Mental Health In-patient Services: Improving Safety
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Steve Barclay
I commend my hon. Friend for the service he gives as a community first responder. Through that, I know he takes a huge interest in these matters. As with the point about data, I am extremely keen that where there is good practice, we are socialising that across the country as a whole, rather than having it in pockets. I would be extremely keen to work with him on the lessons coming out of north Lincolnshire and on how we scale that across the country, so that good practice can be adopted more widely. Indeed, the statement today is about how we will ensure that the lessons from Essex can be applied more widely, so that best practice is socialised across the country.
Madam Deputy Speaker (Dame Eleanor Laing)
I thank the Secretary of State for his statement, which will be welcomed by everyone across Essex.
Lung Cancer Screening
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Madam Deputy Speaker (Dame Eleanor Laing)
Before we come to the statement, I am required to put on record Mr Speaker’s disappointment that an important policy has not been announced first to the House. Not only have Ministers been on the airwaves trailing the policy on lung cancer, but a detailed press notice appeared on the Department’s website well before the start of this statement. Mr Speaker has repeatedly made it clear that such announcements should be made first to the House, that to do otherwise is discourteous to the House, and that this practice must not continue.
The Secretary of State for Health and Social Care (Steve Barclay)
Thank you, Madam Deputy Speaker. May I first address the remarks you made on behalf of Mr Speaker? Of course, any disappointment expressed by Mr Speaker is a matter of concern. No discourtesy was wished on the part of the Government. It may be helpful to clarify that no change of policy is being announced in the statement; it is an expansion of an existing policy, which I hope the House will regard as good news. However, we very much take on board any concerns that Mr Speaker has expressed.
With permission, Madam Deputy Speaker, I would like to make a statement on our national lung cancer screening programme for England. About a quarter of patients who develop lung cancer are non-smokers. We all remember our much-missed friend and colleague, the former Member for Old Bexley and Sidcup, James Brokenshire. He campaigned tirelessly to promote lung cancer screening and was the first MP to raise a debate on that in Parliament. His wife Cathy is continuing the brilliant work that he started in partnership with the Roy Castle Lung Cancer Foundation.
In 2018, after returning to work following his initial diagnosis and treatment, James told this House that the Government should commit to a national screening programme and use the pilot to support its implementation. I am sure many colleagues in the Chamber will recall him saying:
“If we want to see a step change in survival rates—to see people living through rather than dying from lung cancer—now is the time to be bold.”—[Official Report, 26 April 2018; Vol. 639, c. 1136.]
Despite being a non-smoker, James knew that the biggest cause of lung cancer was smoking and that the most deprived communities had the highest number of smokers. That is why I am delighted that today the Prime Minister and I have announced a national lung cancer screening programme, building on our pilot programme, which will target those who smoke or have smoked in the past.
Lung cancer takes almost 35,000 lives across the UK every year—more than any other cancer. Often, patients do not have any discernible symptoms of lung cancer until it is well advanced; in fact, 40% of cases present at A&E. Since its launch in 2019, and even with the pandemic making screening more difficult, our pilot programme has already given 2,000 lung cancer patients in deprived English areas an earlier diagnosis. That matters because NHS England states that when cancer is caught at an early stage, patients are nearly 20 times more likely to get at least five years to spend with their families.
We all know that smoking is the leading cause of lung cancer. It is responsible for almost three quarters of cases, and in deprived areas people are four times more likely to have smoked. We have deployed mobile lung trucks equipped with scanners to busy car parks in 43 deprived areas across England. Before the pandemic, patients from those areas had poor early diagnosis rates, with only a third of cases caught at stage one or two. To put that in context, while a majority of patients diagnosed at stage one and two get to spend at least five more years with their children and grandchildren, less than one in 20 of those diagnosed at stage four are as fortunate. Thanks to our targeted programme, three quarters of lung cancer cases in those communities are now caught at stage one and two.
Targeted lung cancer checks work. They provide a lifeline for thousands of families.
We need to build on that progress, which is why we will expand the programme so that anyone in England between the ages of 55 and 74 who is at high risk of developing lung cancer will be eligible for free screening, following the UK National Screening Committee’s recommendation that it will save lives. It will be the UK’s first and Europe’s second national lung cancer screening programme. If results match our existing screening—there is no reason to think that they will not—when fully implemented the programme will catch 8,000 to 9,000 people’s lung cancer at an earlier stage each year. That means that each and every year around 16 people in every English constituency will be alive five years after their diagnosis who would not have been without the steps we are taking today. That means more Christmases or religious festivals with the whole family sitting around the table.
Alongside screening to detect conditions earlier, we are investing in technology to speed up diagnosis. We are investing £123 million in artificial intelligence tools such as Veye Chest, which allows radiologists to review lung X-rays 40% faster. That means that suspicious X-rays are followed up sooner and patients begin treatment more quickly.
How will our lung cancer screening programme work? It will use GP records to identify current or ex-smokers between the ages of 55 and 74 at a high risk of developing lung cancer, assessed through telephone interviews. Anyone deemed high risk will be referred for a scan, and will be invited for further scans every two years until they are 75.
Even if they are not deemed at high risk of lung cancer, every smoker who is assessed will be directed towards support for quitting because, despite smoking in England being at its lowest rate on record, tobacco remains the single largest cause of preventable death. By 2030, we want fewer than 5% of the population to smoke. That is why in April we announced a robust set of measures to help people ditch smoking for good, with 1 million smokers being encouraged to swap cigarettes for vapes in a world-first national scheme. All pregnant women will be offered financial incentives to stop smoking, and HMRC is cracking down on criminals who profit from selling counterfeit cigarettes on the black market.
The lung cancer screening programme has been a game changer for many patients: delivering earlier diagnoses, tackling health inequalities and saving lives. We are taking a similar approach to tackle obesity, the second biggest cause of cancer across the UK. The pilot we announced earlier this month will ensure that patients in England are at the front of the queue for innovative treatments by delivering them away from hospital in community settings. Together, this shows our direction of travel on prevention, which is focused on early detection of conditions through screening and better use of technology to speed up diagnosis and then treatment, because identifying and treating conditions early is best for patient outcomes and for ensuring a more sustainable NHS for the future, for the next 75 years. I commend this statement to the House.
Wes Streeting (Ilford North) (Lab)
Before I begin, I would like to take this opportunity to pay tribute to the life of Margaret McDonagh, Baroness McDonagh of Mitcham and Morden. Margaret was the first women general secretary of the Labour party and the best: a political organiser second to none; kind, compassionate and made of steel. I am one of so many people throughout the Labour party and the Labour movement who benefited from Margaret’s kindness, generosity and wisdom. She was a friend, a mentor and a political hero. It breaks my heart that so many glioblastoma victims like Margaret have no hope of treatment and that a diagnosis means a death sentence. So, in sending, I am sure, condolences from across the House to Margaret’s sister, my hon. Friend the Member for Mitcham and Morden (Siobhain McDonagh), the best tribute we could make to Margaret and the best condolences we could offer her sister and family, is to unite across the House and resolve to do everything we can to make the breakthrough discoveries we need so that other people like Margaret do not receive this devastating death sentence.
I also join the Secretary of State in paying tribute to the late James Brokenshire, who was unbelievably kind to me when I went through my own cancer diagnosis—even more generous given what he was going through, which was so much worse.
I thank the Secretary of State for advance sight of the statement.
Lung cancer patients in this country are less likely to survive than patients in most European countries. Why? Because patients today find it impossible to get a GP appointment. On receiving an urgent referral, they wait too long for a scan. On receiving a cancer diagnosis, they wait months for treatment. And before the Government blame covid, the target for patients to start treatment within 62 days of referral has not been hit
since 2015.
The Secretary of State was not joking when he said that he is not announcing anything new today. The programme announced today will not be fully rolled out until 2030. So, after 13 years in Government, they are not announcing action today and not even for the next Parliament, but for the one after that. I thank the Health Secretary for making commitments for a second-term Starmer Government to deliver.
On the workforce, the problem with the plan is that the NHS simply does not have the staff to deliver it. The Prime Minister and the Health Secretary have been all over the media setting out the upcoming workforce plan, although they have not yet said a word to the House. Is this why it will take seven years to roll out the screening programme, because they have no plan to bring down NHS waiting lists today? We have been waiting almost as long as we have been waiting for the right hon. Member for Mid Bedfordshire (Ms Dorries) to hand in her resignation and call a by-election.
