Covid Pandemic: Testing of Care Home Residents

Daisy Cooper Excerpts

Wednesday 1st March 2023 Commons Chamber

[Helen Whately]

I completely agree with my hon. Friend about the covid inquiry being the right place for people to go through the details of what happened—who said what and, as he said, the genuine debates that took place behind the scenes. This was a new virus and, at the time, we had only limited information about it. For instance, when it first hit our shores, it was not known who would be most vulnerable to it. We also did not know about asymptomatic transmission. There was a huge amount of uncertainty at the time, but the best possible decisions were made. As for the timing of the public inquiry, that is not within the control of Ministers.

[Daisy Cooper (St Albans) (LD)]

The leaked WhatsApp messages from the then Health and Social Care Secretary, the right hon. Member for West Suffolk (Matt Hancock), showed that, despite a shortage of covid tests in September 2020, one of the Minister’s advisers sent a test to the home of the right hon. Member for North East Somerset (Mr Rees-Mogg) by courier. This is yet more evidence that it is one rule for Conservative Ministers and another for everyone else. Can the Minister please inform the House how many other Government Ministers, Conservative MPs and their families received priority tests during the pandemic when there was a shortage of tests?

[Helen Whately]

It is difficult for me as a Minister to see WhatsApp messages from me in the pages of a newspaper. If the hon. Lady has read those, she will have seen that I was seeking a test for a member of my family and that I used exactly the same test app as everybody else to try to access a test that was needed.

NHS Workforce Expansion

Daisy Cooper Excerpts

Tuesday 28th February 2023 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

A healthy population and economic growth are two sides of the same coin, but, because the Conservative Government have failed to invest in our health and social care services, the ticking time bomb of ill health is starting to explode, and the Government wonder why they cannot get sustainable economic growth.

I welcome this motion today for two reasons: first, because it focuses on recruiting many of the staff that our NHS needs; and secondly because it focuses on training more district nurses and more health visitors, which would help us to shift the focus of healthcare in this country away from urgent and reactive care towards community and preventive care.

I wish to touch on GPs, dentists and social workers today. GP appointments have become increasingly difficult to secure, with some patients now resorting to DIY doctoring, by carrying out medical treatments on themselves. Our GPs are not to blame. They are overstretched and understaffed like every other part of our NHS, but the Conservative Government have repeatedly broken their promise to recruit more GPs, so where is the plan to turn that around?

There is now a crisis in this country on access to dentists, in part because of the lack of staff. The Government’s response last year was to create a one-off, time-limited £50 million emergency fund for dentists to create emergency catch-up appointments, but the uptake has been modest in most regions. In the east of England, just 13.7% of the allocated funding has been spent, and in my own constituency of St Albans that money created zero new appointments—absolutely zero.

To make matters worse, dental practices are now being penalised for under-delivery, because the funds will be clawed back from their frontlines instead of being ringfenced. The Health Service Journal reported last week that there is due to be a record Government underspend of £400 million on dentistry this year, while patients face an access crisis. Will the Government commit to ringfence this funding for NHS dentists to ensure that it is not clawed back?

The Government’s disastrous dental contract has created this access crisis. Not only has it created a two-tier system between rich and poor, but children’s life chances are being set back because of the impact of poor oral health. Our children, more than anybody else, need good teeth to set them up for later in life, but eight in 10 NHS dental practices are not taking on children.

Last November, I visited the Royal London Dental Hospital and its Tooth Fairy Project, a dedicated new surgical centre for children waiting too long for operations, which removes problematic teeth or performs multiple fillings. It was a fantastic facility to see, and the staff were extraordinary, but the statistics on child tooth extractions are terrifying. I have had cases in my own constituency of St Albans where parents simply cannot get NHS dental appointments for children. I have also been made aware of just how bad the situation has become in other areas, such as North Yorkshire, where only half of children managed to see an NHS dentist last year. In fact, last week, I was told that, in Harrogate, if a person was lucky enough to find an NHS dentist taking on any new patients, they face a two-and-a-half-year wait to see them. That is a shocking state of affairs. A Minister should visit places such as Harrogate in North Yorkshire to speak to patients and dentists and see the situation for themselves. The Government must urgently reform that broken dental contract, ringfence unspent funds and retain our experienced dental practitioners so that more patients can see a dentist when they need to.

When people cannot see a GP or a dentist, they end up in A&E. More than ever, the Government need to get around the table and agree a fair deal with all our NHS staff. We know why A&Es are under so much pressure. It is, in part, because people cannot get out of hospital when they need to as social care is collapsing as well. The number of vacancies in social care stands at 165,000, and it is rising alarmingly: in the past year alone, it increased by 55,000.

The Liberal Democrats are calling for the introduction of a carers’ minimum wage. We would pay £2 per hour more than the current minimum wage for all carers, meaning that by April this year, the hourly pay would be £12.42. A staggering 850,000 care workers would benefit from that increase in pay, and more than 80% of them would be women. Social care needs serious solutions from a serious Government, so will the Minister seriously consider introducing a carers’ minimum wage?

Our health and care services are one ecosystem. Whatever claims the Government make about how much they are spending and what they are trying to do, the British public can see that it is too little, too late. Targets are being missed left, right and centre, and everything that the Government say is worlds apart from the lived experience of our constituents, who are struggling to get the help that they need. Never again will the British public trust this Conservative Government with their NHS or their care services.

