Health and Wellbeing Services: East of England

Helen Whately Excerpts

Wednesday 1st March 2023 Westminster Hall

[The Minister for Social Care (Helen Whately)]

It is a pleasure to respond to this debate, and I congratulate my right hon. Friend the Member for Witham (Priti Patel) on securing it. She brought her legendary laser-like scrutiny to healthcare in her constituency and the wider east of England region. As we would expect, she covered a huge amount of ground with passion and insight. She forensically dug into the detail and asked many challenging questions of me and the Government more broadly.

Several other hon. Members from the east of England made contributions, including my right hon. Friend the Member for Chelmsford (Vicky Ford), my hon. Friends the Members for Clacton (Giles Watling) and for South Norfolk (Mr Bacon), and the hon. Member for Cambridge (Daniel Zeichner). From a little further afield, we heard from the hon. Member for Strangford (Jim Shannon)—he is no longer in his place, but it always a pleasure to hear his frequent and well-informed contributions to healthcare debates.

I welcome the work that hon. Members are doing in their constituencies to support their constituents’ health and wellbeing. They are showing an interest in the activities of health and social care services in their areas, and are asking very pertinent questions. That is a very important way of driving improvement and holding the people closer to the frontline to account. I also thank them for the work they are doing, including in this debate and behind the scenes by lobbying Ministers such as me and others in the Department of Health and Social Care, to get the things that they rightly want for their constituents.

It was good to hear my right hon. Friend the Member for Witham pay tribute to Essex County Council; her comments chime with my experience of working with it. I had a call with the council on Monday to talk about the work we are doing together to reduce the number of patients in hospital waiting for discharge. I know it is working extremely hard. Its data is better than the average data across England. I heard some really good things about what the local authority is doing, working with the NHS to help patients get out of hospital more quickly, and to avoid going into hospital in the first place, which we know is better in general, particularly for older people who can lose condition if they have a long stay in hospital. I, too, have been very impressed by Essex County Council and the innovative, proactive approach that it is taking in these areas.

My right hon. Friend covered a huge amount of ground. I will respond to several of her points, but if I do not manage to cover every single one—not all of her points address areas within my brief; it might also take a huge amount of time—I am happy to ask my ministerial colleagues in the Department of Health and Social Care to follow up on those topics beyond my social care and community health brief.

I turn first to primary care, which is clearly a significant part of the points that my right hon. Friend and others have raised. She talked about the GP numbers in her area, in the context of a fast-growing population in the east of England. Nationally, we have an ageing population living with more health conditions, which is putting greater demand on our health services and, crucially, on GPs, who are not just the gatekeepers but also, in knowing the individual, have real expertise in understanding the complexity of people’s health conditions. Those relationships are really important.

The GP-patient ratio is a particular concern for my right hon. Friend and other east of England colleagues. We have been boosting the primary care workforce, as she will know. The Government are on track to deliver our manifesto commitment of 26,000 more people working in primary care by 2024. We have already recruited more than 25,000 of those 26,000. On GPs specifically, there are more than 2,000 full-time equivalent doctors in general practice as of December last year compared with a year before. We are increasing the numbers of people working in general practice.

I realise that the pressures still remain and it takes time to make these changes; I also realise that there are disparities in the numbers of GPs in different parts of the country. Within a particular area, from one town to the next, there can be very different levels of GP coverage. This is very much a work in progress, and of course it takes time to train doctors, as we all know.

I was very glad to hear my right hon. Friend the Member for Chelmsford speak about the Anglia Ruskin medical school, one of five new medical schools that we have opened. It is playing its part in delivering a 25% uplift—a record uplift—in the number of medical students training in England. I know that my hon. and right hon. Friends supported the opening of this medical school, which is really important.

The school is not only important for its contribution to increasing the number of future doctors across the country, but also because it is located in the east of England. That is no coincidence. This and the other medical schools—there is one close to my constituency in Kent—are particularly located in areas where there is a relative shortage of doctors, because medical school graduates are more likely to work when they qualify in the area in which they have trained. We would expect to see graduates from Anglia Ruskin medical school sticking around in that area, to help to address some of the shortages of doctors locally.

Another point about the new medical schools is that they are looking at how they train the doctors that we need for the future NHS, where more care needs will be out of hospitals. We know that people will be living longer with multiple health conditions. Medicine is shifting, and therefore students in the new medical schools are particularly likely to spend time as part of their placements in primary care and community care settings, and so will be ready and trained to work in those settings and to address some of the gaps in primary care, for instance.

My right hon. Friend the Member for Witham called for a new health centre; my hon. Friend the Member for Clacton also talked about a primary care hub. I have been in contact with the Minister for Primary Care, my hon. Friend the Member for Harborough (Neil O’Brien), during the debate. I assure my right hon. Friend that he stands ready to meet her to discuss the proposal for a new health centre in Witham. I am sure he will also be delighted to talk to my hon. Friend the Member for Clacton about his campaign. We know these facilities are really important. We clearly need to make sure that we have the workforce to meet the demand, but having the right facilities can make a real difference to what services can be provided closer to people’s homes as part of primary care and community care, rather than people having to go into hospital.

My right hon. Friend the Member for Witham and my hon. Friends the Members for Clacton and for South Norfolk spoke about access to dentists, which we know has been a huge challenge. Clearly, the pandemic has made a difficult situation harder, with a lot of appointments not happening during the pandemic because of the covid risks, so there is a backlog to make up. The Government recognised the challenge back in 2022 and made an additional £15 million of funding available for dentistry, of which £2 million was provided specifically to the east of England region. There has since been an increase in the number of dentists in the region. However, we recognise that there are ongoing challenges. Back in July last year, the Government announced a package of improvements to the NHS dental system as part of the plan for patients. The Under-Secretary of State, my hon. Friend the Member for Harborough, has oversight of dentistry and continues to work on improving the dental contract in order to improve access to dentists, and I am sure that he will make further announcements in due course.

My right hon. Friend the Member for Witham talked about the Essex mental health independent inquiry. I know how important it is that the inquiry makes progress, because all patients deserve to be treated with dignity and respect, and my thoughts are with those affected and their families. Following concerns from the chair, a discussion took place in January with the chief executive of the Essex Partnership University NHS Foundation Trust, which has been taking action to encourage more staff participation in the inquiry. The Government continue to believe that a non-statutory inquiry remains the most effective way to get to the truth of what has happened, but we must ensure that this approach works and exhausts all possible solutions. There is an ongoing problem with staff engagement, and if the inquiry finds that it is unable to access relevant records, the position will be reviewed. I can assure my right hon. Friend that Ministers and officials are in regular contact with the inquiry and with NHS England colleagues, who are working closely with the trust to review progress.

[Giles Watling]

This morning I met Paul Scott, the CEO of EPUT. He assured me that, even though it is has been cumbersome and there have been problems with staff reporting back and so forth, the trust is reaching out and wrapping its arms around them. Although I feel that sometimes EPUT is a large and cumbersome body, he feels confident. Is the Minister equally confident?

[Helen Whately]

It is very good to hear that update. I refer my hon. Friend to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), who has oversight of mental health in the ministerial team and who can go further into the progress of the inquiry. It is good to hear that he is taking such an active interest in the work of the inquiry, because it is clearly important, and I thank him for that.

Hon. Members have touched on community diagnostic centres. We in Government see them as incredibly important, because we know that many patients across the east of England, and more widely across England, are waiting for a diagnosis for their condition. Waiting for a diagnosis can be one of the most worrying times, particularly if someone is concerned that they may have cancer, which is why the Government have been opening more community diagnostic centres across the country—an innovation to provide easier access to vital community diagnostic services and to speed up diagnosis. By separating some of these services from acute hospitals—the hot site, I suppose—we can ensure efficient processes to diagnose as many people as possible at pace. The good news is that we have recently announced the approval of two new community diagnostic centres via the mid and south Essex integrated care board, and there are more in the pipeline with other Essex integrated care boards. I encourage my right hon. Friend the Member for Witham and others to keep an eye on our progress with community diagnostic centres, as I am sure she is doing.

Finally, I want to talk about integration and the broader question of health and wellbeing in our communities. My right hon. Friend the Member for Witham spoke about the health challenges and disparities in her constituency and across the east of England. We see real differences and inequalities, not only in life expectancy but, crucially, in healthy life expectancy. That means people’s ability to work and have fulfilling, independent lives, to have relationships and the quality of life we would like for everybody.

The Government are determined to improve that—for instance, under the auspices of levelling up in healthcare. Crucial to achieving that is the work of our integrated care system, the integrated care boards and integrated care partnerships. They bring together all the organisations across the national health service, local authorities, social care and third sector organisations, which play an important part in our health and social care systems. Indeed, joining up NHS organisations is an important part of that in its own right. All of us who spend time with the NHS in our constituencies know that it is not one thing; it is multiple organisations. Bringing them together, along with the wider health and social care system, is important.

It is crucial for our integrated care boards and integrated care partnerships to look at the needs of populations, looking at the population as a whole, and to set out strategies for reducing health disparities and, as my right hon. Friend the Member for Witham talked about, for closing the gap—levelling up for those with a lower healthy life expectancy. That is absolutely crucial to the work of integrated care systems. It is relatively early days for these entities. The extent to which they are established varies around the country, but we are seeing an excitement and a willingness in those organisations to come together.

I have spoken to many chief executives and chairs of integrated care boards, as well as local authorities around the country. We have talked about integration many times before; it has been a buzzword for decades in health and social care. What I am hearing from the frontline is that this time it really feels like it is working and making a difference. As part of those conversations, I have spoken to many about the work they are doing on looking upstream at prevention, crucially, and the steps we can take jointly between the health system and local authorities to prevent ill health.

[Feryal Clark]

The Minister mentioned prevention and the role of local authorities. She will know that the public health funding formula for local authorities was set in 2013 and has not been reviewed. There are real disparities across the country in how they are funded. Do the Government have a plan to review that, to ensure that areas such as the east of England get the fair funding they deserve?

[Helen Whately]

The hon. Lady will know very well that we are under substantial fiscal constraints as a Government, recognising the extra spending we put in through the pandemic to keep our economy going and come out as strongly as we have. We also face challenges with inflation and the cost of energy. She will also know that in the autumn, against those constraints, the Chancellor showed the Government’s commitment to health and social care by putting an extra £14.1 billion into health and social care, including a record funding increase for social care of £7.5 billion over the next two years.

The Government’s commitment to health and social care should be clear to the h L. We are driving efforts behind the establishment of the effective working of integrated care boards and integrated care partnerships, because of the importance of joining up the system. It is not just about the public health budget; what we need to do to prevent future ill health and reduce disparities is much broader than that.

In conclusion, I thank my right hon. Friend the Member for Witham and other hon. Members for this important conversation, which has shown the complexity and the interconnections in our health and social care system. It is important to have joined-up systems, not only to treat people in the here and now, but crucially to intervene earlier and prevent ill health. We want to achieve not only longer lives for our constituents, but healthier and happier lives.

Covid Pandemic: Testing of Care Home Residents

Helen Whately Excerpts

Wednesday 1st March 2023 Commons Chamber

[Liz Kendall (Leicester West) (Lab)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the testing of care home residents during the covid pandemic.

[The Minister for Social Care (Helen Whately)]

The covid-19 pandemic was an unprecedented global health emergency involving a novel coronavirus that we were still learning about day by day, even hour by hour. Even in those early days, the UK Government and colleagues in my Department were clear that testing would be crucial. That is why the former Secretary of State, my right hon. Friend the Member for West Suffolk (Matt Hancock), set ambitious testing targets to drive a true step change in the quantity of tests, because he knew that testing would be a vital lifeline until vaccines could be developed and proven safe and effective.

The importance of testing was never in doubt, and there was full agreement on that in every part of Government, from the chief medical officer to the Health Secretary and the Prime Minister. But in a situation where we had the capacity to test, at most, a few thousand each day, tough decisions about prioritisation had to be made. Those decisions were taken on the best public health advice available. Thanks in no small part to the bold testing ambitions driven by the Government, we were able to build the largest testing network in Europe.

I put on record my thanks to all those who worked tirelessly on this mission day and night, from civil servants to the NHS and, of course, our incredible social care workforce, who did so much to look after their residents. They all deserve our lasting gratitude.

The situation in our care homes was extremely difficult during the pandemic, not just in England but across the UK and, indeed, across the world. Because of the vulnerability of residents and the large number of people who come in and out of care homes, it is vital that we learn lessons.