While the Health Secretary writes the Labour party’s 2028 manifesto, junior doctors who treat lung cancer patients are due to walk out on strike for five days. More than 650,000 operations and appointments have already been cancelled due to NHS strike action. Is it not time for the Health Secretary to accept he has failed, step aside and call in the Prime Minister to finally meet junior doctors? If the Prime Minister has time to negotiate gongs for Conservative cronies with Boris Johnson, he has time to meet junior doctors.
Today we learnt that the National Cancer Research Institute announced it will be closing after 22 years, due to
“uncertainty in the wider economic and research environment.”
There is still so much we do not know about cancers and so many treatments still to be discovered and developed, yet clinical trials have fallen off a cliff in recent years.
What impact does the Health Secretary expect the closure to have on cancer clinical trials?
After 13 years of Conservative rule, the verdict is in. A report published today by the King’s Fund reveals that the NHS has fewer CT and MRI scanners than other advanced countries, and
“strikingly low numbers of…clinical staff”.
That explains why the King’s Fund also found that the NHS was hit harder during the pandemic than other healthcare systems. It is not just that the Government did not fix the roof when the sun was shining; they dismantled the roof and ripped up the floorboards. It also helps to explain why patients in this country are less likely to survive treatable conditions, such as breast cancer and stroke, than those in comparable nations, and why we have one of the lowest levels of life expectancy. The King’s Fund summed it up with something of an understatement, saying that the NHS had “seen better days.” Is it not the case that the longer the Conservatives are in office, the longer patients will wait?
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Before I call the Secretary of State, let me say to the hon. Member for Ilford North (Wes Streeting) that I think the whole House will join him, and me, in sending condolences to the hon. Member for Mitcham and Morden (Siobhain McDonagh).
Steve Barclay
On behalf of His Majesty’s Government, Madam Deputy Speaker, I echo your sentiments and those of the shadow Health Secretary in sending the House’s condolences to the hon. Member for Mitcham and Morden (Siobhain McDonagh), and also our fond remembrances of Margaret McDonagh. She played a pivotal role in the 1997 landmark election for the Labour party, and her loss will be keenly felt on the Labour Benches, but also much more widely across the political spectrum.
The hon. Gentleman raised a number of issues relating to screening, on which there is much consensus in the House, but one issue that he did not particularly note is the importance of this programme in closing the health inequality gap. The detection of stage 1 and stage 2 cancers, which has had such a remarkable impact on survival rates, has been targeted at the areas with the highest smoking rates and, therefore, the most deprived communities. I hope there will be a fairly wide consensus across the House that that is a real benefit of the programme. We aim to take the proportion of lung cancer survivors from 15% to 40% over the next 18 months, and to 100% in the years ahead, and we are talking today about a series of measures that have proved to be effective: there is remarkable evidence of the survival rates that they generate.
The hon. Gentleman raised a number of wider issues related to the Government’s record on cancer. The NHS has seen and treated record numbers of cancer patients over the last two years, with cancer being diagnosed at an earlier stage more often and survival rates improving across almost all types of cancer. Indeed, the expansion of the screening programme is a good illustration of the clear progress that the Government are making.
The hon. Gentleman raised the issue of junior doctors—an issue that we have debated a number of times across the House. He says that he does not support the junior doctors in their demand for a 35% pay rise. They have, of course, offered to spread it over an extra year to take 2024-25 into account, but for that they want a 49% pay rise. This is slightly esoteric: the hon. Gentleman says he does not support their demands, but he also criticises the Government for not meeting those demands.
The hon. Gentleman raised the subject of research funding, and I was grateful to him for doing so, because the Government are spending more than £1 billion on research through the National Institute for Health and Care Research. I have met the president of Moderna, with which the Government have signed up to one of our landmark partnerships with the life sciences sector. There is huge potential for us to work with life science partners as part of our health commitment. It is clear that those within the industry see the Government’s commitment and are responding to it, even if Labour Members fail to do so.
We are expanding our programme because it demonstrably works. It is tackling health inequalities and significantly increasing survival rates. It is part of our wider commitment, through our work with Genomics England and our work on the national screening programmes to screen 100,000 babies. The programmes cover not just lung cancer but, for instance, breast cancer. My hon. Friend the Member for Winchester (Steve Brine), the Chair of the Health and Social Care Committee, raised the issue of HIV screening with me last week. That is one of the areas in which early detection is having clear results. We are diagnosing more cases, which is why survival rates are improving in almost all types of cancer.
Madam Deputy Speaker (Dame Eleanor Laing)
I call the Chairman of the Health and Social Care Committee.
Steve Brine (Winchester) (Con)
I remember dear James Brokenshire saying the words that the Secretary of State repeated today in the House. James made this happen—this is a fantastic prevention announcement. Although this nationally expanded programme cannot prevent lung cancer, will the Secretary of State confirm that we will stick by the principle of making every contact count? When people come forward for a lung risk assessment, we can offer emotional support where a problem has been detected, provide smoking cessation services to those who are still smoking, or just put our arms around people where there are comorbidities. When people come into contact with the health service, will we make every contact count for them?
Neuroblastoma Treatment
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The Minister for Health and Secondary Care (Will Quince)
I thank my hon. Friend the Member for Darlington (Peter Gibson) for securing this important debate. I thank him especially for sharing the experience of his constituent Mark Bell, and the challenging events leading up to the devasting loss of his much-loved son Luke to neuroblastoma. I am pleased that Mark and Carol could be here for this debate. As a parent who has sadly lost a child myself, I send my heartfelt condolences to Mark and his family. No parent should have to go through what his family have; I know that it is a void that can never be filled. I am full of admiration for Mark and his family: as my hon. Friend pointed out, following their tragic loss, they established their charity, the Team Luke Foundation, to help other parents in a similar situation. I commend and applaud its important work in raising awareness of neuroblastoma and supporting parents in accessing the information and advice that they need.
My hon. Friend also referenced the letter to my right hon. Friend the Prime Minister from the hon. Member for Batley and Spen (Kim Leadbeater) about her constituent Beau. I too would like to extend my deep condolences to the family of brave and beautiful Beau, who also lost her life to neuroblastoma. My thoughts are also very much with Shirley and her family. I would like to assure my hon. Friend and all families who are affected by cancer that one of my and the Government’s top priorities is speeding up the diagnosis and improving the treatment of cancer, including neuroblastoma.
Working together with our colleagues in the national health service, the Government have three priorities for cancer care. The first is to recover from the pandemic and the backlog. The second is to get better at early diagnosis, which my hon. Friend made a very eloquent and articulate case for, and to get better treatment using the tools and technologies available to us. The third is to invest in research and innovation, because we know that things such as genomics and AI have the potential to transform our experience of cancer as a society. With my hon. Friend’s permission, I will focus on diagnosis and research.
Let me turn first to early diagnosis. Cancer services, including those for children, are an absolute priority for the NHS—I know that and have seen it at first hand. The NHS is working to raise further awareness of the symptoms of cancer, lower the threshold for referral by GPs and accelerate access to diagnoses and treatment. The NHS long-term plan for cancer aims for three quarters of cancers to be diagnosed at stage 1 or 2. NHS England launched operational delivery networks in June 2021 to enable clinicians to lead and improve cancer pathways for children and young people.
We are also making interventions to diagnose cancer early. NHS England has announced that it is expanding direct access to diagnostic scans across all GP practices, which will cut waiting times and, importantly, speed up diagnosis for patients. Non-specific symptom pathways are transforming the way that people with symptoms not specific to one cancer, such as weight loss or fatigue, are diagnosed or have cancer ruled out. This gives GPs a much-needed referral route, while speeding up and streamlining the process so that, where needed, people can start their treatment sooner. Thankfully, the majority of people referred will be given the all-clear. It is crucial that people who are diagnosed start their treatment promptly, while giving peace of mind to those who do not have cancer.
We have previously discussed this, but I hope my hon. Friend will be pleased to hear that the Department has committed an additional £8 billion over the next two years to increase our capacity for elective activity and for adult and children’s cancer services.
Community diagnostic centres have played a huge role in recovering the cancer backlog. We have 108 community diagnostic centres open and operational as of today, and our aim is to open 160 by 2025, but I want to go much faster. So far, we have delivered over 4 million additional vital tests and checks since 2021, including for cancer. Testing and diagnosing early means we can provide the right treatment on time, which is why, as my hon. Friend said, it is so important.
