Public Health: Coronavirus Regulations

Debbie Abrahams Excerpts

Tuesday 13th October 2020 Commons Chamber

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I support these restrictions with a heavy heart. On balance, I will be supporting the Government this evening, but I want to make just a few quick points.

I would be very careful about subscribing to the Vallance/Whitty orthodoxy that informed these regulations, while not at all examining very carefully respectable bodies of medical opinion to the contrary. I would cite particularly the Heneghan/Sikora/Gupta line. It is important that the Secretary of State and his ministerial team address those things head-on and treat them with the respect that they deserve.

The Secretary of State has my utmost sympathy. When coming into office, he opened a box marked “public health” and found tools for doing all sorts of things, such as sorting out lifestyle problems—obesity, smoking, diet and all of that. I suspect that he found very few that were geared towards dealing with infectious diseases, particularly this infectious disease. He has done some good things to try to remedy that in a very short space of time. May I suggest to him, to sort out the shadow Secretary of State’s obsession with Serco, that he looks again at the Public Health Laboratory Service, which was in its second incarnation as the Health Protection Agency when it was abolished in 2012. He might find in such a thing the means to deal with infectious diseases of this sort in the future.

We need to be careful about groupthink, confirmation bias, a thin evidential basis and uncertainty masquerading as certainty. There is a huge margin of uncertainty with all this, and we all need to develop a level of humility in our attitudes towards dealing with this crisis. That is why I shall be supporting the Government this evening.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I cannot let the right hon. Gentleman get away with that. In 2016, Operation Cygnus was very clear about what needed to happen. It was a question not of if there was going to be a pandemic; it was when. The Government failed to introduce all the recommendations from that exercise. I will not let them get away with this.

[Dr Murrison]

The hon. Lady can do what she likes. The Secretary of State is dealing with the situation that he found at the time. Developing the National Institute for Health Protection in short order from the disaster that was Public Health England was, I think, a very good effort, but there is much more to be done, as I know he appreciates.

May I sound a cautionary note for the Secretary of State? We have gone to great measures to close down schools, and I appreciate the need for that. That was informed, of course, by the Imperial College model, which was a flu model, in essence, and was inadequate for this particular virus. He will know—I hope he does—of the work published in September by the University of Edinburgh group under Ackland, which suggests that that certainly did suppress admissions to ITU. It certainly protected the NHS, but probably over time, unless we get a vaccine, it will cause more deaths directly from covid, quite apart from the incidentals for other diseases, the loss of liberty and livelihood. The Secretary of State needs to understand that and that there is an alternative view. If we do not get a vaccine, I fear, paradoxically, that we will see more deaths, not fewer, as a result of some of the interventions that we have put in place. Of course, Ackland was unsighted on this latest set, but the logic would suggest that those measures too may, over time, if we get a third and fourth wave, cause more trouble than they solve. It is a respectable piece of work and the Secretary of State needs to take account of it.

In all this, we simply do not know and we are learning all the time. We have to accept, I think, the expertise of those advising Ministers and that we have experts for a reason, but there is an alternative view. Unless we get a vaccine—goodness me, I hope we do—I think we may find that the cure is worse than the disease in terms of lives lost directly to covid, incidental lives lost to other common diseases—stroke, heart attack and particularly cancer—loss of liberty, loss of livelihood and the compete trashing of our economy. That is what is at stake. I do not envy the Secretary of State in his work.

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[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I would like to make the following points based on my 20 years’ experience as a former public health consultant.

Unfortunately, I do not believe that the new tier system and measures that were introduced yesterday are sufficient to contain the virus. The localised approach will not work because of seeding. The virus travels where people come from. I came down on the train yesterday—I talked to the hon. Member for Altrincham and Sale West (Sir Graham Brady) about this point—and there might have been people who were asymptomatic who unknowingly have spread the virus, unfortunately. There may also have been people who wanted to exercise their personal choice, who have the virus and knowingly exposed people to that risk. Unless the Government are prepared to set up roadblocks across the M1, M6, M62 and all other routes to and from the north, I am afraid that, just as happened in the first wave in Italy, the virus will spread.