It is equally vital that we learn those lessons in the right context. Selective snippets of WhatsApp conversations give a limited and, at times, misleading insight into the machinery of government at the time. The covid inquiry is important so that we have the right preparations in place to meet future threats and challenges.

[Liz Kendall]

Throughout the covid pandemic, Ministers repeatedly claimed that they had thrown a protective ring around England’s care homes and that they had always followed the evidence and scientific advice, but WhatsApp messages from the former Health Secretary revealed in today’s Daily Telegraph suggest that nothing could be further from the truth.

Will the Minister confirm that the chief medical officer first advised the Government to test all residents going into care homes in early April 2020? Can she explain why the former Health Secretary rejected that advice and failed to introduce community testing until 14 August—a staggering four months later? Can she publish the evidence that following the advice would have muddied the waters, as the right hon. Member for West Suffolk (Matt Hancock) claimed? And can she confirm that 17,678 people died of covid in care homes between the CMO’s advice and the Government finally deciding to act? She should know, because she was responsible for care homes at the time.

Former Ministers are touring the studios this morning claiming that this delay was simply because there were not enough tests. Where is the evidence for that? Even if tests were in short supply, why were care homes residents not prioritised when the devastating impact of covid was there for all to see?

Nobody denies that dealing with covid was unbelievably difficult, especially in the early days, but care home residents and staff were simply not a priority. Yet the former Prime Minister and former Health Secretary were first warned about the emerging horror in care homes by my hon. Friend the Member for Hove (Peter Kyle) in March 2020. I myself raised the lack of testing in care homes with the Health Secretary on 8 April, 28 April, 19 May and 17 June 2020, long before the CMO’s advice was finally followed.

The Minister will no doubt say that all these issues will be looked at in the public inquiry, but its findings will not be available for years. The families of the 43,000 care home residents who lost their lives will be appalled at the former Health Secretary attempting to rewrite history—an attempt that will turn to ashes along with his TV career. We need more humility and less celebrity from the right hon. Member for West Suffolk, and above all we need answers.

[Helen Whately]

It is relatively easy for the hon. Member to come to the House today and make these highly political points. Knowing how she and I worked together in the pandemic, and that she and I talked about all that we were doing to look after people in care homes, I am shocked and disappointed by the tone she has taken today, when we are dealing with extremely serious questions.

I will turn first to some of the difficult prioritisation decisions that were made, given the limited quantity of testing we had at the beginning of the pandemic. The Government followed the expert public health advice available at the time. We had the capacity to test just 3,000 cases a day in mid-March, and I am sure colleagues will understand why the health advice at the time was to prioritise those working on our NHS frontline and, for instance, the testing of people in hospitals and care homes who had symptoms. In fact, the courts have already agreed that our prioritisation decisions on testing were completely rational.

As we dramatically ramped up testing capacity, we also adjusted that prioritisation in line with the public health advice and the capacity, so by mid-April—just a month later—with testing capacity exceeding 38,000, we were in a position to test more widely. In fact, that is reflected in our adult social care plan published on 15 April, which made it clear that everyone discharged from a hospital to a care home should be tested even if asymptomatic, and that all discharged patients, regardless of the result of their test, should be isolated for 14 days. It is worth reflecting just what a dramatic increase in testing the Government oversaw, from just 3,000 in March 2020 to over 38,000 in mid-April, to over 100,000 by mid-May, to the point where we could test many millions in a single week. We established the largest testing network in Europe from a standing start, and the science proves that it saved lives.

The hon. Lady asked about the content of the WhatsApp messages that have been published. I say to her that it is a selection from a larger quantity of messages. Clearly, while there were discussions and debates between Ministers and colleagues, partly on WhatsApp, there were also meetings and conversations and other forums in which advice was given and decisions made. A huge quantity of that is with the public inquiry, but I can say to her that, for instance, a meeting to discuss the implementation of the advice on testing was not referenced in the WhatsApp messages she is talking about. There is an email following the exchange to which she is referring that says, “We can press ahead straightaway with hospitals testing patients who are going into care homes. And we should aspire, as soon as capacity allows and when we have worked out an operational way of delivering this, that everyone going into a care home from the community could be tested.” As I say, she is basing her comments on very selective information.

As I said, the hon. Lady knows how the Government, and me personally, strained every sinew, worked day and night, and did everything in our power to help people, and specifically the most vulnerable, during the pandemic. She and I spoke about it regularly during our frequent calls. In fact, at the time I appreciated her perspective, questions and insights from her own area of Leicester. I say to her that we should go about this discussion in the right way for the country. This is not the time to play political games. We should look to save lives. That is the purpose of the public inquiry: to learn lessons in the right way in case this should ever happen again.

[Sir Oliver Heald (North East Hertfordshire) (Con)]

My hon. Friend will agree that it was Labour that called for a public inquiry, and the Government agreed to it. It is a full public inquiry and we could not have a better judge than Dame Heather Hallett, one of our most experienced and distinguished judges. She will do a very thorough job. Does my hon. Friend agree that what we are seeing today is a bit of trial by media and party politics?

[Helen Whately]

My right hon. and learned Friend is exactly right; we are having a public inquiry and the Government are fully co-operating with it so that it has all the information required to look through all that happened, to investigate it and, rather than trying to score political points, to truly learn lessons for the benefit of the country.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

On 2 April 2020, I wrote to the former Health and Social Care Secretary, jointly with my right hon. Friend the Member for Leicester South (Jonathan Ashworth), highlighting the urgent need for testing in care homes for staff and residents and, in particular, for patients being discharged from hospital. I knew at the time, as did other colleagues, that without that testing, care homes in my constituency and those across the country were suffering a heavy toll of deaths of residents. Indeed, one of our care home managers died of covid in my constituency.

Furthermore, at a session of the Select Committee on Health and Social Care in July 2021, I asked the right hon. Member for West Suffolk (Matt Hancock) why the Government had not taken up the offer from care providers of facilities to isolate people discharged from hospital before admitting them to care homes. He told me that he did not know anything about the letter, despite it being sent by Care England. Will the Minister now admit that the Department and Ministers failed to understand and to involve social care in the key decisions about the covid pandemic, and ignored letters offering help that could have saved lives?

[Helen Whately]

The hon. Lady is right about the importance of testing. It is a view that she has and that I had at the time; some of the exchanges will show how I, as Social Care Minister, was arguing very hard for testing for care homes, as Members would expect. I know that other Ministers and other people were arguing for the things that they had oversight of. Ultimately, of course, the Health Secretary and the Prime Minister had to make decisions, based every step of the way, clearly, on the scientific advice on these things, as we did. To that point, during the course of the pandemic, as the capacity allowed, millions of tests were distributed to care homes. As I have said, as the capacity increased, care homes were prioritised in that process. Specifically to address one of the points she made, let me say that the guidance set out on 15 April was not only that everyone discharged from hospital to a care home should be tested, but that they should be isolated.

[Mr Peter Bone (Wellingborough) (Con)]

It seems that the Opposition want to rewrite history. The fact is that at the time people did not know what was right or what was wrong. The then Secretary of State listened to a whole lot of advice and then had to make a decision. Even one of the WhatsApp messages I have seen said:

“Tell me if I’m wrong”.

What should happen is that the covid inquiry should deal with all these matters properly. The one question I have for the Minister is this: is it possible to get the covid inquiry to report earlier?

[Helen Whately]

I completely agree with my hon. Friend about the covid inquiry being the right place for people to go through the details of what happened—who said what and, as he said, the genuine debates that took place behind the scenes. This was a new virus and, at the time, we had only limited information about it. For instance, when it first hit our shores, it was not known who would be most vulnerable to it. We also did not know about asymptomatic transmission. There was a huge amount of uncertainty at the time, but the best possible decisions were made. As for the timing of the public inquiry, that is not within the control of Ministers.

[Daisy Cooper (St Albans) (LD)]

The leaked WhatsApp messages from the then Health and Social Care Secretary, the right hon. Member for West Suffolk (Matt Hancock), showed that, despite a shortage of covid tests in September 2020, one of the Minister’s advisers sent a test to the home of the right hon. Member for North East Somerset (Mr Rees-Mogg) by courier. This is yet more evidence that it is one rule for Conservative Ministers and another for everyone else. Can the Minister please inform the House how many other Government Ministers, Conservative MPs and their families received priority tests during the pandemic when there was a shortage of tests?

[Helen Whately]

It is difficult for me as a Minister to see WhatsApp messages from me in the pages of a newspaper. If the hon. Lady has read those, she will have seen that I was seeking a test for a member of my family and that I used exactly the same test app as everybody else to try to access a test that was needed.

[Tim Loughton (East Worthing and Shoreham) (Con)]

I seem to recall that two years ago, when there was a limited supply of testing equipment, there were all sorts of calls for certain groups to be prioritised. There were also urgent calls for available beds in hospitals to be freed up to cope with the likely surge in cases. In hindsight, some of those priorities may have been wrong, but at the time it was an urgent situation. Will my hon. Friend confirm that exactly the same set of priorities about access to testing prevailed in Wales, and it took the Welsh Government two weeks longer to mandate testing for care home residents in Wales than it did in England? Why are we not seeing equal outrage from the Opposition about that?

[Helen Whately]

My hon. Friend makes an important point about the challenges that were faced around the world in handling the pandemic, and very conspicuously for us across the UK. Decisions were having to be taken in Scotland, Wales and Northern Ireland as well as here in England. Had Opposition Members been in our position, in government, and having to make these difficult decisions, I am sure that they, like us, would have strained every sinew and done their very best to make the best possible decisions in a situation of limited information.

[Janet Daby (Lewisham East) (Lab)]

Even if we now know that the Secretary of State was not following the scientific advice, the Minister was in her job at the time these decisions were being made. Can she explain why she did not do the right thing then? Was she not listening to the chief medical officer either?

[Helen Whately]

I fear that the hon. Lady did not hear my previous answer, which was that the public health advice and the advice of the chief medical officer was followed. Of course there is a job to do when advice is given, and then there are the practicalities of implementation. As the volume of tests became available, those tests were used as advised, following the public health advice.

[Dr Kieran Mullan (Crewe and Nantwich) (Con)]

I will not forget the totally shameless politicking by Opposition Members during the pandemic. I specifically remember the Deputy Leader of the Opposition, who is no longer in her place, and the Leader of the Opposition talking about how we had the worst death toll in Europe. They said that again and again. [Interruption.] I hear the shadow Minister say from a sedentary position that we did, but the studies now show that we were ahead of Italy, ahead of Spain, broadly in line with France and Germany, and very far from the worst in Europe. Have we ever heard any Opposition Member come to the Dispatch Box and apologise for misleading the British public about our record during the pandemic? Does my hon. Friend agree that they might seek to do that before criticising us any further for our record?

[Helen Whately]

My hon. Friend is right. The right thing for us to do as a country is to reflect overall on how we handled the pandemic, on the decisions that we made and, indeed, on how prepared we were in the first place. That is the right way to do it. Of course we regret every life that was lost; I think about the families who lost mothers, fathers, brothers, sisters and grandmas. It is so deeply sad that so many lives were lost, but that is something that affected us here in England, across the UK and, indeed, across the world. But the right thing for us to do is to look at these things in the reasoned environment of the inquiry and then use the lessons learned and the reflections from that inquiry to make sure that, in the event that we ever have to face another pandemic like it, we can do better.

[Karin Smyth (Bristol South) (Lab)]

The Government entered the pandemic unprepared, ignoring the lessons from Operation Cygnus, and ran the NHS at 96% capacity. That was part of the problem. We all know that mistakes happen. We all know that it was really difficult. However, today is disappointing, because some humility should have been brought to this place. More than 17,000 people lost their lives. It is our job as the Opposition to scrutinise decisions. The former Secretary of State has thrown his colleagues under a bus because of his own vanity, but I suggest that Government Ministers need to use this time before the inquiry to ease families’ suffering by coming forward with more detail on actually what did happen.

[Helen Whately]

There has already been a legal investigation into some of the aspects that we are talking about today. Given the huge number of decisions that had to be made and the period of time that we are talking about, the right way to do this is to bring all the evidence together, in the form of a public inquiry, and have it fully examined. That is the best way to answer the sorts of questions that the hon. Lady suggests.

[Damian Green (Ashford) (Con)]

This is a profoundly serious question—literally a matter of life and death. As such, I am sure that my hon. Friend is right to say that the appropriate way to reach conclusions is through a proper public inquiry conducted by a very distinguished judge. Can she assure the House that the Government will be as transparent and as open as possible in giving evidence to that public inquiry, so that we can all be confident at the end of this that we have reached the appropriate conclusion?