Urgent and Emergency Care Recovery Plan

Daisy Cooper Excerpts

Monday 30th January 2023 Commons Chamber

[Steve Barclay]

Within my right hon. Friend’s question is, I think, how we get more flow into hospital: once bed occupancy goes above a certain threshold, lack of flow is the key interaction that drives inefficiency within hospitals. That is why we are putting in the extra capacity. It is also a question of reducing the numbers going to hospital in the first place and speeding up the discharge of those who are fit to leave. Whereas at the moment someone might sit on a ward for three days because they have to have antibiotics every day, if one continuous dose of antibiotics can be administered through new kit at home, not only is that a much better patient experience but it relieves pressure on the wards.

[Daisy Cooper (St Albans) (LD)]

I welcome the additional transparency on data for 12-hour wait times, because it is only by shining a light on the problem that we can see just how bad it is, but the targets set out in the plan today are utterly woeful. The Royal College of Emergency Medicine says that we need 13,000 beds; the Government are offering 5,000. The percentage of patients who are seen within four hours should be 95%; the Government are aiming for 76%. Heart-attack and stroke victims should be seen within 18 minutes; the Government are aiming for only 30 minutes. Surely the truth is that this woeful lack of ambition means that our emergency care services are themselves on life support and that patients will continue to die needlessly for a very long time to come.

[Steve Barclay]

First, I thank the hon. Lady for recognising the steps that we have taken on transparency. That has been an area of challenge and it is part of my wider commitment to transparency.

The ambition of the targets has to be realistic, and targets are not a ceiling but a floor. It is about saying, “How do we set a target that is realistic?” Of course, we will aim to do better than that, but it is about setting something that the system feels is achievable, because that in turn gets much more buy-in.

On beds, we are increasing capacity, as my right hon. Friend the Member for Wokingham (John Redwood) alluded to. What it is really about is freeing up patients who are fit for discharge from hospital, who should not be there and would actually prefer to be getting care at home. It is about looking at the end-to-end bed capacity, not simply at beds within the acute sites.

NHS: Long-term Strategy

Daisy Cooper Excerpts

Wednesday 11th January 2023 Commons Chamber

[Steve Barclay]

My hon. Friend highlights an extremely important area of innovation that speaks to the point about how to adopt that at scale. I will come on to the issue of virtual wards. At Watford, they told me that it was saving the equivalent of another ward of the hospital by enabling people to be discharged to recover in their homes where it was more comfortable. Patient satisfaction was extremely high—over 90% in the programme in Watford. Not only that; the clinical wraparound support means that if they need to return to hospital, they are able to do so.

[Daisy Cooper (St Albans) (LD)]

I, too, have seen the virtual ward at Watford General Hospital, which serves my constituents. We are very proud in west Hertfordshire that we were the first hospital trust to have that virtual ward, but he will know from his visit that the No. 1 priority of every member of clinical staff in that hospital is to have funding from the new hospitals programme to improve our hospitals in Watford, Hemel and St Albans. Could the Secretary of State please pledge to write to me within the next seven days to report on his meeting with the hospital trust and tell us whether and when we will finally get some funding, after being overlooked for decades?

[Steve Barclay]

It was extremely helpful to discuss the priorities for the new hospital build with the clinical team and the leadership team at Watford. I could see that for myself, and we are committed to it. This is an issue that my hon. Friend the Member for Watford (Dean Russell) champions assiduously on behalf of the people of Watford, but I know that it matters to a wider cohort there and I am happy to write further to the hon. Lady as she requests.

The virtual ward at Watford—it is great to have cross-party support for that innovation—is further facilitated by the funding we announced in the autumn statement: the further £500 million this year, £600 million next year and £1 billion the year after. The Opposition say we are “failing to recognise” the scale of the current challenges in the NHS, yet when I set out in the statement the additional actions that we are taking, it was both to respond to the pressures from flu—the sevenfold increase we have seen, with 100 times the number of patients in hospital with flu compared with last year—and to facilitate the innovation that they highlight in programmes such as virtual wards.

NHS Winter Pressures

Daisy Cooper Excerpts

Monday 9th January 2023 Commons Chamber

[Steve Barclay]

First, I am very happy to write to my right hon. Friend with further details. For the benefit of the House, in relation to the £500 million announced in the autumn statement, local authorities gave the Department and NHS England their data returns on Friday. We will have that data, which I will be able to share more specifically in relation to the £500 million. The £250 million for NHS England announced today is for very urgent delivery into systems and that will be going out extremely quickly.

[Daisy Cooper (St Albans) (LD)]

NHS leaders have today told the Health Services Journal that the Government have just seven to 10 days to get the additional funding to discharge hospital patients to the frontline for it to make any difference whatever. The NHS Confederation has said that the next three months in the NHS will likely be defined by critical incidents being declared. Will the Secretary of State promise that the extra funding will reach the frontline in the next seven to 10 days? Will he please finally declare a national critical incident, so that we can mobilise every single bit of our NHS to save lives and save the NHS?

