(3 years, 1 month ago)
Ministerial CorrectionsMany of my former public health colleagues are very concerned about lifting mitigations today in the context of escalating cases—50,000 currently—12 million people who have not been vaccinated and an NHS and care workforce who are frankly on their knees. What estimates have the Government made of the effect of extending the wearing of masks and other mitigations three weeks after 80% of the eligible population have been vaccinated on incidence of long covid, hospitalisations and deaths?
The vaccination programme could in no way have delivered the extraordinary uptake without the backbone being NHS doctors, nurses and pharmacists, working with our armed forces, local government and the private sector to deliver it.
(3 years, 1 month ago)
Commons ChamberMy right hon. Friend is right that there is no such thing as a wrong batch of Oxford-AstraZeneca vaccine in the United Kingdom. Our independent regulator regulates all manufacturing sites for AstraZeneca, Pfizer and the other vaccines. The AstraZeneca vaccine produced in the Serum Institute is the same vaccine—the Vaxzevria vaccine brand that is approved by the MHRA and the European Medicines Agency. There was some confusion in parts of world such as Malta last week, which the MHRA, the EMA and the Commission helped to clear up. I reassure my right hon. Friend that anyone who has had an Oxford-AstraZeneca vaccine and has the UK app or the letter to demonstrate their vaccination can travel. I think that 33 countries now recognise our vaccine certification.
Many of my former public health colleagues are very concerned about lifting mitigations today in the context of escalating cases—50,000 currently—12 million people who have not been vaccinated and an NHS and care workforce who are frankly on their knees. What estimates have the Government made of the effect of extending the wearing of masks and other mitigations three weeks after 80% of the eligible population have been vaccinated on incidence of long covid, hospitalisations and deaths?
The vaccination programme could in no way have delivered the extraordinary uptake without the backbone being NHS doctors, nurses and pharmacists, working with our armed forces, local government and the private sector to deliver it.
(3 years, 1 month ago)
Commons ChamberThis is the wrong Bill at the wrong time. To introduce a Bill like this when the covid pandemic is far from over and staff are on their knees shows a lack of understanding of what is needed.
I am concerned that this reorganisation of the NHS is being used as an opportunity to extend the involvement of UK and international private healthcare companies. The Bill proposes that private healthcare companies can become members of the integrated care boards, potentially meaning they will be able to procure health services from their own companies. Under the Bill, ICBs will have only a “core responsibility” for a “group of people”, in accordance with enrolment rules made by NHS England. There are concerns that this evokes the US definition of a health maintenance organisation, which provides
“basic and supplemental health services to its members”.
What is included in the core responsibilities?
Why is there no longer a duty but only a power for ICBs to provide hospital services? What does that mean for the thousands waiting for elective surgery? What about those waiting for cancer and other therapies? For those who say, “What does it matter who provides our healthcare as long as it meets the NHS principles of being universal, comprehensive and free at the point of need?” I say that not only is the Bill a clear risk to those founding NHS principles but there is strong evidence that equity in access to healthcare, equity in health outcomes and healthcare quality are all compromised in health systems that are either privatised or marketised, as the NHS has increasingly become.
That brings me to my third area of concern: health inequalities. It is notable that the Bill places the duties for the reduction of health inequalities with ICBs. The 2012 duty on the Secretary of State and NHS England to reduce inequalities is repealed, showing the clear lack of commitment to levelling up and the reduction of the structural inequalities that have been laid bare by this pandemic and contributed to the UK’s high and unequal covid death toll. With this change, the Secretary of State is ignoring not only decades of overwhelming evidence that clearly shows that health inequalities are driven at national policy level, but the Prime Minister’s commitment to implement the recommendations that Professor Sir Michael Marmot made in his covid review last December to tackle inequalities and build back fairer.