To understand what we need to do now, we must understand how we got to this position. It is abundantly clear, as has already been said, that the national test and trace programme is not fit for purpose. In spite of clear WHO guidance, it was not fully operational in June when the first lockdown measures were eased, and as a consequence it has failed to cope with the predicted rise in infections ever since. On top of that there were, unfortunately, significant specific failures.

I support the calls of the CMO, SAGE and others for a short circuit break to help drive down infection rates, but that should be at the national level. Any circuit break period should be used to undertake the transfer of test and trace to local public health departments. That must be accompanied by full resource transfer. Currently, less than 10% of the money used by local authorities at a local level has been reimbursed by the Government. That is unjustifiable and unsustainable, and it must be resolved.

In addition, the circuit break should be used first to ensure that the NHS and social care are fully prepared. They must have adequate PPE. They must have flu vaccines. They must have regular testing regimes. We should identify vulnerable people for supportive shielding, and not via some algorithm. We need to define exactly how we are going to support people in a way that does not mean they will be detrimentally isolated. We must also make sure we have simple, coherent messaging with local community engagement, and I support what the Government are trying to do with the simplification. We must also make sure that we have monitoring and enforcement capacity.

All workers and businesses need to be fully supported during any circuit break. We are at war with the virus. The Treasury needs to recognise that and respond adequately. Finally, the Government must recognise that covid is a disease of poverty.

Covid-19 Update

Debbie Abrahams Excerpts

Monday 5th October 2020 Commons Chamber

[Matt Hancock]

Yes, absolutely. People are asking questions about how the vaccine will be rolled out and of course I understand why people are so interested in that. We will of course protect the most vulnerable first and we will do that on the basis of clinical advice. The JCVI brings together the best clinicians in this area and it meets very regularly. Decisions of the JCVI will not be on the critical path to the roll-out of the vaccine—I have been assured of that.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

One of my 15-year-old constituents had a covid test over a week ago, and in spite of chasing, is still none the wiser as to whether she has covid or not. Not only is she having to self-isolate, but her mum, a nurse, is having to take the precaution of self-isolating, something she says her ward can ill afford. On top of that, last month, the time taken to get test results back from the national Test and Trace programme to Oldham’s public health team, to enable them to trace the cases that the national programme is failing to get in touch with, was 12 days—12 days, not 24 hours. Will the Health Secretary please tell my constituent how many of the 16,000 or so lost test results were from Oldham, and how many contacts—not cases— have not yet been traced?

[Matt Hancock]

The good news is that the turnaround time of test results has been coming down. I would love to take up the case of the individual who has not had a result back, as the hon. Lady has described, because that is rare: the majority of cases now come back the next day. I will specifically look into turnaround times in Oldham, because an average of 12 days seems a lot longer than I expected, and I will make sure to get back to the hon. Lady at the appropriate opportunity.

Coronavirus

Debbie Abrahams Excerpts

Tuesday 15th September 2020 Commons Chamber

[Matt Hancock]

Yes. The NHS covid-19 app, which will be available this month, will, as one of its features, ensure that people can go to a pub, restaurant or hospitality venue and scan the QR code quickly. Contact details will then be safely collected in case they are needed for contact tracing purposes. We are making the scheme mandatory. It has been very successful voluntarily and we are going to roll it out mandatorily, so I urge hospitality businesses in Bridgend, and right across England and Wales, to download a QR code for themselves and put it where it is very easy to use and obvious, so that all of us, when we go to the pub in Bridgend or anywhere else, can very easily scan in. If there is an outbreak, we can then contact trace that outbreak and keep the virus under control.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I do not underestimate the challenges the Health Secretary has faced over the past few months, but six months on, after many, many warnings of the likelihood of a second wave and of what would happen without a fully operational test, track and isolate system in place before lifting the lockdown, unfortunately the Government are still not getting the basics right. That is happening in my constituency in Oldham. We did not have a mobile testing unit turn up and we are still not getting the data we need to trace covid-positive cases.

For starters, will the Secretary of State sort out the private contractors for the national test and trace system; make sure that public health directors are getting timely, high-quality data on covid cases, including occupational workplace details; and, fundamentally, make sure our local authorities have the resources they need to trace all contacts, and ensure restrictions are understood and observed?