[Steve Barclay]

The very purpose of today’s announcement—I have made it on the first day that Parliament is back—is to give that urgent uplift in funding to local authorities and ICBs so that they can act now, knowing that that funding is available. They have the additional £500 million, which is ramping up as well. That is part of a wider package of measures—NHS England putting in community support with 7,000 more beds—but the purpose is to recognise the very real immediate pressure the frontline has been under. It also needs to be viewed as something that other healthcare systems across the globe have faced: a very sudden and very significant spike in flu seven times higher than last month and 100 times what it was last year.

NHS Workforce

Daisy Cooper Excerpts

Tuesday 6th December 2022 Commons Chamber

[Wes Streeting]

The hon. Gentleman is not looking forward to me solving the problem half as much as I am looking forward to solving the problem. As far as I am concerned, the general election cannot come soon enough. I say to Government Members, “Be careful what you wish for”, because I intend, indeed, to set out Labour’s plans in detail. I am happy to stretch that to half an hour if that is where the demand takes us.

[Daisy Cooper (St Albans) (LD)]

rose—

[Wes Streeting]

I give way to my Liberal Democrat friend.

[Daisy Cooper]

I am grateful for a number of the interventions, not least the most recent one. Is it not true that, as hospital trusts meet with regard to the new hospital programme today, they will discuss how big the new hospitals should be? Given that we need more space to train the doctors and nurses of the future, does the hon. Member agree that it would be criminal if they tried to cut corners by planning hospitals that are smaller than they need to be?

[Wes Streeting]

I wholeheartedly agree. I seemed to hear from the Health Secretary this afternoon a one-size-fits-all approach from the Government, as though every hospital’s needs will be the same and we can import a standardised model for every hospital site. I would be happy to be proven wrong, and I would be even happier if the Secretary of State got the ball rolling on some plans that are already agreed, and on which trusts have spent a significant amount of time and taxpayers’ money. I would be even more delighted if we got some of those hospitals open, but I would wager that when we get to the end of the Government’s life, we will not have seen anything like 40 new hospitals delivered or even in the pipeline.

--- Later in debate ---

[Daisy Cooper (St Albans) (LD)]

Let us imagine what this debate could have been. If the former Prime Minister—the former former Prime Minister, I should say—had accepted the workforce amendment to the Health and Care Bill 13 months ago, this debate could have been so different. The Government could have crunched the numbers, NHS frontline workers would know that the cavalry was coming, and patients would be able to see light at the end of the tunnel. Instead, here we are as Members of Parliament with a roll-call of horror stories, because somehow, in 2022, waiting more than 12 hours for an ambulance is the new normal. How on earth has it come to this?

We know that there are workforce problems in every part of our health and social care sector and every corner of our country, whether general practice, dentistry, pharmacies, midwifery, nursing—all are overstretched and understaffed. But it is midwives who send me their most distressed emails, because they often train for their dream job, only to be plagued by nightmares that they have not done enough to help new mothers and their babies in their time of need.

Just last week I spoke with paramedics and other ambulance staff as I took a three-hour ride out with my local ambulance service. At 7 o’clock in the morning we were called to see the first patient. That patient had been waiting at home, on the floor, since 6 pm the night before—13 hours. Before we could get to see that patient, we were called to a more urgent call. When we finally got to the hospital with that second patient, the paramedics checked the list of patients who had arrived at the hospital. They were distressed that they had not been able to get to that first call, and wanted to make sure that another ambulance had done so. They were exhausted. They said that in a 12-hour shift they may get only one 20-minute break. They were exhausted because there are not enough staff.

For most of my constituents, day in, day out, access to their GP really matters, and too many of them are struggling. That is no wonder, because the Government said they had a target of recruiting 6,000 more GPs, but they have admitted within three years that they will fail to meet that target. It is frustrating for patients, but it is also dangerous for GPs and their staff. This summer we heard reports from Walton-on-Thames in Surrey, where police had been called to a GP surgery because people were making threats of physical violence. That is surely unacceptable. Where is the urgent drive to recruit and retain our GPs?

How on earth will we retain and motivate highly trained professionals when our hospitals are on the verge of collapse? Up and down the country there are hospitals in dire need of repair. In Eastbourne—I see the hon. Member for Eastbourne (Caroline Ansell) is in her place—there have been concerns for a long time about whether the hospital may or may not be coming. It was recently reported by some staff that they had been told—allegedly—that a new hospital was even a bare-faced lie.

[Caroline Ansell (Eastbourne) (Con)]

I thank the hon. Lady for advising me ahead of the debate that she might mention the hospital in my constituency. I am not sure of her particular interest in Eastbourne, although it was named by Time Out as its place to visit in 2023. For the benefit of those in my constituency who may be following this debate, am I pleased to share that, in relation to the workforce—the matter before us today—there has been a 25% increase in full-time staff over the past 10 years. That is a 10-year increase in nurses and midwives, a 10-year increase in doctors and dentists, and a 10-year increase in allied health professionals. They also report £20 million—[Interruption.]

[Caroline Ansell]

Thank you, Madam Deputy Speaker. Is the hon. Lady therefore pleased and relieved to hear that, despite staff concerns that there would not be a new hospital, there has been a run of incredibly positive meetings and we are assured that, in the words of the chief executive, “once-in-a-generation” investment is coming?

