East Kent Maternity Services: Independent Investigation

Helen Whately Excerpts

Thursday 20th October 2022 Commons Chamber

[Dr Johnson]

NHS England has announced that it is investing an additional £127 million into the maternity system in the next year. That money will go towards the maternity workforce and improving neonatal care. In addition, £95 million was invested last year to support the establishment of more than 1,200 more midwifery posts and 100 more consultant obstetric posts. Work is already under way as part of the biggest nursing, midwifery and allied health care professional recruitment drive in decades. That will help us to increase the number of midwives in East Kent but also elsewhere.

[Helen Whately (Faversham and Mid Kent) (Con)]

I thank my hon. Friend for her statement, and particularly for the tone in which she made it. Dr Kirkup’s report is harrowing reading, but nothing compared with the harrowing experiences of the parents whose babies were severely injured at birth, stillborn, or lost in the days after they were born, particularly when so many of those incidents were avoidable. It is a shocking litany of clinical and management mistakes, missed opportunities, failures to take responsibility and an incomprehensible normalisation of baby death, despite all the efforts to improve safety since the Mid Staffs scandal. I ask my hon. Friend to put herself in the shoes of an expectant mum—I know that as a mum she will be able to do that, as well as from her experience as a clinician—and categorically assure me and all the parents to be who are soon to have babies in the East Kent trust, that the maternity units in those hospitals are safe for them to give birth?

While there are worthwhile sections on actions in the report—I commend Dr Kirkup for his report—it does not get to the bottom of the problem, which is truly one of accountability. Can my hon. Friend assure me that never again will a trust find reasons to excuse catastrophic outcomes, that never again can critical reports be dismissed as a “load of rubbish”, and that never again can staff blame patients for a hospital’s failings? How will she assure herself as a Minister—I know this is a difficult role—that every maternity unit in every hospital across the country is safe for mothers to give birth?

[Dr Johnson]

I know my hon. Friend has campaigned hard as both a Minister and a Back-Bench MP for safety in the national health service. On safety at the East Kent trust, we have already talked about the regional team there. There is also a maternity safety support team in the trust working actively on the ground to ensure that lessons are learned and services improved. I have been given some figures that demonstrate that the outcomes are improving. As I said earlier, steps are in place to ensure the quality of service and to feed back the quality of service to ensure that no woman is spoken to in the way described in the report.

From a wider perspective, we are looking at both the workforce as described but also at how we ensure that problems are not just picked up, but developed and followed through. We are also looking at the Kark report that looked at how managers are held responsible. We will talk more about that in due course.

Statutory Storage Limits for Gametes and Embryos

Helen Whately Excerpts

Monday 6th September 2021 Written Statements

[The Minister for Care (Helen Whately)]

My noble Friend the Parliamentary Under-Secretary of State and Minister for Innovation (Lord Bethell of Romford) has today made the following written statement:

Family units and family formation in the UK are vastly different today than they were when the Human Fertilisation and Embryology Act (the HFE Act) was introduced and last reviewed. In a modern society, some individuals are choosing to start their families later in life and are increasingly choosing to use new and effective techniques to freeze their eggs, sperm, or embryos to preserve fertility. The reasons for this are diverse but can include not being ready or able to start a family, medical conditions that might lead to premature infertility, or undergoing gender reassignment.

The HFE Act currently sets the statutory storage limits for eggs, sperm, and embryos at 10 years, with the possibility of extension up to 55 years for those who can demonstrate a clinical need. The Government recognise that these current arrangements are increasingly disadvantageous towards women and unnecessarily restrictive of individual freedom of choice about when to start a family.

In view of the significant scientific innovation and societal changes, the Government launched a public consultation on 11 February 2020, to seek views about changing the statutory storage limits. The consultation ran for 12 weeks and closed on 5 May 2020.

The Government are today announcing the publication of the Government response to the consultation.

We received 1,222 responses to the consultation, including 17 from key sector organisations. The responses were analysed and carefully considered by the Department of Health and Social Care giving due regard to the importance of equality, facilitating reproductive choice, administrative burden, and public acceptability.

In the light of these factors and the public response, the Government are announcing a change to this policy; to increase the statutory storage limits for eggs, sperm, and embryos for everyone, regardless of medical need, to 10-year renewable storage periods, with a maximum limit of 55 years. The legislation will be introduced when parliamentary time allows.

The regulator, the Human Fertilisation and Embryology Authority (HFEA), will provide oversight during the introduction of these changes to ensure they are rolled out effectively and safely.

The proposed policy change is intended to facilitate greater reproductive choice and will allow for less stressful decision-making in family formation. Importantly, it will provide equity for all, regardless of medical need, and will help reduce administrative burden for clinics and the regulator.

A copy of the Government’s response to the consultation will be deposited in the Libraries of both Houses.

A regulatory triage assessment has also been published alongside the consultation. It can be accessed on gov.uk and will also be deposited in the Libraries of both Houses.

Attachments can be viewed online at: http://www.parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2021-09-06/HCWS256/.