The NHS continues to do groundbreaking research to improve treatment for children with neuroblastoma. Supported by the National Institute for Health and Care Research and Great Ormond Street, it has identified a new drug target for children with neuroblastoma, with the hope that new, less intrusive therapies will be developed by targeting a developmental cell type that exists only in neuroblastoma tumours after a child is born. This team of scientists and doctors at Great Ormond Street and University College London has been awarded a £519,000 Wellcome Trust innovator award to continue its ground- breaking research using image-guided surgery for childhood cancers—that is specifically for neuroblastoma.
The NIHR has also awarded funding to support the development of a treatment decision aid for parents of children with neuroblastoma that has sadly relapsed. The study will consist of two phases and aims to develop an intervention to support parents who are having to make multiple different treatment decisions after their child has relapsed. I will gladly meet my hon. Friend and the NIHR to see what further steps we can take to boost research into neuroblastoma.
My hon. Friend referenced the letter that the hon. Member for Batley and Spen sent to my right hon. Friend the Prime Minister regarding the bivalent vaccine trial, which is not currently available in the United Kingdom. UK clinicians and researchers are hesitant about the US trial of bivalent vaccines for children in remission with neuroblastoma, because it has no comparator group to enable measurement of the treatment’s effectiveness and effect. I also understand that the trial involves very intensive and invasive post-treatment monitoring. Nevertheless, I know discussions are ongoing in the international community, including here in the United Kingdom, on the optimal trial design that will generate the high-quality evidence needed to understand the real efficacy of the bivalent vaccine in this group of patients.
Again, I thank my hon. Friend the Member for Darlington for bringing this hugely important matter to the House and, importantly, for sharing Luke’s story. I thank Luke’s family for the work they are doing, not just in raising awareness, which of course is hugely important, but in the support they are giving to families in similar positions. I am pleased to assure my hon. Friend that, together with groundbreaking research supported by the NIHR and the continued efforts of the NHS in recovering cancer services, the treatment of neuroblastoma and all other cancers remains an absolute top priority for not just me but this Government.
Let me conclude by saying that my hon. Friend asked three specific questions, and my answer to all three is: yes, yes and yes.
Finally, I ask you to indulge me on something, Madam Deputy Speaker. Without embarrassing the Whip on duty—Whips rarely get a mention—let me say that I understand my good friend, my hon. Friend the Member for North Cornwall (Scott Mann), is marrying his partner Nicola this weekend. I wish him all the very best for a wonderful day and them a very happy future together. [Hon. Members: “Hear, hear.”]
Madam Deputy Speaker (Dame Eleanor Laing)
I am sure that the whole House will join the Minister and me in sending our congratulations and best wishes to the hon. Gentleman and his fiancée and family for a wonderful wedding at the weekend—we hope the sun shines for them.
I also thank the House for a very constructive debate. I have said before that I do wish that people who watch our proceedings would pay more attention to these kinds of debates, where we are discussing a matter of great importance and sensitivity, and where the House can welcome the family of a little boy such as Luke, and let them know that we, as a whole Parliament, are working for them and that this place is not only about loud and aggressive argument.
Question put and agreed to.
National Carers Week
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Several hon. Members rose—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. It is obvious to the House that we have plenty of time this afternoon and there is not enormous pressure. I certainly do not wish to impose a time limit on speeches, but all so far have been longer than they ought to have been. I ask Members to keep speeches to under 10 minutes, because this is not the only debate today; another debate follows and it is fairly heavily subscribed. What Members have to say can usually be said pretty well in under 10 minutes, rather than in well over that.
I call Wendy Chamberlain.
Mental Health Treatment and Support
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Several hon. Members rose—
Madam Deputy Speaker (Dame Eleanor Laing)
I ought to have said after the Minister had spoken that the original Question was as on the Order Paper, since when an amendment has been proposed as on the Order Paper, and the Question is that the original words stand part of the Question. I do not think that my putting that to the Chamber after the hon. Member for Hemsworth (Jon Trickett) has spoken will have made any difference to his speech—I do hope not. I prefer to get procedure absolutely correct. It will be obvious that a great many people wish to speak this afternoon and we have limited time. Therefore, we must have an immediate time limit of five minutes, which is quite generous really. We begin with Dean Russell.
Miriam Cates (Penistone and Stocksbridge) (Con)
It is well reported that mental health difficulties have become both more prevalent and more talked about in recent years. Lockdown has certainly had a detrimental impact on the mental health of the nation, which is completely unsurprising. Isolation and loneliness are significant contributors to poor mental health. We have also had the economic consequences of inflation putting pressure on people’s personal finances, and the consequences of the NHS backlogs that have been referred to in this debate, but I particularly want to focus on children’s mental health.
As has already been mentioned by other hon. Members, we have had a rise in diagnosable mental health conditions among children since before lockdown. We have gone from about one in nine children having potentially diagnosable mental health conditions to one in six. I am sure we have all had cases in our constituencies—tragic stories of children who no longer leave home because they are too anxious, who are not able to go to school. We have seen a rise in the number of ghost children, many of whom are not turning up at school because of anxiety and mental health issues.
The Opposition have talked a lot about all the money that needs to be spent. The Government are spending money, boosting mental health spending by at least £2.3 billion by 2024. The motion calls for improved outcomes for people with mental health needs. We all want that, but prevention is better than cure, and it is simply not sufficient to call for ever more money to expand remedial capacity without addressing the root cause of the problem. It is a bit like having a leaky roof and calling for ever larger buckets to catch the drips: we need to fix the roof. Many will cite poverty, poor housing and not enough youth services as the causes. All are contributing factors, I have no doubt, but there are two less well understood, less talked about, and potentially more significant factors contributing to poor child mental health.
The first, which has been mentioned already, is the clear correlation between the rise of smartphones and social media and deteriorating mental health in young people. The extent of online harms cannot be overstated. My right hon. Friend the Member for Chelmsford (Vicky Ford) mentioned pornography. Violent pornography is now routinely encountered by children on the internet, with 1.3 million visits a month by UK children to adult sites. There is also eating disorder and suicide content—again, as my right hon. Friend so articulately mentioned —and child sexual abuse material and exploitation. Anxiety issues are compounded by social media platforms. Children stay up all night waiting for likes on their social media profiles. There is clearly a relationship between more time spent on screens and less outdoor activity, which is another good indicator for poor mental health.
There seems to be a relationship between children spending more hours on social media and worse mental health. The Online Safety Bill, which is going through the other place at the moment, will deal with some of those issues, but I urge Ministers to encourage their colleagues in Government to accept some of the amendments that their lordships have tabled to strengthen the age verification provisions, to make it absolutely watertight that children cannot access some of the worst of those harms. However, we urgently need some proper research into whether it is safe for teens to have smartphones or to go on social media at all. Some have said that their smartphones are as addictive as cigarettes—that they are the opiate trade of the 21st century. I applaud the campaign group UsforThem and its “Safe Screens for Teens” campaign, which is calling for proper research into the health impact of smartphones on teens and whether, like tobacco and alcohol, it is necessary for there to be a legal age limit for accessing some of these platforms, or indeed having a smartphone at all.
A second, under-discussed contributing factor to poor child mental health is family breakdown. We are not talking about a small number of children affected: the UK has the highest rate of family breakdown in the OECD and in the western world. Some 44% of our children will not spend their childhood living with both of their biological parents. There is not enough recent data on this issue, but Office for National Statistics studies from 2010 suggest that back then, 3 million children did not live with their father and 1 million had no meaningful contact with their father. Given those figures, a mental health crisis among children and young people is absolutely no surprise.
Of course, family breakdown leads to other factors that contribute to poor mental health, such as poverty and low income. Some 80% of single-parent households are on universal credit, I think. That is no surprise at all, as there is only one adult in the house to fulfil all the roles and responsibilities of a parent. It puts pressure on housing costs, as one adult is supporting the household—of course there are going to be pressures on housing costs. Single parents are absolute heroes, and I take my hat off to them. Being a parent is an incredibly difficult job when there are two adults in the house. Single parents are heroes, but few would say that it is an ideal situation.
Family breakdown is far worse for the poor, which of course is closely linked to marriage rates. Married relationships are statistically less likely to break down than cohabiting ones, and marriage rates have remained very high in high-income groups, but have collapsed in low-income groups.
