Future of the NHS

Graham Stringer Excerpts

Monday 31st January 2022 Westminster Hall

[Matt Vickers]

This is a debate that we have in every election campaign, and other than the issues around dentistry, which I am sure we will come to, the NHS remains free at the point of use. I will fight the corner to keep it that way, and I am sure that the hon. Gentleman will do so as well.

[Graham Stringer (Blackley and Broughton) (Lab)]

I think everybody in this room would agree with the principle that the NHS was founded on—care that is free at the point of use—but the NHS has had many structural forms since its inception immediately after the second world war. My concern is that its current form and the proposals that the Government are bringing forward further centralise the NHS, and waste further money on bureaucracy, mimicking the private sector and creating an artificial market. Does the hon. Gentleman agree that that is a waste of money, and that the NHS should be decentralised in order to provide better services to local communities?

[Matt Vickers]

I am sure we are going to hear about the ways in which these structural reforms will take place with that very aim in mind. I am going to try to get through my speech, because I am sure that Members would prefer for everybody to get in and to hear from the Minister, who is wiser on this issue than I am.

In my view, the Health and Care Bill does not represent an attempt to create a “pay for play” system—quite the opposite. While I am sure the Minister will go into detail about this point in his response, my understanding is that the Bill is largely the work of the NHS itself, inspired by NHS England’s own desire to restructure its organisational system to be more efficient and effective. It builds on the NHS’s own long-term plan, as set out in 2019, and the NHS people plan, which was published in 2020. Many of my conversations with leaders from my local NHS trust suggest that the answers to improving health outcomes require multi-agency working and empowerment of local health agencies, and my understanding is that the reforms and structural changes in the Bill set out to do exactly that.

One point on which I strongly agree with the petitioners is the need to drive value for money within our NHS, reducing management costs and excessive use of consultants, so that the huge increases in funding for the NHS can actually reach the frontline, not just fund more fruitless layers of bureaucracy. I am hopeful that the Minister will update us on what is being done to drive efficiency in that regard. Another point that I fundamentally agree with is the petitioners’ view that private finance initiative contracts have no place in our NHS. I know all too well the debilitating effect they have on the ability of the NHS to administer care across our country. Nationally, PFI contracts cost our NHS £1 billion a year and restrict numerous hospitals across the breadth of Great Britain.

I have seen at first hand how PFIs have damaged our local services in the Tees Valley. South Tees Hospitals NHS Foundation Trust, in particular, has been plagued by a dodgy new Labour PFI contract. The James Cook University Hospital was completed in 2003, but its PFI contract does not run out until 2034, and will cost over £1.5 billion. The trust currently has to meet annual payments of £57 million a year—more than £1 million every week. Of course, hospital upgrades and rebuilds are expensive, but that trust is paying £17.5 million over and above what an equivalent Treasury-funded hospital would cost annually. Shockingly, that is enough to pay for more than 530 nurses. It is ludicrous.

Even if there were not an extra 530 nurses at South Tees, there is so much the hospital could do with this money, such as investing in its building, equipment and staff to help improve health outcomes and inequalities. Excessive costs from historic PFI contracts are listed as the largest single contributory factor to the hospital’s troublesome financial position. At time when retention is a huge issue for our NHS, this money would be crucial to making a substantial difference to the working lives of our NHS heroes. I am glad that in 2018 a Conservative Government decided that PFI contracts would be phased out. However, hospitals up and down the country are now stuck dealing with a Labour legacy that has damaged our NHS, our people and our ability to tackle health inequalities across this country.

Public Health

Graham Stringer Excerpts

Tuesday 14th December 2021 Commons Chamber

[Wes Streeting]

My hon. Friend makes such an important point. Going back to the staff surveys, particularly given that the overwhelming majority of staff are vaccinated, it is not that they do not want their colleagues to be vaccinated, but that they have concerns about the way in which the Government are going about this. We accepted from the Government and from NHS England a very clear view that omicron has raised the stakes in this regard, which has had a big bearing on our position. It is very difficult for me and my colleagues on the Labour Benches to put ourselves in a position that is on the other side of the argument from the NHS and from the public, but the point about engagement is really important. The Government must work with and take the workforce with them. It is not good enough for us to just clap for the NHS, or clap for carers; we must work in partnership with them and respect that these are people who have given their lives to public service and caring for others. They do care. They will instinctively be on the right side, but they just need some persuasion, some patience and genuine engagement and that is where the Government have gone slightly wrong.

[Graham Stringer (Blackley and Broughton) (Lab)]

My hon. Friend started off his speech in an excellent way and has got better as he has gone through it. I say that, but I will almost certainly not be in the same Lobby as him on some of the votes this evening. There is a general point to the specific point that he is making on vaccines, which is that the Government should be clear, explicit and transparent on every issue that they raise if they want to take with them people who are not just worried about vaccines but worried about this whole affair. Repeatedly, the Government have refused to do a cost-benefit analysis on the impact of their policies. We have before us now a number of statutory instruments without impact assessments. Does he agree that that information should be available?

[Wes Streeting]

Let me say to my hon. Friend that, in his intervention, he started off well, dipped in the middle and then got better at the end. He made some absolutely fair points about impact assessments and transparency. In fact, I can see the Vaccines Minister waving impact assessments at me, so I am sure that she will make them available to my hon. Friend.

It comes back, as we have discussed at various points today and previously in relation to these sorts of restrictions and measures—it is how I began, and will begin to close, my contribution—to how we really cannot be complacent when it comes to public support, public compliance and public consent for the measures that we are considering. We know that we have asked so much of the British people and they have played their part. We also know that recent events have dented their trust and confidence and their willingness to comply, because they have seen No.10 saying one thing and doing another. That makes it even more important that, when we discuss measures that impact on people’s lives, livelihoods and liberties, we have these sorts of exchanges, look over the evidence rigorously, test each other’s assumptions and come to a conclusion.

With some of the exchanges that we have heard today, people across the country on both sides of these arguments can at least take some reassurance from the fact that, when these matters are under consideration, we do take them seriously. The Government could do a little better sometimes on bringing measures forward in advance of their implementation and on setting out the rationale and argument, and not just assuming that, because measures have been supported by the public previously, they will be supported today. I think we have public support for the measures under consideration this afternoon, but we should not be complacent about it. That is why it is right that we spend so much time exploring these issues.

--- Later in debate ---

[Graham Stringer (Blackley and Broughton) (Lab)]

As you know, Madam Deputy Speaker, I was trying to help you with the intervention by withdrawing from the list, but I am grateful to be on top of the list for the Labour Benches.

I agree with my right hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer) the Leader of the Opposition when he says that the Prime Minister is a threat to public health. I think that that is absolutely right. I draw a different conclusion from my hon. Friends on the Labour Front Bench on how we should respond: not by being irresponsible but by taking a look at the way the Government have dealt with the whole of the covid crisis from the very beginning to what they continue to do.

I am a member of the Science and Technology Committee. Together with the Health and Social Care Committee we produced a 150-page report. I hope that right hon. and hon. Members have had the time to read it. They may not agree with its conclusions, but it contains very valuable information. The key point, which a lot of the press missed, was not that the Government followed the science on the issue but that they got into a groupthink with the scientific advisers and did not challenge them. They assumed that science was something handed down on tablets of stone, whereas it is not. It is a process and it needs challenging by those of us who have responsibility in this House for making laws and policies, and by other scientists. We seem to be repeating that process.

My Committee had as a witness this morning Susan Hopkins. Let me say that at best—if I can use a word somebody else used—the advice we were getting from her as an adviser was opaque. The information we were getting was opaque when it should be transparent. This time last week, the Deputy Prime Minister stood up and said there was no plan to go to plan B. Some 36 hours later, we were starting plan B. Why was that? What was the scientific advice given?

We were told fairly definitively that no such advice was given to change the view. What changed the view was that the Prime Minister was in a state of crisis and under pressure from his own Back Benchers and everybody else. That is not a sensible way to make decisions. It is not a sensible way to make decisions to put forward statutory instruments that say—the Under-Secretary of State for Health and Social Care, the hon. Member for Erewash (Maggie Throup) was waving a sheet about, which may or may not have been the impact assessment—that no impact assessment has been done.