[Helen Whately]

I can absolutely assure my right hon. Friend that the Government are sharing with the public inquiry a huge quantity of evidence so that it can reach the best possible, best informed conclusions.

[Clive Efford (Eltham) (Lab)]

The emails and WhatsApp messages expose the fact that the scientific advice was that people leaving hospital should be swabbed before going into care homes, and the Government ignored that. That shows that the Government were not following scientific advice. The Minister has said that other priorities had to be considered before the Government could implement that policy, but no one would have been more aware of the competing priorities than Professor Whitty. What was it that the Government knew that Professor Whitty did not when they decided not to follow his advice?

[Helen Whately]

It really feels as though Opposition Members have not been listening to my answers. The public health advice was followed. The situation was that we had a limited capacity for testing. That is not spelled out in those messages, because, as I have said, other meetings and other conversations were taking place. As soon as testing capacity was available, further testing was used—for example, on people being discharged to care homes. Having been Care Minister at the time, I can tell the hon. Gentleman how hard we worked across Government. We all worked—not only me, but all of us involved in this—to get millions of tests out, during the course of the pandemic, to care homes in order to help protect those residents. This was followed by our prioritising those in care homes for the vaccination because, when it came down to it, although testing was helpful, what really made a difference was being able to vaccinate people. That is what really started to provide protection.

[James Wild (North West Norfolk) (Con)]

Is it not regrettable, if all too typical, that the Labour party ignores the fact that when the pandemic struck there was capacity for only 2,000 tests a day—ignoring, too, the huge, successful efforts to massively increase that capacity—and instead chooses to leap on partial information to make political points rather than listen to the full facts of the public inquiry?

[Helen Whately]

My hon. Friend is absolutely right about how we ramped up incredibly fast from a capacity of just 3,000 tests a day in March 2020, to more than 38,000 in mid-April, and more than 100,000 by May. We were then able to test many millions per week during the course of the pandemic. That was the most extraordinary increase in the capacity to produce, carry out and analyse tests, and he is absolutely right to draw attention to it.

[Derek Twigg (Halton) (Lab)]

The Minister said that what my hon. Friend the Member for Leicester West (Liz Kendall) said was shocking. What is shocking is the number of people who died but who might have been saved in the first place. Is the Minister really saying that, at the beginning of the pandemic, there was no rush to get people out of hospital and back into the community without being tested?

[Helen Whately]

The questions about the discharge policy have been interrogated on a number of occasions, including by Select Committees. The hon. Gentleman will well know that in general, and in the work that we are doing now on discharge, it is rarely good for somebody who is medically fit for discharge to continue to be in hospital beyond that time. So of course it is right that when people are medically fit, they should be discharged home. The guidance of how that was done was set out on a number of occasions during the pandemic, and that guidance was updated both as we learned more about the virus and as greater testing capacity became available.

[Alexander Stafford (Rother Valley) (Con)]

I am very proud of this Conservative Government’s record during the pandemic: 400 million tests, a world-leading and world-beating vaccine programme, and £400 billion spent to keep jobs and people’s prospects going. Clearly, hard decisions were made, and hindsight is a wonderful thing, but we should not be reflecting with hindsight now; we should deal with the facts at hand. Does the Minister agree that this Government will continue to take measures, and that if—God forbid—there is another pandemic, we will not let party politicking get in the way of making decisions to protect lives, fund jobs and keep our country going?

[Helen Whately]

My hon. Friend is absolutely right to point out the extraordinary things that were done during the pandemic. I do not think that the Government should seek to take credit for that; so many people worked incredibly hard, whether in local authorities, social care or the NHS, or through their involvement in supply chains and the huge efforts to secure personal protective equipment when that was incredibly hard to get hold of across the world. I am glad that he draws attention to some of those things. He is absolutely right that, in the context of the public inquiry, we should reflect overall.

[Mrs Emma Lewell-Buck (South Shields) (Lab)]

In April 2020, now-disappeared Government guidance in relation to hospital discharges stated:

“Negative tests are not required prior to transfers/admissions into the care home.”

It was later reported that the Minister then leaned on Public Health England to alter its proposed advice to care homes from ensuring that those discharged from hospitals tested negative to not requiring any testing at all. Why, at every stage, were the Government content to send people to their deaths in our care homes?

[Helen Whately]

I do not recognise the hon. Lady’s account at all. If she looks back at one of the legal cases that has looked into this question, she may find more accurate information about some of the conversations that went on behind the scenes. I can assure her that, as she would expect, in my capacity as social care Minister, I fought the corner for people receiving care—both home care and in care homes—throughout the pandemic.

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

Leaked WhatsApp messages will be partial and selective, but in reading even those I note that the Minister was doing her job on behalf of my constituents. In a message on 8 April, she spoke up for a care home in Newcastle-under-Lyme and raised it with the Government and her fellow Ministers. Everyone was doing their best. I served in the lessons learned inquiry, and there are lessons that can be learned with the benefit of hindsight, but the hindsight that we have seen from the Labour Front Bench is opportunistic. Does she agree that the Government were doing everything they could to respond to an unprecedented situation under severe pressure and severe supply and capacity constraints?

--- Later in debate ---

[Helen Whately]

My hon. Friend is 100% right. The context is absolutely important as part of this conversation. It was a global pandemic about which very little was known and about which we worked incredibly hard to find out more, and on which we continually made the best possible decisions in the light of the information that we had. At all times, we prioritised protecting people and saving lives, particularly those who we learned would be most vulnerable. It is extremely disappointing to see an attempt to play politics with this issue.

[Dan Carden (Liverpool, Walton) (Lab)]

Care home residents and their families were failed not just at the beginning of the pandemic but in the months and years that followed, as families and loved ones were prevented from visiting. The leaked WhatsApps show that the Minister was arguing against the ban on visiting. Can she say why the ban was sustained for so long throughout the pandemic, and what plans she has to ensure that families with loved ones in care homes have the right to visit if this ever happens again?

[Helen Whately]

I know how strongly the hon. Member feels about this. Clearly, we are having ongoing conversations about visiting in care homes at the moment. As is evident in the WhatsApps, I was concerned during the pandemic about ensuring that families were able to see loved ones in care homes. As I have said in response to a number of questions, public health advice had to be taken into account all the way through the pandemic. Getting the right balance between protecting people from the risk of covid being taken into care homes and seeing friends and family will, I am sure, be looked into as part of the public inquiry discussions to answer questions such as his about the decisions taken on visiting. I will continue to work with him here and now to ensure that those who are currently in care homes get the visiting that they need.

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

The front page of today’s Telegraph, which reveals that the medical advice was not followed, will be heartbreaking for so many families up and down the country, re-opening the grief that so many felt about the loss of their loved ones. I have listened carefully to the Minister’s responses, and she has basically said that she is unable to compel the public inquiry to move more quickly—that it is above her pay grade. But what she could do now is commit to lobbying the Government to complete that public inquiry before the end of the year, and to doing everything she can to bring those answers forward for all those families who are today feeling so deeply hurt and upset.

[Helen Whately]

On the first point about the use of public health advice, the hon. Lady is wrong; all decisions were informed by public health advice. On her request about the public inquiry, that inquiry is independent of government, so I cannot do what she asks.

[Florence Eshalomi (Vauxhall) (Lab/Co-op)]

To reiterate the point that my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) just made, every time there is a statement, every time there is a revelation, every time such an issue is raised, whether in this House or in the press, it triggers trauma for many people who have not healed from losing their loved ones, who were not able to go to funerals, and who were not able to seek closure. I hope that the Minister will reflect on her response in that context.

To come back to the public inquiry, Covid-19 Bereaved Families for Justice said that the revelations show why the inquiry must allow the bereaved families to

“be heard in the hearings and for our lawyers to cross-examine key people”—

including the former Secretary of State, the right hon. Member for West Suffolk (Matt Hancock)—

“so we can get full answers to our questions in the right setting instead of having to relive the horrors of our loss through exposés.”

Does the Minister agree?

[Helen Whately]

As I have said, we are talking about, very sadly, people’s lives being lost—people’s mothers and fathers, grans and grandpas, sons and daughters, and sisters and brothers. We should always remember the genuine and real human cost, as well as all those who worked in health and social care looking after dying people and who had a traumatic time themselves.

On the trauma that the hon. Lady talks about, it is Labour Front Benchers who have asked the urgent question and made this conversation happen in this forum rather than in the context of a public inquiry, which might encourage a more reasoned form of debate. I hope she will have noticed that my tone fully appreciates the points that she makes, but it is not for me to dictate who will give evidence to the public inquiry.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

As the Minister will recall, I spoke for the Opposition on dozens of regulations to do with the pandemic, and on occasions I questioned some of the decisions that were made. The suspicion was that sometimes political rather than medical or scientific decisions were taken. What has come out overnight has caused me to question that again, and I hope she can understand why. It is an important question of trust for us as politicians but also for the wider public. Does she agree that rather than a partial and selective release of information to sell newspapers or books, the public deserve from the Government the release of all information so that we can get to the bottom of this?

[Helen Whately]

I do remember many of those SI debates. I can assure the hon. Gentleman that it was not political decision making as he suggests. At every step of the way, Ministers such as I, the Health Secretary and of course the Prime Minister were making incredibly difficult decisions but always trying to do the right thing to save people’s lives and to protect people from that cruel virus which particularly attacked those who were most vulnerable, such as the frail elderly. In doing so, we continuously took public health advice. The way to look into everything that happened is indeed through the public inquiry: that is where the evidence is being provided and that is the forum in which the reflections will be taken and the lessons can be learned.

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

My heart goes out to the bereaved families and I cannot imagine what they must be feeling again today. My heart also goes out to care workers, many of whom lost their lives having contracted covid. Many also survived but are now living with long covid and have lost their livelihoods. The Minister may be aware that advice from the Industrial Injuries Advisory Council that would give compensation to just some of those brave workers is currently with the Department for Work and Pensions. In a recent meeting with me, the Minister told me that it could take years for that to be taken up. What conversations has this Minister had with the DWP and, if it will take years, will her Department set up a compensation scheme so that those brave workers get the support they deserve?

[Helen Whately]

As the hon. Lady says, care workers were among those on the frontline during the pandemic and they had some incredibly difficult experiences. They took the risk of catching covid and, very sadly, some care workers and NHS workers were among those who lost their lives. Others have long covid. The question of compensation is currently with the Department for Work and Pensions. The Minister for Disabled People, Health and Work, my hon. Friend the Member for Corby (Tom Pursglove), is in his place on the Front Bench: his Department is looking at this and will respond in due course.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for her answers. Everyone’s thoughts and prayers are with those who lost loved ones. The impact of the covid lockdown on mental health was felt most keenly in care homes. To see what the elderly people were put through, and learn that the full protections were not in place and they could not see loved ones at the end of life, is totally unacceptable. What would the Minister offer to those who lost precious hours with those they loved and adored on hearing this tragic news today?

[Helen Whately]

I reiterate to those living in care homes and their loved ones and families that the Government took every step throughout the pandemic to protect those we knew were vulnerable. For instance, we prioritised testing with more than 180 million tests going to care homes during the pandemic, and we prioritised vaccinations. I remember talking to residents in care homes at the time, and vaccination was a huge moment for them because it was the first time they had felt really protected from that cruel virus. I know how hard it was for families that they could not see loved ones in care homes, and that was one reason we put out guidance about visiting, saying that if someone was close to end of life they should be able to receive visitors. I will continue to do my utmost as Minister for Social Care to make sure that we do our very best for those living in care homes.

NHS Workforce Expansion

Helen Whately Excerpts

Tuesday 28th February 2023 Commons Chamber

[The Minister for Social Care (Helen Whately)]

I am grateful for this chance to come to the House and talk about the NHS workforce. I am happy to begin with something that I expect is a point of agreement with those on the Opposition Benches: praising our fantastic NHS workforce and all they have done through the pandemic and are doing now as we recover from covid. Hon. Members will not be surprised to learn that my colleagues the Secretary of State for Health and Social Care and the Minister for Health and Secondary Care, who has responsibility for workforce, are today focused on discussions with the Royal College of Nursing, so it is my particular honour to speak on behalf of the Government today and to take a moment to re-set the tone, and indeed raise the bar, in this debate.

