NHS Dentistry: Bristol and the South-west

Baroness Laing of Elderslie Excerpts

Monday 24th January 2022 Commons Chamber

[Darren Jones]

On a point of order, Madam Deputy Speaker.

[Madam Deputy Speaker (Dame Eleanor Laing)]

A point of order at the end of an Adjournment debate?

[Darren Jones]

It is for clarification and for guidance, which I think is a point of order, if I may, Madam Deputy Speaker? My question to you is: the Minister suggested I had not been in touch with her to arrange an appointment, but it was the previous Minister. I wanted to ask if I was able to clarify that on the record.

[Madam Deputy Speaker]

That is not a point of order for the Chair, but I understand why the hon. Gentleman wanted to clarify that. [Interruption.] Order. We will not have any more shouting from people who are sitting down.

[Maria Caulfield]

I think it is very disappointing for the right hon. Member for Exeter (Mr Bradshaw) to say that there is no point in meeting or that it would be a pointless meeting. That is the sort of constructive engagement that Labour MPs in Bristol have. I have been very constructive and very open in offering to meet—my very first line in the response to this debate was that I was willing to meet—the hon. Member for Bristol North West to discuss that. If he was not serious about it, it is a shame that he has not been more constructive this evening. However, I am very clear that we are offering a range of options for patients. I have put on record and I have not shied away from the fact that patients are struggling to see their dentist. I have not shied away from the fact that dentists are not happy with the current contract, and we are instigating contract reform. I have not shied away from the fact that, with the current infection control measures, restrictions are still in place. However, as the Minister responsible for dentistry, I remain committed to playing my part to ensure patients can access NHS dentistry no matter where they live.

Question put and agreed to.

Mental Health Act 1983: Detention of People with Autism and other Lifelong Conditions

Baroness Laing of Elderslie Excerpts

Thursday 20th January 2022 Commons Chamber

[The Minister for Care and Mental Health (Gillian Keegan)]

I take this opportunity to genuinely thank my right hon. and learned Friend the Member for South Swindon (Sir Robert Buckland) for securing a debate on this vitally important topic. Improving the care and treatment of autistic people is something he has championed, particularly through his commitment to reform of the Mental Health Act. I thank him for his continued work on this matter, no matter where he is sat. I give him my commitment that I share his determination for change, and I will continue to work with him. There is absolutely no place for poor-quality care for autistic people or anybody with a learning disability in our society. The system needs change.

I recently visited Norfolk to meet the families of those affected by the tragedy that occurred at Cawston Park Hospital, which was the subject of a previous Adjournment debate. I met the parents of the young people who suffered and sadly died and heard at first hand about the experience of people with autism and people with Down’s syndrome in health and care settings, and it was shocking. Such experience has too often fallen unacceptably short of the standard of care that individuals and families—those people who are the most vulnerable and often voiceless—should rightly expect. It is truly awful to hear about such appalling experiences.

We are taking action for children, young people and adults, for people who have been in-patients for longer than they should, and to prevent people from being admitted, even for a short time, when they do not need to be. I welcome this opportunity to set out the immediate and longer-term actions we are taking. They include our planned Mental Health Act reforms, which will provide the opportunity to change the legal framework and to reinforce and underpin the changes we are making now. I cannot commit today to a timetable for that, but the planning is well under way and I will keep my right hon. and learned Friend informed.

To keep people safe now, all autistic people and people with a learning disability must receive high-quality, safe care. That is our first priority. We know that some people may require support in a mental health hospital; when that is necessary, it should have a clear therapeutic benefit, be the least restrictive support possible, be close to home and be for the shortest possible time. We will not tolerate instances of abuse or poor-quality care.

To ensure that people are safe, all autistic people and people with a learning disability in an in-patient setting now receive a safe and wellbeing review. These reviews, which are led by NHS England, are a priority and the majority will be completed by the end of January. We also fully support the more robust approach that the CQC is taking in increasing the amount of shorter, unannounced inspections and closing hospitals that do not provide a high-quality standard of care.

My right hon. and learned Friend mentioned people who are in long-term segregation. There are about 100 of them and a couple of cases were mentioned in the debate. Every single one of them will receive independently chaired reviews of their care and treatment. The reviews will consider how to move towards a less restrictive or, ideally, community-based setting.

As part of a wider £31 million package to support discharge and develop community support, we have provided funding for a senior intervenors pilot. These independent experts will work to resolve blockages in the path to discharge, where there can be multidiscipline teams who basically do not agree or manage to find a solution among themselves. The senior intervenors will help to unblock things for those people in a long-term situation, and move them towards a less restrictive setting and back into the community, which is where we want people wherever possible.

My hon. Friend the Member for Broxtowe (Darren Henry) mentioned the need to build and make sure we have the right support in the community. The Government want to make sure that, wherever possible, autistic people and people with a learning disability are able to lead full lives in the community, close to their families, with the right support in place to prevent crisis.

In the NHS long-term plan we committed to reduce the number of autistic people and people with a learning disability who are in-patients in mental health hospitals by 50% by the end of March 2024. Since 2015, we have achieved a 29% reduction, which is equivalent to a reduction of around 800 in-patient beds—800 people—and means we need to close around 600 more to meet the target. I am firmly committed to achieving that.

The building the right support programme is our national policy to ensure that autistic people and people with a learning disability are supported in the community, and more than £90 million of additional funding for community services and support for discharges has been provided for 2021-22 to help to achieve that. Joint action across organisations and systems is essential to drive progress, so we are developing an action plan to outline the steps that we and all our partners will take to deliver that action with urgency, and we will publish it as soon as possible. We also know that early diagnosis is key, as the hon. Member for Strangford (Jim Shannon) mentioned, and that prevention and intervention at an early stage are vital, so we are investing £2.5 million to test and implement the most effective ways to reduce autism diagnosis waiting times for children and young people in England. Additionally, we are investing £600,000 in significantly expanding an autism early identification pilot to at least 100 schools over the next three years. Those actions and others set out in our all-age autism strategy, which was published in July, should make a big difference.

I want to touch on the subject of “do not attempt CPR” decisions, which hon. Members have mentioned. My right hon. and learned Friend the Member for South Swindon mentioned the culture; we are working to ensure that there is a culture of compassionate care for autistic people and people with a learning disability that is also of the highest quality. The Department has remained crystal clear that it is unacceptable for DNACPR decisions to be applied in a blanket fashion to any group of people.

We have also developed and trialled the Oliver McGowan mandatory training in learning disability and autism for all health and social care staff, working with Health Education England and Skills for Care. The programme is backed by a £1.4 million investment, and I think it will go a long way towards changing the culture.