Mr David Davis (Haltemprice and Howden) (Con)
On a point of order, Madam Deputy Speaker. You will be well aware, because you have chaired many of the debates, that there has been a campaign in this House for over a year to stop SLAPPs—strategic lawsuits against public participation—which are used by very rich men to oppress free speech in this country. Just in the last hour or so, the High Court has ruled one of those SLAPPs cases out of order: the case of Mr Mohamed Amersi against the ex-Member of this House Charlotte Leslie has been struck down. In my view, that is a great victory for free speech. Because it is so important, I give notice that I will be raising the matter on the Adjournment.
Madam Deputy Speaker (Dame Eleanor Laing)
I thank the right hon. Gentleman for his point of order. It of course needs no comment from the Chair, except to say that I think the whole House will agree with him that this is a good judgment and an important step forward. I do indeed recall chairing many debates on the matter, and I am sure the whole House will look forward to his raising it on the Adjournment. We will recommence the debate with Danny Kruger.
Several hon. Members rose—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. I need to reduce the time limit to four minutes with immediate effect.
New Hospitals
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The Secretary of State for Health and Social Care (Steve Barclay)
It is like a two-for-one offer.
With permission, Madam Deputy Speaker, I will make a statement on the new hospital programme.
As we celebrate 75 years of the NHS this summer, we must continue to set up its success for the 75 years to come. At the heart of this is our new hospital programme, the biggest hospital building programme in a generation, which will help us to deliver on our manifesto commitment to build 40 new hospitals by 2030. Today, I reconfirm to the House our commitment for 40 new hospitals to be built by 2030.
We made our manifesto commitment in 2019, and in 2020 we listed 40 schemes as part of the new hospital programme. Since we formally launched the schemes, we have learned more about the use of reinforced autoclaved aerated concrete, more commonly known as RAAC. RAAC is a lightweight form of concrete that, between the mid-1950s and the mid-1980s, was commonly used in the construction of a number of public buildings, including hospitals—often on roofs and occasionally in walls and floors.
We now know that RAAC has a limited lifespan, with difficult and dangerous consequences for the people who rely on or work in those hospitals. I know this has caused considerable concern to colleagues in this House, to NHS staff in those hospitals and to constituents who are treated in them.
We remain committed to eradicating RAAC from the wider NHS estate. As part of the spending review allocation up to 2024-25, we allocated £685 million in immediate support to the affected trusts, but in some cases we must go much further. Seven hospitals in England were constructed, either wholly or in major part, with RAAC, and an independent assessment shows they are not safe to operate beyond 2030. Two of the hospitals are already part of the new hospital programme, namely the West Suffolk Hospital and James Paget University Hospital. The five remaining hospitals have submitted expressions of interest to join the programme but are not yet part of it. Those are Airedale General Hospital in Keighley, Queen Elizabeth Hospital in King’s Lynn, Hinchingbrooke Hospital near Huntingdon, Mid Cheshire’s Leighton Hospital, and Frimley Park Hospital in Surrey.
We accept in full the independent assessment that these hospitals are not safe to operate beyond 2030. Today, I confirm to the House that we will expand our new hospital programme to include those five further hospitals built with significant amounts of RAAC. With the two RAAC hospitals already in the programme, the seven RAAC hospitals will be rebuilt completely using a standardised design known as Hospital 2.0, with the aim of completing all seven by 2030. I can confirm to the House today that these new hospitals will be fully funded.
I want to take a moment to thank all those who have campaigned so tirelessly for new hospitals to be built to replace the existing RAAC hospitals, including my hon. Friends the Members for Keighley (Robbie Moore) and for Shipley (Philip Davies), who have championed Airedale vociferously; my right hon. Friend the Member for Surrey Heath (Michael Gove), who has campaigned so strongly for Frimley; my hon. Friend the Member for Huntingdon (Mr Djanogly), who lobbied hard for Hinchingbrooke; my hon. and learned Friend the Member for Eddisbury (Edward Timpson) and my hon. Friend the Member for Crewe and Nantwich (Dr Mullan), who led the campaign on Leighton Hospital; and my hon. Friend the Member for North West Norfolk (James Wild), my hon. Friend the Member for North Norfolk (Duncan Baker), who is my Parliamentary Private Secretary, and my right hon. Friend the Member for South West Norfolk (Elizabeth Truss), who all campaigned so assiduously for the hospital in King’s Lynn.
Taken together, the new hospital programme represents a huge commitment to strengthening the NHS estate. Since 2020, we have committed to invest £3.7 billion by the financial year 2024-25, and we expect the total investment to now be more than £20 billion for the programme as a whole. Resolving the uncertainty over the RAAC hospitals, which today’s announcement achieves, in turn allows much-needed clarity for the rest of the new hospital programme. The programme has been divided into cohorts 1 to 4, and construction in cohort 1 has already started. Cohort 1 contains eight schemes. Two hospitals are already open to patients, with the new Louisa Martindale Building at the Royal Sussex County Hospital in Brighton due to open later this year. Work at Moorfields Eye Hospital is due to start imminently, having cleared its final business case.
Cohort 2 comprises 10 schemes. The following schemes will now be ready to proceed, in line with plans set out by the respective trusts: the National Rehabilitation Centre; Derriford emergency care hospital in Plymouth; Cambridge Cancer Research Hospital; Dorset County Hospital in Dorchester; and St Ann’s Hospital, Christchurch Hospital, the Royal Bournemouth Hospital and Poole Hospital, all of which are in Dorset. A further two schemes within cohort 2, Shotley Bridge Community Hospital and the women and children’s hospital in Cornwall, will also be approved to proceed, but in line with the standardised design elements we are promoting through Hospital 2.0, on which I will set out further details in a moment. As such, with the uncertainty that surrounded the RAAC hospitals now addressed, all the cohort 2 schemes can proceed, and they will be fully funded.
The cohort 3 schemes include major hospital new builds at Sutton, Whipps Cross, Hillingdon, Watford, Harlow, Leeds and Leicester. Today’s announcement confirms that those schemes will now proceed and be fully funded. They will be constructed using the Hospital 2.0 standardised approach. It is worth reminding the House of the merits of using that methodology. First, although longer will be taken on the initial design, the current approach of each scheme constructing its own bespoke design has meant that the average time from design to completion of a major hospital has been about 11 and a half years. By embracing modern methods of construction, we will massively speed up the construction phase and, in addition, accelerate Treasury and other government assurance processes. There has been much debate to date on when hospitals start, but the more important issue is when schemes are completed. A standardised modular design has been shown to work in other sectors—for example, when building schools and prisons—and is widespread across the private sector.
Today’s announcement confirms that all cohort 3 schemes can now proceed. In turn, enabling works that had been held up due to the uncertainty about the RAAC hospitals can now progress. I pay tribute to right hon. and hon. Members who have campaigned strongly for the cohort 3 hospitals to proceed. They include my right hon. Friends the Members for Uxbridge and South Ruislip (Boris Johnson), for Chingford and Woodford Green (Sir Iain Duncan Smith), for Harlow (Robert Halfon) and for Epping Forest (Dame Eleanor Laing), and my hon. Friend the Member for Hertford and Stortford (Julie Marson). I know that not all of them can raise points during this statement, but the latter three have all championed Harlow and its case. I also pay tribute to my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn), to name just some of those who have raised these issues. [Interruption.]
Steve Barclay
Opposition Members have asked for the update and called for the programme, but they do not want to hear about it when the announcement is being made.
Turning to the hospitals in cohort 4, two of the schemes —West Suffolk Hospital and James Paget University Hospital—are RAAC hospitals. As I touched on a moment ago, they have been confirmed as part of the seven RAAC schemes. They will therefore be funded for completion by 2030. Four more hospitals in cohort 4 remain on track for completion by 2030: Milton Keynes University Hospital, Kettering General Hospital, Musgrove Park Hospital in Taunton and Torbay Hospital. Again, I pay tribute to the Members for those constituencies, including my hon. Friends the Members for Milton Keynes South (Iain Stewart), for Milton Keynes North (Ben Everitt), for Kettering (Mr Hollobone), for Taunton Deane (Rebecca Pow) and for Torbay (Kevin Foster).
The remaining seven hospitals within that cohort will also proceed as part of the new hospital programme. The work will start on those schemes over the next two years, but they will be part of a rolling programme where not all work will be completed by 2030. That is a reflection of the disruption that two years of the covid pandemic caused, as well as the pressure from construction inflation.