I am very happy to talk about our NHS workforce at a time when we have record numbers of doctors and nurses working in our health service. I am equally happy to talk about our social care workforce, the very people the hon. Member for Ilford North (Wes Streeting) seems to forget time and time again. I note that they are forgotten in his motion again today. In contrast, the Government are working with our whole health and social care workforce, not only training record numbers of doctors and nurses, and recruiting a whole host of healthcare professionals into the NHS, but bringing historic reforms for the social care workforce—all that despite the global pandemic, which created the most challenging backdrop any Government have faced for decades.

[Karin Smyth (Bristol South) (Lab)]

Will the Minister give way?

--- Later in debate ---

[Helen Whately]

I will make a bit of progress, so that there is the opportunity for Back Benchers to speak.

We have heard and will no doubt continue to hear about how we have been in power for 13 years so far, so it is only right to look at some of the figures since 2010. Since 2010, we have 35,000 more hospital doctors and 46,000 more nurses and health visitors, not to mention a nearly 50% increase in medical consultants and a near 60% increase in paramedics. That is what we have done.

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

I am very grateful to the Minister for giving way. In addition to the excellent point she made about the absence of social care in the motion, does she agree that the figures the Opposition have chosen to use in the motion do not give the whole picture at all? They do not include vacancies filled by bank staff, very often from the same hospital.

[Helen Whately]

My hon. Friend makes a very good point about the selective use of figures by Opposition Members.

[Karin Smyth]

I want to pick up the point about social care, on which, as the Minister knows, I am very keen to see progress. Her Government shelved their social care plans. The former Prime Minister said he had fixed social care, leading the entire country through that dance. He promised people that it was fixed and that people in their older age or with disabilities could be secure, so it is rather shameful for her to raise that point without then saying—maybe she will go on to do so—when we will actually see any progress on social care. Why have her Government shelved their plans?

[Helen Whately]

On the contrary, we have already made progress on some things in our social care White Paper published just over a year ago. We will soon publish next steps, particularly focused on workforce reforms. I have been talking to several stakeholders involved in exactly that area over the last few weeks. If the hon. Lady is patient she will see some of that coming forward.

I was talking about some of the things that we have done to vastly increase the number of healthcare professionals in the NHS. As part of our ambitions for the future, more than 26,000 students were accepted on to nursing and midwifery courses in England last year—a 28% increase on 2019. We are on track to meet our manifesto commitment of 50,000 more nurses by 2024. Much as we continue to strive to go further and faster, those are the figures as they stand. We might wish to make a comparison with Labour-controlled Wales, though it is sometimes hard to do so because it does not collect crucial data such as vacancy rates. One has to wonder why. That is the same Labour-run Wales where patients are twice as likely to be waiting for treatment as in England. Some 50,000 people are currently waiting over two years, while here in England we eliminated two-year waits last year.

I will move on from the situation in Wales, as I am sure Opposition Members will be glad to do so. The Leader of the Opposition has said that he thinks we are hiring too many people from overseas in health and care. The same gentleman spent several years campaigning for a second referendum on freedom of movement. Whatever his views this week, it is the work of a responsible Government to look at every available option to give this country the health and care workforce that it needs. Alongside training more doctors and nurses, recruiting from overseas and giving people from other countries a chance to work in the NHS is the right thing to do.

[Chi Onwurah]

I am pleased to hear the Minister say that it is the Government’s duty to look at every available option. During the pandemic, I take it that she clapped on her doorstep for the NHS workforce who did so much to get us through it, so why will she not look at the option of abolishing the non-dom tax loophole, to fund more nurses and doctors and a better NHS in future?

[Helen Whately]

A responsible Government take a responsible approach to funding our public services, including the NHS. Later I will come to exactly the point about the Opposition’s proposals to use that funding pot again and again for the health service.

Coming to social care and international recruitment, we have put care workers on the shortage occupation list. As a result, social care employers have already been able to offer care worker visas to more than 34,000 people. I welcome international nurses joining our nursing and midwifery register, and I make no apology for continuing to encourage bright and talented international doctors to come and work in the NHS. In fact, that is the very idea of the points-based immigration system that we have so successfully implemented.

As well as recruiting the best and the brightest, it is vital that we retain them. Ultimately, our goal is to make sure that the NHS is one of the very best places to work in the world; both my parents were NHS doctors and, believe me, I have had plenty of conversations about why sometimes it is not. What is most frustrating is when the system prevents them from giving people the very best care.

It is not simply all about pay, as Opposition Members might have us believe. The hon. Member for Ilford North talked about nursing pay, but he will understand that we are currently in talks and now is not the moment to play politics with this issue. We are pleased that the Royal College of Nursing has paused strike action. We have no doubt that both sides are committed to finding a fair and reasonable settlement—one that recognises the vital role that nurses and nursing play in the health service, the wider economic pressure facing the United Kingdom and the Prime Minister’s priority to halve inflation.

[Wes Streeting]

Will the Minister give way?

[Helen Whately]

I will not, as the hon. Gentleman had a long time at the Dispatch Box.

Our talks are focused on pay, terms and conditions and enhancing productivity. We are hopeful that we will find a pragmatic way forward. We also know that pensions and the interaction between pension, pay and taxes matter. In general practice, we are consulting on changes to the pension scheme so that clinicians who want to stay in the NHS will not have to worry that they might lose out financially. Going beyond pay, from my conversations with staff I know the importance of their day-to-day experience at work, and of having the resources and the support that they need. We will continue to press ahead with supporting the mental health and wellbeing of NHS staff.

As we work to support our workforce, we must move beyond discussion just about numbers and pay. In the NHS we have one of the largest workforces in the world, with many hundreds of organisations within it. It is an entire ecosystem. We have an incredible opportunity to do things differently at real scale, with bold new ways of working. Take our surgical hubs, which are getting hundreds of thousands more patients quicker access to procedures. Community diagnostics centres are bringing diagnostic care nearer to home without the need even to visit acute hospital sites.

We are empowering our community pharmacists to do more. We have already introduced a range of new clinical services in community pharmacy, including blood pressure checks and minor illness referrals from GPs and NHS 111. This year we will introduce more services, including a pharmacy contraception service. Just as these innovations are good for patients, they are good for the workforce too, freeing up more time for colleagues to do what they do best.

On training, the Opposition motion calls for an expansion of medical school places. I will not pre-empt the upcoming NHS workforce plan, but I can say that it will set a clear direction for our workforce, making sure that we have the right people with the right skills in the right places over the next 15 years. It was this Government—through the Chancellor when he was Health Secretary—that expanded medical school places from around 6,000 each year to more than 7,500—a 25% increase in just three years. In fact, that was such a substantial expansion that it saw the creation of five new medical schools in England, one of which in east Kent I visited earlier this month. There, they are not only training more future doctors but innovating in how they do so, preparing medical students to work in the NHS of the future.

Equally, it is not for me to tell the House what will be in the spring Budget. In the current fiscal environment there are far fewer public spending elements that can be traded off against health and care spending compared with previous decades. Yet even when faced with tough choices in the autumn, including very real pressure on public finances, this Government made a deliberate choice to prioritise health and social care, including investment of an additional £14 billion over the next two years.

When it comes to the spring budget, I can guarantee to the House that our sums will add up, unlike those of the hon. Member for Ilford North, who seems to be banking on what he believes will be an inexhaustible pot of non-dom taxation, including for his uncosted and unfunded reorganisation of primary care. He did not mention that much earlier—a policy so roundly mocked by the sector that we woke up to it on the “Today” programme and found it had been put to bed by “Newsnight”.

Since the business investment relief scheme, introduced in 2012, non-doms have invested more than £6 billion in the UK. They play their part in supporting the vital public services that we all depend on. Even a former Labour shadow Chancellor has said that scrapping non-doms would probably end up costing Britain money—to be fair, that seems to be the Labour party’s main objective, with £90 billion of unfunded spending commitments to date, and counting.

[Grahame Morris]

It is not correct that Labour’s spending plans are unfunded, and I hope that the Minister will put the record right. On the cancer plan, there is information out there that the incidence of cancer is increasing. To get value for money, would it not be sensible for the Government to invest in precision radiotherapy, as a treatment that improves patient outcomes in a cost-effective manner? That would get the best value for money for the taxpayer.

[Helen Whately]

I know that the hon. Gentleman feels very strongly about the issue; we have talked about radiotherapy. He will know that we have invested more than £160 million in improving radiotherapy equipment. This year, we are investing an extra £50 million in the cancer and diagnosis workforce. We are continuing to work hard with the NHS on reducing the backlogs that we have seen since the pandemic, when people did not come forward for cancer treatment as they would have in normal times.

[Aaron Bell]

The Minister mentioned non-dom status under the previous Labour Government, and what they said about it. Is she aware that Alistair Darling said that

“such a charge could discourage men and women—doctors and nurses, business men and women—from coming to this country…and we do not want to turn them away”?—[Official Report, 9 October 2007; Vol. 464, c. 171.]

Gordon Brown considered a five-year cap and abandoned it. Ed Balls said that it would end up “costing Britain money”. The supposed heir to Blair is sitting at the Opposition Dispatch Box, opposite the Minister. Is it not surprising that he has not learned more lessons from new Labour?

[Helen Whately]

My hon. Friend makes an excellent point. We hear about this source of funding again and again—we hear that non-doms will provide all this money—but plenty of the shadow Health Secretary’s predecessors in Labour have said that they do not think the policy he suggests would generate any more income whatsoever.

It will imminently be time to give Back Benchers an opportunity to speak, so let me end by saying that it has been an honour to open this debate on behalf of the Government and to respond to the array of misrepresentations from Labour Front Benchers. The NHS exists to care for patients, and they should always be our first priority, but the NHS’s greatest asset is its workforce.

From a lifetime of talking to staff, I know that what they want is to care for patients in a way they feel proud of. They can do that only if they themselves are cared for, feel valued, are looked after and have enough colleagues to support them. The Government are working flat out on every one of those areas. We are hiring more staff, harnessing new technology, joining up health and social care, and building bridges between parts of the system like never before. I know how tough it has been and, on too many days, how tough it still is on the frontline. I am determined that we will continue to do what is right by health and social care staff, for them and for the people they look after.

England Rare Diseases Action Plan 2023

Helen Whately Excerpts

Tuesday 28th February 2023 Written Statements

[The Minister for Social Care (Helen Whately)]

The Government have published England’s second Rare Diseases Action Plan today, on international Rare Disease Day.

Approximately 3.5 million people in the UK are living with one of over 7,000 rare diseases, such as muscular dystrophies or Huntington’s disease. People living with rare diseases often face complex journeys to diagnosis, treatment and care.

Our action plan is part of our continued commitment to improve the lives of those living with rare conditions, as outlined in the 2021 UK Rare Diseases Framework. It follows publication of England’s first Rare Diseases Action Plan in February 2022, and highlights progress made in the past year, as well as setting out 13 new actions for the year ahead.

Key achievements in the last year include:

changes to the UK National Screening Committee to support robust decision making within the constraints of more limited evidence bases, to help improve how decisions are made on newborn screening for rare diseases;

extensive public engagement to support design of a whole genome sequencing research study embedded in the NHS to screen for up to 200 rare genetic conditions in newborns where early intervention could transform outcomes;

identification of over 1,000 new, complex diagnoses for people with rare diseases, via the Genomics England Clinical Research Interface, to inform the most appropriate clinical care;

expansion of innovative digital educational resources on rare diseases, which have had strong uptake by healthcare professionals;

creation and rollout of a toolkit for virtual healthcare consultations, to improve care co-ordination for patients with complex, multi-system rare diseases;

recruitment of over 2,500 new volunteers to the National Institute for Health and Care Research (NIHR) BioResource, to increase scientific understanding of rare diseases and facilitate improved diagnostics and treatments;

completion of innovative research studies, such as the MELODY Covid-19 study, to inform targeted treatment policies for the rare diseases community.

Our second action plan will continue to build on this record, adding significant new commitments against each of the framework priorities, developed in close collaboration with members of the rare disease community. These include:

addressing health inequalities for people living with rare diseases by gathering the evidence needed to include rare diseases in NHS England’s Core20PLUS5 Framework, enabling Integrated Care Systems to develop targeted actions to reduce these inequalities;

changes to commissioning of services for rare diseases within NHS England, to improve co-ordination of pathways for access to specialist care, treatment, drugs, social care, mental health and special educational support for those living with rare diseases;

seeking feedback from the rare disease community on how to improve NIHR’s Be Part of Research platform, to make it easier for people living with rare diseases to participate in clinical research.