My final point is on social care. As chair of the all-party parliamentary group on dementia, I express my profound disappointment that, 19 months since the Prime Minister pledged to fix the broken care system, it still has not been fixed. The Bill is a missed opportunity to set out the framework for social care reform in the context of an integrated health and social care system. For people with dementia and their family carers, who have suffered disproportionately from covid, this is a real blow. They deserve better. For me, the principle of health and social care—
(3 years, 1 month ago)
Commons ChamberAgain, this is an important issue. My hon. Friend may have heard the response that I gave earlier about the test and release scheme. I am eagerly waiting to look at the results of that and see whether we can provide further flexibilities. I hope she will also welcome some of the flexibilities that we have already announced, including the changes that will take effect on 16 August.
I take this opportunity to condemn the vile online racism against some members of the England football team yesterday after they had given their all for their country.
The World Health Organisation has expressed its concerns about rising infections in England and the risk to the 17 million people who still remain unprotected by vaccination. But even those who have been vaccinated are at risk of long-term illness and disability if they become infected; Office for National Statistics data indicates that one in seven infected people of working age will experience ill health after 12 weeks.
May I follow my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) in chasing the Health Secretary about his estimates of the incidence of long covid as a result of the third wave? What discussions has he had with the Work and Pensions Secretary about what that means when it comes to support through the social security system if people are unable to work?
The hon. Lady raises the importance of vaccination, and she is right to do so. As I mentioned earlier, according to the ONS, nine out of 10 adults in this country have antibodies, which are part of the wall of protection.
The hon. Lady is right to mention that cases will rise in this wave. We have been very open about that. I hope that she heard earlier in my statement that there is no perfect time to start opening up. The risk is that, if we do not do it now and wait until after the summer, the schools will be back, and if we wait longer it will be winter—there is a real, serious risk, which we have been advised about, that the wave could be even bigger than what is anticipated at this point. Many more people would then end up getting infected and, by extension, getting long covid.
I hope that the hon. Lady can consider all that together in a balanced way. If she would like to meet any Ministers or officials in my Department to understand the situation better, I will be happy to arrange that.
(3 years, 1 month ago)
Commons ChamberI can tell my right hon. Friend that the AstraZeneca-type vaccine being used in India is, I think, referred to as Covishield. We have not used Covishield in the UK, and we are in intensive discussions with our European friends to ensure that they have the facts to hand and that they can respond accordingly.
Today’s Health Foundation covid report adds to evidence from Professor Sir Michael Marmot on the UK’s high and unequal covid death toll. It shows not only that the UK has suffered high levels of mortality with the second highest level of excess deaths for working-age people in Europe, but that people of colour and disabled people were five and six times respectively more likely to die than their white counterparts and their non-disabled counterparts. On top of that, those in poverty were nearly four times more likely to die from covid than those in more affluent groups.
Following my question to the Health Secretary yesterday, when I asked whether the Government were committed to levelling up, I am now asking when they will implement the recommendation from Sir Michael Marmot and the Health Foundation to address these inequalities and build back fairer.
I am looking closely at those recommendations. I want to look at the expert advice of everyone out there who is providing good, sensible advice about how we can come together to tackle this pandemic. The hon. Lady is right to point out that the pandemic has, sadly, been disproportionate in certain communities and in its impact, including, sadly, on disabled people and people from ethnic minorities. That is true not just in the UK; it is true across the world, and we need to work out a plan to deal with that, and also, if there is ever a future pandemic, to ensure that we have learned the lessons.
(3 years, 1 month ago)
Commons ChamberI will be making a statement to Parliament on just that issue. I think I will probably make it tomorrow.
Last December, Professor Sir Michael Marmot revealed that the high and unequal covid death toll across England was down to historic structural inequalities that successive Conservative Governments have allowed to go unchecked. Last week, he quantified that, showing that Greater Manchester had a 25% higher covid death toll because of those structural socioeconomic inequalities. When will the Health Secretary deliver on the Prime Minister’s promise to me in January to implement Sir Michael’s recommendations to address those inequalities in my constituency and others, and ensure that we build back fairer?
The hon. Lady raises an important issue. We have seen, sadly, that through the pandemic, because of various inequalities up and down the country, some people have suffered a lot more than others. It is an important point, and we need to do more—we all collectively need to learn from this. I give her the assurance that I know that Public Health England and the chief medical officer are looking into it and will report to Ministers shortly.