[Mr Steve Baker]

I have in my hand the impact assessment for vaccination as a condition of deployment in health and care providers—I was not able to get in earlier. I feel confident that the Front Benchers will know that the estimate is that 88,000 people will leave the health sector, 73,000 will leave the NHS, 15,000 will leave the independent health sector, and 35,000 workers will leave domiciliary care. Does the hon. Gentleman agree that that is reason enough to vote against imposing this on the nation?

[Graham Stringer]

That is very interesting. It is also interesting that papers circulated by the Vote Office said there was no impact assessment. That does not impress me.

The point I was just about to make—I do not know if other hon. and right hon. Members have noticed this—is that the 355-page Act passed at the start of the epidemic, the Coronavirus Act 2020, is barely being used. The Government could have used the Civil Contingencies Act 2004 to bring in some of the restrictions that they have placed—maybe necessarily, maybe unnecessarily—on people’s freedoms. The difference between the 2004 Act and the Public Health (Control of Disease) Act 1984 is quite simply that much less scrutiny is available under the latter. Once regulations are passed, if there is not a sunset clause, they last. The Government should not be rewarded for unnecessarily using tough authoritarian legislation when other legislation was available that would have allowed more scrutiny.

The Government have refused to give information. My hon. Friend the Member for Ilford North (Wes Streeting) began his speech by saying that different people have different views and weigh the factors of civil liberties and health in different ways. That is absolutely right, but the Government will not tell us the costs and benefits of their policies. We now know that three quarters of a million people have failed to be tested for cancer. This is not a win-win situation. Cancer patients who are yet to be tested will eventually die because of the decisions being taken, because services are not available; some people will die of covid.

To come to the right decisions, this House needs all the information available, but it is not coming from the NHS and it is not coming from Government Ministers. That is why I will not give the Prime Minister the benefit of my support for the way he has arranged to respond to this covid crisis.

Covid-19 Vaccinations

Graham Stringer Excerpts

Monday 20th September 2021 Westminster Hall

[Jack Dromey (Birmingham, Erdington) (Lab)]

It is a pleasure to serve under your chairmanship, Ms Ghani, and I welcome the Minister to her position in Government and here today. One of the welcome innovations of parliamentary democracy in recent years has been the notion that the public can trigger debates by way of e-petitions, and we are here to debate two e-petitions that commanded significant public support.

The hon. Member for Carshalton and Wallington (Elliot Colburn) was absolutely right to talk about the development of the vaccines as a remarkable triumph of British science, and all those who have been involved deserve huge credit—not least because the consequence has been to save the lives of tens of thousands of people who would have otherwise have died. We in the Labour party are committed to following the science and, as has been said eloquently, we can see that vaccination is having a dramatic impact, reducing hospitalisation and preventing people from becoming very ill with covid. As the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) rightly said, it is absolutely vital that everyone who can get the vaccines should do so. We therefore need to send an unmistakable and united message from Parliament: by keeping uptake rates high, we can beat the virus. Anyone who is worried about the vaccine—there are many—should speak to health professionals about their concerns and receive proper advice. They should not be influenced by anti-vaxxer fantasists, whose advice is not just wrong, but dangerous to health and wellbeing.

[Graham Stringer (Blackley and Broughton) (Lab)]

I agree with the point that my hon. Friend is making. I was talking to a 14-year-old over the weekend, and she said that she had seen on the internet a magnet that was attracted to somebody’s arm because they had been vaccinated. Does my hon. Friend agree that the internet companies and the Government should get such nonsense taken down as soon as they can?

[Jack Dromey]

My hon. Friend is absolutely right. Some of the propaganda that we have seen, including on the internet, is positively pernicious. If anyone is seduced into believing it and, as a consequence, catches covid and dies because they are not vaccinated, those responsible bear should bear a heavy burden for what they are doing. Everyone with power, including the internet companies, needs to be more proactive and dynamic in ensuring that shameful propaganda is not propagated on social media.

Over the past year, we have seen the tragic impact of coronavirus on our communities. I stress once again that it is absolutely vital that the importance of taking the vaccine is constantly emphasised. I think of Jane Roche in my constituency, who lost her father and, five days later, her sister to covid. Jane remains distraught to this day, one year on. People such as Jane know all too well just how important it is that vaccine uptake remains high, so that no one should suffer the grief that she has suffered. Like other hon. Members who have spoken in the debate, I therefore strongly encourage everyone to get vaccinated for their own protection, but also for that of the wider community.

The Labour party calls on the Government to make a more direct effort to vaccinate those from communities in which vaccination rates are low, particularly young people. I hope that in her response, the Minister will be able to update us on the Government’s efforts to tackle the problems of low uptake.

On vaccine passports, in relation to the petitions before us, we understand why the public might be confused or anxious about perceived discrimination against those that are not vaccinated. I have to say that the Government’s approach to covid passports has been chaotic at times. There has not been consistent clarity from Ministers about what vaccine passports are supposed to achieve, how they would work and what would be expected from the public, businesses and workers, and that meant we had a degree of chaos over the summer and no real preparation before the winter. Two weeks ago, the then vaccines Minister, the right hon. Member for Stratford-on-Avon (Nadhim Zahawi), stood before Parliament to confirm the introduction of covid passports and stress their importance; days later, the Secretary of State for Health and Social Care said that they had been scrapped. No matter the measures being introduced, businesses, workers and consumers need clarity from the Government, not conflicting messages and rapid U-turns. We have therefore repeated many times that we would not accept any certification or passport scheme that was vaccine-only.

The Welsh Labour Government have made some interesting progress on this very issue. They followed the data and applied a mandatory risk assessment that takes into consideration the full risk posed, and then recommends a range of mitigations on that basis. For large venues, crowded events and close-contact businesses, such as nightclubs, the NHS covid pass application is mandated for use; that means using familiar mitigations such as masks, social distancing and ventilation in most business settings, based on the risk level. Use of the NHS covid pass gives people the option to present a negative test result as an alternative to full vaccination.

We do not support the introduction of any scheme that provides access to a service for only fully vaccinated people. Free testing should therefore remain widely available so that we can identify and isolate the virus. The approach in Wales has been welcome in other respects, as it makes a clear distinction between venues such as local cafés on one hand and Wembley stadium on the other, where different mitigations for covid are needed.

We also do not support any potential covid pass scheme for access to essential services that does not get the balance right. That includes, but is not limited to, access to doctors and dentists, supermarkets and other essential retailers. We do not agree that vaccine passports should be used for day-to-day, routine access to the office, health services, dentistry or food.

On health and social care workers, we want everyone working in care homes to take up the vaccine—that is absolutely essential. The vaccine is safe and effective. I stress again: do not believe the sometimes poisonous propaganda of the anti-vaxxers. However, we do not support the case for compulsory vaccination. There are serious warnings from the care sector that the Government’s plan could lead to staff shortages in already understaffed care homes, which would have disastrous consequences for the quality of care.

Again, the UK Government should learn from the work done in Wales, which is running the fastest vaccination programme in the world, and has vaccinated a far greater proportion of its care staff than England. The Welsh Government have rejected compulsory vaccinations and have instead chosen to work closely with the care sector to drive up uptake, as well as valuing the workforce, including a proper pay rise. The Government should focus on driving up standards and retention of staff by treating care workers as the professionals they are, with improved pay, terms and conditions and training. We need all care homes and care workers to have proper personal protective equipment, regular testing and good training.

We are now approaching what is likely to be one of the most challenging winters that the national health service has ever faced, and the top priority must be to protect it. We urgently need a plan from Government that sets out the direction of travel in the next stages. Any plan for the winter period must, first, get vaccination rates up in areas where uptake is low; secondly, outline how and by when vaccinations for children will be rolled out; thirdly, finally fix the issues of self-isolation and sick pay; fourthly, provide proper ventilation in schools and public buildings; and, fifthly, provide a clear plan for businesses, workers and consumers. Those are significant steps the Government could take to greatly improve the country’s response to coronavirus. I hope that when the Minister responds, she will be able to outline in more detail the Government’s plan to fix those problems.

