(3 years, 1 month ago)
Commons ChamberI beg to move,
That the draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021, which were laid before this House on 22 June, be approved.
As we head towards a winter where care homes may have to battle with covid and flu, the question we should ask ourselves is this: what more can we do? Over the last year and a half, covid-19 has sadly taken many thousands of lives, particularly the lives of older people and those with underlying health conditions, and particularly the lives of those who need the kind of care received in a care home. There have been more than 40,000 deaths among care home residents. They were mothers and fathers, grans and grandads, brothers and sisters, sons and daughters. Sadly, we have lost some of our dedicated care workers, too: despite all the efforts that have been made by care homes and their staff, local authorities and by us in Government to keep covid out, despite personal protective equipment, despite testing, despite isolation. Throughout the second wave, care homes used 26 million tests and—
On a point of order, Mr Deputy Speaker. I raised a point of order earlier this afternoon about the lack of an impact assessment before the House, despite it having been referred to on 22 June as having been made available. I was informed during the course of that point of order that pressure was going to be put on the Government to explain why there was no impact assessment. It is therefore a source of great disappointment that the Minister has not started off her speech with such an apology and explanation.
Thank you for that point of order, Sir Christopher. The Minister is on her feet and she looks as if she may respond to that point of order herself, as it is not a point for the Chair.
In one moment. Vaccination teams have made multiple visits to care homes since then and as a result 96% of those living in older age care homes have had their first dose and 93% have had their second dose. Some 92% of residents living in working age care homes have had their first dose and 87% have had their second dose. Take-up among staff has also been strong, with 86% of staff in older age care homes having had their first dose and 75% having had their second dose, and 83% of staff in working age care homes having had their first dose and 72% having had their second dose. Our vaccination teams have gone to great lengths to support and encourage those who have been worried about the vaccination, along with care home managers and care colleagues. I am sure that Members will join me in thanking everyone in the NHS, local authorities and care homes who have worked so hard together to achieve such levels of vaccination.
I will make some progress. As the Prime Minister and our chief medical officer have said, even when we are no longer in a pandemic, the virus will remain in some shape or form and we will have to learn to live with it. It will continue to circulate and potentially evolve into new variants, and there is a serious risk of a resurgence of flu and other seasonal infections. A combination of covid and flu may be unpleasant for many of us, but it will be life threatening for those who are most vulnerable.
We must ask ourselves: what more can we do to protect those who will be most vulnerable?
Thank you, Mr Deputy Speaker. There is not a great deal more that I can say on that point. As I have said, the impact assessment is being worked on and we will share it with colleagues as soon as we can. That is all I can say on that particular point.
Further to that point of order, Mr Deputy Speaker. Yesterday, I asked the House of Commons Library to inquire of the Department where this impact assessment was, and the Department informed the Library that it was about to present the impact assessment. It did not say that the assessment was still under preparation. The implication was that it was ready to be given to the House and it was just a matter of time—they said they would do it as soon as possible.
Again, I can only say what I have heard during the debate and apparently the impact assessment is simply not available. This is clearly not the best situation. We can see exactly what it is, but it is what it is.
It is a pleasure to follow the hon. Member for Tooting (Dr Allin-Khan). I am delighted that the Official Opposition share my view and that of many of my colleagues that these are bad regulations and that they should be opposed this evening.
Both the Welsh and Scottish Governments, as I understand it, are against this type of regulation. The Minister told us that other Administrations were watching, but this Administration should be watching what the other Administrations are doing and following their lead. I must say that this was probably the most depressing performance from a Minister that I have listened to in this House. She showed a cavalier disregard for the conventions and courtesies of this House, and, as she has admitted to, she completely breached the rules under the Government’s better regulation framework, which is designed to inform decision making for regulations that affect businesses and individuals in this country. When criticised, the Minister’s response is best described as dumb insolence, and that is just not good enough. One question that I would have liked to ask in an intervention was: what is the Government’s rationale for not requiring care home residents to be vaccinated?
These regulations were laid on 22 June. There was an accompanying explanatory memorandum that expressly referenced a full impact assessment. It said:
“A full impact assessment of the costs and benefits of this instrument is available from the Department of Health and Social Care…and is published alongside this instrument and its Explanatory Memorandum”.
The Minister has not explained what has happened to it, whether it ever existed, and whether it contained information that she found embarrassing and has therefore been suppressed.
An impact assessment is not an optional extra. As the Secondary Legislation Scrutiny Committee made clear in its report of 6 July: “An impact assessment is a fundamental tool for those who wish to scrutinise legislation before nodding it through”. Indeed, an impact assessment should be cleared by the Minister before the proposals are brought forward. The Government’s better regulation framework principles, set out in March 2020, says:
“Where government intervention requires a legislative or policy change to be made, departments are expected to analyse and assess the impact of the change on the different groups affected – which should generally take the form of an impact assessment.”
That has not happened. Why has it not happened? I put down some parliamentary questions about this, because I feared that we would not get the impact assessment, and those questions have received holding answers rather than substantive answers. One asked what estimate he has made
“of the number of employees in…England who will face dismissal from their employment as a result of the enactment of regulations …and whether those staff will be eligible for compensation”.
There was not an answer to that, and there has not been one so far today. I then asked what estimate has been made
“of the number of staff employed in care homes in England who have not been vaccinated against covid-19 for (a) clinical reasons and (b) reasons of personal choice including religion, belief and conscience”.
Again, no answers—not even to parliamentary questions. How can we hold the Government to account if they will not even answer our questions?
My constituents are absolutely livid about what is being proposed. I will not quote extensively from a letter that I received from Mr Davis from Ferndown, but he says that it is completely wrong and unethical and that it makes no sense. An NHS consultant in Christchurch says that, “Mandatory vaccination would be crossing the Rubicon on medical choice, medical confidentiality and bodily autonomy.” These are vital elements of the right to privacy. A Christchurch care home manager to whom I have spoken has said that the whole proposal “undermines” the need for parity of esteem between care workers and NHS workers.
You may have seen, Madam Deputy Speaker, the article in the British Medical Journal on 8 July, which says that, while it may reduce the risk of transmission, vaccination
“is not a panacea for safety”.
Why are we not saying that people who have had previous infection and got immunity from that are exempt from these regulations? I think that this is an unnecessary, disproportionate and misguided proposal. I hope that, given what has happened in Scotland and Wales, we reject these regulations and put the Minister out of her misery.
I thank the hon. Gentleman for his point of order. As I said earlier, it is a totally unsatisfactory situation, irrespective of whether anybody has been misled by the statement in one of the official documents. Those on the Treasury Bench will have heard the point of order and will make absolutely certain that it gets through to the Department. I will, as the hon. Gentleman has asked, raise it with Mr Speaker at the prayer meeting tomorrow morning.
On a point of order, Mr Deputy Speaker. It always used to be the convention in this place that if a Minister was unable to answer all the questions raised in a debate, they would offer to write to hon. and right hon. Members whose questions had not been answered in the time available. Bearing in mind the cavalier way in which Ministers seem to be treating the conventions of the House, I wonder whether it is within your offices to be able to put pressure on the Government to restore that convention as a matter of courtesy.
I look particularly at my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), who had a pertinent question that could have been answered in two words. It was not answered and I am sure his constituents, on behalf of whom he speaks, will feel aggrieved about that. Why cannot this place restore some sense of reasonableness and good manners?
