North East Ambulance Service

Chris Bryant Excerpts

Monday 23rd May 2022 Commons Chamber

[Maria Caulfield]

It is working. Neonatal deaths and stillbirths have reduced by 25%, so the systems are working. When they do not, we need to investigate and find out why.

[Chris Bryant (Rhondda) (Lab)]

It feels as if there is no sense of urgency. I introduced the Assaults on Emergency Workers (Offences) Act 2018 to protect emergency workers; I hope that it is working, but assaults on ambulance staff and paramedics are still increasing. No wonder so many of them are leaving. We need a radical overhaul to ensure that we recruit more staff into the NHS, including more paramedics, and that fewer of them leave because of burnout.

What I really do not understand is why the Minister is not announcing an investigation today. Apart from anything else, surely it is an offence to provide false information to a coroner. Should that not be investigated by the police?

[Maria Caulfield]

I reassure the hon. Gentleman that the police have investigated and that they did not find evidence of that. As I have said at the Dispatch Box, I will look into specific cases to be confident that no stone has been left unturned with respect to the allegations in The Sunday Times. There are measures in the Police, Crime, Sentencing and Courts Act 2022 that increase sentences for assaults on emergency workers, which we take extremely seriously.

Government Contracts: Randox Laboratories

Chris Bryant Excerpts

Thursday 10th February 2022 Commons Chamber

[Maggie Throup]

The evidence has been put in the Library and the information is there. I want to make it clear that my Department went through as much evidence as it could. As I said earlier, we were at the start of a pandemic; nobody had ever seen anything like it before. I make no apologies for making sure that we had everything in place to keep the country safe.

[Chris Bryant (Rhondda) (Lab)]

Oh dear; I almost do not know where to start. I have to be very careful, because the Standards Committee may well want to return to some of these issues and I will not stray into that territory. There is no rule that says that a Minister cannot be inappropriately lobbied, but there are rules saying that Members are not allowed to engage in paid advocacy. We may need to look at the rules to make sure there is a better way of dealing with this issue. I am not making any allegations about the Health Secretary or anybody else. I just wonder: when the Minister voted to protect Owen Paterson on 3 November, did she know about all of this or not?

[Maggie Throup]

I respect the hon. Gentleman and I look forward to the outcome of the work of his Committee. The code of conduct for MPs rightly remains a matter for Parliament. Today, we are talking about the Humble Address that my Department responded to, quite rightly. There are lessons that can be learned. We are now looking at making sure we have mechanisms in place for the future. Standards are in place in the House and it is quite right that hon. Members meet those standards. I look forward to the outcome of your Committee’s work to make sure we have a rounded approach and that the situation with Mr Paterson does not happen again.

Elective Treatment

Chris Bryant Excerpts

Tuesday 8th February 2022 Commons Chamber

[Sajid Javid]

Absolutely; I agree wholeheartedly with my hon. Friend. There are already 44 surgical hubs up and running across the country, including in London. I went to see one at Moorfields, which is getting through cataract operations more quickly and seeing more people per day than ever before. He is right to talk about their importance and the funding is there in the plan to see many more of them across the nation.

[Chris Bryant (Rhondda) (Lab)]

The key issue seems to be the workforce. It is about trying to ensure that people do not leave the workforce now or do not leave it early. It is also about recruiting enough people, sometimes into specialties that are not necessarily the sexiest ones that people are pushed into at the beginning. For instance, there is no chance of getting diagnoses within the target set in 2018, which we now hope to meet in 2024, unless we train more pathologists every single year. This year, we will not train enough pathologists to meet the number who are leaving this year, so we are going backwards rather than forwards. How will the Secretary of State address that?

[Sajid Javid]

I agree with the hon. Gentleman about the importance of the workforce, especially in the context of specialisms, and pathology is a really good example. That is why we are putting record amounts of investment into the workforce and training. It is also one of the reasons why, to get a more joined-up plan in health, I have decided that Health Education England should be merged with the NHS. This will enable more joined-up thinking and much better planning for the future, especially in specialist areas.