We want to end inappropriate detentions for autistic people and people with a learning disability, and we are introducing once-in-a-generation reforms to the Mental Health Act that will be critical to achieving that. Under our proposed reforms, we will limit the scope to detain autistic people or people with a learning disability under section 3 of the Act. We want to prevent the detention under section 3 of people who do not have a co-occurring mental health condition; they simply have a learning disability.

We want to ensure that the right services are in place, allowing individuals to receive the best possible care in the community. Our proposed reforms will create new duties for commissioners to ensure an adequate supply of community services and ensure that every local area understands and monitors the risk of crisis at an individual level. This will transform our capability to provide those services in the community and to keep people safe in their community.

I thank all hon. Members for their contributions and thank my right hon. and learned Friend again for securing this vital debate. It is important that we continue to listen to people with lived experience and to their families, most importantly, in shaping and delivering high-quality care, both in in-patient settings, where they still exist, and in the community. Having heard some truly shocking experiences as Minister for Care and Mental Health, I am grateful that the debate has given us an opportunity to set out my personal commitment and to give a voice to those people who, for too long, have not had one.

In addition to the work that the Government are undertaking now and in the longer term, we must make sure that all autistic individuals and people with other lifelong conditions are treated with dignity and respect and are able to lead fulfilling lives in their community. I am absolutely determined to see that happen, and I look forward to working with my right hon. and learned Friend; I know that he is determined, too. There should never be an instance of people with a learning disability and autistic people being treated as anything less than equal in our society. He has my commitment that I will work with him to achieve that.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Before I put the Question, I am sure that the whole House will wish to join me in congratulating the right hon. and learned Member for South Swindon (Sir Robert Buckland) on his knighthood. [Hon. Members: “Hear, hear.”] Congratulations, Sir Robert—I see that we have quite a lot of Sir Roberts around.

Question put and agreed to.

Public Health

Baroness Laing of Elderslie Excerpts

Tuesday 14th December 2021 Commons Chamber

[Relevant documents: First Special Report of the Joint Committee on Statutory Instruments, Rule of Law Themes from COVID-19 Regulations, HC 600 and the Government Response, HC 774; Fourth Report of the Justice Committee, Covid-19 and the criminal law, HC 71.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

The Business of the House (Today) motion just agreed to by the House provides for the motions on the four statutory instruments on today’s Order Paper, each relating to public health, to be debated together until 6.30 pm. At the end of the debate, the Deputy Speaker will call the Minister to move each motion formally and will put the Question on each motion separately. I hope that that clarifies the situation for the House.

[The Secretary of State for Health and Social Care (Sajid Javid)]

I beg to move,

That the Health Protection (Coronavirus, Wearing of Face Coverings) (England) (Amendment) Regulations 2021 (SI, 2021, No. 1400), dated 9 December 2021, a copy of which was laid before this House on 9 December, be approved.

[Madam Deputy Speaker]

With this we will take the following motions:

That the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 6) Regulations 2021 (SI, 2021, No. 1415), dated 13 December 2021, a copy of which was laid before this House on 13 December, be approved.

That the Health Protection (Coronavirus, Restrictions) (Entry to Venues and Events) (England) Regulations 2021 (SI, 2021, No. 1416), dated 13 December 2021, a copy of which was laid before this House on 13 December, be approved.

That the draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) (No. 2) Regulations 2021, which were laid before this House on 9 November, be approved.

[Sajid Javid]

The covid-19 pandemic has caused upheaval across the world, forcing Governments everywhere to wrestle with how to keep their citizens safe while protecting the liberties that we all hold dear. We have learned a lot from our experience and the experience of others, and of course we are still learning. But we can take huge pride that thanks to the defences that we have built, so much of this year has been a year of recovery. We have enjoyed greater freedom than at any time during the pandemic so far. Thanks to the rapid progress of our vaccination programme, our investment in treatments and our decision to open up during the warmer summer months, we are in a far stronger position than we were last winter.

But even as I stood at this Dispatch Box back in July to announce the major milestone of taking step 4 in our road map, I said that

“we know that the greatest risk to the progress we have made is the possibility of another new variant, especially one that can escape immunity and puncture the protective wall of our vaccination programme”.—[Official Report, 12 July 2021; Vol. 699, c. 22.]

We have always known that variants have the potential to knock us off our course, and we have built the capacity to identify and respond to those that pose a threat.

The vast majority of new variants present no risk whatsoever. Since the summer, there have been hundreds of new variants, but only one of them—omicron—has been designated a variant of concern. For example, just last month, I updated the House from this Dispatch Box on AY.4.2, a new form of the delta variant, which preliminary analysis showed at that time might be more infectious. I said then that we would keep it under review, and that is what we did—and we took no action.

But omicron is a grave threat. We acted early to slow its spread, strengthening our testing regime and placing 11 countries on the travel red list, but despite those swift steps, the data over the past few days has shown more cause for concern. I would like to reinforce to the House today—to all hon. Members—why omicron represents such a risk to the progress that we have all made so far together.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Let us allow the Secretary of State to finish his speech. He has some important information to put before the House, and I now want to hear that information.

[Sajid Javid]

The settings to which this measure would apply include, of course, NHS hospitals, and GP and dental practices, regardless of whether a provider is publicly or privately funded. Anyone working in health or social care activities regulated by the Care Quality Commission will need to be vaccinated against covid-19 if their role will involve direct contact with patients, apart from a few limited exemptions—for example, for medical reasons. The definition of “fully vaccinated” is currently two doses, but we are keeping this under review, and of course I urge everyone who works in the NHS and social care to get their boosters too.

As we have just heard, concerns have been raised about the impact of the measures on the workforce, especially during these winter months, although even before the pandemic workplace policies were in place requiring the hepatitis B vaccine for those who have to perform certain clinical procedures. We are already allowing a 12-week grace period to give people the chance to make the positive choice to get protected, and we are aiming to start enforcing these requirements from 1 April next year—subject, of course, to the will of the House.

--- Later in debate ---

[Sajid Javid]

I must make progress. I am sorry.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The Secretary of State is right; he must make progress, as other people need to speak now. Please let us allow the Secretary of State to conclude his speech.

[Sajid Javid]

Thank you, Madam Deputy Speaker.

Today, the chief executive of NHS England has written to me, reinforcing the importance of getting the jab in the interests of patient and staff safety. I will be placing a copy of this letter in the Libraries of both Houses today. Despite the concerns that some people have raised, I am pleased to say that we have already seen a net increase of more than 55,000 NHS staff vaccinated with a first dose since we consulted on the policy in September.