I thank the hon. Gentleman for his point of order. I have been a Member of Parliament for 29 years and many times, at the end of a debate, Ministers have said they cannot deal with each point that has been raised. We were under time pressure today, as has been pointed out by a number of Members, and therefore a number of questions have gone unanswered. Again, those on the Treasury Bench will have heard the point of order and will bring it to the attention of the Minister in order that she is able to answer the questions that went unanswered in her summing up.
(3 years, 1 month ago)
Commons ChamberThe Government are speaking with one voice, and I believe our view is very clear.
Tomorrow, my right hon. Friend will be asking the House to approve regulations that will put thousands of care workers in England out of a job. Two weeks ago, we were promised that a regulatory impact assessment was available. As of midday today, it is still not available. When will it be available, and why has it not been made available so far?
The guidance that we will publish today will be very clear on that.
On a point of order, Madam Deputy Speaker. It arises directly out of the response that the Secretary of State gave to me. Tomorrow this House is being asked to approve the Draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021. When that instrument was laid on 22 June, the explanatory memorandum said:
“A full impact assessment of the costs and benefits of this instrument is”—
I emphasise “is”—
“available from the Department of Health and Social Care…and is published alongside this instrument”.
As of 12 o’clock today, I have been trying, through the good offices of our excellent colleagues in the Library, to get an answer from the Department as to when we are going to get that impact assessment. The officials at the DHSC are quoted by the Library as having said, “The impact assessment has not been laid yet”—we knew that—and, “We will be laying it at the earliest opportunity.” This is very serious, because on 6 July the Secondary Legislation Scrutiny Committee referred to the impossibility of being able to scrutinise the legislation properly without the impact assessment. Despite the Secondary Legislation Scrutiny Committee recommending that the debate be deferred, nothing has happened and all that the Secretary of State said in response to me was, “Well, we don’t know where it is but don’t worry about it—we’ll carry on tomorrow anyway.” That is just not good enough. I would be grateful for your guidance, Madam Deputy Speaker, as to what we can do to ensure that we have an informed debate with the impact assessment before us.
Further to that point of order, Madam Deputy Speaker. In intending to be helpful to those on the Treasury Bench, I have noticed, looking at the said regulations, that they do not actually come into force until 16 weeks after they are approved by the House. It seems to me that in four months there is plenty of time for the Government to produce the relevant information for the House and for the House to take a decision, with no detriment at all to the health and safety of anyone in our care homes.
I thank both hon. and right hon. Gentlemen for their points of order. I am sure the House is well aware that it is not a matter for the Chair. I will not spring it on the Secretary of State for him to give an answer on this operational matter, but Mr Speaker usually observes that it is helpful to the House for Members to have as much information as possible before them when a matter of importance is to be considered.
Further to that point of order, Madam Deputy Speaker. The explanatory memorandum falsely asserted that the full impact assessment is available. Why was the House misled in that way?
Once again, the hon. Gentleman knows that I cannot answer that question, because what is said by Ministers and their Departments is not a matter for the Chair. However, if it were to be the case that a spokesman for a Minister had suggested that something had happened that had not happened, and on which Members were trying to rely and could not rely, Mr Speaker would take a very dim view of that. It is better if Ministers make sure that their Departments give as much information as possible to Members ahead of discussions.
(3 years, 5 months ago)
Commons ChamberYes, the data on the impact of the vaccine—including side effects from the vaccine and the rare occasions when, sadly, people die after having had the vaccine—are published by the Medicines and Healthcare products Regulatory Agency. If there are any data in this area that are not published but my hon. Friend would like to be published, he can write to me and I would be very happy to look into publishing them. Essentially, we take an attitude of being as transparent as possible, because there are side effects to the vaccine as there are to all pharmaceutical drugs and we want to be completely open and transparent about those side effects—essentially to reassure people that the risks are extremely low.
My right hon. Friend answered a question from me on this very subject by saying that the data was not available. I cannot understand why crucial data—such as the number of people who have been vaccinated for more than three weeks, who are then admitted to hospital and subsequently die—is not collected. Why is that?
This data has been collated recently; it is in the so-called SIREN study from Public Health England. I am very happy to look into exactly the data that my hon. Friends are looking for and, if we have it, to publish it. I think we have what has been asked for, but let us try to do this by correspondence to ensure that we get exactly what is being looked for. On the face of it, my hon. Friend is absolutely right; it is exactly the sort of thing that we are looking at, but I want to make sure that we get the details right.
As I was just saying, each step of the road map is guided by the data and the progress against the four tests. We were able to take the first step on 8 March, when we allowed the return of face-to-face education in schools, relaxed the rules on two people gathering outside for recreation and allowed care home residents to nominate a single regular visitor, supported by regular testing and personal protective equipment.
The regulations before the House today ease restrictions further—again, in a careful and controlled way. First, they allow us to put in place the remaining measures of step 1, which will come into force on Monday. That means that the “stay at home” rule will end and six people or two households will be able to meet outdoors, and outdoor sports can resume. The regulations also commit the remaining steps of our road map into law, so that we can gradually ease restrictions at the right time before eventually removing them all together, which we hope to be able to do on 21 June.
It is a pleasure to follow my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady). I thank him for his leadership in the campaign that so many of us support, trying to ensure that some common sense and proportionality are brought to this debate and that we have our freedoms back, because we should not have them taken away from us unless there is the most compelling justification.
As my hon. Friend said, this is also an issue of trust. The Government are using the slogan “data not dates”, but the data is either being withheld or ignored. I have been regularly looking at the so-called coronavirus dashboard. Suddenly, when the data got rather good from my perspective but bad from the Government’s perspective, it disappeared. The latest data on the dashboard for hospital admissions in Dorset goes back to 11 March, so I had to make my own inquiries, and I found out that within the last week, there have only been three hospital admissions in all the hospitals throughout Dorset. We have 1,200 beds in our hospitals, and we have a population of over three quarters of a million people. That data does not tell me that it is reasonable that we should continue to have a lockdown and that people should be deprived of their social and economic liberty. One of my constituents who is very good on these things wrote to me saying that 5,000 cases from 1.9 million tests shows that 99.993% of the population were unaffected. That is what we are talking about in terms of proportionality.
The Health Protection (Coronavirus, Restrictions) (Steps) (England) Regulations 2021 extend to 94 pages. How do the Government believe that we can support the regulations when there is not even an impact assessment for them? If there was an impact assessment, it would point out that every day those regulations remain in place is costing the economy about £1 billion—£1 billion a day. We can get a lot of for £1 billion, and if a cost of £1 billion a day is being incurred, there certainly needs to be a lot more justification than the Government have so far adduced during this debate.
I expect that people will increasingly take the law into their own hands as they see that there is no risk in going out and meeting in the open, as was confirmed in evidence to the Science and Technology Committee, and that there are very few risks associated with social mixing with people who are already vaccinated. The Government have got it completely wrong on risk assessment. My advice to the Minister would be to go and get some risk assessment therapy during the Easter break and then come back with some new ideas in April. He should reflect on the adage that the welfare of humanity is always the alibi of tyrants. That, in essence, is what this debate is about, and that is why I shall be voting against these measures.
After Greg Clark’s four-minute contribution, there are seven Members left to speak. To get everybody in, we will reduce the time limit to three minutes, and the winding-up speeches will start no later than 4.44 pm.