These actions are supported by recently announced Government funding for ground-breaking research, including investment of nearly £790 million in 20 NIHR Biomedical Research Centres, and £12 million of funding to support the Medical Research Council (MRC)-NIHR UK Rare Disease Research Platform. This research forms the essential foundations to improve understanding, diagnoses and treatments of rare diseases, translating scientific breakthroughs into clinical advances.

Under the action plan, the millions of people with rare diseases in England will see more efficient and equitable access to care and new treatments introduced. Over the coming year, we will closely monitor the progress of these actions, seeking input from those living with rare diseases to ensure we are measuring the outcomes that matter most. Progress will be reported in 2024, as part of England’s commitment to report annually over the 5-year lifetime of the UK Rare Diseases Framework.

Through this second action plan, we will continue to take steps towards achieving our overarching vision—delivering improvements in diagnosis, awareness, treatment and care, and creating lasting positive change for those living with rare diseases.

[HCWS586]

Cystic Fibrosis: Living Costs

Helen Whately Excerpts

Thursday 2nd February 2023 Westminster Hall

[The Minister for Social Care (Helen Whately)]

It is a pleasure to serve under your chairmanship, Ms Harris. I thank the hon. Member for Strangford (Jim Shannon) for not just securing the debate, but the tone in which he conducted it and his well-established support for the cystic fibrosis community. His continued presence at cystic fibrosis debates over the years has impressed on the Government the vital role that public services play in supporting people with cystic fibrosis, as well as driving home the stark realities of living with the condition. I also thank him for his kind works to me as a Minister in the Department of Health and Social Care.

I pay tribute to all hon. Members who have taken the time to speak in the debate. The hon. Member spoke powerfully about what it is like for people living with cystic fibrosis and the challenges and costs, including the cost of medication, food and energy and the loss of income, drawing on the good work in the Bristol University report, “The Financial Costs of Cystic Fibrosis”, which I have indeed read. I thank my hon. Friend the Member for Ashfield (Lee Anderson), who spoke powerfully from his personal experience of his wife living with cystic fibrosis. He talked about the extra heating and food costs and the need for 4,000 calories a day for somebody with the condition, which practically is expensive to do. He spoke about how it is a 24-hour challenge and, indeed, what the nights are like living with someone with cystic fibrosis. I welcome the optimism he brought to this Chamber as he spoke about some of the improvements to quality of life thanks to medical innovations.

My hon. Friend spoke powerfully about the CF warrior in his constituency—little Amelia Rose Ratcliffe—and what her life and, particularly at the moment, the life of her parents looking after her is like. Again, there are a lot of extra costs and all the extra trips for appointments and to the hospital. It was good to hear that there is free parking at his local hospital. He spoke powerfully about the constant worry for parents and how there are lots of little Amelias and their families all around the country. As a parent myself, I can imagine how worrying it would be for the parents of a child with a condition such as cystic fibrosis.

I think this is the first time that I have spoken in a debate with the hon. Member for Stretford and Urmston (Andrew Western), so I welcome him to Parliament. He spoke about Eva, who is older than Amelia and in school year 11, and about how she has missed a lot of school and the challenges and worries that brings—for instance, in respect of what her life will be like after school and what employment opportunities she will have. In particular, he brought into the conversation the issue of the anxiety that adults and especially young people with cystic fibrosis experience, as well as the broader mental health impact. Those are really important issues for us to discuss.

It was also good to hear from the hon. Members for Rutherglen and Hamilton West (Margaret Ferrier), for Blaydon (Liz Twist) and for Bristol East (Kerry McCarthy), and, of course, from my fellow Front Benchers, the hon. Members for Linlithgow and East Falkirk (Martyn Day) and for Denton and Reddish (Andrew Gwynne). It has been good to have this number of people contributing to a debate on this subject in Parliament.

I wish to recognise the fantastic work undertaken by the Cystic Fibrosis Trust, which advocates on the behalf of people living with cystic fibrosis and their families and continues—very effectively indeed—to bring their needs to the attention of parliamentarians. The work of the trust to help people with the increased financial burdens associated with cystic fibrosis, be it through direct financial assistance or by providing advice and information to those in need, is substantial and should be commended. The trust’s continued support for people with the condition, along with the support provided by other voluntary sector organisations, is invaluable.

During this debate, we have talked and heard about the pressures that face people with cystic fibrosis because of the increased cost of living; indeed, those pressures are set out clearly in the report from the University of Bristol. Although the increased cost of living affects us all, it has been rightly acknowledged by the Members present that the cost of living situation for people with cystic fibrosis is far more acute than the pressures that face most people.

The majority of people with cystic fibrosis will claim at least one form of benefit, with many claiming two or more benefits, and I know how important that money is to those who rely on it. As a country, we will spend around £66 billion this financial year on benefits to support disabled people and people with health conditions. In fact, specific spending on the main disability benefits—personal independence payment, disability living allowance and attendance allowance—is more than £7 billion higher in real terms than it was in 2010. Significant amounts of money are going to those who claim benefits, including disability benefits, but I have clearly heard the conversation today about how life can still be very hard for those with cystic fibrosis who claim benefits.

The Government are committed to helping those with cystic fibrosis who are able to work to do so. Our goal of reducing the disability employment gap remains, and we continue to support disabled people to start, stay and succeed in work. We do this through a range of mechanisms which, particularly for cystic fibrosis, take into consideration the impact of such a condition on someone’s ability to work. For instance, mechanisms include increasing work coach support in jobcentres for people with health conditions who receive universal credit or employment support allowance, and disability employment advisers in jobcentres who offer advice and expertise on how to help disabled people and people with health conditions into work.

For people who are in work, the Disability Confident scheme encourages employers to think differently about disability and health, and to take positive action to address the issues that employees face in the workplace. Also, the information and advice service provides tailored guidance on supporting and managing health and disability in the workplace. In addition, we support Access to Work grants towards the extra costs of working beyond standard reasonable adjustments, to ensure that people such as those with cystic fibrosis who can work have the support that they need to do so.

Several Members spoke about the cost of energy. To help with the rising cost of energy, our energy bills support scheme is delivering a £400 non-repayable Government discount in instalments over six months to help 29 million households with energy bills over the winter. The energy price guarantee, which saves a typical household around £900 this winter, will be extended to April 2024. Also, over the past year there has been extra support for people on means-tested benefits such as universal credit, to help them with the higher energy costs we have been talking about. Sums of £650 were paid out in two payments last summer and November to households in that situation, with an additional £150 for those on disability benefits.

The household support fund, which is £1.5 billion in total, has gone to local authorities to provide support to the most vulnerable people in their communities. Local authorities judge who most needs that help and how best to give it. Local authorities have provided support to help with energy costs, and sometimes specifically to help people whose health needs contribute to their finding it difficult to afford their extra energy costs. The fund was intentionally distributed in such a way as to give local authorities the flexibility to use it most effectively to help their communities and the people they know most need help.

Let me address some of the concerns expressed about the costs directly linked to cystic fibrosis, such as prescription costs and challenges in attending appointments. It is true to say—it has come up this afternoon—that not everyone with cystic fibrosis will qualify for free prescriptions, but there are prescription charge exemptions in place in England to help patients with the greatest need to afford prescriptions. For instance, people with cystic fibrosis who receive benefits may be exempt through the NHS low-income scheme.

Those who have to pay NHS prescription charges and need many prescription items can save money with a prescription prepayment certificate, which allows people to claim as many prescriptions as they need for a set cost. A three-month prescription prepayment certificate, which costs £30.25, or an annual one, which costs just over £108, will save people money if they need four or more items in three months or 12 or more items in 12 months. A holder of a 12-month certificate can get all the prescriptions they need for just over £2 a week.

[Kerry McCarthy]

I understand what the Minister is saying—it is said every time we raise this issue—but the only reason why people with cystic fibrosis are not covered by the rules that apply, say, to people with diabetes is that cystic fibrosis was seen as a childhood disease, and it was thought that people with cystic fibrosis would not live past the age of 16. That is an anomaly. It is good that they can get the season ticket, but they should not be treated like that. If they had survived beyond the age of 16 when the rules were brought in, they would not be treated like that now. Does the Minister therefore agree that it is still unfair?

[Helen Whately]

I absolutely hear the hon. Member’s argument, and similar points were made during the debate. As the Minister with oversight of major conditions, cystic fibrosis is not the only condition about which I have received letters, parliamentary questions and lobbying in general asking for exemptions to prescription charges. We cannot just look at cystic fibrosis in isolation; a similar argument could be made in relation to a number of other conditions. As I have set out, the way the system works is specifically designed to help people on low incomes with the cost of prescriptions and make it more affordable for people who have to get a lot of prescriptions during the course of a year.

[Jim Shannon]

I want to follow on from what the hon. Member for Bristol East (Kerry McCarthy) said. I think I referred in my contribution to the 1968 legislation. The perception at the time was that children who had CF were not going to survive, and that therefore there was no need to include CF, but today there are more adults who have CF than ever. The point that I am making is that things have changed. Will the Minister convey that information to the DWP in as strong a fashion as we have in this Chamber, and ask the DWP to look at that? I know it is not the Minister’s responsibility to look at that, but if that is agreeable to her, it would be helpful.

[Helen Whately]

As ever, the hon. Member is extremely persuasive. I will be happy to take that up with ministerial colleagues who are responsible for prescription charges, but I do say that this is the case not just for cystic fibrosis. We should be aware that we would be similarly lobbied on behalf of other conditions, so we need to be aware of the breadth of the issue raised. However, I shall be happy to take up the matter with ministerial colleagues.

I want to pick up on the cost of attending medical appointments, which was also raised. To help people to get to appointments, the NHS healthcare travel costs scheme provides financial assistance to eligible patients who need assistance with their travel costs. That includes patients in receipt of a qualifying benefit and those on the NHS low-income scheme.

Another way to alleviate the cost pressures of medical appointments for people with cystic fibrosis—I stress that this is only where appropriate; I do not want to be misconstrued—is for appointments to be virtual. NHS England is supporting NHS providers to embed and spread the use video consultations innovatively, where that is the right thing for a patient, and in discussion with the patient in respect of their individual needs. For some patients, that is helpful in reducing the number of journeys they make to appointments—but I am clear, and I know very well, that some appointments should and have to be in person, particularly whenever anybody wants that.

[Jim Shannon]

I tried to illustrate this point earlier, but although I understand that, with the restructuring of hospitals, not every hospital can specifically respond to everything—hence the centralisation of medication and healthcare—when it comes to cystic fibrosis and getting an appointment with a consultant, physio or whoever it might be, one factor is the distance that a great many patients have to travel, especially those in rural areas. The Minister has said that those on benefits can qualify for travel costs, but for some people it is not the cost alone; it is the travel itself. I am sorry for going on a wee bit, Ms Harris, but as I said earlier, for most people with CF that means two to five hours every day of their lives, so the impact on them is greater. The Minister has talked about the physical and mental health aspects, but there are wider aspects, which include the long distances that people have to travel just to get the treatment they are after.

[Helen Whately]

The hon. Gentleman makes an important point about having to travel further for appointments and treatment, which affects people in rural areas generally. Those costs will clearly affect those who have to travel regularly and frequently, such as patients with cystic fibrosis who need many appointments. I am very happy to take away the point he raises and to look at whether we should do something different or specific for those living further away from wherever they need to go for treatment.

I want to pick up on the point about hospital parking, which is clearly another cost that might be affecting people. The Government committed to introducing free hospital car parking for those in great need, including frequent out-patient attenders, as part of our election manifesto. NHS trusts and NHS foundation trusts are required to comply where applicable with NHS car parking guidance, which outlines that disabled patients and visitors should receive free parking for the duration of their attendance at, or visit to, hospital. It also makes it clear that parking will be provided free to all out-patients who attend hospital for an appointment at least three times in a month and for an overall period of at least three months. Importantly for parents of children with cystic fibrosis, parents of children who are admitted as an in-patient overnight should receive free parking between the hours of 7.30 pm and 8 am while visiting their child. I was glad to hear from my hon. Friend the Member for Ashfield that, as I have heard in other places, there is indeed free parking for the patients with cystic fibrosis he mentioned and their families.

I want to mention the innovative work—which also touches on the virtual appointments that I mentioned a moment ago—that Royal Brompton and Harefield NHS Foundation Trust is doing in partnership with NuvoAir, whereby patients use spirometer devices at home to measure lung function and access the results on their phones or tablets via Bluetooth. The results can be shared with a specialist cystic fibrosis clinical team at the Royal Brompton Hospital during virtual consultations, saving the patients time and money while ensuring effective monitoring by the clinical team. There is a balance here, because although the many appointments mean extra journeys, we are doing things to improve the lives of people with cystic fibrosis and to help with the practicalities of the necessary extra treatment and care.