(3 years, 3 months ago)
Commons ChamberAs co-chair of the all-party parliamentary group on dementia, I welcome this debate on Dementia Action Week. In Oldham, there are approximately 3,000 people living with dementia, more than six out of 10 of whom are living with a severe form of one of the many brain diseases that cause dementia. By 2030, that figure will be nearer 4,000.
Dementia Action Week provides an opportunity to highlight the urgent need for the Government to bring forward social care reform proposals. As such, I support the Alzheimer’s Society’s “Cure The Care System” campaign, which focuses on the need to reform social care funding and on driving up the quality of care for people living with dementia.
People with dementia are by far the largest user group of adult social care, but they face devastating care costs, often paying an additional 15% for their care provision. The average cost for someone with dementia or their family is £30,000 a year. Because of the lack of dementia training for our hard-working care staff and the continued disconnect between health and social care, people with dementia often receive inappropriate care. More and more of us will need dementia care, and more and more of us will become dementia carers for those we love, so it is vital that we get social care reform right.
For carers in the community, the pandemic has presented its own challenges. About half of carers are aged over 65, and they have undertaken an additional 92 million hours of care. This is unsustainable and the Government have to recognise that. It is vital that social care reform supports the needs of our army of family dementia carers by looking at respite provision. In addition, carers’ assessments must be backed by the resources to support the needs identified. The Government cannot continue to just dump additional responsibilities on to local authorities while cutting their resources, particularly in areas such as mine.
The Government’s forthcoming social care reforms provide an unmissable opportunity to cure the care system. While dementia as a condition is not yet curable, the care system is, as we have heard. I believe in the principle that healthcare and social care should be provided universally and free at the point of need, and that this is fundamental. In addition, I will be arguing that this should be provided through progressive taxation. The social care reforms also need to support people with dementia to live as they choose, keeping their independence as well as taking part in activities that they enjoy in environments that facilitate their wellbeing. Care needs to be truly person-centred, with control given to people in receipt of it. Lastly, our wonderful care staff must be valued and paid for their work.
Before I close, I want to recognise the impact that the pandemic has had on dementia research. As others have said, we need a commitment from the Government about fulfilling their promise on doubling dementia research, and I would be grateful if the Minister could include that in her closing remarks.
(3 years, 3 months ago)
Commons ChamberAs you will be aware, Mr Deputy Speaker, this is Dementia Action Week. I am co-chair of the all-party parliamentary group on dementia. In conjunction with the Alzheimer’s Society, we are arguing in the #CureTheCareSystem campaign that there is a desperate need to reform social care. While covid cases are going down in most places in the UK, dementia cases are only going to go up. By 2040, it is estimated that well over 1 million people in the UK will have some form of dementia, with a cost to the economy of £94 billion.
During the pandemic, people with dementia have been the worst affected. Figures from the Office for National Statistics show that more than one in four of those who have died from covid also had a diagnosis of dementia, making dementia the most common underlying condition among those who have died from the disease. We know that the number of excess deaths of people with dementia—those not with a covid diagnosis—was about 5,000 higher than in the previous year.
There are a number of reasons for these data. The Government did too little to protect care homes at the height of the pandemic. Hospital patients were quickly moved from hospitals to care homes, all without testing, spreading the virus amongst vulnerable residents. There were also problems in accessing PPE and testing for care staff. Many of us can remember cases of care staff using bin-bags as aprons, or having to make round trips of hundreds of miles to access testing.
The second cause of the excess deaths has been the worsening of people’s conditions, primarily because of the isolation that many have experienced and the lack of ability to use basic skills, such as speech, which they are at risk of losing. For people with dementia living in the community, it is estimated that family and friends have provided an extra 92 million hours of care during the pandemic.
People with dementia and their carers need more than warm words. They need action to address the dementia premium in care home fees. On average, someone living with dementia or their family will pay £100,000 for their care. For them, for their carers, and for the dementia moonshot, we needed much more from the Government in the Queen’s Speech. With the Government’s proposed integration of the NHS and social care in their new Bill, the principle that healthcare and social care should be provided universally and free at the point of need is fundamental. I argue that it should be provided through progressive taxation.
