Draft NHS Counter Fraud Authority (Establishment, Constitution, and Staff and Other Transfer Provisions) (Amendment) Order 2020

Helen Whately Excerpts
Wednesday 8th July 2020

(3 years, 8 months ago)

General Committees
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Helen Whately Portrait The Minister for Care (Helen Whately)
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I beg to move,

That the Committee has considered the draft NHS Counter Fraud Authority (Establishment, Constitution, and Staff and Other Transfer Provisions) (Amendment) Order 2020.

It is a pleasure to serve under your chairmanship, Mr Mundell. Like any organisation, the NHS is not immune to fraud. As hon. Members are aware, the Government have backed the NHS with the biggest cash boost in its history: an extra £34 billion by 2023-24. That money will make a difference to many people. Yet, fraudulent activity in the NHS means that the money intended for patient care sometimes ends up in the pockets of those who did not legitimately earn it, meaning fewer resources available to be spent on frontline health services such as patient care, health care facilities, doctors, nurses and other staff. It is taxpayers’ money, and we have a duty to spend it appropriately. An effective counter-fraud organisation that is able to operate independently is crucial—a body that can act without external interference or influence and perform functions that cannot be undertaken at a local level, such as serious and complex investigations that cross borders and cases of alleged bribery and corruption on a national level.

As a result, the NHS Counter Fraud Service was set up in 1998 as part of the Department of Health. Since then, the function has evolved, and in autumn 2017 the NHS Counter Fraud Authority was launched as an independent special health authority. The National Health Service Act 2006 means it is limited to a maximum lifespan of three years, and so is due to be abolished on 31 October 2020. To prevent that, a statutory instrument was laid on 11 June 2020 to extend the abolition date of the NHSCFA by three years, to 30 October 2023.

I want to take this opportunity to highlight the important work of the NHSCFA and set out why we need to extend its lifespan for a further three years. The NHSCFA is a national centre of excellence. It has built strong relationships with organisations across the health and law enforcement sectors so that we can take the fight to those who seek to deprive the NHS of resources for patient care. Fraud is a hidden crime; to fight it, we have to find it. The NHSCFA is continually developing its intelligence and investigation capabilities, and is breaking new ground in how it detects and prevents fraud. It has also set important national standards for the counter-fraud work of NHS providers and commissioners. It also applies to independent healthcare providers and NHS organisations. Its work is clearly bearing fruit.

The NHSCFA’s latest strategic intelligence assessment shows an overall estimated reduction in losses from fraud of £60 million between 2017-18 and 2018-19. It also showed a £27.6 million reduction specifically on dental contractor fraud, thanks to a relentless focus by the NHSCFA over recent years, along with an £85 million annual reduction in fraud losses from false entitlement claims for help with healthcare since 2017.

It is clear that that approach is working. To change direction now would be a mistake. The concerted approach by the NHSCFA to improve fraud awareness and drive up fraud reporting across the NHS is bearing fruit, so we need it now more than ever, especially when we are in the middle of the greatest threat to public health that we have seen in generations.

As part of the Government’s response to coronavirus, the Chancellor has repeatedly said that the NHS will get the funding it needs. An initial £5 billion coronavirus fund was established at the Budget in April 2020. That was then increased to a £14.5 billion emergency response fund, of which £6.6 billion was earmarked to support our health services. We are continuing to work with the NHS and Her Majesty’s Treasury to ensure the NHS gets the funding and resources it needs.

Although we have seen the nation coming together to celebrate the heroic work of NHS staff, coronavirus unfortunately presents a heightened risk of fraud, where criminals may seek to exploit the situation. Never before has a counter-fraud response to this investment been so important. “Protect the NHS” is not just about protecting staff. It is also about the money that taxpayers contribute to this invaluable national resource.

The NHSCFA has played a key role during this period and has produced and shared coronavirus threat assessments with partners, and coronavirus counter-fraud guidance specifically for the NHS. This includes guidance outlining the unique risks during the coronavirus response and specific guidance outlining types of mandate fraud, and how to identify, prevent and respond to them.

As technology evolves, the risks to the NHS will also evolve, especially the risks from fraud, so we will need organisations such as the NHSCFA to co-ordinate the response at a national level. If we made the decision to abolish the NHSCFA today, that would expose the NHS to significant financial risks. It would mean that there would be no ability to record and assess accurately the nature and scale of fraud, and inform the response to it, both within the NHS and across the wider health sector. That would result in serious and complex fraud investigations being transferred elsewhere—for example to other NHS bodies, the police or the Department of Health and Social Care.

John Howell Portrait John Howell (Henley) (Con)
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I thank the Minister for giving way and for the examples that she has just set out. However, could she give us an overall picture of where the fraud is arising? Is it arising from within the NHS, from organisations with which the NHS has a relationship or from the man in the street?

Helen Whately Portrait Helen Whately
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I thank my hon. Friend for his intervention. The fraud we see comes from a range of the categories he has just mentioned, sometimes including members of the public and users of the NHS, but sometimes also organisations with which the NHS has contractual relationships.

Let me come back to the point I was making about the downsides there would be if we did not decide to continue the NHSCFA today. If we were to do that, it would undermine NHS funding—much-needed resources that are critical for patient care. I therefore urge hon. Members to keep this vital organisation in place and allow it to keep doing its important work, providing confidence and even certainty for many people. I commend the draft order to the Committee.

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Helen Whately Portrait Helen Whately
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I welcome the helpful and constructive comments from the shadow Minister, who shares the perspective of the Government on the important role of the NHSCFA and the importance of preventing and tackling fraud in the NHS. I want to reiterate that never before has a counter-fraud response to protect the Government’s investment in the NHS been so important, and that only a national organisation such as the NHSCFA can gather and process the information and intelligence arising from the huge range of threats to the NHS.

I should reiterate that the vast majority of people do not commit fraud in their interactions with the NHS; the problem is very much from a minority. The NHSCFA carries out the Secretary of State’s counter-fraud functions in respect of the health service in England, and it has the crucial ability to distil data and enable a focus on prevention in its counter-fraud response.

The shadow Minister asked about cross-NHS working. The NHSCFA is working hard to build and develop capability across the NHS and among NHS organisations, to extend consistent principles, national standards and best practice to all parts of the NHS, and to drive a national, co-ordinated and cross-organisational response. The focus is on prevention, because we know that preventing loss is more cost-effective than prosecuting suspects and recovering funds that have already been lost.

The shadow Minister asked about a revised strategy for the CFA, and I can assure him that it is being drafted and will be published soon.

Justin Madders Portrait Justin Madders
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On the updated strategy, we have talked a lot about personal protective equipment in the last few months, and it is fair to say there are some unusual entrants into that market. Will the updated strategy look at how PPE is procured moving forward?

Helen Whately Portrait Helen Whately
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The shadow Minister makes an important point about PPE. Clearly, the Government have had to move very rapidly to increase the procurement of PPE to meet the needs of the NHS and social care during the pandemic. PPE procurement for covid-19 is centrally managed, not managed by NHS trusts, and therefore falls outside the remit of the NHSCFA. It is being investigated by the DHSC anti-fraud unit, but that is being supported by the NHSCFA. No doubt lessons learned from the covid experience will be used by the NHSCFA in developing its processes and the strategy that we have been referring to.

Extending the current model will provide the opportunity for the NHSCFA to continue its work and consolidate its organisational design, which it has been working on over the last three years. The Department will continue to oversee the function of the NHSCFA, in its sponsorship role, to ensure that it remains fit for purpose. The draft order is an important and integral piece of secondary legislation to allow the NHSCFA’s independent and crucial remit to continue. I urge all hon. Members to approve it.

Question put and agreed to.

Health and Social Care Workers: Recognition and Reward

Helen Whately Excerpts
Thursday 25th June 2020

(3 years, 9 months ago)

Commons Chamber
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Helen Whately Portrait The Minister for Care (Helen Whately)
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I welcome this debate, because our NHS and care system is only as strong as the people within it. Throughout the pandemic, NHS and care workers have taken centre stage; we have all seen the dedication and care with which they approach their work, and the esteem in which they are held by the public, as these petitions demonstrate. This debate has also demonstrated the esteem in which they are held by hon. Members. I am determined that we should look after our health and social care staff, just as they look after us.

First, I will talk about pay, as that is the focus of the petitions. I want to reinforce that we have already delivered multi-year pay and contract reform deals for over 1 million NHS staff, in partnership with trade unions. In the past three years, nurses have seen their starting salaries increase by more than 12% and the vast majority of nurses have seen their pay increase by at least 6.5%, while the starting salaries for healthcare assistants have also increased by 16%. We have also increased pay for junior doctors to recognise the huge contribution that they make to our NHS. By the end of their four-year deal, junior doctor pay scales will have increased by at least 8%.

My hon. Friend the Member for Crewe and Nantwich (Dr Mullan) referred to the Government’s commitment to increase the number of doctors and nurses in the NHS, and he rightly said that recruitment and retention is not just about pay, but about experience. I am determined that we must improve the experience for the NHS workforce.

The shadow Minister spoke about vacancies in the NHS. I hope that he will welcome the good news that we heard today in the latest NHS workforce statistics that the number of nurses in England has gone up by more than 12,000 in the past year and we have over 6,000 more doctors. Compared with 2010, we now have 23,100 more doctors and 22,200 more nurses in the NHS. We want to recruit more, however, so we are providing financial support for nurses to train, and from this September, new and continuing nursing students will be able to get a maintenance grant of at least £5,000 per academic year.

Our social care staff have also played an incredible role during the pandemic. I am always blown away by the compassion that is shown by our care workers, who look after people who are at their most vulnerable. That was articulated so well this afternoon by my hon. Friends the Members for Peterborough (Paul Bristow), for Watford (Dean Russell), for Beaconsfield (Joy Morrissey) and for Rother Valley (Alexander Stafford) and many other colleagues.

Hon. Members will be aware that the Government do not set pay for social care workers in England. However, we are committed to raising the profile of our social care workforce and giving them the support they need. At a recent meeting of the Health and Social Care Committee, we heard from care workers about how some of them felt underappreciated by the public as a whole, and that is something we need to fix. After all, this is a job where staff have a chance to make a difference to people’s lives every single day that they go to work. As a start, we have adopted the CARE brand, for which I thank Care England. We have taken that on in order to build recognition of care workers.

Since the pandemic hit us, we have put in place support for care workers who have been at the frontline during this time. We are providing mental health support and bereavement support commissioned from Samaritans and Hospice UK. We have launched the care workforce app to bring together resources and guidance, and we are providing funding of £3.2 billion and then a further £600 million for local authorities to pass on to care providers so that they can provide full pay to staff who are isolating. We have made it clear to local authorities and providers that we expect that to happen.

One of the petitions that is in front of us today is entitled:

“We would like the government to consider social care as equally important to NHS”.

That is something that I passionately believe in. Social care is, absolutely, equally important. I know my colleagues in Government agree. As we heard in this debate, that sentiment is shared by many hon. Members, and we rightly now talk about health and social care workers in the same breath.