This debate has powerfully brought to life the extra challenges facing people living with cystic fibrosis and their families. It has been helpful to air the issues relating to extra costs and anxiety and the practical difficulties of living with the condition. I pay tribute to all those involved in supporting people with cystic fibrosis and all those living with it. The drive and determination to improve things is inspirational, and I hope that I have reassured everybody about the Government’s commitment to supporting patients with cystic fibrosis and their families.

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 24th January 2023 Commons Chamber

[The Minister of State, Department of Health and Social Care (Helen Whately)]

Right now, we are putting an extra £750 million into our health and social care system to free up beds in hospitals. Looking ahead, we will shift the dial on the decades-old problem of delayed discharge by properly planning for discharge, making more care available at home, and joining up health and social care in a way that has never been done before. That is how we are freeing up beds in hospitals such as the Alexandra in Redditch.

[Rachel Maclean]

I thank the Minister for that answer. In Worcestershire, we warmly welcome the £2.6 million that has been allocated as our share of the discharge fund. Will the Minister set out when my constituents who use the Alexandra will start to see these changes flowing through? What practical changes will they see and what impact will there be on waiting times and waiting lists?

[Helen Whately]

I thank my hon. Friend for her excellent and important question about her local share of the £750 million of extra funding for discharge this winter. I can tell her that, in Worcestershire, money is already going into extra placements in homecare, community care and care homes, and into providing practical support to help people when they get home from hospital, in partnership with the voluntary sector. I assure her that we will publish the spending plans for her area and the rest of the country shortly.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

8. What assessment he has made of the implications for his policies of the number of excess deaths in 2022.

--- Later in debate ---

[David Linden (Glasgow East) (SNP)]

15. What recent assessment he has made of the potential impact of the UK’s departure from the EU on recruitment in the health and social care sector.

[The Minister of State, Department of Health and Social Care (Helen Whately)]

We have record numbers of staff in the NHS in England. We are on track to hit our target of 50,000 more nurses since 2019. Speaking of 50,000, there are more than 50,000 more people working in social care since 2016. We are boosting the home-grown workforce, recruiting from the EU and welcoming health and social care workers from all around the world.

[Alison Thewliss]

It is undeniable that EU-trained medics and social care staff face extra bureaucracy and higher costs as a direct result of Brexit, making working and staying in the UK a much less attractive option. Given the pressures on all four NHSs and the social care sector, we cannot afford to turn anybody away right now, so what discussions has the Minister had with the Scottish Government about removing the barriers that the hostile environment places on people who want to come here, work and contribute to our NHS and social care sector in Scotland?

[Helen Whately]

Of course the hon. Lady would like to make everything about either Brexit or the Union—or, most often, both—but the fact is that a doctor, nurse or care worker from the EU who wants to work here can do so. We are also welcoming people from the rest of the world, and there are 12,000 more staff in the NHS in England from EU and European economic area countries since the referendum.

[David Linden]

In the Baillieston area of my constituency, one of the biggest issues people raise with me is the difficulty in accessing GPs. Part of the problem is that we do not have enough GPs. The Royal College of General Practitioners shows that 49% of EU-trained medics experienced issues with their visas, which led 17% of them to think of leaving the UK altogether. When will the Minister grasp this issue, speak to the Home Office and get rid of the hostile environment that means many of my constituents do not get access to the GPs they need?

[Helen Whately]

If the hon. Gentleman had been listening to earlier questions, he would have heard about the increased number of GPs in England, with more than 2,000 more GPs now working in England. Coming to the question of the NHS in Scotland, which is of course run by the SNP-led Scottish Government, I have heard that NHS Scotland is “haemorrhaging” staff, in the words of the chair of the British Medical Association in Scotland.

[Mr Speaker]

I call the SNP spokesperson.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

With more than 4,000 fewer specialist doctors from the EU or the European Free Trade Association in the UK than in pre-EU referendum trends, there is clear evidence that shutting off free movement is a totally unnecessary barrier to recruitment for our care and health services. Have the Minister and Secretary of State made representations to the Cabinet to discuss the disastrous effects of Brexit on the UK?

[Helen Whately]

Yet again, an hon. Member from the SNP thinks it is all to do with Brexit, when the facts show that that is simply not the case. As I said a moment ago, 12,000 more staff from EU and EEA countries are working in the NHS in England since the referendum. However, I point the hon. Gentleman yet again towards his own party’s record in government in Scotland and the problem of the NHS in Scotland haemorrhaging staff.

[Paul Bristow (Peterborough) (Con)]

10. What recent progress he has made on tackling the covid-19 backlog in elective care.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

T8.   On World Cancer Day 2022, the then Secretary of State for Health and Social Care, the right hon. Member for Bromsgrove (Sajid Javid), announced a 10-year cancer plan to make us a world leader. Today, cancer services are buckling under immense pressure. Can the Minister confirm that the strategy will be fully resourced and will she commit to working with cancer charities to ensure that it is delivered?

[The Minister of State, Department of Health and Social Care (Helen Whately)]

Right now, we are seeing more people come forward for cancer diagnosis or to be given the all-clear. We are supporting services with an extra £8 billion for elective recovery. Cancer is an important part of our major conditions strategy, which the Secretary of State just announced, because we are determined to include patients’ cancer outcomes.

[Lucy Allan (Telford) (Con)]

In today’s Shropshire Star, my local paper, there is an eight-page spread on what is happening to healthcare in Shropshire, which is described as a war zone. Will the Secretary of State meet me and other Shropshire MPs to discuss the challenges we face?

Cancer Outcomes: Tees Valley

Helen Whately Excerpts

Monday 16th January 2023 Commons Chamber

[The Minister of State, Department of Health and Social Care (Helen Whately)]

Let me begin by thanking my right hon. Friend the Member for Middlesbrough South and East Cleveland (Mr Clarke) for securing this debate. He has been working hard to make sure that his constituents get faster diagnosis and better treatment for cancer. He mentioned working together with his constituents on the clinical side, doing tremendous work to lead efforts to diagnose and care for people in his area, as well as fundraising. I heard him mention the Pink Ball, which sounds tremendous. I pass on many congratulations to all those involved and commend them for their work.

As my right hon. Friend said, many people are affected by cancer, whether due to a diagnosis themselves or somebody they are close to. Many people have therefore lived through that difficult experience of waiting to hear whether they will be diagnosed with cancer, or have the all-clear after being referred for testing. For patients with cancer, it is quite simple: faster diagnosis saves lives. That is why this Government are helping the NHS recover and transform health services in the aftermath of the pandemic, with a particular focus on the earlier diagnosis of cancer.

I will talk a little about what we are doing nationally, but I will focus on my right hon. Friend’s constituency. He mentioned the high prevalence of cancer in his constituency and the wider Tees Valley. To give a sense of the scale, in 2020, there were just under 4,000 cancer diagnoses in the Tees Valley, so that gives a sense of the number of people who could benefit from faster diagnosis, which we know can improve outcomes. There is more that we can and should do to prevent people, both nationally and in the Tees Valley, from developing cancer in the first place, such as policies that help people maintain a healthy weight and lifestyle and stop smoking, and promoting the uptake of the HPV vaccine, particularly in groups where coverage is lower.

[Alex Cunningham]

The Minister mentioned my magic word—smoking. Could she give us some indication of when the Government will bring forward the tobacco control plan? She recognises, as I do, that in the most deprived inner-city communities the incidence of smoking is higher and lung cancer is higher as a result. I would be interested to know what plans she has to bring that forward.

[Helen Whately]

The hon. Gentleman is absolutely right to pick up on what I said about the importance of supporting people to stop smoking, but for the sake of this Adjournment debate I will focus on responding to my right hon. Friend’s speech, particularly looking at cancer diagnostic services.

We want to level up diagnostic services for cancer around the country so that people with symptoms of potential cancer can receive an accurate diagnosis and begin treatment as quickly as possible. That is part of our ambition to reduce health disparities in more deprived areas, such as some areas in my right hon. Friend’s constituency, and to improve early-stage cancer diagnosis rates for all. A key part of improving early diagnoses is ensuring that people come forward when they suspect that they have cancer.

Sadly but understandably, during the pandemic we saw the number of urgent referrals for cancer fall, but it is positive that in the North East and North Cumbria integrated care board over 13,000 patients had their first consultation appointment following an urgent GP referral in November last year. That is an 18% increase from November 2020 during the pandemic, and nearly a 20% increase on the figures for November 2019 prior to the pandemic. That indicates that in the Tees Valley, as we are seeing across the country, people are coming forward to be diagnosed or discover that they have the all-clear from cancer, which is the case for most people.

In a moment I will talk about our innovative new community diagnostic centre programme, but first I want to highlight some of the other things we are doing to improve the early diagnosis of cancer. One important innovation is introducing the serious non-specific cancer pathway, which Tees Valley has successfully implemented. This means that GPs can refer patients into the service when there are possible symptoms of potential cancer, or someone has a gut feeling that something is not right. That is especially important for patients who do not fit specific pathway referral criteria but whose symptoms are more generic.

In addition, Tees Valley has initiated a programme of targeted lung health checks aimed at people aged between 55 and 74. My right hon. Friend referred to that and the impact that it is having. It is anticipated that the programme will result in around 530 diagnoses of lung cancer over the next four years. In deprived areas of Middlesbrough, Hartlepool and Darlington, clinicians are taking part in a trial to assess the benefit of the new GRAIL test that looks for signs of cancer in a sample of blood. This is hugely exciting as it can identify cancer where no symptoms are even present, allowing for earlier diagnosis.

However, the waiting list for diagnostic tests in England currently stands at over 1.59 million patients, with around 26% of those patients waiting more than six weeks. In the North East and Yorkshire region, the waiting list for diagnostic tests has over 200,000 patients, with just over 20% of those waiting more than six weeks. These are figures that we very much want to improve because, as I have said, earlier diagnosis can mean better outcomes. We want to get to the point where 95% of patients needing a diagnostic test receive it within six weeks by March 2025. Equally, early-stage cancer diagnosis is a key ambition of the NHS long-term plan, which aims to ensure that 75% of cancers are identified at stage 1 or stage 2.

[Tim Farron]

What the Minister says about the waiting time for diagnostics is very troubling. What is even more troubling is that in my part of Cumbria 43% of people who have had a diagnosis of cancer are now waiting more than two months for their first treatment. In North Cumbria and Northumberland, the figure is 62%. Can she say what she is going to do to speed up treatment for those people who have had a diagnosis of cancer?

[Helen Whately]

Yes of course. More people coming through for referral for cancer diagnosis and increased early rates of diagnosis feed through into us needing to increase the rates of treatment. The NHS is treating more people for cancer, but of course this is taking time because of the increased levels of referrals. We are working very hard to do this.

I want to return to talking particularly about cancer diagnosis and what we are doing to do that earlier, and specifically about the community diagnostic centres that are being rolled out across the country supported by £2.3 billion of capital investment. Local health systems can bid for a share of that funding when they make the case for community need and clinical value, and I am delighted to say that 89 community diagnostic centres are currently operational across the country. Hard-working NHS staff have so far delivered more than 2.7 million additional checks at these centres. Specifically in the Tees Valley, I know that my right hon. Friend has been working with his local NHS to support its proposal for a new diagnostic centre in Stockton-on-Tees, and I can update him with the good news that this new site has been approved, with a planned opening date of December 2023.

[Matt Vickers (Stockton South) (Con)]

Can I thank the Government for this fantastic investment in my part of the town? It will save lives. Also, importantly, can I thank the Government for challenging us locally to deliver it more quickly so that we can save more lives more quickly and make a bigger difference to the community? Thank you very much. We are going to do our best.

[Helen Whately]

It is good to be able to talk about good news. As my hon. Friend says, his area is not only getting a community diagnostic centre but getting it quicker because the timeframe for doing it has been brought forward. That is tremendous, and I look forward to his area achieving that later this year. It is great that we have been able to announce the date when it will open.

The new Castlegate site for the Tees Valley community diagnostic centre is planned for construction on the Castlegate shopping centre site as part of the local regeneration project. There are excellent transport links, which means that it will be accessible to the whole community. It is important to make these places accessible in order to get people to come forward for testing and screening. This will be the latest addition to the 14 existing community diagnostic centres in the North East and Yorkshire region and the four hub-and-spoke sites in the Tees Valley area, which have so far delivered over 250,000 tests.

