Covid-19 Update

David Amess Excerpts

Thursday 22nd July 2021 Commons Chamber

[Nadhim Zahawi]

In the interests of time, I should say that I have addressed this question fully. Suffice it to say that I gently disagree with the hon. Member in that society came together, as we saw with the vaccination programme, with 80,000 vaccinator volunteers and 200,000 other volunteers. People are doing the right thing, as are corporates. We are working flat out in terms of the critical workforce, critical infrastructure and the frontline, and we announced on Monday that this would apply also to NHS and social care staff.

[Sir David Amess (Southend West) (Con)]

I applaud the vaccination programme, but a number of my constituents have received the AstraZeneca vaccine from batches made in India, which is not recognised by the European Medical Agency. Will my hon. Friend reassure those constituents that they will be able to travel to Europe—to France and Italy, for instance?

[Nadhim Zahawi]

I am grateful to my hon. Friend for his championing of his constituents’ concerns. He is absolutely right to raise them, although I would say to him that the European regulator recognises all AstraZeneca Oxford vaccinations in the United Kingdom and recognises our pass. France has now issued clear guidance that it recognises all batches of the AstraZeneca Oxford vaccine, as well as most of the rest of Europe, and our regulator and the EMA are working with the Italian authorities to get that right. Suffice it to say that I also had a vaccine from one of those batches and it is an excellent vaccine.

Do Not Attempt Resuscitation Orders: Guidelines

David Amess Excerpts

Wednesday 21st July 2021 Westminster Hall

[Martin Vickers]

The hon. Gentleman makes some powerful points, particularly, as I just mentioned, about the involvement if not of the patient themselves, certainly of the next of kin.

There have been examples of elderly people who reported that they felt pressured into signing these orders against their will. On 16 June, the Daily Mail reported that research carried out by the University of Sheffield found that 31% of the patients in its study who were admitted to hospital for covid were issued with do not resuscitate orders. That is unacceptable. Decisions of that nature are for the individual. They have the right to make their decisions without feeling unduly pressurised.

There have also been reports of care home residents having these orders imposed without consent and some reports speak of “blanket use”, which again is completely unacceptable.

Another report was of a 76-year-old man being issued a DNAR order following a heart attack, from which he made a full recovery. The order had not been discussed beforehand, but when his wife protested, she was reportedly told to “let him go with dignity.” The situation was only put right after the intervention of a more understanding member of staff and the order was revoked.

Throughout the pandemic, there have also been distressing reports of disabled people being denied vital medical treatment. According to the charity Mencap, a number of disabled people have died prematurely when intervention could have saved their lives. However, such intervention was denied owing to DNAR orders that should not have been in place.

Suffice it to say that some of the stories I have heard are frankly sickening, especially those involving the disabled or those suffering from mental illness. Having said that, I do not want to identify individuals in specific cases, although one widely reported case referred to a former Member of the European Parliament, which is sort of halfway to identifying the person involved. However, as I say, that case has been public for some time. She was admitted to hospital in Oxford for an operation on a broken pelvis. After being discharged, she was, of course, shocked to discover that a DNAR order had been in place, without her knowledge or consultation. In the event, her heart stopped during the procedure, supposedly owing to the fact that she suffers from Parkinson’s disease.

I am sorry to say that, as a result of reports I have read, I am able to come to no other conclusion than that clinicians are making assumptions regarding their patients’ quality of life and chances of survival that frequently are harsh and unnecessary. It is evident that a robust response is required from the Department of Health and Social Care. Any delay is unacceptable.

Ministers from the Department have rightly offered reassurance. However, it is time we saw action. Best practice guidelines are already in place, having been set by the Resuscitation Council UK. However, the examples I have given clearly show that the guidance does not appear to have been adhered to by some clinicians.

[Sir David Amess (Southend West) (Con)]

I congratulate my hon. Friend on securing this debate. Does he agree that when a loved one is admitted to hospital or a care home, whatever their age, when DNAR is discussed with their friends or relatives it has to be handled very carefully, because it could be a great shock? Also, was he aware that a former colleague of ours has said, following my raising this subject at business questions two weeks ago, that her husband had a DNAR order placed upon him without her express consent?