[Matt Hancock]

The answer is yes. In Oldham in particular, where there has been a very serious outbreak, making sure we have that connection between the national system and the data flowing through to local contract tracers is incredibly important. We are working on some innovative solutions proposed by the local authority and others in Manchester to enhance that system as much as we possibly can to keep control of the virus.

Coronavirus Response

Debbie Abrahams Excerpts

Monday 20th July 2020 Commons Chamber

[Matt Hancock]

I will look precisely at putting mobile testing units in Maltby and Dinnington and look, again, at the local data, along with the local authority, to see what we can do.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

I, too, welcome the Health Secretary’s change of heart and his assurance that complete pillar 2 testing data will be sent to local public health departments each day and not each week. The delay has inhibited local public health departments’ ability to contact and trace covid-infected people, letting the virus spread in some areas. Given that many of us have been asking for these data for a number of weeks now, what is his assessment of the number of people who have been infected as a result of the delay, the impact on public confidence, and the hit that local economies will take because of these failures?

[Matt Hancock]

We have been building the test and trace system and improving the data that flows from it and underpins it all the way through this crisis, and I am glad that the hon. Lady is pleased by the continued progress that we are making. That is the way to look at this. We have been building this extraordinary service at extraordinary pace, and I am really glad we are able to get more.

Coronavirus

Debbie Abrahams Excerpts

Tuesday 7th July 2020 Commons Chamber

[Matt Hancock]

My right hon. Friend the Secretary of State for Business, Energy and Industrial Strategy is working closely with the beauty industry regarding how it can open in a covid-secure way, taking into account clinical advice. We have, however, been able to change some advice to allow for the reopening of camp sites. I am very pleased about that, and it will help lots of families to enjoy summer safely. It is disappointing to hear of the blanket approach taken to not having any camping in the New Forest—I went camping there as a child, and enjoyed it very much. On a campsite people must be particularly careful of shared facilities, and ensure that they are cleaned properly, but there is a way to open campsites safely and securely, and doing that in the New Forest, and elsewhere, will help people to enjoy summer safely.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

The Secretary of State’s comments on Sunday, when he suggested that my Greater Manchester public health colleagues needed help in interpreting the pillar 2 data that they received from centrally contracted private labs, was nothing short of insulting. These are some of the most talented, dedicated and professional people with whom I have had the privilege to work. They do not need help; they need timely, patient-identifiable, and complete data, which they have not been getting. Instead of trying to shift the blame for the Government’s mess in handling the covid crisis on to our amazing public health teams and care home staff, what is the Secretary of State doing to ensure that people get those data? Why will he not announce local thresholds for easing and reinstating lockdowns, as Germany and other countries have done? Finally, will he apologise for his patronising remarks to my public health colleagues?

[Matt Hancock]

I will not allow a divisive approach to tackling this crisis. We will all work together. We will work together with local authorities, local Mayors and local areas, and we will do that in Manchester and across the board. I just hope that the hon. Lady will take the message back to Manchester about how keen we are to work collegiately and together. That is the right way forward.

I have already answered the question on thresholds for changes to local lockdowns. We have to apply judgment. Again, we do this in consultation with and working hand in glove with the local area. On the point about data, the hon. Lady might want to have a word with her friend, the shadow Secretary of State, because he was right to acknowledge that the sharing of this sort of data, which is a complicated task, is constantly improving.

Covid-19 Update

Debbie Abrahams Excerpts

Monday 29th June 2020 Commons Chamber

[Debbie Abrahams (Oldham East and Saddleworth) (Lab) [V]]

The age- standardised covid mortality rate for severely disabled men is nearly 200 per 100,000, and for severely disabled women, it is over 141 per 100,000. That compares with death rates of 70 and 36 per 100,000 for non-disabled men and women respectively. When poverty is factored in, it will show even higher death rates for disabled people. Will the Secretary of State undertake an immediate analysis of the impact of covid on disabled people living in poverty? Will he speak to his counterpart in the Department for Work and Pensions about releasing data on the disabled social security claimants who have died during the covid pandemic, as to date those data have been very limited?

[Matt Hancock]

I am absolutely determined to address the questions and the impact of covid on those who live with disabilities. The hon. Lady’s point is important and this will form part of our work on inequalities and the response to covid. The Minister for Equalities is taking that work forward.