Some work within cohort 4 will start next year. That includes a new surgical hub at Eastbourne, alongside the discharge lounge already under construction. We will discuss key worker accommodation on the site with the trust, as part of engagement with the local housing association. At Charing Cross Hospital in Hammersmith, work will begin on temporary ward capacity to enable the floor-by-floor refurbishment to proceed. In Nottingham, work will begin on a new surgical hub and three new operating theatres will begin as part of the wider redesign, taking forward the Ockenden report recommendations. In Lancashire, a new surgical hub will be opened at the Royal Preston Hospital, which is due to be completed this year. We will reconfigure services across two trusts. I am sure that one of those sites will be of interest to Mr Speaker, as it is expected to be near Chorley. We are in active discussion with the Royal Berkshire Hospital, given the problems with the existing site, which had already made a 2030 completion date very stretching. In addition, we are building three new mental health hospitals in the Surrey and Borders, Derbyshire and Mersey Care areas.
Turning to Devon, I pay tribute to my hon. Friend the Member for North Devon (Selaine Saxby) and my right hon. and learned Friend the Member for Torridge and West Devon (Sir Geoffrey Cox), who have secured new community diagnostics centres at North Devon. The discharge hub there is near completion, and we will take forward discussions with the trust and the local housing association on key worker accommodation over the next two years, as the first part of the North Devon new hospital build. We will discuss the original refurbishment proposal alongside the new build Hospital 2.0 option.
In summary, the cohort schemes will all proceed, but the commitment to completion by 2030 applies to the 40 schemes set out today, which meets our manifesto commitment to build 40 hospitals by 2030.
Finally, let me set out the merits of the Hospital 2.0 approach. Building new hospitals in this way has clear advantages. Construction experts estimate that with modular design, the efficiency saving will be in the region of 25% per square foot. That is essential in addressing the pressure of construction inflation and unlocking the additional schemes that are being absorbed as a result of the RAAC announcement.
There is one key risk to today’s announcement: the plan announced by the Labour party. As we speed things up, it is determined to grind them to a halt. The plan Labour set out on Monday said:
“as a first step, before we commit to any more money, we’d make an assessment of all NHS capital projects to make sure money is getting allocated efficiently”.
So the risk to these schemes is from those on the Benches opposite.
Today’s announcement confirms more than £20 billion of investment for the NHS estate. It confirms that all seven RAAC hospitals, which NHS leaders have called on the Government to prioritise, will be prioritised, with complete rebuilds using modern methods of construction. It allows all cohort 2 schemes to proceed once business cases have been agreed, and modular build will be used for two of those schemes. It gives trusts the certainty to begin enabling works on major schemes in cohort 3 and a package of early work for schemes in cohort 4, two of which will be accelerated as part of the RAAC programme.
In 2019 we committed to the biggest hospital building programme in a generation, and today we confirm the funding to build 40 hospitals by 2030. I commend this statement to the House.
Steve Barclay
It is a very strange approach to complain about Members coming to the Chamber. The hon. Gentleman almost sinks his own point with his opening gambit. We are here because of the campaigning of Conservative Members for new hospitals. That is why, when they see that there is a statement on new hospitals as part of that campaign, it is no surprise that they are in the Chamber. It is pretty odd to complain about Members coming to the Chamber because they are interested in what is happening in their own constituencies.
It is equally strange for the Opposition to appear to be complaining about a plan that they have been calling for over recent weeks. The shadow Secretary of State has repeatedly said that he wants to see the new hospitals programme plan. We have set that out in the statement today, to which he says he is concerned that we only have a plan. A plan on the Government side beats no plan on the Opposition side.
The hon. Gentleman also seems, slightly oddly, not to welcome a commitment to over £20 billion of investment in the NHS estate. He seems to have an objection to me giving a commitment to address the issues of RAAC hospitals, which NHS leaders themselves have said should be prioritised and which independent reports have said create a risk beyond 2030, and coming to the Chamber after discussions with Treasury colleagues and others across Government to confirm that we now have funding to address the seven RAAC hospitals that he has called for action on.
The shadow Secretary of State then seems to have an objection about speed, yet the whole thrust of my statement was about how we are changing our methodology through the use of modern methods of construction, learning from what has been done in the education sector, the justice sector and the private sector about delivering construction schemes at pace. That gives more confidence on cost; it stops local chief executives changing the specifications once designs are under way; it allows things to be built more quickly; it allows us to benefit from technology, with construction in factories as opposed to more conventional construction; and it allows us to deliver schemes more quickly.
It is for that reason that Conservative Members campaigned so strongly for it, none more so than my right hon. Friend the Member for Pendle (Andrew Stephenson), who has been an assiduous champion of the case for Airedale General Hospital. As the statement sets out, we are committed to addressing the RAAC hospitals, and fixing them has in turn unblocked something that was causing delay to the programme for the enabling works for cohort 3, in particular.
Cohort 2, where schemes are well advanced, will also now be able to proceed. We also updated the House on the more bespoke approach being taken to some of cohort 4. The shadow Secretary of State is right to talk about a sense of jeopardy, because those on the Opposition Front Bench have said they want to pause, review and stop the schemes we will be proceeding with. That is the real risk to the new hospitals programme. We have a new approach. We have a clear plan. It is the Labour party that wants to stop it.
Madam Deputy Speaker (Dame Eleanor Laing)
I call the Chair of the Health and Social Care Committee.
Steve Brine (Winchester) (Con)
I am grateful for the statement; the Select Committee will want to have a good look at it, and we will start when the Secretary of State comes to see us next month. At the last election, I promised my constituents significant investment in Winchester Hospital. That is already happening, and now with early work in cohort 4 we have the promise of the elective hub to scale the orthopaedic list. Can the Secretary of State be clear with my constituents that, as the new Hampshire hospital comes together as part of the wider cohort 4, it will be for clinicians to make the clinical case on what safe and sustainable services look like in the long term for those people?
Steve Barclay
St Mary’s is part of three aspects of the Imperial NHS trust: there is the work at Charing Cross in Hammersmith, where we are building the temporary ward to unblock the refurbishment, which will be floor by floor, and the work in Hammersmith with the cardiac—[Interruption.] The hon. Member for Hammersmith (Andy Slaughter) may want to chunter, but I am trying to explain the investment we are placing into the constituencies, so we have funding going into—[Interruption.]
Madam Deputy Speaker (Dame Eleanor Laing)
Order. I have asked the hon. Gentleman politely to stop shouting. I hope he will do so.
Steve Barclay
Thank you, Madam Deputy Speaker. We recognise the importance of the Imperial bid; that is why we are starting to build the temporary ward capacity at Charing Cross and the first phase of work is under way on the cardiac elective recovery hub, to bring cardiac work on to the Hammersmith site. On St Mary’s Hospital, we have already put in some initial funding to explore the new site with Transport for London and Network Rail. That will go into the rolling programme, of which St Mary’s will be part, alongside the redesign that is needed, taking on board the changes at Charing Cross and Hammersmith.
Patient Choice
Baroness Laing of Elderslie Excerpts(1 year, 5 months ago)
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Steve Barclay
Not since the famous 1p on income tax from the Lib Dems, which was to be spent on every issue going past like a passing bus, have we heard of money being spent in as many different ways as the non-dom money. No wonder the hon. Member for Ilford North (Wes Streeting) said it with a smile; the whole House could see how credible that proposal is.
The theme of the hon. Gentleman’s response was comparison, so I think we should compare the substance of the announcement on patient choice with the situation where Labour is in office. In Wales, patients do not have the ability to choose where they receive treatment; that right is not offered to patients. In NHS Wales, patients registered with a GP in Wales do not have a statutory right to choose at which hospital they receive treatment. We can compare what a Government in England are doing—empowering patients, giving them that choice as well as the information and technology they need to make it—with NHS Wales, run by the Labour party, which deprives patients of their choice.
I hesitate to draw the comparison with Wales, however, because another Labour Front Bencher, the hon. Member for Denton and Reddish (Andrew Gwynne), says that he does not want Labour to be judged on its record in Wales. That is slightly confusing because the leader of the Labour party, no less, says that he wants Labour in Wales to be
“a blueprint for what Labour can do across the UK”.
So they cannot even compare among themselves, never mind compare between England and Wales.
The hon. Member for Ilford North talked about strike action but seemed to skirt around the fact that the Government have reached a deal with the NHS Staff Council in relation to Agenda for Change staff—a deal that his own union, Unison, voted 74% in favour of. His own union—the union that gives him money—supported the deal. He chides us about junior doctors, but those of us who were present in the Chamber the last time heard him say that he did not support the junior doctors’ demand for 35%. When we did negotiate with them, they even increased their demand to 49%, when next year is added in, further confusing the position.