Once again, as other hon. Members have done cross party, I emphasise the importance of vaccine take-up. Covid-19 vaccines have saved thousands of lives and been crucial in protecting the national health service. It is critical that we maintain the protection the vaccine affords and send a clear and unambiguous message to all that vaccines work, and that anyone who can, should receive the vaccine.

--- Later in debate ---

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

Thank you, Ms Ghani.

I am grateful to my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) for introducing this debate on these important topics, and I commend him for setting out the importance of vaccines in combating so many diseases. When we look at the history of vaccination programmes in previous eras, we realise just what impact they have had on people’s lives.

We know that the covid vaccination programme is the nation’s best line of defence against covid-19. Vaccinated people are far less likely to face severe disease from covid-19, to be admitted to hospital or to die from it. They are also less likely to pass the virus to others. More than 93 million covid-19 vaccinations have already been administered, and the latest estimates from Public Health England indicate that the programme has saved more than 112,300 lives and prevented more than 24 million cases.

As other hon. Members have done, I pay tribute to everyone who has played a crucial role in the success of the vaccine roll-out—our brilliant scientists, clinical trial participants, the armed forces, NHS England, frontline healthcare workers, vaccine volunteers and local and central Government. Their life-saving efforts have helped to maintain the rapid pace of the roll-out across the entire country. I also recognise the brilliant work of the former Minister for vaccines, my right hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi). I know that I have very big shoes to fill.

The public’s continued willingness to get vaccinated, to test, to self-isolate if they have symptoms and to follow behaviours and actions that mitigate all methods of transmission has played a key role in the lifting of restrictions. Over autumn and winter, the Government will aim to sustain the progress made and prepare the country for future challenges, while ensuring that the national health service does not come under unsustainable pressure.

In my first debate as Minister with responsibility for vaccines, I join the plea of my hon. Friend the Member for Carshalton and Wallington and other hon. Members for those not yet vaccinated to take up their vaccine offer and join the around 89% of the UK who have had at least their first dose. I am sure the whole House will join me in thanking them for playing their part in helping us all to live safely.

We will continue to make vaccines easily available to everybody, to maximise uptake among those who are eligible but to date have not taken up the offer. In England, 11.3% of people ages 16 and older—more than 5.5 million people—remain unvaccinated, which heightens the risk of rising hospitalisations, particularly when prevalence is high. Take-up so far varies by ethnicity, age and deprivation, with some groups recording lower rates of vaccine uptake than others.

Building on lessons learned through phases 1 and 2 of the vaccine roll-out, the Government continue to work closely with the NHS to make it as easy as possible to get a vaccine, including through “Grab a Jab” in England, pop-up vaccine sites across the country and easy-to-use walk-in sites found on the NHS website. Pop-up sites include those at football stadiums and shopping centres, reaching out to the whole community. The Government have partnered with transport providers, such as Uber and FREE NOW to ensure access to vaccine sites is easier than ever before.

The hon. Member for Birmingham, Erdington (Jack Dromey) asked how the Government have reached out to people who are hesitant to take part in the vaccination programme. Despite having been in post for only a matter of days, I reassure him that the Government and the NHS are working closely together to ensure that we reach out and get the extra 5.5 million jabs into the arms that need them, and fill the gap that is in the community. I reassure him that that is one of my key priorities in my role as vaccine Minister.

The last 18 months have shown that the pandemic can change course rapidly and unexpectedly. It remains hard to predict with certainty what will happen. There are a number of variables, including the levels of vaccination, the extent to which immunity wanes over time, how quickly and how widely social contact returns to pre-pandemic levels, which is partly to do with the return to schools and as offices reopen, and whether a new variant emerges that fundamentally changes the Government’s assessment of the risk. That is why the autumn and winter plan sets out our plan B.

Vaccine status certification is part of the Government’s plan B if the data suggests action is required to prevent unsustainable pressure on the NHS. For venues, certification could allow settings that have experienced long periods of closure to remain open, compared to more stringent measures that may severely reduce capacity or cause them to close entirely. The autumn-winter plan committed to publishing further details shortly on the proposed certification regime that would be introduced as part of plan B.

In this scenario, certification would be introduced in a limited number of venues. Communal worship, wedding ceremonies, funerals and other commemorative events and protests would also not fall under the certification regime. Exemptions would continue to apply for those who cannot be vaccinated for medical reasons, those on covid vaccine clinical trials and for under-18s.

The NHS covid pass would continue to certify individuals based on vaccination, testing or natural immunity status, with more than 200 events and venues already introducing voluntary certification and the NHS covid pass as a condition of entry.

Care home staff provide a critical role in supporting the health and wellbeing of some of the most clinically vulnerable to the effects of covid-19 in society, and have maintained their dedication and professionalism through highly challenging conditions. Since the start of the pandemic, the Government have committed over £6 billion to local authorities through non-ringfenced grants to tackle the impact of covid-19 on their services, including adult social care. We continue to be committed to supporting the social care sector.

To prevent individual susceptibility to covid-19, from 11 November it will be a condition of deployment for anyone working or volunteering in Care Quality Commission regulated care homes that provide accommodation for persons who require nursing and personal care to be fully vaccinated. Thanks to the incredible efforts of people across the sector, over 1.2 million social care workers in England have now been vaccinated. This is a fantastic achievement and an important step for staff to protect themselves, their loved ones and the people they care for from becoming seriously ill or dying from covid-19.

[Graham Stringer]

Can the Minister answer the question that her predecessor failed to answer on the Floor of the House on Second Reading of the Bill? Everybody agrees that it would be a good idea if all care workers were vaccinated, but why will it be effective to force reluctant care workers to either have it or lose their employment, when other people entering care homes—hairdressers, musicians and entertainers and such—would not be forced to? How is that an effective policy?

[Maggie Throup]

I thank the hon. Gentleman for the question. If he will excuse me, I have obviously been in post a short time. As I am led to believe, it is people who regularly go into care homes that will need this. It is not just restricted to the actual carers. If anybody needs to go into a care home in an emergency situation, that is a different scenario. If I may, however, I will clarify that after the debate.

Vaccine uptake nationally in the care home workforce is high, at 85.6% for first doses. This is in line with vaccine uptake in the general population. There is, however, significant variation at a regional, local and individual care home level. Vaccine requirements are designed to level up uptake in the care home workforce. While the majority of care home workers have been vaccinated, the latest published data as of 12 September highlighted that only 81.3% of older adult care homes in England were meeting the SAGE advice that 80% uptake of first doses among staff is the minimum needed to reduce the risk of outbreaks in these high-risk care settings.

While residents in care homes are some of the most at risk from covid-19, the responses to this initial consultation on care homes made a clear case for extending this policy to other settings where vulnerable people receive care and treatments. The Government are therefore seeking views on whether to extend vaccination requirements to other frontline health and care workers—those with face-to-face contact with patients and clients through the delivery of services, as part of a CQC regulated activity. Recent research has shown that people infected with both flu and covid-19 are more than twice as likely to die as someone with covid-19 alone and nearly six times more likely than those with neither flu nor covid-19, so vaccination requirements for both flu and covid-19 are being considered.

I trust that the debate will have helped to dispel some of the myths that hon. Members have raised about vaccinations, and will really reach out to the public to ask them, as colleagues have done, to go and get vaccinated to protect themselves and others. To conclude, I reassure the House that we are doing everything we can to widen and deepen our wall of defence that the vaccine provides. The ask of our NHS colleagues is challenging and complex, yet they have risen to this challenge and do it every day. Once again, I thank them for their dedication.

Coronavirus

Graham Stringer Excerpts

Wednesday 16th June 2021 Commons Chamber

[Graham Stringer (Blackley and Broughton) (Lab)]

I will not be joining the Secretary of State in the Lobby later on, partly for civil liberties reasons, but I do agree with what he is saying about vaccination. About four years ago, the Science and Technology Committee looked at the level of flu vaccination in care homes, which at that time was about 20%. Flu, like covid, is a killer of elderly people. Will he be looking to make not only covid vaccination, but flu vaccination a condition of employment?