(3 years, 5 months ago)
Commons ChamberI beg to move amendment 1, page 3, line 29, leave out clause 5.
With this it will be convenient to discuss amendment 2, in clause 6, page 3, line 38, leave out from “force” to end of subsection and insert “on 1 October 2021”.
This amendment will incorporate into the Bill the guidance for policy makers issued in August 2010 that there should be two common commencement dates each year, one of which is 1st October, for the introduction of changes to regulations affecting businesses.
Amendment 1 stands in my name and the names of my hon. Friends the Members for Wellingborough (Mr Bone) and for Shipley (Philip Davies).
The purpose of amendments 1 and 2 is to try to address the quality of the legislation that we produce in this House. Using clauses as a means of giving the power to change a whole mass of other legislation has long been a bugbear of mine and is exactly what clause 5 does, which is why the Bill would be better without it. I know that, inevitably, the response from the Government on these issues is always, “Oh, well, this is belt and braces and it will save time in the future because we won’t have to bring forward fresh legislation or statutory instruments in order to cover scenarios that we have not yet thought about.” It seems to me that the case has not been made, which is why I have moved amendment 1.
Amendment 2 is a similar provision to the one on which I was briefly trying to engage the Under-Secretary of State for Education, my hon. Friend the Member for Chichester (Gillian Keegan), when we were discussing the Education and Training (Welfare of Children) Bill. The Minister would not engage with me because she felt that that Bill was a deregulatory Bill—she was probably right—and that, therefore, this provision did not really apply. None the less, the purpose of this is to try to ensure that there should be two common commencement dates each year for regulations that impact on businesses, and that one of those should be 1 October, because that seems to be closest to the time when this Bill will be implemented, so that is the date that I have chosen. Perhaps the Minister will be able to give me an assurance that it is indeed the Government’s policy to deregulate and reduce the regulatory burden on businesses and individuals, and to reassert that the Government accept the virtue of having two days each year that might be described as regulatory days, because that will not only facilitate the effectiveness of our legislative process, but make it much easier for those who are impacted on by our legislation to respond and prepare for it. That is why I moved amendment 1 and have spoken to amendment 2.
I congratulate my hon. Friend the Member for Sevenoaks (Laura Trott) on the outstanding work that she has done in introducing the Bill, and I reiterate the Government’s support for the legislation. I believe that everyone has the right to make informed decisions about their bodies, but our role in Government is to support young people in making safe, informed choices where necessary to protect them from the potential harm that cosmetic procedures can do to their health. The increasing popularity of cosmetic procedures and the pressures on our young people to achieve this aesthetic ideal are well documented, and I believe that the Bill is an important step in putting those necessary safeguards in place.
I acknowledge the intentions behind the amendment tabled in the Public Bill Committee by the hon. Members for Swansea East (Carolyn Harris) and for Bradford South (Judith Cummins) to introduce a medical necessity test on the face of the Bill, and I hope that they have taken assurances from the explanation by my hon. Friend the Member for Sevenoaks of the work that she has done to explore this. The standards set by the General Medical Council already require doctors to consider the best interests of the patient to cover the ethical treatment of under-18s.
It has been an absolute pleasure to work with my hon. Friend to take this step towards greater regulation of the cosmetic procedure industry. I look forward to the Bill’s successful passage through the Lords.
Because time is running short, I thank those who have contributed to this short debate, and so that we can move on to Third Reading, I beg to ask leave to withdraw the amendment.
Amendment, by leave, withdrawn.
Third Reading
I add my congratulations to the hon. Member for Sevenoaks (Laura Trott). I know that this has been no mean feat, especially during the current challenging times, and there has had to be a lot of patience, but it has been rewarded today. It is important that we act to protect our young people, especially with the pressures that they face. This is one of those great bits of legislation where I think if we stopped our constituents in the street and asked them about it, they would think it was already like this. This is a common-sense, practical and proportionate way to protect our young people, and we give it our full support.
I, too, support this Bill. I notice that it was first canvassed as a possibility in the 2017 Conservative manifesto, which contained a commitment to ensure the
“effective registration and regulation of those performing cosmetic interventions.”
I had not realised the extent to which children had been able to access botulinum toxin and cosmetic filler procedures without a medical or psychological assessment; nor had I realised that practitioners did not need to be medically qualified to perform the procedures and that there are no mandatory competency or qualification frameworks related to their administration. Obviously, this Bill will help to avoid the potential health risks of such procedures, which include blindness, tissue necrosis, infection, scarring and psychological impacts.
It seems to me that my hon. Friend the Member for Sevenoaks (Laura Trott), so early on in her obviously very promising political career, has been able to identify an issue on which there is a lot of enthusiastic support. I congratulate and thank her for bringing the Bill forward, and I hope that it makes successful progress in the other place after its passage here.
(3 years, 5 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Welcome to this version of Westminster Hall. May I thank all the people involved in facilitating this important development in our democracy? There have been some changes, which I will set out briefly. One is that we start five minutes earlier, so that we can finish this debate at five minutes to 11. I remind hon. Members participating, both physically and virtually, that they must arrive at the start of the debate and they are expected, under the instructions of the Deputy Speaker, to remain for the duration of the entire debate. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks’ email address. We ask that Members attending physically clean their spaces before using them and before leaving the room, so that those spaces can be used by others later. Without further ado, I call Andy Slaughter to move the motion.
I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on introducing this very welcome and extremely timely debate. He has set out the arguments very comprehensively and I shall endeavour not to repeat too many of the key points.
I will repeat, and I am sure that everyone speaking this morning will also repeat, our grateful thanks to NHS and public health staff who are working so hard to deliver this vaccine. It has been a national success story; there is no doubt of that whatever. It is an extraordinary logistical achievement, of which the NHS can be extremely proud. I had my vaccine on Saturday at St Charles’ Hospital and it was an extraordinary, professional operation; swift and effective. I think everyone should be very proud of what they have done.
Of course, that does not mean that that we should not be able to focus on some of the outstanding questions that arise regarding the delivery of the vaccine in London. As has been stated, London as a city, as a region, is not achieving the same figures as other parts of the country, which should be a cause for concern. My particular concern is my own borough, my own constituency area, Westminster North. It is apparently the second-worst performing borough in the country with just 69% coverage of 65-plus. City of London and Westminster South are also performing very poorly.
This does matter very greatly, for reasons we all understand. It matters in terms of individuals and in terms of the public health of the borough, but I would also suggest to the Minister that it is a particular concern because the central London economy is so critical to our national economic revival. Therefore, being confident that we have good coverage in central London seems, to me, to have a significance even over and above the pure public health considerations.
I want to focus on two particular themes, the first of which I am afraid is going back to the question of data. For the reasons that my hon. Friend the Member for Hammersmith has outlined, inner London generally has a highly complex set of population characteristics. We need to understand the particularity of those circumstances to be effective in delivering to those populations. While it is useful, indeed, to have the national and regional—north-west London, in my instance—and some of the borough data, we need to be able to look at local data, understand it and know that it is accurate.
I have yet to see the information that is provided to the directors of public health. As of this point, the middle of March, nearly three months into the vaccination programme, it has not yet been shared with me. The fact that it has not been shared with me by my local authority reflects its concerns that the data is not accurate. The Minister will have heard, no doubt, from many other people, that there is a concern that building up from the basis of the local data to a larger picture and then expanding it out to a national picture will give different results, and people will start looking at variations in that data and asking questions about it. I understand that point and can see that it is indeed difficult to get those statistics all squared off. On the other hand, I am absolutely clear that unless we understand the difference between what is in happening in, for example, the Mozart estate area in the Queens Park ward, and in Belgravia and Knightsbridge, we will not get a proper understanding of where the priorities should be.