[Martin Vickers]

My hon. Friend makes some important points. I was unaware of the particular case that he mentions, but it is yet another example of what is happening without the approval of the patient or their family.

As I say, Ministers from the Department of Health and Social Care have quite rightly offered reassurance, but clearly some clinicians appear—I say “appear”—to be treating the guidance merely as a tick-box exercise. However, we are talking about life and death decisions.

Decisions regarding our own mortality can be uncomfortable, obviously for ourselves but also for our loved ones. This issue highlights the need for a cultural shift to ensure that everyone feels supported to hold open and honest conversations about what they would like to happen at the end. These conversations need to take place as early as possible, as we approach old age or learn that we have significant health problems. It is only by doing so that we can be sure that our wishes and those of our loved ones are honoured, as well as reducing the distress of the relatives of patients who have chosen to have DNACPR orders in place.

I would be interested to hear from the Minister what she proposes to do to support health and care clinicians, professionals and workers in holding conversations about these orders, and the importance of their involving patients and their families.



Earlier, I referred to the ministerial oversight group. Will the Minister confirm that the Government are thinking about that recommendation? I stress that the group must include health and social care providers, including those in the palliative and end-of-life sector, as well as those involved in local government and voluntary and community organisations. I would be grateful if the Minister confirmed that.

To conclude, the overuse of these orders over the course of the pandemic is a national scandal. Reports suggest that there are people who are not with us today who otherwise would have been. Likewise, some of the lucky ones who have made a full recovery did so despite having one of those orders attached to them. We all recognise that our medical professionals face extremely difficult decisions. This issue deals with profound matters: the relationship between doctor and patient, and for many like me, who regard human like as sacred, the orders go against our deepest religious and spiritual beliefs and cannot be dealt with in a matter-of-fact way. I know that the Minister and her colleagues will take this matter extremely seriously and will want to provide the reassurance and confirmation that it will not be allowed to go on.

Motor Neurone Disease (Research)

David Amess Excerpts

Monday 12th July 2021 Westminster Hall

[Sir David Amess (Southend West) (Con)]

I congratulate the hon. Member for Linlithgow and East Falkirk (Martyn Day) on the way he introduced the debate—I agreed with all his points. I do not have the expertise of the hon. Member for York Central (Rachael Maskell) in this area, but I wish to make a number of points, mainly on behalf of a friend of mine.

The National Institute for Health and Care Excellence says that most people with the disease will die within two to three years of developing symptoms, as we have already heard, with only 25% alive after five years and just 10% after 10 years. I certainly appreciate that, in the light of the global coronavirus pandemic, the Minister has many calls on her time. Of course, many of these illnesses existed before the pandemic and still do now, and they have to be dealt with.

A local Southend guesthouse owner who happens to be a friend of mine had to work 12 hours a day to recover financially from the first lockdown but developed problems with his left hand and leg. Physiotherapy did not help, and pain spread to the entire left-hand side of his body. An appointment was made with a neurologist, and it was revealed that he had motor neurone disease and had only two to four years to live. He is no longer able to work and is having difficulties obtaining financial support.

That upsetting story about my friend is, unfortunately, replicated throughout the country. Relevant up-to-date information about symptoms and how to check for motor neurone disease should, I believe, be widely accessible and discussed in hospitals with relevant communities to raise awareness of the disease.

Furthermore, people living with terminal illness often die before they get the benefits that they need, which is ridiculous. I am very pleased that the Government have announced that they will reform the benefits system for terminally ill people. I hope that is done as a matter of urgency so that patients and their families do not have to spend their valuable time battling for financial support.

The best way to treat a disease and to find a cure is to fully understand it, so as we have already heard, specific research targeted at motor neurone disease, not just general neurological conditions, is very much needed. Increasing Government funding from less than £5 million annually to £50 million annually over five years—I know that is a lot of money—would not only help to fund a new research institute, but help us to discover effective treatments and save the Government in healthcare, social care and benefits in the long run.

If we pioneer the way in motor neurone disease research, it would truly put our country on the map again, at the forefront of international scientific and medical discovery. I was delighted to sign the letter from my hon. Friend the Member for Northampton South (Andrew Lewer) to the Minister, in which he asked for more investment from the Government in specific motor neurone disease research. That is much needed and would benefit neurovegetative diseases such as the dementias.