Although I firmly believe that these measures are a proportionate way of protecting those at greatest risk, I know that hon. Members have questions about whether we would extend them further. Let me say clearly to the House today—once and for all—that although we have seen plans for universal mandatory vaccination in some countries in Europe, I will never support them in this country. I firmly believe that getting vaccinated should be a positive decision. I assure the House that the Government have no intention of extending the condition of deployment to any other workforces or of introducing mandatory vaccination more widely.

The regulations that we are debating today are not measures that any of us would like to be putting in place, but they are measures that the situation demands, because when the facts change, our response must change too. As we look ahead to a winter with omicron in our midst, the measures before the House today will fortify our national defences and guard the gains that we have all made against this deadly virus. I commend these regulations to the House.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Before I call the shadow Secretary of State, it might be helpful for the House to know there will be an immediate time limit of five minutes on Back-Bench speeches, which will reduce later in the afternoon.

--- Later in debate ---

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

In St Helens, 99% of care home staff are vaccinated, and at Whiston Hospital, the best one in the country, 91% have had the first vaccine, 89% the second vaccine and 64% the booster. That has all been done with persuasion, not with the threat of the sack. These people are in a vocation. It is not just a job to them; they believe in the patients. We must not get to the stage where we are threatening people. The GPs have even been involved in persuading the care home staff. Everyone has been involved for some considerable time and that is the way to do it—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Let me just make this clear: more than 40 people wish to speak this afternoon and if people make interventions, it is simply not fair on those at the end of the list who will be trying to speak later on. The hon. Lady is only one of many. The shadow Secretary of State is being very fair, as was the Secretary of State, in answering all the questions, but I must ask people to be reasonable.

[Wes Streeting]

It may have been a speech rather than an intervention, Madam Deputy Speaker, but I thought it was a very good one, and I welcome what my hon. Friend has said.

Children and Young People with Complex Needs

Baroness Laing of Elderslie Excerpts

Friday 10th December 2021 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

I took the hon. Gentleman’s raised eyebrows as an indication that he wished to raise a point of order before I adjourn the House. We could have had more time on the debate, so I gave him the opportunity to make the point. The Minister is at liberty to say whatever she wishes at the Dispatch Box—that is not a matter for me—but she may wish to respond to his point.

[Maggie Throup]

Further to that point of order, Madam Deputy Speaker. I promise to write to my hon. Friend on the specific issues that he raised and I will look into them very seriously.

--- Later in debate ---

[Sir Charles Walker]

Further to that point of order, Madam Deputy Speaker. I thank the Minister for that kind offer. It was not an attack on her—I think she is as disappointed as I am.

[Madam Deputy Speaker]

I appreciate the points that the hon. Gentleman and the Minister have made.

Question put and agreed to.

Adult Social Care

Baroness Laing of Elderslie Excerpts

Wednesday 1st December 2021 Commons Chamber

[Gillian Keegan]

My right hon. Friend is right that this is a start. It is a 10-year vision, and obviously we had a three-year spending review and the spending that we set out was a three-year spending settlement, so of course it is just a start.

On the steps to ensure that local authorities move to a fair rate and a fair cost of care, we are exploring a number of options, and we will set out further detail at the local government finance settlement later this year. Local authorities moving towards a fair rate of care is key to building a solid foundation for the future adult social care system, so we will be working closely with them to shape the best possible approach to implementation across different local markets. We will shortly be engaging with local authorities and providers, and we will publish further guidance in due course.

My right hon. Friend is absolutely right about the workforce. I have never worked in a business where the workforce was not key to anything that needed to be delivered, but in the care sector in particular, it is impossible to deliver anything without the workforce. It is also difficult to look at the workforce structure. As I say, it is the largest workforce in the country, with 1.54 million people working in it, but with 40% churn and very high amounts of zero-hours contracts and of retraining. I have never seen something that has that—[Interruption.] This has been the case for decades, and nobody has done anything to address it. [Interruption.] Nobody has done anything to address it. We do need to address it, and that is what we are here to do today, but—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Please do not shout at the Minister.

[Gillian Keegan]

Thank you, Madam Deputy Speaker. As was clear from their 13 years in Government, Labour Members are not interested in finding the answer, and they are certainly not interested in listening to my version of giving the answer.

Having 40% churn and such a high degree of insecurity in the workforce is not sustainable, so we need to fix that. We need to put the knowledge and skills frameworks in place. We need to invest in training and learning. We need to ensure it is captured and transferable. We need to have career routes that mean people can progress in the workforce. In my short time in the job, that has been immediately identifiable. The hon. Member for Sheffield, Heeley (Louise Haigh) and I worked on professionalising the social care workforce about four-and-a-half years ago, when we set up the all-party parliamentary group on social care. The issue has been recognised. It is not easy to fix. It is a large private sector. There is very large and increasing demand, but we are going to take the steps to fix it and the White Paper starts that process.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her statement, and for the progress that she is clearly trying to achieve.

Workforce availability for care homes is vital. Today a representative of a care home bordering my constituency rang to say that a quarter of its staff are off work owing to close covid contacts, although they are now treble-jabbed, and it has no more staff and a lack of agency staff to employ. What can be done through this strategy, Minister, to ensure that the recruitment and retention of care workers are improved?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I cannot believe that the hon. Gentleman said “Minister” again. I thought that he was beginning to get it, and that he would not make me unhappy any more!

[Jim Shannon]

I should have said “the hon. Lady”.

[Madam Deputy Speaker]

I thank the hon. Gentleman very much for that. I can say “Minister”; it is the hon. Gentleman who cannot. Minister!

[Gillian Keegan]

Thank you, Madam Deputy Speaker.

The hon. Gentleman has asked a good question. Dealing with covid is very challenging for many workforces, which is one of the reasons for our taking the difficult step of making vaccination a condition of deployment in this sector, and also offering the third dose—the booster—which many of those people have now had. It reduces the likelihood of transmitting or contracting covid, although it does not eliminate it altogether. The hon. Gentleman is right about the pressures on the workforce, which are increased by the need to manage covid in the case of residents and also people who are in their own homes. We have invested £162.5 million to help with those pressures in the short term.

--- Later in debate ---

[Gillian Keegan]

Yes of course. There are regional differences in care. There are lots of regional differences. There are differences in how much the care cap of £86,000 is worth, which is what I think my hon. Friend is concerned about. There are regional differences in how much people pay for care: it is much cheaper in various areas compared with the more expensive areas. I am asked why we will have a fixed sum of £86,000, and that is a good question. If we are looking at it as a percentage of assets, £86,000 will be different for different people, of course. The question was: why should we not base this on a percentage of assets? When I looked at the system we would have to build, I saw that it would be absolutely unworkable. It will be difficult to implement the cap anyway, because we will need a metering system that every council will have to operate for everyone who is paying for social care at different rates and different times. The system that we will have to build is very complex. Having a cap that will also enable us to talk to other players such as insurers, to see what other insurance products come forth, was considered the only implementable way.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I gently suggest to the Minister that the rule about facing the Chair when addressing the House is not just about courtesy and politeness—I know that she is the most courteous and polite person on the planet. It is also because if she is looking at someone who has asked a question, the microphone does not pick up her voice. I say this to everyone. That is why it is important to face this way; if she does so, she can be properly heard.