My local authority has told me that part of its anxiety is that there is a variance between the use of the Office for National Statistics data and the national immunisation management system data, which has led to a significant national population variant of, I believe, as high as 5 million. As my hon. Friend outlined, there is good reason to believe that the percentage variance will be greater in central London than anywhere else in the country. We have seen that in terms of the census and the population figures. I had a debate on the 2001 census because of my concerns about accurate recording of population. However, it is unclear to me, from discussions with people working in the local health service, what population denominators are being used locally. It is unclear who is using what data, and as a consequence it is unclear whether such local data as exists is even remotely accurate.
The question is: does that matter? I would say that it does, because if we are spending time trying to find people who are simply not present, to raise the vaccination rate, for good reasons, we are wasting time and effort on them, whereas at the same time—both phenomena are, I think, true simultaneously—there are wards, estates and communities in my constituency, as there will be in others, where we are failing to make contact with people who need to be contacted, because they are extremely hard-to-reach populations. My hon. Friend outlined some of the reasons for that. There is a high relative proportion of single people who will not necessarily have ties to communities, and links so that we can use the normal channels of communication. There is a high proportion of people with mental health problems, again, often living singly. There is the largest private rented sector in the country, with a high degree of population churn, which means that when talking to someone it is often unclear whether they are the same person who was living there six months before. Unless and until we can be sure of the granular data and understand the baseline population statistics on which it is based, we have a problem.
A secondary data problem concerns ethnicity and understanding some of the issues around both the take-up of the vaccine and vaccine reluctance, which are different components. The issue is that, in central London, we have the largest Arabic-speaking populations, a very diverse set of communities, but these are being recorded under “ethnic—other”, and therefore it is difficult for us to be able to focus in on those communities, which are important, in terms of delivery.
I have written to the Minister with some of these questions, but even since I wrote to him there has been new information from the local authority and from the clinical commissioning groups that raise questions for me about the data. We need to know whether the population that we are chasing is there, whether we are chasing hard-to-reach people or whether we need to focus in on people who have vaccine reluctance. I was told last week—
Order. I am sorry, but if the hon. Lady were participating physically, I would by now have been staring her down, because a lot more people wish to participate in the debate. I hope that she will bring her remarks to a swift close so that I can call the next speaker.
It is a pleasure to serve under your chairmanship once again, Sir Christopher, albeit for the first time virtually. I congratulate the hon. Member for Hammersmith (Andy Slaughter) on securing the debate, which is important for all Londoners. It is a pleasure to follow the hon. Member for Westminster North (Ms Buck).
In the London Borough of Harrow, we have had an outstanding performance on vaccination rates. We received congratulations from the Secretary of State for Health and Social Care on that performance, and I put on the record my appreciation and thanks to the fantastic team—both from the NHS and the volunteers—who made this possible. To set it in context, more than 70,000 people in Harrow have had their first vaccination, out of an adult population of just under 200,000, which is a remarkable performance, at the Hive centre, which opened in December, and at Byron Hall and Tithe Farm, which opened in January. To get to this stage so quickly has been remarkably good.
That has to be set against the fact that Harrow is the most ethnically diverse borough in London. Others have a higher number of different sections of population, but we literally have someone from every country on the planet and various different communities, so it is a direct challenge to reach all those different communities and to encourage them to come forward to get their vaccinations. This fantastic effort also has to be set against the position that, at the beginning of the pandemic, Northwick Park Hospital came very close to being overwhelmed by the number of covid cases. Sadly, we have had a very high death rate, and at one stage Harrow had the highest covid transmission rate in London, so achieving this vaccination rate has been vital.
More than 35,000 people have had their first vaccination at the Hive since the middle of December, and the Prime Minister visited the site to see at first hand the excellent work that is being done. However, we are experiencing problems, and I will relay some of those for the Minister. There is reluctance among the Afro-Caribbean, Bangladeshi and Pakistani communities, who are hard to reach. There have been real difficulties in getting them to come forward; there is a reluctance to have the vaccine. Among the white British, Irish and Indian population, there have been no such problems—they have come forward in their droves to receive their vaccinations, which is good news.
The supply problems are really serious. To give the Minister an example—I hope he will be able to answer this—the capacity at each of our vaccination centres is roughly 860 doses a day, yet this week, our centres will only receive 400 doses. That is less than half a day’s work, so the lack of supply is holding us back from achieving even faster vaccination rates.
The real problem that emanates from that is that we are having particular difficulties in contacting younger people who have underlying health conditions. They are among the most reluctant to come forward, because of the myths and legends about what the vaccine does to people’s bodies. I am pleased that we now have a myth-buster to combat this unfortunate propaganda, which is spreading very widely among different communities. An excellent video has also been put together by different community leaders, coming together irrespective of race, religion, colour or creed to say why it is important that people have the vaccination, to encourage people to do so, and to try to combat some of this insidious propaganda.
Also on the issue of vaccine supply, my centres complain that they get notified only a day in advance of the vaccine arriving, which of course means that it is very difficult to schedule people in to get their vaccinations. Can we have a better plan for supply of vaccine, which is vitally important? Equally, allowing flexibility to GPs undertaking vaccinations at GP surgeries would help considerably. It would reach those harder-to-reach groups, because people trust their GPs in the way that they do not necessarily trust going to a large vaccination centre.
I will end my remarks by saying that in Harrow, certainly, we have achieved remarkably well, but we can do better provided that we get the supply, that we have better notice, and that the facilities continue to arrive. At the end of April, two of our mass vaccination centres will close, and there will be the potential for complete chaos when we come to the second doses, because everyone will be invited to attend one centre in Harrow to get their second dose. I predict that is going to be quite chaotic, so I would ask that we look at potentially keeping those centres open for a further period to ensure that every adult gets their opportunity for at least the first dose by the end of July, as per the plan that the Minister has.
Thank you, Sir Christopher, and I look forward to listening to what other colleagues have to say.
As there are still eight more speakers and we start the wind-ups at 10.33, I am afraid that I now have to impose a four-minute maximum time limit.
We are now in the second year of coronavirus, and we have all experienced highs and lows throughout this period. At the beginning, we were told that this is a great leveller, given that Prince Charles and the Prime Minister had it. Rather than the “we are all in it together” narrative, it is maybe more fair to say that we are all in the same storm, but in different boats. Nowhere have we seen that differential impact more clearly than in the vaccine roll-out in London.
We all remember the pictures of the memorably named William Shakespeare having his jab early in December, but it took a good 10 days for the vaccine to reach the magnificent gothic splendour of Ealing town hall, and sadly the supply in London has lagged behind other parts of the country. It has been a magnificent effort. We have all seen the brilliant statistic that a third of the population have been done, but again, there is room for improvement here. We remember the highs and lows—the 50,000 fatalities figure came just before the miracle of the vaccine at Christmas that has given everyone hope—but that maxim of differential impact is one we have to look at.