[Daisy Cooper]

The hon. Lady asks about my particular interest, and she will be aware that as the Liberal Democrat spokesperson for health and social care I have asked the Government on 10 occasions about releasing funds for my local trust, and other hospital trusts across the UK, for the new hospital programme that the Conservatives promised in 2019.

Other hospital trusts are deeply concerned about the lack of progress on the new hospital programme. In Sutton, for example, St Helier Hospital was built before world war two. My own trust, West Hertfordshire Teaching Hospitals NHS Trust, which covers St Albans, Watford and Hemel Hempstead, has buildings that are life-expired. I have been there a number of times and seen the extraordinary work by professionals in my local hospital trust. We had the first virtual ward during the pandemic, and we have two robotics suites. We also have a lift that breaks down right next to the ward that treats children who are ill. When that lift breaks down, ambulances have to be stationed outside one side of the hospital so that they can drive around to the other side. This is completely unacceptable.

Will the Minister confirm that all of those hospitals right across the UK—wherever they may be—will get the funding they were promised under the new hospital programme and that there will not be delays and penny-pinching? A Conservative Member no longer in his place asked where we would train all of the planned thousands more doctors and nurses. If there is any penny-pinching on the size of our new hospitals, they certainly will not get trained in our area.

Our NHS and social care need people, tech, beds and buildings. There is no silver bullet to solving all of the issues in our NHS and social care, but getting some proper workforce planning in place would be the closest thing to that. That is why my Liberal Democrat colleagues and I are happy to support the motion.

Oral Answers to Questions

Daisy Cooper Excerpts

Tuesday 6th December 2022 Commons Chamber

[Helen Whately]

I thank my hon. Friend; it is good to hear that she has visited a local care home. I have also heard what she heard from staff. Although face masks are important for infection control, we know that they have downsides, such as making communication harder. I have asked for updated public health advice on the use of masks in care homes and I look forward to updating hon. Members and the social care sector on the guidance about that shortly.

[Daisy Cooper (St Albans) (LD)]

My constituent is a victim of sexual misconduct by a medical professional, but they cannot challenge that professional’s fitness to practice because of the five-year rule. The General Medical Council wants that rule to be scrapped and the Government consulted on whether to get rid of it more than a year ago. Can the Minister say whether it is the Government’s intention to scrap it? Will she meet me to discuss how important it is that the GMC can explore whether a potentially dangerous medical professional who is still practising may be unfit to do so?

[Maria Caulfield]

I thank the hon. Lady for her campaigning on this serious issue. I am happy to meet her and I suggest that we also meet the patient safety commissioner, Henrietta Hughes, to discuss it further.

Accountability in the NHS

Daisy Cooper Excerpts

Wednesday 30th November 2022 Westminster Hall

[Sir Mike Penning]

I completely agree with the hon. Gentleman. I know that right next to my constituency, my hon. Friend the Member for Watford (Dean Russell) goes to Watford General Hospital and looks at the boards to see whether people can medically be discharged, but they cannot because there is a lack of joined-up thinking.

This is different. This is about the need for the NHS, when it may or may not have made a mistake, to address it full-on at the start. It should not draw up the drawbridge, with people having to go through the long, drawn-out procedure of making complaints and going to the ombudsman. For a Minister to say to a colleague and fellow MP, “Perhaps this person needs to take legal advice,” is not the attitude we should have towards people who have done the right thing. The NHS has said that they should have an operation, and the NHS has mucked up and botched—I use that word under privilege. At the same time, the person’s life has been detrimentally affected for years and years to come.

I know the Minister is not the Minister responsible, but because we are all constituency MPs, I guarantee that before he was in his position, people were at his surgeries or wrote to him to say, “This happened to me within the NHS. What can you do to help me do something about it?” Somewhere along the line, perhaps the short debate we are having today will nudge the Department of Health and Social Care and the Government —I was a Minister in several Departments—to look at ministerial oversight.

[Daisy Cooper (St Albans) (LD)]

The right hon. Gentleman is making a fantastic speech. In the light of this week’s shocking reports from Byline Times about the amount of sexual abuse and rapes that have occurred in hospital settings, does he agree that to improve accountability, we need the Government not only to urgently repeal the five-year rule, which limits some people from making complaints to the NHS, but to have clear, systematic and consistent data collection on all sexual misconduct across all hospital settings?

[Sir Mike Penning]

As usual, I agree with the hon. Lady. We do not agree on everything, but we agree on 99% of things.

This is the crux of the matter, and there are two real issues here. In the case that I spoke about earlier, which goes way back to the ’80s, the gentleman’s mental and physical health has not been great. Other people, including the extreme examples alluded to by the hon. Lady, may be mentally affected in a way that I and many of the people in this room probably cannot understand. To have a block exclusion post five years seems so arbitrary in the modern world. The Government really must look at whether there should be an arbitrary rule and perhaps leave it to others to decide, rather than setting down in regulation the exceptional circumstances that might well have been in place. Trusts do have delegated powers—many more powers than I think they should have—and I know the new Act will help that, but it does not take into consideration the points that we have tried to raise in this morning’s debate.