Elective Care Recovery in England

Chris Bryant Excerpts

Monday 7th February 2022 Commons Chamber

[Edward Argar]

I am grateful to my hon. Friend, who puts his finger on an extremely important point. I believe that one in five in Wales is on a waiting list. This Government have put in place measures already to help bring down waiting lists, and the plan is due to published imminently, but we are still waiting to see what the Welsh Government intend to do—or whether they even have a plan.

[Chris Bryant (Rhondda) (Lab)]

May I urge the Government to abandon this talk of a “war on cancer”? It was Richard Nixon’s term and it was thought to be outdated back then. To many people, when Ministers talk about fighting cancer and how somebody has been particularly plucky or courageous for fighting cancer, it feels as though they are telling off the people who do not survive for not being courageous enough. I know that that is not what anybody means, so may we completely change that language? As I understand it, the Prime Minister has also announced another cancer target today: to get to 75% of all cancer diagnoses being made at stage 1 or stage 2. How on earth is he intending to get to that?

[Edward Argar]

I am grateful to the hon. Gentleman for his remarks. He speaks often on this topic from experience, and it is right that we listen carefully to him. I take his point about the importance of language and how different terms and approaches to it will be interpreted by people who are undergoing treatment or a diagnosis for cancer, and I take the point in the spirit in which he meant that observation. On the Prime Minister’s target, the Prime Minister is unapologetically ambitious in seeking to tackle waiting lists and improve performance on cancer care. That is why we are investing record levels in our NHS and bringing forward new diagnostic hubs. It is also why the hon. Gentleman will see measures in the plan, when it is published imminently—coupled with the plan that the Secretary of State set out on Friday—that will help to reassure him, but I am always happy to talk to him about these issues.

Oral Answers to Questions

Chris Bryant Excerpts

Tuesday 18th January 2022 Commons Chamber

[Maria Caulfield]

I thank the hon. Gentleman for his question. I put on record—I am sure this is shared by the whole House—our sympathy for Geoff and his family. There is no doubt that despite cancer being a priority throughout the pandemic, there have been pressures on the system. I again thank the staff, as Geoff’s family have, for carrying on throughout. I want to reassure the hon. Gentleman that the NHS is focusing on recovering cancer services to pre-pandemic levels; an additional £2 billion of funding was made available to the NHS and there were 44,000 more staff from October 2020. We are absolutely committed to getting back on track for pre-pandemic levels. Cancer has always been a priority. That is no comfort to Geoff and his family, but hopefully they can be assured that we are doing all we can.

[Chris Bryant (Rhondda) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Sajid Javid)]

Eight weeks ago, when this House last met for Health and Social Care questions, the world had not even heard of the omicron variant; but a third of the total number of UK covid-19 cases have been recorded since then. The action the Government have taken in response to omicron, and the collective efforts of the British people, have seen us become the most boosted and tested country in Europe, and the country with the most antivirals per head in Europe. That is why we are the most open country in Europe. I have always said that the restrictions should not stay in place a day longer than is absolutely necessary. Due to those pharmaceutical defences and the likelihood of our having already reached the peak of case numbers and hospitalisations, I am cautiously optimistic that we will be able to substantially reduce measures next week. The best thing we can all do to continue that progress is get boosted now.

[Chris Bryant]

May I put on record my gratitude to the Secretary of State for all the help he provided to my constituents before Christmas? He went beyond the call of duty, and I am very grateful to him.

The aftershock is often worse than the earthquake. My anxiety about covid is that it was the earthquake, but we still have the aftershock to come—that is, all the problems in cancer care, and the lack of doctors in emergency medicine, as well as in so many other disciplines. How will we make sure that the 6 million people on waiting lists get the care that they really need, and that the number does not grow over the next few months?

Access to Radiotherapy

Chris Bryant Excerpts

Wednesday 12th January 2022 Westminster Hall

[Chris Bryant (Rhondda) (Lab)]

I congratulate my hon. Friend the Member for Easington (Grahame Morris) on securing this important debate, and not for the first time—he is a repeat offender. His determination and laser focus on this issue are really important in trying to save lives.

I hope it is not too mawkish if I say a few words about my own experience of cancer, even though I have not had radiotherapy, because radiotherapy is not normally used to treat my form of cancer—melanoma—although it is for other forms of skin cancer such as squamous and basal cell carcinomas. The timing of my cancer was amazingly fortunate. It was three years ago yesterday that I went to my GP with a dodgy mole—I urge anyone who ever worries about a mole to get it checked out, because my hon. Friend is absolutely right that early detection saves lives. I was very fortunate that my GP sent me straight to a dermatologist, who cut it out for the first time within 10 days. The second bout was two weeks after that.

