Covid-19 Vaccine Update

Baroness Laing of Elderslie Excerpts

Thursday 4th February 2021 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Nadhim Zahawi)]

With permission, I would like to make a statement on coronavirus, but before I do that I wish my shadow opposite number, the hon. Member for Nottingham North (Alex Norris), a happy birthday.

Our nation is getting safer every day as more and more people get protected by the biggest immunisation programme in the history of our health service. More than 10 million people have now received their first dose of one of our coronavirus vaccines. That is almost one in five adults in the United Kingdom. We are vaccinating at scale, while at the same time retaining a close focus on the most vulnerable in our society to make sure those at greater need are at the front of the queue.

I am pleased to inform the House that in the UK we have now vaccinated almost nine in 10 over-80s, almost nine in 10 over-75s and more than half of people in their 70s. We have also visited every eligible care home possible with older residents in England and offered vaccinations to all their residents and staff. That means we are currently on track to meet our target of offering a vaccine to the four most vulnerable groups by mid-February.

That is an incredible effort that has drawn on the hard work of so many, and I want to just take a moment to thank every single person who has made this happen: the hundreds of thousands of volunteers up and down the country, the scientists, our colleagues in the NHS—the GPs, the doctors, the nurses and the vaccinators—those in social care, the manufacturers, the local authorities, the armed forces, the civil servants who work night and day to make this deployment possible, and anyone else who has played a part in this hugely logistical endeavour. It really is a combination of the best of the United Kingdom. At our time of national need, you have given us a big boost in our fight against this deadly virus, which remains a big threat to us all.

There are still more than 32,000 covid patients in hospital, and the level of infection is still alarmingly high, so we must all stay vigilant and keep our resolve while we keep expanding our vaccination programme, so that we can get more people protected even more quickly. We have an ambitious plan to do that. We are boosting our supply of vaccines and our portfolio now stands at more than 400 million doses, some of which will be manufactured in the United Kingdom, and we are opening more vaccination sites, too. I am pleased to inform the House that 39 new sites have opened their doors this week, along with 62 more pharmacy-led sites. That includes a church in Worcester, Selhurst Park—the home of Crystal Palace football club—and a fire station in Basingstoke, supported by firefighters and support staff from Hampshire Fire and Rescue Service.

One of the greatest pleasures for me over the past few months has been seeing the wide range of vaccination sites that have been set up right in the heart of our local communities. Cinemas, mosques, food courts and so many other institutions have now been transformed into life-saving facilities, giving hope to people every day. Thanks to that rapid expansion, we have now established major national infrastructure. There are now 89 large vaccination centres and 194 sites run by high street pharmacies, along with 1,000 GP-led services and more than 250 hospital hubs. Today’s announcement will mean that even more people will live close to a major vaccination site, so we can make vaccinating the most vulnerable even quicker and even simpler.

We have always believed in the power of science and ingenuity to get us through this crisis, and I was pleased earlier this week to see compelling findings in The Lancet medical journal, reinforcing the effectiveness of our Oxford-AstraZeneca vaccine. It showed that the vaccine provides sustained protection of 76% during the 12-week interval between the first and second dose, and that the vaccine seems likely to reduce transmission to others by two thirds. That is really great news for us all, but we will not rest on our laurels.

No one is really safe until the whole world is safe. Our scientific pioneers will keep innovating, so that we can help the whole world in our collective fight against this virus. I saw how wonderful and powerful this ingenuity could be when I was one of thousands of volunteers who took part in the Novavax clinical trial, which published very promising results a few days ago. Today, I am pleased to announce another clinical trial—a world-first study that will help to cement the UK’s position as a global hub for vaccination research. This trial will look at whether different vaccines can be safely used for a two-dose regime in the future to support a more flexible programme of immunisation. I want to reinforce that this is a year-long study, and there are no current plans to change our existing vaccination programme, which will continue to use the same doses. But it will perform a vital role, helping the world to understand whether different vaccines can be safely used. Our scientists have played a pivotal part in our response to this deadly virus, and once again they are leading the way, helping us to learn more about this virus and how we should respond.

It has been heart-warming to see how excited so many people have been to get their vaccine and to see the work taking place in local communities to encourage people to come forward to get their jab. Hon. Members have an important role to play too. I was heartened to see colleagues from both sides of the House coming together to encourage take-up within minority ethnic communities through two joint videos posted on social media last week. As the video rightly says, “MPs don’t agree all the time, but on taking the vaccination, we do.” I could not agree more, and I am grateful to every single Member who has come forward to support this national effort. We want to make it as easy as possible for colleagues to do so. This week, we published a new resource for Members that provides more information on the vaccine roll-out and what colleagues can do to increase the take-up of the vaccine in their constituencies. That is an extremely valuable resource, and I urge all Members to take a look at it and think about what they can do in their constituencies.

Our vaccination programme is our way out of this pandemic. Even though the programme is accelerating rapidly and, as the chief medical officer said yesterday, we appear to be past the peak, this remains a deadly virus, and it will take time for the impact of vaccinations to be felt. So for now, we must all stand firm and keep following the steps that we know make a big difference until the science can make us safe. I commend this statement to the House.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Happy birthday to the hon. Member for Nottingham North (Alex Norris).

--- Later in debate ---

[Nadhim Zahawi]

I am grateful to the hon. Lady for her question. We will do so in a couple of ways. First, once we have enough vaccine supply to be able to offer the vaccine to every adult in the United Kingdom—every eligible group from 1 to 9 and then phase 2—we will then look at our vaccine supply strategy. At the moment, we are nowhere near having enough supply to be able to make that offer. That has to be our priority. She mentions COVAX, but that is only part of the story for us in the United Kingdom. We have put about £450 million-plus into COVAX, but a total of £1.3 billion into the vaccine initiative of GAVI, the Vaccine Alliance. We are, I think, the largest donor, not only in money but per capita. We are making a big, big impact globally in both research and development, and vaccinations to low and middle-income countries.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I appreciate that colleagues have complicated questions to ask the Minister and that the answers are therefore also complicated, but I must ask for a bit more speed now, because we have taken an hour. I should stop proceedings on this item of business, but I will not do so because I appreciate that there are important questions to be asked. I urge Members to go just a little faster.

[John Howell (Henley) (Con) [V]]

First, let me offer my congratulations to the Minister on achieving more than 10 million vaccinations. I wonder whether he will comment on how soon I will be able to wander down to my local chemist to get a jab, as I did for flu.

--- Later in debate ---

[Nadhim Zahawi]

I am grateful for my hon. Friend’s excellent, thoughtful suggestion. I will certainly take that away and discuss it with the Minister responsible in the Department.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Thank you. We have covered a lot of ground. I will now suspend the House for three minutes, so that the Chamber can be prepared for the next item of business.

National Security and Investment Bill

Baroness Laing of Elderslie Excerpts

Report stage & 3rd reading & 3rd reading: House of Commons & Report stage: House of Commons
Wednesday 20th January 2021 Commons Chamber

[Mr Kevan Jones (North Durham) (Lab)]

I supported the Bill on Second Reading and continue to do so, because, of course, in terms of putting on the statute book the protection that we need, it is a vital piece of legislation, but, as the right hon. Member for New Forest East (Dr Lewis) said, it is possibly some seven years late. That highlights the conflict that takes place within not just this Government, but all Governments, between wanting national prosperity and national security. We had this during the coalition Government—the hon. Member for Tonbridge and Malling (Tom Tugendhat), I think, referred to it as the “golden age”, or, as the Australians would call it “a Government full of panda huggers”—but that has clearly changed. What has also changed since even 2013 is that we have a better understanding of how states are using their economic power not only for defence purposes, but to project their power to change the international world order.

It has come as a great shock to many people that, in the past few years, the international rules-based order, which we have all accepted since the second world war, has come under threat not only from hostile states, but from individuals who basically want to throw everything up in the air and see what lands.

Clearly, when it comes to China, to mention one nation, its investment strategy, including belt and road and other initiatives, is clearly being used not just in terms of projecting its economic power, but for geopolitical reasons. If we look at the long list of Chinese individuals on various standard-raising bodies—whether it be UN bodies or standard setters in the telecoms industry—we can see which areas they want to influence. The Bill is very important in ensuring that we protect that critical national infrastructure. There will be that debate—as Members will see if they read the ISC’s report, in 2013—between prosperity and security. For me, security has got to be the key cornerstone of this legislation, but it will, I think, lead to some very difficult decisions having to be taken.