[Margaret Greenwood (Wirral West) (Lab)]

The Minister said that there was a lottery in how people paid for their care. There certainly is, and this is raised with me on a regular basis by my constituents. A quarter of Wirral adults with ongoing health needs were denied continuing healthcare over the summer, according to figures from NHS England. I think the Minister would agree that the CHC—continuing healthcare—system is unfair. Just at the very time when families need support, they often find themselves facing huge bills for care and having to consider selling the home of the person who needs care. Can she tell us what action she will take to ensure that no person has to sell their home to pay for their care, or was that just another hollow promise from the Prime Minister?

Covid-19 Update

Baroness Laing of Elderslie Excerpts

Friday 26th November 2021 Commons Chamber

[Sajid Javid]

Regardless of the news about this variant, the booster programme remains crucial. In fact, as I said earlier, it is even more important because of this news. My hon. Friend asked about whether the programme can be extended to lower age categories; as he knows, boosters were extended to the 40-to-49 age group on Monday, and the Joint Committee on Vaccination and Immunisation is already considering whether the programme can be extended further. I await its advice.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the Secretary of State for having come directly to the House this morning.

Health and Care Bill

Baroness Laing of Elderslie Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Dame Eleanor Laing)]

With this it will be convenient to discuss the following:

Government new clause 37—Offence of offering to carry out virginity testing: England and Wales.

Government new clause 38—Offence of aiding or abetting etc a person to carry out virginity testing: England and Wales.

Government new clause 39—Virginity testing offences in England and Wales: penalties.

Government new clause 40—Offence of virginity testing: Scotland.

Government new clause 41—Offence of offering to carry out virginity testing: Scotland.

Government new clause 42—Offence of aiding or abetting etc a person to carry out virginity testing: Scotland.

Government new clause 43—Virginity testing offences in Scotland: penalties and supplementary.

Government new clause 44—Offence of virginity testing: Northern Ireland.

Government new clause 45—Offence of offering to carry out virginity testing: Northern Ireland.

Government new clause 46—Offence of aiding or abetting etc a person to carry out virginity testing: Northern Ireland.

Government new clause 47—Virginity testing offences in Northern Ireland: penalties.

Government new clause 48—Virginity testing: consequential amendments.

New clause 1—Licensing of aesthetic non-surgical cosmetic procedures—

“(1) No person may carry on an activity to which this subsection applies—

(a) except under the authority of a licence for the purposes of this section, and

(b) other than in accordance with specified training.

(2) Subsection (1) applies to an activity relating to the provision of aesthetic non-surgical procedures which is specified for the purposes of the subsection by regulations made by the Secretary of State.

(3) A person commits an offence if that person contravenes subsection (1).

(4) The Secretary of State may by regulations make provision about licences and conditions for the purposes of this section.

(5) Before making regulations under this section, the Secretary of State must consult the representatives of any interests concerned which the Secretary of State considers appropriate.

(6) Regulations may, in particular—

(a) require a licensing authority not to grant a licence unless satisfied as to a matter specified in the regulations; and

(b) require a licensing authority to have regard, in deciding whether to grant a licence, to a matter specified in the regulations.”

This new clause gives the Secretary of State the power to introduce a licensing regime for aesthetic non-surgical cosmetic procedures and makes it an offence for someone to practise without a licence. The list of treatments, detailed conditions and training requirements would be set out in regulations after consultation with relevant stakeholders.

New clause 12—Protection of the title of “nurse”—

“(1) A person may not practise or carry on business under any name, style or title containing the word ‘nurse’ unless that person is registered with the Nursing and Midwifery Council and entered in sub part 1 or 2 of the register as a Registered Nurse or in the specialist community public health nursing part of the register.

(2) Subsection (1) does not prevent any use of the designation ‘veterinary nurse’, ‘dental nurse’ (for which see section 36K of the Dentists Act 1984) or ‘nursery nurse’.

(3) A person who contravenes subsection (1) is guilty of an offence and liable on summary conviction to a fine not exceeding level four on the standard scale.”

New clause 21—Prohibition of virginity testing—

“(1) A person is guilty of an offence if they attempt to establish that another person is a virgin by making physical contact with their genitalia.

(2) A person is guilty of an offence if they provide another person with a product intended for the purpose, or purported purpose, of establishing whether another person is a virgin.

(3) A person is guilty of an offence if they aid, abet, counsel or procure a person to establish that another person is a virgin by making physical contact with their genitalia.

(4) No offence is committed by an approved person who performs—

(a) a surgical operation on a person which is necessary for their physical or mental health; or

(b) a surgical operation on a female who is in any stage of labour, or has just given birth, for purposes connected with the labour or birth.

(5) The following are approved persons—

(a) in relation to an operation falling within subsection (4)(a), a registered medical practitioner; and

(b) in relation to an operation falling within subsection (5)(b), a registered medical practitioner, a registered midwife or a person undergoing a course of training with a view to becoming such a practitioner or midwife.

(6) There is also no offence committed by a person who—

(a) performs a surgical operation falling within subsection (4)(a) or (b) outside the United Kingdom; and

(b) in relation to such an operation exercises functions corresponding to those of an approved person.

(7) For the purpose of determining whether an operation is necessary for the mental health of a girl it is immaterial whether she or any other person believes that the operation is required as a matter of custom or ritual.

(8) This section applies to any act done outside the United Kingdom by a United Kingdom national or resident.

(9) A person who is guilty of an offence under this section is liable, on summary conviction, to imprisonment for a term not exceeding 12 months, to a fine, or to both.

(10) The court must refer the case of any person guilty of an offence under this section who is subject to statutory professional regulation for investigation by the relevant regulator.”

New clause 22—Prohibition of hymenoplasty—

2(1) A person is guilty of an offence if they undertake a surgical procedure for the purpose of re-attaching membrane tissue, creating scar tissue or otherwise attempting to re-create the hymen in the vagina of a patient.

(2) A person is guilty of an offence if they advertise the service of hymenoplasty or any service that purports to ‘re-virginise’ or otherwise re-create or re-attach the hymen of a patient by way of surgical procedure.