Finally, on health inequalities and the UK’s appalling, high and unequal covid death toll—driven, as Professor Sir Michael Marmot has said, by the key causes of rampant poverty and inequality, a decade of austerity, the underfunding of the NHS and a political culture that fuels division—I repeat my challenge to the Health Secretary and the Prime Minister to adopt Sir Michael’s covid review recommendations and build back fairer.
(3 years, 3 months ago)
Commons ChamberMy right hon. Friend is right to praise the incredible efforts in Bournemouth, which I know he has played a very direct and personal part in delivering, and I look forward very much to visiting as soon as I can get down there—and, by the way, I agree with Sir John Bell that Bournemouth is a great place to go on holiday and I am sure my right hon. Friend agrees about that too.
On global support, of course as and when we have excess doses we will look to support countries around the world with those doses, but the number of doses that we can support around the world from our excess purchases is small compared with the spectacular support we have already given the whole world with the more than 400 million doses of Oxford-AstraZeneca vaccine that have been delivered at cost. The majority of Oxford-AstraZeneca doses have been injected in low and middle-income countries, and 98% of all COVAX jabs given so far have been that vaccine delivered on the back of British science, supported by the UK Government, Oxford university and AstraZeneca, doing this all without taking a profit. We should be very proud of that.
The wider the gap between the rich and poor, the bigger the difference in our life expectancy and healthy life expectancy. That has been laid bare over the last year: the UK’s high and unequal covid death toll has been driven by the rampant poverty and inequality that successive Conservative Governments have allowed to go unchecked. In January, the Prime Minister promised to implement Professor Sir Michael Marmot’s recommendations to address that and to build back fairer, so what discussions has the Health Secretary had with the Prime Minister on that, and will investigating the UK’s structural poverty and inequality be part of a covid inquiry?
I discussed this issue with the Prime Minister. The office for health promotion is intended to be able to tackle some of those issues, led clinically by the chief medical officer, to make sure we can strengthen the public health case around Government, because so many policies of Departments outwith the Health Department are critical in addressing the question the hon. Lady raises.
(3 years, 4 months ago)
Commons ChamberIt is incredibly important that all care workers take up the jab if they possibly can, unless they have a vital medical reason not to, because the jab of course not only protects us, but protects people we are close to, and care workers are close to people who are vulnerable—that is in the nature of the job. That is why I think it is right to consider saying that people can be deployed in a care home only if they have had the jab, and we are looking into that. We have not said that for those who work in domiciliary care—caring for people in their own homes, rather than in a care home—because those in care homes are at the highest risk of all, but I would absolutely urge anybody who is a carer, whether they work in social care or are an unpaid carer, who has not already got the jab to please do get it, to protect not just them, but those to whom they have a duty of care.
As the UK rolls back lockdown restrictions, the global death toll has reached 3 million, and the World Health Organisation is warning that the world is approaching the highest rate of infection so far. With three new variants in three continents, all these variants now in the UK and the reduced efficacy of the different covid vaccinations against these variants, it is clear that the UK’s success in fully emerging from this pandemic is co-dependent on how well the rest of the world is doing. I asked the Health Secretary about global co-ordination of surveillance of new variants back in February, and the World Health Organisation is now consulting on this, so can he update the House on our response to this consultation?
This is an incredibly important subject. I agree with the substance of what the hon. Lady asked in the question, and she is quite right to raise this. We have put in place the new variant assessment platform, allowing any country around the world to use our enormous genomic sequencing capability if they want to sequence positive cases to discover what is happening in their countries, but our borders testing system, in which all positives are sequenced, also means that we in fact get a survey from around the world through those who have travelled to the UK, and we can relay that data back to individual countries so that they understand that better. Of course, it would be far better if something like the new variant assessment platform was run on a multilateral basis globally—for instance, by an organisation such as the WHO. We are engaged with the WHO on making sure that it is available, but my view was that we needed to get on and offer this to everybody and then build a network of labs around the world that can make such an offer so that sequencing can be available in every country, because it is currently far too patchy.