I am delighted that the Prime Minister said in a recent press conference that that money was going to be reimbursed, but following the Budget we have not yet seen that money and I am none the wiser as to whether we will see it. Can the Minister therefore reassure us that the support promised will actually be seen through, and that that £370 million will reach pharmacists?

Secondly, hon. Members have already referred to the Ernst and Young report. Three quarters of independent pharmacies are under pressure and may be forced to close within the next 12 months, and between two thirds and three quarters of community pharmacies will potentially be in financial deficit by 2024, according to that report. I asked a written question about the report but was told that, as it was not in the public domain, the Government would not comment on it. That is not true; it is in the public domain and I would like the Government to comment on it. If the Government agree with what the report says, the Minister needs to act.

Thirdly, we know that independent pharmacies do not gain the discounts given to big multiples, which are often part of a single wholesale and retail chain. Why can the Minister not ensure that the independent pharmacies are paid the same and are allowed to make the same profit margins on prescriptions and other services?

Summing up, I know that the Minister has good plans for pharmacies, because she has talked them through with me in the past, and I am grateful to her for sparing that time. However, pharmacies need to be open and functioning if they are to take advantage of the plans that we have for them. There must be a financial model that allows pharmacies, especially independent pharmacies, to make a reasonable living for the exceptionally valuable work that they do nationally and in their communities. I look forward to hearing some solutions to these problems from the Minister.

Future of Health and Care

Bob Seely Excerpts

Thursday 11th February 2021 Commons Chamber

[Matt Hancock]

On the contrary—this White Paper covers health and care. It covers the integration of the NHS and social care at a local level. Of course there is further work on funding, as we have committed to in our manifesto, but the integration of those services, which has been so important during the pandemic, is one of the critical pieces of the forthcoming health and care Bill.

[Bob Seely (Isle of Wight) (Con) [V]]

I congratulate the Secretary of State on this very important plan and announcement. As he knows, the Island is already piloting some ideas, so I thank his team of excellent advisers and the Secretary of State himself. May we have more pilot schemes to support his work? As he knows, the benefit of his approach may be felt more strongly on the Isle of Wight than anywhere else in Britain, due to our excellent but unavoidably small hospital at St Mary’s, the smallest county council in England, and our age profile. We want to help him and we want to be at the front of the queue. Will he also please consider the position of the 12 unavoidably small hospitals in England as part of the programme, of which St Mary’s is the most unique because it is on an island? I thank the Secretary of State and his team for their great work.

[Matt Hancock]

With an ask like that, it is hard to say anything other than yes, enthusiastically. I am keen to work with my hon. Friend, who is such an incredible voice for the Isle of Wight. The services on the Isle of Wight, by its island nature, are more closely aligned together than in many other parts of the country, but nevertheless suffer from some of the bureaucratic silo requirements in current legislation. I hope that these proposals will be received enthusiastically by all those involved in the provision of health, social care and public health on the Isle of Wight because they will remove the legislative barriers to closer integration and allow them to continue in the direction in which I know they are enthusiastically working with my hon. Friend’s support.

National Security and Investment Bill

Bob Seely Excerpts

Report stage & 3rd reading & 3rd reading: House of Commons & Report stage: House of Commons
Wednesday 20th January 2021 Commons Chamber

In conclusion, is there a reason why we cannot put all the pieces of the jigsaw together and present clear legislation which ensures that both the investor and the company know and understand the prerequisites and that we are all able to play our part to ensure that the security of this nation—the United Kingdom of Great Britain and Northern Ireland, better together—is not at stake, while enabling us to thrive in the future?

[Bob Seely (Isle of Wight) (Con)]

I thank the Minister for his work and for being here for the debate; I know how busy he is, so I am most grateful. I will speak to new clause 4, which provides a definition of “national security”. After listening to some of the speeches, I wonder whether I am going to play the role of General Melchett in “Blackadder” when I insist that “security” is not a dirty word. Let me try to put the argument in favour of a national security definition. My hon. Friend the Member for Tonbridge and Malling (Tom Tugendhat) suggested that I do so, and I am grateful to him for the opportunity. Like him, I thank Nicole Kar and Alice Lynch, who supported the work of the Foreign Affairs Committee.