[HCWS256]

Support for Carers

Helen Whately Excerpts

Thursday 22nd July 2021 Westminster Hall

[The Minister for Care (Helen Whately)]

It is a pleasure to serve under your chairmanship, Mr Hollobone.

I start by thanking the right hon. Member for Kingston and Surbiton (Ed Davey) and the hon. Member for Bath (Wera Hobhouse) for securing this debate on such an important topic. The right hon. Member spoke powerfully of his own first-hand experience of care, first as a child and now as an adult caring for his disabled child. As others have said, sharing such personal experiences adds so much to the conversations we have in this House. I am also truly grateful for all the work he does to champion the voice of carers.

Other Members have also spoken powerfully. For instance, the hon. Member for Sheffield Central (Paul Blomfield) talked about Holly, and what he said really brought to life the experiences of a young carer. The hon. Member for Caithness, Sutherland and Easter Ross (Jamie Stone) described some things a Member of Parliament can do for their constituents. Sometimes, they seem to be small things, but they make such a big difference to an individual’s life. The things we can do as constituency MPs to unlock something that has been locked away because of a decision made somewhere up there makes all the difference. The hon. Gentleman really brought that issue to life.

I pay tribute to all the carers and young carers across the country. Caring for a relative, a friend or a neighbour is something that many people do. In fact, around one adult in 10 provides care, and about 23% of carers have high-intensity caring responsibilities, providing more than 50 hours of care a week. Carers do an amazing thing. The compassion and fortitude they demonstrate, often in difficult circumstances, are truly inspiring to all of us, but their task is hard. It can leave people with so little time and energy for themselves.

I come back to the numbers. There are at least 6.5 million unpaid carers in the UK, and about 5.4 million in England. That is based on the 2011 census, which is now around 10 years out of date, so we know that the figure is now significantly higher, and may have increased due to the pandemic.

The last sixteen months have clearly been incredibly challenging—especially in the early weeks and months of the outbreak, when we all found ourselves facing the steepest of learning curves. For carers, as for frontline health and care workers, the complex and demanding routines that they follow became even more complex and intense due to the restrictions. Many carers were also looking after somebody who was likely to be vulnerable to covid, so had the added worry of what would happen if that person was to catch the virus. However, just like our dedicated NHS and social care colleagues, carers of all ages kept going throughout the pandemic: they kept caring and doing what was needed for the person close to them.

I want to briefly mention the support the Government have provided to carers during the pandemic. We have focused on supporting them—a focus that continues to this day, even as the remaining restrictions lift and we try to move towards a new kind of normality. That is why we included exemptions from some regulations and added flexibility to help carers, including allowing emotional support to count towards the 35 hours of care provided by carers, and relaxing the rules for breaks in care. We listened to carers’ concerns about access to testing, and made them a priority group alongside other essential workers.

There is one vital achievement that I want to mention: the fact that hundreds of thousands of unpaid carers have now received their vaccine—an important step in protecting them and the people they care for from coronavirus. I would beg to differ from the portrayal presented by the right hon. Member for Kingston and Surbiton. Ministers have worked hard—and I can say this for myself, personally—to ensure that carers were prioritised to receive the vaccination after recognising their concerns, often, for the individuals who they cared for.

A huge collective effort went into identifying carers during the vaccination programme—identifying those already known to GPs, the DWP and local authorities, and working with local carers’ organisations to identify carers eligible to be prioritised for the vaccine. That work has also brought other benefits; it has fostered new local connections and dialogues, and has helped to raise awareness across primary care services about the critical role that carers play and the significant contribution that they make.

I will pick up on a point made, I think, by the hon. Member for Sheffield Central, on the importance of identifying carers. There has been ongoing work to better identify who carers are. We know that carers do not necessarily even think of themselves as carers, and that young carers can often be overlooked. There is a particular line of work in working with schools to identify young carers and provide them with more support.

[Wera Hobhouse]

I thank the Minister for giving way, for her response and for her clear understanding. Will she listen to our demand to look at the eligibility criteria so that all in education can be included in the carer’s allowance?

[Helen Whately]

Yes, I have heard that. I have also received correspondence about the situation of somebody who may be in full-time education and seeking eligibility for the carer’s allowance. Yes, I am absolutely listening to that. I truly recognise the pressures that carers experience, whether it is juggling caring with work or with education. I have spoken myself to younger carers in that situation as well.

I want to go further on identifying carers—overcoming some potential data protection issues—and on trying to bring together our data sources, so that we have a clearer sense of who carers are and so that we will be able to contact them to offer support. During the pandemic, I found that it was not possible to write to all the carers in the country and say, “This is what is available to you.” I want us to go further on having the best data that we can.

[Ed Davey]

What the Minister is saying about identifying carers is absolutely critical for future Government policy on carers. It is why we talked about putting an explicit duty on the NHS in the Health and Care Bill, which is before Parliament. That would be a real step forward. Is the Minister willing to meet me and carers’ organisations to discuss the critical issue of how we can work together with the health service and local authorities, so that we can identify the carers in our communities?