If we had this debate on the Floor of the House, I think we would have a full Chamber of colleagues. Rather than talking down the NHS, they would be saying, “When things go wrong, we need to address them.” When I was Police Minister, there was a big mistake under my portfolio, and I went before the House, explained that mistakes were made on the funding formula and put my hands up. I took a lot of flak for that, but it was a way to address things going forward. With the NHS being such a massive organisation, and an organisation that the public want to be able to trust, it must be better for us to address the issues at the start of a complaint.

The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes, did not write the letter that I mentioned; it was written by her officials, who desperately want to defend the NHS. The complaint was not about the NHS in general; it was about a specific issue that we need to address. We are all here as Members of Parliament because we are supposed to represent the taxpayer—representation through taxation. I should be able to represent my constituents in that way without being told to go to the ombudsman. I know I have to go to the ombudsman, because I have been here a very long time, so I am capable of working that out. I am also capable of working out that we are outside the time limit, given the five-year rule.

We need a change of mindset. I do not want individual Ministers to say, “This operation should take place, that one shouldn’t, and the hospital should have this number of wards”, but there has to be ministerial oversight when things go well, and when things go wrong.

My constituent has given me permission to raise his case. I think it would be more useful not to put his name on the record here, but I will pass another letter to the Minister, which I hope might get a little more positivity when the Minister responsible writes back to me, rather than a response that fobs us off and says, “Please go away.”

Contact in Care Settings

Daisy Cooper Excerpts

Thursday 27th October 2022 Commons Chamber

[Daisy Cooper (St Albans) (LD)]

Let me extend my sincere thanks to the hon. Member for Liverpool, Walton (Dan Carden) for leading the debate, and to the hon. Member for Chatham and Aylesford (Tracey Crouch) for co-sponsoring the application. I pay tribute to both Members for sharing their own experiences and those of their constituents in such a powerful way. I am also extremely grateful to the Relatives & Residents Association, to Rights For Residents and to John’s Campaign. Their endless determination to highlight this glaring gap in the law in order to protect some of our most vulnerable, at their most vulnerable, has been critical to the securing of this important debate.

I have to say that, unlike the two hon. Members who have spoken already and unlike many from the campaign groups—some of whom are here today—I have not been personally impacted by this matter, but many of my constituents have. There have been too many examples of families being separated from their loved ones, often, as I have said, when they were at their most vulnerable. Each and every story has been absolutely heartbreaking, and I wish to share just two of them today.

Nearly two years ago, in November 2020, during a debate in Westminster Hall secured by the hon. Member for Beaconsfield (Joy Morrissey), I was able to tell colleagues about my constituent Steph. Steph’s mum had dementia, and had been living in a care home since December 2018, after it had become impossible for Steph’s dad and sister to look after her at home. Steph’s mum was visited every single day, by Steph, Steph’s dad or one of her four siblings, until the pandemic hit early in 2020. Before then, they had been able to lovingly hold her hand, comb her hair, remember stories together, and reminisce about the past. However, this was not just about visiting; Steph and her family were providing essential care.

Contact with and reassurance from loved ones is incredibly important to all of us, but it is especially critical for people with dementia. Family members know their loved ones best. They can identify the very subtle changes in their physical and mental health more quickly. Residents often feel more comfortable about opening up and sharing their concerns with close family members than they might with a care worker, and that is even more true when they do not always understand what is happening to them as well as you or I might.

Suddenly, however, Steph and her family were separated from their mum. For more than a year, contact was limited. Initially it was limited to phone calls or sometimes video calls, and although that was relaxed a little in the latter half of the year, the family were still only allowed to visit Steph outdoors, in a garden building. Unsurprisingly, like so many others in this awful situation, Steph’s mum simply could not understand what was happening. When presented with an iPad for video calling, she thought she was watching a television programme. She could not understand that she could interact with it, and found the ordeal incredibly confusing. Fences, window visits, plastic screens as barriers—none of those worked for people living with dementia either. They became incredibly frustrated because they just could not hear what was being said. Sometimes, they simply could not recognise their loved ones at all at such a distance. Others simply could not comprehend what was going on. Some felt as if they had been put in prison.

In early spring 2021, Steph’s mum’s condition deteriorated. She was moved to a hospice, where family members could finally spend time with and be close to her, and comfort and care for her. Sadly, she passed away in April last year. After such a long time of being physically separated from her mum, Steph says that she was, in a sense, almost lucky that in a different setting she and her family could actually spend time close to their beloved mum at the end of her life. Too many others have been denied those precious final moments together.

Restrictions were not limited to care homes: dementia patients and the vulnerable were prevented from seeing their children, spouses and carers in other health settings, too. I would also like to talk about Lynn, a constituent and friend. She discovered this whole experience at Christmas time last year. Lynn’s husband, Andy, also has dementia. Until December 2021, Lynn had been looking after Andy at home, with the help of regular professional carers. In a devastating blow, Andy’s condition suddenly deteriorated on Christmas day. He had to be admitted to our local A&E department, and was transferred to an acute admissions ward while a bed in a suitable ward was found.

Although other wards were now accepting visitors, the unit Andy was in was supposed to be temporary, so Lynn could not see him at all. The rules were the rules, and there were no exceptions for people such as Andy, who needed familiar reassurance and help to communicate their needs. As it turned out, because of a lack of suitable beds, Andy spent almost two weeks in that ward. It was not until Lynn contacted me, and I intervened by contacting the hospital management, that she was allowed access to her husband Andy.