New clause 4 provides a non-exclusive framework of factors that the Secretary of State would be obliged to regard when he is assessing takeovers or work in this field. It does not limit the Secretary of State in any way, as my hon. Friend the Member for South Ribble (Katherine Fletcher), who spoke eloquently, and others suggested. It provides a public recognition and a public baseline of things that should be considered. As such, it is a sensible amendment to improve the Bill, as well as providing a wider public service by defining national security in the modern era. I would like to make a few background points and then speak for between five and 10 minutes on a few other points.

We need a definition of national security, because the alternative is to have a vague and unstated set of assumptions. The amendment is broad, but it sets quite a high benchmark. It is not a generalised catch-all, nor does it contain a substitute for an industrial policy; that is another debate. The Cadbury takeover would not be included in this, nor would a Stilton creamery in South Notts—it might in France, but not in this country.

In this country we have a tendency to romanticise vagueness, as if planning were a bad thing and muddling through a strategic art as well as a national pastime, with this just-in-time Dunkirk spirit. I think it was Churchill who noted that, actually, Dunkirk was a military disaster, not a victory, and that if we had got our security and strategy right in the years previously, we could have avoided glorifying disasters because we would not have been in that disastrous position in the first place. A more systematic approach to national strategy—frankly, I think we need a national strategy council—but also to security and the definition of national security is important.

My next point is that the nature of national security has changed, and we need to be mindful of that. It is not simply about defence and espionage and the immediate threat to the realm. We have seen from Russia and China a combining of non-military and military, of covert and overt strategies—people call it hybrid war, grey war, under-the-radar war; there are about 25 definitions doing the rounds. This is not a war as such, but it is a form of state struggle and state conflict. Some states in the world, including very significant states such as Russia and, perhaps to a lesser extent, China, see things as a zero-sum game. We need to understand that liberal internationalism is not the only show in town and not the only way to understand international affairs. The west is good at many things, but seeing the world through the eyes of others is not necessarily one of them.

These new states, as many people here have said, use multiple and novel tools, including economic power, energy power, espionage, blackmail, information war and even cultural and religious power, as well as military and paramilitary power, and they use different templates and different tools in different parts of the world. Clearly, the tools that China uses in Xinjiang province are different from the ones that it uses in the City of London or to reach out to parliamentarians. The tools that Russia uses in eastern Ukraine or Kiev are different from the ones that it uses in the UK. Is the Kremlin’s use of Russian Orthodoxy a national security threat to us? No, of course not. But is its use of oligarchs and informal channels to influence senior political and financial elites in our country—the hon. Member for Aberavon (Stephen Kinnock) called it “elite capture”—a potential threat to national security? Yes.

The right hon. Member for North Durham (Mr Jones) was right to mention how states are using those new powers and how they use power to bend or break the international system. My hon. Friend the Member for Tonbridge and Malling has also spoken about that repeatedly, as indeed have many of us on the Foreign Affairs Committee. That international system is not perfect, but it has served humanity well.

It is important to understand that national security is not just about a narrow defence threat; it is broader. China has published a document, “Made in China 2025”, outlining how it plans to dominate data, artificial intelligence, big data and so on. Is it a threat to our communications infrastructure if we are dominated by a one-party state with a very different values system? I am not saying definitely, but potentially it would be.

The Henry Jackson Society and I produced a report on Five Eyes supply chain reliance on China. Over a quarter of British supply chains are dominated by China, and the UK is strategically dependent on China for 229 categories of goods, 51 of which have potential applications in critical national infrastructure spheres. We need to be mindful of the impact of that on our national security.

There are companies that are going to be bought and universities that are going to be working on gait technology and facial technology. I do not doubt that there are some countries in the world that will use that technology to improve their mass transport systems, but there are countries—China is potentially one of them—that will use it as a means of controlling their people more effectively and developing the sort of Orwellian state that is a potential threat to humanity and mankind.