As I say, I broadly welcome what is being put forward in this Bill, and I will come on to some of the new clauses in a minute, but can I first refer to new clause 7? It has already been spoken to by the Chair of the ISC, the right hon. Member for New Forest East, in terms of oversight. The ISC is not looking for work, I can tell hon. Members that. I have been a member of it for a few years now, and we have a lot on our plate. We do not actually want to be a regulator or in any way to have to decide what should go ahead and what should not—that is the role of Government—but I think it is crucial that those decisions, some of which will be very controversial but taken for perfectly good security reasons, do need to have oversight from outside the Executive.

As the right hon. Gentleman has outlined, that cannot be done by the BEIS Committee. Again, I would not want to take away from any of the work it is doing, but we are the only Committee of all the Committees we have that has the levels of security clearance—it has STRAP clearance—to look at the evidence that will have to be put forward for taking these decisions. I think this would give the public confidence in the Bill, and when such decisions are being taken in future, the public can actually have confidence that there is some oversight of the reasons why they are being taken. So I do support new clause 7, but I accept what my Chairman says about wanting some indication of the Government wishing to take this on board. May I also raise the fact that this is not just for this Bill? I am also serving currently on the Telecommunications (Security) Bill Committee, and it is an issue—exactly the same issue—there as well.

I think the Minister is sympathetic to this, but I can tell him now—and I do not want him to admit it—that he will be getting a lot of pushback from the Cabinet Office, because the Cabinet Office somehow sees it as its role to prevent the ISC from seeing anything. As the right hon. Member for New Forest East said, it hides behind the Justice and Security Act 2013, but as he very eloquently outlined, there is already a mechanism to allow us to look at this. This is going to be an increasing problem. If hon. Members read the Act, they will see that it does not actually say that it is about actual Departments; it is about access to sensitive and secure information. That is going to be an increasing issue, whether for this Government or future Governments, because, as that is used by more Departments, it is important that Parliament and the public at least have some oversight of it.

I do not want to bash the Cabinet Office, but hon. Members will remember, if they look at the 2013 ISC report, that it is the same Department that, even though it was told by BT that BT was going to contract with Huawei, somehow conveniently forgot even to tell Ministers until much later. So, I think it is important to ensure that we have robust oversight. I look forward to the Minister’s response on whether he is going to agree to this letter. If he can give such an indication today, or even when it goes to the other place, that would be welcome, and if that is the case, I think it would be quite right not to press new clause 7. I think this is something that is missing from the Bill.

May I now refer to other new clauses? New clause 4 stands in the name of the hon. Member for Tonbridge and Malling and others, and I congratulate his Committee on its report. I accept what the hon. Member for South Ribble (Katherine Fletcher) has just said about defining national security. Putting that on the face of the Bill, as new clause 5 does, limits what can be done, although it is good to have a debate on this. New clause 4 is slightly different, however, because it sets out a framework within which these decisions can be taken.

The Bill does not define national security or the list, and I understand why: because we cannot list the entities, and, as the hon. Lady said, something might come up in the future that is critical national infrastructure but that we have not yet thought about. We need sufficient flexibility to be able to address such situations.

New clause 4 also covers the following important area:

“(g) the potential of the trigger event to involve or facilitate significant illicit or subversive activities, including terrorism, organised crime, money laundering and tax evasion; and

(h) whether the trigger event may adversely impact the safety and security of UK citizens or the UK.”

We see good examples of states that are making strategic investments for geopolitical or security reasons or in order to acquire technologies, but, as came out in the ISC Russia report, many states are increasingly using fronts and other individuals to acquire such assets, and, having not an exhaustive list, but a framework that covers this would also flag up such matters to the Department.

We talk about critical national infrastructure being things such as power stations, electricity grids, gas mains and telecoms, but might we also say that our food distribution network, for instance, is a part of critical national infrastructure? In the early 2000s we had the fuel delivery lorry drivers’ strike, which led to a critical situation, and control of such events could fall under this. These things might be done not by a state, but by individuals related to it, perhaps acquiring large property portfolios in certain areas. Although new clause 4 is not perfect, it covers these matters.

I accept what my hon. Friend the Member for Newcastle upon Tyne Central (Chi Onwurah) is trying to achieve in amendment 7. She wants this unit to have the resources to ensure that it can do its job, and that is very important. However, we also need to ensure that there are no untimely delays, because we do not want this to be a hindrance to business.

Amendment 7 also raises the issue of the personnel who are going to perform this task. I have a huge concern, which I have raised already in terms of the Telecommunications (Security) Bill, about the type of individuals we are going to get in that unit. It is vital that we have people with not only the necessary security clearances but also the right security mindset. Some reassurance on that from the Minister would be welcome.

Overall, however, I welcome this Bill. It takes a huge step in the right direction. As my Chairman, the right hon. Member for New Forest East said, it is strange that we wait for seven years and then get two Bills very quickly, and I also look forward—I hope in the near future—to a further Bill, the hostile state actors Bill, which is another recommendation from our Russia report.

I thank the Minister for the constructive way he has taken this Bill forward—and I will be cheeky and just say to him that if he can deliver extra vaccines in Chester-le-Street this week, that will be very welcome.

[Madam Deputy Speaker (Dame Eleanor Laing)]

We now go over to Sam Tarry—oh no, he’s here!

[Sam Tarry (Ilford South) (Lab)]

I am indeed, Madam Deputy Speaker; I hope you are not too confused that I am here physically. Thank you very much for kicking me off.

I spoke at length on this legislation in Committee, where I moved a number of Opposition amendments to try to strengthen it and where we heard salient and wide-ranging witness statements and testimony on this crucial legislation. Indeed, as many Members across the House have said, the Bill is an important and, frankly, long overdue piece of legislation that will provide more robust powers for the Government to intervene when corporate transactions threaten national security, as the Labour party has long demanded. That is why we support the Bill and have tabled amendments to make it more robust.

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[Andrew Griffith (Arundel and South Downs) (Con) [V]]

May I first take the opportunity today to congratulate our friends in the United States? They are one of our longest and most enduring partners, including in the domain of investment, where we are each one of the largest investors in each other’s economy. In fact, 1 million people in the UK go to work every day for an American company, and 1 million Americans work for British companies.

Unlike many of the other speakers in this debate, I want to talk about investment. This Bill should not be about the NHS or employment law or foreign policy, but it is—or at least it should be—about the world-liberating, poverty-alleviating force that is the global movement of capital to make a profitable return. We are all deeply vested in its continued success. The UK economy is one of the most open in the world, and our prosperity depends on that. The salaries and pensions of one in every three nurses, doctors and teachers depend on the cyclotron of capitalism that combines our world-leading science and intellectual capital with human talent from all over the world to invest in and create economic activity here in the UK. So I am pleased that the Minister, who I know is a great friend of business, has once again confirmed that the Government will always enthusiastically champion free trade and provide the warmest of welcomes to overseas investors. He is right to remind us that, since 2011, over 600,000 new jobs have been created in our economy, thanks to over 16,000 foreign direct investment projects.

In putting forward new clause 5, Opposition Members put forward a veritable laundry list of subjective factors that are at odds with the clarity and certainty that investors need from this Bill. They would put the UK into a concrete overcoat at just the moment of our greatest opportunity. From the buoyant top, we would plummet to the depths of the world rankings in attracting international investment. It is almost as if Opposition Members do not want the British people to taste the fruits of the successful Brexit that they tried to thwart.

From an external perspective, the British economy is a highly attractive investment prospect: a stable, pro-free enterprise democracy with tariff-free access to European markets, close links to the faster-growing Commonwealth countries and native use of English, the universal language used by the fastest-growing sectors and economies of the world. The opportunity is the stability of Switzerland, combined with the dynamism of Singapore.

As net zero champion, I see examples daily of entrepreneurs and investors pursuing opportunities in the expanding clean growth sector. British-based firms are exporting electrolysers to Europe and fuel cells to Asia. The City of London is a world-leading hub for green finance, while our airports and airlines are the same in sustainable aviation. Elsewhere, similar opportunities exist in artificial intelligence, quantum computing, the life sciences, satellites, aerospace and FinTech, where the UK science and research base positions us very strongly. It is not just rhetoric; economists rightly forecast that UK growth this year will outstrip the US, Japan and the EU.

