Sickle Cell Treatment

Catherine West Excerpts

Wednesday 8th December 2021 Westminster Hall

[Mr Pat McFadden (Wolverhampton South East) (Lab)]

I beg to move,

That this House has considered the treatment of sickle cell.

Thank you for chairing our proceedings, Mrs Miller. I am very pleased to open this debate. I chair the sickle cell and thalassaemia all-party parliamentary group, which works for a better understanding of sickle cell and better treatment for those living with the condition. I am enormously grateful to all hon. Members who have supported the APPG’s work, including our late colleague Sir David Amess, who was one of our officers. I am also grateful to the Sickle Cell Society, which provides the secretariat function for the APPG. I also thank Parliament’s digital engagement unit, and the hundreds of individuals from around the country who have emailed me in advance of today’s debate.

The focus of our debate is the APPG’s recent report, “No one’s listening”, which has a number of findings and recommendations in relation to the care of people with sickle cell. The trigger for our report was the tragic and avoidable death of Evan Nathan Smith in North Middlesex University Hospital in 2019. The coroner’s report into Evan’s death, published in April of this year, found that he would not have died if medical staff had recognised his symptoms and treated him sooner. The report pointed to a

“lack of understanding of sickle cell disease in the medical and nursing staff looking after Mr Smith”

and

“a failure to appreciate the significance of those symptoms by those looking after Mr Smith at the time.”

Evan Smith was just 21 years old; he had his whole life in front of him. His death is not the only one in which a lack of understanding of sickle cell and mistakes in treatment have been contributory causes.

[Catherine West (Hornsey and Wood Green) (Lab)]

I thank my right hon. Friend, my hon. Friend the Member for Edmonton (Kate Osamor) and all the other Members who have done a lot on this topic in the House. Despite this being a long-running disease, we have not paid enough attention to it at an institutional level, be that in primary or secondary care. That needs urgent redress.

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[Mr McFadden]

My hon. Friend makes some very strong points, and I will discuss some of them, including the question of race.

Since the report’s publication, I have continued to receive emails from sickle cell patients all around the country that confirm the report’s findings, and I want to put on the record my gratitude to each and every person who has taken the trouble to write to me, whether it was just after the report was published or in advance of today’s debate.

Let me set out the main findings of the report for the House. Let us begin with a positive: we found a good level of trust among sickle cell patients in the specialist haematology departments of hospitals that look after them on a long-term basis. We found clinicians passionately committed to better treatment and honest enough to tell us when that good treatment was not there. We found that where there is a good level of understanding and knowledge, sickle cell patients are generally well treated and well looked after, but we also found a huge gulf between the good level of confidence and trust in the specialist parts of the system, and treatment in the more generalised parts of the system—specifically A&E and general wards.

Our key findings include the unacceptable variability of treatment, depending on where someone lives or who happens to be on duty at the time; patients having to battle for the pain relief to which they are entitled; and protocols on pain relief—for example, that it be administered within 30 minutes of arrival—being regularly and repeatedly ignored or not being implemented. Witnesses told us of waiting for hours in excruciating pain. Some clinicians spoke of adherence to the pain relief guidelines within their hospital being as low as just 20% or 30%. There is a lack of compliance with care plans that have been agreed for individual patients, including with the hospital where a patient has turned up, and people have been told, “That doesn’t apply here.”

We found a dangerous lack of communication between the general and specialist parts of the system. In Evan Smith’s case, he had been in the hospital for over two days before the haematology unit even knew he had been admitted. That finding was described as “shocking” by one haematologist who gave evidence to the group. Such delays can contribute to mistakes, with the most terrible consequences. As well as deaths, we heard about a number of near misses where care had gone badly wrong and the patient had still survived.

There is a lack of awareness of the condition and a lack of understanding about how to respond to a sickle cell crisis among some NHS staff. Everyone in the healthcare system knows the key symptoms of a heart attack or a stroke, and how to respond to them. With sickle cell, however, the patient experience is often one of being caught in a perpetual loop of trying to teach staff about what is happening to them and what treatment they need, often at the time that they are experiencing excruciating pain.

[Catherine West]

I thank my right hon. Friend for giving way a second time; he is being very generous. Does he agree that that lack of awareness goes all the way through to the research community, whereby sickle cell is one of the most under-researched diseases, despite the fact that research into it has many different and interesting applications through its links to malaria and all sorts of other diseases, and that there is simply not enough research funding going into understanding this disease?