We all know that the NHS was and continues to be under considerable pressure, but the lack of suitable one-to-one care with somebody who Andy trusted had devastating effects. Lynn was utterly distraught by his very dramatic and sudden weight loss in the days that she was separated from him. Eventually, after further direct contact from my office, the ward sister finally agreed that Andy’s professional carers could also visit.

We all know that dementia is, sadly, a progressive condition, but neither Lynn nor I were in any doubt that the pace of Andy’s deterioration in those days over Christmas last year was hastened by the lack of contact with those whom he loved and trusted. He had been denied access to his essential caregivers. Andy is now in a care home. When I spoke to Lynn last night, she simply said:

“It is so important that people in care homes have access to their loved ones. Andy isn’t ready to be stuck there until he dies, without love and physical contact. The humanity needs to come back into care.”

We have come a long way since last Christmas, and even further since the beginning of the pandemic, but as winter approaches the NHS and care settings are once again expected to struggle with a surge in covid cases. It is not inconceivable that what happened to Lynn and Andy could happen again to them and to many others.

We now understand much more about effective infection control with covid. Regrettably, we now also understand—from harsh lived experience—the impact of separating those with dementia from their loved ones and essential carers. Guidance exists so that safe visiting can be facilitated by care home operators but, as we have already heard, the overwhelming response from relatives across the country shows that it is just not being implemented in a consistent or fair way.

As it stands, care homes continue to apply rules far in excess of the measures recommended by Department for Health and Social Care guidance. It has been reported that more than 10% of care homes permitted no visitors at all during covid outbreaks between April and September this year; that 20% of care homes confined residents to their rooms for up to 28 days during an outbreak; and that almost half of homes have some form of visiting restrictions in place, even when there is no outbreak at all. As it stands, relatives do not feel empowered to do anything at all about the wildly varying rules put in place by the homes they have entrusted their loved ones to.

In advance of this debate, the CQC got in touch with Members to set out what it thinks it can do about this scandal. The CQC agrees it is vital that people are able to spend time with the people they love. It tells us that, when it becomes aware of guidance, it will take action but—this is the critical point—the CQC does not have the power to require care homes to report any visiting restrictions they put in place.

I am grateful to the Chamber engagement team for conducting research in advance of today’s debate. As we have heard, 363 people have responded to the survey in the last few days, and more than 70% of relatives with concerns about their loved ones in care homes had not contacted the CQC to make a report. Those who did contact the CQC reported mixed success. Some told us that things improved, but the vast majority said either there was no improvement, the CQC was not interested or the CQC simply did not respond.

This is the crux of it: one person who responded to the survey, a woman called Joanne, said

“because I spoke to the CQC we were threatened with eviction from the home.”

This is what so many of my constituents tell me. They fear making a report to the CQC because there are no legal protections for visiting their family members. They are terrified of being labelled a troublemaker, of being stopped from visiting their loved ones altogether or of their loved ones being evicted. There is a huge power imbalance, which cannot be right.

Members met the relatives’ campaign group in Parliament in March, and we heard heartbreaking testimony from families and service users about the effect of these instructions. Every single person agreed that the guidance simply was not working, everybody agreed that enough was enough, and everybody agreed that we needed protections in law. Everyone except the then Minister, who unfortunately was not able to make it until the very end of the session with a pre-prepared speech, and who had not heard the powerful and harrowing testimonies of those who attended, many of whom are in the Public Gallery today.

The new Minister is here to hear some of those powerful testimonies, and I hope she will conclude, as we have, that the evidence is overwhelming. We must put an end to this scandal. We have to be able to say, “Never again.” As other Members have said, there is cross-party support and we will work with the Government to put this into law. Surely the time has come to create a new legal right to maintaining contact.

[Several hon. Members rose—]

Procurement of Evusheld

Daisy Cooper Excerpts

Wednesday 12th October 2022 Westminster Hall

[Sir Gary Streeter (in the Chair)]

There has been a lot of interest in this debate. I will call Daisy Cooper to move the motion and then call the Minister to respond. There will not be an opportunity for the Member in charge to have the final say, as is the convention for a 30-minute debate.

[Daisy Cooper (St Albans) (LD)]

I beg to move,

That this House has considered the procurement of Evusheld.

It is a pleasure to serve under your chairship, Sir Gary. I am pleased to have secured this important debate on behalf of the forgotten half a million immunocompromised and immunosuppressed patients in England, and the 18,617 people who have signed the parliamentary e-petition calling on the Government to fund the preventive covid-19 drug Evusheld. I pay tribute to the extraordinary campaigning work of Evusheld for the UK, Blood Cancer UK, Kidney Care UK and many other charities that have given their members a voice. There is clearly significant interest from colleagues across the House, and I will endeavour to take as many short interventions as possible.