In the months ahead, as we pledged in our manifesto, we will be looking at how we can build a long-term solution for social care, so that in the long term care workers get the rewards they deserve, and—as argued for by my hon. Friend the Member for Bolsover (Mark Fletcher), in particular—so that everyone can have the dignity and security that they deserve.

Finally, I want to raise the contribution of our overseas staff. The NHS has benefited from the contribution of so many people from all over the world. I would like to take a moment to thank all our overseas NHS staff. I know that this has been a difficult time for many of you, especially as we have learned that BAME communities have been disproportionately impacted by the virus. We are so grateful to you for your hard work, and I want the system to do all it can to protect you.

On 21 May, the Prime Minister announced that NHS and social care workers would now be exempt from the immigration health surcharge. NHS and care workers who paid the surcharge from 21 May will be refunded, and we are getting on with the arrangements as fast as we possibly can. We are also continuing to provide free visa extensions and auto renewal of visas for workers who are eligible, and we will be introducing a new fast-track healthcare visa to make it quicker and easier for health and care staff to come and work in our health and social care system.

Our NHS and social care workers do a truly wonderful job delivering world-class care to so many. I would like to thank everybody who signed the petitions for making their voice heard. I would like to end by encouraging everyone who is thinking about joining our health and care system to do so. Caring for others is one of the greatest and most important vocations. We will do everything in our power to protect and support health and social care workers during this pandemic and beyond.

Testing of NHS and Social Care Staff

Helen Whately Excerpts
Wednesday 24th June 2020

(3 years, 9 months ago)

Commons Chamber
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Helen Whately Portrait The Minister for Care (Helen Whately)
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I beg to move amendment (a), to leave out from “medicine” to the end and add:

“and recognises the unprecedented action the Government has taken in its tireless efforts against Coronavirus to protect the NHS and save lives.”

The coronavirus pandemic is the most serious public health emergency that our nation has faced for a generation and our NHS and social care system has been well and truly on the frontline. Today, I would like to outline the work we have done to protect our NHS and social care from the threat of this invisible killer, as well as our work to safely ramp up services now that this virus is in retreat.

On protecting the NHS and social care, we have worked hard to boost the resilience of our health and care system, so it would not be overwhelmed, as we have sadly seen elsewhere across the world. A major part of this mission was our Nightingale hospitals. This was one of the most ambitious projects this country has ever seen in peacetime, building hospitals in just a matter of weeks in exhibition centres and conference venues. That hard work from so many meant that, even at the peak of the pandemic, there was more critical care capacity than there was when coronavirus first hit our shores, so our NHS was able to give outstanding critical care to everyone who needed it.

Our social care system has also been at the heart of the pandemic, and we have worked hard to give it the support it needs. In March, we announced £1.6 billion of funding for local government and £1.3 billion of funding via the NHS. In April, we announced a further £1.6 billion, as well as our comprehensive adult social care action plan. In May, we announced a £600 million infection control fund for care providers in England, which includes funding so that social care staff can be on full pay if they have to isolate due to covid. That work is bearing fruit, thanks to the dedication, expertise and compassion of care workers throughout the country.

Fifty-eight per cent. of care homes have had no reported cases of coronavirus. Every life lost in our care homes fills me with sorrow, whether it is from coronavirus or not. However, we are seeing a sustained reduction in the number of coronavirus deaths. This week’s Office for National Statistics figures for England and Wales show that the number of deaths in care homes has fallen once again—down from 536 to 360 in the last week.

This has been hard, but through this crisis we have strengthened our health and care system, and we are looking to see what lessons we can take forward as we look ahead to the winter.

Suzanne Webb Portrait Suzanne Webb (Stourbridge) (Con)
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Will the Minister let me know what steps the Government are taking to protect black, Asian and minority ethnic health and care staff?

Helen Whately Portrait Helen Whately
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I thank my hon. Friend for that intervention. She makes a really important point. One of the things that I have put much thought into over recent weeks is making sure that our staff of black and Asian minority ethnicities have the protection that they need. Both for the NHS and for the social care system, we have supported the development of risk assessment frameworks to identify the risks, with recommendations on what steps can be taken. I am working with the system to make sure that those are put into practice.

Coming back to the lessons that we are taking forward, one of the things that has been a great success has been the adoption of new technologies such as, for instance, online GP consultations. Some 99% of GP practices now have video consultation capability, while hospitals have been doing virtual out-patient appointments and care homes have been using tablets—the digital kind of tablet!—to keep people in touch with their families. We are also seeing new ways of working to help those on the frontline to make quicker decisions and cut red tape. We will keep driving these important reforms so that we can give everyone a better experience of health and social care.

As the Prime Minister set out yesterday in the House, we have succeeded in slowing the spread of the virus. On 11 May, 1,073 people were admitted to hospital in England, Wales and Northern Ireland with coronavirus, and by 20 June this had fallen by 74% to 283. This has reduced the pressure on the NHS so it has been able to carefully ramp up important services. Hon. Members have raised questions about two specific services in the motion, and I will address them both.

First, coronavirus has had a real impact on many people’s mental health, so there is a lot of concern about mental health services remaining open and available. Our NHS mental health services have remained open for business throughout the pandemic, using digital tools to connect people and provide ongoing support. This has proved especially effective for young people. Throughout the pandemic, we have provided £9.2 million of additional funding for mental health charities. We understand that we may see an increased demand for mental health services in the months ahead, and we are preparing for this, together with the NHS, Public Health England and other partners.

Secondly, hon. Members have raised questions about cancer services—another area where we are working hard to maintain care. For example, we have been operating surgical hubs where providers work together across local cancer services to maintain access to surgery. Although some cancer diagnostics and treatments have been rescheduled to protect vulnerable patients from having to attend hospitals, urgent and essential cancer treatments have continued. The latest data suggests that referrals are back to over 60% of the pre-pandemic levels, partly due to the NHS Help Us Help You campaign. This campaign has an important message that I am keen to repeat today. Anyone who is worried about chest pains, fears that they might be having a heart attack or a stroke, feels a lump and is worried about cancer, or is a parent concerned about their child should please come forward and seek help, as they always would. The NHS will always be there for us if we need it, just as it has been there for all of us throughout this crisis.

Emma Hardy Portrait Emma Hardy (Kingston upon Hull West and Hessle) (Lab)
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On that note, will the Minister also encourage people suffering from vascular disease to seek appropriate treatment as quickly as possible?

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Helen Whately Portrait Helen Whately
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The hon. Lady is absolutely right. The Under-Secretary, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), says to me that the hon. Lady is a very powerful campaigner on this subject. For that and for other conditions, people must absolutely come forward and get the help that they need. The NHS is there for that reason.

My third and final point is on testing. Testing for the virus and tracing how it spreads is critical to containing it as we ramp up services and ease the national lockdown. This is especially important for our NHS and social care system so that we can protect our colleagues and the people they look after. We have already built an immense national infrastructure for testing. Back in March, we had the capacity across all our testing channels to conduct fewer than 2,000 tests a day, whereas yesterday we saw more than 237,000 tests carried out. As we have built capacity, we have prioritised those in need. We started with the patients who needed a test, then expanded to NHS and social care workers and their families, then to other critical key workers, before we expanded to the wider community.

Today NHS England and NHS Improvement have written to NHS trusts and foundation trusts to outline further steps that must be taken in the NHS, including continuing to prioritise testing for all NHS staff with symptoms; extra testing of non-symptomatic staff when there is an incident, outbreak or high prevalence; and regular surveillance testing of staff which, on the advice of our chief medical officer, will be fortnightly or more frequently, depending on local or national epidemiology.

Clive Efford Portrait Clive Efford (Eltham) (Lab)
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On the testing figures that we get every day, after we take out studies that are being done through testing, along with double testing and those tests that are sent out through the post, are we not down to just about a third of the numbers that the Government claim are taking place? How can we have any confidence in what the Government say about what they are going to be doing about testing going forwards?

Helen Whately Portrait Helen Whately
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The hon. Gentleman has talked about taking out large numbers of testing; as the Minister for Care, I have seen a huge demand from the social care sector for testing through those channels, so I would not take out other forms of testing. For example, testing through tests sent to people’s homes very much counts and should be considered as part of our testing programme.

We have put a rigorous focus on testing in care homes, too. We met our target of offering tests to all staff and all residents of care homes for over-65s and those with dementia in England by 6 June. We then announced that we were able to extend the testing programme to all adult care homes. Since the launch of whole care home testing, we have provided over a million test kits to more than 9,000 care homes, and we are now able to send out more than 50,000 test kits a day. We are also running a prevalence study to get a detailed picture of coronavirus infection in care homes. Phase 2 of that study has just gone live, meaning that 10,000 residents and staff across 100 care homes will have repeat swab and antibody tests.

Tim Farron Portrait Tim Farron
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The Minister is being generous in taking interventions. Does she agree that to keep care homes safe from the coronavirus, the testing needs to happen regularly, not just once or even twice, and it needs to include people displaying no symptoms whatsoever? Does she also agree that, particularly for those NHS sites that are deemed to be clean and that are attempting to be covid-free, which are often the places where surgery will take place, the regular testing of staff even on a weekly basis, whether or not they display symptoms, is essential, not only, for example, to bringing back the mental health and maternity services that are currently lost to Westmorland General Hospital, but to making sure that the whole of our health service can operate as normal?

Helen Whately Portrait Helen Whately
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I absolutely recognise the importance of repeat testing, both in the NHS and in social care. Our policies, and the testing programmes that we have in place and are launching and taking forward, are based on the clinical advice as to what the right programme to have in place is. I have set out the programme for the NHS, which is based on the advice of the chief medical officer, and we have sought advice from the Scientific Advisory Group for Emergencies on what the repeat testing programme should be for the social care sector.

Jonathan Ashworth Portrait Jonathan Ashworth
- Hansard - - - Excerpts

I am genuinely grateful to the Minister for giving way. We are trying to engage with the Government on what we think is a constructive proposal, and not to do the usual political knockabout. I did a bit of that yesterday at Health questions, as she knows, but today I am trying to adopt a different tone—

Helen Whately Portrait Helen Whately
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Trying.

Jonathan Ashworth Portrait Jonathan Ashworth
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Trying, yes. Just so that we can understand this, is the Minister saying that the Government’s position on weekly testing of all NHS staff, whether symptomatic or not, is that that is not an appropriate clinical intervention—as distinct from saying, “We simply do not have the testing capacity at this stage, but it is something we would like to do in future”?

Helen Whately Portrait Helen Whately
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I am sure the hon. Gentleman was listening when I outlined the policy for the national health service. That is based on the chief medical officer’s advice. I think that is pretty clear. The Opposition’s position is not entirely clear, given that the hon. Gentleman started out saying “Weekly testing when necessary”, but said in his speech that it was weekly testing, whatever. On the other hand, we have been clear and the hon. Gentleman can look at the letter from NHS England and NHS Improvement to NHS trusts for further information.

I should move to the conclusion of my remarks—[Interruption.] Hold on, I thought we were not having any more political knockabout. We have established a national testing programme on a scale and at a pace that has never been seen before in this country. We will keep expanding that so that we can use high-quality testing to give confidence and certainty to anyone who needs it.