[Helen Whately]

I am very happy to meet the right hon. Gentleman to talk about that. It is about the technicalities of data, data sitting in different places, and how we can overcome that so that we have a better and common information source. Yes, I am absolutely happy to meet him.

I will come back to some of the things that we did during the pandemic, because I want to cover the topics that have been raised in the debate. We published guidance specifically for carers to try to support them through the pandemic, including on maintaining their own health and wellbeing. We provided PPE for unpaid carers who live separately from those for whom they care, in line with the clinical advice on when it is appropriate for a carer to use PPE. Crucial to all that was drawing on the experiences and insights of carers, including young carers, during the pandemic. We held a series of roundtable discussions in order to do that. Young carers frequently fly under the radar of services and community networks that would otherwise help them.

We provided extra funding to charities, including £500,000 to the Carers Trust in order to provide support to those who experienced loneliness during the pandemic, and over £150,000 to Carers UK so that it could extend its helpline opening hours in order to provide information and support to unpaid carers. We have supported initiatives for young carers, including providing over £11 million to the Sea, Hear, Respond programme, which ran from June 2020 until March 2021, in order to support more vulnerable children and young people.

We have also worked to give extra support to young carers in education. During the national lockdown, schools and colleges remained open for the children of critical workers and vulnerable children, including young carers. I recognise that if a young carer looks after somebody who is more vulnerable to covid, they will be more worried about going to school, so I am determined to ensure that, as part of our catch-up programme for children, some of the £3 billion education recovery package can be used to support young carers who have missed out on school.

I want to talk about day services, which provide essential respite for carers. It is so important that carers, particularly those who do high-intensity care, have time to see a dentist or doctor, to go shopping or to do something for themselves. Such respite is so important, and the day service or respite care is of great value to the individual who attends it. I was truly disappointed to read Carers UK’s new research report, “Breaks or breakdown”, which was published during Carers Week. It said that

“72% of carers have not had any breaks from their caring”

during the pandemic. However, many respite services and day services have not been fully operational for much of the last 16 months. I want to see the reopening of such services. That is one reason why, as part of the infection control fund, we have given nearly £1.5 billion to social care during the pandemic. One use of that fund has been to support the reopening of day services.

I know we can go further. Just last week, I spoke to local authority leaders and emphasised to them the importance of reopening day services and respite services, and I urged them to take advantage of the support that is on offer. I personally commissioned two surveys of day service provision—one last October and one in spring this year. During that period, that provision has increased; the situation in the recent report was better than last year’s, but it is not yet back to the pre-pandemic level. I will continue to work with adult directors of social services, the Ministry of Housing, Communities and Local Government and local authorities to fully understand the challenges in getting day services back to the level that they were at before.

[Liz Twist]

I very much welcome the efforts made to reopen day services. However, will the Minister accept that many local authorities already find their social care funding stretched incredibly hard and so find it difficult to maintain some of those services? Does the Minister accept that there is a funding issue here?

[Helen Whately]

Of course, there are financial pressures across public services, and more widely across our economy we face an extremely challenging time, but we have given significant extra funding to local authorities to support them through the pandemic. That is why I urge them to prioritise this issue. I emphasise the importance of the carer’s needs assessment that local authorities carry out, because that is such a crucial way of identifying what support a carer may need for themselves and their wellbeing, including the need for respite and taking a break from caring, and then making sure that that happens.

[Jamie Stone]

Further to what the Minister just said, Migdale Hospital in my constituency has in recent times lost a lot of beds. That is a combination of the NHS, and—because healthy policy is devolved—the Scottish Government. Does the Minister agree that that is a real problem? This is not joined-up government. Whatever influence she can bring to bear on the Scottish Government to reverse those decisions, which fly in the face of good government, would be helpful.

[Helen Whately]

The hon. Gentleman has made his point very clearly. He knows that that is a devolved matter, but SNP Members are listening, and I hope that they take up his concern.

Effective support for carers can never be created or offered in isolation, and it is critical to me that the views of carers are central to how my Department develops policy. Just a few weeks ago, Carers Week provided an opportunity to highlight the invaluable contribution of carers and for others to commit to improving their quality of life. I personally made a pledge to work nationally and locally in my constituency to promote caring communities, and I wrote to all MPs urging them to do the same.

I will continue to play my part and will listen to and champion the needs of all carers as our country continues its recovery to a new kind of normality. I have and will continue to meet a wide range of carers’ organisations and to speak to Ministers from across Government to ensure that our regulations, policies and services are fit for purpose and consider the needs of carers. That engagement has included roundtable discussions and regular calls with individual carers charities, including Carers UK, Carers Trust and the Children’s Society, and I will continue to work with colleagues across Government, MPs and local authorities to increase our support for carers.

The Government do not have all the answers. Several hon. Members have spoken today about local organisations and initiatives that support carers. Local carers’ groups play such an important role—by putting carers in touch with others in similar situations, for instance, so that they discover that they are certainly not alone; and by providing practical support, advice and respite. That is from Carers UK and the Carers Trust to any number of local groups; during the debate, I have heard mention of Kingston Carers’ Network, Gateshead Carers, a young carers organisation in Bath, Tykes Young Carers in Sutherland and Sheffield Young Carers. I should mention Crossroads Care Kent, who I met the other day in my capacity as the Member for Faversham and Mid Kent. I heard about the excellent work that it does. Across the country, these voluntary groups, charities and charitable organisations do such an important thing in supporting carers, and I recognise that.