I urge Opposition Members to withdraw their amendments to the Bill and to allow it to go forward today. Having allowed the golden goose of the UK economy to continue to prosper, we can engage in a legitimate debate about how best all may share in the fruits of that success. [Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. We cannot have Members sitting here in the Chamber—under the cover of masks, so I cannot see their mouths moving—making comments about things that people are saying virtually. It just does not work and, quite frankly, it is not fair. We really must watch the level of behaviour while we are trying to balance this difficult situation in the Chamber.

[Jim Shannon (Strangford) (DUP) [V]]

Thank you, Madam Deputy Speaker, for allowing me the opportunity to speak this afternoon. I have followed with great interest every stage of the Bill. I do so with a somewhat vested interest. That is not that I have investment portfolios or similar, because I do not, but because I am fully aware of the potential that exists within Northern Ireland for foreign investment from the positive advantage we now have.

As the previous speaker, the hon. Member for Arundel and South Downs (Andrew Griffith), said, Brexit has given us some opportunities for investment for the future. I see potential for that, as he does, and hopefully as others do, too. Northern Ireland has become the cyber capital of Europe, with our low business rates, superfast broadband in urban areas, wonderful global connectivity—before the pandemic, at least—and a highly skilled local workforce. It is little wonder that more people have decided to make Northern Ireland the home of their global business, and the opportunity is there for much more.

For that reason, I have followed the Bill closely to ensure that it protects our nation as a priority, and I am firmly behind the Government in that aim. I support the objectives that others have set out, and that the Secretary of State will set out at the end of today’s debate. I also want to ensure that the Bill is not overly prohibitive to companies that see opportunity to invest in my constituency of Strangford and in the Ards council area, but have concerns about the mechanism through which the Secretary of State can put a hold on investment for certain reasons.

I share the concerns of my colleagues that more detail is needed on what constitutes a reason for the Secretary of State to become involved. It is my desire that, rather than a substantive statement by the Secretary of State coming after the passing of the Bill, one should be appended to it. I seek some clarification on this matter. That would enable investors and those businesses seeking investment to know the parameters within which they are working.

I must be clear: I do not wish to water down the aims of the Bill—that is not my intention whatsoever. However, I share the concern of some Members that Chinese companies are under an obligation to share information with the Chinese Government. I remain concerned about overly onerous legislative commitments for small investments and small firms, but I must accept the evidence of the loopholes that foreign investment companies have made their way through by purchasing intellectual property rights and the like. I see how our system has been abused thus far, and I stand with Government on the need for an overhaul, which is the purpose of this legislation. However, I believe that we need the detail to have the strong and all-encompassing legislation required to keep our nation safe. I again implore Ministers to consider this. The safety of the nation has been spoken about by many Members, and it is certainly a priority for me and my party.

Covid-19: Vaccinations

Baroness Laing of Elderslie Excerpts

Monday 11th January 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful for the hon. Member’s backing and support. He asks a number of important questions, and I will attempt to answer them now. Suffice it to say that it would be sensible for us to recognise that test and trace now delivers 85% of those who are tested positive in terms of identifying their direct contacts and the indirect contacts at between 92% and 96%. Over 5 million people have been tested and isolated and are therefore not transmitting or spreading this virus, and 55 million people have been tested. That is a pretty major undertaking, with capacity now touching 770,000 and tests running at about 600,000 a day. From a standing start of about 2,000 a day back in March, that is a pretty remarkable achievement for NHS test and trace.

The hon. Gentleman asked about 24-hour provision. There are two priorities for the NHS, and we have looked really long and hard at this. Priority No. 1 is obviously to target very closely those four most vulnerable categories. Priority No. 2 is to try to get a vaccination to them as quickly as possible, which is about throughput. This is linked because if we were to go to a 24-hour regime, it would be much harder to target the vaccine at those four cohorts. Obviously, when we have limited vaccine volume, we do not want staff standing around waiting for people in centres that are open 24 hours. Also, many of those people are over 80, and we are going into care homes to vaccinate the residents of those homes. The decision to go from 8 to 8 was made because we want to ensure that there is an even spread and very close targeting.

That is linked to throughput—how many vaccinations can we get into people’s arms as quickly as possible? We do not want vaccines sitting in fridges or on shelves. That goes to the hon. Gentleman’s question on the 24 hours, but also the pharmacy question. All the 200 pharmacies that we are operationalising can do 1,000-plus vaccinations a week, so the focus in phase 1, certainly with the first four categories—and, I think, with the total nine categories—is very much on targeting and throughput. The 2,700 sites are the best way that we can target that. Obviously, primary care is very good at identifying those who are most vulnerable or over 80 and, of course, getting into care homes, hence why the NHS plan and the plan we have published today are very much based around those priorities.

As we enter phase 2, where we begin to want to vaccinate as many adults as quickly as possible, we want convenience of course. We want to be able to go into many more pharmacies, so people can walk to their local pharmacy, or GP, and get their jab, when we have limitless volumes of vaccines. We have clearly now got that optioned and it will come through in the weeks and months ahead. That is the reason for that. The hon. Gentleman is absolutely right: the limiting factor continues at this stage to be vaccine volumes. The NHS has built an infrastructure that can deploy the vaccine as quickly as possible, but it is vaccine volumes that will change. With any new manufacturing process, especially one where we are dealing with quite a complex process—it is a biological compound that we are producing—it tends to be lumpy at the start, but it very quickly stabilises and becomes much more even. We are beginning to see that, which is good news.

We are absolutely committed to making sure the health and social care workforce are vaccinated as quickly as possible, and of course we are committed to making sure the residents of care homes are vaccinated by the end of this month—January. I reaffirm that commitment to the hon. Gentleman.

I think the hon. Gentleman’s final question was on data. I am glad that he agrees that it is important, because the Prime Minister’s absolute instruction to us as a team is that we have to make sure we publish as much data as possible as quickly as possible, hence why we have moved to a rhythm of daily data and on the Thursday more detailed publication, which will have regional breakdowns. The NHS is committed as it builds up more data to publish more and more. The nation expects, and rightly wants to see, the speed and the targeting that we are delivering, but I am confident that the NHS has a solid plan. We have the volunteers and the Army—two great institutions of this country—delivering this campaign and with the support of Her Majesty’s Opposition I am sure we will do this.

[Madam Deputy Speaker (Dame Eleanor Laing)]

We now go to the Chairman of the Health and Social Care Committee, Jeremy Hunt.

[Jeremy Hunt (South West Surrey) (Con) [V]]

I congratulate the Minister on getting this programme off to a flying start: to vaccinate 2 million people, including a third of over-80s, six weeks after the first dose was approved is an extraordinary achievement unmatched by any similar country. May I ask him about the speed of the roll-out? Many people want teachers to be jabbed as quickly as possible, but is it the case that all those in groups 1 to 4 will need their second jabs before we can make real inroads into other key groups? And will he publish the breakdown of numbers vaccinated not just by region but by local authority area, because a lot of people would like to know just how many people have been vaccinated in their local area?

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[Nadhim Zahawi]

There is a lot to unpack there; let me try to take the points in reverse. We can guarantee that those who have had their Pfizer vaccine will get their booster within the prescribed period of up to 12 weeks. The hon. Lady asked about those who have had a second jab already. Information went out to primary care networks and hospital hubs, saying that those who have an appointment up to 4 January should be able to have their appointment honoured. Beyond that, they have been working very closely with the NHS England team centrally, which we have been supporting with resources and actually phoning to postpone those appointments further; hence why we have protected many more people.

It is worth reminding the House that for every 250 people from the most vulnerable cohorts that we protect, we save a life. For every 20 people in care homes that we vaccinate, we save a life. The focus is therefore now very much on care homes. We began with the Pfizer vaccine into care homes. Of course, last week—on 4 January—we started to roll out the AstraZeneca vaccine, which is much easier to administer into care homes, especially for the roving teams. It had to spend two days in hospitals before it was released to primary care networks, but the moment it was released, it went into care homes and now some areas in England. We have about 10,000 care homes where we have to vaccinate residents and, of course, those who look after them. Some have done their care homes already; others are beginning to do the same thing. All will be done by the end of the month.

The hon. Lady talked about people having to travel long distances. I mentioned in my opening statement about the strategy that there will be 2,700 vaccination sites. I think she may have been confused about the figure of 1,200, which is the number of primary care networks, hospital hubs and large vaccination centres, but there will be 2,700 vaccination sites. By the end of the month, no one will be more than 10 miles away from a vaccination site.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the Minister for being so assiduous in giving very thorough answers to the long and complicated series of questions that have already been put to him, but I must say to the House that we now have half an hour more for the rest of this statement, so I insist on having questions, not statements, from everyone. I specifically mention this to people who are coming in virtually, because they seem to lose a sense of timing when they are not here in the Chamber. A question means a question—just one question. I say to the Minister, who has been most assiduous, that where he has already given an answer to the question, I will not insist that he has to give the answer again because the person who is now asking it has not listened to his first answer.