(3) A person is guilty of an offence if they aid, abet, counsel or procure a person to undertake a surgical procedure for the purpose of re-attaching membrane tissue, creating scar tissue or otherwise attempting to or re-creating the hymen in the vagina of a patient.

(4) This section applies to any act done outside the United Kingdom by a United Kingdom national or resident.

(5) A person who is guilty of an offence under this section is liable, on conviction, to imprisonment for a term not exceeding 5 years.

(6) The court must refer the case of any person guilty of an offence under this section who is subject to statutory professional regulation for investigation by the relevant regulator.”

New clause 28—Secretary of State’s duty to report on long term workforce planning—

“(1) The Secretary of State must prepare and publish a report each year on projected workforce shortages and future staffing requirements for health, public health and social care sectors in the following five, ten and twenty years.

(2) The report must report projections of both headcount and full-time equivalent for the total health, public health and care workforce in England and for each region, covering all regulated professions and including those working for voluntary and private providers of health and social care as well as the NHS.

(3) The projections must be independently verified and based on projected health and care needs of the population for the following 5, 10 and 20 years, consistent with the Office for Budget Responsibility long-term fiscal projections.

(4) All relevant NHS bodies, arm’s-length bodies, expert bodies, trade unions and the Social Partnership forum must be consulted in the preparation of the report.

(5) The assumptions underpinning the projections must be published at the same time as the report and must meet the relevant standards set out in the National Statistics Authority’s Code of Practice for Statistics.

(6) The Secretary of State must update Parliament each year on the Government’s strategy to deliver and fund the long-term workforce projections.”

New clause 29—Duty on the Secretary of State to report on workforce planning and safe staffing—

“(1) At least every five years the Secretary of State must lay before Parliament a health and care workforce strategy for workforce planning and safe staffing supply.

(2) This strategy must include—

(a) actions to ensure the health and care workforce meets the numbers and skill-mix required to meet workforce requirements,

(b) equality impact assessments for planned action for both workforce and population,

(c) application of lessons learnt from formal reviews and commissions concerning safety incidents,

(d) measures to promote retention, recruitment, remuneration and supply of the workforce, and

(e) due regard for and the promotion of workplace health and safety, including provision of safety equipment and clear mechanisms for staff to raise concerns.”

Amendment 10, in clause 34, page 42, line 12, leave out from beginning to the end of line 17 and insert—

“(1) The Secretary of State must, at least once every two years, lay a report before Parliament describing the system in place for assessing and meeting the workforce needs of the health, social care and public health services in England.

(2) This report must include—

(a) an independently verified assessment of health, social care and public health workforce numbers, current at the time of publication, and the projected workforce supply for the following five, ten and 20 years; and

(b) an independently verified assessment of future health, social care and public health workforce numbers based on the projected health and care needs of the population for the following five, ten and 20 years, consistent with the Office for Budget Responsibility long-term fiscal projections.

(3) NHS England and Health Education England must assist in the preparation of a report under this section.

(4) The organisations listed in subsection (3) must consult health and care employers, providers, trade unions, Royal Colleges, universities and any other persons deemed necessary for the preparation of this report, taking full account of workforce intelligence, evidence and plans provided by local organisations and partners of integrated care boards.”

This amendment would require the Government to publish independently verified assessments every two years of current and future workforce numbers required to deliver care to the population in England, based on the economic projections made by the Office for Budget Responsibility, projected demographic changes, the prevalence of different health conditions and the likely impact of technology.

Amendment 40, in clause 108, page 96, line 9, leave out subsection (2) and insert—

“(2) In this Part ‘protected material’ means—

(a) all statements taken from persons by the HSSIB during a safety investigation or in the course of deciding whether an incident is going to be subject to an HSSIB investigation,

(b) records revealing the identity of persons who have given evidence in the context of the safety investigation,

(c) information that has been collected by the HSSIB which is of a particularly sensitive and personal nature, such as (but not limited to) copies taken by the HSSIB of health records, care records, clinical notes, or personnel records,

(d) material subsequently produced during the course of an HSSIB investigation such as (but not limited to) notes, drafts and opinions written by the investigators, or opinions expressed in the analysis of information obtained through the investigation,

(e) drafts of preliminary or final reports or interim reports, and

(f) information that would be subject to legally enforceable commercial privileges.”

This amendment would define more closely the materials covered by the “safe space” protection provided for by the Bill.

Amendment 41, page 96, line 32, leave out

“information, document, equipment or other item held by that individual”

and insert “protected material”.

This amendment is consequential on Amendment 40.

Amendment 43, in clause 109, page 96, line 43, leave out from “Part” to end of line 24 on page 97.

This amendment would remove the ability of the Secretary of State to make regulations authorising disclosure of protected material beyond that provided for in the Bill.

Amendment 74, page 101, line 1, leave out clause 115.

Government amendments 24 and 127.

Amendment 57, page 110, line 11, leave out clause 127.

This amendment seeks to ensure that a profession currently regulated cannot be removed from statutory regulation and that regulatory bodies cannot be abolished.

Government amendments 86 and 87.

Government new schedule 1—Virginity testing: consequential amendments.

Government amendment 88.

Amendment 42, in schedule 14, page 218, line 30, leave out paragraph 6.

This amendment would remove the provision allowing coroners to require the disclosure of protected material.

[Edward Argar]

This broad group of amendments concern improving patient safety and the quality of health and care services, both of which are a priority for this Government. For that reason, this Bill will put the Health Services Safety Investigations Body on a statutory footing. The HSSIB will be one of the first independent healthcare bodies of its kind, leading the way in investigating for the purpose of learning, not blaming. For the HSSIB to be able to perform this “no-blame” role, the integrity of safe space is paramount. I look forward to contributions from right hon. and hon. Members from both sides of the House, recognising the depth of expertise, particularly that residing in the hon. Member for Central Ayrshire (Dr Whitford), on how best to make safe space work. As we discussed extensively in Committee, we recognise that ultimately this comes down to: what is the appropriate balance to be struck? Different views are likely to be aired again today.

Within this group, I will also address amendments brought forward by colleagues, including my right hon. Friend the Member for South West Surrey (Jeremy Hunt), on the health and social care workforce. Ensuring we have the workforce this country needs will, in the short-term, tackle the elective backlog. Crucially, in the long-term, as we build back better, it will help to reduce damaging health inequalities. For those reasons, I will later speak in more detail about this Government’s plans on the workforce, some of which of course are already in motion. I hope I can reassure the House that the provisions already made in this Bill, alongside the Government amendments I am about to discuss, do go sufficiently far to address these important issues.