[Matt Hancock]

Yes we will, for exactly the reason that the hon. Gentleman sets out.

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[Graham Stringer (Blackley and Broughton) (Lab)]

As ever, it is an honour to follow the hon. Member for Broxbourne (Sir Charles Walker). On his interesting point about SAGE, we could do with full disclosure from the Government about all the facts that they have available to them on covid. In the Science and Technology Committee this morning, we were told that vaccinations have saved 14,000 lives. I have no doubt that that is an accurate figure, but there are many figures that have not been given. As we said the last time we debated this issue, only one side of the equation is given. Let me ask this question: how many lives have been lost in order to save capacity in the NHS? When it comes to looking at people untested and untreated for cancer, heart disease and other diseases, we will find that the figures are of a similar, if not greater, magnitude than the number of people who have died from covid.

We should have transparency and open declarations of what really happened with the 26,000 deaths in care homes, where untested people were sent from hospital. We should have disclosure about all those people who were triaged by age and who were not treated, and all those people in care homes who were not allowed into hospitals because they were not taking people from care homes. There is a great deal more information that we require in order to make a rational decision about whether the lockdown should continue. I agree with the right hon. Member for New Forest West (Sir Desmond Swayne) that what we have here is the Government asking for emergency powers when there is no longer an emergency.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

I thank the hon. Gentleman for giving way; we were in the Science and Technology Committee this morning. Does he share my disquiet at the fact that the vaccine effectiveness numbers that Public Health England has published—96% effectiveness against hospitalisation from two doses of Pfizer, and 92% from Oxford-AstraZeneca—are much higher than the numbers that have been plugged into the models used by Imperial and the London School of Hygiene and Medical to underpin the data that the Government are relying on?

[Graham Stringer]

I agree completely that those sorts of numbers—the real numbers, as opposed to model numbers—are the numbers that should have been plugged into that model. They would have given a different scenario. The hon. Gentleman makes my point: in order to come to rational decisions about what risks we should take as a country and what risks individuals should take, we should have all the information up to date and available. The Government have refused on a number of occasions to give out that information. They have run a campaign to scare people into accepting their decisions.

To go back to the comments of the hon. Member for Broxbourne, who was talking about elections to SAGE, at least the behavioural psychologists who advise the Government have made a public apology. They say that they have undermined their professional credibility by joining the campaign of fear. I wish that the Government would not only put out more information, but apologise for frightening people. They should not frighten the electorate, and they certainly should not frighten people in this Chamber into taking people’s liberties away.

One of the things that has annoyed me most in the last 15 months is when the Prime Minister and the Secretary of State for Health and Social Care say, “We instruct you”—meaning the population—“to do various things,” when there is nothing in the legislation that would give the Secretary of State or the Prime Minister the ability to instruct individuals. We live in a liberal democracy in which we pass laws that are enforced by the police, and then the courts make a decision if there is a prosecution, not one in which the Secretary of State acts like some kind of uniformed Minister of the Interior.

I will vote against the regulations today. We need a more direct debate on the issue and we need what Members have searched for—a straightforward comparison, with real statistics, of what risks everybody faces.

Air Ambulance Funding

Graham Stringer Excerpts

Monday 26th April 2021 Westminster Hall

[Graham Stringer (in the Chair)]

I remind hon. Members that there have been some changes to normal practice, in order to support the new hybrid arrangements. Timings of debates have been amended to allow technical arrangements to be made for the next debate. There will also be suspensions between each debate. I remind Members participating physically and virtually that they must arrive for the start of debates in Westminster Hall. Members are expected to remain for the entire debate. I must also remind Members participating virtually that they are visible at all times, both to each other and to us in the Boothroyd Room. If Members attending virtually have any technical problems they should email the Westminster Hall Clerks email address. Members attending physically should clean their spaces before they use them and as they leave the room. I would also like to remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall—obviously not when speaking.

Coronavirus

Graham Stringer Excerpts

Thursday 25th March 2021 Commons Chamber

[Jonathan Ashworth]

The hon. Gentleman invites me to offer endorsement before I have read the details—he is a canny operator in this place—but in principle his suggestion sounds reasonable. I look forward to no doubt receiving an email from him later today, which I will be able to read when I am on the train back to Leicester.

[Graham Stringer (Blackley and Broughton) (Lab)]

My hon. Friend is giving us an interesting insight into the history of the epidemic in this country and the discussions that took place. Would he care to put it on record that we should immediately start an independent public inquiry into what has gone on so that we can get a full picture? It is a feeble excuse to say that people cannot attend a public inquiry when virtually every Select Committee in this House is having witnesses every day.

[Jonathan Ashworth]

My hon. Friend is absolutely right: we need a public inquiry. Mistakes have been made. There have been examples of poor decision making. When we went into the crisis, our health and social care capacity was less than it should have been, and our public health capacity, after cutbacks over many years, was lacking. We were late going into lockdown a year ago; maybe that was not unreasonable, but we were also late going into lockdown the second and third time. Of course we need a public inquiry to get to the bottom of all these matters.

The Secretary of State is embarking on a reorganisation of the national health service. Yesterday, he made an interesting speech about the future of public health, which he opened by saying that one lesson of this crisis is that we need to set up a national institute of health security. I agree with him on health security, as it happens, but the Government cannot, on the one hand, say that they have learned lessons from this crisis and they need to do X, Y and Z while, on the other hand, the Prime Minister says it is too early to learn lessons and we cannot have an inquiry. My hon. Friend the Member for Blackley and Broughton (Graham Stringer) is absolutely right and I totally agree with him.

We have concerns about schedule 21 of the 2020 Act, but we are where we are, and the procedures of the House leave us little room for manoeuvre, so we will support the Government in the Division Lobby, should it come to that, albeit that we would rather not be in this situation.

Schedule 22 is another schedule that is open to abuse, and I hope the Government will review it and come forward with alternatives; given recent events, the power it contains on gatherings has caused understandable concern. However, some progress is offered by the public health regulations, which expressly include—I think for the first time, and in relation to each step of lockdown relaxation—the right to gather for purposes of protest. That is welcome but, to be frank, it should have been there all along. I have some concerns that, to comply, organisers must take into account, in the words of the regulations,

“any guidance issued by the government relevant to the gathering”,

which means that the Government, through guidance, which could be general or specific to a particular protest, can determine what is allowed by way of protest. I hope the Minister, who is a decent man and a fellow Leicestershire MP, can offer us some guidance on that in his response.

Notwithstanding our concerns, we understand why the 2020 Act must stay on the statute book and why the public health regulations must receive the support of the House today. The pandemic is not over. The virus is surging again. Deaths are increasing across the world after going down for some weeks. Mutations could emerge, which could bounce back at us and set us back considerably. Although they would probably not put us back to square one, they could evade the success of our vaccination programme. A year ago, I concluded my remarks by observing:

“The crisis has exposed the vulnerability of a society in which insecure work is rife, deregulation is king and public services are underfunded. When we come out on the other side, as we will, we have to build a society that puts people first.”—[Official Report, 23 March 2020; Vol. 674, c. 61.]

Rebuilding that society becomes ever more urgent every day.

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[Graham Stringer (Blackley and Broughton) (Lab)]

It is a pleasure to follow the hon. Member for Broxbourne (Sir Charles Walker).

On 7 March in Manchester there was a demonstration, not about milk but about the pay of NHS staff. Karen Reissmann, a political opponent of mine at general elections, was arrested and served with a fine of £10,000. That is an extraordinary attack on civil liberties. The very small group of people at the demonstration were socially distanced. Professor Woolhouse has told the Science and Technology Committee that while no risk is zero, the risk of catching covid-19 in the open air is minimal. We need to stop these restrictions now. That is one of the reasons why I will not be voting for the Government’s proposals.