Several hon. Members mentioned social care reform, and they know well that we are committed to bringing forward proposals this year for reform of the adult social care system. As part of those proposals, we are absolutely considering unpaid carers. We want to build a system in which unpaid carers are truly supported and those who receive care have more choice and control over their lives. We are working closely with local and national organisations so that our approach to reform is informed by diverse perspectives, including those with lived experience of the care sector.

On the Health and Care Bill, I want to ensure that the voices of unpaid carers, as well as care home residents and others who receive care and support, are truly heard in integrated care systems. That is why the Bill places new duties on integrated care boards and NHS England to involve carers.

I thank hon. Members for their contributions on this important topic. I know that all those who have spoken share my deep commitment to supporting our unpaid carers and young carers, who have sacrificed and given so much, especially in the past 16 months, and continue to do so. As Minister for Care, I have seen at close hand how challenging and unwelcome the pandemic has been for people caring, as well as those being cared for.

We should all be humbled, inspired and strengthened by everyone who has endured this most stressful of times. I hope that the House will join me in a heartfelt thank you to each and every carer and young carer across the country for all that they are doing to support, protect and care for their loved ones.

NHS Update

Helen Whately Excerpts

Wednesday 21st July 2021 Commons Chamber

[The Minister for Care (Helen Whately)]

I apologise to you, Madam Deputy Speaker, and to the Opposition spokesperson, the hon. Member for Tooting (Dr Allin-Khan), for the late sight of this statement.

Before I start my remarks, I would like to take the opportunity to pay tribute to the noble Lord Stevens, who will shortly be standing down as chief executive of the NHS. I thank him for his dedicated service over the past seven years, especially his stewardship during our battle against this virus and his huge contribution to this nation’s vaccination programme. I am sure that the whole House will join me in thanking him and giving him our best wishes for the future.

With permission, Madam Deputy Speaker, I would like to make a statement on our support for the NHS. In the NHS’s proud 73-year history, no year has been as tough as the last. Everyone working across the NHS has achieved incredible things in the face of great difficulty—from building the Nightingale hospitals in just a matter of days to rolling out our life-saving vaccination programme. They have been there for us at the best of times and at the worst of times. As a Government, we have sought to give them what they need at every stage of the pandemic.

Today, I would like to set out for the House some of the support we have been giving. Throughout the pandemic, we have worked to deliver manifesto commitments—50,000 nurses, 40 new hospitals and 50 million more GP appointments—and we are taking every opportunity to invest in our NHS to make sure that patients feel the benefits of the latest treatments and technologies.

Only this week, we announced a new innovative medicines fund to fast-track promising new drugs. This builds on the amazing work of the cancer drugs fund, which has already helped tens of thousands of patients access promising cancer treatments, while we use the data to make sure that they represent good value for the wider NHS. It is estimated that one in 17 people will be affected by a rare disease in their lifetime, and this fund will support the NHS to fast-track access to treatments that could have clinical promise. This new £340 million initiative takes our dedicated funding for fast-tracking promising drugs to £680 million, showing that we will do everything in our power to give patients access to the most cutting-edge therapies.

Doing right by the NHS means making sure that colleagues have the right team around them. This was true when we made our manifesto commitment for 50,000 more nurses by March 2024, and it remains especially true in the face of the challenges brought by the pandemic. I am pleased to report that we have almost 1.2 million staff working in NHS trusts, an increase of over 45,300 compared with a year ago. This includes over 4,000 more doctors and almost 9,000 more nurses, taking us to over 303,000 nurses in total, and we are on track to deliver on our 2024 commitment.

We recognise that, with so much being asked of our NHS staff, many will not yet be feeling the difference of these extra colleagues on the frontline, but I can assure those hardworking nurses that you will feel it soon. Yesterday, I heard from NHS Employers that, for the first time, Hull University Teaching Hospitals NHS Trust will have a full complement of nursing staff when the intake of new nursing graduates begins work in September. I know that we all look forward to hearing that kind of news from more and more places across the country.

Finally, I want to update the House on our autism strategy. Our NHS long-term plan set out our commitment to improving the lives of autistic people. Today, we have launched our new autism strategy, which sets out how we will tackle the inequalities and barriers faced by autistic people so that they can live independent and fulfilling lives. I am truly grateful to everyone who has contributed to shaping this strategy, including autistic people and their families, and the all-party parliamentary group on autism in particular. I would like to take a moment to recognise the contribution of Dame Cheryl Gillan, the former Member for Chesham and Amersham, for her incredible advocacy of autistic people, including the inquiries she led in 2017 and 2019. She left an incredible legacy, and we are all so grateful to her for her work.