As I have set out today, there has been incredible action across our NHS and social care as we respond to this invisible killer. Thanks to the efforts of so many, crucial services have not been overwhelmed and all coronavirus patients who were admitted to hospital were able to receive urgent care. Because we have made such progress on slowing the spread of the virus, we have been able to ramp up other important services as part of our plan to get Britain back on her feet. However, we cannot be complacent and we must be ready for any increase in the rate of coronavirus infection and also for the winter, when, as hon. Members know, there is a greater risk of seasonal flu. As we keep ramping up services, we will ensure that we have the surge capacity to act quickly if necessary.

I want to finish by thanking the incredible NHS and social care staff who have been on the frontline of the pandemic. There has been a collective effort from so many, including healthcare professionals who have volunteered to return, and medical students, allied health- care profession students and nursing students who have stepped up at this important time for our country. The whole House and the whole nation are grateful to them for their heroic work.

Oral Answers to Questions

Helen Whately Excerpts
Tuesday 23rd June 2020

(3 years, 9 months ago)

Commons Chamber
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Helen Whately Portrait The Minister for Care (Helen Whately)
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I know how difficult it has been for people with learning disabilities and their families during lockdown, particularly without the back-up of day centres. I want to see those important services reopening as soon as it is possible and safe to do so, but that decision will need to be made locally. We are talking to the Local Government Association and others about what guidance and support may be needed to get day services up and running again.

Pauline Latham Portrait Mrs Latham [V]
- Hansard - - - Excerpts

I thank the Minister for that answer, and I would like to wish her a happy birthday. Unlike schools, day centres such as Whitemoor in my Derbyshire constituency are normally open throughout the summer to provide desperately needed stimulation for many adults with special needs. What measures will she introduce to ensure that staff working at day centres are adequately supported to function as safely as possible, as soon as possible?

Helen Whately Portrait Helen Whately
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I thank my hon. Friend for her birthday greetings. She makes a really important point: as day centres reopen, they need to be safe for staff and users. Risk assessments will need to be carried out, and some may need to use personal protective equipment. Public Health England is developing guidance on the use of PPE in community settings. Local authority-run services should have PPE provided by the local authority, and services provided by other organisations that struggle to get PPE from wholesalers should be able to access emergency local supplies.

Ruth Cadbury Portrait Ruth Cadbury (Brentford and Isleworth) (Lab)
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What recent assessment he has made of trends in the length of referral-to-treatment waiting lists.

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Lee Anderson Portrait Lee Anderson (Ashfield) (Con)
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What steps his Department is taking to support the social care sector during the covid-19 outbreak.

Helen Whately Portrait The Minister for Care (Helen Whately)
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Social care is at the frontline of this cruel global pandemic here in the UK and around the world. We have brought together support across Government, the NHS, Public Health England, local health protection teams, the Care Quality Commission and local authorities, and done our utmost to help care homes and home care services to look after those in their care. The majority of care providers have been covid-free. Our support includes access to testing, PPE, guidance based on evidence from around the world, improved oversight and funding.

Lee Anderson Portrait Lee Anderson
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I have received many emails from constituents who are desperate to see and visit their family members in care homes, after months of not seeing them. Will my hon. Friend assure me and care workers in Ashfield and Eastwood that the Government will do everything they can to ensure that care homes have the right support and guidance, so that they are prepared to deal with an influx of friends and family visitors as they begin to open their doors in a safe way?

Helen Whately Portrait Helen Whately
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My hon. Friend makes an important point. I know that the current restriction on visiting is hard for residents in care homes and their families, and has a real impact on health and wellbeing. We are updating our visitor guidance and intend to publish it soon.

Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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I, too, wish the Minister a very happy birthday.

I am sure the Minister will agree that lessons must be learned from what has happened so far, because the virus is not over for social care. With 13,375 deaths from covid-19 in care homes, what does she think she should have done differently?

Helen Whately Portrait Helen Whately
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The hon. Lady is absolutely right that there will be a time when we will look back and learn lessons, and I wish that not so many people had died in social care, but right now we are looking ahead. We are making sure that we have in place the plans to support the social care sector through the months ahead, and we are also pressing ahead with work on social care reform.

Tim Farron Portrait Tim Farron (Westmorland and Lonsdale) (LD)
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If he will publish the timetable for the NHS England plan to roll out stereotactic ablative radiotherapy to all cancer centres by April 2021.

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Oliver Heald Portrait Sir Oliver Heald (North East Hertfordshire) (Con)
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What steps his Department is taking to support the mental health of NHS workers during the covid-19 outbreak.

Helen Whately Portrait The Minister for Care (Helen Whately)
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Our NHS workers—from the doctors, nurses and allied health professionals to the healthcare assistants, porters and all those who work behind the scenes—are truly heroes. I wish to say a special thank you to students: thank you to the medical students and nursing students who courageously stepped up to work at the frontline in a global pandemic. I am determined to do all that we can for our NHS workers. We have set up a round-the-clock mental health support line, which includes a freephone helpline run by the Samaritans and an out-of-hours text support service provided by Shout.

Cherilyn Mackrory Portrait Cherilyn Mackrory
- Hansard - - - Excerpts

I thank the Minister for her answer and wish her a very happy birthday.

Due to physical challenges with geography in rural communities, such as much of my Truro and Falmouth constituency, there can be higher incidences of mental health issues, loneliness and isolation, and that has been intensified by the covid-19 pandemic. Will my hon. Friend provide an update on departmental plans for support for mental health issues in rural communities?

Helen Whately Portrait Helen Whately
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My hon. Friend is absolutely right: we anticipate an increase in demand for mental health support, including in rural communities, as a result of the pandemic. We are working with the NHS and a wide range of stakeholders to understand the need for mental health support all over the country and to make sure that that support is in place.

Jane Stevenson Portrait Jane Stevenson
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In my regular meetings with the Royal Wolverhampton NHS Trust, the issue of staff mental health has been repeatedly raised as a serious concern, especially among staff who are working with covid patients. Will the Minister join me in thanking those staff at New Cross Hospital and reassuring them that mental health support will be available for all staff who need it?

Helen Whately Portrait Helen Whately
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I would be delighted to join my hon. Friend in thanking the staff at New Cross Hospital for all that they have been doing in these incredibly difficult times. Mental health support absolutely should be, and is, there. There is the mental health support helpline and the text messaging service. It is also really important that NHS trusts take steps locally to ensure that their staff have the support that they need.

Oliver Heald Portrait Sir Oliver Heald
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When we stood with our neighbours and clapped for the carers, we showed solidarity across the nation with them and recognised the strain, stress and anxiety under which many of them were working. Can the Minister assure me—and say what practical steps can be taken to ensure—that, as they work through the experiences they have had, they will get the care and support necessary for them, and that we care for our carers?

Helen Whately Portrait Helen Whately
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The clap for carers initiative was fantastic because it was a moment when we showed, as a nation, our support for our health and social care workers, but my right hon. and learned Friend is right that clapping is not enough. One thing that I want to do in the months ahead is bring forward the people plan—work that had to be paused because of covid—and to ensure that it includes all possible support for the NHS workforce, so that the NHS can be the best place to work in the world.

Rosena Allin-Khan Portrait Dr Rosena Allin-Khan (Tooting) (Lab)
- Hansard - - - Excerpts

Even before the covid pandemic, our frontline NHS and care staff were already working in overstretched and under-resourced settings. It is heartbreaking to see how the virus has taken its toll on them. They have had to deal with redeployment, not enough PPE, a fear of losing patients and getting ill themselves. These are all factors leading to staff burnout and very poor mental health. After all their sacrifices, our frontline staff deserve their mental health to be taken seriously. Is the Minister satisfied with the Government’s current package of support for frontline NHS and care staff?

Helen Whately Portrait Helen Whately
- Hansard - -

The hon. Member is absolutely right about how hard it has been for NHS staff stepping up, and we cannot say enough how grateful we are for what they have done. I also recognise the mental health burdens on the NHS workforce who have worked in these really stressful circumstances. It is important not only that the package of support is there now, but that it is there for some time to come, because we know that the trauma and effects of working in these environments may take a while to play through.

Steve Brine Portrait Steve Brine (Winchester) (Con)
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What plans he has to meet the cancer targets in the NHS long-term plan.

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Paul Holmes Portrait Paul Holmes (Eastleigh) (Con)
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What steps his Department is taking to support the health and social care workforce during the covid-19 outbreak.

Helen Whately Portrait The Minister for Care (Helen Whately)
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Our health and social care workforce are at the frontline in fighting this cruel disease. I would particularly like to talk about social care workers, who in the past have not had the same recognition as NHS workers. Let this pandemic be the moment when that changed and when we, as a society, recognise the skills, compassion and commitment of our entire care workforce. We have sought to put in place the same support for social care workers as there is for NHS workers and funding to local authorities to pass on to care providers, so that they can pay social care staff full wages for isolating due to covid-19.

Paul Holmes Portrait Paul Holmes
- Hansard - - - Excerpts

I wish the Minister a happy birthday. The coronavirus pandemic has highlighted how vital social care workers are to our nation, and we as a House should thank them for the job that they do. Unpaid carers in particular have borne a huge weight throughout this pandemic, so will my hon. Friend tell the House what steps she has taken to support unpaid carers during this period?

Helen Whately Portrait Helen Whately
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Unpaid carers are vital in our society. Being an unpaid carer is hard at the best of times, but even harder during this pandemic, and my hon. Friend is right to draw attention to that. During the pandemic, we have published guidance specifically for carers. We provided funding to extend the Carers UK helpline, we made unpaid carers a priority group for testing, and we are working with local government to support the reopening of day care services as soon as it is safe to do so.

Harriett Baldwin Portrait Harriett Baldwin (West Worcestershire) (Con)
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What plans he has in place for the provision of continuing healthcare for people recovering out of hospital from covid-19.

Helen Whately Portrait The Minister for Care (Helen Whately)
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We know that people who have been very ill with covid will take some time to recover and may need ongoing help after they have left hospital. At the moment, as part of the covid emergency measures, continuing healthcare assessments are not required, which means that people can be properly discharged when they are well enough and have access to the ongoing healthcare they need.

Harriett Baldwin Portrait Harriett Baldwin
- Hansard - - - Excerpts

Happy birthday to the Minister. Our wonderful NHS staff have helped so many people recover from this terrible disease and leave hospital, and many of them will have been ventilated for a long time. Is the Minister planning to set up a specialist service that helps with those very difficult cases where a lot of rehabilitation will be needed?

Helen Whately Portrait Helen Whately
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My hon. Friend raises an important point. We are still learning about the impact of this horrible disease, but we know it may take people some time to recover and they may need extra help after they have been discharged from hospital. We are indeed doing work to ensure that the right support is there for them.

Joanna Cherry Portrait Joanna Cherry (Edinburgh South West) (SNP)
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What plans he has to ensure that the NHS has the capacity to tackle the next phase of the covid-19 outbreak.