It will come as no surprise to the House to discover that people in Wales are almost twice as likely to be waiting for treatment as people in England. That is the true comparison that we are addressing. We can see that situation play through to people waiting more than 18 months. In England, we have virtually eliminated 78-week waits—at the end of March, it was under 11,000—but in Wales, it will come as no surprise to Members, the number was closer to 75,000, and of course Wales has a smaller population. So we can compare waiting times, which we in England are bringing down. We have an electives plan, we cleared virtually all the two-year waits in the summer and over 90% of the 18-month waits at the end of March, which contrasts with the situation in Wales. We are giving patients choice, enabling them to move if they want to in order to get quicker treatment elsewhere. We are on the side of patients. We can see what the Labour party is doing by its disastrous performance in Wales.
Steve Brine (Winchester) (Con)
This form of patient choice has of course been available for at least 15 years; it just has not been made available to patients. Can the Secretary of State confirm that the referral management centres sitting at integrated care board level will be compelled, not asked, either to change that or to get out of the way altogether? Given that the vast majority of people on the waiting lists are already there with a specific trust, how exactly will they be given the option either to stick where they are, or to twist and exercise that choice to receive treatment sooner?
Steve Barclay
I share my hon. Friend’s desire. As part of this announcement, payment will follow patients to incentivise trusts to take on more, which further underpins patient choice. We are actively engaged on accelerating the diagnostic centres and, as a result of ministerial intervention, we have speeded up the diagnostic centre programme. I look forward to updating the House on how many additional scans and tests will now be done this year, as opposed to the original plan for those tests to be done in 2024. I am very happy to have further discussion with him.
Madam Deputy Speaker (Dame Eleanor Laing)
I normally allow a bit of movement between statements, but it seems that a change of scene and personnel is not necessary as everyone is already in place.
Government PPE Contracts
Baroness Laing of Elderslie Excerpts(1 year, 11 months ago)
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Madam Deputy Speaker (Dame Eleanor Laing)
Order. The hon. Lady should not be on her feet when the Minister is answering an intervention from another Member. She is simply getting in the way of the dialogue, and that is not the polite way to do it. If her intervention is to be taken, it will be taken in due course. Standing up for a long time while there is another dialogue going on is really not very polite.
Brendan O’Hara
I hate to say it, but my goodness you are predictable, Sir. That was probably the most predictable question I could ever have imagined. I will come to that later in my speech. Compared with what went on in this place, the audit of the Scottish Government’s treatment of the procurement process is squeaky clean. I so look forward to having that conversation in about six minutes.
Many of those opportunists hit the jackpot in the Government’s VIP lane for PPE procurement. Prominent among them was PPE Medpro, whose bid to supply the UK Government with face masks and surgical gowns was in the high-priority lane after, we are told, some particularly enthusiastic lobbying was carried out on its behalf by someone down the corridor. Indeed, the peer in question was so enthusiastic about the abilities of PPE Medpro to deliver that she made her passionate pitch to Ministers before the company was even incorporated. Through remarkable powers of persuasion, she persuaded Ministers to propel that embryonic company—one with no experience in delivering medical or protective equipment, and one with which, she told them, she had no personal involvement and from which she did not stand to gain financially—straight into the VIP lane.
Madam Deputy Speaker (Dame Eleanor Laing)
Order. I remind the hon. Gentleman that he is in danger of straying. I have let it go so far, but I remind him, as I remind the House, of what the Deputy Speaker said at the beginning of the debate. The normal rule—that reflections must not be cast upon Members of either House of Parliament, except on a substantive motion, which this is not—remains in force. I know that the hon. Gentleman will be careful in what he says.
Brendan O’Hara
Thank you, Madam Deputy Speaker. I will attempt to stay on the right side of that line, and I am sure that you will instruct me should I stray again.
On 25 June 2020, just 44 days after PPE Medpro had been legally incorporated, the firm was handed its first UK Government contract, worth almost £81 million, for the supply of face masks. Very shortly thereafter, it was awarded a second contract, worth in excess of £120 million, to provide 25 million surgical gowns. Earlier this year, The Guardian reported that it had seen the contract that was signed between PPE Medpro and the gown manufacturer in China. The price that PPE Medpro paid for the gowns was just £46 million, and even adding a bit for shipping, logistics and storage leaves, by any reasonable calculation, a whopping profit of around £70 million of public money from a contract worth £120 million.
To add insult to injury, when the cargo of gowns finally arrived, a quick technical inspection from the national health service deemed them not fit for purpose and they were never used. I understand that the situation is so serious that the company is currently under investigation by the National Crime Agency, but inexplicably, up until a couple of hours ago, the peer involved was still operating under the Conservative party Whip. As the right hon. Member for Ashton-under-Lyne (Angela Rayner) said, this stinks. We know it stinks and the public—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. I am quite sure that the hon. Gentleman intends to talk just about the process and the goods and so on, and that he will not be mentioning any peer in particular. He said “the peer involved”, so he referenced not just peers in general, but a particular peer. I am sure that he does not want to make reference to any particular peer, but will just talk about the process.
Brendan O’Hara
I shall from now on, Madam Deputy Speaker; thank you.
This whole process stinks, and we all know it does. That is why we have to see what this Government know. They deliberately created the conditions in which such behaviour could flourish, and they have to release what they know.
Dawn Butler
My hon. Friend makes an extremely valid point. I spoke in Committee this morning. I am not going to read the book but I think we have to scrutinise it and cross-check the information that the Minister gave in Committee against what is in the book. The new Ministers who have come into post should be a little more humble, because what has happened is shocking. The cronyism and the corruption that has happened in the Government in plain sight is truly shocking. The Government are now spending £10 million burning PPE. It is like they are burning the evidence—we wonder why. [Interruption.] Sorry, the Minister said that I have just criticised the Minister for storing PPE. He is right. I would not want the Minister to spend nearly £1 million every day storing PPE. I also do not want him to burn PPE. He should be using the PPE—give it to people who are travelling on the tube. We are having a flu epidemic and it will help to resolve that, so don’t heckle me when this is your responsibility—[Interruption.] I mean the Minister. Sorry, Madam Deputy Speaker. The Government are incompetent as well as corrupt and it is not just cronyism. The situation is so ridiculous—[Interruption.] Am I not allowed to call it what it is, Madam Deputy Speaker? It smells like corruption to me.
Madam Deputy Speaker (Dame Eleanor Laing)
Order. It is perfectly in order for the hon. Lady to say “incompetent”, but I would be grateful if she would find another form of words, rather than saying “corrupt”.
Dawn Butler
This is so ridiculous, Madam Deputy Speaker. When the Netflix series comes out, nobody is going to believe it is a true story. I know we are not supposed to speak about the Conservative peer too much, but we learn today that they are taking leave of absence from the Lords. I am not saying this in jest, but I hope she is not on her yacht trying to do a runner because a lot of money has gone missing. In a previous Minister’s own words, he was being “bullied” into giving this contract—[Interruption.] No, I don’t feel sorry for him, but he was being bullied. Two Ministers were being bullied, so it is important that we investigate the VIP lane.
As I said earlier, the National Audit Office said that companies were put there by mistake and were still given millions of pounds. Surely that shows us that due diligence was not done; the company was there by mistake. How did it get all that money? When the Minister gets to his feet, could he tell the House how many of these companies existed before the pandemic? If he cannot, of course, we look forward to that information being available in the Library or when this motion passes today, which I hope it does.
For the avoidance of any doubt, we all know that the VIP lane was a bit dodgy—that is just a fact and on record—but this has all come to light not because Parliament managed to force the Government to reveal everything that happened, but because a bank reported unusual activity and dropped a certain person and her husband in fear of reputational damage. That is what has brought this particular scandal to light and the National Crime Agency has now investigated.
As others have said, this is just the tip of a very large iceberg. The Serious Fraud office is also investigating contracts won by another company, Pharmaceuticals Direct Ltd, which paid a whopping £20 million fee to a middleman, Surbjit Shergill, who worked for Samir Jassal. Together, they had a hotline to the then Prime Minister’s special adviser, Munira Mirza. We also know—we have seen the emails—that they were helped by the right hon. Members for West Suffolk (Matt Hancock) and for Witham (Priti Patel).
If a company has to go through due diligence and believes that it is participating in a proper process, why would it agree to pay a politically connected middleman £20 million? That does not make any sense. If everybody is treated the same, there would be no need to pay somebody £20 million to move up the list. As you said, Madam Deputy Speaker, I cannot say the word “corruption” —I am trying to think of other words; hopefully more will come to me and I will use them—but it feels very much like cash for covid contracts. What happened to that money is a mystery. The Serious Fraud Office continues to investigate the case 18 months after it was referred.