Today’s strategy builds on our previous strategy, “Think Autism”, and we have made so much progress since then. We now have diagnostic services in every area of the country and a much better understanding and awareness of autism, but there is much more to do. The life expectancy gap for autistic people is still about 16 years on average compared with the general population, and almost 80% of autistic adults experience mental health problems during their lifetime. The coronavirus pandemic has been tough for many autistic people. Far too many autistic people face unacceptable barriers in every aspect of their lives—in health, employment and also education —so we have worked together with colleagues in the Department for Education to extend the strategy to children and young people as well as adults, reflecting the importance of supporting people all through their lives, from the early years of childhood and through adulthood.

The strategy is fully funded for the first year, and it contains a series of big commitments, including getting down the covid backlog; investing in reducing diagnosis waiting times for children and young people; preventing autistic people from avoidably ending up in in-patient mental health services; improving the quality of in-patient care for autistic people when they are receiving it; funding the development of an autism public understanding initiative so that autistic people can be part of communities without fear or judgment; funding to train education staff so that children and young people can reach their potential; and many more commitments. This landmark strategy will help to give autistic people equal opportunities to flourish in their communities, as well as better access to the support that they need throughout their lives, so that all autistic people have the opportunity to lead fuller and happier lives, as they deserve.

We owe so much to our NHS and the incredible people who work there. They have done so much to support us at this time of national need. As a Government, we will give them what they need, not just through this pandemic but to face the challenges that lie ahead. I commend the statement to the House.

--- Later in debate ---

[Madam Deputy Speaker (Dame Eleanor Laing)]

Just before the Minister responds, I will say that Mr Speaker will be annoyed, to say the least, that the hon. Member for Tooting (Dr Allin-Khan) did not receive the statement from the Minister in time. The Minister did apologise at the beginning of her remarks, so I have noted that apology and we do not have to go any further on that, but I have also noted what the hon. Lady has said.

[Helen Whately]

Thank you, Madam Deputy Speaker. I reiterate my apology to the hon. Lady for the late sight of the statement and thank her for her invitation to join her, but I will say that I am shocked by some of the language that she uses. I would just say—[Interruption.]

[Madam Deputy Speaker]

Order. The hon. Member for Tooting must not shout at the Minister across the Dispatch Box. She was heard, and the Minister must be heard.

[Helen Whately]

What we say in this Chamber is clearly important and it has ripples beyond the Chamber, so I for one consider the tone of what we say to be extremely important. The hon. Lady spoke about pay for NHS staff. As she knows, the Government asked for recommendations from the NHS pay review bodies. The Government are rightly seriously considering those recommendations, and we will be responding as soon as we possibly can. She also knows that last year the Chancellor committed to NHS staff receiving a pay rise at a time when there is a wider freeze on public sector pay, recognising the extraordinary lengths that NHS staff have gone to during the pandemic.

The hon. Lady talked about the pressures on NHS staff, which she and I know go back a long way, but yes, of course they have been so much greater during the pandemic. We know that NHS staff have gone above and beyond, time and again, during the pandemic to care for patients. Recognising that, and knowing that that has been happening throughout the pandemic, I have worked with NHS England, and particularly the people team there, to put in place all possible support for staff during these difficult times. That includes practical support with some of the day-to-day challenges of working shifts and the extra disruption to people’s lives and home lives during the pandemic, as well as mental health support, including setting up 40 new mental health hubs for staff, which I have heard from staff on the frontline are really making a difference. In fact, some of these things are making the NHS a better place to work for the future, and we should try to continue some of the improvements to mental health support for staff, recognising the importance of this to people who are doing extremely challenging jobs.

I also say to the hon. Lady that we now have record numbers of staff in our NHS. We have over 300,000 nurses, as I said earlier—around 9,000 more nurses than a year ago—and record numbers of doctors, so we have more staff in our NHS. We are also seeing a huge interest in NHS careers. For instance, we have seen a 21% rise in applications to UCAS for nursing degrees this year, which comes on top of a rise last year as well. I welcome the fact that so many people now want to join our NHS to support it, and I am determined that we as a Government will continue to support our NHS workforce in the weeks and months ahead.

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

May I start by echoing the Minister’s thanks to Lord Stevens, who is about to step down as chief executive of the NHS? One of my proudest achievements as Health Secretary was to secure a £20 billion annual rise in the NHS budget, and that would not have been possible without a close partnership with Lord Stevens. Indeed, he taught me a number of things about how to negotiate with the Treasury. He is someone who believes in the NHS to his fingertips, and he will be missed in all parts of the House, both on the Opposition Benches, but also on this side, where we have long forgiven him for his new Labour origins. We wish him well for the future.

This statement is about the NHS. The biggest pressure facing the NHS, apart from covid patients themselves, is the covid backlog, and I draw to the Minister’s attention the concerns that I and a number of people have as we face these enormous waiting lists. The previous Labour Government had considerable success in bringing down waiting lists, to their credit. They would also say that there were unintended consequences in terms of lapses in parts of the system with the safety and quality of care. Will the Minister, as we once again try to bring down waiting lists, agree that the Government will redouble their focus on safety and quality of care so that we do not have to relearn the lessons of Mid Staffs, Morecambe Bay and a number of other sad tragedies?