The second point I want to make is about the Government’s statement that they believe in “data, not dates”. That is a curious thing for them to say, because when you look at what they say, there is no data there. There are dates—lots of dates—and when we have asked Ministers and scientists, how we, as parliamentarians can check the data to see whether things are going well or badly, and so that we can ask for it to be speeded up, no information is given to us. Quite simply, it is a slogan. The Government should be telling us what level of admission into intensive care, what level of infections, what level of hospital admissions and what level of vaccinations could lead to us being freed earlier. That is another reason why I will not be voting for the proposals before us; they are not giving Members of Parliament the tools that they need to deal with this.

My third point, in some ways my most fundamental point, is that we have only ever been given one side of the story. People have died of covid, but if we look at what the cancer charities are telling us at the present time, we will see that at least 50,000 people are expected to die because they have not been tested over the past 12 months. Every area of health service provision has been diminished because of the actions that have been taken on covid.

I cannot get past this point without also highlighting what Patrick Vallance told the Science and Technology Committee. If we had had the same level of intensive care facilities as Germany and France—they have about five times the level that we have—many of those other services could still have been provided. We have lost jobs. School children will suffer for the rest of their lives—hopefully not, but I think that that is the case—because of what has been done to protect people.

I cannot support what the Government propose. The big reason behind it, I suppose, is that Governments can get a taste for authoritarianism and for large powers. I do not want them to get a taste for that. I want this to be the end of it. I would like it to be the end of it today, or in six months, or on 21 June. I think that is unlikely, but I do not want this or any other Government to think that we should give these powers to a Government ever again.

Deaths in Mental Health Care

Graham Stringer Excerpts

Monday 30th November 2020 Westminster Hall

[Graham Stringer (in the Chair)]

Before we start, I remind hon. Members of the new rules in Westminster Hall. They should be getting used to them now, but some have not been in a Westminster Hall debate. I ask Members to sanitise their microphones using the cleaning materials provided before they use them, and dispose of the materials as they leave the Chamber. Members are also expected to honour the one-way system, which means going round clockwise, coming in by the left entrance and leaving by the other entrance. Members can intervene only if they are on the call list. If you are on the call list, you are expected to be here at the start of debate but, unlike the position prior to covid, it is quite permissible to leave after having spoken.

Before I call the hon. Member for Hartlepool (Mike Hill), I need to advise hon. Members that I have been informed that there are active Health and Safety Executive criminal legal proceedings against Essex Partnership University NHS Foundation Trust relating to deaths in mental health care facilities between October 2004 and April 2015. I have further been informed that the trust has pleaded guilty in those proceedings to failures of care relating to the deaths of 11 patients. Active proceedings are sub judice until sentencing or discontinuance under the House’s resolution. Therefore, Members should be mindful of matters still before the court—in particular, the judgment and sentencing in this case.

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[Mike Hill]

The statement reads:

“I am mum to Matthew James Leahy, born December 1991. He was a beautiful soul. He understood compassion and he cared for others. He was generous, he was kind, he was smart. He was funny and in his younger years he wanted to be a comedian. He was quite shy in large groups, and was a loyal friend. He was never one to encourage a fight but he would stand up for himself and the ones he loved. And I’m proud to say my son was honest, not a liar, not like some I’ve come across on this journey.

He loved the outdoors, loved anything water sports related and was a fantastic skier. Having left Grammar school, where he excelled in mathematics and computer science, he set up his own computer business, travelling between clients on his motorbike and was doing really well. He had a natural talent for swimming. He actually saved two ladies from drowning and when 18 he became a qualified life guard.

Aged 19 Matthew was having trouble sleeping and complaining of pains in his stomach and having stomach cramps. He was also hallucinating. When Matthew became poorly we turned to so called professionals for help, to help us to understand what was happening with our son. He was sectioned for care and treatment. This sectioning and the failings in care at that time, although noted briefly in the inquest verdicts, have never been investigated.

After Matthew’s death medical records showed that the first psychiatrist involved in his care picked up a B12 and folate deficiency and possible coeliac disease, combined with a thyroid issue. However, these discoveries were never addressed, as a new psychiatrist took over Matthew’s care and put him straight on to anti-psychotic medication. Any further physical checks were minimal.

On 7 November 2012, Matthew was placed under section 3 of the Mental Health Act and admitted to the Linden Centre in Chelmsford, Essex. By 15 November, some seven days in the ‘care of the state’, my son was dead. The last days of his life in a place he called ‘Hell’. And I now believe it truly was a hell on earth.

Alone, malnourished, over-medicated, scared, bleeding, bruised, reportedly raped, injected multiple times, ignored, and frightened. No records of any staff in those last seven days of his life offering him any comfort. I had been advised not to visit and to give him time to settle on the ward. I will live with the guilt for the rest of my life that I listened to so-called professionals and I was not there when my son needed me the most.

An inquest into my son’s death was held in January 2015. An open narrative verdict was reached, which concluded that my son, ‘Matthew James Leahy was subject to a series of multiple failings and missed opportunities over a prolonged period of time by those entrusted with his care. The jury found that relevant policies and procedures were not adhered to, impacting on Matthew’s overall care and wellbeing leading up to his death.’

How the inquest concluded I will never know. Staff were not interviewed by police after Matthew’s death. An internal investigation was carried out, which the Parliamentary and Health Service ombudsman has deemed flawed and not fit for purpose. This flawed investigation formed the basis of every investigation actioned after Matthew’s death.

The ligature was destroyed, the defibrillator was destroyed. Door logs were not downloaded. CCTV was hidden for over seven-plus years, and parts of it either not retained or deleted. So, so many more issues exist.

I have not been able to determine or control any of this—investigations, reviews, reports etc—all processes that have happened around me, with me being entitled to some information and some explanation, but little voice, little influence and little power.

I did think that the system would be open and honest, would explain what went wrong, hold to account those responsible for any failings and afford justice for failing my most precious son. However, I have discovered a deeply troubling mismatch between what I expected and what I found. In any other walk of life, if there had been failings, heads would roll. This has never happened, despite criminal offences being proved.

If the tragedy of losing Matthew hasn’t been bad enough, to not know the full circumstance that led to his death ‘whilst in the care of the state’ is unforgiveable. I still do not have full disclosure and have never seen internal statements. ‘Duty of Candour’ went out of the window the moment Matthew died.

It came to light after Matthew died that paperwork had been falsified, backdated and slipped into his files. It took me four-plus years to finally persuade Essex Police to register this falsification of mental health documents as a crime. I thought, ‘At last, they are listening to me.’ Then the bomb dropped. ‘We won’t be prosecuting, as it’s not in the public interest.’

The Trust has failed to take steps to protect patients in their care. The question remains why no individual has been held to account and why some staff involved in failing my son and other patients have actually been promoted to high-ranking positions within the NHS.

The Coroner called for a Public Inquiry after the inquest in 2015. There have also been multiple calls from various MPs in the last five years. The Parliamentary and Health Service Ombudsman went on national television after ‘The Missed Opportunities Report’ was published to say that if he had the power to, he would call a Public Inquiry.

In October last year, the Public Administration and Constitutional Affairs Committee held an evidence session on the Ombudsman’s Report into the failed care of Matthew and of Ben Morris. (Ben died in the Linden Centre in 2008 aged 20 years).

During the session, the Minister for Patient Safety, Mental Health and Suicide Prevention explained, ‘that Public Inquiries do not happen for individual cases. In this case, a Public Inquiry is not an appropriate response because we are talking about two cases’.

I have now been joined in this fight calling for a Statutory Public Inquiry into Essex Mental Health Services by multiple bereaved and failed families. (55 families and growing). How multiple deaths can have gone on unchallenged for so many years and so many people in official positions, not involved with this scandal, have entrapped themselves by collaboration the moment they came across it has baffled me. How the system did not prevent these deaths or at the very least detect the failings/changes needed earlier I’m sure is a question in many failed families’ minds, not just mine.

Where is the Government’s anger? Its thirst for Truth and Justice? Its commitment to getting answers and ensuring it never happens again?

Many families are losing loved ones while under the care of state mental health system. Whether that be due to mental illness, additional vulnerabilities such as autistic and/or learning disabled individuals, those misdiagnosed, or dementia...it does not discriminate.”