I was fortunate that all that could happen very quickly. If I had gone to the doctor on my birthday last year or this year, I do not think I would have got the same speedy response. I had a stage 3B melanoma—incidentally, I must say to the hon. Member for Westmorland and Lonsdale (Tim Farron) that satellites are not always good. A microsatellite from a melanoma is a really bad thing. If I had left it another three months, it would probably have been a stage 4, and there are only four stages.

I was also fortunate that two weeks before I went to the doctor, the National Institute for Health and Care Excellence allowed the use of immunotherapy for melanoma in an adjuvant setting at stage 3, rather than just at stage 4. I hope the Minister will confirm that NICE is looking at the use of the various kinds of immunotherapy in an adjuvant setting for people with stage 2 melanoma.

I say all that because I was told at the time I had a 40% chance of living a year—three years have now passed so I am very grateful that the immunotherapy I received has dramatically improved my chances of living. I say gently to the hon. Member for Westmorland and Lonsdale that, sometimes, the drugs are a really important part of the cancer treatment package. I do not think there is a competition between different parts of the package; there are clearly instances where drugs, chemotherapy or radiotherapy is the right route.

My anxieties are that, first, we have a massive catch-up job to do, and secondly, that I do not think we had the capacity needed to tackle the problem even before we went into covid. We have a growing population in this country, and a growing number of cancers, but last year’s figures show a nearly 10% fall in the number of people receiving radiotherapy. That is not good news in any shape or form. There may be people whose deaths from cancer are unknown to us because they ended up not being diagnosed and then died with or of covid, so they may not appear in the statistics, but they will certainly appear in many people’s family statistics and life experiences.

There are things that the Government could do immediately, many of which have already been laid out by hon. Members. Something needs to be done about the workforce, because every part of the cancer pathway has a shortage of staff. A lot of staff have been redeployed during covid to help run A&E departments. Nurses, hospital orderlies and receptionists from the same teams have ended up being redeployed to other parts of the operation. They have been very happy to do that, but it has meant that, in nearly every cancer discipline—the one I know best relates to dermatology, obviously—there is now a series of vacancies.

A lot of staff are burnt out, exhausted, demoralised and uncertain whether they want to stay in the profession. I think this is the fifth Minister to whom I make the same plea: that she and the Government look at the series of things we could do to enable people who have recently left the profession to come back. That might include financial rewards. We could do more to enable people to stay all the way through to retirement age. A significant number retire early, partly because of that sense of burn-out. They do not necessarily want a financial reward; they would actually quite like a sabbatical of a couple of months or something like that, simply to recharge their batteries so they can come back into the profession and not retire early. We certainly need to do something about the problem that doing extra hours or sessions is now barely worth it for many people, because the financial reward is minimal. A major issue will come up very shortly relating to pensions and pension funds for many doctors in many of these disciplines.

In all those areas, the Government could do far more to increase capacity now, then they have to look at increasing capacity for the future. One of the most important parts of the process is diagnosis. We do not have enough radiologists, radiographers, histopathologists and pathologists in the UK. There is a massive shortage—something like a 10% vacancy rate. We are not even allowing enough people to train this year to fill the vacancies that exist now, let alone the additional vacancies that there will be in five or 10 years’ time, so we are building up a bigger problem for ourselves.

That takes me to my biggest concern of all. Before covid, every winter we were running the NHS at 95% capacity. It is pretty difficult to run anything at 95% capacity, because the moment you have a crisis of any kind whatsoever, you are stuffed. It is a bit like those baggy gym shorts that have an elastic band in them. When someone gets beyond a 34-inch, 36-inch or 38-inch waist, suddenly there is no more stretch in the pants, as you know, Mr Davies—[Laughter]—because you understand the science of elastic bands, obviously. However, I make a serious point. We have run the NHS far too close to complete capacity for far, far too long, and not only in intensive care units, where we have many fewer beds per 100,000 people than any country in the European Union or any advanced country in the world. We also have many fewer hospital beds per 1,000 people than any other advanced country in the world. We need to look at the long-term issues and say to ourselves that, if we really want an NHS that will not be crippled by a pandemic or by winter, we have to invest significantly in the future. Every single time a Minister stands up, they always say very nice things. The Minister who is here today has lots of clinical experience of her own, and we are enormously grateful for the work that she has done in the NHS during the pandemic. However, in the end, warm words butter no parsnips—not that one really wants butter on parsnips. I love a parsnip, although it is odd that we are the only country in Europe that actually eats them—mostly they are fed to cattle, but that is by the by.