[Bob Stewart (Beckenham) (Con)]

I will be as quick as I can, Madam Deputy Speaker.

Some of my Beckenham constituents have contacted me to say that they think they should have had the vaccination already; two of them are in their 90s, so I am slightly alarmed. I am told that GPs are not necessarily the people to go to in order to ask what is happening, so I wonder who my constituents and I should go to when the system—inadvertently, perhaps—does not actually give out an appointment that it might have done.

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[Nadhim Zahawi]

I commend the Israeli Government and health service for a stellar job in vaccinating their most vulnerable communities. We have a lot to learn from other countries, including the throughput—the speed at which they manage to vaccinate—which is something from which we can all learn so that we can improve our output. NHS England and the teams on the frontline have been doing a tremendous job and is worth us all thinking about that: we stand on the shoulders of real heroes.

[Madam Deputy Speaker (Dame Eleanor Laing)]

We are way over time, so I am going to take only four more questions and I would be grateful if they could be swift.

[Jeremy Wright (Kenilworth and Southam) (Con) [V]]

I congratulate my hon. Friend on the progress made so far, but ask him for some reassurance about those whose appointments have been cancelled due to the vaccine unexpectedly not being available. Will he confirm that they will not be forgotten about, that they will not lose their place in the queue and that they will be reached swiftly?

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[Nadhim Zahawi]

It is not our capacity, but the manufacturers’; AstraZeneca produces the Oxford vaccine, and Pfizer-BioNTech produce their vaccine, and Moderna’s is now also approved and in process. There are a number of processes throughout the manufacturing process. When we go from the bulk vaccine into fill and finish, there is a period of time and a sterility test the vaccines have to go through. Then there is batch testing by both the manufacturer and the regulator. All of that gets better and better every single day. It is a new manufacturing process. Oxford-AstraZeneca are delivering 100 million vaccines, which is what we have bought from them, and we have bought 40 million from Pfizer. We will have millions of vaccines in the weeks and months to come. We will meet our target of mid February for delivering the opportunity of a vaccine to the four cohorts most vulnerable to covid.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the Minister. I am sorry to the nine colleagues who have not been called to ask their questions. I hope they will encourage their colleagues to ask shorter questions in future, because that is how we will manage to be fairer in getting more people in.

Public Health

Baroness Laing of Elderslie Excerpts

Wednesday 6th January 2021 Commons Chamber

[Stephen Doughty (Cardiff South and Penarth) (Lab/Co-op)]

The Secretary of State mentions the vaccine as one of the crucial routes out of this, and I pay absolute tribute to all the incredible scientists and NHS staff who are preparing to deliver it. However, one of the things my constituents are asking me is how we can be sure that the production of the vaccine will meet the ambitions the Prime Minister and others have set out and that we are building the types of facility we need to continue to ramp up production to the highest levels we can. Can the Secretary of State explain what is going on, because I was concerned to hear about the factory in Wales that is not operating seven days a week? Why is that? Is it because it is not getting enough supply into its system?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Before the Secretary of State answers the question, let me say that we can have interventions of course—this is a debate—but they must not be long interventions. I give notice now that the time limit for Back-Bench speeches will be three minutes from the beginning, and even with three minutes not everyone on the Order Paper will be called, because there is not enough time.

[Matt Hancock]

Thank you, Madam Deputy Speaker. I will try to answer these interventions briefly, but they are important because people want to know what is the way out of these restrictions, and that is absolutely central to the case I am making.

The fill and finish plant in Wrexham is doing a brilliant job, but it can fill and finish vials only at the speed at which the vaccine material, which is a biological material, not a chemical compound, can be produced. It is doing a brilliant job at the pace that it needs to go. AstraZeneca and Pfizer are manufacturing the material itself, and they are also working as fast as they can, and I pay tribute to them and their manufacturing teams, who are doing a terrific job.

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[Matt Hancock]

Yes I will. I am glad I took that final intervention. The people of Wolverhampton have come together to deliver community testing in an incredibly impressive way. I have heard about the work of the gurdwara, bringing together leaders of all different faiths to make sure that we get testing out into the community. We need to do the same with the vaccine programme, because both are critical.

In the meantime, we must stay at home, protect the NHS and save lives. That eventually will carry us to a brighter future.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Before I call the hon. Member for Leicester South (Jonathan Ashworth), I confirm that a three-minute limit will be imposed immediately on Back-Bench speeches.

Covid-19 Update

Baroness Laing of Elderslie Excerpts

Thursday 17th December 2020 Commons Chamber

[Matt Hancock]

My hon. Friend is absolutely right, and I am grinning because I think this is the first time in the dozens and dozens of statements I have made this year when the hon. Member for Leicester South (Jonathan Ashworth) has not mentioned track and trace. I will tell you why, Madam Deputy Speaker: the latest statistics show that where communications were available, 96.6% of people were reached and told to self-isolate. That is because of the huge improvements in contact tracing and testing that have been delivered this year—[Hon. Members: “By local authorities.”] Including, of course, by local authority partners, but also by the brilliant national NHS Test and Trace system, which we should all congratulate. Getting those contact rates—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. This is not a moment for shouting. Listen to the Secretary of State.

[Matt Hancock]

I think the moment when we see contact rates of more than 90% should be one where everybody comes together and says thank you and well done to everybody at NHS Test and Trace and all their partners, whether they are in the public sector or are the brilliant private sector partners that we all support.

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[Matt Hancock]

I am very grateful for what my right hon. Friend says about the vaccination centre in Harlow. It is an uplifting sight visiting a vaccination centre. Rarely have I seen so many smiles on faces this year, which has been such a difficult year, as when I visited the Milton Keynes vaccination centre last week. I am really glad that it is working well in Harlow. I add my thanks to his thanks to the GPs, the volunteers and the staff—all those organising the vaccinations.

In terms of a route map out of the tier, of course in time the vaccination programme will help, but for now the best thing people can do is to bring the case rate down by doing everything they personally can to not pass on this disease. Unfortunately the case rate in Harlow is 302 per 100,000—very, very elevated—and in nearby Epping Forest, unfortunately, it is over 500. It is a very serious problem. We all have to pull together to try to sort out this growth of the virus locally, and that is the route to tier 2.

[Madam Deputy Speaker (Dame Eleanor Laing)]

May I echo to the Secretary of State what my right hon. Friend the Member for Harlow (Robert Halfon) said on behalf of the people of our community?

[Sarah Owen (Luton North) (Lab) [V]]

Scientific advisers, healthcare workers and doctors have all warned that the Christmas season will result in higher infection rates. The public are not fools and know that tougher restrictions will likely be needed in the new year. Will the Secretary of State come out with the obvious and admit now that he will need to bring in harsher restrictions in January, ending the uncertainty faced by families and businesses, or will he just allow these dangerous mixed messages to continue from Government?

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[Matt Hancock]

I agree with every word my hon. Friend has just said. Over this Christmas period, I hope that people will, yes, take a moment to have some relaxation, especially given what a tough year it has been, and have the chance to see loved ones, but do so carefully, knowing that one in three people who have this disease does not know that they have it because they have no symptoms. Anybody can be inadvertently passing it on to a vulnerable loved one, so they need to be very, very careful. To reiterate, it is in the best interests of everybody, their loved ones and their community to get a test at the first sign of symptoms—testing is now very, very widely available right across the country—and if the test is positive or if they are contacted by NHS Test and Trace because they are a contact, to isolate and do so not just because they have to but because it is the right thing to do to isolate fully and properly.

Finally, I strongly agree with my hon. Friend in wanting to thank you, Madam Deputy Speaker, the whole of your team and all the staff of the House for supporting me in the many times I have had to come to the House this year and, in what has been an incredibly difficult year for the House as well as for the nation, for all the work they have done to support us in keeping our democracy going all the way through this, no matter how bad it got.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the Secretary of State for his kind words. The whole House, and certainly the whole of Mr Speaker’s team, thank the Secretary of State, his Ministers and the shadow Ministers, who have worked so hard to keep us informed all the way through this dreadful pandemic.