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David Amess Portrait Sir David Amess (Southend West) (Con)
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What progress his Department has made on delivering covid-19 testing kits to care homes.

Helen Whately Portrait The Minister for Care (Helen Whately)
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We are doing all we can to help care homes control and prevent covid outbreaks, and the majority of care homes have not had outbreaks. Testing is an important part of that. On 11 May, we launched a programme of testing all staff and residents in care homes, starting with older people and those with dementia, based on public health guidance. We met our target of offering tests to all these care homes by 6 June, which involved sending more than 1 million test kits to 9,000 care homes. We are now getting tests out to all the other Care Quality Commission-registered care homes for adults that ordered them on the testing portal.

David Amess Portrait Sir David Amess
- Hansard - - - Excerpts

Further to what my hon. Friend has said, will she confirm that there is a rolling programme to test for covid-19 in our care homes? Recently, a care home in my constituency had a whole-home test and found that someone was positive. When it then asked for another test for everyone, it was told by NHS England that it was not eligible, and that cannot be right.

Helen Whately Portrait Helen Whately
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I will say two things on that. First, when a care home has a new outbreak, either for the first time or after having recovered from a previous outbreak, it should contact its local health protection team to arrange for initial testing of symptomatic residents, in order to confirm the outbreak. The local health protection team or the director of public health can then refer the care home to the national testing team so that it can be prioritised for whole-home testing.

Giles Watling Portrait Giles Watling (Clacton) (Con)
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What recent assessment he has made of the effectiveness of NHS services for the treatment of mesh complications.

Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020

Helen Whately Excerpts
Wednesday 10th June 2020

(3 years, 9 months ago)

General Committees
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Helen Whately Portrait The Minister for Care (Helen Whately)
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I beg to move,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020 (S.I. 2020, No. 500).

It is a pleasure to serve under your chairmanship, Mr Mundell. These amending regulations were made by the Secretary of State on 13 May and are rightly being brought before the Committee today for the scrutiny and debate that they require. The regulations made amendments to the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020, which, as amended, remain exceptional measures, brought forward to reflect unprecedented challenges and times.

While these regulations are necessary to meet the public health needs of the coronavirus pandemic, it is also important that this House plays its proper role, and that due process and the rule of law are maintained. On 1 June, further amendments were made to the regulations. Those amendments will be debated in the House on 15 June, while today’s debate will focus on the amending regulations, which came into force on 13 May.

This country has been, and still is, engaged in a national effort to beat coronavirus. Great work has been done by the British public to help flatten the curve and ensure that our NHS is protected. We are currently moving on a path of cautious relaxation of some of the restrictions and requirements of the regulations, taking small steps to ease the measures guided by the science. We have reduced the restrictions in these amendments to minimise the impact on people’s rights and begin a cautious return to normal life. I will now outline what the regulations do and then set out the policies and processes underlying their development and their implementation, and finally their monitoring and review.

On 26 March 2020, the Health Protection (Coronavirus, Restrictions) (England) Regulations 2020 came into force, with a requirement in the regulations to review them at least every 21 days. The first review took place on 16 April and no changes were deemed appropriate at that time. Some minor changes were brought in on 22 April to clarify the regulations and ease the operation of the regulations. The regulations were then reviewed again on 7 May. While no changes were deemed appropriate at that point, fresh evidence and advice subsequently enabled the Government to bring in some changes, which came into force on 13 May. Those are the amendments we debate today.

The amendments that came into force on 13 May were made to provide clarity, to reduce socioeconomic cost where safe, and to ensure continued compliance while mitigating health risk. Some technical changes were made to make it clear that people can visit a shop to collect goods they have ordered online, by post or by phone, and to clarify that people can visit household waste and recycling centres.

Some further changes enabled additional economic activities to take place, where the health risk in doing so was minimal and the socioeconomic cost of continuing the restriction was no longer considered necessary and proportionate. Those changes were: to allow garden centres to reopen; to allow outdoor sports courts to reopen; to make it clear that it is permitted for hotels to provide accommodation to any key worker, to support their effort to respond to covid-19; and to enable all house moves, rather than only reasonably necessary house moves, including visits to estate agents and show homes.

There was a specific enforcement change to increase the amount of the fine associated with the fixed penalty notice, to ensure that compliance with the regulations remains high. The final change was to permit outdoor recreation for the purpose of wellbeing, rather than just outdoor exercise, and to permit outdoor recreational exercise with one other person outside your household.

The Prime Minister made a statement to this House on 11 May regarding the Government’s plan to ease restrictions over the coming weeks and months. The measures I outlined above were a cautious first step in delivering this plan. I recognise that the regulations continue to place demands upon individuals, society and businesses and are a strain on our daily lives. The regulations have played and are playing an important role in reducing infection and transmission levels, and as an amended package are still very much necessary. However, as soon as the science has indicated it is safe to do so, we have begun to take small steps in easing the regulations to enable a return to normal life and restart the economy, and to ensure people face only those restrictions that are truly necessary and proportionate.

The regulations are lawfully made under the power in the Public Health (Control of Disease) Act 1984, and comply with all the Government’s human rights obligations. Above all, they help to save lives and protect public health, which is why Parliament has given Ministers these powers. The Committee will be aware that applications for judicial review and other legal actions are in the offing, which I will not be able to comment on. We also recognise that some people are impacted more than others by these regulations, and have made changes through these amendments to reduce the restrictions and lift some of that burden.

A significant challenge is involved in reaching a balance between protecting the public’s health and upholding individual freedoms. The Government are constantly reviewing the regulations to achieve the right balance, and measures are in place to help us do so. First, the regulations set out that a review of the restrictions and requirements must take place at least every 21 days to ensure that each restriction or requirement continues to be necessary

“to prevent, protect against, control or provide a public health response to the incidence or spread of infection in England”.

We completed the first review as required on 16 April 2020, and the second was completed on 7 May. The maximum review period—that is, the maximum period of time between reviews of the regulations—has subsequently been amended so that a review must take place at least every 28 days. That is part of a set of amendments made on 28 May, which are to be debated by this House on 15 June. Between these formal reviews, the Secretary of State keeps the restrictions and requirements under constant consideration, and the Government will make changes only when we are confident that we can do so safely.

Secondly, these regulations are led by the best available scientific evidence, along with consideration of their economic, operational, social and policy implications. Thirdly, as we understand the potential for harm to both public health and the economy if measures are relaxed too soon, we have developed five tests to guide policy considerations on whether and when it would be desirable for the measures to be eased. The tests are as follows.

First, to protect the NHS’s ability to cope, we must be confident that we are able to provide sufficient critical care and specialist treatment across the UK. Secondly, we must see a sustained and consistent fall in the daily death rates from covid-19, so that we are confident that we have moved beyond the peak. Thirdly, there must be reliable data from the Scientific Advisory Group for Emergencies showing that the rate of infection is decreasing to manageable levels across the board. Fourthly, we must be confident that the range of operational challenges, including testing capacity and personal protective equipment, are in hand, with supply able to meet future demand. Fifthly, we must be confident that any adjustments to the current measures will not risk a second peak of infections that overwhelms the NHS. Ministers conduct those reviews, guided by officials and experts, ensuring that the measures continue to be both proportionate and necessary.

Members of this House have rightly pointed out that their approval is being sought retrospectively. However, we have acted urgently: we understand that the regulations place great restrictions on people, society and business, and the Government have therefore sought to ease them as soon as it is safe to do so. The impact that the coronavirus is having on the UK is changing as both the R rate and incidence rate change, and the regulations must reflect that. However, it is also critical that this House can play its proper role, and that due process and the rule of law are maintained. That is why we want to maintain an ongoing dialogue with Parliament.

As Members will be aware, further changes to the regulations were made on 28 May and came into force on 1 June. Those changes include allowing increased social contact outdoors, in groups of up to six people from different households; enabling élite athletes to train and compete in currently closed facilities; opening some non-essential retail; requiring additional businesses to close by law; ensuring that venues such as community centres can open for education and childcare services; and ensuring that those who are required to self-isolate on arrival in the UK can stay in hotels. We have also amended the maximum review period to 28 days to ensure that where needed, there is time to assess the impact of previous relaxation of the measures. Those amendments will be debated by the House on 15 June. We will therefore continue to use the powers given to us by Parliament in the best interests of the public, and to welcome the scrutiny that rightly comes with that responsibility.

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Helen Whately Portrait Helen Whately
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In summing up, I want to restate the Government’s commitment to working with Parliament in developing the policies that find expression in the legislation that we debate in the House. I appreciate the tone of the comments made by the hon. Member for Ellesmere Port and Neston, and particularly his opening remarks about wanting to support the Government in the measures we are taking and, overall, our drive to succeed in crushing coronavirus. There were many questions in his speech, and I shall do my utmost to cover them in my response, but as he spoke at pace I might not manage 100% to do that. I will do my best.

I think his first point could be encapsulated as a preference for us to debate regulations and amendments sooner. I appreciate that point, but he and other hon. Members will appreciate the situation that we are in, with a global pandemic hitting us and other countries with extraordinary aggression. That has required extremely rapid action to protect people’s lives. The hon. Gentleman also knows that we must act as quickly as we can to protect people’s livelihoods and wellbeing. That means looking to move promptly, albeit cautiously, towards easing some of the restrictions when the science indicates that it is possible for us to do so.

The hon. Gentleman asked me about what happens with the review process. It is conducted by the Secretary of State for Health and Social Care following discussion with other Ministers. It is guided by officials and experts, and SAGE provides scientific evidence and advice. Overall, the process is to ensure that the measures are necessary and proportionate.

The hon. Gentleman asked about impact assessments. We acknowledge that the impact of the restrictions is hard. It is tough on many individuals and hard for businesses, but it is variable: it is harder on some than on others. In my role as Care Minister, I talk to carers looking after people with learning disabilities, autism and a range of other health conditions. That group has been hit particularly hard by the restrictions and the loss of services, given that it is not considered safe to access them. I am mindful of the variable impact.

Justin Madders Portrait Justin Madders
- Hansard - - - Excerpts

I am grateful to the Minister for giving way, and I hope she will answer all the questions. I take it from what she has said that there is not actually a formal impact assessment but reviews are undertaken. Will she explain why the Department has not issued copies of them, following my written question?

Helen Whately Portrait Helen Whately
- Hansard - -

What I do know is that there is a huge volume of inquires coming into the Department at the moment. I am personally handling a large number of questions and letters from colleagues, so there is huge demand on the Department to respond to inquiries.

The Government absolutely are considering the impact on businesses and individuals—the economic, personal, physical and mental health impact, including on those with protected characteristics. We take those impacts very seriously, and we want to provide as much support as possible to mitigate the negative impacts on people.

The hon. Gentleman asked about transparency and the publication of, for instance, SAGE documents. I am sure he is aware that a suite of documents from SAGE has been published online.

The hon. Gentleman also asked about fines and the reason for their increase in the instrument. The reason for the increased fixed penalties is to act as a greater deterrent to those who might break the rules.