The serious point is that we need to invest in every single part of the NHS. The cancer catch-up is a matter of life and death. I think that, if I had gone to the GP yesterday, my life would not have been saved. That is a distressing thing to be able to say to one’s constituents. I hope that the Minister will come up with some answers for us.

--- Later in debate ---

[Maria Caulfield]

I do not disagree with the hon. Gentleman. I may be a new Minister, in post for weeks rather than years, but I have 20 years of oncology experience, and in my experience radiotherapy has a fantastic role to play. It is indeed the case that significant progress has been made, particularly in the field of lung cancer, with stereotactic radiotherapy to specific areas. However, radiotherapy will target a specific area; it will not give systemic treatment, like adjuvant treatment to prevent recurrence or neoadjuvant treatment for metastatic disease, where the disease is in multiple parts of the body. As Members of Parliament, we need to be cautious that we do not give patients the impression that they should be asking for radiotherapy instead of surgery and chemotherapy. There needs to be a discussion with their oncologist and their medical teams as to the appropriateness of radiotherapy. Yes, it is often cheaper than chemotherapy to give. Yes, it is a quicker treatment and sometimes—not always—has fewer side effects. But it has to be a clinical decision. There are important reasons why radiotherapy is given to some patients and not others. That is something that patients really need to have a discussion—

[Chris Bryant]

We all understand that clinical decisions have to be made. Our anxiety is that clinical decisions sometimes end up being made because there is not enough availability of facilities or staff, or—the third aspect to this—because lots of patients simply are not presenting at the moment. They are not coming in the doors of the NHS because of covid. That potentially means—for instance, in relation to bowel cancers, lung cancers and melanoma—that we will see people presenting much later and therefore there will be a much more dangerous prognosis for them.

[Maria Caulfield]

I absolutely take that point on board. There are clinical reasons, if a patient has presented later, why radiotherapy may or may not be suitable. Again, they are clinical decisions that a patient needs to be discussing with their oncologist.

The hon. Member for Westmorland and Lonsdale (Tim Farron) raised the issue of satellite units. Again, I would just be slightly careful. Cancer alliances are mapping out cancer services in their areas, and I am very happy to meet colleagues who would like better provision in their local area, but they also need to meet their cancer alliances, which are looking at service provision locally.

I would just caution Members on the issue of having multiple sites for radiotherapy. These are specialist treatments, needing specialist equipment and specialist staff. I went into oncology more than 20 years ago, when surgery was done by general surgeons. They were doing mastectomies on women and colostomies on bowel cancer patients. Moving surgery into being a specialist field, with specialist provision, has transformed the way that we are able to look after women who are going through mastectomies, and bowel cancer patients, who may not necessarily need a colostomy now, because surgical treatments have advanced so much. There is sometimes a rationale for those services to be offered by specialist units, rather than multiple satellite sites.

--- Later in debate ---

[Maria Caulfield]

It is about replacing existing equipment, but also investing in new. Some of the equipment is 10 years old. Radiotherapy has changed a lot over those 10 years, so the replacement equipment can do more than what it replaces. As I pointed out, we are also investing in new radiotherapy equipment, with £250 million into two proton beam therapy facilities at Christie’s and at UCL—new facilities that will be able to provide state-of-the-art radiotherapy treatment. I hope I have reassured Members that we are addressing this as a top priority.

[Chris Bryant]

Will the Minister give way before she sits down? She sounds very like she is finishing.

[Maria Caulfield]

I was finishing, but I will give way one more time.

[Chris Bryant]

The Minister may not be able to answer the question today about adjuvant provision of immunotherapy for people with stage 2 melanoma, but if she could write to me, I would be very grateful.