[Helen Whately]

I thank my right hon. Friend for his question. I know that in his time as Health Secretary, he did a huge amount to raise the standards of safety and have a greater focus on patient safety in the NHS. That is still clearly making a difference today. He is absolutely right that we need to ensure that we focus on that as we work to bring down the backlogs from the pandemic. It is not only that; I am mindful of making sure that we continue to support our NHS workforce as they, on the one hand, look after patients with covid and, on the other, work to reduce the backlog. That pressure is continuing, but I am determined that as we bring down the backlog, staff will continue to be supported and will, in fact, continue to have time off, annual leave, the breaks they need and the wider support so that we look after our workforce as well as providing the care that patients need.

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

I have listened to what has been said in the statement, and I was surprised that it did not cover the subject of NHS pay, which had been well trailed in advance. I would have hoped that the UK Government would match the 4% that the Scottish Government have offered NHS workers, backdated to December 2020. The Scottish Government have also secured agreement for a real living wage for social care staff at £9.50 an hour and underwritten the promise with £64.5 million in support. Why is it that this UK Government are unable to match the Scottish Government’s commitments to give NHS and social care staff the pay that they deserve and need?

[Helen Whately]

I thank the hon. Member for outlining the approach in Scotland towards pay. Pay is a devolved matter. As I said earlier to the shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), we are reviewing the recommendations from the pay review bodies, and we will be making an announcement for pay in England in due course.

[Simon Jupp (East Devon) (Con)]

I thank the Minister for her updates. On another matter, I am receiving emails from East Devon constituents concerned that their first, second or both jabs have not been registered properly and do not appear on the NHS app. It is putting their holiday plans in doubt. From September, they may not be able to access some venues when covid passports could be introduced, although not with my support. The papers are filled with similar stories from across the country. Not only will covid passports create a two-tier society but it also appears to be a system that is based on sometimes inaccurate data. Is this really a good idea, Minister?

[Helen Whately]

Well, I welcome the fact that so many of my hon. Friend’s constituents have received their vaccination. Where there are problems with the data, I am sure he will know that the vaccines Minister, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi) is very assiduous on these specific matters. I will raise with him the examples. It may well be that the Minister will get directly in touch with my hon. Friend and resolve the situation.

[Munira Wilson (Twickenham) (LD)]

I start by echoing the remarks of the Minister and the right hon. Member for South West Surrey (Jeremy Hunt) regarding Lord Stevens. He happens to be a constituent of mine, but he has also been a phenomenal chief executive of the NHS and I hope he will be making some well-informed interventions on the Health and Care Bill in the other place.

The statement rightly applauds our NHS staff and says how much we owe them. It says that the Government will give them all that they need. Words and clapping are cheap. Where on earth is the widely reported and trailed pay deal announcement that was expected today? Does the Minister really believe that the 1% pay rise, which is actually a pay cut, is giving NHS doctors and nurses what they need? Is that really a just reward for their sacrifices of the last 18 months?

[Helen Whately]

I agree that pay for our NHS workforce is clearly very important. That is why we are considering the recommendations of the pay review body and we will make an announcement on pay in due course.

[Paul Bristow (Peterborough) (Con) [V]]

I hugely welcome the Minister’s statement today, particularly the news about the autism strategy, but as we look beyond the pandemic, there is real concern from charities and patient groups that many patients have missed being diagnosed with some very serious conditions due to lockdown and covid restrictions. GPs have a crucial role in dealing with this issue. Will the Minister set out the steps that her Department is taking to provide an extra 50 million GP appointments a year?

[Helen Whately]

My hon. Friend makes a really important point. We have seen people not come forward for treatment during the pandemic and it is worth reiterating that if anyone is worried about their health, it is really important to seek that help and get a diagnosis or seek treatment. We are working to increase the number of appointments available in primary care. One thing we have also seen during the pandemic is that GPs have increased remote working and virtual appointments. We know that many people need to be able to see a GP in person, but there are also opportunities to combine GPs being able to offer services in person and virtually in a way that is good, hopefully, for GPs and patients.

[Jim Shannon (Strangford) (DUP)]

I thank the Minister for the statement and what she spoke about earlier. I want to ask about the NHS wage increase, which is on my mind. On the TV screens this morning, a nurse gave her story—it was very heartfelt, for those who had the opportunity to hear it—about the difficulties of retaining staff and ensuring that they were able to cope through the process. There is a real need to respond positively on the wage increase. A petition on that has also been handed into Government. I believe in my heart that NHS staff should receive the 3% increase. Does the Minister agree that 3% is enough, given their tireless and admirable efforts in tackling covid-19, and can she confirm that NHS staff will receive the wage increase and that it will be a priority for her and the Government?

[Helen Whately]

The hon. Gentleman is asking me to pre-empt the Government’s response to the recommendations of the pay review body and I am afraid that I am not able to do that at the Dispatch Box today. What I can say is that we are considering its recommendations and we will make an announcement on pay for NHS staff as soon as we can.