The hon. Gentleman made a very important point about whether fines have had a disproportionate impact on people from BAME communities. That is clearly a very serious concern. We are working with policing partners to analyse the data, to determine whether there has been a detrimental impact on those from BAME backgrounds. Let me make it absolutely clear that no one should be subject to police enforcement on the basis of their race.

The hon. Gentleman asked a number of questions about testing. There has been a phenomenal ramping up of the volume of testing that has been carried out. I have seen the enormous efforts that have taken place to increase the volume of testing available to the care sector, and particularly to care homes. We are getting testing kits directly out to care homes so it is easy for them to access tests. The team that did that has done a truly phenomenal job, at pace. I absolutely appreciate the hon. Gentleman’s desire for data on the testing programme—both the numbers and what they tell us. However, as he said, it is really important that we share accurate data that is supported by the UK Statistics Authority, and we are working with it to make sure that we share reliable, robust, informative data on the testing programme.

Nick Smith Portrait Nick Smith (Blaenau Gwent) (Lab)
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Could the Minister say by what date a fully functioning test and tracing app will be ready for use?

Helen Whately Portrait Helen Whately
- Hansard - -

I thank the hon. Gentleman for his question. To make it clear, the important thing is to have a fully working test and trace system. That is up and running, using the tried and tested method of a human contact tracing system. The app is under development to complement that. It has been piloted, as he knows, on the Isle of Wight, and it will be brought online in due course. The important thing is that we have a fully working test and trace system to support the easement of the measures that has already taken place.

Nick Smith Portrait Nick Smith
- Hansard - - - Excerpts

I absolutely agree that the test and trace app has to be fully functional and working well, but may I press the Minister on when she thinks it will be ready for use?

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Helen Whately Portrait Helen Whately
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I have already given my answer. I have nothing further to give on that point.

Justin Madders Portrait Justin Madders
- Hansard - - - Excerpts

We have talked about the importance of the reviews of the regulations. Can we have a commitment that those will now be published?

Helen Whately Portrait Helen Whately
- Hansard - -

I have set out the process that is taking place and I am not going to give the hon. Gentleman the commitment that he asks for, but he has made it clear that that is what he would like to see.

To sum up, these amendments are an important and cautious step towards returning to normal life. We have listened to the public and to the scientific evidence and we are taking the steps to ease the restrictions over the coming weeks and months. We understand the burden that restrictions place not only on individuals but on society as a whole. We maintain only the restrictions that are necessary and proportionate at any given time. There will be many occasions over the coming weeks and months when we will be able to debate these questions further. As I said, the changes brought in on 1 June will be brought to the House for debate on 15 June.

I end by paying tribute to the NHS and care workforce, to whom we all owe the greatest respect for the work they do each and every day, and to the people of the United Kingdom for their patience and strength in helping to combat this pandemic. The steps we have been able to take towards normal life are a testament to the people of the UK and their fortitude in tackling this outbreak. As a Government, we will play our part by making sure that the burden is no more onerous than it absolutely needs to be. These regulations ensure that that remains the case.

Question put and agreed to.

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 2) Regulations 2020 (S.I. 2020, No. 500).

Covid-19: Human Fertilisation and Embryology

Helen Whately Excerpts
Wednesday 3rd June 2020

(3 years, 10 months ago)

Written Statements
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Helen Whately Portrait The Minister for Care (Helen Whately)
- Hansard - -

My hon. Friend the Parliamentary Under Secretary of State (Minister for Innovation) (Lord Bethell) has made the following written statement:

We are today laying a negative solution statutory instrument, which will extend the statutory storage period for embryos and gametes from 10 years to 12 years in certain circumstances.

To support wider changes to the health service in responding to the pandemic, fertility treatment in the UK across the NHS and private sector was temporarily suspended on 23 March. While this suspension was lifted from 11 May, there may still be delays for some patients in accessing their fertility treatment, as clinics need to meet robust safety criteria in order to restart treatment.

In recognition of the potential impact this may have on those wishing to start a family, the Government committed to extending the current 10-year storage limit for embryos and gametes by two years, in certain circumstances, to enable sufficient time for all fertility treatment to resume and patients to make new arrangements without having to rush their decision-making.

The new statutory instrument allows anyone who currently has frozen their eggs, sperm and embryos to extend their storage for an additional two years, provided there is appropriate consent. Currently the storage period for embryos and gametes is limited to a maximum of 10 years, after which people must choose whether to undergo fertility treatment, or have their frozen eggs, sperm and embryos destroyed. People with medical conditions that have caused fertility problems can extend for longer, but this SI allows them two additional years before they need to provide supporting medical evidence.

The Government have recognised that the suspension of fertility services has been extremely worrying for patients, the announcement of this SI provides them with some much-needed reassurance and most importantly gives more time to try for their much longed for family and was welcomed by patient stakeholder groups.

Earlier in the year the Government launched a consultation for views on whether the current primary legislation to store their frozen eggs, sperm and embryos for 10 years should change. The consultation closed on 5 May. The Government will be making a separate set of decisions about the law in the light of the analysing the consultation responses and announcing those later in the year.

[HCWS264]

Human Tissue

Helen Whately Excerpts
Tuesday 19th May 2020

(3 years, 10 months ago)

Commons Chamber
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Helen Whately Portrait The Minister for Care (Helen Whately)
- Hansard - -

I beg to move,

That the draft Human Tissue (Permitted Material: Exceptions) (England) Regulations 2020, which were laid before this House on 25 February, be approved.

Before I explain the draft regulations, I would like to say a few words about why we are changing the law on organ donation. Today more than 5,000 people in England are waiting for a transplant, but, sadly, by the time a suitable organ is found some people will have become too ill to receive one. Tragically, last year alone 777 patients were removed from the transplant list and 400 died waiting for a transplant. There is no option but to take decisive action to address the acute shortage of organs and save the lives of those waiting for a transplant. That is why we passed the Organ Donation (Deemed Consent) Act 2019, which amends the Human Tissue Act 2004 and sets up the new system of consent for organ and tissue donation in England, which is known as “deemed consent” or “opt-out”.

I wish to thank the hon. Member for Barnsley Central (Dan Jarvis), my hon. Friend the Member for South Basildon and East Thurrock (Stephen Metcalfe), my right hon. Friends the Members for Maidenhead (Mrs May) and for South West Surrey (Jeremy Hunt), a previous Member of this House, Geoffrey Robinson, and Lord Hunt of Kings Heath for their work and support, which has got us to where we are today. They all started this journey for us showing immense leadership, and they continue to show their strong commitment to this cause.

Subject to approval of these regulations, we aim for deemed consent to become legal on 20 May. While not many transplants are taking place earlier, during the peak of covid-19, NHS Blood and Transplant has already started the recovery process to get transplant units up and running as much as possible. Guidance on how best to restart or extend the transplant service was sent by NHSBT to all transplant units on 26 April. A letter was then sent on 1 May to all trusts with transplant units, asking them to actively review the situation where transplant units have reduced their services.

To illustrate the progress that is being made to get the transplant system up and running again, on a normal day NHS Blood and Transplant would have received about 55 referrals of a potential donor and would aim for five actual donors, and it would carry out about 70 transplants a week. During the peak of the pandemic, there were days when there were no referrals, many days when there were no donors, and many days when there were no transplants. As of last week, there have been 167 referrals, 11 donors and 38 transplants. Continuing the tremendous effort to restore all transplant services will enable us to reap the benefits of the deemed consent legislation as soon as possible; by “benefits” I mean save the lives of people waiting for transplants.

I understand that some have disagreed with the timing of going ahead with this law, but we assessed the impact of going ahead with deemed consent very carefully. This horrific pandemic taught us a lot about how precious human life is, and we know that the fight against it will continue for some time, while thousands of people will still be waiting for a transplant. I therefore believe very strongly that we have a duty now, more than ever, to push ahead with measures that will reduce human suffering and help people to improve their quality of life. That is exactly what this law does.

We are of course fully aware that public confidence is important. The deemed consent legislation was first introduced to the House in July 2017, and became law in March 2019, so it has had a long process of parliamentary scrutiny, alongside three public consultations. The Government have been raising awareness of the law and the choices available for over a year, and the 20 May implementation date has been used actively in communications since late February. Putting this legislation on hold would increase the anxiety of thousands of people, who see this law as their only hope to get a new lease of life, and would confuse the communications that have already been in the public domain for some time.

From the outset, we have been clear that deemed consent would apply only for routine transplants, to increase the number of organs and tissues available and help those that are on a waiting list. Examples of routine transplants are heart, kidneys or lungs. Novel transplants will still require express consent. The organs and tissues specified in the regulations are included because they could be used for non-routine transplants, such as a face transplant. Such transplants are outside the scope of what we want to achieve. Demand for novel transplants is very low, and people would not normally identify organ donation with them.

During formal scrutiny of the regulations, the Joint Committee on Statutory Instruments cleared the regulations with no comments. Meanwhile, the Secondary Legislation Scrutiny Committee drew the regulations to the attention of the House, and this is testimony to how integral the regulations are for making the new system of consent work, and how important the law change will be when it is introduced.

Let me now discuss the detail of the regulations. The Organ Donation (Deemed Consent) Act 2019 sets out that deemed consent to transplant activities in England will apply only to permitted material. The Secretary of State has a delegated power to specify in regulations what relevant material—meaning, what organs, tissue and cells—will be excluded from the system of deemed consent. To clarify, the organs, tissues and specific cells that are listed in the draft statutory instrument are organs, tissues and cells that cannot be transplanted without express consent being in place, as that would be a novel transplant.

Regulation 2(2) sets out the detailed list of organs and tissues that will require express consent in order to be transplanted under all circumstances—such as the brain, spinal cord and face. As a result of our consultation, we expanded the list of reproductive organs and tissues in this regulation, to provide clarity and put it beyond doubt that removing any parts of a reproductive organ will require express consent in all cases. This is to ensure that if and when such transplants are carried out in future in the UK, they will be outside the scope of deemed consent.

Regulation 2(3) sets out that some relevant material—for example, skin or bone—will require express consent if used for a novel transplant, but not if used for a routine transplant. This is to ensure that current practices for tissue donation, under which tissue from a leg, for example, is removed routinely, are not disrupted by deemed consent. So, although a leg transplant would require express consent, if only the skin from a leg is taken, deemed consent may apply; however, if tissue is required from reproductive organs, this will always require express consent. That addresses the feedback from our consultation.

Regulation 2(4) allows for the trachea to be removed under deemed consent when it is attached to the lungs. This is to allow routine heart and lung transplants, which also require the trachea to be removed with the heart and lungs, to continue under deemed consent. However, the trachea is also listed in regulation 2(2), as trachea transplants by themselves are novel and therefore excluded from deemed consent.

Regulation 2(5) excludes the removal of certain cells if they are to be used for advanced therapy medicinal products—also known as ATMPs—which are therapies made from tissue cells or genes after manipulation in a laboratory. They are used for treatment of a disease or injury, and often use human tissues and cells as starting materials. For example, an ATMP can treat knee damage by taking cartilage cells from a living patient, growing and modifying them in a lab, and re-injecting them into the patient’s knee.