[Maria Caulfield]

My understanding is that it is available for stage 3 melanoma, as the hon. Gentleman has highlighted, and that it is still in clinical trials for stage 2. It is available within clinical trials. We expect the data to come forward shortly and then a decision will be made. That is where we are with melanoma.

Vaccination Strategy

Chris Bryant Excerpts

Wednesday 12th January 2022 Commons Chamber

[Chris Bryant (Rhondda) (Lab)]

Having turned 60 yesterday—[Interruption.] It is very difficult to believe, isn’t it, Mr Speaker, but you are not saying I am misleading the House, obviously. Having turned 60 yesterday, I feel I ought to ask a question about the elderly. Quite a lot of people in the elderly group who have had their booster vaccines will have had them in September and October of last year. I had mine at the beginning of November. What will our policy be from now, because, as the right hon. Member for Forest of Dean (Mr Harper) pointed out, the immunity that comes from the booster runs out somewhat after 10 weeks?

[Maggie Throup]

I wish the hon. Gentleman a happy birthday for yesterday. He does not look a year older than 59—just one day older. He makes a good point. The JCVI, which provides advice for Ministers, has considered that question. Towards the end of last week, it felt that a fourth dose or a second booster was not appropriate at this time and that it was important to focus on first boosters and people coming forward for their first and second doses. But I reiterate that the JCVI continues to keep the question under constant review and, should the situation change, it will provide that advice.

Public Health

Chris Bryant Excerpts

Tuesday 14th December 2021 Commons Chamber

[Dr Liam Fox (North Somerset) (Con)]

Let me begin by saying a word about the vaccine programme and issuing a plea to Ministers.

It is important that, with the emergence of omicron, we do not accidentally underplay the success of the vaccine programme to date. We know that vaccines will generate a number of immune responses—the production of neutralising antibodies, the production of marker antibodies, and a T-cell response—and, although with omicron a booster dose is required to bring about the level of neutralising antibodies that we saw following our response of two doses to the delta variant, the whole programme gives both individual and community protection; and we are starting from a very different place from the place where we were with the delta variant.

It is very important for us to encourage people, especially young people, to get their second dose. May I make a plea that we stop hearing from Ministers the phrase “two doses don’t work, three doses do”? I think that it is undermining the Government’s own programme. May I also make a plea that we drop this constant reference to the doubling time of the current variant? The fact that the measured doubling has been two days in the very early stages is no measure whatsoever that that is something that we will see in the future. If it doubled every day, the whole population would be affected in nine days. This is not modelling; it is simple extrapolation, which does not contribute to a sensible debate on the subject.

When it comes to the proposals before us today, lawmakers need to look at several elements. Are these measures necessary, are they proportionate, are they enforceable and will they be effective? Let me begin with the 10-day quarantine, which was a bad measure to begin with. It was disproportionate and it was likely to bring about a recurrence of the “pingdemic”, so I am glad that it is being dropped. However, the point made by the right hon. Member for Exeter (Mr Bradshaw) is a key one which must be answered by the Government. If having the red list is pointless and if enforced 10-day quarantine is pointless, why are some people still in enforced 10-day quarantine? It is incumbent on the Government, having abandoned the policy, to let those people go free, otherwise I fear that the Government may face legal action.

[Chris Bryant (Rhondda) (Lab)]

The right hon. Gentleman is making a very important point. Some Welsh rugby players who had covid in South Africa did 10 days’ quarantine there and are halfway through quarantine in England, and they are now being told that they must complete the whole of the quarantine period. When the position is as illogical as that, it brings the whole thing into dispute.

[Dr Fox]

I absolutely agree, and what we do not require is more advice from Ministers on this subject; we require decisions from Ministers on this subject.

I also want to raise the issue of masks. I receive letters, as I imagine all Members do, from people who say, “There is no point in wearing masks because they do not stop transmission.” I assume that those people would not like their surgeons to wear masks during a surgical procedure. This is nonsense: mask wearing is a common-sense thing for us to do if it reduces transmission to some degree. It is a minor inconvenience to the vast majority of people and it is a sensible measure for the Government to introduce, and I therefore support it.