[Mr McFadden]

I very much agree with my hon. Friend. Indeed, the next finding that I was going to cite is a lack of research and innovation in treatment. There has only been one new drug approved in the UK for sickle cell treatment in decades and it was approved just before our report was published.

For each of the findings, we made recommendations: about training; about compliance with clinical guidelines; about reviews of sickle cell treatment in secondary care; about communications change; very importantly, about a stronger voice for patients in all of this; and in many other areas, too.

Underlying all those individual findings and recommendations are some key overarching themes. First of all, the experiences that I have described have contributed to a damaging loss of trust among sickle cell patients in the system that is there to help them. Some patients told us that they avoided going to hospital at all costs, no matter how serious their crisis, because they found the whole experience so exhausting and debilitating, or, as one woman put it,

“to avoid the mental strain of another battle...when she does not have the energy to advocate for herself”.

It cannot be right that people who need help have so little trust that they do not seek that help from the very system of care that is supposed to be there for them.

Secondly, there is the unavoidable question of race. Sickle cell is a condition that predominantly, but not exclusively, affects black people. Many patients told us of being treated with suspicion when they sought treatment, being regarded as troublesome by staff, being thought of as drug-seekers, and encountering negative and sometimes even hostile attitudes.

The principle of racial equality in healthcare is fundamental. No one is seeking to put one group of people above another, but we want to see equality in healthcare treatment and right now with sickle cell we do not have that. That situation is completely unacceptable and, following this report, it must be addressed.

Thirdly, the findings that we cite in our report are not new; these things have been happening for a long, long time. They have been raised time and again, and the fact that this situation is continuing has led to a great deal of anger and frustration among those living with sickle cell and their families.

Yet, even though all of those things are true, this might—just might—be a moment of opportunity. Why do I say that? Soon after the Secretary of State for Health and Social Care was appointed, he spoke about the “disease of disparity” and about how the covid pandemic had exposed a number of long-standing health inequalities, including racial ones. I welcome the Secretary of State’s commitment to address these inequalities and his warm welcome for our report on the day it was published. Perhaps this is a moment when we are more aware of health inequalities than we would have been before the pandemic; maybe this period can be a turning point for change.

There is no need for this to be a partisan issue. No one is pretending that the findings in our report only began in recent years or under one Government. These things have been there for a long time. However, perhaps the experience of the pandemic will give us a new-found resolve; maybe it will mean that this time people listen.

From the Secretary of State and the Department to the NHS in every part of the United Kingdom, we want this report to mark a moment of change in the treatment of sickle cell. We want to ensure that the issues raised in the report are addressed once and for all, and that training is improved so that staff throughout the system understand, and have a knowledge of, the condition. We want to ensure that care plans and pain relief protocols are adhered to by both the generalist and the specialist parts of the system. We want to step up research and innovation in treatment and restore trust among sickle cell patients. Most of all, we want to ensure that there is equal health treatment for everyone, regardless of the colour of their skin. That is not too much to ask for, but we do not have it at present.

Today I appeal to the Minister, the Secretary of State, my own Front-Bench team and the other parties represented here to become our allies in this and to work with us. Please do not let this be a missed opportunity. Let us collectively resolve that we will not have me, or another chair of the APPG, standing here in a few years’ time making exactly the same points as I am making today. Let us make sure that this time people do listen, that we act on these long-standing failures in the care of people with sickle cell and that we improve healthcare for people with this condition once and for all.

Covid-19 Update

Catherine West Excerpts

Monday 29th November 2021 Commons Chamber

[Sajid Javid]

If my right hon. Friend is suggesting that there are mixed views on the efficacy of face coverings in helping to fight the pandemic he would be right, but I would point him to UK work by Public Health England—published, if I remember correctly, last month—referring to a number of reports setting out how in certain settings face coverings could help.

[Catherine West (Hornsey and Wood Green) (Lab)]

What urgent action is being taken to vaccinate people who are bed-bound?

[Sajid Javid]

For those who are bed-bound, home-bound or vulnerable for other reasons and who cannot make it to vaccination centres, vaccinations are primarily carried out by GPs. I do not have the numbers of how many have been done, but recently to encourage more people to be vaccinated more quickly we changed the GP payment system, which seems to have helped as well.