Let me be blunt: the Government have got this badly wrong. Some of our most vulnerable people are now in an impossible position, or, as some of them have said, they have been left to rot. People with blood cancer, vasculitis, kidney transplants, multiple sclerosis, long- term conditions and rare diseases and those on immunosuppressant drugs are crying out for the preventive drug Evusheld. Why? For them, the covid infection is just as deadly—in fact, more so—than when we first went into lockdown two and a half years ago. They do not mount a response to covid through the vaccines like the rest of us. Covid is not just a bad cold or an inconvenience, but a killer disease. In a society where people are allowed to walk around with that killer disease without being required to wear a mask, test or isolate, nowhere is safe for the immunocompromised—not inside or out.

[Andrew Selous (South West Bedfordshire) (Con)]

I share the passion with which the hon. Lady speaks. Does she agree that it is incredibly important that the clinicians and scientists take this decision through the usual rigorous methods, and not us as politicians?

[Daisy Cooper]

I welcome that intervention and I do agree. I will outline all the scientific evidence that backs the decision to procure Evusheld and roll it out right now, this side of Christmas.

[Catherine McKinnell (Newcastle upon Tyne North) (Lab)]

I congratulate the hon. Lady on securing this timely debate. I was contacted by a constituent ahead of it, who reiterated that as autumn and winter approach, we are even more vulnerable and isolated. Given what we face, I am sure the hon. Lady agrees that it is urgent for Ministers to listen to this debate and set out plans to support immunosuppressed patients and people during the difficult winter ahead.

--- Later in debate ---

[Daisy Cooper]

The hon. Lady is right. I will set out not only that the scientific evidence backs up the case for Evusheld, but that there is strong political consensus for it. Of course, the voices of those affected must be heard.

There is nowhere that is safe for these people: not shops, not schools, not supermarkets, not buses, not even the very GP surgeries and hospitals that they need to visit to manage the conditions that make them vulnerable. They are at extreme risk of hospitalisation and death, and they have been left with no choice but to lock themselves away from family and friends for two and a half years. Many now face a third winter of shielding.

[Mark Logan (Bolton North East) (Con)]

I agree with the hon. Lady’s sentiments. I have a constituent who has been shielding for 30 months—a 26-year-old who is the son of Mrs Rehana Patel. Along with the hon. Lady, I plead that the Government continue to give serious consideration to the use of Evusheld to help those thousands of clinically vulnerable people across my constituency and the rest of the UK.

[Daisy Cooper]

I thank the hon. Member for his intervention.

Let us move on to the facts. Is Evusheld safe and effective? Yes, it is. The Medicines and Healthcare products Regulatory Agency approved it in March, seven months ago. Is there enough scientific evidence? Yes, there is ample evidence.

[Sir Mike Penning (Hemel Hempstead) (Con)]

The hon. Lady and I have had conversations about this issue and about my own constituents. What I cannot understand is that the RAPID C-19 committee has looked at this 11 times. These are supposed to be experts that are looking at it. She is quite right to want evidence that proves that the committee is wrong. How come we have got into a situation where Government scientists are saying one thing and the rest of the scientific community is saying something completely different?

[Daisy Cooper]

I thank the right hon. Member for his intervention. That is exactly the question I would like the Minister to answer.

There are two significant problems with the most recent report published last week. First, it effectively says that the RAPID C-19 group looked at the results of a trial run on actual people in December 2021 and concluded that the evidence was so good that they were going to recommend that Evusheld be rolled out to patients. However, in May of this year, they looked at non-clinical data—test tubes, petri dishes and the like—and decided that the results were not good enough. It does not take a rocket scientist to work out that high concentrations of a virus in a petri dish do not translate to tests in real human beings.

[Julian Sturdy (York Outer) (Con)]

I understand that 33 other countries have approved the use of Evusheld, including every G7 member apart from the United Kingdom. What do you think we can learn from the other parts of the world that have approved this important treatment for the immunocompromised?

[Daisy Cooper]

I am grateful for that question. In fact, Evusheld is now so effective that not only has it been rolled out in 33 countries, but a number of countries, including Japan, Italy, Spain and Israel, have actually put in repeat orders for Evusheld, and the Centers for Disease Control and Prevention in the US has even launched a public drive to increase uptake. In private discussions, both the Minister and his predecessor have indicated to me in meetings that there was some evidence that countries had bought the drug but were not using it.

Let us be clear: the failure of any Government to identify clinically vulnerable patients and distribute the medication to them has nothing to do with the effectiveness of that particular drug. Before we throw stones in glass houses, we should remember that of immunocompromised patients in England who caught covid and were referred for treatment, only 17% actually got it. That failure to distribute is more to do with the fracturing of our health systems; it is not about the effectiveness of this drug.

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

I thank the hon. Lady for bringing forward this vital debate on behalf of the many constituents who have contacted me and in my capacity as chair of the all-party parliamentary health group. Does she agree that when people feel they are being left to rot, it is not only their physical health that is impacted; their mental wellbeing is crippled in the stage of recovery where they need the most support possible?

[Daisy Cooper]

The hon. Member is absolutely right. Many people are clinically vulnerable because they have a health condition, and their physical health is getting worse, as it would when someone is stuck at home for two and a half years, but the mental health impact is also incredibly profound. We know that many of our constituents have experienced suicidal thoughts.

I turn now to the advice of the RAPID C-19 oversight group, which has been mentioned. The Government refused to share this advice for some time, and many of us were asking for it. I was pleased to see that this advice was finally published last Thursday on 6 October. I was pretty shocked for two reasons. First, the report actually says that the group looked at real-world data and the impact on people and that data was very strong. Then it looked at the data in a non-clinical setting and decided not to roll it out. That seems absurd to me.