Let me look specifically at new clause 4. As I said, my hon. Friend the Member for South Ribble talked about the need to be nimble, and she is exactly right, but osmosis is not a way to provide a definition of national security. The new clause obliges the Government to look at a series of areas. We tried to make it broad, but it sets a high bar. It requires the Government to look at the critical supply chain, critical national infrastructure and national resource. A year ago, who would have argued that personal protective equipment manufacture, vaccine supply or AstraZeneca’s cyber-security were national security issues? Probably nobody. Who now would deny it? Probably nobody. This is a significant element of our national security.

Another example—one that has worried me greatly—is that the Government did not see Huawei’s domination of 5G as a national security issue. They chose not to listen to those people in the agencies who said that it was and set a clear political direction. It concerned me particularly that, bizarrely, BEIS and other Ministries presented Huawei in this House as a private firm when, clearly, it was part and parcel of the Chinese state. Therefore, having a clear definition in the Bill of what Ministers are obliged to look at would help to guide them to come to good decisions in the national interest, and that is what we are trying to do.

We are trying to do things in the national interest to improve the Bill where we can. Paragraphs (b) and (c) address the threat from individuals and to individuals. Paragraph (c) addresses the nature of potential acquirers of UK firms. The hon. Members for Aberavon and for Newcastle upon Tyne Central (Chi Onwurah) spoke very eloquently about this, and Huawei is instructive.

My hon. Friend the Member for Tonbridge and Malling spoke about two companies that were bought when perhaps they should not have been, and we need to look at the nature of potential acquirers of UK firms. It is not an attack on laissez-faire economics or on our role as a free market and dynamic, global economic centre to accept that a national security definition, along with good laws, helps to provide a framework for honesty and integrity in business life. Paragraph (f) addresses national security and our responsibility to oppose modern slavery and genocide, which is an important issue for me, but again it sets an extraordinarily high bar.

Paragraph (g) addresses the potential threat of global organised crime. Again Russia, specifically, has tried to influence other countries in this way. Yes, that could be a potential national security risk. Finally, paragraph (h) gives the Secretary of State the flexibility to take a generalised approach to things that are not in the interests of the UK and are a threat to our interests or our citizens.

This new clause is a baseline, not a limiting factor. It helps to provide guidance for the Secretary of State and for BEIS. Frankly, this should be cross-departmental. We need our own CFIUS, and why we do not have one I do not know. Again, that is a concern. I will not address it now, because it clearly is not in the amendment and I am wrapping up.

I fear that the vagueness on national security does not help this Bill, nor does it help national security and its role. Clarity is needed in the long term to help us provide better strategy and a better understanding of the opportunities and risks that face this country in the years ahead.

[Kim Johnson (Liverpool, Riverside) (Lab) [V]]

I start by congratulating Joe Biden and Kamala Harris, and by wishing for a violence-free inauguration today. Good riddance to the outgoing President. We will not miss his hate speech.

The National Security and Investment Bill seeks to usher in sweeping reforms to how our Government can scrutinise foreign investment. It proposes strong measures to toughen foreign investment rules and to bring the UK into line with other major countries in key sectors. These steps to keep high-growth and strategically important companies in the UK are overdue and highly welcome, but does the Secretary of State agree that, for the UK to have an active industrial policy that works in the public interest, the Government must go further than just blocking hostile mergers and acquisitions, and instead implement a robust industrial strategy that puts critical national infrastructure at the heart of Government policy?

One example is the recent takeover of Arm, the crown jewel of the British tech sector—a genuine global powerhouse worth more than £31 billion and with more than 6,000 employees. Its recent sale to Nvidia, a US tech giant worth more than £338 billion that is tucked away in the tax-light and secrecy-heavy state of Delaware, provides a clear example of the risky and problematic sale of a British firm to foreign investors, which threatens both security fears and job losses.

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[The Parliamentary Under-Secretary of State for Business, Energy and Industrial Strategy (Nadhim Zahawi)]

May I add my congratulations to President Biden and Vice-President Kamala Harris, and their national security team?