Health and Care Bill

Catherine West Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Mary Kelly Foy]

Before I address the amendments tabled in my name, I want to briefly voice my support for amendments 11 to 13 and new clauses 15 to 17, in the name of my hon. Friend the Member for Liverpool, Walton (Dan Carden), which call for improved regulation of alcohol marketing and labelling, for minimum unit pricing in England and for better assessment of treatment outcomes. Sadly, my hon. Friend cannot be here today, as he is with his family and his father Mike, who is receiving palliative care after many months of treatment for lung cancer. I know how important these issues are to my hon. Friend; I express my love and solidarity, and that of the whole House, at this difficult time for him and his loved ones.

Smoking is one of the biggest causes of ill health. It has a devastating impact on our population: it killed approximately the same number of people in 2019 as covid 19 in 2020, and one in every two smokers will die from smoking-related illnesses. The Government and the Opposition both support a smoke-free 2030, but without meaningful action, that ambition will be missed by seven years—or by double that number of years, in the case of the poorest in society.

[Catherine West (Hornsey and Wood Green) (Lab)]

Does my hon. Friend agree that Professor Marmot’s work on social and health inequalities shows that 0.5% of GDP should be spent on health inequalities such as those she describes?

[Mary Kelly Foy]

I could not agree more. Michael Marmot is one of the most important health inequalities experts around.

To make matters worse, smoking rates among young adults have surged to 25% above pre-lockdown rates. However, despite the damage that missing the 2030 target would cause, there is nothing in the Bill that would help to achieve the Government’s ambition to make smoking obsolete. That is why the all-party parliamentary group on smoking and health, of which I am the vice-chair, is fighting to get the 2030 ambition back on track. I was delighted to hear the Minister say in Committee that the Government would review the APPG’s proposals as they developed their own tobacco control plan, but that plan, which was due this year and expected in July, is now likely to be delayed beyond the end of the year. If the Government are serious about creating a smoke-free England by 2030, they will implement the APPG’s recommendations as soon as possible, and the Bill provides the ideal opportunity for them to do so.

Let me quickly summarise new clause 2. It gives the Secretary of State powers to add health warnings to cigarettes and cigarette papers. The Government are reviewing the proposal, but have said that more research is needed. Health warnings such as “Smoking Kills” have been shown to be effective on billboards and tobacco packs, so why on earth would they not be effective on individual cigarettes? At least eight peer-reviewed papers have been published in the last five years showing that the measures are effective. Similarly, new clause 3 would give the Secretary of State powers to require health information messages to be inserted in cigarette packs. That has been a legal requirement in Canada since 2000, and there is substantial evidence to show that it works there. Research carried out in the UK supports its use here as well.

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[Alex Norris]

I think that a solution might be a little from column A and a little from column B, but I am grateful to the hon. Gentleman for making that point.

We have heard about the modesty of the strategy from the hon. Member for Buckingham. The reality is that any benefits from the obesity strategy will be outstripped by losses in the nation’s health caused by the impact of the cut to universal credit. We want the strategy to succeed, but it needs to be seen in that broader category.

Obesity is an important issue, with nearly two thirds of adults carrying excess weight. Childhood obesity is also a significant issue, with one in 10 children starting primary school obese, rising to one in five by the time they leave—extraordinary at such a young age.

[Catherine West]

I thank the shadow Minister, who is making an excellent argument, and colleagues across the House for all their work on this important Bill. Does he agree that we could do an enormous amount for the health of the nation by looking holistically at the role of exercise and prescribing exercise through the national health service, including swimming—the statistics on 11-year-olds who can swim 25 metres are going backwards due to all the lessons they have missed during coronavirus—and other important sports?

[Alex Norris]

Yes, I agree. I look with real sadness at the loss of exercise-on-prescription schemes that were part of the public health grant but have gone over the last decade. Similarly, on swimming, the decisions in the Budget relating to local authorities will lead to councils, which are setting their budgets as we speak, closing more leisure centres and swimming pools. We should mourn those losses, which come as a result of a weak bit of public policy.

In the Bill, the proposed watershed with regard to high fat, sugar and salt products is broadly a good thing. With that in mind, we do not oppose Government amendments 31 to 39, which are relatively modest tweaks, but we should not lose sight of the fact that we are talking about a significant proposal; I know that colleagues have interest in this. Beyond a watershed on traditional broadcast media, we will also see a complete online ban of high fat, sugar and salt advertising. This is a blunt tool in pursuit of an important goal.