ATMPs are an exciting technology, and new therapies are being developed all the time. Current ATMPs are being developed using tissue and cells taken from living donors, but it is also possible to use material from deceased donors to develop novel ATMPs. As such ATMPs are novel, we want to make sure that the donation of such cells cannot happen without express consent being in place. Our consultation raised questions about the public’s understanding of such novel technologies, so we want to ensure that express consent is required.

Now that I have set out the detail of the regulations, I must highlight that before deciding whether a change to the regulations would be needed in future, the Government would need to consider evidence, public acceptability and clinical need, guided by recommendations from NHSBT’s advisory group research and innovation in transplants. Any changes would need to be approved by Parliament, following the same procedure as we are now, so Parliament would have full oversight. The regulations restrict deemed consent to routine transplants, so they continue current practice, under which express consent needs to be in place for non-routine transplants. There is no additional cost to the health system, so no impact assessment has been prepared.

In conclusion, I am glad that I am able to present these regulations to the House today. They are an important part of the implementation of the 2019 Act, as they prevent deemed consent from applying to novel transplants. The new system of consent will help to save and improve the lives of many people waiting for a transplant. Donating organs is one of the greatest gifts a person can give. I urge everybody to talk to their families and their loved ones about their wishes. I am proud that all of us present are playing a part in making something positive happen in these very challenging times. I commend the draft regulations to the House.

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Helen Whately Portrait Helen Whately
- Hansard - -

May I welcome the hon. Member for Nottingham North (Alex Norris) to his place on the Front Bench and say how very good it is to see him there? I thank him for his kind words at the beginning of his speech and for his constructive tone in this debate. I look forward to that in our future conversations. I also welcome all the helpful and constructive comments we have heard from those who have been able to contribute to the debate today remotely and the work of all of those who have been involved in getting this legislation on to the statute book.

As I said in opening the debate, thousands of people up and down the country are in desperate need of a transplant. While covid-19 has completely stopped transplant services in some countries, we have been able to continue with very urgent transplants, and that is testament to the great work of NHS Blood and Transplant and NHS England. We now want to go further, and we must increase the availability of organs for transplant, which this important legislation will allow us to do, especially at a time when covid-19 has taught us so much about how fragile life is.

I should say that patient safety and the involvement of the family in discussions about organ donation will remain absolutely a paramount consideration, and we will keep raising awareness of the importance of organ donation. The communication campaign from NHS Blood and Transplant has seen awareness as high as 62% of the population at the height of the campaign, and that must go further. We must continue tackling some of the myths about organ donation.

Coming to some specific questions and points made by other Members, the hon. Member for Nottingham North asked about the recovery plan following covid-19 and the unavoidable reduction in transplants that has happened during the pandemic. We are determined to see transplant units become fully operational as soon as possible. Most transplant units are working on their plans to reopen or to increase services if they have stayed open, and I expect to see a rapid ramping up of their activity.

The hon. Gentleman asked about specialist nurses, and I can confirm that specialist nurses have indeed been recruited and have training ongoing in, for instance, the principles of this legislation and in practical sessions on the conversations and approaches to families. I am happy to come back to him separately with some further detail about that work.

The hon. Gentleman and the hon. Members for Strangford (Jim Shannon) and for Coventry North West (Taiwo Owatemi) made very important points about BAME communities. It is clearly of great concern that there is reduced access to organs for transplant, with a shortage particularly of donor organs for some people in BAME communities. We really want this law to address some of those very concerning health inequalities. Specifically, black and Asian people wait on average about 11 months and six months longer, respectively, for an organ match than the rest of the population. That is absolutely something that this legislation should and must address.

The hon. Member for Nottingham North asked about communications to BAME communities, because that is crucial for the success of this change. I should say to him that there has been specific funding to BAME and faith groups to raise awareness within their communities, but I agree that more must be done to make sure that this is successful.

The hon. Member for Coventry North West asked about screening for covid-19. There are two sides to this. First, a registry has been set up to monitor covid cases among those waiting for a transplant, and, secondly, I have been assured that the organs of those who have covid would not be donated and used for transplant.

I was also asked about the resources to fund this, and I can say that of course we will make sure that the NHS has the resources it needs to be able to carry out these crucial transplants.

It is important that this legislation is approved to provide legal certainty that deemed consent will apply only to the routine transplants that so many people in this country need. I want to thank everyone who has spoken and contributed to the work on these regulations. The regulations are an integral part of making the new system of consent work, and I would urge all my fellow parliamentarians to approve them. We owe it to everyone waiting for a transplant to make sure that Max and Keira’s law comes into force and makes a difference to all those who are waiting for a transplant.

Nigel Evans Portrait Mr Deputy Speaker (Mr Nigel Evans)
- Hansard - - - Excerpts

I announced to the House earlier this afternoon my provisional determination that a remote Division would not take place on the question now before the House. This is also my final determination.

Question put and agreed to.

Resolved,

That the draft Human Tissue (Permitted Material: Exceptions) (England) Regulations 2020, which were laid before this House on 25 February, be approved.

A& E Departments: Staffing

Helen Whately Excerpts
Monday 23rd March 2020

(4 years ago)

Commons Chamber
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Helen Whately Portrait The Minister for Care (Helen Whately)
- Hansard - -

I thank the hon. Member for Rhondda (Chris Bryant) for calling this debate and for leading us in that tribute to the NHS workforce.

As we stand here, our NHS faces daunting challenges, as it will continue to do for weeks and months to come. I, too, want to take a moment this evening to thank each and every one of our health and care staff and their individual families for all they are doing for our country at this most challenging of times. I know they are making incredible sacrifices, selflessly working at the frontline in looking after our families in our hour of need, while their families are at home concerned for their safety and welfare. They are there on the frontline around the clock, tackling this head-on. As a country, we will be eternally grateful to them, and from us all, thank you.

I will also pause, if I may, to mention some of the heart-warming gestures across our communities, such as small businesses and large multinationals offering staff hot drinks and hot food, supermarkets making specific opening times for NHS and social care staff, and hotels and chains making beds available to staff to use. Thank you to each and every one of you. You do our country proud.

I want to assure everyone this evening and, most importantly, all our NHS staff that we are here to support them, and we will not let them down. First, we know the NHS needs more people to fill the gaps when staff have to stay home and to cope with the particular needs of patients with coronavirus. We have made a call to arms to those who have left the healthcare professions in the last three years. The healthcare regulators have been contacting doctors, nurses, pharmacists, paramedics and others to ask them to return to practise to support the coronavirus response, and the response from the workforce has been amazing. At noon today, 1,930 doctors and 5,630 nurses had responded by indicating that they were willing to return to the NHS. They will help the NHS not only to treat coronavirus patients, but to continue other emergency healthcare, including urgent operations and cancer treatments. We are also working with professional leaders across nursing, midwifery and allied healthcare professionals to see how students in their final year of study can provide support at the frontline. Our nursing leaders, staff representatives and university bodies will put out a joint statement on that tomorrow.

As we welcome so many doctors, nurses and allied healthcare professionals back to the NHS, we must look after them and all those who work in our health service. I know that staff at the frontline are worried and need assurances that there is sufficient personal protective equipment for everyone who should be using it. The safety of those on the frontline is of paramount importance. We have stocks of PPE nationally and NHS England is working to make sure that the NHS frontline has the equipment it needs. I know there have been problems with distribution in some places, but that is now being resolved by NHS England, which has restructured its logistics operations so that equipment should now be getting to those at the frontline who need it.

Jim Shannon Portrait Jim Shannon
- Hansard - - - Excerpts

There is some indication in the news today that some of the personal protection equipment and material available is not up to standard. Will the Minister confirm that everything the Government are sourcing is of a standard suitable for the needs of staff at the frontline?

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Helen Whately Portrait Helen Whately
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I have been absolutely assured that the equipment being supplied to the frontline is appropriate and that it has been tested to make sure that it is fit for purpose.

Julian Lewis Portrait Dr Julian Lewis
- Hansard - - - Excerpts

Quite a major distribution and logistics firm in my constituency has offered drivers and vehicles for the cause of fighting the virus. Is there some sort of central one-stop shop to which volunteers and offers of that sort can be directed, so that they can be put to best use? I appreciate that the Minister may not be able to answer me immediately, but if she cannot, perhaps she could inform me afterward.

Helen Whately Portrait Helen Whately
- Hansard - -

One of the fantastic things we have seen over the last few days is the number of offers to help from all parts of society and the economy. There are some specific contact details for ways in which people can help, and I will be happy to share them with my right hon. Friend after the debate.

Chris Bryant Portrait Chris Bryant
- Hansard - - - Excerpts

Many local authorities say they have no masks, no aprons and no gloves, let alone the training in how to remove them. I am reliably informed by A&E doctors that with some of the material the danger of infection comes when one is taking it off. Are the Government working with all the other Governments in the UK to make sure that there is enough PPE for all our local authorities as well?

Helen Whately Portrait Helen Whately
- Hansard - -

A huge amount of work on PPE is going on. PPE has been distributed to GPs, community pharmacists and dentists, and it is being distributed at the moment to all care providers across England. There is also work going on to make sure we know the other needs for PPE in the system—for example, in local authorities—to make sure that supplies get to where they are needed. We are also doing our best to make sure that there is clear guidance on when people need to use PPE. Sometimes people think they need it all the time, for everything, but that is not the case. We need to make sure it is used when it is needed—for example, during close-contact clinical care of people who have coronavirus symptoms. I must move on now; otherwise, I will spend all my time talking about PPE and there is more to discuss.

I know that testing is very much on people’s minds. We in the UK have tested more people than almost any other major economy outside China, South Korea and Italy. We have been increasing testing by the day. This week, we hope to reach 10,000 tests a day, and within four weeks Public Health England and the NHS expect to be conducting up to 25,000 tests a day. After that, the number will continue to increase up to 250,000 tests a day and more. With more testing capacity, we will be able to test more patients and, critically, NHS and social care staff.

Chris Bryant Portrait Chris Bryant
- Hansard - - - Excerpts

The former Health Secretary, who is now Chair of the Health and Social Care Committee, said earlier today that the claim 10,000 tests a day are being done now is a myth and that the number is 5,500 a day, where it is stubbornly stuck. Does the Minister disagree with him?

Helen Whately Portrait Helen Whately
- Hansard - -

That is not the data I have received. I have set out the trajectory on the testing, on the basis of the information I have. As I say, our commitment is to keep on ramping up testing, because we know it is an important part of our response.

Rushanara Ali Portrait Rushanara Ali
- Hansard - - - Excerpts

Will the Minister give way?

Helen Whately Portrait Helen Whately
- Hansard - -

If the hon. Lady will let me, I will make a little progress, as I believe I have less than five minutes left.

We know that we must keep NHS staff safe, but we must also support them and their work. The Government are working with the NHS on a package of support for NHS staff to help them through the coming weeks and months, which includes guidance to their line managers; support for occupational health; and psychological and emotional support, because, as the hon. Member for Rhondda said, they are facing extremely challenging times, and we are very aware of the emotional demands that will place on our frontline staff. I urge every NHS employer to be making sure that staff are getting food supplies—hot meals and hot drinks. Whatever NHS staff need to help them get through each day, they should be getting. The Government have committed to funding for health and social care to support us through the coronavirus. That funding should be being used and we should make sure that staff are being helped in every way that they can be.