There are two things that will take us to the other side of this: vaccine uptake among the population and the hesitancy that people talk about, and supply. London has nudging 10 million people—some 12% of the population. My own borough has 360,000 people. Initially, we had the town hall, then we had a second venue in Southall— in the west of the borough. Both those were closed last week. The latter did a record 1,200, I think, before shutting its doors until further notice. There has been a magnificent effort from volunteers and NHS staff, and everyone was poised. I have heard nothing but praise about the efficiency of the operation, but then they were all stood down.
There are old divides between the inner city and the leafy suburbs, but my seat has both: Ealing is known as “queen of the suburbs”, but there are wards of deprivation in Acton, where there has been no vaccination centre; it is a bit of a vaccination black spot. I hope the Minister will help me to address that issue. Acton is big enough to have a tube or rail station with every compass point on several different lines—Central, District, and Piccadilly—but there is no vaccination centre. Given the characteristics of its population, the Acton-shaped hole makes the issue even more urgent.
As a whole, London—our nation’s capital—sometimes seems to have experienced this over-promising, and this moonshot rhetoric. Not that long ago, we were promised 24-hour vaccinations in the capital. That was being said in January. The experience of our centres last week was far from that.
We are waiting for the second dose and hopefully there will be a big surge, but it concerns me that there seems to be a bit of anti-London rhetoric from the Government at times. That stretches to the fact that we have a towns fund with new bungs bringing in prosperity and opportunity—but not in London, which has been completely excluded in favour of red wall locations. I would caution the Government not to let that apply to vaccination supply. London is not immune from deprivation, poor housing and overcrowding: I have those in my wards in Acton. Localised need should drive allocation, not centralised supply.
Order. I am sorry to interrupt, but you have gone beyond your time limit. I do not know whether it is because you cannot see the clock. My job is to try to ensure that everybody is able to speak. I call Feryal Clark.
It is a pleasure to join this very important debate, Sir Christopher, and I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing it.
The speed of the roll-out of the vaccination programme is a great source of hope for all of us. Those of us who have lost loved ones are particularly grateful to the NHS, to the scientists and to so many people who have come together to produce this vaccine, because we all know how important it is to protect our constituents, and our friends and family.
Locally, I pay tribute to my local authority, which has set up a helpline that is proactively contacting people who have not been vaccinated, and addressing and answering their questions. Government resources will make a big difference to other local authorities to help support that effort, and we need that back-up from Ministers.
I also thank the Royal London Hospital, Queen Mary University, GPs’ surgeries, the London Muslim Centre and other partners who have been helping with the vaccination effort in my constituency. Many people will be aware that in the first wave Tower Hamlets had the fourth-highest age-standardised death rate in the country. Although we are a young population, relatively speaking, there are huge health inequalities and huge issues with deprivation, severe overcrowding, intergenerational households and many other factors that, as other colleagues have said, make inner London extremely vulnerable to this pandemic.
In the second wave, we saw that the spread of the virus caused more deaths, which is why it is vital that we get to those who have not yet been vaccinated and those who have underlying health conditions by increasing the supply of the AstraZeneca vaccine, and that we get to those who did not take up the vaccine when they were offered it, for a number of complicated reasons, as other colleagues have mentioned. In some cases, it is about reticence, but it is also about practicalities and about deprivation. It is not just ethnic minority communities who are affected, although we have seen big differentials; it is also those from white disadvantaged backgrounds and from working-class backgrounds who have been disproportionately affected, both in terms of death rates and in lower take-up of vaccines.
What we need to do now is make sure that the vaccines are in the right places. The centralised hubs are, of course, useful and important, but it is also vital that we get vaccines to local GP surgeries. As I have said to the Minister time and again, it is vital that we get more vaccines to pharmacies and that pop-up clinics get up and running. The ones that we have are very good and very helpful, but the unpredictability of supply, the inability to plan and the lack of local flexibility are all leading to sub-optimal outcomes, when we could have better outcomes.
So today I call on the Minister, once again, to get the vaccines to the local providers and to provide local authorities with additional support, so that they can do the chasing, as is the case in my local authority. What we have seen is that when GPs are responsible for getting vulnerable patients, including homebound patients, vaccinated in my borough, 95% of those patients have been vaccinated. So this is not rocket science; we can address the gaps.
I am grateful to the Minister for the work that he has done so far and I appreciate that in him we have a listening ear. I hope that he listens to the arguments that have been made—not just by Members in my party, but by Members in his own: we have to get the supplies in. Going forward, as other colleagues have pointed out, we also need to address some of the deeper underlying conditions and to make sure that people’s vulnerabilities are addressed.
There is one final issue. Ramadan is coming, so we are in a race against time to vaccinate vulnerable constituents from the Muslim community in our city, because if we do not vaccinate them there will be even greater risks. So I hope the Minister will address that point, as well as the importance of getting more supplies into London—
May I begin by making it clear that I am not here to raise criticism for criticism’s sake? I am here because I understand how imperative it is that the vaccine programme is successful. Although I welcome the scale of the programme and the number of vaccinations delivered, I am extremely concerned about the vaccination take-up in my constituency, and the inconceivable decision to open the two new vaccination centres miles away from the NHS declared low take-up wards of concern.
Let me briefly explain the geography. The borough of Merton is split in two: Mitcham and Morden, and Wimbledon. Merton’s inequalities in health are stark, with an eight-year difference in life expectancy between parts of Mitcham and parts of Wimbledon. The Minister will be aware of Tudor Hart’s inverse care law—that the areas in the greatest health are then statistically more likely to receive better health services.
Look no further than Merton. When the state-of-the-art Nelson health centre was opened in one of the wealthiest, richest wards of Wimbledon, Mitcham received the “Wilson portacabin”. When lateral flow testing was introduced at community pharmacies, they were opened everywhere but Mitcham. When a decision was made to relocate acute hospital services—guess what? The proposals moved them miles further away from the most deprived areas, with the statistically worst health. While many of these decisions are baked into decades of inequality, the location of a vaccination centre is a decision for here and now.
Here is the state of play: there are two centres in Merton; one in Wimbledon and one in Mitcham. However, take-up of the vaccine across the borough has varied significantly and, as ever, the devil is in the detail. Merton has 25 middle and lower layer super output areas. Of the 12 with the highest vaccination take-up rates, 11 are in Wimbledon. In all 12 Wimbledon areas, over 93% of over-70s have received their first dose. Compare that with Mitcham and Morden, where seven of the 13 areas are still below 90%, and Mitcham West, where the vaccination take-up was just 81%. That means that one in five residents have been offered, but not accepted, the vaccine.
I recognise the breadth of factors as to why this could be, and that accessibility of the vaccination centre is only one. However, it is a significant one, particularly given that, of the two new large-scale vaccination centres that are set to open in Merton, both are in Wimbledon—two centres, miles away from the wards with the lowest take-up areas, which also have statistically lower levels of car ownership. Are we not supposed to be breaking down barriers, rather than throwing up even more?
I am not calling for Wimbledon to lose their services, but the Minister must surely see the absurdity of this decision.
I will have to limit the last two speakers to three minutes each. If they have not seen it, there should be a countdown clock at the top of their screens to help them keep to the time limit.
Thank you, Sir Christopher, for your stewardship of our proceedings this morning. I am grateful to colleagues from north, south, east and west London for speaking on behalf of their unique constituencies but also identifying some common problems; to the shadow Minister, who has shown, as always, the support and solidarity that London MPs can expect from northern colleagues; and to the Minister himself. The Minister will be able to judge whether he has satisfied us on every point raised today by how many people turn up to his Friday briefing this week.