I thank all hon. Members who have tabled amendments and new clauses and have spoken to them so eloquently: the hon. Member for Dundee East (Stewart Hosie); my right hon. Friend the Member for New Forest East (Dr Lewis); the shadow Minister, the hon. Member for Newcastle upon Tyne Central (Chi Onwurah); my hon. Friend the Member for Tonbridge and Malling (Tom Tugendhat); the hon. Member for Aberavon (Stephen Kinnock); the hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone), who spoke so pithily; my hon. Friend the Member for South Ribble (Katherine Fletcher); the right hon. Member for North Durham (Mr Jones); the hon. Member for Ilford South (Sam Tarry); my hon. Friend the Member for Arundel and South Downs (Andrew Griffith); the hon. Member for Strangford (Jim Shannon); my hon. Friend the Member for Isle of Wight (Bob Seely); the hon. Member for Liverpool, Riverside (Kim Johnson); my hon. Friend the Member for Beckenham (Bob Stewart); the hon. Member for Warwick and Leamington (Matt Western), my neighbour; and of course my right hon. Friend the Member for South Holland and The Deepings (Sir John Hayes), who reminded us of the words of the great Edmund Burke.

National security is an area of utmost importance, and that has been reflected in a sober and considered debate, with the excellent contributions that we have heard today, and, indeed, over the past few months. I will take this opportunity to respond to some of the points raised this afternoon.

New clauses 4 and 5 create a non-exhaustive list of factors that the Secretary of State must have regard to when assessing national security risks arising from trigger events. In fact, the Secretary of State has joined us to demonstrate how important this Bill is to him. I congratulate him on his elevation to being my new boss at BEIS.

As currently drafted, the Bill does not seek to define national security or include factors that the Secretary of State must or may take into account when assessing national security risks. Instead, factors that the Secretary of State expects to take into account when deciding whether to exercise the call-in power are proposed to be set out in the statement provided for by clause 3, a draft of which was published alongside the Bill. The Secretary of State is unable to call in an acquisition of control until that statement has been laid before both Houses. It is clear from the debate today, and also from conversations with colleagues, that these are the amendments on which there is strongest feeling in the House, and in the Foreign Affairs and Development Committee, so I will take care to set out the Government’s case.

The Bill’s approach reflects the long-standing policy of Governments of different hues to ensure that powers relating to national security are sufficiently flexible to address the myriad risks that may arise. As we heard from my hon. Friend the Member for Beckenham, national security risks are multi-faceted and constantly evolving, and what may constitute a risk today may not be a risk in the future. Indeed, the Foreign Affairs Committee, chaired by my hon. Friend the Member for Tonbridge and Malling, said in its own excellent report that

“an overly specific definition of national security could serve to limit the Government’s ability to protect UK businesses from unforeseen security risks.”

[Bob Seely]

Does the Minister accept that what is being proposed is not a limiting arena of what constitutes national security but a baseline of what constitutes national security, and that there may be a reason to adapt it over time? Indeed, paragraph (h) of new clause 4 makes an assumption that it can be expanded.

[Nadhim Zahawi]

My hon. Friend makes an important point. As I mentioned, the statement that the Secretary of State has laid with the Bill takes in much of the direction of travel of this amendment from the Foreign Affairs Committee.

I acknowledge that the Foreign Affairs Committee is pushing for more detail rather than less, but I would reassure them that the Government agree with their main conclusion that the Secretary of State should provide as much detail as possible on the factors that will be taken into account when considering national security. Importantly, however, that is only up until the point that the detail risks the protection of national security itself. That is why the Government have taken this approach in the draft statement provided for by clause 3. In that statement, we identify three types of risk that are proposed to form the basis of the call-in national security assessment. These are: the target risk, which considers the nature of the acquisition and where it lies in the economy; the trigger event risk, which considers the level of control and how it might be used; and the acquirer risk, which covers the extent to which the acquirer raises national security concerns.