At business questions recently, I asked the Leader of the House to find time for a debate on research into motor neurone disease. In his answer, I was told that our 2019 manifesto

“committed to doubling funding for dementia and neurodegenerative disease research”.—[Official Report, 22 April 2021; Vol. 692, c. 1150.]

I hope that that is done urgently and that research into motor neurone disease receives its fair share.

In conclusion, one in 300 people will develop motor neurone disease in their lifetime and there is currently no cure. That is not a small percentage of our population. We need more investment, and I hope that the Minister will commit to it.

Covid-19 Update

David Amess Excerpts

Tuesday 6th July 2021 Commons Chamber

[Sajid Javid]

No one wants another wave of covid cases. As the hon. Lady will have heard, what is different this time, as we sadly see cases rise, is the vaccine. The link between case numbers and hospitalisations has been severely weakened, as I have set out to the House in quite some detail, and that is what matters.

[Sir David Amess (Southend West) (Con)]

I welcome my right hon. Friend’s appointment as Health Secretary and his sensible statement today further easing restrictions. Following on from what other colleagues have said, will he confirm to Southend residents that the booster vaccine will be available this winter and that enough centres will remain open to administer it efficiently?

[Sajid Javid]

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

NHS Integrated Care System Boundaries

David Amess Excerpts

Tuesday 29th June 2021 Commons Chamber

[Sir Bernard Jenkin (Harwich and North Essex) (Con)]

I am sorry that this debate is unlikely to be the penalty shoot-out that some people may have been looking for.

We know that the Government are about to publish a new Bill on the NHS, but it is not widely known or understood that the NHS in England is being prepared for a major reorganisation. The clinical commissioning groups established by the Lansley reforms have gradually been subsumed into groups called integrated care systems. These ICSs are not legal entities, but single executive teams that have effectively merged the CCGs. Their boundaries are established according to the local health economies. For example, the North East Essex CCG has been merged with two Suffolk CCGs to form the Suffolk and North East Essex ICS, which commissions all NHS services across the whole area. This enabled Ipswich Hospital NHS Trust and Colchester Hospital University NHS Foundation Trust to be merged. I have to say that this is highly effective. In my nearly 30 years as a Member of Parliament, I can honestly say that the NHS in our area has never been better led.

[Sir David Amess (Southend West) (Con)]

I know that my hon. Friend will agree that we have had a fabulous football result this evening.

Going back to the days when my hon. Friend’s father was a Health Minister, when the noble Lord Fowler was Secretary of State and when the late Lord Moore was Secretary of State, would he agree that we have had far, far too many of these reorganisations, and that we need to halt the process in our area at the moment?

[Sir Bernard Jenkin]

I will come to that point later; I shall not want to repeat myself.

[Sir Bernard Jenkin]

I was anxious to give way to the hon. Gentleman to show that there is cross-party concern about this matter; I am sure that his point will be enlarged upon by my right hon. Friend the Member for Maidenhead (Mrs May).

All this is being put at risk at a time when the NHS is still reeling from the impact of covid-19. The new Bill will place ICSs on a statutory footing, which is a good thing, but there is also a proposal that the ICS boundaries should be redrawn to be coterminous with upper-tier local authority social care boundaries, and that is what we are questioning.

I am most grateful for the way my right hon. Friend at the Dispatch Box has listened recently to MPs affected by these proposed changes and has consulted us. He therefore already understands why I and others remain so concerned, but I must put it on the record that the rest of the consultation process has been not just inadequate but in defiance of proper transparency and accountability.

[Sir David Amess]

Absolutely outrageous!

[Sir Bernard Jenkin]

My hon. Friend says that is outrageous.

A firm of organisational consultants, Tricordant, was instructed by NHS England and NHS Improvement East of England to host roundtables in recent months with all the stakeholders in and around the NHS in the east of England. For some reason, it was told to exclude the MPs. Tricordant has produced several drafts of its report, which have been shared among existing ICS leaderships, NHS providers and tier 1 local authorities, but not with MPs. A few of us were eventually briefed by NHS England at the Minister’s behest, but I am mystified as to why we were not positively engaged at the outset.