If there is one takeaway for the Minister from this debate, it is the need, in the laudable rush to hit overall targets, not to forget those left behind. That could be people of certain ethnicities. I draw his attention to the Royal College of Nursing’s work on this issue, which shows that even among nursing staff there is a disparity between different ethnicities. There are also those who fall through the net. I have a 68-year-old constituent who, because of her good health for 20 years, lost her NHS number and now is told that she has to wait eight weeks before she can get the vaccine. There are people who simply fall through the net, and it is partly our job to ensure that that does not happen.
On the hesitancy issue, I ask the Minister to look at the work that we are doing in Hammersmith and in north-west London. It is really good stuff. It is good practice that perhaps can be reflected elsewhere. He might even, after having seen it, want to go away and fund it.
Question put and agreed to.
Resolved,
That this House has considered covid-19 vaccine take-up rates in London.
The sitting will be suspended until 11 o’clock. May I ask those who have participated in this excellent debate to leave as quickly as possible?
(3 years, 5 months ago)
Commons ChamberWe obviously had a tiered system over the autumn and one of the challenges we found was of people travelling from a part of the country where rates are higher to those where rates are lower. Therefore, while we do not rule out a localised approach to outbreaks, we will move down the road map as a nation across England.
People understand figures more than percentages, so I ask my right hon. Friend: how many people in England have been admitted to hospital having already had a vaccine for at least three weeks? That figure will illustrate the risk assessments that people would like to be able to make in respect of this set of vaccines. In the same way that I have been told that flu vaccines are only 40% efficient, these seem to be at least 80% efficient, which is really good news.
I do not have those specific figures to hand, but the MHRA—the regulator—regularly publishes what are called adverse events when somebody still has a problem with coronavirus having had the vaccine or has a response to the vaccine, and I will ensure that the appropriate body, whether it is MHRA or Public Health England, publishes both the number and the percentage.
(3 years, 7 months ago)
Commons ChamberI hear my hon. Friend’s point, and I share his view that throughout this pandemic the vast majority of people have behaved with great responsibility. I know that people in tiers other than tier 4 thought very hard about whether they should gather with relatives, even within the easing that was allowed during the Christmas period, and rightly so. We must all play our part in controlling the virus and stopping its spread.
I will make some progress.
At the time of these provisions we were seeing an exponential rise in cases in London, Kent, and some other parts of the south-east, and it was clear that the tier 3 restrictions were not sufficient. We identified the existence of a new variant in those areas, and further analysis showed us that the new variant was driving the steep trajectory of infections. The new and emerging respiratory virus threats advisory group—NERVTAG—tells us that the new variant demonstrates a substantial increase in transmissibility, compared with other variants, and that the R value appears to be significantly higher, with initial estimates suggesting an increase of between 0.4 and 0.9.
There is no evidence to suggest that the new variant of the virus is more likely to cause more serious disease, but increased infections lead to increased hospital admissions and, sadly, increased loss of life. These winter months already pose great challenges for our NHS. That is why we had to take the action that we took before Christmas, and the further steps announced today to control the relentless spread of the virus. However, it is not all bad news.
I am making some progress and I am mindful that many Members want to speak this evening.
The roll-out of the Pfizer vaccine is happening at pace, with more than 600,000 people receiving it between 8 and 20 December. Vaccinations in care homes started on 16 December, and the NHS has already been getting the vaccine to those who are most vulnerable, and the care workers who look after them. Now, the Oxford-AstraZeneca vaccine has been approved, and it is much easier to get out to people and into arms. There is every reason for optimism, but we are not there yet. We must suppress the virus now and in the weeks ahead.
On the specific measures in these regulations, in response to the greatly increased risk, the addition of tier 4 stay-at-home measures will be familiar to people from the November national restrictions. Tier 4 involves minor changes to those national restrictions. As of November, people in tier 4 areas must stay at home and not travel out of tier 4. They may only leave for a limited number of reasons such as work, education, or caring purposes. We are advising that clinically extremely vulnerable people in tier 4 areas should do as they did in November and stay at home as much as possible, except to go outdoors for exercise or to attend health appointments. The regulations contain the same exemptions as other tiers for childcare and support bubbles. We advise that people elsewhere avoid travelling into a tier 4 area, unless they need to do so for work, education or health purposes.
Can my hon. Friend help me? Statutory instrument 1572 required the people of Christchurch to move from tier 1 to tier 2, and it came into effect on 19 December. Today, the Secretary of State has announced that the people of Christchurch should be moving into tier 4, with effect from midnight tonight. What has happened between 19 December and today to force the people of Christchurch to lose all that liberty?
One thing that I will do when I have finished speaking is see whether I can look up the specific data for the hon. Member’s constituency. In general, however, the announcements made today, just as with previous announcements, are based on the data that we are seeing, which includes rapidly rising rates of infection in certain areas, the level of new infections, the trajectory and hospital pressures.
The tier 4 regulations require all non-essential retail, indoor entertainment, hairdressers and other personal care services to close. International travel is also restricted to business trips only. However, we have listened to hon. Members and the public about what is most important to people in their daily lives so, unlike in the November restrictions, communal worship and a wider range of outdoor recreation are still permitted. We also recognise the restrictions’ impact on businesses and continue to provide them with ongoing support to help get through the crisis.
We know that these measures are hard. We know that they keep families and friends apart, yet we also know that they are necessary for us to get through this situation and to prevent the loss of lives as we do so. This virus thrives on the things that make life worth living, such as social contact, but that means we can all play our part in stopping the spread—as I said, if not for ourselves, then for others. The end is in sight, but for now it is our duty here in Parliament to put in place these restrictions—onerous though they are—to control this virus. I commend the regulations to the House.
This House legislated explicitly for specific arrangements to govern the celebration of Christmas, and no sooner than the House had risen itself for Christmas, the Government, by ministerial fiat, changed those arrangements. We are asked this evening to give retrospective legislative approval to the changes that they made. We are in the absurd position of being asked to vote for the ghost of Christmas past.
Sometimes in a democracy, process has an importance. I am constantly—daily—confronted by individuals and businesses facing ruin, notwithstanding the huge investment that they made in covid-secure premises and procedures. What we have never had, and what we have always been asking for, is the cost-benefit analysis that the Government made on each of the restrictive measures that make up the menu of their tier system. I do not for one moment question the motives of Ministers. I do, however, question their ability, in exactly the way that I question my own ability.
When the House rose, the lobby of Government scientific advisers—a lobby, we should remember, that had already publicly expressed their frustration that their earlier strictures on how Christmas should be celebrated had not been fully taken on board by the Government—announced that they had discovered a new strain of the disease so much more transmissible than the earlier one. They bounced the Government. I have to accept, of course, the possibility that they may be absolutely right, but I know this: were I presented by such a lobby of eminent scientists—eminent people leading in their field—and told that they had discovered this new emergency, and that so many more people were going to die, and unless I did what they said, I would be responsible for their deaths, I would find great difficulty in having the wherewithal to identify and ask the right questions to be sure that they were on the money, or 100 miles from it.