I cannot say the same for the Government’s covid passport. I do not believe it passes the necessity test, and I think the good working of the insurance industry and the availability of civil remedy in the courts are enough to drive the behaviour of venues towards sensible public health policy. We, as a Government, should not be creating criminal offences unnecessarily. I worry about enforcement and penalties in a system that is already overloaded. There is no evidence from Scotland or elsewhere that covid passports actually work. France was mentioned earlier, and there are more than twice as many people in hospital with covid in France than in the United Kingdom.

--- Later in debate ---

[Steve Barclay]

In a moment.

There is much that we still do not know about this virus, as there is a wide range of opinions on its severity. Hospitalisations and deaths always lag infections by about two to four weeks. We are not at the topping-out point in South Africa, so we do not know what the peak will be, but even a small percentage of widespread transmission will be significant—a point rightly made by the Opposition Front Bench, and the Secretary of State when he opened the debate. This is not, as some suggest, solely an issue for the NHS. Widespread infection and staff absences would have a wider economic impact on areas from our supply chains to our factories.

[Chris Bryant]

The Secretary of State said earlier that he might be able to provide the House with an update on the issue of whether people who have come back from South Africa and are stuck in quarantine have to fulfil their whole quarantine. I have constituents from the Rhondda—rugby players—who are still stuck. They had already done 10 days of quarantine in South Africa; surely they can be released tomorrow.

[Steve Barclay]

I will come to that matter directly—not just because they are rugby players, but because it is an extremely important issue.

[Chris Bryant]

They are Welsh rugby players.

[Steve Barclay]

Indeed.

Covid-19 Update

Chris Bryant Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

My right hon. Friend is right to point to the distinction between, sadly, people who die with covid and those who die of covid. There is a difference. I have come to the Dispatch Box before to say, certainly with the delta variant—we do not have enough data on omicron yet for reasons that he will understand—that, as I am told by the NHS, approximately 20% of the people in hospital who have covid are there because they happen to have covid, rather than them being there because of covid.

[Chris Bryant (Rhondda) (Lab)]

Why are PCR tests so expensive in the UK? Why is the UK the second most expensive place in the world to have a PCR test? Why does the Government website still advertise PCR tests for £15 or £20 when they are not available anywhere in the UK for £15 or £20? Why are such PCR tests still being advertised given that, when someone goes through to the company concerned, the test ends up being £50, £60, £70, £80, £120 or £150? Is there not something that we can do to get the price of these tests down? A family going on holiday at Christmas or new year could end up spending £1,000 to £1,500 just on the tests.

[Sajid Javid]

The UKHSA has removed many so-called providers of PCR tests from the listing on the Government website. It has set a minimum price that must be met to try to avoid misleading prices. Unlike some other countries, we have not chosen to subsidise the cost of private PCR tests, because we have rightly concentrated our resources on the PCR tests that are available for people domestically if they have symptoms.

Health and Social Care

Chris Bryant Excerpts

Friday 3rd December 2021 Commons Chamber

[Edward Argar]

I am grateful to my hon. Friend for highlighting both the investment and the need for us, as the custodians of the taxpayer’s pound, to make sure that the money is well spent by implementing innovation and reform so that it gets to the frontline and delivers patient care, which is exactly what we are doing.

[Chris Bryant (Rhondda) (Lab)]

I have a sneaking suspicion that we will not get to the second private Member’s Bill today, so I hope it is okay if I mention that I am enormously grateful to the Government. The Secretary of State for Health and Social Care has just texted me with the good news that the Government and I, and all the charities, will be working together on acquired brain injury. We will now have a national strategy across all Departments. It is a miracle that the Government have suggested that I should co-chair it with the Minister for Care and Mental Health, because I can be very irritating—[Laughter.] I see I have united the House. Seriously, this is a really good day and I hope we will be able to make a dramatic difference to the millions of people in this country who have suffered an acquired brain injury. Answer that!

[Edward Argar]

I have never found the hon. Gentleman to be irritating in any way, and I have always enjoyed my interactions with him on a range of issues. On a serious point, I pay tribute to him for his campaigning work on this issue. It is a huge step forward, and I know the insight he will bring, working with the Minister for Care and Mental Health, will genuinely make this a strategy of which we can all be proud. I congratulate him on his achievement.