The White Paper produced in February 2020—incidentally, just as we perhaps should have been anticipating the pandemic, instead of planning an upheaval of the NHS—talks about this coterminosity of boundaries, but it also has a whole section on the primacy of place. I will explain this, but those two objectives are fundamentally incompatible. The consultation exercise then appears to have been driven by that dogmatic insistence on coterminosity, and has been further confused by a lack of clarity about the problem that actually needs to be solved.

In Essex and Suffolk, areas larger than single counties were ruled out so Ministers will be presented only with a choice between the boundaries as they are and two county ICS areas—one for Essex and one for Suffolk. Discussions concerning the future of the Suffolk and North East Essex ICS have been strongly weighted towards the county councillors and their officers. Not all relevant NHS stakeholders have been consulted, which is why NHS Providers, which represents NHS leaders across the country, has spoken out on their behalf. Individual NHS leaders are understandably reluctant to criticise proposals in public, but they are known to be against the change, including the leaderships of the acute trusts across the east of England.

I understand why the county councils want this change, and I completely respect their ambition. Essex has made clear to me its frustration at making time for meetings with three different ICSs. I can also see that the new boundaries are superficially attractive, because they align NHS commissioning with the boundaries for the health and wellbeing board and other statutory public services, such as the Essex police and the local resilience forum. Essex County Council acknowledges the extremely successful place-based working implemented by Suffolk and North East Essex ICS, which incidentally has been complimented by the Care Quality Commission, the King’s Fund and the National Audit Office.

The new legislation is intended to extend place-based working to all areas. None the less, the Tricordant report would be misleading if it did not express the clear preference of NHS leaders in Essex to retain the existing ICS boundaries, primarily in recognition of the long history of operating as a single health economy, the significant flow of patients across the county border, the strength of existing relationships in the system, and the progress that has been made locally in integrating health and care services.

There are practical difficulties with the changes for Harwich and North Essex, which are replicated in other parts of England. Enablers of effective place-based working—the leadership, the philosophy and having all the partners sitting around one table—are essential to build effectiveness. A place—I use that term advisedly—that has thrived as part of one system will not necessarily thrive as part of another. Superb progress has been made in north-east Essex in recent years and, more recently, in mid and south Essex. These systems are now working not just because commissioning reflects what is called place but because people have grown into their roles and developed relationships of trust across different organisations. All that will be discarded by the wholesale changes to NHS commissioning by imposing coterminosity.

Dementia Action Week

David Amess Excerpts

Thursday 27th May 2021 Commons Chamber

[Sir David Amess (Southend West) (Con)]

The House is at its best on occasions such as this when we can demonstrate that we are members of the human race. We have heard some very heartfelt stories. Dementia is a heartbreaking illness for those who suffer from it and for the family and friends of the person so afflicted. It is very stressful when someone is admitted to hospital and those they know are told that they have dementia, and it turns out to be a urine infection.

With the coronavirus pandemic dominating the headlines for over a year, many other health conditions that existed before and continue to do harm have been somewhat put aside. The issues surrounding dementia can be loosely broken up into two concerns: the health complications and the financial structures. We should not accept dementia as simply a part of growing old. It is a real issue, and is the leading cause of death in England. Currently 850,000 people are living with the condition in the UK.

Our wonderful national health service staff and health professionals have done a brilliant job of delivering the successful vaccination programme, but people with dementia have been worst hit by the pandemic, accounting for over a quarter of all covid-19 deaths. The percentage of those in Southend West—we have the highest number of centenarians in the country—with the condition is higher than the average for England, and the east of England and Essex. This is not a health problem that we can ignore; it is a serious local and national issue, although we have some wonderful care homes in Southend that are doing magnificent work on dementia.

Dementia is so different from many other health problems because the NHS does not always cover it free of charge. Our party’s manifesto committed to seeking cross-party consensus to bring forward reform proposals, and stated that

“no one needing care has to sell their home to pay for it.”

I have received emails from worried constituents with financial concerns about paying for their own healthcare or for that of elderly family members. I am pleased that reform of the social care system was mentioned in the Gracious Speech, and I hope that the Government ensure that no one has to lose their principal private family residence and their savings to pay for healthcare.

For individuals, relying on the carer’s allowance to support their family members struggling with dementia is proving extremely difficult during the coronavirus pandemic and an adjustment is needed. A financial barrier is stopping people receiving life-saving care and attention, and that needs changing. I urge the Government to implement cross-party talks and explain what steps will be taken to ensure that dementia healthcare is affordable for all. I have previously raised that issue in the Chamber and in questions.