[Mrs Flick Drummond (Meon Valley) (Con)]

I thank the Minister for her update and the announcement on the autism strategy, which is much welcomed. It has been a very tough 16 months for every single worker in the NHS and I salute every one of them around the country, particularly in the Meon Valley, of course. I also praise every volunteer in the vaccine centres that have played such a successful role. I have been keeping in touch with the local NHS bodies and patients about progress towards a new hospital in Hampshire, one of the 40 in our plan. Can my hon. Friend confirm that her Department is engaging with the Hampshire Hospitals NHS Foundation Trust to move this project forward as soon as possible, as it will benefit my Meon Valley constituents?

[Helen Whately]

I join my hon. Friend in thanking NHS staff in the Meon Valley and also, as she says, the many volunteers in her area and across the country who have been so invaluable in their support during the vaccination roll-out. She asked about her new hospital in Hampshire. She will know that the Government are going full steam ahead with bringing forward new hospitals, and I will take up her specific question with my hon. Friend the Minister with responsibility for hospitals.

[Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)]

First, let me associate myself with the Minister’s comments about Lord Stevens and Dame Cheryl Gillan. Both contributed massively to the Public Accounts Committee, albeit from different sides of the witness table.

This statement is disappointing. It is great to hear about the autism strategy, but that was already a written statement today. Why have we not heard about the backlog, social care or NHS pay? The Minister has talked about recruiting more people. I could go to town on how many failed targets there have been, and we are still not sure whether the Government will meet this one. The key issue in NHS staffing is retention of staff. If she cannot tell us about NHS pay now, when, Minister?

[Helen Whately]

The hon. Lady is absolutely right that retention is vital to us for maintaining the staff that we have in the NHS. For instance, to achieve our 50,000 more nurses for the NHS, there will be a combination of new domestic recruitment, staff training to become nurses, international recruitment, but also retaining the nurses that we have, which is a really important part of it. That is why we worked so hard during the pandemic to support NHS staff to stay with the NHS. What we have seen—I am truly grateful to many staff for this—is people sticking with the NHS during this time. Some staff have even delayed their retirement in order to help the NHS through the pandemic. Looking ahead, we must be ready to continue supporting staff, including, for instance, staff who are nearing the end of their careers, making sure that, if they want to work a bit differently—more flexibly for instance—that should be available. That is one thing among a whole host of things that we are doing in order to support the retention of staff.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I must just say to the House that the hon. Member for Hackney South and Shoreditch (Meg Hillier) is not the only Member this week and in recent weeks who has addressed the Minister as “Minister”. I am sorry to pull up the hon. Lady. I am doing it to her because I know that she can take it and will not be upset by my criticising her. I am rather more gentle with the new Members, so I thank the hon. Lady for helping me in this by allowing me to use her as an example. When a Member asks a question, you do not say, “Minister, are you going to do this?” You say, “Madam Deputy Speaker, or Mr Speaker, does the Minister understand that she must do this?” We must not lose sight of that because it changes the way in which dialogue occurs in this place. Just because it is hot, the end of term and we have covid problems does not mean that we let our standards fall.

[Mr Steve Baker (Wycombe) (Con)]

On Monday, Sky News was among those who reported that frontline health workers in England are to be spared self-isolation rules in an emergency move to tackle the pingdemic that has triggered an NHS staffing crisis. I am very pleased, because, of course, the NHS has a special place in all our hearts and in all our constituents’ hearts, but so, too, does food in the supermarkets and on our tables, and the capacity of businesses to recover, particularly theatres, which have been in the news. What will my hon. Friend do to ensure that everyone is freed from this great curse of the pingdemic, which is keeping us from our recovery?

[Helen Whately]

Isolation is an important part of our defence against the pandemic. We know that those who are contacts are around five times more likely to be infectious. That is why isolation is so important. My hon. Friend is correct to say that there has been a very specific policy for a limited number of NHS and social care staff in exceptional circumstances and subject to a risk assessment. The conditions for someone to work if they are a contact are: they are double vaccinated; they receive regular PCR testing; and the decision is subject to the approval of the director of public health, or an appropriate public health individual. As I say, the conditions are very limited and specific. The Prime Minister also said that we will make sure that crucial services will be able to continue to operate, even while recognising that many people are currently isolating; that that goes beyond health and social care; and that in mid-August we will introduce a new system.

[Rachael Maskell (York Central) (Lab/Co-op) [V]]

I spent 20 years working in the NHS, but I have never known the NHS to be under such extreme pressure.

Mental health needs are unmet; NHS waiting lists are going through the roof; GPs are completely overrun and unable to cope; and there is no solution to our social care crisis. The Tories have achieved what I did not believe was possible: they have broken the NHS and care service and they have broken the NHS and care staff. In that shadow, the Minister should be ashamed to bring such a vacuous statement to the House today. Will she now immediately enter into urgent cross-party talks on how we can rescue this disastrous mess before staff and patients bear further sacrifice.

[Helen Whately]

I do not agree with the hon. Lady’s description of the situation. It is clearly absolutely true to say that our NHS staff and social care staff have done tremendous things during the pandemic, and clearly they are still doing so as covid is still so much with us. They have gone above and beyond time and again. It has been important that we have put in place extra support and we will continue to make sure that there is extra support for staff. We will announce our decision on NHS pay in due course.