There is a second problem with the evidence that was published last week. It lists the evidence that the group reviewed, and it leaves out one very critical scientific study by the Francis Crick Institute—a study that I believe the Government commissioned themselves. That study was commissioned to look at the effectiveness of a different drug: sotrovimab. That report concluded that sotrovimab was effective, and the Government are using that report to justify why they continue to use sotrovimab. However, the report also concluded that Evusheld was even more effective. So why not buy Evusheld too? Perhaps the Minister can enlighten us.

On the same day the Government published this RAPID group report, The Lancet—the world’s highest-impact general medical journal—carried an article by 19 experts calling on the World Health Organisation to update its guidance on Evusheld, based on the study the Government commissioned. In the article, those experts say that Evusheld should be used for not only preventative, prophylactic use, but treatment. The UK Government are really trailing behind. Can the Minister tell us why the RAPID study ignores this vital piece of research, which they must have known about?

Many of the people we are talking about have already had five or six vaccine jabs, even though they will mount very little, if any, response. The Government say it is important that these people get those vaccines, because they say some response is better than none. Why does that same test not apply to Evusheld? Why is it being singled out and held to an impossible standard?

Let us look at what the Government are proposing, instead of following the science. Ministers have referred Evusheld to NICE for further clinical and cost-effective assessment; apparently, we might hear back in April 2023. That is another delay—another six months of isolation—even though every other covid treatment and vaccine was urgently procured before being appraised. I ask again, why is the Government’s treatment of Evusheld so inconsistent?

[John Glen (Salisbury) (Con)]

My constituent Helen Nash asked me to be here to support the case that the hon. Lady is making. She makes the key point: while the Government did a lot of great work to accelerate the availability of vaccines for the population at large, this particular cohort seems to be subject to a very different set of criteria. That is the great concern. While we must rely on clinical advice, we must also have the same situation for all people, regardless of their status.

[Daisy Cooper]

I agree with the hon. Gentleman. One of the big concerns that has not been answered by the Government so far is why their approach to this drug is so inconsistent with their approach to others. As I say, Ministers have referred Evusheld to NICE, and it is not at all clear why their treatment of it is so different.

Meanwhile, the Department of Health has proposed that immunocompromised patients have an antibody test, and that those who do not respond well enough could join an Evusheld trial. Let us be clear what that trial would mean in real life. It would require some of the people who have been shielding to stay alive for two and a half years to come out of shielding like the rest of us, but without any protection from covid vaccines, knowing that they might only be given a placebo. It would be like taking lambs to the slaughter. I would be astonished and appalled if that proposal passed anyone’s ethics test. I do not know if the Minister would support one of his loved ones taking part in such a trial, but I certainly would not. Can the Minister therefore tell us why his Department wants to take this dangerous approach instead of the approach suggested by the Drug Safety Research Unit, which has called on the Secretary of State to roll out Evusheld now, for this winter, and to run an observational study of the impact?

Another question that has arisen is whether there are problems with supply. The answer is no. AstraZeneca has dismissed that claim.

[Dan Jarvis (Barnsley Central) (Lab)]

The hon. Lady is presenting a powerful case; I congratulate her on securing this important debate. Max Johnson is a 14-year-old heart transplant recipient. He was the key figure in the organ donation campaign that was supported by Members right across the House. Max and his family are being supported by their local MP, the hon. and learned Member for Eddisbury (Edward Timpson), but we have kept in close touch. Max’s life has been turned upside down since the start of the pandemic, with no light at the end of the tunnel of isolation. Does the hon. Lady agree that Max, along with thousands of other people across the country, has the right to a better life and should be allowed access to Evusheld without any further delay?

[Daisy Cooper]

I completely agree.

I do not know how much a dose of Evusheld costs. I hope that, when the Government enter into negotiations with AstraZeneca, they will get a good price for the taxpayer. However, all Members of this House know what the cost is to our constituents who are affected. They have given up jobs, caring responsibilities and vital moments in their lives—they could not go to weddings, funerals or births. Some of them no longer run vital volunteer-led community services. Some have lost their life, and some are suicidal; they are thinking of taking their life because the psychological torture of prolonged shielding is too much for them to bear.

Those people are getting even more ill, because no one can be locked up for two and a half years without getting problems with their back or knees, or experiencing extreme loneliness and mental ill health. Those are all problems that are piling up for our already overstretched NHS. If those immunocompromised patients get covid, they are far more likely to end up in an intensive care unit, which we know will cost us thousands and thousands of pounds. There is also a risk of variant escape, because several studies show that new variants and virus mutations are more likely in immunocompromised patients. Against that backdrop, Evusheld is the cheap option.

Two years ago, Members stood in this room and begged Health Ministers to change their minds on care home restrictions, which were supposed to protect people but were so tight that some people started dying of neglect. We are at risk of that happening again. The Government changed course after that debate and can do so again today. The people affected by this feel that they do not have a life; it feels like a life sentence. Ministers have it in their gift to give those people their life back, and on behalf of the half a million, I urge the Minister—I beg him—to do it today.