[Jim Shannon (Strangford) (DUP)]

rose—

[Madam Deputy Speaker]

It is alright. I have not forgotten that we have a late entry. The final question—I call Jim Shannon.

[Jim Shannon]

May I take this opportunity to wish you, Madam Deputy Speaker, and your family a very merry Christmas and happy new year? Thank you for all you do in this House. I congratulate the Secretary of State and all his team on their energy and dedication in what has been an extremely difficult year. It has given us encouragement whenever he has come to the House.

Students, families and workers from England, Scotland, Wales and Northern Ireland will be travelling by boat, train, car and plane to meet their families from all tiers and very strict conditions. What discussions has the Secretary of State had with the devolved Administrations, in particular Northern Ireland, to ensure that travel can continue to happen within the regulations that we must all adhere to?

[Matt Hancock]

I thank the hon. Gentleman very much for his kind words. He said that people have been encouraged every time I have come to the Dispatch Box. Given some of the things I have had to announce, I am sure that is not quite true, but it has been my duty to come and answer questions as much as possible. I have probably answered more questions from the hon. Gentleman than from anyone, and I am very happy to answer this last one for this year.

I spoke to Robin Swann, the Health Minister for Northern Ireland, this morning as part of a call with all four of us across the devolved Administrations. We are determined to ensure that people can travel across the whole of the UK as much as is safely possible, but, again, we urge caution and personal responsibility. People can take advantage of this change in the regulations over Christmas to see loved ones—sometimes loved ones they have not been able to see all year—but we urge them to do that with the appropriate concern for the risk of spreading the disease, and to make sure, therefore, that everybody has a merry Christmas and a happy new year. We will return here, no doubt, in 2021 with the hope of that vaccine coming fast into view so that we can get to the point where I do not have to return every week to discuss restrictions and, instead, we can all get our freedom back.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the Secretary of State for his patience in going through the whole statement, and everyone who is here to continue doing their duty on behalf of their constituents. We hope that the Secretary of State has a little bit of rest over Christmas, but we are all pretty sure that he will continue working to try to keep our people safe. Thank you.

In order to allow everyone in the Chamber the safety to leave without the hordes coming in for the next statement, I will suspend the House for a few minutes.

Covid-19 Update

Baroness Laing of Elderslie Excerpts

Monday 14th December 2020 Commons Chamber

[Sir Robert Neill (Bromley and Chislehurst) (Con) [V]]

The Secretary of State has to recognise that the decision in relation to London will have a crippling effect upon the hospitality industry in the capital, not least because this is the time of year when they might most hope to make good the losses that they have already suffered—[Interruption.]

[Madam Deputy Speaker (Dame Eleanor Laing)]

We have lost Sir Robert for the time being, but would the Secretary of State like to answer half the question?

[Matt Hancock]

I got the gist of it, Madam Deputy Speaker. My hon. Friend is right to express the concerns about the hospitality industry. This will be a significant blow to the hospitality industry, and we only take this action because it is absolutely necessary, because of the rates of increase of this virus right across London, and especially in Kent. Therefore it is necessary, and the best thing we can do is all work together to try to get London out of tier 3.

[Mr William Wragg (Hazel Grove) (Con)]

rose—

[Madam Deputy Speaker (Dame Eleanor Laing)]

I do beg the hon. Gentleman’s pardon and apologise for confusing the Secretary of State. We are actually going to Calder Valley and Craig Whittaker.

[Craig Whittaker (Calder Valley) (Con) [V]]

Will my right hon. Friend join me in thanking all those local authorities, such as Calderdale, that have already come forward to put in place community testing? Can he assure me that central Government will stand squarely behind local areas, which are doing everything they can do to move to lower restrictions, as we hope Calderdale will later on in the week?

[Matt Hancock]

My hon. Friend makes his case, as other West Yorkshire colleagues have today. The roll-out of mass community testing in Calderdale has been impressive. There is lots more work to do, and my message, as I am sure he would reiterate, is let’s get tested and let’s get this virus under control in West Yorkshire.

[Madam Deputy Speaker]

And now I call William Wragg.

[Mr Wragg]

Thank you, Madam Deputy Speaker, for that warm welcome.

Further to the question from my hon. Friend the Member for Harwich and North Essex (Sir Bernard Jenkin), the approach of Essex and Hertfordshire shows that district authorities can be dealt with separately between tiers. With that tantalising prospect, will my right hon. Friend the Secretary of State commit to looking closely at the very encouraging data from Stockport, and indeed other boroughs of Greater Manchester, in reviewing those tiers this Thursday?

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[Matt Hancock]

The best thing we can do for the wedding industry is to try to get the vaccine rolled out as fast as possible to protect people, so that this virus no longer kills as many as it sadly does today. I join my hon. Friend in paying tribute to all those in Gloucestershire, including in south Gloucestershire, who are working so hard. There has been a very difficult spike in the virus. Thankfully, it is coming down now, and I hope to see the number of hospitalisations in her area reducing. While that is happening, we have to get on with the roll-out of the vaccine, which is a 24/7 job. I pay tribute to and thank all the NHS staff who are working so hard to make that happen.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I will suspend the House for three minutes in order to allow colleagues to leave safely, and to allow those who are coming in for the next fixture to attend safely.

Covid-19 Update

Baroness Laing of Elderslie Excerpts

Thursday 26th November 2020 Commons Chamber

[Matt Hancock]

Subject to the results of the pilots, which are ongoing, we hope to allow testing in England to allow for visiting in care homes before Christmas. I will absolutely have another conversation with my opposite number Robin Swann, who is the Health Minister for Northern Ireland. Robin Swann is an excellent Health Minister, we work very closely together, and I am absolutely sure that together we will be able to make progress on testing and other matters. He and I are constantly in touch about how we can best serve the communities of Northern Ireland, from the position of the UK Government’s role in procuring tests around the world and, of course, his vital role in keeping people safe right across the Province.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I thank the Secretary of State; we have completed our exchanges on the statement.

In order to allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next item of business, I will now the House.

Smokefree England: Covid-19 and PHE Abolition

Baroness Laing of Elderslie Excerpts

Thursday 12th November 2020 Commons Chamber

[Liz Twist]

Sorry, Madam Deputy Speaker. I am getting carried away.

I will be asking the Minister what he will be doing to ensure that vital maternity safety programmes, such as the saving babies’ lives care bundle, can get back on track. I will be asking him what he will do to develop a national strategy for reducing rates of smoking in pregnancy among women from disadvantaged communities, learning the lessons from the areas where the greatest declines have been seen in smoking in pregnancy. I will be asking him how he will ensure that mental health trusts are required to implement National Institute for Health and Care Excellence guidance and that the Care Quality Commission is directed to assess that when it carries out its inspections. Finally, I will be asking him what steps he will take to ensure that smokers with mental health conditions receive evidence-based advice about switching from smoking to vaping.

I want to elaborate a little further on those issues. As a result of comprehensive action at national, regional and local levels, significant progress has been made over the years on bringing down smoking rates in England. The 2019 prevention Green Paper’s commitment to make England smokefree by 2030 was an appropriately ambitious and welcome commitment to continuing this important mission. However, a year on from the end of the Green Paper consultation, we have yet to see the Government’s response or their promised and much-needed further proposals, which would enable us to meet the 2030 ambition.

Despite our national progress, smoking remains the leading cause of preventable illness and death in England. Each year, smoking kills more people than obesity, alcohol, drug misuse, HIV and traffic accidents combined. Smoking is a particular challenge in my constituency of Blaydon, where 17.4% of adults smoke, compared with 15.3% across the north-east and 13.9% nationally. Smoking costs Blaydon £1.8 million every year, largely as a result of NHS treatment costs, lost productivity due to ill health and premature death caused by smoking. For communities such as Blaydon, achieving the smokefree 2030 ambition will be tough, but it remains essential for the health and wellbeing of our community. However, analysis by Cancer Research UK finds that on current trends, disadvantaged communities such as my own will not become smokefree until the mid-2040s. This rate of progress is not acceptable and not affordable for our most deprived communities.

The last tobacco control plan was two years late, as we have heard. It should have been published in 2015, and it was delivered in the summer of 2017 only because of the commitment of the then Health Minister, the hon. Member for Winchester (Steve Brine), who I am pleased to say has just joined us. The tobacco control plan that he introduced included the ambition for a smokefree generation, and now that the Government have committed to deliver this by 2030, the pressure is on. Our current tobacco control plan is set to run out in 2022, leaving an eight-year gap in which, according to Cancer Research UK, the rate of smoking prevalence decline must be 40% faster than our current trajectory if our nation is to meet the 2030 tobacco control plan commensurate with the scale of the ambition to be smokefree by 2030.