New clause 14 in the name of the hon. Member for North East Bedfordshire would implement a more nuanced system, as proposed by the advertising industry itself. This is mirrored in amendments 106 to 109 in the name of the hon. Member for Buckingham. We probed this point in Committee. I was surprised then, and remain surprised, that there seems to be little interest from Ministers or the Department in even having that conversation and exploring creative alternatives. The desired benefits are non-negotiables. If there are other ways to achieve those benefits, they ought to be approached with an open mind.

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[Dr Whitford]

I would say that really no one who has a health problem should be stigmatised. Having dealt over 33 years in the NHS with many people who were problem drinkers, I know that the public image of someone who abuses alcohol is quite a caricature. There will be many people across this House who drink more than is healthy for them and I have met many people as patients from the middle and upper classes who had serious alcohol problems, so we should get away from the stigma and the caricature. We will not spot everyone who needs to deal with alcohol just by looking at them.

[Catherine West]

I commend the work of my hon. Friend the Member for Liverpool, Walton (Dan Carden) in this regard. Does the hon. Lady agree with me that the whys and wherefores are all very well in this debate, but in the end the cuts to local government, which would primarily be providing services in relation to alcohol abuse, have been most disgraceful, and that is why we are seeing the huge increase in the number of people who have passed away from alcohol disease in the last couple of years following covid?

[Dr Whitford]

There is no question but that, after public health moved into local government—we can absolutely defend that because, as I have said, health is often delivered by things that are nothing to do with the NHS—the problem was that the budget was then cut, so the potential benefit of putting public health into local government was lost due to the cuts to services.

On alcohol not being classed as a less healthy food, with this Government I find it hard not to ask: why not, and what or who may have influenced that decision? I certainly support amendments 11 to 13 from the hon. Member for Liverpool, Walton (Dan Carden), which would include alcohol, particularly the medium and high-strength alcohols, under less healthy foods, so that alcohol is covered by advertising regulations. I also support his new clause 15, which would mandate much clearer labelling of alcohol units, or whatever measure, on labels. It is no good just saying “Drink aware” or “Drink Responsibly” when the consumer has not actually been given the tools on the product to make a proper choice, such as by asking, “How much is in this?” Why not agree to use a simple, straightforward approach? A lot of public health advice is in units, so why not actually use them? People would then learn to be aware and ask, “How many units have I already drunk today?” or “How many units have I already drunk this week?”

New clause 17 calls on the UK Government to follow Scotland, and now Wales, by introducing a minimum unit price for alcohol. The UK Government have the advantage in that they can do that by setting alcohol duty based on unit, instead of on classes of drink. In every Budget we hear about a penny on a pint of beer, or so much on spirits, but why not do it by unit? It is much more accurate, and it would still allow the raising of taxation to help fund alcohol services, as well as those public services most hit by alcohol abuse, such as healthcare and policing. Under devolution the Scottish Government, and now the Welsh Government, did not have that power.

Over the past year and a half of the pandemic we have, unfortunately, seen a big increase in both smoking and alcohol consumption, as people struggled to cope with the loneliness and boredom associated with lockdowns and pandemic restrictions. However, the initial valuation of minimum unit pricing in Scotland showed that alcohol sales fell, for the first time in many years, by more than 7% in Scotland, compared with a continued rise in England and Wales. It was not possible to demonstrate a reduction in overall alcohol-associated admissions to hospital, which may include car accidents, violence and so on, but there was a drop in admissions due to alcoholic liver disease, suggesting that the policy was working. More evaluation after the pandemic will be required, but an immediate impact was an almost three-quarters drop in the sales of cheap white cider. That product is cheaper than soft drinks, and predominantly used by young—indeed, often under-age—drinkers, who purchase it, or get someone else to purchase it, so that they can drink it at home. However, that sector is literally disappearing overnight.

It will be important to review and maintain the pressure of the unit price on a regular basis, because young drinkers also drink many other products—this is the same issue as young smokers; more people are being recruited, often into problem drinking and problem products. Minimum unit pricing does not affect good wine, high-end spirits, or what is sold in a pub, but it does affect what someone can buy in a small shop to then hang out with their mates in their bedroom. Some of those products are not affected by the 50p unit price, and that must be kept under review.