What I would certainly want, and what I believe the Government need, is an alternative source of expertise—a competitive source of expertise—particularly statisticians leading in their fields, who would be able to furnish me, to arm me, to arm Ministers, with the right questions to ask about the validity of the modelling and the data. It can only improve the decision-making process. But what is really galling in all this is then to hear on the airwaves Professor Ferguson being interviewed, giving his wisdom to the nation once again, to all intents and purposes as if he were still a key Government adviser. I do hope that the Minister winding up the debate will be able to assure us that that is most certainly not the case. I was always rather jealous of Poole, Christchurch and Bournemouth, because our infection rate in the New Forest was substantially lower than theirs, but they turned out to be in tier 2 and we were in tier 3. Now we are all together in tier 4.
My right hon. Friend is absolutely right to say that we are now in tier 4, but in statutory instrument No. 1646, which was laid before this House on 29 December, we were in tier 2. Today—one day later—we are in tier 4. Is that not a mockery?
The reality is this. These are the questions that my constituents put to me, and I am reduced to saying, “It’s one of life’s great mysteries.” The decision-making process is entirely opaque. That is why I voted against it when I had the chance.
(3 years, 8 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It is a pleasure to serve under your chairmanship, Sir Christopher, and a great pleasure to be speaking in a debate secured by my very old, wise and aged colleague, my right hon. Friend the Member for South Northamptonshire (Andrea Leadsom)—the high priestess of early years. As she said, I speak as the chair of the all-party parliamentary group on the first 1,001 days. I also recently stood down as chair of the Parent-Infant Foundation, the charity that she founded and that is having such an important effect on the whole movement for 1,001 days. I have been very proud to chair that charity for the past six years.
It is great to see this subject coming into the mainstream. We have had a number of Westminster Hall debates, including on the impact of covid on maternity, families and children in lockdown. Before the general election, I held a debate on health visitors. Since “The 1001 Critical Days” manifesto, the important document produced about eight years ago by my right hon. Friend, we have had various reports, including “Babies in Lockdown”, “Rare Jewels” by the Parent-Infant Foundation, “Building Great Britons”, and several Select Committee reports, including by the Health and Social Care Committee and the Science and Technology Committee, all of which were serious, heavyweight studies of the first 1,001 days.
This is, at last, not a new subject. I come to this debate much in the mode of Elizabeth Taylor’s sixth husband: knowing what was expected of him, but struggling to make it new and fresh. But we will give it a go.
Children, particularly very young children, have been the forgotten element in the whole pandemic lockdown; so too have parents of very young children. The lockdown, the regulations, and the alienation from or unavailability of family member support networks—which many of us, as early parents, took for granted—have had mental health impacts on new parents and single parents in particular. We should not underestimate that. It will be a long time before we can get back to a degree of normality and start to see the impact that missing out on those important contacts and support mechanisms in those crucial early months has had and will have for many years to come.
Early years has for too long been forgotten when it comes to Government spending. Many of us have been going on about that for a long time, and it is worth repeating. Work done a few years ago estimated that the cost of perinatal mental illness is £8.1 billion each and every year. The cost of child neglect in this country is £15 billion each and every year. That means that we are spending more than £23 billion on getting it wrong for parents and very young children in those crucial early years. If we were to spend a fraction of that amount on greater preventative intervention measures for those who most need it in those crucial early years from conception to age two, that bill would be reduced significantly and it is a false economy not to be doing that.
It was disappointing to see just £300 million in additional funds being given to the social care sector—that is, the adult and children’s social care sector—in the spending review, even though there is a shortfall of some £3 billion in local authority children’s social care alone, not to mention all the problems with public health and the shrinking numbers of health visitors, which I will come back to in a moment.
Why is that important? My right hon. Friend the Member for South Northamptonshire has given us some of the figures. Up to 20% of women experience mental health problems in pregnancy or the first 12 months after birth, and 50% of all maltreatment is related to children under the age of one. It has been estimated that 122,000 babies under the age of one live with a parent who has a mental health problem. One third of domestic violence begins during pregnancy—a figure I could not believe when I first came across it. The Government are doing good work with domestic abuse legislation, but we need to be addressing the problem at source. If domestic violence is happening in a household, what sort of physical and psychological message is that sending to the newborn child? The same applies to even before it is born as well: there are signs that communication within the womb itself is a factor. Suicide is one of the leading causes of death during the period of pregnancy to one year after the birth of a child. That is a deeply tragic figure, but it preventable if proper systems and checks are in in place.
About 40% of children in the UK have an insecure attachment to a parent or carer by the age of 12 months. The figure that I have always used—this is, I think, the killer point—is that for a child at the age of 15 or 16 who is suffering from some form of depression or low-level mental illness while at school, there is a 99% likelihood that his or her mother suffered from some form of depression or mental illness during or after pregnancy. It is as direct a correlation as that. If we do not do something within those first 1,001 days, we will reap the consequences, as will children, not just during childhood but into adulthood as well.
Child obesity rates are all connected to what happens in the first 1,001 days. Last year we also had worrying figures—this is particularly topical now—about the dwindling vaccination rates in England. In particular, only 86.5% of children had received the full dose of the measles, mumps and rubella vaccine. We have effectively lost our immunity status, because the World Health Organisation target to protect a population from a disease is 95%. One hopes that parents in particular will take up the covid vaccination as it is rolled out, because we have seen the effects on the children’s population of not having vaccinations in recent years.
The Children’s Commissioner estimates that 2.3 million children are living with risk because of a vulnerable family background and that more than one third within that group are invisible—they are not known to services and are therefore not getting any support. That is why it is crucial, particularly before those children present at school and come on the radar, that health professionals at various levels are having contact with those children and families to ensure that everything is all right. They can give that help and support and that tender affection and empathy, but they are also an early warning system for when things are going wrong, right up to safeguarding issues. The one thing that all those ailments have in common—there are a lot more that I have not mentioned—is that they come under the remit of the health visitor to a varying extent. I will come back to the importance of health visitors.
The impact of covid is great, as I have said, and I will not go over that again, but more families with babies and young children under five have been tipped into vulnerability due to the secondary impacts of the lockdown. At a time when families, and particularly families from deprived communities and single-parent families, need face-to-face contact with people like health visitors the most—I also refer to health visitors as the trusted uniform services who are usually welcomed over the threshold, whereas with social workers and others a barrier goes up instantly—more than 70% of health visitors have been repurposed to other aspects of the health service to deal with covid. That really is a false economy.
I pay tribute to Cheryll Adams, the chief executive of the Institute of Health Visiting, who is standing down from the outstanding role she has played for the cause of health visitors and their importance in the first 1,001 days. She will be greatly missed, but I am sure she will not quit the scene altogether, because of her dedication to the cause. Her report showed that 82% of health visitors reported an increase in domestic violence and abuse; 81% an increase in perinatal mental illness and poverty; 76% an increase in the use of food banks and speech and communication delay among children; 61% an increase in neglect; and 45% an increase in substance abuse. Finally, 65% of health visitors have a case load of more than 300 children under the age of five.
Is that sustainable? My worry is that even in the good times without a pandemic, health visiting was greatly stretched. One of the great achievements of the coalition Government was the delivery of a promise to institute 4,200 additional health visitors, based on the Kraamzorg system in Holland, which we visited and saw. It was a huge achievement—I think we were just a few dozen short of 4,200 by the time we got to 2015—and yet I fear that those numbers have dwindled back almost to the level that was inherited. That is such a false economy. Health visitors are a critical part of a universal offer to all families in the first 1,001 days. The report by the First 1001 Days Movement says:
“It is essential that governments invest in the delivery of the Healthy Child Programme and that this programme supports babies’ emotional wellbeing and development. We believe that all families should be able to access care from a named health visitor who offers them a high-quality service that is proportionate to their needs.”