I would like to address each of the arguments made in the report, so that I can ease the concerns of hon. Members across the House. First, there are concerns that without a narrow definition of national security, the investment screening unit would be inundated by notifications, hampering its ability to deliver its crucial role. I acknowledge that, for business confidence in the regime, it is essential that we deliver on our statutory timeframes for decisions, which is why it is so essential that we do not allow any broadening of the assessment done by officials as part of the regime to occur, whether by inexhaustive lists, as my hon. Friend the Member for Isle of Wight has just said, or by any other form. To include modern slavery, genocide and tax evasion as factors that the Secretary of State must take into account as part of national security assessments, as these amendments propose, would not reduce the demands on the investment security unit but potentially increase them.

Secondly, there is concern that ambiguity could hinder the success of the regime. Let me be clear that this regime is about protecting national security—nothing more, nothing less—hence its real focus. Thirdly, the Foreign Affairs Committee report suggests that the staff responsible for screening transactions may lack sufficient clarity on what kinds of transactions represent legitimate national security risks, leading to important transactions being missed or to a large volume of benign transactions overwhelming the investment security unit. I want to assure hon. Members, and my hon. Friend the Chairman of the Foreign Affairs Committee, that the investment security unit will be staffed by the brightest and best, with many of them being recruited on the basis that they have essentially written the book on national security.

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[Nadhim Zahawi]

They will be able to draw on all the experience, culture and, of course, resources of Government to be able to do their job properly, I assure the right hon. Member of that.

The report sets out a fear, as we have heard elsewhere, that without a definition of national security in the Bill, interventions under the NSI regime will be politicised. I wholeheartedly agree that it is crucial for the success of the regime that decisions made are not political but rather technocratic, dispassionate and well judged. I repeat the words of my right hon. Friend the Member for Reading West (Alok Sharma), the former Business Secretary, who on Second Reading assured the House that:

“The Government will not be able to use these powers to intervene in business transactions for broader economic or public interest reasons, and we will not seek to interfere in deals on political grounds.”—[Official Report, 17 November 2020; Vol. 684, c. 210.]

Indeed, if the Secretary of State took into account political factors outside the remit of national security, the decision could not be upheld on judicial review. It is with this in mind, and our focus on protecting foreign direct investment, which so many colleagues are concerned about, especially as we come out of the covid challenge, that politicised decisions will not be possible under the NSI regime. I hope right hon. and hon. Members feel I have sufficiently explained the Government’s approach. We have sought to deliver what the Foreign Affairs Committee and the Opposition recommend.

[Bob Seely]

I will not labour the point beyond this. The Minister says that tax evasion will not be a bar. I accept that the Government made that statement. Does he accept that, in Australia, tax evasion is one of those significant elements? He rather implies that tax evasion and tax evaders will not be opposed in buying UK companies, so how high will the bar be set on criminality or on unsavoury characters—maybe people close to Russian Presidents and oligarchs and questionable companies?

[Nadhim Zahawi]

As colleagues have said, the Bill has been a long time in gestation, from 2017 to the 2018 consultation and White Paper and now today. We look at what other countries do, and I think we have reached a proportionate position. Of course, as I say, the Secretary of State’s statement sets out exactly how he would assess the risks to national security. I hope I have addressed that.

My final point of reassurance is that there will be further scrutiny on this point. As I explained in Committee, the statement provided for by clause 3 will go out to full public consultation prior to being laid before Parliament, and the Government will listen carefully to any proposals for further detail.

Amendments 1, 2, 3 and 6 broadly seek to ensure that the scope of the regime as a whole is right, that mandatory notification covers the right sectors and that both the statement and the notifiable acquisition regulations are reviewed within a year. Amendment 1 would require notifiable acquisition regulations to be reviewed within a year of having been made, and once every five years thereafter. It is right that the Secretary of State keeps a constant watch on these regulations. Indeed, it is vital that he has the flexibility to reassess and, if needed, seek to update the regulations at any time. The nature of his responsibilities under the regime creates sufficient incentive for this regular review.

Amendment 2 would, in effect, introduce two further trigger events to the regime. It would mean that a person becoming a major debt holder would count as a person gaining control of a qualifying entity. The amendment would also mean that a person becoming a major supplier to an entity counted as a person gaining control of a qualifying entity.