I was disappointed that new clause 30, which is listed for discussion tomorrow, was not included in this group. It calls on the Government to reform the out-of-date Misuse of Drugs Act 1971, and to devolve it so to allow the devolved nations to take a public health approach to tackling drug addiction, in the same way as we take a public health approach to dealing with alcohol. Such an approach has already been demonstrated in many countries across the world, yet the Government keep sticking their head in the sand.

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[The Minister for Health (Edward Argar)]

I am grateful for this evening’s debate. More than once during the passage of the Bill, I have put on the record the Government’s commitment to improving and protecting the public’s health and have paid tribute to the hard work and dedication of our NHS and public health professionals in rising to the greatest infectious disease challenge of modern times. I would again like to put on the record those important points, with which I know Opposition Front Benchers agree.

Our commitment to public health is clear in the Bill, in the proposals set out in the Government’s recently published plan for health and care, “Build Back Better”, and in our wider programme of public health reform. A focus on the prevention of avoidable diseases is a central principle in delivering a sustainable NHS and in levelling up health outcomes across the country.

Childhood obesity is one of the biggest health challenges that this nation faces. The latest data from the national childhood measurement programme revealed that approximately 40% of children leaving primary school in England were overweight or living with obesity.

[Catherine West]

The Minister is being generous in allowing interventions. Is the Bill silent on the challenge around prescriptions for exercise? In an earlier intervention, I mentioned the impact of school swimming. Unfortunately, we are going backwards: fewer 11-year-olds can swim 25 metres—that is just an example. On childhood obesity, we need to address both: not just diet, but exercise.

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[Barbara Keeley]

rose—

[Catherine West]

rose—

[Edward Argar]

We have considered what help people want and when they want it.

--- Later in debate ---

[Edward Argar]

My right hon. Friend is right to highlight that this is talking about personal care costs, so he is right in his point on that.

Did I see the hon. Member for Hornsey and Wood Green (Catherine West) rise earlier?

[Catherine West]

The Minister did indeed. He is being very generous in giving way. A lot of research went into the work by Mr Dilnot some time ago and a very independent assessment was made. Can he explain why, in this clause, he is going away from those recommendations and taking a fresh look at it?

[Edward Argar]

While the hon. Lady and I do not always agree on everything, she asks a perfectly a reasoned and measured question. I pay tribute to Andrew Dilnot’s work on his report. I just happen to think that, on this point, we diverged from what he proposed and we believe that what we are proposing is the right way forward. We have always intended for the cap to apply to what people personally contribute, rather than on the combination of their personal contribution and that of the state. It will mean that people with fewer chargeable assets meter towards the cap more slowly, because they are paying much less each week than people who are entirely self-funding. This amendment will make it simpler to understand the amount that will go towards the cap and make it fairer.

Covid-19 Vaccinations

Catherine West Excerpts

Thursday 4th November 2021 Commons Chamber

[Maggie Throup]

My hon. Friend makes a good point: I do not know why the pharmaceutical companies come up with these tongue-tying names for their drugs. As I said earlier, we need to make sure that we roll out the new antiviral to the right people. The important and exciting thing is that the drug can be taken in people’s homes.

[Catherine West (Hornsey and Wood Green) (Lab)]

Today marks the day when we have the most covid cases ever, so it is a sad day for the UK.

My concern is schools. The advice is that ventilation works against covid, yet schools are desperately underfunded for ventilation measures. Will the Minister speak to the Minister for School Standards to ensure that the budget for such measures can be refreshed so that all children, staff and families can be as protected as possible from covid?

[Maggie Throup]

I agree with the hon. Lady that it is so important to protect our youngsters. A lot of investment has gone into making sure that there is ventilation in schools, but I will talk to my counterpart in the Department for Education to see whether more can be done.

Medical Cannabis: Alleviation of Health Conditions

Catherine West Excerpts

Thursday 4th November 2021 Commons Chamber

[Ronnie Cowan (Inverclyde) (SNP)]

I beg to move,

That this House has considered the matter of the use of medical cannabis for the alleviation of health conditions.

I would like to start by paying tribute to the mums and dads, brothers and sisters, grandparents, guardians, extended families and friends who have campaigned diligently, respectfully and passionately to bring about the reform in access to medical cannabis that they so desperately desire. Many are full-time carers, with all the pressure and time constraints that that entails, yet they have found the time and the commitment to energise a campaign—a campaign that far too many politicians and medical professionals have turned a blind eye to.