I will begin by addressing new clauses 36 to 48, new schedule 1 and amendments 86 and 87, which comprise the package of Government amendments to prohibit virginity testing in the UK. I offer my deepest thanks to my hon. Friend the Member for North West Durham (Mr Holden) for his tireless efforts in proposing these amendments originally and in supporting the Government in proposing our variations on them, which we believe achieve the right balance—I will turn to that in a moment—as we bring forward this ban.

I should also put on the record my gratitude to the Opposition Front-Bench team for their constructive engagement on this issue, which does not divide us on party political lines but is about doing the right thing. I am grateful to the shadow Ministers on the Opposition Front Bench: the hon. Members for Ellesmere Port and Neston (Justin Madders) and for Nottingham North (Alex Norris).

In July, the Government promised in our violence against women and girls strategy that virginity testing will not be tolerated in the UK and will be banned at the earliest opportunity, so I am delighted that we are introducing amendments that demonstrate the strength of our commitment to the removal of all forms of abuse against women and girls. Our amendments will create three offences: conducting a virginity test; offering virginity testing; and aiding or abetting another person to conduct a virginity test in the UK or on UK nationals overseas. Each offence will carry a maximum penalty of five years’ imprisonment and/or an unlimited fine. This sentencing reflects the long-term physical and psychological damage that this repressive practice can cause.

The offences begin to tackle the harmful misconceptions that surround a woman’s sexuality. This House’s commitment to legislate is a profoundly important step forward in helping to tackle the damaging myths concerning the so-called purity of women’s sexuality. In response to concerns that, once the offence is banned in the UK, vulnerable women and girls will be taken abroad and subjected to virginity testing there, the offences will carry extraterritorial jurisdiction.

The proposals have been discussed by Health Ministers throughout the UK, including in the devolved Administrations, and I am working with them to ensure that the whole of the UK together tackles this abhorrent practice. I put on record my gratitude to the devolved Administrations for the constructive manner in which they have engaged on the issue. I hope that the House will pass the amendments today and allow us to take another step forward in our shared endeavour and important work on safeguarding and improving the lives of women and girls throughout the United Kingdom.

Let me turn briefly to new clause 21, tabled by my hon. Friend the Member for North West Durham—I thank him again for doing so. I hope that what I have said will reassure him and the rest of the House that the package of Government amendments that I have just discussed go further to protect women and girls from this form of abuse and are the most effective vehicle by which we can achieve what we seek to do. Our package of amendments set out that the conducting, offering or aiding of a virginity test is simply indefensible. The amendments ensure that victims are protected on our shores and abroad and that the sentencing of those convicted reflects the detrimental physical and psychological impacts of the practice. I therefore hope that my hon. Friend will feel able not to press his new clause to a vote and instead to support our amendments. I am incredibly grateful to him—as, I am sure, is the House—for his campaigning vigour on this issue.

My hon. Friend also tabled new clause 22, which seeks to ban the practice of hymenoplasty. The Government remain concerned that hymenoplasty is also driven by a repressive approach to female sexuality and is closely related to virginity testing, which we have made clear today is not an acceptable practice in the United Kingdom or elsewhere. We announced in the violence against women and girls strategy that we would set up an independent expert panel to explore the complex clinical, legal and ethical aspects of the procedure in more detail. The panel, which includes key stakeholders with ethical and clinical expertise, has already met and will shortly make its recommendations to Ministers, before Christmas. It is crucial that, having asked the panel to contribute, we carefully consider its views before we make a firm decision to ban hymenoplasty. However, I assure the House that although we cannot accept the new clause today because we await the recommendations of the review panel, we will of course fully reassess our position as soon as the panel makes its recommendations.

If we are to ensure patient safety and quality of care, it is vital that we have the workforce in place to deliver it. That is a priority for the Government and I reassure the House that we are taking the necessary steps to secure the workforce of the health and social care sector. Members throughout the House would all agree that although investment in technology, in new hospitals and buildings, in therapeutics and in kit are all phenomenally important, the golden thread that makes that investment valuable is the workforce—the people who always go above and beyond, particularly in the past 18 months, to make that equipment more than just a shiny piece of kit but something that actually saves lives. They are absolutely the heart of what we are doing.

Health and Care Bill

Baroness Laing of Elderslie Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Matt Hancock (West Suffolk) (Con)]

I support new clause 49 because I support the action that is needed to make reforms to social care that are long overdue. I have listened carefully to the debate, and it is vital that we understand that the new clause would deliver one part, but not the whole, of the package that was set out by the Government in September. There is no doubt whatever that that package, as a whole, improves the provision of social care, makes the way it is paid for fairer, and removes some injustices that have existed in the system for far too long.

First, the proposal that has been put forward—and I think it is the right proposal—is for a cap on the costs that individuals face in paying for their care. The contributions from the state, even if they are from another part of the state such as local government, are not individuals’ care costs, and it is therefore wrong that they should be contributions towards the cap. The cap has the stated goal of being a cap on the cost of care to an individual, not a cap on the cost that accrues to both the individual and a local authority.

Let us look at what would happen if the new clause were not passed. The provision of care by local authorities is different in different areas, largely according to how well off those local authorities are. A richer council that pays more costs than the statutory minimum as set out in the Care Act 2014 would help local residents to meet the cap sooner than a poorer council that pays only the statutory minimum of care costs, and therefore people who live in poorer areas would take longer to reach the cap, so we would end up, in effect, with a postcode lottery cap meaning that people from poorer areas would tend to have to contribute more. That is wrong, and I am very glad that it is put right by the proposals that are before us today.

Secondly, for those with lower asset values, the rise in the floor in the means test is more important. It is the rise in that floor that makes this system fair. When the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), read out a long list of places with low asset values on average—places where house prices tend to be lower—he listed exactly the areas that will benefit most from the rise in the floor. [Interruption.] We can see what Labour Members are doing. [Interruption.] They are taking a narrow area, and they are taking a specific detail, and they are ignoring all the parts of the package that benefit the people who will benefit from this package as a whole. [Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. We will not get anywhere if people shout. This is supposed to be a reasonable discussion.

[Matt Hancock]

Thank you, Madam Deputy Speaker.

A further point that is being ignored by those who are trying to make a meal of this new clause is that the cutting of the daily cost offset is much more valuable to those on low incomes than any change in the cap, because the cap, by its nature, is there to protect assets, and those who do not have many assets gain far more benefit from the cut in the daily cost that would otherwise clock up their contributions to the cap much more slowly.

Taken together, these elements make up a package that is beneficial to those on low incomes. It helps to make the system fairer.