The Government are now officially, in Melanie’s words,

“on notice of…Gross and systemic Neglect (resulting in multiple avoidable deaths)…Physical, sexual, and emotional abuse and exploitation of the vulnerable—most of them young, historical and sadly, ongoing.

The right people in Government need to understand the full extent of the Essex Trust’s Failures and I have every faith that once the Government commits to a Full Statutory Public Inquiry into Essex Mental Health, the fundamental truth of what and still is going wrong will be revealed.

Through that knowledge I hope justice and accountability are afforded and that necessary change is made for others who, like I and many others did, look to services when they need safe, compassionate care for their loved ones.”

I have to echo that point in respect of some horrendous cases in the Tees Valley, my own patch.

I will conclude with the following words:

“I offered the Government Matthew’s sad death to be a catalyst of learning and change months ago. Please call a Public Inquiry into Essex Mental Health Services without further delay. Make the changes in Essex and send the learning across the country. I hope then that I can start to grieve the loss of my son and Matthew will be able to then rest in peace.”

I know I have kept my speech narrow, but I felt it appropriate to reflect the true voice of the petitioners. Thank you, Mr Stringer, for allowing me to do that.

[Graham Stringer (in the Chair)]

There are a number of people on the list who wish to speak. I will start with a time limit of four minutes, and call James Cartlidge.

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[Janet Daby (Lewisham East) (Lab)]

It is a pleasure to serve under your chairmanship, Mr Stringer. The circumstances of the debate are truly heartbreaking. I begin by extending my condolences to the family of the late Matthew Leahy and all families who have lost loved ones with mental illness at the hands of those who were supposed to protect them and care for them.

For many decades, mental health has not received enough attention or funding in comparison with physical illness. I draw attention to the mental health unit in Lewisham, which has already been viewed as not being fit for purpose—it was not built for people who have mental health problems—yet funding has never materialised for the changes needed to make it suitable for people with mental health problems. With the pressures of the pandemic, medical professionals are reporting more and more that people are suffering with mental illness due to economic hardship or loneliness, so it is clear there will be greater demand for mental health services over the next few years. It is imperative that we have well-functioning and well-funded mental health services to prevent needless deaths of the most vulnerable who are in need of those services. Medical professionals, the police and everybody around them also need support to be able to care for people with mental health illnesses. They need training, supervision and, most of all, not to be overworked. They also need to be able to debrief when they find things difficult.

I would like to raise the case of the late Kevin Clarke, from my constituency of Lewisham East, who sadly died following a mental health relapse. My condolences go out to his family, who are still bereft from the loss of Kevin, who, despite not posing an immediate threat to anyone, was handcuffed and placed in a leg restraint while telling the police that he could not breathe. In October, an inquest concluded that the officer’s restraint and supervision towards Kevin were excessive and sadly contributed to his death. However, the police were not the only professionals involved in his care. Other professionals were also in contact with him prior to this tragic incident.

A strategy of care needs to be in place for all mental health patients, one in which patients are listened to and family members are involved, so that loved ones can talk about preventative measures and their concerns, as well as contribute to the care plans that are needed. Mental health doctors, mental health nurses, social workers and care staff all need to work collaboratively with all professionals involved in keeping the most vulnerable people safe and secure, and to prevent these fatal, awful incidents of suicide or types of restraints leading to death. Change needs to happen.

[Graham Stringer (in the Chair)]

Hon. Members have either not turned up or taken less time than expected, so, unusually, I will increase the time limit for the last speakers to five minutes.

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[Dr Allin-Khan]

Yes, of course it would be in everyone’s best interests for the inquiry to take place as soon as possible. After all this time, Melanie deserves some answers. I support her call for a statutory public inquiry into Essex mental health services and for the appointment of an independent chair. It is crucial that lessons are learned from Matthew’s case.

I will take this moment to read a few words from Melanie about why a statutory public inquiry is so important to her:

“To come this far and then get fobbed off with a review or general inquiry…would simply take…us all back to square one.”

She goes on to ask that the Minister do something real and meaningful that paves the way for truth, justice, accountability and change. There is an opportunity here for the Minister to commit to providing a grieving mother with answers about her son’s death, and to learning lessons so that other families do not suffer in this way. We cannot, and must not, delay any further.

[Graham Stringer (in the Chair)]

We have plenty of time, but I ask the Minister to leave enough time for the wind-up at the end.

Public Health

Graham Stringer Excerpts

Wednesday 7th October 2020 Commons Chamber

[Alex Norris]

I am grateful for that intervention and I share that view. I have seen the hon. Gentleman’s tweet this afternoon in which he is very clear about that. Like me, he will have followed local Nottinghamshire data closely, and there should be close consultation with hon. Members, and with leaders such as the Mayor of Mansfield, and the leader of Nottinghamshire County Council. A one-size-fits-all approach is not the best route scientifically, and it will also breed local discontent and mean that people might be less inclined to follow it. So I support the hon. Gentleman in that venture.

Although rising restrictions are an inevitable part of rising infection rates, there is nothing inevitable about the loss of control of this virus. The Government promised us a world-class test and trace system, but rather than building on tried and tested local options in local government, they pursued a big national private contract. It was a triumph for dogma at a time when we need evidence-based leadership, and of course it has been a debacle.

The Government had a chance to fix this at a time when infection rates were relatively low, but they failed to do so. They have now lost control of the virus entirely, and our people will lose freedoms as a result. Yesterday, I saw a Minister blame the British people for rising infection rates. I thought that was extraordinary. Our constituents have made incredible sacrifices over the last several months; they do not deserve to have the Government thumb their nose at them for it.

Frankly, the Government can deflect as much as they want, but it will not wash. I would like to hear from the Minister today what they are doing to get this right and when it is going to happen. No more being sent hundreds of miles for tests, no more delayed results, no more lost spreadsheets. Drop the ludicrous defence of the indefensible. Let us stop pretending it is all okay when it is obviously not.

I have debated a number of these statutory instruments, and it is striking that every one of them has related to the north or the midlands. Rather than levelling up, we risk entrenching the north-south divide in this country. It is no longer reasonable to say, either, that these are going to be short, sharp interventions.

[Graham Stringer (Blackley and Broughton) (Lab)]

My hon. Friend mentions that many of these lockdowns have been in the north of England and the midlands. Does he agree that the figures for Chorley, Wyre, Lancaster, Oadby and Wigston, Wolverhampton, and West Lancashire, where there is lockdown, hardly vary from those in areas where there is no lockdown that have Conservative MPs, such as Barrow, Darlington, Craven and Newark? It reeks of political bias rather than objective decision making.

[Alex Norris]

I am grateful for that intervention, and I am about to make a related point. There seems to be no direction for when an area might exit restrictions or, indeed, what it might need to do in order to do so. The Minister started by saying that the Government are following the best epidemiological guidance, but it is unclear, as my hon. Friend mentions, why some areas are in lockdown despite having lower infection rates than others that are not. Again, that breeds cynicism and frustration.

It is also true that these restrictions ought to be accompanied by greater economic support, as well as much clearer communication. Perhaps the Minister could be a trailblazer and do what the Prime Minister was unable to do by saying what a local community needs to do to exit lockdown and, in the meantime, what precisely is likely to be done to support it.

In conclusion, we do not oppose these restrictions, but we strongly oppose the incompetence that has led us here. British people have missed births, weddings and funerals to fight this virus. Now, more people will not even be able to go and see their parents or their grandchildren, because the Government have not got a grip. No wonder their patience is running so thin.

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[Graham Stringer (Blackley and Broughton) (Lab)]

This House and the other place gave the Government enormous powers in March when the country was faced with the pandemic and a crisis. I believe the Government have abused those powers. They have taken arbitrary decisions and they have taken politically biased and prejudiced decisions. Most of all, as the Leader of the Opposition said at Prime Minister’s Question Time, they have shown “intergalactic incompetence” in what they have done—just sheer incompetence.

It turns out that the Government’s incompetence means that the massively overcentralised cure they have provided with the lockdowns is turning out to be worse than the disease itself. They have made more than 200 announcements, according to The Daily Telegraph. How many people can follow that number of announcements? People just ignore them, as colleagues have said. The Government have made 18 U-turns. It is not surprising that people have not followed those things.