I could speak about so many more cases. For those who are interested, there is a thread on my Twitter account about some of the other companies where there are huge questions to be answered. The Government need to open up their books and ensure that there is proper scrutiny. Yes, of course we accept that mistakes were made and that some of them were unavoidable, but the Department of Health and Social Care did not do the fraud checks that it was supposed to do; we had to push it, and that did not come out until a whole year later. There has been negligence, but there has also been something a little more sinister happening in Government.
Those people who stole money from the public purse during a national crisis should be ashamed. They should not say, “I was doing it for the country” as they are not when they are pocketing millions of pounds. It is not patriotic; it is a word that you are not happy with me using, Madam Deputy Speaker. Those people took the money unlawfully, really—they were helped by Government Ministers—and they will have had plenty of interest payments from their ill-gotten gains. Now is the time, during the cost of living crisis, to give that money back. That includes the donations given to the Tory party by those people who had a bung from the covid crisis—they need to come back into the public purse.
Dame Nia Griffith (Llanelli) (Lab)
My hon. Friends have set out very clearly the shocking scandal of the PPE contracts. They have also mentioned people who were working hard on the frontline, putting themselves in danger to help others; and, of course, all those who lost loved ones. I will concentrate on the damage that the VIP lanes have done to loyal, reputable companies—the backbone of British business—who offered to be generous and go the extra mile to help, rather than looking for chances to rip the taxpayer off.
BCB International, a company that operates in my constituency and in Cardiff, is a long-established manufacturer and supplier of life-saving equipment, including medical equipment. Its primary customers in the UK are the Ministry of Defence, the Ministry of Justice and many police forces, and it exports approximately 40% of its turnover. It makes, for instance, very good fuel for camping gas stoves called FireDragon. It was registered, it was known to the MOD and the MOJ, it had a good reputation, and it was ready to go. In March 2020, it was engaged in the production of its high-quality hand sanitiser, Dr Browne’s, in Llanelli. It employed up to 100 staff, and worked 24/7. The 80% alcohol sanitiser passed all the appropriate tests, and was well liked and used by the NHS in Wales, as well as by a number of police forces and other public bodies.
Owing to the PPE shortages, the UK Government made a commitment early in the pandemic to “back British business”, and their “UK Make” programme, headed by Lord Deighton, was tasked to unleash the potential of UK industry to scale up domestic PPE manufacturing. In May 2020, Lord Deighton said:
“As countries around the world face unprecedented demand for PPE, British industry is stepping forward to make sure vital pieces of equipment reach our workers on the frontline.
My role is to increase our homegrown PPE supplies, both now and in the future, by investing in the potential of UK manufacturing.”
However, I understand that the “UK Make” policy was withdrawn in September 2020.
In May 2020, following the Government initiatives, BCB invested £700,000 in new hand sanitiser production equipment. It also bought in high-quality FFP3 face masks from Europe, set up gown production, and made oxygen bottle bags. It supplied all those, successfully and on time, to the Welsh NHS, to Welsh and English police forces and to the MOD.
From March 2020, the company regularly tried to sell its British PPE products to the Department of Health and Social Care, and it has provided a brief overview of just some of the names that it was in contact with. I do not have time to read them out now, but the company tells me that although it made these contacts and sent many other emails, it was never contacted back. That is an utter disgrace, and today we have seen why that was the case. There was no need for it to be the case. Good, loyal companies that did everything they possibly could and turned their workforces to working for the country were completely ignored.
As has been mentioned, it was not like that in Wales, and companies have spoken very highly of the Welsh procurement procedure. It is no wonder that the Auditor General for Wales has said:
“In contrast the position described by the NAO in England, we saw no evidence of a priority being given to potential suppliers depending on who referred them.”
Those are extremely strong words, from an auditor referring to what was happening in England. The Welsh Government put in place good arrangements overall. That is such a contrast, and this is what is so damaging to all the good businesses in this country who want to play by the rules.
Neil O’Brien
I will give way, but I am trying to respond to everyone’s points first. If Members can hold on, we will get there.
As I was saying, those two Members both made the point that we wanted to get more UK producers making PPE. The Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince), has already made the point that we have gone from 1% of FFP3 masks being made in the UK to 75%. I should also mention our work with Moderna to get more development and production of vaccines happening in the UK as part of that exciting deal.
The hon. Member for Glenrothes (Peter Grant) said that one potential supplier had been incandescent with rage because they did not get a contract. That is the system working. People were being turned down for contracts; 90% of those who went through the—[Laughter.] Madam Deputy Speaker, I am desperately trying to respond to all the points. [Interruption.]
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Give the Minister a chance to respond to all the questions. I have tried to give enough time for that, so let him get on with it.
Neil O’Brien
Thank you, Madam Deputy Speaker. I am keen to reply to them. The hon. Gentleman said that only 3%—
Neil O’Brien
I am about to explain the due process that we went through and the incredibly forensic work that our civil servants did. Just to be clear—again, for the benefit of the House—Ministers did not make decisions on contracts. Officials, as usual, made the decisions on contracts. I will talk more about the process that we went through in the very short time that we have remaining.
During the dark days of the pandemic, we had a collective approach that saw hundreds of millions of life-saving vaccine doses delivered, the largest testing infrastructure in Europe established from a standing start and the distribution of tens of millions of items of PPE. It was a uniquely complex challenge even in normal times, but a particular challenge when the entire world was trying to get these goods. [Interruption.] Opposition Members might want to have the courtesy to listen to the answers of the questions that they have asked—a strange approach.
We delivered 20 billion items to the frontline and to our broader workforce—we are still in fact delivering 5 million items a months. That was enough to deliver a response to a worst-case scenario, which, fortunately, did not emerge. That is why we have that 20% excess stock that I mentioned earlier. It is simply not the case, as one hon. Member mentioned, that we had five times too much PPE. However, let us remember the context. It was the former Leader of the Opposition, the right hon. Member for Islington North (Jeremy Corbyn), who said that it was a “matter of safety” and of patients’ safety. We agreed, which is why we acted. It was the shadow Health Secretary who said:
“Our NHS and social care staff deserve the very best protective clothing…and they urgently need…it.”
We agreed. It was the current shadow Chancellor who called for a
“national effort which leaves no stone unturned”.
That is exactly what we did. [Interruption.]
Neil O’Brien
What did the hon. Member for Brent Central say there? [Interruption.] No, she does not want to repeat it.
Let me be clear, Madam Deputy Speaker: at every point in the procurement process, the process is rightly run by our brilliant commercial professionals. Ministers are not involved in the procurement process; Ministers are not involved in the value of contracts. Ministers are not involved in the scope of contracts, and Ministers are not involved in the length of contracts. That is something echoed by the National Audit Office, whose report concluded that the Ministers had properly declared their interests and that there was
“no evidence of their involvement in procurement decisions or contract management”.
The role of Ministers was exactly what we would expect. Approaches from suppliers were passed on to civil servants for an independent assessment. Let us again look at the scale of the effort: 19,000 companies made offers, around 430 were processed through the high-priority group, and only 12% of those resulted in a contract for 51 firms. That group was primarily about managing the many, many requests that were coming in to Ministers from people across the House and from people across the country who were desperate to help with that national challenge of getting more PPE, and there had to be a way of dealing with them. To be clear, due diligence was carried out on every single company, financial accountability sat with a senior civil servant, all procurement decisions were taken by civil servants, and a team of more than 400 civil servants processed referrals and undertook due diligence checks. It was a huge operation run by the civil service, and I thank them for their work in getting our NHS the PPE that it needed.
Let me be clear, I will not stand here and say that there are not any lessons to be learned; of course there are. But we should be clear about what those lessons are. Despite the global race to get PPE, only 3% of the materials sourced were fit for purpose, but we have built more resilient supply chains. We are implementing the recommendations of the Boardman review of pandemic procurement in full. I have mentioned the growth of UK procurement of face masks and of vaccines.
In closing, I wish to thank all of those who have been involved in this important conversation. We should be rightly proud of what was achieved during those dark and difficult days at the start of the pandemic, operating in conditions of considerable uncertainty. We were in a situation where, literally, there was gazumping going on. If people did not turn up with the cash, things were removed that they had bought from the warehouses. That was the global race that we were in to source these things. The 400-strong team of civil servants who led this process did a remarkable job from a standing start of sourcing the goods that we needed.