My final point on new clause 49 is this. For years and years—including the years when I was Secretary of State, and including the entire 13 years when Labour was in power—nobody fixed the problem of social care. This Government have come forward with a package, and if we pull apart one part of the package, there is a risk to the package as a whole. As Sir Andrew Dilnot said on the radio this morning,

“the whole package is a significant step forward”.

It is always easy in politics, and in life, to say, “I just accept the bits of the package that I like”—and, in the case of the Labour party, to say, “I accept the bits that are very expensive for taxpayers.” Instead, we must look at the package as a whole, which is funded, and which can be delivered, for the first time in several decades, because it hangs together. The Government have presented a whole package, and it is the best possible option in the fiscally constrained times in which we live.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. It will be obvious to the House that a lot of people wish to speak and that there are a lot of amendments still to be spoken to. We have only an hour left, so I am going to impose a time limit of four minutes immediately. I apologise to the hon. Member for Bootle (Peter Dowd) for not giving him notice that he would have only four minutes, but I am sure that he will manage.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

I am going to reduce the time limit to three minutes in the hope that as many people as possible can get in.

--- Later in debate ---

[Several hon. Members rose—]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Members will appreciate that I have had to give precedence to people who have amendments in their names on the Order Paper, so not everyone else will have a chance to speak this evening.

[Apsana Begum (Poplar and Limehouse) (Lab)]

In the interests of time, I will just speak to my amendment 99 and new clause 57 tabled by my hon. Friend the Member for Streatham (Bell Ribeiro-Addy).

The Government often talk the talk on health inequalities but fail to walk the walk. New clause 57 sets out a requirement that NHS England must publish guidance in relation to health inequalities, which I wholeheartedly support. My amendment 99 seeks to put in provisions to reduce inequalities between non-migrant and migrant users of health services. Campaigners and experts have argued that the pandemic has shown more tangible action is needed to tackle health inequalities. The increased risks of those on lower incomes and black, Asian and minority ethnic communities catching and dying from covid-19 have been well documented, yet the provisions outlined in the Bill will likely make the situation much worse.

--- Later in debate ---

The Deputy Speaker put forthwith the Questions necessary for the disposal of the business to be concluded at that time (Standing Order No. 83E).

[Madam Deputy Speaker (Dame Eleanor Laing)]

Amendment 102 has been selected for separate decision. I call Mrs Maria Miller to move the amendment formally.

The right hon. Lady is not here, but I understand that the Minister can move the amendment formally.

Clause 19

General functions

Amendment made: 102, in page 21, line 25, at end insert—

“(c) set out any steps that the integrated care board proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).”—(Edward Argar.)

This amendment requires the joint forward plan for an integrated care board and its partners to set out any steps it proposes to take to address the particular needs of victims of abuse (including domestic abuse and sexual abuse, whether of children or adults).

[Madam Deputy Speaker]

There is great excitement on the other side of the House, but there is no doubt about the procedure. As the Minister had already indicated his intention to accept amendment 102, it was perfectly in order for him to move it.



Clause 25

Care Quality Commission reviews etc of integrated care system

Amendment made: 114, page 37, line 27, at end insert—

“(2A) The priorities set by the Secretary of State under subsection (2)(a) must include priorities relating to leadership, the integration of services and the quality and safety of services.”—(Jeremy Hunt.)

The Secretary of State has the function of setting priorities for the Care Quality Commission in carrying out assessments in relation to integrated care systems. This amendment requires the Secretary of State to set priorities relating to certain matters.

Clause 69

Procurement regulations

Amendment proposed: 72, in page 64, line 1, at end insert—

“(3A) The regulations must make provision in relation to the procurement of the services referred to in paragraph (1)(a) (other than primary medical services, primary dental services and primary ophthalmology services) that before any contract for a service with an annual value in excess of £5m may be awarded to an organisation that is not an NHS trust or NHS foundation trust—

(a) the business case for the award of the contract must be published;

(b) any responses to the proposal in the business case must be considered and published;

(c) the process for awarding the contract must be open and transparent and non-discriminatory at every stage, including (but not limited to)—

(i) procurement strategy and plan,

(ii) invitation to tender,

(iii) responses to invitations,

(iv) evaluation of tenders,

(v) decision to award, and

(vi) contract awarded;

(d) the process for awarding the contract must demonstrate due regard to the principles established in the Public Contracts Regulations 2015 (S.I.2015/102) or any regulations which may supersede them;

(e) in any case where it is claimed that an emergency justifies an award without the process being used then the responsible body must within 14 days publish the business case for the award of the contract and the record of the decision.”—(Justin Madders.)

Question put, That the amendment be made.

Randox Covid Contracts

Baroness Laing of Elderslie Excerpts

Wednesday 17th November 2021 Commons Chamber

[Alexander Stafford]

I am just surprised that the Opposition Benches are empty for an Opposition day debate when so many people claim that they want to discuss the issue. It is your debate. Perhaps you could explain where your Back Benchers are? I am intrigued because your side called it. Do they really care?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Now that the hon. Gentleman has properly intervened and addressed the House not from a sedentary position, I can officially hear him, and I will just make it clear that he should not say “you”. The substance of what he says is not a matter for me, but he should not say “you”.

[Alexander Stafford]

Apologies, Madam Deputy Speaker.

[Madam Deputy Speaker]

We have had quite a lot of that today, including during Prime Minister’s questions. Just do not do it. Let us try to keep to the rules.

[Tony Lloyd]

Quite right, Madam Deputy Speaker. In fact, had you not said that, I would have defended you, in that it is certainly not your debate, except in so far as it belongs to the House and, importantly, to the country, because that is what matters in this issue. It matters that the public have an opportunity to know what went on during this whole saga.

I want to talk briefly about the VIP fast-track situation. In November 2020, I approached Health Ministers about a constituent’s company, Jones & Brooks, which is a printing company that has printed extensively for the national health service. This was at the same time as the VIP fast-track structure was coming in. So good was the VIP fast-track structure for me as an Opposition Member of Parliament that it took me until, I think, July this year to get a proper response, and that was only when I insisted on meeting the Minister for Health, the hon. Member for Charnwood (Edward Argar). To give him credit, once this was brought firmly to his attention—I had done it many times—I got an answer. It was the answer I did not want: my constituent’s company did not get any joy from that exchange. However, what a world of difference there is between companies that can talk to Ministers, be put on a VIP fast track and have the opportunity to be awarded contracts—with or without proper surveillance by those in charge—and those, as in the case of my company, that are given no such consideration.

The Minister for Care and Mental Health has to take that on board because procurement does matter. The opportunity for people to engage in the procurement process matters, because one of the many ways of tilting the weighing scales of life is simply not to allow people even to be in the bidding process. That does matter, and it is the difference between those on the VIP structure and those such as Jones & Brooks and my constituent Ronnie Blair, who were not even allowed to get to the starting blocks. It does matter, because that is actually low-level corruption.