Coronavirus

Debbie Abrahams Excerpts

Wednesday 11th March 2020 Commons Chamber

[Matt Hancock]

Yes, Ofsted absolutely will take a lenient view of the impact of coronavirus on what happens in schools. When it comes to the broader point about what households should do when one person tests positive, that is of course something we are considering very closely. At the moment, the number of cases is at a level such that we can give individual advice to each household. It is likely that that will not be possible throughout this situation, so we will make sure that there is formal public guidance for everybody, so that everybody knows what to do.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Will the Secretary of State clarify a point that was made by the Secretary of State for Work and Pensions on Monday? She said that social security claimants who were due to take a work capability or work-related activity assessment would not have their social security support stopped, but those claimants were omitted from the group that the Chancellor talked about in the Budget statement, so will the Secretary of State clarify who is right? Will he also make sure that information is available for the deaf and the visually impaired? There is a gap in the information in that respect.

[Matt Hancock]

On the latter point, I entirely agree, and it goes with the earlier point about communications in foreign languages. On the first point, I will ensure that the Work and Pensions Secretary writes to the hon. Lady with the answer.

Health Inequalities

Debbie Abrahams Excerpts

Wednesday 4th March 2020 Commons Chamber

[Jo Churchill]

If the hon. Gentleman will bear with me for just a few minutes, I want to push on rather than incur the wrath of Madam Deputy Speaker.

I am clear that there must be integration across Departments, because dealing with these issues is about having a warm home that is suitable for you and those you love, and about having an environment that sustains your health. It is about good education, so that people are equipped with the skills to look after their health. It is about having jobs that are purposeful and rewarding.

The health inequalities challenge is stubborn, persistent and difficult to change, and I recognise the enthusiasm, energy and frustration that those who will speak in this debate will bring. The Government have firmly signalled their intention to take bold action on these issues. We are committed to reducing inequalities and levelling up. To be effective in reducing health inequalities, we need a long-term sustainable approach across all Departments. Early onset diseases, disability and avoidable mortality are concentrated in poor areas, so this is where we must act if we are going to make the system fairer.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

Will the Minister give way?

[Jo Churchill]

I ask the hon. Lady to bear with me for just a minute.

It is important that we improve those with the worst-affected health the fastest. It is unacceptable that a man born in Blackpool today can expect 53 years of healthy life, while a man born in Buckinghamshire gets 68 years. We know that there is also inter-area variation, which is unacceptable. We have an opportunity to seize the initiative to do this across the country. The ageing grand challenge is to ensure that everybody can enjoy a further five years of healthy life by 2035, while narrowing the gap between rich and poor.

We set out our intentions in the prevention Green Paper published last year. The public consultation closed in October, following significant engagement. We had some 1,600 responses, which is more than double the average the Department usually receives from such public consultations. We are analysing the responses and developing our reply, which we will publish shortly. We want to shift the focus from treating illnesses to preventing illnesses and driving healthy lives. The NHS long-term plan contains commitments that outline the role the NHS can play in supporting that shift.

We are passionate, and I am passionate, about our commitment to an NHS that is fit for the future. That is why we are funding it with an extra £33.9 billion.

[Debbie Abrahams]

I commend the Minister for many of the points she is making. I want to clarify the point about interdepartmental work. We know from seminal works such as “The Spirit Level” that when we reduce the gaps between rich and poor, focusing not just on income but on wealth and power inequalities, we get increases in life expectancy across the community, as well as in social mobility, educational attainment and so on. If the Government recognise that, will they commit to considering what impact policies will have on health inequalities as they are being developed?

[Jo Churchill]

The hon. Lady will appreciate that I cannot speak for all Departments, but it is my job to drive home the value of health in those Departments and to ensure that, as she says, we think about the broader consequences across the policy-making piece.

In answer to my right hon. Friend the Member for South West Wiltshire (Dr Murrison), smoking does remain one of the most significant public health challenges. It affects disadvantaged groups in particular and exacerbates inequalities. That is particularly apparent when looking at smoking rates in pregnancy. Three weeks ago, I visited Tameside Hospital in Greater Manchester to see its smoking cessation work. It started with a much higher than average smoking rate, and having a tailored public health budget in the locality has allowed it drive down into the inequality within the community. It has a specialist smoking cessation midwife to help these young women, their families and their partners give up smoking—for their own health, yes, but also for the health of their babies.