Dementia is the only condition of the top 10 leading causes of death in the UK for which there is no treatment to prevent, cure or slow its progression. The rapid development of treatments and vaccines for covid-19 showed us what science can achieve with political will and the right resources and collaborations.

Covid-19: Community Pharmacies

David Amess Excerpts

Thursday 11th March 2021 Westminster Hall

[Sir David Amess (Southend West) (Con) [V]]

I congratulate my hon. Friend the Member for Thurrock (Jackie Doyle-Price) on securing this debate and on being determined that it would not be a hot air debate but one in which we actually work together to find some solutions.

Although many GPs’ surgeries closed their doors at the start of the pandemic, pharmacies have stayed open and even increased their hours of operation in order to meet the extra demand for their services. They have been a lifeline for the elderly and vulnerable, delivering medicines to those shielding or self-isolating. Many pharmacies in Southend have also supported care homes, sourcing medication where there were shortages of end-of-life medicines. When needed, they have also assisted with the reuse of medicines in care homes under national protocols.

Working with local general practitioners, chemists are now processing the majority of prescriptions electronically, reducing the number of face-to-face visits that are required. The discharge medicines service has just rolled out to Southend pharmacies, so that they are able to see all the medicines that a patient has been given upon being discharged from hospital, which improves safety and reduces potential errors. Many pharmacies have also joined the vaccination programme. Their experience in handling large numbers of patients effectively has been vital in delivering the first jab to the elderly and clinically vulnerable.

Having visited a number of pharmacies in my constituency before the coronavirus outbreak, I am aware of the pride that they feel in serving their community and of their ambitions for the future. Frenchs Chemist in Leigh-on-Sea suggested running a phlebotomy clinic three days a week and installing a treatment room with ultrasound scanning facilities, so that many routine scans can be carried out without the need for a hospital visit. Derix Healthcare Pharmacy, also in Leigh-on-Sea, is keen to take on more work, such as producing blister packs on behalf of the hospital, which is a very time-consuming task, and has offered to perform medicine use reviews and other services currently carried out in hospitals, freeing up staff time on wards and in out-patient departments.

As chairman of the all-party parliamentary group on liver health, I have worked closely with our brilliant secretariat, the Hepatitis C Trust, to promote the delivery of testing and treatment for hepatitis C in community settings. A report published by the APPG in 2018 showed that, in order to eliminate the disease, levels of testing and diagnosis needs to be much higher. Offering testing and treatment in community pharmacies presents an important opportunity to access at-risk groups who are already attending for other services. Hepatitis C is a major cause of liver cirrhosis and cancer, and in order to eliminate it as a public health concern by 2030, those who cannot be reached by traditional healthcare settings must be offered more help locally.

Of course, all this comes at a price, and many pharmacies are struggling to continue the level of service they currently offer. Coping with the pressure of additional demand during the covid-19 crisis has meant many extra costs in staffing and PPE and an increased cost of medicines. The advance payments made during the pandemic, which allowed them to cope with additional demand on their services, were welcome but will have to be paid back—a total of £370 million—putting pressure on pharmacies to cut services and opening hours. This is a real opportunity for our wonderful pharmacies to deliver even more services than they have been given the power to do at the moment.

[Sir Graham Brady (in the Chair)]

I thank everybody for keeping to time so well, making sure that we have sufficient time left for each of the Front-Bench spokespeople to have up to 10 minutes to wind up, and for the hon. Member for Thurrock (Jackie Doyle-Price) to have at least a couple of minutes at the end to sum up.

Covid-19

David Amess Excerpts

Monday 22nd February 2021 Commons Chamber

[Sir David Amess (Southend West) (Con) [V]]

I was delighted with today’s announcement by the Prime Minister. It gives us something to look forward to, if all goes well, on 21 June—and for selfish reasons because two of my daughters can have the sort of weddings that they would have wished for. However—there is always a “however”—I still have constituents who are self-employed, business owners or limited company directors that have not received financial support for close to a year now. I have signed a cross-party letter to the Chancellor urging him to support the 3 million who have been excluded. I hope he takes note of this letter and delivers in the Budget next week.