I would like to thank the Backbench Business Committee for supporting me in bringing this debate forward today. I would also like to thank those Members who have reorganised their diaries and travelling arrangements to be here today. There are a number of MPs who would normally be here today to debate a subject that is close to their hearts, but for a variety of reasons, not least COP26, they are not. I guarantee they would all support any move by this Government to make it easier to access or research medical cannabis. I have never heard any MP argue against those objectives. There is confusion about drugs in general, which tempers some people’s desire to speak out, but the provision of medicine to sick people is not an issue.

[Catherine West (Hornsey and Wood Green) (Lab)]

I congratulate the hon. Gentleman on securing cross-party support for this debate. On research, does he agree it is encouraging to see the potential curative effects of various elements of this drug, as we call it, in treating very serious forms of epilepsy?

[Ronnie Cowan]

It is great to see that research has now been undertaken, and I have a list of five or six projects looking at medical cannabis across a range of different medical conditions, but there is still the issue that many academic organisations cannot get access to the cannabis or hemp plants they require because they are graded as category 2, which keeps the plants out of their hands. The paperwork and processes they have to go through to access the raw product are prohibitive, and recategorisation from category 2 to category 4 would aid the research of a host of academic establishments.

Why are we not making it easier for people to access medical cannabis? Why are people who would benefit from medicine derived from the hemp plant being denied that opportunity? Why can some medicines be purchased on private prescription only? Why are we not making medicines that are widely available in other countries available in the United Kingdom?

NHS England Funding: Announcement to Media

Catherine West Excerpts

Monday 25th October 2021 Commons Chamber

[Edward Argar]

We should make sure that general practice is an attractive career for newly qualified doctors wherever they are in the country. I suspect it will be for those individuals joining the profession to determine where they wish to practise, but I suspect my hon. Friend will do a very good job of explaining to them the joys of working in Rother Valley.

[Catherine West (Hornsey and Wood Green) (Lab)]

There are very worrying press reports about a lack of midwifery. Can the Minister put his hand on his heart and tell us that every single trust in the country has a safe ratio of staff to women giving birth?

[Edward Argar]

The hon. Lady asks a very important question. Patient safety, including in midwifery and births, is central to what we are about in this Government and in NHS England. That is one reason why we have seen more than 9,000 more nurses, midwives and health visitors recruited, but we need to continue to do more, and we will continue to do so.

Covid-19 Update

Catherine West Excerpts

Tuesday 6th July 2021 Commons Chamber

[Sajid Javid]

I am very happy to confirm to my hon. Friend that the booster programme will start in September. We still have to get the final advice from the JCVI on exactly how it will work, but it will be administered throughout the United Kingdom and that, of course, includes to his constituents in Southend.

[Catherine West (Hornsey and Wood Green) (Lab)]

Parents in my constituency have been in touch regarding ventilation in their children’s schools. What advice will health officials give to the Department for Education about putting ventilation in schools and paying for extra measures, which might mean that children can stay in school longer without the fear of covid transmission and that staff will be protected as well?

[Sajid Javid]

That is another very good question. The Education Secretary will be speaking right after me about some of the changes that we are making and how they will affect schools. When it comes to ventilation, there has been, during the course of this pandemic, more funding to schools to make certain adjustments. Not only will that kind of support continue, but some of the measures that we are announcing today will help schools and schoolchildren.

Covid-19 Update

Catherine West Excerpts

Monday 28th June 2021 Commons Chamber

[Sajid Javid]

My hon. Friend has raised an important issue. Even before I had this job, that issue came up again and again when I was a constituency MP just like him, and I absolutely understand it. It has especially been raised by older members of my constituency; people have brought this issue up where they are perhaps not as familiar with technology and they want that face-to-face meeting. I have already asked for advice on that and I will write to him on it, if I may.

[Catherine West (Hornsey and Wood Green) (Lab) [V]]

Many constituents have contacted me about GP provision too, particularly the letting of key practices to private US healthcare companies. Will the Secretary of State take this opportunity to reassure me and my constituents that he intends to keep our NHS public?