[Alex Cunningham]

Will the Minister give way?

[Helen Whately]

I want to respond to the other comments from my right hon. Friend the Member for Middlesbrough South and East Cleveland, who also raised the important role that the independent sector has to play in meeting the needs of patients. Last month, my right hon. Friends the Prime Minister and the Secretary of State for Health and Social Care launched the elective recovery taskforce, bringing together academics and healthcare experts to advise the Government on how best to unlock capacity in the independent sector to reduce waiting times. The independent sector is also helping us directly to tackle the diagnostic backlog, providing additional capacity in underserved communities and forming productive partnerships with the NHS to run community diagnostic centres.

The hon. Member for Westmorland and Lonsdale (Tim Farron) asked about effective treatment, and I am pleased to say that the NHS has treated a record number of people for cancer in the last year, with more than 321,000 people receiving their first cancer treatment between December 2021 and November 2022, which is up by more than 10,000, or 3%, on the same period pre-pandemic. Within the North East and North Cumbria ICB, 1,690 patients started their first treatment for cancer in November 2022. The number has recovered following the pandemic—the equivalent figure for November 2019 is 1,652.

The NHS continues to offer cutting-edge treatments, including newly developed drugs and radiotherapy. Just a week or so ago, my right hon. Friend the Secretary of State signed a memorandum of understanding with BioNTech to bring innovative vaccine research to England, with the potential to transform outcomes for early-stage and late-stage cancer patients.

I thank my right hon. Friend the Member for Middlesbrough South and East Cleveland for raising this important issue and for his continued commitment to improving cancer care in the north-east and Tees valley region. I encourage him to continue his excellent work with his local NHS system, and I look forward to continuing to work with him and the NHS as we meet the challenge of reducing diagnostic waiting times and improving cancer outcomes.

Question put and agreed to.

NHS: Long-term Strategy

Helen Whately Excerpts

Wednesday 11th January 2023 Commons Chamber

[The Minister of State, Department of Health and Social Care (Helen Whately)]

I welcome this chance to come to the House and speak about everything that we are doing right now, in the months ahead and for the longer term, so that people can get the healthcare they need from our health and social care system at a time when it is under huge pressure—when we face the worst year for flu for a decade, with 100 times as many patients in hospital with flu as there were a year ago; when the NHS is working through the backlogs caused by our fight with covid; and when we know that the NHS is struggling with the high number of people coming to emergency departments and the difficulty of discharging people to be cared for at home.

These issues are mirrored in health systems across Europe, and indeed across the rest of the United Kingdom. Despite what Opposition Members are saying, the honest truth is that there are no silver bullets. I know that NHS and social care staff are working incredibly hard in the face of these challenges; I want to assure them, and everyone, that the Government are working flat out on short and long-term solutions to these great challenges. That work is supported with record NHS funding, rising further to £165 billion by 2025, and with more funding for social care, with the record increase of up to £7.5 billion over the next two years that we announced at the autumn statement. We have committed to getting waiting lists down and getting people the care they need more quickly, and we will do so.

I thank hon. Members for their contributions to the debate. I particularly thank those who have been constructive and thoughtful this afternoon. The Chair of the Health and Social Care Committee, my hon. Friend the Member for Winchester (Steve Brine), spoke about increased demand for care and the importance of prevention. My hon. Friend the Member for Erewash (Maggie Throup) brought in her expertise as a biomedical scientist when she talked about the potential for innovative diagnostic tests to improve care and productivity. My hon. Friend the Member for Peterborough (Paul Bristow) shared the story of how the life of a constituent was saved through first aid and brilliant NHS care.

We heard from my hon. Friend the Member for Southend West (Anna Firth), who works incredibly hard to support her hospital and who often comes to me with suggestions. My hon. Friend the Member for Bosworth (Dr Evans), who brings expertise as a doctor, spoke about the 50% increase in the number of people over 100 in the last decades. He talked about the increased demand for healthcare and brought in many ideas for what more we can do to increase healthcare supply. My hon. Friend the Member for Don Valley (Nick Fletcher) reminded us of some of the excellent care that the NHS is providing in his area. He also asked for a new hospital.

My right hon. Friend the Member for Wokingham (John Redwood) spoke about workforce and bed capacity. My hon. Friend the Member for Newcastle-under-Lyme (Aaron Bell) spoke about the context of what we face, the extra flu admissions at Royal Stoke University Hospital and covid. My hon. Friend the Member for Devizes (Danny Kruger) spoke about the importance of integration in health and social care.

There are three more hon. Members I want to mention—I am sure they know who they are—because they represent constituents in Wales. They are all Conservatives; nobody is on the Opposition Benches representing Welsh constituencies today. Nobody here is standing up for Labour’s record in Wales. My right hon. Friend the Member for Vale of Glamorgan (Alun Cairns), my hon. Friend the Member for Clwyd South (Simon Baynes) and my hon. Friend the Member for Aberconwy (Robin Millar) all reminded us of Labour’s shocking record of running the NHS in Wales. They spoke about more patients waiting over two years for treatment in Wales than in England, about a higher treatable mortality rate, and about the fact that it was not the Conservatives but a Labour Government in Wales who cut health spending. That is a record that no Labour Member has proved willing to defend.

Let me now respond to some of the criticisms from Opposition Members, starting with the way in which the NHS prepared for this winter. Back in August the NHS published its winter plan, which included proposals to increase capacity by 7,000 beds and increase the use of virtual wards, to ramp the number of staff to handle calls, and to establish system control centres in each of the 42 integrated care systems: that was delivered in December. We gave more than 17 million people a covid booster vaccine, and gave more than 19 million their flu jabs. The shadow Secretary of State is talking over me, but I recommend that he listen to what we have been doing.

We set up a national discharge taskforce to work with hospitals and the wider health and care system to improve flow in the system. We published “Our plan for patients”, which included a £500 million adult social care discharge fund that is being spent on more home and residential care packages and boosting the social care workforce to help get patients out of hospital—that is happening right now.

However, as we feared, the combined pressures of flu and covid, alongside unprecedented demand, have indeed left our health system facing enormous challenges this winter. That is precisely why, as my right hon. Friend the Secretary of State said in his statement on Monday, we are taking immediate further action to support the NHS and local authorities. We are providing £200 million of additional funding for short-term care placements to help patients to be discharged more quickly and safely from hospitals, and an extra £50 million in capital funding to expand hospital discharge lounges and ambulance hubs as a matter of urgency.

As we come out of this winter, we know that these problems will not suddenly disappear, and that is why we are already making plans for the future. For instance, we have six national “discharge frontrunners” leading the way in exploring new long-term initiatives to free up hospital beds. As was announced in the autumn statement, we will marry those new ideas with a further £600 million next year and £1 billion the year after in order to transform the way in which we handle discharges.

At the same time as putting in money here and now, we have plans in place which will transform our health and social care system over the next decade. Our integrated care systems are bringing together health and social care in a way that has never been seen before. Our NHS workforce plan will provide a long-term staffing plan for the next 15 years. We are bringing forward ambitious social care reforms, including workforce reforms to develop social care as a career. Our reforms are timely, ambitious and deliverable, developed in partnership with health and social care organisations, unlike Labour’s new plan for primary care, an expensive top-down reorganisation, uncosted and unfunded, and described by the chief executive of the Nuffield Trust as costing “a fortune” and “out of date”—like the Labour party.

Our health system, like others across Europe, is facing a multitude of pressures. We are taking action, in the short, medium and long term, to tackle each and every one of those pressures, and I am determined to ensure that the work we are doing will make things better not only in the here and now, but next winter, next year, and every year thereafter.

Question put (Standing Order No. 31(2)), That the original words stand part of the Question.

Aortic Dissection: Patient Pathways and Research Funding

Helen Whately Excerpts

Tuesday 13th December 2022 Westminster Hall

[The Minister of State, Department of Health and Social Care (Helen Whately)]

What we heard from the hon. Member for Enfield North (Feryal Clark) was a shame, but I will focus on what we heard from my hon. Friend the Member for Mid Derbyshire (Mrs Latham), which was one of the most powerful speeches I have ever heard in Parliament. It was also one of the most painful to hear, but I know that is not a patch on what she will have experienced in losing her son, Ben, so tragically, aged just 44. As she told us, he went to A&E to get help and was sent home, and then he died. How awful that was for her as his mother and for his whole family, including the loving wife he leaves behind and his two children. I am so sorry that she and all his family have had to go through that.

I cannot commend my hon. Friend enough on coming to the House and talking about her experience; on doing so in the Chamber, as she has done; on coming to meet me and other Health Ministers; and on drawing on her experience, her son’s experience and her whole family’s experience to try to make things better for other people who are at risk of aortic dissection—to prevent others from going through what she has gone through, and to try to save the lives of others so that some good can come out of what she has been through. I have a huge amount of respect for my hon. Friend for doing that, and I know that many people across the country, including those who will not necessarily even know what she has done, will be grateful to her for it. I thank her myself for that.

My hon. Friend helped to set up the Aortic Dissection Charitable Trust. She has been working with that trust very effectively to raise awareness of aortic dissection, improve diagnosis, and prevent aortic dissection in the first place, saving lives in doing so. She made several specific requests and asked several questions during her speech, which I will come to in a moment. We also heard from the hon. Member for Strangford (Jim Shannon), who is always so thoughtful in what he says and how he says it. He makes such valuable contributions to debates in this place, and it is so good to see him again—I think it is the third time in less than 24 hours that we have talked about healthcare.

[Jim Shannon]

I see more of the Minister than my wife.

[Helen Whately]

The third welcome I want to give is to Bob Harris, who is here today. He himself has suffered aortic dissection, and is working as an ambassador on this issue. It is very good to have him here with us.

We have heard during this debate about the sudden and heartbreaking impact that aortic dissection can have on families. That is why it is absolutely right that we should be talking about this issue today: we should be talking about how to raise awareness of the condition among medical professionals, about how to improve diagnosis so that aortic dissection is detected as quickly as possible, and about the research we need to make sure that more people survive. Sadly, around 4,000 people suffer from an aortic dissection in the UK each year, yet still many people have never heard of the condition. It is crucial that it is diagnosed and treated urgently, otherwise very sadly, it can be fatal. It need not be.

As we have heard today, diagnosing aortic dissection promptly is, unfortunately, not straightforward. The condition is relatively rare, which means medical professionals may be less familiar with its presentation. The symptoms of aortic dissection, such as chest pain, can be similar to other more common conditions, making it harder to accurately diagnose. Care pathways for aortic dissection vary across the country, meaning different patients often get different treatments.

I can reassure my hon. Friend the Member for Mid Derbyshire and other hon. Members here today that I am determined to improve the way the condition is diagnosed and treated. Earlier this year, NHS England launched its aortic dissection toolkit, which sets out the steps that commissioners, providers and clinicians should take to improve the care of patients with acute aortic dissection. The toolkit covers the pathway for aortic dissection, from recognition and diagnosis to treatment.

NHS England’s regional teams are currently implementing the toolkit within their local services, and we expect those improvements to significantly reduce delays to diagnosis and improve patient outcomes following treatment. NHS Digital has also made changes to NHS Pathways, which is a triage system used by NHS 111 and 999, to improve the recognition of chest pain likely to be associated with aortic dissection. However, I heard my hon. Friend say that the toolkit does not cover all the challenges that she is aware of in the pathway, so I will take that away and see how we can go further to make sure the toolkit is comprehensive or supplement it as necessary.

We have also heard today about the importance of raising awareness of aortic dissection among medical professionals. The Royal Colleges of Radiologists and Emergency Medicine published a best-practice guideline last year on the diagnosis of aortic dissection in the emergency department, in response to a report published by the Healthcare Safety Investigation Branch in 2021. I expect that to have a major impact on the prompt diagnosis of aortic dissection. The Royal College of Emergency Medicine, which sets standards of care in all emergency departments in the UK, has also developed guidance to support the timely diagnosis of aortic dissection. However, my hon. Friend told us that a freedom of information request showed that only some EDs are using the guidelines. Again, I will look into that, as guidance should be followed consistently across emergency departments.