During this debate, we have heard a number of deliberate obfuscations of the different things that Ministers and officials do. To be clear, all of these decisions went through an eight-stage forensic process that was run entirely by officials and it did not get anyone a contract to go into this high-priority group. It was simply about managing the sheer number of bids for contracts that were coming in to people across this House. At the time, although memories are very short and the barracking on this continued—
Sir Alan Campbell (Tynemouth) (Lab)
claimed to move the closure (Standing Order No. 36).
Question put forthwith, That the Question be now put.
Question agreed to.
Main Question accordingly put and agreed to.
Madam Deputy Speaker (Dame Eleanor Laing)
Order. It is inadvisable for people to shout other things if I am listening for the Ayes having it.
Resolved,
That this House –
(a) notes that the Department for Health and Social Care purchased more than £12 billion of Personal Protective Equipment (PPE) in 2020-21;
(b) regrets that the Government has now written £8.7 billion off the value of this £12 billion, including £4 billion that was spent on PPE which did not meet NHS standards and was unusable;
(c) is extremely concerned that the Government’s high priority lane for procurement during the pandemic appears to have resulted in contracts being awarded without due diligence and wasted taxpayer money;
(d) considers there should be examination of the process by which contracts were awarded through the high priority lane; and
(e) accordingly resolves that an Humble Address be presented to His Majesty, that he will be graciously pleased to give direction that all papers, advice and correspondence involving Ministers and Special Advisers, including submissions and electronic communications, relating to the Government contracts for garments for biological or chemical protection, awarded to PPE Medpro by the Department for Health and Social Care, references CF-0029900D0O000000rwimUAA1 and 547578, be provided to the Committee of Public Accounts.
Smokefree 2030
Baroness Laing of Elderslie Excerpts(2 years ago)
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Maggie Throup (Erewash) (Con)
It is a pleasure to follow the hon. Member for Stockton North (Alex Cunningham). Like him, I could tear up my speech after listening to that of my hon. Friend the Member for Harrow East (Bob Blackman). I congratulate my hon. Friend and the hon. Member for City of Durham (Mary Kelly Foy) on securing this important debate, which I have been eagerly awaiting for some time. I wish the hon. Member for City of Durham a speedy recovery.
I thank the all-party parliamentary group on smoking and health, which is so excellently chaired by my hon. Friend the Member for Harrow East, for all its work on this important area. It has undoubtedly been instrumental in changing the Government’s policy on smoking and their perception of the issue. I am sure that its work has contributed to saving many lives. I thank my hon. Friend for his invitation to become a member of the APPG; I am delighted to accept.
The reasons why we need to tackle smoking and become smoke free by 2030 have been well rehearsed in previous debates in Westminster Hall and this Chamber and repeated today, but I make no apology for highlighting the key reasons again. Smoking remains the single biggest cause of preventable illness and death. Surely we have a duty to do everything in our power to prevent ill health and death. Shockingly, cigarettes are the only legal consumer product that will kill most users: two out of three smokers will die from smoking unless they quit. More than 60,000 people are killed by smoking each year, which is approximately twice the number of people who died from covid-19 between March 2021 and March 2022, yet it does not make headline news. In 2019, a quarter of deaths from all cancers were connected to smoking.
The annual cost of smoking to society has been estimated at £17 billion, with a cost of approximately £2.4 billion to the NHS alone and with more than £13 billion lost through the productivity costs of tobacco-related lost earnings, unemployment and premature death. That dwarfs the estimated £10 billion income from taxes on tobacco products. People often tell me that we cannot afford for people to stop smoking because of the revenue generated by the sale of tobacco, but I argue that as a society, and for the good of our nation’s health, we cannot afford for people to smoke.
Achieving smoke-free status by 2030 will not only save the NHS money but, more importantly, save lives. If we are determined to bring down the NHS backlog, we need to prevent people from getting ill in the first place. If we want to achieve our goal of improving productivity, we need a healthy workforce. It takes a brave and bold Government to implement policies whose rewards will mainly be reaped by the next generation, but that is the right thing to do.
I want to focus on just one of the well-researched and well-received recommendations in the Khan review: the age of sale. The fact that retailers use the Challenge 21 and Challenge 25 schemes indicates just how hard it is to determine a young person’s age. Age of sale policies are partly about preventing young people from gaining access to age-restricted products such as cigarettes and alcohol. More importantly, as Dr Khan states, they are about stopping the start. Dr Khan recommends
“increasing the age of sale from 18, by one year, every year until no one can buy a tobacco product in this country… This will create a smokefree generation.”
That may seem pretty drastic, but so are the consequences of smoking. If we ask smokers when they started, the majority will say that it was when they were in their teens. The longer we delay the ability to legally take up smoking, the fewer people will take it up, and the fewer will therefore become addicted. Let’s face it: never starting to smoke is much easier than trying to quit.
We have already proved in the UK that raising the age of sale leads to a reduction in smoking prevalence. Increasing the age of sale from 16 to 18 in 2007 led to a 30% reduction in smoking prevalence for 16 and 17-year-olds in England. Other hon. Members have mentioned the change in America. I would argue that increasing the age of sale by one year every year is more acceptable than raising it in one go from 18 to 21, for example, or even to 25.
Dr Khan has also called for additional investment in the stop smoking services currently provided by local authorities. However, I am a great believer in making every contact count—every contact that someone makes with a GP, as an out-patient, as an in-patient or on a visit to a pharmacy. Every time a smoker sees a healthcare professional, it should be seen as part of the healthcare professional’s duty to better the health of their patient.
I was honoured to share the stage with Dr Javed Khan at the launch of his review in June, and I was pleasantly surprised by the virtually universal welcome that his recommendations received. Indeed, polling carried out by YouGov backs that up: 76% of respondents support Government activities to limit smoking, or think that the Government should do even more; just 6% say that they were doing too much; 76% support a requirement for tobacco manufacturers to pay a levy or fee, to finance measures to help smokers quit and prevent young people from smoking; 63% support an increase in the age of sale; and, for the benefit of those on the Government side of the Chamber, 73% of those who voted Conservative in 2019 support the Government’s smoke free 2030 ambition.
In our 2019 manifesto we committed ourselves to levelling up, and that commitment has been reiterated by our new Prime Minister. Levelling up is not just about infrastructure; it is also about levelling up our health and life chances. That is particularly important for my constituents, because 16.6% of adults in Erewash are currently smokers, which is above the national average. With average annual spending on cigarettes estimated to be around £2,000, it is not just the health of smokers that is being affected, but their pockets as well. Becoming smoke free by 2030 would lift about 2.6 million adults and 1 million children out of poverty, and so would aid our levelling-up agenda.
Before I end my speech, I want to raise the issue of e-cigarettes, or vaping. The Khan review contains a specific recommendation on this, and I want to explain why it is so important. As with cigarettes, the age of sale is 18, but time after time I see young people at the end of the school day using vapes—and that is outside schools without sixth forms. It is illegal for a retailer, whether online or on the high street, to sell vaping products to anyone under the age of 18, so I am not sure how under- age users are obtaining the devices. The manufacturers are obviously aiming some of their marketing at this age range through the use of cartoon characters, a rainbow of colours, and flavours to match. The function of e-cigarettes should be solely as an aid to quit smoking, and not, as I fear, as a fashion accessory and, potentially, the first step towards taking up smoking.
The proliferation of vape shops in our high streets and online proves that vapes have become an industry in their own right, and are now being used by tobacco companies to maintain their profits as restrictions on tobacco increase. I therefore ask the Minister to work with his colleagues in the Home Office, the Department for Levelling Up, Housing and Communities and the Department for Education to see what more can be done to clamp down on the illegal supply of vapes to those under the age of 18. I also ask him for an update on progress in getting a vaping device authorised through the Medicines and Healthcare products Regulatory Agency—a step that would send the strong message that vapes are an aid to quitting smoking and not an alternative to smoking.
Finally, let me ask a question that has already been asked by other Members today: will the Minister provide a date on which we can expect the tobacco control plan to be published?
Motor Neurone Disease
Baroness Laing of Elderslie Excerpts(2 years ago)
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Several hon. Members rose—
Madam Deputy Speaker (Dame Eleanor Laing)
Order. It will be obvious that we have well under an hour left for this debate. If every Back Bencher takes about six or seven minutes, everyone will have an equal chance to contribute. I hope we can manage without a time limit.