I shall turn now to the NHS long-term plan. The successful delivery of the plan is essential to the achievement of the smokefree 2030 ambition. The plan published in January last year sets out welcome commitments to tackle smoking in the NHS. By 2023-24, NHS-funded tobacco dependence treatment will be offered to all hospital in-patients who smoke; all pregnant smokers and their partners, too, if they smoke; and all long-term users of specialist mental health and learning disability services who smoke.

The evidence is clear of the benefits this will bring, both to smokers and to the NHS. Smokers are 36% more likely to be admitted to hospital and smoking is responsible for almost 500,000 admissions each year in England. One hospital patient in four is estimated to smoke. The increased demand that smoking places on NHS treatment capacity translates into an enormous financial burden. Each year, smoking costs the NHS around £2.6 billion, including avoidable secondary care costs estimated at £890 million a year. The cost in the north-east to the NHS is around £132.3 million a year, with smoking in Blaydon alone responsible for around £300,000 of that. Across the north-east, it is estimated that implementing the long-term plan commitments at just 40% coverage, as is aimed for by the end of 2021-22, would deliver net savings of nearly £12 million to the NHS in the north-east.

In the north-east, progress towards implementation of the long-term plan’s commitments on smoking is well under way. Treating tobacco dependency is one of two key priorities for the north-east and north Cumbria integrated care system population health and prevention work stream. To focus efforts across the region, a dedicated north-east Smokefree NHS/Treating Tobacco Dependency Task Force was established in 2017. The taskforce has provided strategic direction, developing regional resources and facilitating partnership working with all stakeholders, including NHS trusts, local authority tobacco commissioners, Public Health England and primary care.

As of April 2020, all NHS trusts in the north-east had achieved smokefree NHS status by implementing updated smokefree NHS policies and pathways to identify and treat smokers from admission, in line with national guidance. Across the north-east, trusts have established good links between hospitals and community stop-smoking services funded by local authorities to ensure treatment started in hospital is continued after patients leave hospital. Trusts are training staff to build capacity. They have also signed the NHS smokefree pledge as a clear and visible way to show commitment to helping smokers to quit and to providing smokefree environments.

Elsewhere, progress has not been so heartening, and it is clear that the funding and focus promised by the long-term plan are much needed. An audit of smoking cessation advice and services in NHS acute hospitals, published earlier this year by the British Thoracic Society, concluded that there is poor adherence to national standards and slow progress in identifying and treating smokers. In fact, in many cases the situation is worse than at the time of the last audit in 2016. One smoker in two is not asked whether they would like help to quit. Only one hospital in three has a hospital-funded smoking cessation practitioner, compared to one in two in 2016. Referral to hospital smoking cessation services is available in only four out of 10 hospitals. In 2016, the figure was more than half.

Progress on the long-term plan’s commitments has also not been immune from the impact of the covid-19 pandemic. Early implementation sites chosen to stress test the new tobacco dependency treatment pathways set out in the long-term plan were due to start in April, but this had to be delayed until last month. With winter approaching, and the risk of co-circulation of covid-19 and seasonal flu looming, there is a real risk that work to deliver the long-term plan’s commitments on smoking could be derailed. If we are to achieve the smokefree 2030 ambition, addressing smoking where contact with smokers is greatest is an opportunity that must not be missed

Let me turn to smoking in pregnancy. The Minister is as concerned as I am about this issue, on which there is too little progress. This needs to be a major focus of the next tobacco control plan. Ensuring that more pregnancies are smokefree not only protects the baby as it grows and reduces the risks of complications such as stillbirth and miscarriage; it also gives children the best start in life. NHS England has included addressing smoking as a key part of the initiative to reduce stillbirth and neonatal deaths through its saving babies’ lives care bundle, which is designed to encourage trusts to implement evidence-based measures to improve the safety of pregnancies. However, as with other aspects of NHS activity, this work has been undermined by the impact of covid-19, with a key aspect—carbon monoxide breath tests for all women—currently suspended. I understand that there are also reports from local authorities’ stop-smoking services that fewer pregnant women are being referred for them for support by maternity services. What will the Minister do to ensure that those vital maternity services get back on track as a matter of urgency?

Despite work in the NHS, progress has not been made anywhere near swiftly enough. There are big variations in the performance of different parts of the country. In a soon-to-be published analysis, Action on Smoking and Health finds that rates of smoking in pregnancy have increased in the past five years in a third of clinical commissioning groups, while declines have been seen in less than half, or 44%. It is therefore hardly surprising that the Government seem so unlikely to achieve their ambition of reducing rates to 6% by 2022. In the north-east, we continue to have some of the highest rates of smoking in pregnancy in the country. These are driven by high levels of disadvantage in the region, but, unlike in some regions where rates have even increased, rates in the north-east have fallen in the past five years, from 17% in 2016 to 15% in 2020. Progress has been driven by the regional tobacco programme in the north-east and by the work of NHS England, Public Health England and local government.

The Minister might be interested to hear that a recent analysis by The Times found that areas of the country that were likely to have seen big drops in rates of smoking in pregnancy were also more likely to have implemented financial incentive schemes to support pregnant women to quit. Evidence on the effectiveness of these schemes has been accumulating for many years; they have been shown to increase quit rates when implemented alongside evidence-based quit support. Such incentive schemes are in place in Greater Manchester and South Tyneside. Madam Deputy Speaker, I can see you looking at the clock, so I shall press on.

[Madam Deputy Speaker (Dame Eleanor Laing)]

For the sake of clarification, there are very few people present and the hon. Lady is making important points, so, just for once, I am not putting her under any time pressure.

[Liz Twist]

As you say, Madam Deputy Speaker, this is an important issue.

I return to my point about developing a national strategy for reducing rates of smoking in pregnancy among women and the disadvantaged communities they come from. What does the Minister plan to do to ensure that those reductions are seen and that there is a continued decline in smoking in pregnancy?

Let me turn to smoking and mental health. The last tobacco control plan for England was widely welcomed for including a specific focus on smoking and mental health. With such high rates of smoking in the community and such little progress in reducing rates, this focus was long overdue. Progress has been made since the plan was published, with mental health trusts being set a target: to implement smokefree settings, in line with NICE guidance on smoking, by 2018.

However, despite that, an ASH survey commissioned by Public Health England to look at trust implementation found the following:

“Staff behaviour often enables smoking, with staff accompanying patients on smoking breaks every day in 57% of trusts.

In 55% of trusts, patients were not always asked if they smoked on admission.

Only 47% of trusts offered the choice”

of stop smoking medications

“in line with NICE best practice”.

The impact of covid-19 is likely to have further hindered the implementation of NICE guidance. The Mental Health and Smoking Partnership, a coalition of leading mental health and physical health charities, has raised concerns that some trusts have been rolling back what smokefree policies they had put in place. There are concerns that the Care Quality Commission is not assessing the implementation of NICE guidance on smoking in a consistent way, with trusts receiving conflicting messages on implementation from different parts of the system. Another question I ask the Minister is whether he will ensure that mental health trusts are required to implement NICE guidance PH48 and that the CQC is directed to address this when it carries out inspections.

Action in mental health in-patient settings is only the tip of the iceberg; most smokers with a mental health condition will never have an in-patient stay. The NHS long-term plan has committed to implement a universal smoking cessation service in mental health settings. A promising area for support in the community, and via primary care, is improving access to psychological therapies services, which were established in 2008 with the ambition of scaling up access to talking therapies. About 1 million people with depression and anxiety access IAPT services each year. It is estimated that about 28% of people with depression and anxiety smoke. Quitting smoking has also been found to improve depression, with the same effect as taking antidepressants, so there is a major opportunity to improve both mental and physical health by integrating smoking cessation support into IAPT services. Research by the University of Bristol is under way to explore the integration of support for smokers with these talking therapies, and the early findings are positive. Individual local services, such as Talkworks in Devon, have also started to explore the potential of integration. However, smaller-scale pilots, although important, miss the big opportunity to reach many thousands each year with additional support.