Let me give the House an example of the incompetence as it has affected Salford. Of the 15,841 test cases that went missing, 200 were in Salford, and the results for a third of those took more than a week to arrive. The incubation period of the disease is gone in that time. Some of those people who had been tested and were waiting for results that did not come were in care homes. Some of them were over 90, the most vulnerable group possible.

The Government need to get rid of the centralisation and do what has been the history of public health in this country, which is to move decisions down to the local level, where people can work on a granular level. We can have sensible local test and trace systems that immediately get things into the system and allow local people to take action.

I said that the cure is worse than the disease. On 8 April, the Government were given a paper that showed that more than 200,000 people were likely to die because of the health service being switched off. At present, hospital beds are empty and people cannot get tested for cancer and other diseases very easily. We need to get the health service working, and one way to do so is to ensure that the test and trace system works effectively so that people can be treated immediately. I hope that the Minister will take this back to the Secretary of State and the Government and decentralise their policies immediately.

Covid-19 Update and Hospitality Curfew

Graham Stringer Excerpts

Thursday 1st October 2020 Commons Chamber

[Matt Hancock]

I will do everything I can, both policy-wise and personally, to support our great distilleries, including in my right hon. Friend’s part of the world. One of the wonderful things of the last few years has been the massive expansion in the number of local distilleries and breweries, and I am glad she supports her local gin distillery, no doubt both in her official capacity and perhaps with a tipple at home.

[Graham Stringer (Blackley and Broughton) (Lab)]

Through you, Mr Speaker, may I say to the Secretary of State that I voted against him last night not because I want the virus to rip through the country? Quite the reverse, I want him to get decisions right, and I do not think he is getting them right at present. The 10 o’clock curfew is bad for jobs and bad for the economy, and it is not controlling the spread of the virus. There is no scientific justification that he has been able to give for it. I believe he would make better and more correct decisions if he consulted Parliament, and the House of Commons in particular, particularly on local lockdowns. Today, Merseyside is being locked down and the Merseyside MPs cannot talk about that. Will he agree, before taking further measures, to bring every new restriction back to this House?

[Matt Hancock]

Of course the restrictions will come back to this House in the normal way. As the hon. Gentleman well knows, yesterday we made the further commitment that, wherever possible, all nationally significant measures will be brought forward for a vote before being implemented. I was very pleased that, as a result of that, there was an overwhelming majority of support for renewal of the Coronavirus Act yesterday.

Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020

Graham Stringer Excerpts

Monday 14th September 2020 General Committees

[The Minister for Patient Safety, Mental Health and Suicide Prevention (Ms Nadine Dorries)]

I beg to move,

That the Committee has considered the Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020 (S.I. 2020, No. 791).

It is a pleasure to serve under your chairmanship, Mr Twigg. The regulations were made by the Secretary of State on 23 July and came into force on 24 July. We introduced the regulations to make it mandatory to wear face coverings in some indoor settings in England, such as shops, supermarkets and indoor transport hubs. The regulations are exceptional measures that have been brought forward to mitigate the unprecedented impact of the covid-19 pandemic, and they comply with all the Government’s obligations in relation to human rights.

[Graham Stringer (Blackley and Broughton) (Lab)]

I am grateful to the Minister for giving way so early in the debate. My intervention is relevant to the first point that she made. Paragraph 3.1 of the explanatory memorandum says that the order was laid on 23 July “by reason of urgency”. What was the urgency at that time, when this matter had been under debate for at least three months?

[Ms Dorries]

I will look further into what the urgency was, but I imagine that the evidence that we were getting at the time was that face coverings could prevent people who might be asymptomatic from spreading or contracting the virus. Any measure that can stop an increase in the incidence of coronavirus would have been deemed necessary to halt coronavirus, to stop it increasing in the community and to save lives. I will come back to the hon. Gentleman with further information on that.

The regulations are exceptional measures that have been brought forward to mitigate the unprecedented impact of the covid-19 pandemic, and they comply with all the Government’s obligations in relation to human rights. Above all, the regulations can help to save lives. I urge the Committee to approve the regulations, so that we may continue to use these powers to save lives. The regulations are a necessary response to the seriousness of the situation and the imminent threat to public health that is posed by the spread of covid-19, which is why they were brought into effect under the emergency procedure approved by Parliament for such measures.

It is important that the Committee is able to scrutinise the regulations through this debate. Further amendments were made to the regulations to extend the requirement to wear a face covering to a wider list of indoor settings that are now open to members of the public. Those amendments will be debated at a later date. This debate will therefore focus only on the regulations as they were originally made in July. This country has been, and still is, engaged in a national effort to beat the coronavirus, thanks to the hard work and sacrifice of the British people. Guided by the science, this progress has allowed us to cautiously ease lockdown restrictions, allowing sections of the economy, such as the retail and hospitality sector, to reopen.

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[Graham Stringer]

I am grateful to the Minister, who is as ever being generous. I think she is reading directly from the explanatory memorandum. I wonder if she would be good enough to point the Committee to the evidence she is referring to.

[Ms Dorries]

I will come to explain that a little further in my speech, but we take the evidence on face coverings from a variety of sources: not only the Scientific Advisory Group for Emergencies but the behavioural insights team at the Department of Health and the New and Emerging Respiratory Virus Threats Advisory Group.

When the retail sector reopened and footfall increased, we wanted to enhance protections for members of the public and ensure we were taking the necessary steps to build on the progress we continued to make in reducing the transmission of the virus. That is why we have made it mandatory to wear face coverings in indoor places such as shops, supermarkets and enclosed shopping centres. Similar measures have been adopted in Scotland and Northern Ireland and internationally in countries such as France, Germany and Spain, to name just a few.

I will now outline what the regulations do and set out the policies and processes underlying their development, implementation, monitoring and review. As I have said, the regulations introduced a requirement on members of the public to wear a face covering in relevant places such as a shop, supermarket, enclosed shopping centre and indoor transport hub unless they are exempt or have reasonable excuse not to. The regulations do not apply to employees working in those settings. The wearing of any protective clothing or personal protective equipment by the workforce is a matter for employers following a risk assessment and is part of their health and safety responsibilities. Definitions of shops and transport hubs are included in the regulations, as well as a list of premises that are excluded and where a face covering is not mandatory: for example, restaurants and bars.

The list of settings included reflected the premises that were open to the public at the time of making the regulations. As more settings reopened to members of the public, the regulations were amended to include additional indoor settings and provide more clarity to members of the public on where face coverings must be worn. Those amendments will be debated in due course.

Guidance on gov.uk describes a face covering as a covering of any type covering the wearer’s nose and mouth. People should make or buy their own. Guidance has been published online on how to make and wear a face covering. We are asking people not to use medical-grade PPE as that should be reserved for health and care workers. However, someone wearing PPE would be compliant with the regulations.

While the Government expect the vast majority of people to comply with the rules, as they have done throughout the pandemic, the regulations give powers to the police and Transport for London officers to ensure the requirements to wear a face covering. This could include denying entry to the relevant place and/or directing members of the public to wear a face covering. The police will use the usual four Es approach: explaining engaging and encouraging—and enforcing only as a last resort. In the event that a person fails to comply with a direction from a police officer or a Transport for London officer, a police constable is able to remove the member of the public from the relevant place.

The regulations also include powers for police constables, police community support officers or a TfL officer in relation to the relevant transport hub, to issue a fixed penalty notice to anyone over the age of 18 who is in breach of the law. At the time of making the regulations, that was a fixed penalty of £100, reduced to £50 if paid within 14 days of the notice being issued. Since making the regulations, we have made amendments to the penalty structure, with increased fines for repeat offenders. That is in line with the enforcement provisions in other coronavirus regulations. Parliament will have the opportunity to debate that amendment at a later date.