I wholeheartedly concur.
What should be done? Many suggestions have been made. The LGA recently brought out a report saying that the Government should
“properly resource councils to enable investment in preventative universal and early help services to ensure that children, young people and their families receive the practical, emotional, education and mental health support they need”.
That is absolutely right. The Parent-Infant Foundation, in its “Babies in Lockdown” report, recommended funding for a
“Baby Boost to enable local services to support families who have had a baby during or close to lockdown.”
As my right hon. Friend said, more than half a million babies were born in that period. The report also said we should have a
“new Parent-Infant Premium providing new funding for local commissioners, targeted at improving outcomes for the most vulnerable children.”
I obviously agree with that.
Finally, I will go back to the “Building Great Britons” report, which was produced back in 2015 and made nine main recommendations: that a 1,001 critical days policy should be a mainstream undertaking by central Government; that all local authorities should be required to produce and implement a 1,001 days strategy within the next five years; that national Government must establish a 1,001 days strategy blueprint; that local health and wellbeing boards should demonstrate delivery of a sound primary prevention approach; that the early help recommendations from the Munro review, which I commissioned back in 2010, should be picked up and carried; that we should have a Minister for families, either close to or at Cabinet level, to carry the banner for the importance of the early years and family contexts, which are so important to the social policy of any Government; that we should have more inter-agency training on the importance of the early years; that children’s centres should be repurposed to be these family hubs, which this Government have committed to and which should be a Piccadilly Circus of these services available to all families; and that we should have the research evidence to go with all of that.
In short, we need a full “team around the family” approach; we need to invest in health visitors and other health professionals, including GPs and mental health specialists, particularly around attachment issues. We need them to work with all of those in the early years setting, alongside social workers and others with safeguarding responsibilities—supporting, not supplanting parents, but signposting them to the most appropriate services and ensuring that they are accessible when needed. We need a national roll-out, national guidance and national scrutiny to ensure that it is being delivered, but it should be implemented locally and governed by local circumstances. To not do that is a false economy, and children in future generations will pay the price.
Before calling the next speaker, I will just say that the wind-ups will start at half past 10. There are four more speakers, so if each of them speaks for a maximum of five minutes, we should cover everybody.
(3 years, 8 months ago)
Westminster HallWestminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
I agree that is arguably one of the opportunities of a more cashless society. If people are making a payment, the gift aid opportunities are potentially easier to access than with putting money in a box.
I appreciate that healthcare is a devolved matter, but I am still looking forward to hearing the Minister’s response because I am sure these challenges exist throughout the UK. Indeed, that is why the hon. Member for Strangford is the person who has secured this debate. We can also achieve much by pooling our healthcare expertise across the four nations. We should be making sure that in Scotland, Wales, Northern Ireland and England that we are following the best possible practice, which means raising awareness of symptoms, enabling swift diagnosis and ensuring that children, young people and their families are properly supported.
As the next person on the call list has withdrawn, I call David Linden.
(3 years, 9 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
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(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on his Department’s performance in answering written questions from right hon. and hon. Members.
Parliamentary questions are a key element of Parliament’s ability to scrutinise Government on behalf of the people of the United Kingdom. As the House would expect, we take them very seriously, and as you, Mr Speaker, and hon. Members will know, I take seriously all aspects of my and the Government’s accountability to this House. Prior to the pandemic, my Department had an exemplary record of providing accurate and timely answers. In the last full parliamentary Session, despite receiving more PQs than any other Department, we had the highest response rate in Whitehall. However, as hon. Members will be aware, DHSC, its Ministers and officials have been at the forefront of responding to this pandemic, with the attendant additional workload that has brought.
As such, it is a matter of regret that we have been unable to sustain previous PQ performance, for which I rightly apologise to you and the House. However, it is explicable in the face of a trio of concurrent challenges. The first is volume: between March and October this year, we received over 8,000 written parliamentary questions across both Houses. This compares with 4,000 for the equivalent period last year. The second challenge is timeliness: we have met a rapidly, almost daily, changing situation, and answers drafted by officials are sometimes out of date shortly after they are drafted. We have been prioritising accuracy of response to Members over speed, but this can mean that responses have to be redrafted, with attendant delays.
The third challenge is policy input: despite increasing the administrative resources to respond to parliamentary questions, it remains the same policy officials who are responding to the pandemic operationally and drafting regulations and are the only people with the requisite policy expertise to input into parliamentary questions and responses.
That said, Mr Speaker, although we continue to field exceptional volumes of parliamentary questions, I want to reassure you and the House that we are not making excuses in providing these explanations, and are taking every possible step to recover our performance. We have instituted a parliamentary questions performance recovery plan and are delivering against it by increasing resource where we can and clearing the backlog, focusing on the oldest parliamentary questions first.
More broadly, throughout this challenging time the Secretary of State and Ministers have sought to make themselves regularly available in the House to be questioned and held to account. Between March and October, the Secretary of State made 18 statements and answered seven urgent questions. We have also seen seven general debates on covid since March, and that is not including junior Ministers’ appearances in the Chamber. This is not an alternative to written parliamentary questions, but it is an important reflection of our accountability to this House.
To conclude, written parliamentary questions will continue to be a top priority on which I am briefed weekly. I thank you, Mr Speaker, and hon. Members for your and their patience and recognition of the exceptional circumstances of recent months. In the weeks and months ahead, we will work hard to restore our leading performance, which hon. Members have a right to expect.
Thank you, Mr Speaker, for granting this urgent question, which was born of extreme exasperation. I thank my hon. Friend for his response, his contrition and his apology, and for his offer to do better in the future.
If other Departments can answer 90% of named day questions on time, why cannot the Minister’s? Will he set a date for the clearance of the backlog to which he referred and guarantee future compliance with the rules and the spirit of the rules? This is not just about timeliness; it is about the quality of the answers. Since this is the week of resets, will the Minister now tell his ministerial colleagues and officials to abandon their tactic of, basically, dumb insolence towards those of us who ask challenging questions?
Does my hon. Friend accept that these questions and answers increase public trust in our democracy, and should be a catalyst for improving public policy? If his Department is in the lead in suppressing liberty in this country, is it surprising that there are more questions to his Department than to others? Because issues of liberty are at stake, surely it is all the more important that these questions are answered quickly.
I am grateful to my hon. Friend. As he will be aware, other Departments, while they have heavy workloads, are not leading the response to the pandemic. In response to his final point, he will not be surprised that I do not characterise it in that way. Instead, I would characterise it as the Department of Health being in the lead in saving lives and protecting the NHS in this country.
My hon. Friend asked two other substantive questions. I think his language was a little intemperate in respect of the serious efforts that officials undertake every day to try to provide accurate and timely answers. There is no suggestion that they seek to stonewall or to avoid responding. They do their best, but it is difficult and the situation changes day by day. Where answers are deemed to be inadequate, hon. Members often revert to me directly or table their questions again, and we endeavour to fulfil our obligation to provide accurate answers.
On my hon. Friend’s question about recovery, we have set a trajectory for each month in order to recover performance over the coming months. Of course, that depends to a degree on the workload of officials in responding to the pandemic, as well as in providing answers, but I do not see it as an either/or; we intend to recover performance in parallel with tackling the pandemic.