Rushanara Ali Portrait Rushanara Ali
- Hansard - - - Excerpts

I just have a suggestion relating to NHS workers and overcrowded places. London has a lot of underused properties—empty properties owned by foreign investors. Will the Minister consider making sure that local authorities have powers to use those temporarily to house NHS workers who need to be able to be close to work? Will she make sure that there is a sense of urgency, because she is talking about weeks and months, but NHS workers in my constituency need the protective equipment now and many of them do not have it.

Helen Whately Portrait Helen Whately
- Hansard - -

The protective equipment is being distributed at pace and urgently. I talk of weeks and months because we should not think this situation we are coping with will last just a few days. We will need to support our NHS through these weeks and months. I know that NHS trusts are looking at the accommodation that their workforce will need. I wish to make the important point about the measures that the Government have been taking to make sure that the children of key workers, NHS staff and social care staff are included and are cared for at school, so that these staff do not have to worry about their children’s education. I also wish to thank each and every teacher and support worker who was at school today looking after children so that our NHS and social care staff can look after us.

Before coronavirus hit us, we had already committed to increasing the NHS workforce, particularly boosting the staff it needs in pressure points such as emergency departments. For instance, we have committed to funding an extra 1,500 undergraduate medical school places per year, which is a 25% increase. We are opening five new medical schools across England, often in areas that currently do not have medical training facilities, so we are going to be able to get doctors to the places that most need them. We have also committed to 50,000 more nurses in the NHS, and we are increasing the funding for nursing, midwifery and some allied health professional students studying at English universities to at least £5,000 per academic year, and up to £8,000 a year.

I would like to thank all Members for their contributions to this debate. The coronavirus outbreak is the biggest public health emergency in a generation. It calls for decisive action, at home and abroad, of the kind not normally seen in peacetime. I wish to end my remarks by again sending our country’s thanks and unending support to all our colleagues on the NHS and social care frontline tonight. It is they who will fight back this virus. It is they who are putting themselves in harm’s way to help our families. I know each and every Member of this House, and everyone across the country, will be eternally grateful to them for that. I make this commitment: we are there for you, the NHS staff, and we will do all that we can to support you at this most difficult time in our history.

Question put and agreed to.

Alcohol Harm

Helen Whately Excerpts
Tuesday 17th March 2020

(4 years ago)

Westminster Hall
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Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.

Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.

This information is provided by Parallel Parliament and does not comprise part of the offical record

Helen Whately Portrait The Minister for Care (Helen Whately)
- Hansard - -

I congratulate my hon. Friend the Member for Congleton (Fiona Bruce) on securing the debate. Despite all that is going on around us, there have been some substantial contributions to the conversation that have made some really important points. I am responding on behalf of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who is currently working on emergency legislation for coronavirus, and will do my very best to give a full response to the questions that have been raised.

I thank my hon. Friend the Member for Congleton for her comments, particularly about the work that we are doing in response to coronavirus. I should add that, although I am grateful that she thanked the ministerial team, the thanks should go to those on the frontline, such as the NHS and social care workforce. They are the ones who are really taking the issue on.

I commend my hon. Friend for the huge amount of work that she has done on this matter and for her commitment to ensuring that we reduce the harm caused by alcohol. Most people drink responsibly and the good news is that we are seeing an overall decrease in the number of people who drink, especially among young people. However, the Government are not complacent and are determined to do more to support people at risk from alcohol misuse. Our aim is to ensure that people are directed to the appropriate service wherever and whenever they look for help.

Fiona Bruce Portrait Fiona Bruce
- Hansard - - - Excerpts

I thank the Minister for giving way and for stepping in to respond to the debate. She said that most people drink responsibly, but Drinkaware’s statistics, which are very worrying, show that 49% of men are classified as increasing or higher risk drinkers compared with 31% of women. That is a very high percentage.

Helen Whately Portrait Helen Whately
- Hansard - -

As I said, I fully appreciate and respect my hon. Friend for the huge amount of work that she does to urge us to recognise the harmful effects alcohol can have.

We know that alcohol misuse can have an impact on hospital care and demand. It contributes to a wide range of conditions including cardiovascular disease, cancer and liver disease, as well as accidents, violence and self-harm. Some 12% to 15% of A&E attendances are alcohol-related, and alcohol is a causal factor in the patient’s diagnosis for more than 1.1 million hospital admissions every year. We absolutely take my hon. Friend’s concerns seriously.

As part of our NHS long term plan, alcohol care teams are being introduced in hospitals with the highest number of alcohol-related admissions. It has been shown that those teams significantly reduce avoidable bed days and re-admissions. The seven-days per week service at Royal Bolton Hospital saved 2,000 bed days in its first year, and modelling suggests that alcohol care teams in every non-specialist acute hospital will save 254,000 bed days and 78,000 admissions per year by their third year of operation.

Thanks to the personal testimony and campaigning by hon. Members present and by others who were unable to attend, the Government have invested £6 million to improve outcomes for children with alcohol-dependent parents. That funding includes £4.5 million for nine local areas to test innovative ways of working and to join up systems to support children and families—promising results are emerging in those areas. We have also allocated £1.5 million to voluntary sector organisations to build resources and capacity at national level, including helpline and contact-centre support through the National Association for Children of Alcoholics. We are also investing £6 million through a capital fund to enable local authorities to improve services and facilities for people with alcohol problems.

We continue to educate the public, ensuring that people are aware of the health risks of alcohol through local and national programmes, such as Public Health England’s One You campaign. The alcohol risk assessment in the NHS health check is used to inform a discussion on reducing the individual’s risk. New guidance encourages referral for liver investigation, where risk is identified. In addition, there is a commissioning for quality and innovation—CQUIN—scheme to incentivise increased cirrhosis and fibrosis tests for alcohol-dependent patients.

My hon. Friend also mentioned labelling. We have worked with industry to communicate the UK chief medical officer’s low risk drinking guidelines on the labelling of alcohol products. The Portman Group and others in the industry have made a commitment that labels will reflect the guidelines and we are closely monitoring progress.

We have also made a commitment in the prevention Green Paper to work with industry to deliver a significant increase in the availability of alcohol-free and low-alcohol products by 2025. A roundtable is being organised to take this work forward. Encouragingly, sales of no or low-alcohol beer are up 30% since 2016 and “nolo” alcohol is set to be one of the driving trends of 2020, although I am sure trends are being reviewed in the light of the pandemic.

Public Health England supports local authorities in their work of needs assessment and commissioning alcohol and drug prevention and treatment services by providing advice, guidance and data. PHE is developing UK-wide clinical guidelines for alcohol treatment. That work will promote good practice and improve the quality of service provision, resulting in better outcomes for patients.

We know that alcohol-exposed pregnancies present a significant public health problem across the country. Foetal alcohol spectrum disorder can have a major impact on the early years development of children and their life chances. There is great work under way at local levels to tackle this. For example, the Greater Manchester health and social care partnership recently launched its #DRYMESTER campaign to raise awareness of drinking alcohol when pregnant. NICE are currently consulting on a draft quality standard on FASD. The voluntary sector also plays a vital role here. As part of the children of alcohol-dependent parents funding programme, over £500,000 is being made available to support work on FASD.

Finally, the good news from the budget is that £46 million in funding is being provided to improve support to individuals experiencing multiple complex needs. That includes tackling homelessness, reoffending and substance abuse, including alcohol misuse. In addition, as part of our rough sleepers programme, there is £262 million of new funding for substance misuse treatment services. When fully deployed, that is expected to help more than 11,000 rough sleepers a year. It will enable people to move off the streets and support them to maintain a tenancy for the long term. The funding complements £237 million announced by the Prime Minister for accommodation for rough sleepers, and a further £144 million for associated support services.

Several hon. Members raised minimum unit pricing, particularly the hon. Member for North Ayrshire and Arran (Patricia Gibson), who drew on her experience in Scotland. There are no plans to implement minimum unit pricing in England at present, but the Government continue to monitor the evidence as it emerges from Scotland and Wales.

Several hon. Members talked about the Government’s alcohol addiction strategy. As announced in November, we are undertaking a UK-wide cross-Government addiction strategy. Plans on the contents of the strategy are being developed and we will have more to say on this shortly.

Patricia Gibson Portrait Patricia Gibson
- Hansard - - - Excerpts

I listened carefully when the Minister said that the Government currently have no plans to implement minimum unit pricing. In the light of that, and given the funding and investment she talks about that will deal with the consequences of alcohol addiction, does she agree that tackling the consequences is less effective than tackling the problem at source? Cider and some of the highest content alcohol is on sale in shops in England for less than a bottle of water or a pint of milk. Does she agree that making alcohol a little bit more expensive could have an impact?

Helen Whately Portrait Helen Whately
- Hansard - -

I thank the hon. Lady for her contribution and I take her point. It is important that we continue to look at the evidence and that is the approach we will follow. I thank everyone here today for their contributions to this important debate and for having this conversation.

Jim Shannon Portrait Jim Shannon
- Hansard - - - Excerpts

I urge the Minister to contact each of the regional devolved Administrations, in Scotland, Northern Ireland and Wales. It would be a good idea for interaction with those three regional Administrations, to gauge a universal policy for the whole of the United Kingdom of Great Britain and Northern Ireland and to take all the evidence from other parts of the United Kingdom, which could gel a strategy that we could all agree on. That would be a substantial way forward.

Helen Whately Portrait Helen Whately
- Hansard - -

The hon. Gentleman makes an important point about working together, and the UK Government working with the devolved Administrations, drawing on the lessons that we have all learned and the evidence we all have. I do not think I will make a commitment to do that immediately in the light of the current public health situation, but he does make a very good point.

The Government absolutely are taking action and we are determined to do more to support people who are most vulnerable from alcohol misuse.

Oral Answers to Questions

Helen Whately Excerpts
Tuesday 10th March 2020

(4 years ago)

Commons Chamber
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Helen Whately Portrait The Minister for Care (Helen Whately)
- Hansard - -

This Government will be introducing an NHS visa, which will offer reduced fees and fast-track access for overseas doctors, nurses and allied health professionals to work in the UK. My right hon. Friend the Home Secretary will be outlining detailed plans in due course.

Andrew Bowie Portrait Andrew Bowie
- Hansard - - - Excerpts

Scotland has an increasing crisis of GP shortages, and in NHS Grampian—where £1 million had to be spent on agency nurses this winter—we have an increasing nursing crisis. Some people are understandably concerned that the changes to immigration rules will have an adverse effect. Can my hon. Friend confirm that the new NHS visa will be applicable in Scotland as well?

Helen Whately Portrait Helen Whately
- Hansard - -

Yes, I can absolutely give my hon. Friend that assurance. The NHS visa will be available for doctors, nurses and allied health professionals coming to work in the NHS across the whole United Kingdom.