E-cigarettes are a major opportunity to help more smokers to quit, particularly those with high levels of dependency, common among smokers with a mental health condition. E-cigarettes have been shown to help smokers successfully quit at greater rates than traditional nicotine replacement therapies and to be popular quitting aids. Despite the need among smokers with mental health conditions and the potential for e-cigarettes to save many lives, the attitude towards e-cigarettes within mental health services remains varied. Two excellent examples of good practice in mental health trusts can be found in my region, where the Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust and the Tees, Esk and Wear Valleys NHS Foundation Trust both offer e-cigarettes to their patients as a treatment option, alongside the provision of nicotine replacement therapies. Those trusts have shown not only leadership in treating tobacco dependency and implementing national guidance, but real pragmatism on vaping, which could save the lives of many smokers with mental health problems who may not otherwise be able to quit smoking.

Unfortunately, that pragmatism is not found nationwide, and in many trusts the restrictions placed on vaping are not dissimilar to those placed on smoking. Such inconsistency is also seen in staff attitudes towards e-cigarettes. New unpublished data gathered by ASH found that 46% of mental health nurses and 66% of psychiatrists had received no training on e-cigarettes. As a result, many are uncertain about the role of e-cigarettes in supporting smokers in their care. So I reiterate the last of my questions: what steps will the Minister take to ensure that smokers with mental health conditions receive evidence-based advice about switching to vaping? This is an important issue that requires persistence and detailed attention. I look forward to the Minister’s positive responses to these proposals.

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[Jim Shannon (Strangford) (DUP)]

For the second time today, it is a pleasure to follow the hon. Member for Winchester (Steve Brine), given the knowledge he has of all the subjects we have covered in this debate and the last one. I thank him for his contribution when he was Minister, too. It is always good to see him in his place.

I congratulate the hon. Member for City of Durham (Mary Kelly Foy) on what I think may be the first debate she has led in the Chamber. If it is, I say to her, “Well done and congratulations.” We look forward to many more contributions from her in this place. I was glad to add my name to the request to the Backbench Business Committee for this debate, and to work alongside the hon. Lady to highlight some of these issues.

I believe that freeing smokers from the tyranny caused by their addiction, and the damage it causes to their health and wellbeing, is an issue not just of health but of human rights. I am my party’s spokesperson for health and human rights, and this debate covers both those issues.

This issue is close to my heart, as I know it is for speakers on both sides of the House. Public health policies, which are the responsibility of the devolved nations, have a key role to play in tackling smoking, but so do the Government in Westminster and this debate. I am pleased to see the Minister in his place. He and I have been good friends for a long time, and I look forward to his response because I know it will be positive.

I want to refer quickly, if I may, to the Northern Ireland Department of Health tobacco control strategy, which was implemented in 2012. It was clear that the Northern Ireland Assembly was trying to direct its action at children and young people, disadvantaged people, and pregnant women and their partners who smoked. A review of that strategy undertaken earlier this year found that Northern Ireland has met its target of ensuring that a minimum of 5% of the smoking population accesses smoking cessation services annually, but there is still a group of people who continue to smoke. I am conscious that people have freedom of choice, but we hope that they take note when we present them with the health issues.

That target was achieved, but we are not hitting our targets at population level. There was a target to reduce the smoking rate among manual groups from 31% to 20% by 2020. That rate still lingers around 27%, so that target has not been met. There was also a target to reduce smoking during pregnancy from 15% in 2010 to 9% by 2020. To date, however, that rate has barely declined, so we have hit problems in Northern Ireland. At the time of speaking, the rate is 14%, so we have reduced it by only one percentage point. Let us be very clear: smoking when pregnant puts babies at risk of avoidable harm, including stillbirth, premature birth and birth defects.

We seem to have done better on the target for 11 to 16-year-olds. I am really quite encouraged by that. There has been a reduction from 8% in 2010 to 4%. The target was 3%, so we are one percentage point shy of it, but what we have done there has been quite dramatic. Children who live with smokers are almost three times more likely to take up smoking than children from non-smoking households, which creates a generational cycle of inequality, with smoking locked into disadvantaged communities.

Will the Minister make contact—he probably has—with the Northern Ireland Assembly, and particularly the Health Minister, Robin Swann, to see what has happened there? I feel that we can feed off each other regionally in Administrations, to our advantage. If something is being done right in England, we want to know about it in Northern Ireland, and the same applies in Scotland and Wales.

The disadvantaged communities worst affected by smoking have also been hit hardest by the coronavirus pandemic. Smoking is a leading risk factor for all sorts of things, such as cardiovascular disease and chronic obstructive pulmonary disease, which have been identified by Public Health England as being associated with worse outcomes from coronavirus. When households stop spending money on tobacco, it can lift them out of poverty, and it increases the disposable income available to spend in local communities rather than lining the pockets of the transnational tobacco firms.

Those inequalities are a problem not just for Northern Ireland but in every part of the United Kingdom. The answer is more action at population level through Government interventions that support people, particularly in disadvantaged communities. I believe that the time is right for the Department of Health and Social Care to publish a new tobacco control plan that addresses UK-wide issues as well as those relating just to England—I believe that we should be doing this across the four regions—and provides solutions to the threats posed by Brexit as well as delivering on the opportunities.

Smoking on screen is an issue close to my heart; we have to find some way of addressing it. Smoking is rarely portrayed in an unattractive manner, or associated with negative consequences. Guidelines on smoking have been established by the communications regulator, Ofcom, but they are often not rigorously applied. The UK Government and Ofcom have committed to working with the British Board of Film Classification to ensure a consistent approach across the piece. On the tobacco control plan, I said in 2018:

“A clear causal link has been established between smoking initiation among young people and smoking on screen in the entertainment media. The impact is down to the amount of smoking that young people see, not whether it is glamorised or not.”

Young people may feel, sometimes unconsciously, that smoking is normal, and that we should all be doing it. However, its depiction is linked to greater risk of smoking uptake. In that earlier debate, I asked:

“Will the Minister ask his colleagues who are responsible for the regulation of film and TV in the Department for Digital, Culture, Media and Sport to work with the Department of Health and Social Care, and press Ofcom and the British Board of Film Classification to ensure that their codes effectively tackle the portrayal of smoking in films and television programmes that are likely to be seen by children?”—[Official Report, 19 July 2018; Vol. 645, c. 685.]

At the time, the Minister briefed that Ofcom and the BBFC were dealing with the issue; quite clearly, Minister, that has not happened to the extent that we would like.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The hon. Gentleman promised me that he would no longer address the Minister, but would take to addressing the Chair, in the way one is supposed to in this place. He speaks in this Chamber more than any other Member, and he knows that he must not address the Minister. I cannot understand why he persists in doing it.

[Jim Shannon]

Thank you, Madam Deputy Speaker. I will certainly endeavour to get that right.

In 2018, there was an explosion of new video on demand services, such as Netflix and Amazon Prime, which are particularly popular among young people. Ofcom’s on demand programme service rules, governing video on demand services such as Netflix, have no rules at all on smoking. The use of video on demand continues to grow, so this problem will only get worse. Is the Minister prepared to look at that issue and address it?

The licensing of tobacco retailers is another issue that I spoke about in 2018 that bears raising again. In Northern Ireland, since 6 April 2016, retailers have been obliged to register with the tobacco register of Northern Ireland; the deadline for doing so was 1 July 2016. It built on similar schemes in Scotland and Wales. In 2018, we implemented a track-and-trace scheme that required every retailer to have an economic operator identifier code. That system was required by the EU tobacco products directive, but the Government have confirmed that it will continue after we leave the EU. Can the Minister confirm that all nations in the UK will continue to implement a retail register scheme? Will he ensure that officials at Her Majesty’s Revenue and Customs talk to their opposite numbers in Northern Ireland, Scotland and Wales about their experience of the retail register scheme, and the lessons to be learned about it from the devolved Administrations?

Are the tobacco control regulations on e-cigarettes delivering on the twin goals of helping smokers to quit and protecting children from taking up smoking—objectives supported by all parties and all nations of the United Kingdom of Great Britain and Northern Ireland?

There is a concerning loophole in our regulations: while it is illegal for e-cigarettes to be sold to children under 18, according to advice from trading standards, it is not illegal to give them out as free samples to anyone of any age. Could the Minister give us direction on that? How can we ensure that things are done correctly? I hope the Minister is aware of the article in The Observer in October that highlighted that a supplier working on behalf of British American Tobacco was caught handing out samples from BAT’s popular e-cigarette brand to a 17-year-old without carrying out any kind of age check. That contravenes the spirit, if not the letter, of the regulations. Given the importance of balancing the needs of smokers against any impact on young people, it is vital that a review of these regulations is undertaken. Will the Minister set a timeline for just that?