Ronnie Blair, the managing director of Jones & Brooks, offered me no money, and I would not have taken any money anyway. Maybe that is where it goes wrong: if there is no money changing hands, maybe it does not oil the wheels of procurement. That is an outrageous thing for me to say, and it would be much worse were it true. However, it is true, because we know that Owen Paterson was paid, we know that Owen Paterson broke the lobbying rules and we know that Owen Paterson got access to Ministers, but we do not know what difference getting that access to Ministers made. That is the missing link in this whole sad jigsaw. There are so many things we do not know.

Yes, I welcome the fact that the Prime Minister has now moved a long way on this issue. I welcome the fact that the Prime Minister, who two weeks ago was trying to cover up this scandal and this saga of corruption, is now in favour of openness. That is good. The Minister told us earlier that the Government would not vote against the Opposition motion today, and again that is genuine process. However, you—not you, Madam Deputy Speaker, but the Government—are in the slow learner’s lane on this. The public want to see real alacrity, real commitment and belief that things are going to be sorted out, because we have to get to the bottom of this.

The issue of the noble Lord Bethell is now central. We know that Randox was awarded huge sums of public money—half a billion pounds of public money, which is an enormous amount of money. That may or may not be legitimate vis-à-vis the crisis we faced, but we do know that it failed, with 750,000 tests, to deliver a product that actually worked. That is enormously important, and it is enormously important to know why, after that experience, we saw another contract being awarded to the same company, which could not do the work.

That matters, and the public need reassurance that that was not as a result of the weighing scales of life being altered unfairly in Randox’s favour. In the end, we are not talking about something trivial; we are talking about public safety and, in the case of covid, public life and death. The wrong tests could give results that led to people dying, so again this is not a trivial matter that we can simply sweep under the carpet, as other hon. Members have said.

The position of noble Lord Bethell is fundamental on this. The Minister told me that she did not know whether his phone calls were minuted by departmental officials. If they were not, that is outrageous. Being in a crisis is no excuse. There was no crisis in the Minister’s office and there was no crisis meaning that a civil servant could not be on the phone call, and that is simply the way things ought to have been done. We need to know whether those calls were minuted. If any call was not minuted, there is a real problem, because we do not know what other calls the noble Lord Bethell engaged in. That matters because there may be some things we shall never know from a noble Lord who is so, shall we say, casual in his acquaintanceship with his telephone. [Laughter.] It really does matter, because while I am grateful to my hon. Friends for laughing, it would be funny if it were not so serious.

The questions that the noble Lord Bethell has to answer are those that the Government have to answer. It is good that the Minister is committed to ensuring that the scope is properly identified, and I welcome what she said. The motion before the House defines that scope, but the commitment that the Government will honour it is fundamental, and if it is not discharged, that would be outrageous. If it is not honoured that will probably not be the Minister’s decision, but I hope she will take back the message that her reputation is sullied if others refuse to allow this investigation process to be completed.

We have to know what took place. The only way we can give the public confidence in our public life, in politicians, and in public procurement, is if they have a guarantee that when things go right they really have gone right, and that when they go wrong, we will dig and dig until we see what went wrong. We must ensure that those responsible are no longer in that position, and that as far as we can prevent them, such things will never happen again. This situation matters. It is about public money—enormous amounts of public money—but in the end, it is about public wellbeing, life and death.

I suffered from covid. I was in hospital from covid. I saw doctors, nurses and hospital staff of all kinds coming forward when I had covid, and taking the risk that, without proper PPE at the time, I would give it to them. That was early in the whole process, and we may come to the conclusion that such risk was unavoidable. I am very grateful to those who treated me and saved my life, but I am concerned that nobody else should have lost their life because of a dodgy procurement contract. That is why this matters. We have to know.

--- Later in debate ---

[Maggie Throup]

I reiterate that Arco was awarded contracts for PPE.

Of course, that does not mean there are no lessons to be learned, and I can reassure the hon. Member for Blackburn (Kate Hollern) that the public inquiry will be an important learning moment for us all. We are already making changes: we published our procurement Green Paper last December, we updated our commercial guidance on the management of actual and perceived conflicts of interest in May, and we are implementing the recommendations from the first and second Boardman reviews into improving procurement.

The real lessons, however, are just what we can achieve when we all get behind a shared mission, to protect the British people and to protect the NHS. That is a mission-driven way of working that has seen us work beyond the traditional boundaries and achieve remarkable results. We have tested millions of people for covid-19 and kept millions more safe. I am very proud of that, and so too, I believe, are the British people.

Question put and agreed to.

Resolved,

That an Humble Address be presented to Her Majesty, that she will be graciously pleased to give directions that there be laid before this House the minutes from or any notes of the meeting of 9 April 2020 between Lord Bethell, Owen Paterson and Randox representatives, and all correspondence, including submissions and electronic communications, addressed or copied to, or written by or on behalf of, any or all of the following:

(a) a Minister or former Minister of the Crown,

(b) a Special Adviser of such a Minister or former Minister, or

(c) a Member or former Member of this House

relating to the Government contracts for services provided by medical laboratories, awarded to Randox Laboratories Ltd. by the Department for Health and Social Care, reference tender_237869/856165 and CF-0053400D0O000000rwimUAA1, valued at £133,000,000 and £334,300,000-£346,500,000 respectively.

Royal Assent

[Madam Deputy Speaker (Dame Eleanor Laing)]

I have to notify the House, in accordance with the Royal Assent Act 1967, that Her Majesty has signified her Royal Assent to the following Acts:

Telecommunications (Security) Act 2021

Social Security (Up-rating of Benefits) Act 2021.

Autism and Neurodiversity Research Funding

Baroness Laing of Elderslie Excerpts

Tuesday 16th November 2021 Commons Chamber

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I did not correct the right hon. Gentleman the first time, but it is essential that he faces the Chair rather than the right hon. and learned Member for South Swindon (Robert Buckland), because he cannot be heard if he is speaking to the back of the Chamber. I never understand why, when there is all this space, people want to sit where the occupant of the Chair cannot see them. There must be a reason for it.

[Greg Clark]

I will address you directly, Madam Deputy Speaker. I accept your ruling on that.

One problem people with autism sometimes face is that, when they come to an age where they are looking for jobs, work experience is increasingly important and some employers are reluctant, based on lack of familiarity and nervousness, to give work experience opportunities to young people with autism and other conditions. Work experience is an essential gateway to employment. Will my right hon. and learned Friend join me in encouraging employers to open up and give work experience opportunities to a wider range of young people?