Simon Jupp Portrait Simon Jupp
- Hansard - - - Excerpts

As we all know, nurses, midwives, paramedics and physiotherapists are highly skilled roles, and the Government have been clear that they meet the immigration skills threshold. What steps is the Department taking to dispel the level of fake news on the subject, and to encourage the brightest and best from around the world to apply for these important roles?

Helen Whately Portrait Helen Whately
- Hansard - -

The salary threshold for people coming to work in the NHS in the roles that my hon. Friend mentioned are linked to NHS pay bands, and applicants will have more than enough points to apply under the new immigration system. We are working with NHS employers to encourage international applicants. I thank my hon. Friend for giving me the opportunity once again to dispel any myths in this area.

Justin Madders Portrait Justin Madders (Ellesmere Port and Neston) (Lab)
- Hansard - - - Excerpts

The Minister will have to try a bit harder, because the Chartered Society of Physiotherapy is certainly very concerned that its positions are not going to be covered. Others, such as care assistants, are also below the salary threshold. We are talking about vital roles. There are 100,000 vacancies across the NHS, so will the Minister go back to the Home Office and ask staff to look at the detail of these proposals so that they do not make the NHS staffing crisis any worse than it already is?

Helen Whately Portrait Helen Whately
- Hansard - -

The NHS visa is in place. There are also plans in place to ensure that we have international recruitment alongside investment in a home-grown workforce, and that we increase retention rates and the number of returners to provide the NHS with the staff it needs.

John Spellar Portrait John Spellar (Warley) (Lab)
- Hansard - - - Excerpts

Many skilled health professionals in this country who have been granted refugee status are finding it difficult to get accreditation from the regulating bodies. May I commend to the Minister the healthcare overseas professionals programme of Sandwell and West Birmingham NHS Trust, and invite her to visit that trust? Will she have discussions with the regulating bodies to try to speed up the process for these people, who have the skills and want to work, and whom we need?

Helen Whately Portrait Helen Whately
- Hansard - -

Work has already been done by the regulating bodies. For instance, we are already speeding up the process for nurses from overseas who want to come here to work in the NHS. I would be very happy to have further correspondence with the right hon. Member about the specific problem, and would be delighted if he could send me an invitation to make the visit that he mentioned.

Jeremy Hunt Portrait Jeremy Hunt (South West Surrey) (Con)
- Hansard - - - Excerpts

I congratulate the Department on securing the NHS visa but, as the Minister knows, it does not apply to nurses and care workers in the social care sector. What is the Department’s assessment of the gap there will be in the social care workforce as a result of this new immigration policy, and how are discussions going with the Home Office and No. 10 on that issue?

Helen Whately Portrait Helen Whately
- Hansard - -

I thank my right hon. Friend for his question. I am well aware of concerns in the social care sector, particularly in areas where there are higher vacancy rates. It is important that employers make sure that they are taking the steps they can take to make sure that social care jobs are attractive and, of course, well paid, as they should be. I recognise as well a role for Government in this, supporting the role of working in social care, and overall making sure that we come together and fix the social care crisis.

Jim Shannon Portrait Jim Shannon (Strangford) (DUP)
- Hansard - - - Excerpts

7. What recent estimate he has made of the number of GP practices that have adopted the care for young carers package.

Helen Whately Portrait The Minister for Care (Helen Whately)
- Hansard - -

NHS England outlined the care for young carers offer in GP surgeries in June 2019. The offer includes a package of practical plans and actions to help young carers. Uptake will be monitored at a regional level in England through integrated care systems.

Jim Shannon Portrait Jim Shannon
- Hansard - - - Excerpts

I am grateful for the Minister’s response. However, can she further break down the number of surgeries that have offered priority appointments for carers for home visits and additional mental health checks, and double appointments for the carer and those they provide for? What is she doing to see this rolled out in every GP surgery throughout the nation, bearing in mind that 40% of carers struggle with their own mental health?

Helen Whately Portrait Helen Whately
- Hansard - -

My hon. Friend makes a really important point about support for carers and young carers. I cannot answer on the details of his question right now, but I will take it away, talk to the Under-Secretary of State, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who is responsible for primary care, and the Under-Secretary of State, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), who is responsible for mental health, and come up with a better answer for him.

Julian Sturdy Portrait Julian Sturdy (York Outer) (Con)
- Hansard - - - Excerpts

10. What steps his Department is taking to increase the range of medicines available to patients on the NHS.

--- Later in debate ---
Owen Thompson Portrait Owen Thompson (Midlothian) (SNP)
- Hansard - - - Excerpts

23. What assessment he has made of the potential effect of the proposed points-based immigration system on the provision of health and social care.

Helen Whately Portrait The Minister for Care (Helen Whately)
- Hansard - -

The points-based immigration system is designed so that the UK can attract the brightest and best individuals to work here. As the hon. Member no doubt knows, jobs where there is a recognised shortage of supply, such as nurses, are on the shortage occupation list, and people filling those roles will score more than enough points to come to the UK. We are also introducing the NHS visa to make it easier for doctors, nurses and health professionals from all around the world to come to work here.

Brendan O'Hara Portrait Brendan O'Hara
- Hansard - - - Excerpts

The sector is understandably worried about what a points-based system will mean for their ability to recruit the workforce they need. Soon I plan to reintroduce my private Member’s Bill, which sought an independent review of the impact of Brexit on the sector, but will also now include an independent evaluation of having such a points-based system. Given the importance of an evidence-based approach to policy making, will the Minister agree to meet me and others to see how we can all work together to ensure that the long-term needs of the health and social care sector are met based on the evidence available?

Helen Whately Portrait Helen Whately
- Hansard - -

I thank the hon. Member for his question. I am in contact with stakeholders, as a relatively new Minister in this post, reaching out as much as I can. I am mindful of concerns about vacancy levels but absolutely committed to making sure that, across health and social care, we have the workforce we need.

Owen Thompson Portrait Owen Thompson
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Not only do this Government treat the Scottish Government with contempt, but they treat their own Scottish Tory colleagues in the same way, as they were reportedly livid about the points-based immigration system introduced. Given the implications for health and social care staffing in Scotland, will the Minister ask Cabinet colleagues to reconsider our proposals for a Scottish visa?

Helen Whately Portrait Helen Whately
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We have the NHS visa, which applies to the whole United Kingdom. The Migration Advisory Committee has been clear that UK immigration policy must benefit the whole UK, and Scotland benefits from its own shortage occupation list, which will continue to exist.

Kevin Hollinrake Portrait Kevin Hollinrake (Thirsk and Malton) (Con)
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Does my hon. Friend agree that a German-style system of social insurance for adult social care would relieve the burden and reduce the requirement for overseas workers, by allowing a loved one, a neighbour or a friend to provide that care and be properly remunerated for it?

Helen Whately Portrait Helen Whately
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I am well aware that my hon. Friend is very keen on that particular approach. He has hopefully received a letter from the Secretary of State, inviting colleagues to come to talk to us about the proposals and options for fixing our social care crisis, and I hope he will take that up.

Luke Evans Portrait Dr Luke Evans (Bosworth) (Con)
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Will the Minister consider waiving the NHS surcharge for overseas staff who want to come to work in our NHS?

Helen Whately Portrait Helen Whately
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I am well aware of concerns about the surcharge. Many overseas nurses coming to work in the NHS do not have to pay the surcharge, as it is covered by their employer.

Toby Perkins Portrait Mr Toby Perkins (Chesterfield) (Lab)
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The phrase “brightest and best”, when it appears in immigration talk, is obviously subjective and deliberately vague. What the private sector and local authorities want to know is: under the new Government system, will they be able to get people to come in who want to provide care—people we are desperate for?

Helen Whately Portrait Helen Whately
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For the NHS, we have the NHS visa and a clear route to come to work in the health sector. For social care, there is a job to be done by employers, to make sure that working in social care is an attractive job that is well paid. I also recognise that there is a role for Government and for all of us in Parliament, to come together and support changes to how we fund social care. We need to fix the social care system for the future.

Kieran Mullan Portrait Dr Kieran Mullan (Crewe and Nantwich) (Con)
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12. What steps his Department is taking to increase the range of healthcare professionals permitted to administer low-risk medicines.

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Helen Whately Portrait The Minister for Care (Helen Whately)
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My hon. Friend is right about both how widespread loneliness is and the costs. The cross-Government loneliness strategy does indeed join up the voluntary sector and many parts of Government, led by the brilliant Baroness Barran in the Department for Digital, Culture, Media and Sport. For our part, in this Department we are particularly supporting the growth of social prescribing, which enables GPs to direct their patient to a host of activities, many of which help people to overcome loneliness.

Gregory Campbell Portrait Mr Gregory Campbell (East Londonderry) (DUP)
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Let us try to keep a sense of perspective. Last weekend, Government sources indicated that the worst-case scenario would be 100,000 deaths due to the current virus outbreak. Given that China has reported just over 3,000 deaths and that it has been at the epicentre of the virus for 10 weeks but has a population 20 times greater than the United Kingdom, was the 100,000 figure a helpful reference?

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Siobhan Baillie Portrait Siobhan Baillie (Stroud) (Con)
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Workforce pressures are rightly on the agenda at the moment, and we hear a lot about recruiting internationally, but what are we doing to promote the home-grown workforce—through training and lifelong learning—and getting people to enter the health profession at any time of life?

Helen Whately Portrait Helen Whately
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There has been much discussion today of international recruitment, but alongside that we are committed to boosting our home-grown workforce, particularly to achieve our ambition of an extra 50,000 nurses in the NHS and 6,000 more GPs.

Rushanara Ali Portrait Rushanara Ali (Bethnal Green and Bow) (Lab)
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At a time when the NHS is under pressure as never before because of coronavirus, does the Secretary of State agree that to close Mildmay Mission Hospital in my constituency would be an act of unbelievable folly? It is a specialist unit for people with HIV/AIDS, and to force those patients into the mainstream would endanger lives. Can he commit today to providing the much needed additional funding of £5 million a year to save this very important hospital, which is doing very important work?

Adam Afriyie Portrait Adam Afriyie (Windsor) (Con)
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In Windsor we have an ageing but distinguished population, and we recognise that adult social care is one of the biggest challenges facing the country and local authorities. I thank the Secretary of State for his dedication to resolving these issues, with the better care fund allocation and his call for input from MPs, among others. In those discussions, will he have an open mind to the concept of a precept for adult social care for local authorities?

Helen Whately Portrait Helen Whately
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My hon. Friend will be aware that already some of the funding that adult social care receives is through a council tax precept, but I would be delighted to meet him as part of the cross-party talks we have initiated to address the challenges in social care.

Munira Wilson Portrait Munira Wilson (Twickenham) (LD)
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There are numerous reports of people with symptoms of coronavirus being refused a test by 111 because they cannot name an individual who has been diagnosed with the virus. Yesterday the Secretary of State’s ministerial colleague, the noble Lord Bethell, said about 111 that there must be people who had had “bad experiences”. Will the Secretary of State confirm whether it is indeed policy not to test those with symptoms who cannot be contact traced, or whether many people are simply having a bad 111 experience?