Research is the piece of the puzzle that will drive forward progress and find the treatments of tomorrow. We need to understand better who is at risk of aortic dissection and how we should monitor them, we need to know how to most effectively detect and diagnose aortic dissection in emergency settings and how to improve treatment to make sure patients recover successfully. That is why the Department of Health and Social Care brought together a multidisciplinary group of experts and patient representatives in 2020 to consider research priorities for aortic dissection. That significant event identified research questions in diagnosis, treatment, care, awareness and education and, crucially, what matters most to people with aortic dissection and their families. In response to that event, the Department of Health and Social Care-funded National Institute for Health and Care Research launched a call for research on surgical treatment for aortic dissection. We await the outcome of the commissioning pool early in the new year.

The NIHR invests around £50 million a year on research into cardiovascular disease, including aortic dissection and other heart conditions. For example, the NIHR funded a major programme of work at Barts Health NHS Trust to develop and test a novel surgical treatment for aortic dissection, which is less invasive than routine care, allowing quicker procedure times and shorter hospital stays. It is also vital that we harness our understanding of risk to help prevent aortic dissection. UK Research and Innovation, which is funded by the Department for Business, Energy and Industrial Strategy, is supporting a study on how we can use genetic and other factors to predict aortic dissection and identify people at greater risk. That will pave the way for more preventive measures, such as blood pressure control, to be prescribed.

We know that there is interest in the academic community for a pipeline of research to improve outcomes for people at risk of and who have survived aortic dissection. I encourage researchers working in the field to harness the momentum building around aortic dissection research and to please come forward and make applications for funding.

My hon. Friend the Member for Mid Derbyshire also asked about data and called for more data on aortic dissection to be collected and made public. I will take that request away and raise it with NHS England, because she makes a really important point: the more data we collect, the more we know. Again, making it available more widely is one of the best things that we can do to improve understanding and support research into prevention, diagnosis and treatment. My hon. Friend also requested that we meet to discuss guidelines for genetic screening, which is another thing that I will take away and look into. I will get back to her on that.

This debate has made us all stop and reflect, and I will pause for a moment as well, because I think the hon. Member for Strangford is waiting to intervene on me.

[Jim Shannon]

I thank the Minister for her very helpful response. I always ask these questions, because it is important that we share the issues. In my contribution, I asked whether we could share information with Northern Ireland, Scotland and Wales, because we can all learn from it. We need to collaborate on research, because we can all benefit from it, wherever it may be—in Northern Ireland in my case, and in Scotland in the case of the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar). That might be helpful for us all.

[Helen Whately]

I completely agree with the hon. Member, and we can only do better if we share information across the whole United Kingdom and internationally, as work on this condition will be going on across the world.

This has been a really powerful debate, but it is not a patch on the pain that my hon. Friend the Member for Mid Derbyshire has been through. As she said so powerfully, each life lost to aortic dissection is not just one life affected. The condition affects the lives of all those around the person who is lost, be they mothers like her, fathers, husbands, wives, sons, daughters, grandchildren or friends—everyone who is affected when somebody is sadly lost too soon. I thank her again for her tireless work in raising awareness and campaigning, and I assure her that I will, in turn, do what I can in Government to support her efforts and to improve outcomes for all those affected by aortic dissection across the country.

Motor Neurone Disease Research: Government Funding

Helen Whately Excerpts

Tuesday 13th December 2022 Westminster Hall

[The Minister of State, Department of Health and Social Care (Helen Whately)]

It is a pleasure to serve under your chairmanship, Mr Mundell. I begin by thanking the hon. Member for Kingston upon Hull East (Karl Turner) for securing this debate. I too pay tribute to Doddie Weir, an incredible man who sadly passed away at the end of November. My thoughts are with his wife Kathy, and their sons, Hamish, Angus and Ben.

I had the good fortune to meet Doddie during an online roundtable—online because it was during the pandemic—and I was inspired by his campaign for a brighter future for people living with MND. His charity, the My Name’5 Doddie Foundation, works tirelessly to raise funds for research and provide grants to people living with this cruel condition.

During the pandemic, and again since, I also met with my Mid-Kent MNDA branch as a constituency MP. Those meetings are vivid in my mind. The first call I had with them had literally everybody on the call in tears, as we talked about the experiences of those suffering with MND and their carers—usually family members—and how they were seeing their loved ones losing a bit of themselves day by day to MND. It is such a cruel disease, as the hon. Gentleman said. I am thankful to him and to several other Members of Parliament who have campaigned for research funding and actively lobbied me and other Ministers on that point.

[Chris Evans (Islwyn) (Lab/Co-op)]

I refer Members to my entry in the Register of Members’ Financial Interests, and I am a biographer of Don Revie. This is an important debate, because Don, who played for Hull City during his playing career, passed away from motor neurone disease in 1989. Like Doddie Weir and Rob Burrow, he played sport at a high level. If the Government are going to invest in research, will they look at the fact that sportsmen seem to be more likely than the rest of the population to develop motor neurone disease?

Secondly, I urge the Minister to tell GPs to ensure that people are tested for motor neurone disease early in their journey, because the problem is that it is one of the last things people test for. In the case of Don, he believed that the pain in his back was caused by slipped discs—tragically, it was motor neurone disease. I ask the Minister to look into those two asks.

[Helen Whately]

The hon. Member makes two really important points. As he says, several prominent sportsmen who have been effective campaigners have sadly been affected by the disease, and there is a potential relationship with head injuries. He also made a point about the challenge of diagnosis, which I will take away.

The hon. Member for Kingston upon Hull East rightly talked about the tenacity of campaigners such as Rob Burrow and how effective their visible campaigning has been at raising awareness of MND. The disease affects a significant number of people, with around 5,000 suffering from it right now. Sadly, we know that people do not live very long with MND, so a really significant number of people across the country are being affected over time. It is incredibly cruel for the individuals who suffer.

I heard the request of the hon. Member for Kingston upon Hull East for a meeting, and I will come to some of the plans to address his calls in a moment. As I said, MND has a huge impact on those who have been diagnosed, and it is devastating for them and their families. We have made real progress in research, but we are yet to learn why motor neurones die off. There is still no cure for the disease and only one drug is licensed in the UK to treat MND, which is why the Government committed back in November 2021 to make at least £50 million available for MND research over the next five years.

Before I go into more about research, I want to say something about how we are supporting people living with MND, which is a degenerative condition—often rapidly so—that requires complex and anticipatory care. For that reason, the majority of services for people with MND are specialised and commissioned nationally in the 25 neurological treatment centres across England. In the absence of a cure, we want to make sure that people with MND have access to the best health and care support available to meet their complex needs. It is really important for people suffering from MND and their carers to have specialised and targeted support, including devices to help people with MND to be able to continue to communicate effectively for as long as possible, as well as other types of care.

Since November 2021, we have invested £790 million in the National Institute for Health and Care Research biomedical research centres, which bring together experts to translate scientific breakthroughs into treatments for patients. At the Sheffield centre, researchers have already pioneered evidence-based interventions to manage the symptoms of MND. In September, the Sheffield researchers published promising clinical trial results for the drug tofersen. Professor Dame Pamela Shaw, the director of the NIHR Sheffield BRC, said:

“I have conducted more than 25 MND clinical trials and the tofersen trial is the first trial in which patients have reported an improvement in their motor function.”

I want to emphasise that because, until now, it has been very hard to be optimistic about developing a cure for MND or even effective treatment. The trial is, in fact, grounds for optimism against this cruel disease.

In June, the Government and charity partners invested in a £4.25 million collaborative partnership on MND, which includes LifeArc, the MND Association, the My Name’5 Doddie Foundation and MND Scotland. The Government are supporting groundbreaking research undertaken by the UK Dementia Research Institute. Seven of its 50 research programmes are dedicated specifically to MND, with world experts undertaking discovery science, translational and clinical research to drive medical progress.

There has already been work going on to invest in MND research, but I heard the impatience of the hon. Member for Kingston upon Hull East and have heard from other hon. Members. Indeed, my hon. Friend the Member for Northampton South (Andrew Lewer), who is here today, has also lobbied me and other Ministers on the desire for greater pace and so that money goes towards research quicker and then translates more quickly into treatments.

To that point, yesterday, we announced at the Department of Health and Social Care, together with the Secretary of State for BEIS, how we will deliver the full £50 million research commitment, which will build on our existing investments and successes to more rapidly fund MND research. In that regard, £30 million of Government funding will be invested immediately through specialist research centres and partnerships with leading researchers. That will include £12.5 million to the UK Dementia Research Institute to support groundbreaking research specifically into MND, a further £8 million investment into early-phase clinical research for MND via the NIHR biomedical research centres and £6 million for a translational accelerator that connects the DRI capabilities with those of the Francis Crick Institute, the Laboratory of Molecular Biology and the new MND collaborative partnership. We are investing a further £2 million in the MND collaborative partnership, which will specifically focus on data for MND research.

[Andrew Lewer (Northampton South) (Con)]

I am triggered by the reference to Francis Crick, who was also from Northampton, so there is quite a connection here, also given my great privilege to be the chairman of the all-party parliamentary group on motor neurone disease. I am grateful to the hon. Member for Kingston upon Hull East (Karl Turner) for having this debate, but particularly grateful to the Government for listening, making some really important announcements and pushing this forward. It has been received with great pleasure by the research community and MND sufferers. I hope the Minister will accept my thanks for that. I look forward to working further with her in taking this forward, now that we have the new announcements.

[Helen Whately]

It is good to hear from my hon. Friend. Credit goes to him for his campaigning, both personally and as chair of the APPG on motor neurone disease, together with that of other Members of Parliament, to push for investment to get out to the frontline on research. I look forward to working with him further so we can ensure this investment in research makes a difference for people suffering from MND and their carers, and for those in the future.

I have just mentioned the MND collaborative partnership, which is a mechanism by which the many initiatives that I just described will come together. The first meeting of this virtual institute took place at the end of November, and I am looking forward to hearing about further progress now that the funding is in place. The remainder of the committed £50 million of MND funding is available for researchers to access via the NIHR and the Medical Research Council. Government will support researchers in coming forward with ideas for new research via a joint highlight notice between NIHR and the Medical Research Council on MND. That will allow our funding to be responsive to progress in science and ensure breakthroughs reach patients in the quickest possible time. Further to that, the Secretary of State will shortly host leading researchers and patient groups at a roundtable to discuss MND research and help researchers make the best bids as quickly as possible. That addresses the call for a meeting from the hon. Member for Kingston upon Hull East.

[Karl Turner]

I am grateful to the Minister and I welcome everything that she has helpfully just announced. However, my researcher spoke yesterday to the association and it still requests that meeting. It is the only ask. I accept what she says about roundtables and all sorts of other things going on behind the scenes, but the association wants a meeting with the Secretary of State for Health and Social Care and the Secretary of State for Business, Energy and Industrial Strategy. Perhaps it is difficult to get them together, so there could be separate meetings. That is the only thing the association has asked me to ask for today, so it would be remiss of me if I did not push her to request that meeting after she leaves here.

[Helen Whately]

The hon. Member’s request is very clear. As I said to him a moment ago, the Secretary of State for Health and Social Care will meet researchers and patient groups at a roundtable about this issue. If that is not the same meeting as the one he wants, I am very happy to take that point away and find out exactly what meeting he wants and how we can make sure that it takes place as well as the planned meeting.

I have heard from my hon. Friend the Member for Northampton South over the past few weeks about red tape getting in the way of research, which we clearly do not want to be the case. To help cut red tape, research funders from NIHR and the Medical Research Council are working together so that MND proposals will go to the right scheme at the early idea stage and so that applications can be considered before they even have full sign-off from their universities and institutions.

We are also building on our recent announcement of £790 million for the NIHR biomedical research centres by putting in MND funding, so that it gets quickly to the most promising researchers already working on MND.

To sum up and return to where we started, there is no doubt that MND is a cruel disease that takes people before their time and, as it does so, takes them bit by bit from their loved ones. As yet, there is no cure. However, I say “as yet” because I have hope, and we have real grounds for optimism with the clinical trials. We also have £50 million going into MND research. I have outlined today how we are accelerating that funding to go to the frontline of research and to develop the treatments that will make a difference to MND sufferers, whether here and now or in the future.

In no small part, that is thanks to the late Doddie Weir and his family, Rob Burrows, Ed Slater, Kevin Sinfield, and all the other MND campaigners and carers who have worked so hard to raise awareness of MND and push for more action on MND research. I can assure them that their efforts are not in vain. I personally take inspiration from all their tireless work, which reinforces the Government’s commitment to fund and support research into MND. We owe it to people with MND, future sufferers, and all the campaigners and researchers to push ahead with the groundbreaking research that will help to develop effective treatments and, indeed, cures for this cruel disease.

Question put and agreed to.