We on the Government Benches believe that access to finance is crucial for so many small businesses and large businesses to grow and succeed. They will often take out loans secured against the very businesses and assets that they have fought so hard to build; I did just that when I started YouGov. That is why the Bill allows the Secretary of State to scrutinise acquisitions of control that take place where lenders exercise rights over such collateral, but the Government do not consider that the provision of loans and finance is automatically a national security issue. Indeed, it is part of a healthy business ecosystem that enables businesses to flourish in this country.

Oral Answers to Questions

Bob Seely Excerpts

Tuesday 12th January 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful to my hon. Friend not just for his characteristic support and encouragement, but for his championing of his constituents. I can confirm, as the Secretary of State has said, that all his constituents will be no more than 10 miles away from a vaccination centre, and I am pleased that the Sturdee Road health and wellbeing centre, which is a little over 10 miles away from Lutterworth, is administering vaccines now.

[Bob Seely (Isle of Wight) (Con)]

What recent assessment he has made of the adequacy of the scientific evidence base underpinning the Government’s response to the covid-19 outbreak.

[The Secretary of State for Health and Social Care (Matt Hancock)]

The Government’s response to the pandemic has been informed by a considerable range of expert scientific and medical advice, and we have seen an increasing understanding of coronavirus globally. The UK has produced new scientific evidence throughout the pandemic. When we take decisions, they are based on and guided by the best possible science, but of course policy decisions are for Ministers.

[Bob Seely [V]]

Regarding the stats and science on the island, our vaccine hub at the Riverside centre is expected to be ready on 15 July. We may not receive sign-off and vaccines for that centre until 25 July or later. Given rising infections on the island, our demographic profile and our isolation, I am concerned we are not high enough on the vaccine supply list, despite the great work being done by the Isle of Wight-Hampshire team. I have written to the Secretary of State and the vaccine Minister, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), about this. What can be done to improve the situation, and what reassurance can the Secretary of State give me about the focus on the Isle of Wight?

Covid-19

Bob Seely Excerpts

Tuesday 12th January 2021 Commons Chamber

[Bob Seely (Isle of Wight) (Con) [V]]

I would like to make three brief points.

First, vaccination is undoubtedly a significant and great success story, and I thank all involved nationally and on the Island. On the Island we have vaccinated well over 10,000—probably about 12,000—people so far, so it is under way. Four sites are vaccinating at the moment: Carisbrooke, the Bay practice, Westridge, and doctors and nurses working out of the West Wight sports and community centre in Freshwater, as well as the hospital. I do however have a slight concern, on which I would be grateful to get a direct answer from the Minister—I have written to the Secretary of State and to the vaccine Minister, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi). The vaccine hub at the Riverside centre in Newport is expected to be ready on 15 January; earlier today in a question I accidentally said 15 July; clearly, I meant 15 January, so it will be ready in about three days. We may not, however, receive the vaccines for it and the sign-off for at least 10 days, and potentially more, afterwards. We are therefore potentially missing out on vaccinating about 500 people per day, and over 10 days that is 5,000 people who could have had a first jab. With our rise in infection on the Island, our demographic profile, and our isolation and dependency on ferries and potentially helicopters, I am concerned that we are not high enough on the vaccine supply list—not for the four primary care networks, but for our vaccine centre. As I say, I have written to the Secretary of State about this, but it would be great to get an answer.

Secondly, may we have a medium-term outline of what lies ahead? Businesses need clarity; people, especially in the hospitality sector on the Island and the festival sector need to be able to plan and to know if they can reopen in April or May or later in the summer.

We know that, sadly, 50% of deaths are among the over-80s, and 88%, nearly 90%, of deaths are in the top four at-risk categories. If those good folks are all vaccinated on time, taking into account the three-week period afterwards that it takes for the vaccine to become live, by early March we should be clear of nearly 90% of deaths. That then raises the question of whether we will be coming out of lockdown at that point, or will the Government then say it is not about mortality but about prevalence of covid? We need clarity and a decision on this as soon as possible.

Finally, and related to that, the Isle of Wight is Britain’s festival island, and the Government need to think about support for festivals because they are planning already; their decisions are being made in the next few weeks and help for that sector would be gratefully received.