Exiting the European Union (Agriculture)

Baroness Laing of Elderslie Excerpts

Tuesday 10th November 2020 Commons Chamber

[Edward Argar]

I will take that as a clear invitation. Sam Beggs who was a fantastic member of staff to both the hon. Gentleman and I always sang the praises of Strangford. I need no more than the hon. Gentleman’s kind invitation to take him up on it when travel is more normal.

Question put and agreed to.

[Madam Deputy Speaker (Dame Eleanor Laing)]

In order to allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next, I will suspend the House for three minutes.

Covid-19

Baroness Laing of Elderslie Excerpts

Monday 2nd November 2020 Commons Chamber

[Stephen Doughty]

Yes, and of course the First Minister and the Health Minister, my colleague Vaughan Gething, saw the same evidence, took action and instituted a firebreak lockdown when it was needed.

Other Tory MPs have been simply patronising. The Minister for the Middle East and North Africa, the right hon. Member for Braintree (James Cleverly), said:

“If you want to see how a Labour government would be dealing with the current COVID-19 situation just look at how they’re doing in Wales.”

Well, yes, Minister—we would be feeding kids throughout the holidays and running a fully functioning test, trace and protect system throughout the UK. The figures speak for themselves: since June, 94% have been reached and 95% of their contacts have been reached. Instead of contracting it out to Serco and the other companies under the shambolic oversight of one of the Prime Minister’s pals, we would be acting decisively across the UK, in accordance with the scientific advice, when it mattered.

The Welsh Conservatives are all over the place today, describing our lockdown as “disproportionate and unnecessary” and refusing to back the Prime Minister’s plans for a lockdown in England. What an absolute shambles. A firebreak lockdown is right and has my support, but those affected need the right economic support from the UK Treasury. We have again seen the UK Government wait until the last minute to act to support people in Wales, meaning a huge amount of anxiety for people in my constituency and preventable job losses. That is not to mention the delays in the announcement of support for the self-employed and the failure to do the right thing on furlough and co-operate with Wales in time for our measures to come into place. That the Government instead played petty partisan politics is deeply disappointing and will undoubtedly have led to people losing jobs.

We now need clear answers to a number of questions. Will we see backdated support to address the Chancellor’s failure to act in relation to Wales until he decided to announce the England-wide measures? Will there be confirmation of what the Prime Minister said about the support available if we go into measures again after 2 December? I think he said it would be available “wherever it is needed”. What transparency will there be on the additional support for Wales as a result of the business grant support announced for England? What will happen in terms of universal credit and support for families who are deeply affected by losing jobs and income? We need to see an end to the game-playing.

Lastly, I wish to refer to the issue that I brought up earlier, as did my hon. Friend the Member for Leicester South (Jonathan Ashworth): vaccines. It is crucial that we have hope in these dark times. I thank our NHS, care workers and key workers, and all the brilliant scientists and medical professionals who are working to improve testing capability, drive new treatments and find a vaccine. There are, though, serious questions about the involvement of the chair of the vaccines taskforce in an online seminar costing $200 a head for American investors, and the sharing of official sensitive documents. It is absolutely right that the shadow Chancellor of the Duchy of Lancaster—my hon. Friend the Member for Leeds West (Rachel Reeves)—and my hon. Friend the Member for Leicester South have been asking questions about the conflicts of interest, why that information was shared with that group of people instead of with this House, and whether that was inappropriate. I hope we get some answers from the Cabinet Secretary on those questions, because they are very serious and we need hope and optimism on a vaccine and the information given to this House.

It is clear that we need support for our economy and all those affected, and we need clarity on a vaccine. People need hope in these dark times.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. The time limit is reduced to four minutes.

--- Later in debate ---

[Layla Moran (Oxford West and Abingdon) (LD)]

I feel a bit queasy after the speech by the hon. Member for Isle of Wight (Bob Seely), not because of what he said but because of the microphones—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. I thank the hon. Lady for mentioning it, and I apologise on behalf of the House to the hon. Gentleman who has just spoken. There seemed to be a little bit of disruption and I could not work out what it was, because I could hear something wrong, but other people could not. There is something wrong in the sound system, and I simply apologise to the hon. Gentleman, and we hope that it will be fixed.

[Layla Moran]

Thank you, Madam Deputy Speaker.

I want first to tell the story of what has happened in Oxfordshire over the past couple of weeks. I want to put on record my thanks to the Minister for spending time with me and the hon. Member for Oxford East (Anneliese Dodds) earlier this week, but we were in a strange situation where, as a county, we were raring to go into tier 2. We had been looking at the data and, particularly, listening to the director of public health, but not just to him. All the councils were on board, as were the Oxfordshire Association of Care Providers, the police, both universities and, critically, the local enterprise partnership—all pulling in the same direction, all saying, “We are deeply concerned about the way that the virus is now being transmitted in wider communities. It is now leaking into the 60-plus bracket, and we are worried about overwhelming our local NHS.” So we asked gold command to give us a tier 2 status. Two weeks ago, we were saddened that that was not allowed, and then last week we found out that only Oxford city was going to go into tier 2 and the rest of the county was not, against what was very much a cross-party view, except for those Conservative Members in this House who did not want that to happen.

I have yet to get to the bottom of exactly why that happened. The Minister said that she would go away and look at it: I appreciate that events have overtaken us since then, but at some point we will get through this phase. I have heard the Secretary of State say many times that he believes in the tier system. If he does, it has failed us. We are in the situation we are in now because it has failed us and because test, trace and isolate—particularly the “isolate” bit—is not working.

I believe that people will adhere to this lockdown. They are annoyed and upset—I am sure that many Members’ inboxes are full of people expressing their concern—but they will do it. However, I do not believe they will do it again. This is two strikes, and on a third strike the Government will have a real problem on their hands in terms of the public adhering to a lockdown again. That brings us to where I think we need to be focusing next, which is on an exit strategy. There are many of us across the House who are concerned by this, because an exit strategy is not just a need to decrease R below 1. Yes, we know that that is the start, but what is concerning is that we have done that once before and it has not worked. The tier system has not worked. We have not got on top of this.

What I want to propose in an elevator pitch today is what I, others across this House and Members from the other place have come up with as an exit strategy, which involves three stages. The first has the advantage of being exactly where the Government are now, which is that we bring R below 1. The second stage is critical and it does not involve tiers. It is a national approach that involves, first of all, getting those cases low enough so that TTI works properly, and quantifying what that is. The other part of it is new. It is making use of something that we have that other countries in Europe do not have, which is our unique geography. We start to fight this virus at our borders by testing and quarantining people who are coming in and out. The countries that are beating the virus are doing exactly that—places such as Taiwan and New Zealand. We have to change the approach—if we do not do so then we will keep doing the same thing over and again—and wait to the point of elimination when, hopefully, therapeutics and a vaccine will come to save us. Until we get to that point, I urge the Government to think through their approach again.

--- Later in debate ---

[Dr Allin-Khan]

I am very familiar with the detail, which the Minister uses every single time we have a debate, but I will take that as a hard no and continue with my speech.

For the mental health of people across the country—[Interruption.] The policy is very clear. The Minister is chuntering from a sedentary position; would she like to intervene?

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. [Interruption.] Yes, I appreciate what the hon. Lady is saying. I think this exchange has run its course, and I am sure that she is probably about to come to her conclusion.

[Dr Allin-Khan]

Thank you. As I said, I take that as a hard no.

For the mental health of people across the country, the Government have to address questions that they were slow to answer in spring. For those who rely on sport for positive mental health, will the Minister outline the options open over the coming month? For those with loved ones in care homes, will a new testing and visitation policy be implemented? Where staff are redeployed, will the Minister outline what support will be offered? For those who have lost loved ones to covid-19, what specific mental health support will be offered? Students across the range of education need support, especially those in university. What extra support will be in place for them? I look forward to the Minister’s replies to those questions in her closing remarks.

We are only in November and we face a cruel, long winter. The public want to support the Government’s measures and see the back of the virus, but people also want reassurance that our nation’s mental health will not be put at risk. The years of underfunding of mental health leave us without much faith. We called for a national wellbeing guarantee last month. The Government should have addressed that weeks ago. Now, it is crucial and I plead with the Minister to meet the sector properly and get a plan in place urgently.

It may feel impossible to hope on the edge of a precipice, as we are, but the kindness on display across the UK should bring hope to us all. We continue to extend the offer to work together through the crisis for all our communities. We just need the political will from the Government.