Although we want as many people as possible to wear a face covering, we recognise that some people are not able to wear one, for a variety of reasons. The regulations exempt children under the age of 11, employees or officials acting in the course of their employment in these premises, and emergency responders. There is no general exception on health or disability grounds. To reiterate, we recognise that, for some, wearing a face covering is not possible or would cause distress or difficulty, and there are certain situations in which wearing a face covering is not practical or reasonable.

The regulations provide a non-exhaustive list of circumstances that constitute a reasonable excuse, pursuant to regulation 3(1), for not complying with the legal requirement to wear a face covering in a relevant place. Such circumstances include where a person is unable to put on or wear a face covering because of physical or mental illness or impairment, or disability; where a face covering needs to be removed for communication through lip reading; where a person needs to remove their face covering because it is reasonably necessary to eat or drink; or where a person is required to remove a face covering for identification purposes. There is comprehensive guidance on what might constitute a reasonable excuse, including circumstances that are not expressly included in the regulations—for example, when a person is speaking to or providing assistance to someone who relies on facial expressions to communicate, or where a person needs to remove a face covering to exercise.

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[Graham Stringer]

It is a genuine pleasure to see you in the Chair this evening, Mr Twigg. This is first time I have served under your chairmanship, and I look forward to doing so on many further occasions.

There are a number of things I would like to say about this statutory instrument. Some relate to process, some to science and some are political. On the process, the Minister, for whom I have every respect, made the point that these regulations last for only 12 months, which is absolutely right. However, the downside is that when regulations last for only 12 months, no regulatory impact assessment is required. A regulatory impact assessment would of course have answered some of the questions asked by the right hon. Member for Elmet and Rothwell, as well as by my right hon. Friend the Member for North Durham, my hon. Friend the Member for Warwick and Leamington and my hon. Friend the shadow Minister. That is to be regretted, but it is part of a bigger lack of scrutiny, which I will come to in a minute.

First, I want to make a very general point. I do not envy the Secretary of State for Health and Social Care, any Health Minister, or, indeed, any Minister from other parts of the Government who has to deal with these issues. They are really difficult. People have died. It is difficult to know what to do. When Ministers and the public pray in aid science—of course science should be looked at—I think people sometimes misunderstand its capabilities. If someone wanted to find the escape velocity of a rocket to leave the earth’s gravitational pull, they should go to an astrophysicist, who would give the exact figures. If they are given the weight of the rocket, they will be able to say the force required to reach that velocity, because physics in that sense is an exact science.

The science surrounding this pandemic is not exact and cannot be exact, partly because it is a new virus and people do not know anything. I suspect it will surprise members of the Committee to know that, as far as I am aware, in real situations or in laboratories, no experiments have taken place on covid-19. We are relying on experiments on other germs, bugs, viruses and bacteria, and on other kinds of experiments.

I will come back to the science, but the biggest point, on which I think I am in agreement with the right hon. Member for Elmet and Rothwell, is that there should be much more scrutiny of this legislation. I recently read the Lords Hansard from when the Coronavirus Act 2020 was passed. In that debate, phrases were used such as, “It would normally be anathema to a democratic Parliament to pass these regulations,” and, “Unprecedented powers are being given to the Government.”

The Minister in the Lords gave all the assurances one would have expected him to give: at the appropriate time, when these wide and extensive powers were used, there would be proper parliamentary scrutiny. It is not just about this SI—there have been many such statutory instruments laid and used, in terms of levels of fines and what is and is not against the law, that have yet to receive parliamentary scrutiny. We have been back here for some time. That is a breach of trust, given that all the parties gave the Government support for the Coronavirus Act 2020.

To go back to the science, one problem Ministers have is that most of them do not have a scientific background and, therefore, have not challenged the scientific advice, which cannot be that precise. In early April, the deputy chief medical officer said that masks should not be worn and that they even have a negative effect. I can understand why Ministers followed that. A few days later, on 16 April, the Secretary of State for Transport said that wearing masks would have a negative effect. In the next month, masks were introduced on transport and now we have them in shops and all sorts of places. Challenging the advice and asking for its source in the first place might have led Ministers to reach different decisions earlier, and even to different decisions leading to this SI.

Most of the evidence on masks has come from experiments with mannequins, which are difficult to do, conducted in laboratory settings, not real settings, so when the Government’s scientific adviser and other scientists say that there is no evidence that masks work, they are right, partly because no experiments have been done on this virus. Also, in the experiments and work that have been done we have not had the scientific gold standard of being able to test one experiment against a double-blind experiment.

That is part of the science background. The Government now come along and said that there is some evidence to suggest that, when used correctly, face coverings might have some benefit in reducing the likelihood of getting the virus, but common sense and the non-covid experiments tell us that. The Government advise putting a scarf over one’s face or getting a mask, which is actually not in line with the World Health Organisation’s recommendations. Following experiments conducted not on the virus but by firing laser beams at masks in Australia, published in the Thorax journal, the World Health Organisation recommended that three-layer masks are better than two-layer masks. The Welsh Government have followed that recommendation of having three layers. Our Government say that two is probably okay, but people can do anything they want. Having moved from saying that masks were of no use to saying they are now of some use, they are not using the best scientific advice, which the Welsh Government are using, to advise on which masks should be worn. I think that is a mistake. We have to go one way or the other. It is understandable that Ministers do not always challenge the advice.

When I asked what the latest evidence was, I expected the Minister to say that there was a large meta-study done by Professor Melinda Mills of the Leverhulme Centre in Oxford. It was not fundamental research, but the study looked across the board at all the papers that had been done and found that 120 countries were advising on masks, so we would have been massively out of step not to follow the advice. I realise that the original advice was not in accordance with that, but the Government could probably have moved earlier and more effectively, with parliamentary scrutiny, to the conclusion that they have reached. The Lancet, which has criticised the Government’s tardiness and slowness on this matter, and could have argued with Professor Van-Tam and any of the other advisers, has pointed out that lack of evidence does not mean the evidence is not there. They could quite easily have challenged those things.

Finally, on the point that my right hon. Friend the Member for North Durham made, I was at a meeting at the weekend with leaders of local authorities and some of the Greater Manchester MPs and there was no support from anybody for the Government’s proposals on marshals. Will the Minister guarantee to the Committee that untrained marshals will not be given enforcement powers that would normally lie with well-trained public health officials or the police? The last thing we want is busybody marshals upsetting members of the public by being over-officious. The confusion of the Government’s messages in this and other areas has meant that many members of the public, particularly younger people, have lost trust in the Government’s message and are no longer following it. What would make that situation worse was if we had untrained marshals throwing their weight about and upsetting the public so that there was even less support for what might well be necessary regulations.

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[Ms Dorries]

No, because every policy dealing with covid has to be based on evidence and scientific facts. We have always followed the science and we are still doing that today.

[Graham Stringer]

Is the Minister saying that the advice given to the Welsh Government was different from that given to the United Kingdom Government, dealing with England in this case? Secondly, we on the Science and Technology Committee have had all the scientific advisers before us on a number of occasions and they have been clear that they lay the evidence before Ministers and they may give advice, but, in the final analysis, it is for Ministers to take the decision, which may differ from the detail of the advice, or the advice may have to be interpreted. They are clear that it is not their decision. Does she agree with that?

[Ms Dorries]

On the hon. Member’s point about who advises the Welsh Government, I have no idea. I would imagine it is their chief medical officer. On whether the scientists take the decision about whether people wear masks, no, they do not. That is not their responsibility. Their responsibility is to evaluate and assimilate evidence and provide us with that evidence.

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[Ms Dorries]

I want to be absolutely clear myself before I give a response, so I will come back to the hon. Member on that in the morning.

[Graham Stringer]

I want to make a point similar to the one I made in the Minister’s opening contribution. What was the evidence, when was it given to Ministers, and what meant we had to wait until recess before the decision was taken? That is key to me. I am sure that if she was in opposition, she would be making exactly the same point.

[Ms Dorries]

We know each other too well.

I want to ensure that what I give the hon. Gentleman is an absolutely accurate statement; therefore, I will give it to him in the morning in writing.

I will stick to the substance of the issues that were raised. On the comments about transport police, the British Transport police outside London have the authority and they use their four Es: engagement, encouragement—