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That this House notes the publication of Health Equity in England: The Marmot Review 10 Years On, notes that Government is committed to level up outcomes to reduce the health gap between wealthy and deprived areas, and supports the Government’s commitment to delivering long-term improvements for everyone no matter who they are, where they live or their social circumstances.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

On a point of order, Mr Speaker. On 24 February, during my speech in the Adjournment debate on the deaths of social security claimants since 2014, I incorrectly stated that Daniella Obeng had taken her own life. I would like to correct the record. In fact, Daniella died from bronchopneumonia. She also had a brain tumour that resulted in multiple epileptic fits.

Daniella’s family told me that she was a talented singer with a caring, supportive boyfriend and a wonderful 13-year-old son. After her social security support was stopped in 2016, she struggled to work because of her health conditions. Daniella managed to get a singing contract in Qatar for six months, but after just six days was found dead in her bedroom. The guitarist who was supporting her said that she was having fits during her performances and went to bed to recover. Unfortunately, she never woke up.

I offer my sincere condolences to Daniella’s family. She sounds an absolutely amazing woman.

[Mr Speaker]

Thank you. We need say no more. It is now on the record.

Social Care

Debbie Abrahams Excerpts

Tuesday 25th February 2020 Commons Chamber

[Matt Hancock]

The hon. Lady is dead right, and I have changed that direction of travel. This year is the first year for a generation when there has been an increase in the proportion of the NHS budget going to primary and community care. That change was at the core of the long-term plan. I insisted on that because I entirely agree with her analysis that getting more support out into the community is critical. This has been going in the wrong direction for a generation, and we are just starting to fix it.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I want to pick the Secretary of State up on the point that he made a few moments ago. We had an exchange at the end of January about life expectancy. He says that life expectancy is increasing. It is absolutely clear from Professor Sir Michael Marmot’s report, and it has been clear since 2017, that life expectancy is stalling. Sir Michael said that

“life expectancy actually fell in the most deprived communities outside London for women and in some regions for men.”

I have written to the Secretary of State and I have not yet had a response, but he has an opportunity to correct the record now.

[Matt Hancock]

I saw the letter and I absolutely will reply to the hon. Lady. What I have said before, and I repeat now, is that life expectancy in this country is rising. There are parts of the country where that is not true.

[Debbie Abrahams]

It is flat.

[Matt Hancock]

It is not flat, it is rising, and it is really important that this debate, which is so critical, is based on the facts. The increase in life expectancy should be shared right across the country, and it is not, and we are determined to fix that. We are determined to ensure that life expectancy in this country rises everywhere. That is not the case and it needs to be the case, but life expectancy overall is going up. That is the fact.

[Debbie Abrahams]

The report says that it has almost ground to a halt since 2011. These are the facts, and there is an onus on the Minister to be absolutely clear about this. We cannot fudge this issue.

[Matt Hancock]

As I said, life expectancy is rising, Madam Deputy Speaker.

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[Matt Hancock]

My hon. Friend is absolutely right, and that is the sort of analysis on which we can make decent policy progress, because it based on the facts, rather than on making things up.

[Debbie Abrahams]

rose—

[Matt Hancock]

I will give way to the hon. Lady one more time and then I will move on, because we need to make some progress.

[Debbie Abrahams]

Again, for the record, let me say, as a former public health consultant, that healthy life expectancy is also going down.

NHS Funding Bill

Debbie Abrahams Excerpts

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Matt Hancock]

Exactly. That is precisely true, and what is so frustrating is this—perhaps my hon. Friend knows the answer to this question: what did they do with the half a billion pounds that they did not put into their NHS? It is a disgrace.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

As well as the question of what the money will be spent on—and I welcome the extra investment—there is the question of—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. There is a separate Scottish debate going on, and, however interesting it might be, it is not good if I can hear that and cannot hear the hon. Lady.

[Debbie Abrahams]

I could not hear myself, Madam Deputy Speaker.

It is also a question of who and where. We know that life expectancy is flatlining, that healthy life expectancy is flatlining, and that in some parts of the country, including the north-west, it is actually going backwards. How are we to ensure that we target the money where it is most needed?