[Sajid Javid]

The hon. Lady will know that the NHS is one of our greatest public services. In fact, it is one of the greatest public services that any country has, and it is an example to the rest of the world. It is something that we will cherish and continue to support in every possible way.

Covid-19 Vaccine: Take-up Rates in London

Catherine West Excerpts

Tuesday 9th March 2021 Westminster Hall

[Catherine West (Hornsey and Wood Green) (Lab) [V]]

I thank my hon. Friend the Member for Hammersmith (Andy Slaughter) for securing this debate. What we are seeing is a tale of two cities, but within one constituency in my case. We know from the excellent work of Professor Marmot that the decade of neglecting to address health inequalities, which are writ large under the covid pandemic, is really showing itself in the vaccination strategy.

I thank Dr Maimaris from Haringey Council, who is the head of public health, and Dr Peter Christian of Dukes Avenue practice, who is leading on the GP side. He told me last Friday that one of his colleagues in Wood Green made 30 phone calls, and that of those only one person was keen to take up the vaccine offer. That is the kind of hesitancy that we are seeing. In my constituency, someone who catches the 41 bus from Wood Green to Hornsey Rise sees their life expectancy rise by years and years, so that by the time they get to Highgate, they will be living 15 to 20 years longer than the average person in Wood Green—that is common across many of our London constituencies.

We have been working hard with Christian churches, with Rabbi David Mason in Muswell Hill, and with the Imam in Wightman Road mosque, where I will be at the weekend to push for many more people to take up the vaccine. We really need to understand the granular detail of the levelling-up debate in the national context. It is not just about levelling-up between the north and south of England, but levelling-up within our constituencies. North Middlesex University Hospital and Whittington Hospital have done a wonderful job during the pandemic. I pay tribute to their staff, and call for them to be correctly remunerated. I hope that the Government will review their position on the 1% pay offer, which is just a disgrace.

This is not just about the level of vaccine on offer. We know, for example, that in the Fortis Green and Crouch End wards in my constituency, 99% of eligible people have had the vaccine. That number falls to 74% in Wood Green. Office for National Statistics data up to February 2021 showed that fewer than 50%—some 49%—of black or black British adults said that they were likely to have the jab. We must have high-quality conversations between GPs and their patients to tackle that. We also know from the OpenSAFELY analysis that 60% of black people aged 70 or over had been vaccinated, compared with 75% of south Asians and 90% of white people. Nowhere is that clearer than in my constituency.

What we need to do is to address health inequalities in the wider sense. We need to consider the impact of overcrowded housing, educational attainment, the high incidence of violent crime and all the indicators of inequality, and address them. We cannot have another decade of neglect and unequal distribution. We are a wealthy country; we are simply not spending public funds in the right way to address long-term health inequalities. If anything has shown that, it is this vaccination strategy, which shows it in all its detail.

Oral Answers to Questions

Catherine West Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

What steps he is taking to help enable face-to-face family visits to care homes.

[Catherine West (Hornsey and Wood Green) (Lab)]

What steps he is taking to help enable face-to-face family visits to care homes.

[The Minister for Care (Helen Whately)]

Throughout the pandemic, we have had to strike a balance between protecting people from this cruel virus and social contact. Nowhere has this been harder than in care homes. That is why I am so pleased that, from 8 March, we will be enabling care homes to open up carefully to more visiting. Our guidance will set out how residents can have a named person for repeat visits, with testing and PPE so that those visits can be indoors. We look forward to enabling more visiting as soon as it is safe to do so.

[Helen Whately]

The hon. Member makes an important point. We have been clear that we want to see care homes enabling visiting. We recognise that care homes are having to strike a balance between giving residents access to visitors and making sure that those residents are safe. Our guidance will provide further support to care homes on how they can make sure that those visits happen.

[Catherine West]

Care homes for older folk and disabled people are a basic human right. Given that care home residents—either in the care homes themselves or perhaps in hospital—account for a third of all deaths from covid, should the Government not be trying just a bit harder to provide the staffing that is often required for those extra visits? When will the Government lay out their plan to address social care, which is so clearly lacking and has been promised for about 10 years now?

[Helen Whately]

The hon. Member is right to say that visiting at the moment involves extra staffing—for instance, staff to supervise visits and to support the testing that we will be bringing in with the new visiting guidance. We have already provided funding to the social care sector that can be used to support the cost of visiting, and there is additional funding for extra workforce costs.