I despair that I recently received a response from the Department of Health and Social Care to an inquiry I had submitted in May last year, and one from the Department for Education that I raised in September last year. These Departments really must do better in answering letters. Many of my constituents have highlighted the difficulties they are experiencing with Southend-on-Sea Borough Council distributing the Government’s business support packages. I hope the Government will provide the necessary information, guidance and support to local councils to ensure that business grants are distributed quickly and fairly, because at the moment I do not know who is at fault.

I recently held surgeries for the wonderful local churches and charities in my constituency. The most common theme that was brought up with me was the loss of regular income streams. I urge the Government to look into what financial support can be given to these groups.

I was also very pleased to visit Highlands Surgery and Saxon Hall vaccination centres to see how the roll-out of the vaccine is happening in Southend. I was very impressed with how the centres were being run and the professionalism and dedication shown by Dr Alex Shaw and all the volunteers and staff. I was delighted to learn that the programme was going so well. I thank Mr Anthony McKeever and Tricia D’Orsi for organising those visits. I am, however, still receiving calls and emails from constituents confused about where and when they will receive their vaccinations. Many of them do not realise that they do not have to accept a vaccination at a centre miles away but can actually wait for a local appointment, so there really does need to be clearer communication on this very important issue.

In the fullness of time, of course, there will be an inquiry into what has gone on since the pandemic started, but I ask the Department of Health and Social Care to look very closely into how coronavirus deaths have been recorded. I have too many constituents saying that they believe their relatives died with coronavirus but did not die as a result of it, and frankly the deaths from influenza are puzzling.

I am very pleased with the Prime Minister’s announcement about care home residents being able to receive a named visitor, and I applaud everyone involved in this magnificent vaccine programme, which leads the world.

Covid-19 Update

David Amess Excerpts

Tuesday 2nd February 2021 Commons Chamber

[Matt Hancock]

Yes, I am working with the Housing, Communities and Local Government Secretary on a specific programme for the roll-out of the vaccine to people who are homeless.

[Sir David Amess (Southend West) (Con) [V]]

I very much associate myself with my right hon. Friend’s remarks about the noble Lord Fowler, who of course was in charge of the combined Department of Health and Social Security. While I applaud the Government’s very wise decision not to sign up to the EU vaccination procurement programme, when I visit Highlands vaccination centre tomorrow, will I be able to reassure my constituents that they will still receive their second doses of vaccine on time now that we have left the European Union?

[Matt Hancock]

Yes, I am glad to say that we are working with our EU counterparts to ensure the fair distribution and manufacture of vaccines according to signed contracts, which is the right and proper way that it should be. Thankfully we signed those contracts early and we made sure that we got solid contracts to deliver the necessary doses to the UK. I look forward to those being delivered on, and I have assurances from all quarters that that is what will now happen.

Vaccine Roll-out

David Amess Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

Absolutely. We all want to enjoy those liberties again, and we want to do so safely. Balancing those two things is at the core of the conundrums of policy, and has been throughout this pandemic. The critical thing is to make sure we get this vaccine rolled out as fast as possible. That is at the centre of the route out, throughout these islands and, indeed, across the world. I understand the yearning for a clearer map out, but until we know the impact of the vaccine on transmission, it is hard to put timescales on that.

We have to watch the data. Of course I want to see the number of cases come down, but the reason why that matters so much is that we want to see the number of hospitalisations come down. We want fewer people to die each day from this dreadful disease. The numbers published yesterday—more than 1,800 people died—were truly terrible, and we need to make sure we protect life.

[Sir David Amess (Southend West) (Con) [V]]

Will my right hon. Friend join me in congratulating Anthony McKeever and his team on ensuring that people in Southend are vaccinated? Will he reassure me that Southend will receive its fair share of vaccines, that the four most vulnerable groups will all be vaccinated by the middle of February, and that people in their 80s and 90s will not be asked to travel long distances to a hub in Wickford?

[Matt Hancock]

Yes, that is our goal. All those things are what we are aiming for. I am really grateful for my hon. Friend’s support. Eighty thousand people have now been vaccinated in his area of Mid and South Essex. We have made a whole load of progress, but there is much more to do to make sure the vaccine is fairly there for everyone.