[Mary Robinson (Cheadle) (Con)]

I thank my hon. Friend for her statement. I take this opportunity to thank all the staff who work at Stepping Hill Hospital in my constituency for their tireless efforts throughout this pandemic.

The past 16 months have reinforced the importance of the Government’s goal of getting 50,000 more nurses in the NHS by the end of this Parliament. I am encouraged by the progress that has already been made in that respect. Will my hon. Friend confirm that her Department will also continue to work hard to improve the recruitment and retention that we will need to meet that crucial target?

[Helen Whately]

I, too, thank the NHS and social care staff in my hon. Friend’s constituency and her local hospital for all that they are doing. I welcome her acknowledgement of the progress we are making towards our target of 50,000 more nurses. We are absolutely going to continue with our strong domestic recruitment, in respect of which we are in a really good position because of the increased number of applications for nursing courses. Even in the face of the pandemic, international recruitment is still really strong. Trusts are doing a great job in bringing and supporting international recruits into their organisations and, of course, supporting staff who were already in the NHS. Retention is so important—we must keep those we already have.

[Charlotte Nichols (Warrington North) (Lab) [V]]

I send solidarity to my fellow gingers in the Chamber and beyond who will no doubt be struggling with the heat today, as I am.

NHS staff are justifiably angry. The Minister can tone police my hon. Friend the Member for Tooting (Dr Allin-Khan) all she likes, but frankly she will get shorter shrift if she speaks to the exhausted, demoralised and underpaid NHS staff in my area. Rather than clutching her pearls, will the Minister please turn her attention to delivering the much-trailed pay rise that she has failed to announce today—one that fairly reflects the contributions of NHS staff, redresses years of real-terms pay cuts, and addresses the number of NHS key workers who are still shamefully paid below the real living wage?

[Helen Whately]

The hon. Lady has clearly been speaking to NHS staff in her constituency, and I am glad to hear that. As the Minister responsible for the NHS workforce, I speak to NHS staff all the time to make sure that I understand the things that are most on their minds. Pay is of course on staff’s minds at the moment, but so is the importance of having full teams, so I am glad that we are making progress on increasing the number of staff in the NHS more broadly and the number of nurses specifically. We are also putting in place other support, such as the mental health support that I know is so im

[Jacob Young (Redcar) (Con)]

The Minister will be aware that Redcar and Cleveland currently has the highest rate of covid in the country, but thankfully this is not leading to a huge increase in hospitalisations and deaths because we are also one of the most vaccinated parts of the country, with 71.2% of people having received both doses. What additional support can the Department give to Redcar and Cleveland to ensure that everyone is able to access the jab and protect themselves and our local NHS?

[Helen Whately]

May I say how good it is to hear that my hon. Friend’s area has taken up the jab so strongly, so that so many people are having the protection of both doses of the vaccination? We know that it does not mean that they definitely will not get covid at all, but we know that their risk of hospitalisation, serious consequences and indeed death is that much lower from being vaccinated. Of course, it is important that those who have yet to be vaccinated but who are eligible still come forward; there are more people still to come forward. If my hon. Friend thinks that there is anything specific that we could do further in his constituency, I hope that he will let me or the Minister for Covid Vaccine Deployment know.

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

I join my hon. Friends the Members for Tooting (Dr Allin-Khan), for Hackney South and Shoreditch (Meg Hillier), for York Central (Rachael Maskell) and for Warrington North (Charlotte Nichols) in expressing my dismay at the Minister’s statement, which outlines nothing for the many NHS staff—including the hard-working staff across the bridge from this House, at St Thomas’ Hospital in my constituency—who still have not seen the pay rise that they deserve. Our NHS staff have been working tirelessly for more than a year on the frontline; they are exhausted. They have experienced exceptional levels of trauma and crisis for a prolonged period. Recent research by King’s College London found that intensive care staff reported PTSD, severe depression and anxiety. They need support over the coming years. Will the Minister outline what steps the Government are taking to work with our NHS staff in order to support them to deal with the mental health fallout from the pandemic?

--- Later in debate ---

[Helen Whately]

I join the hon. Lady in thanking NHS staff in her constituency, particularly in St Thomas’ Hospital, just across the river from where we are now, where I had one of my three children and was extremely well looked after. She asks about mental health support for staff. We recognise the pressure and mental health challenges that staff have been facing, particularly during the pandemic. That is why the NHS is putting in place 40 mental health hubs to provide specific mental health support to NHS and social care staff. That is one of a range of things that we are doing to support the mental health of staff through this time.

[Selaine Saxby (North Devon) (Con)]

I welcome the Government’s commitment to our NHS through the delivery of the biggest hospital building programme in a generation. Will my hon. Friend set out the progress that her Department has made towards identifying and progressing the 40 future hospitals that it will be building and significantly enhancing, such as North Devon District Hospital in my constituency?

[Helen Whately]

We have indeed committed to build 40 new hospitals by 2030. Together with eight existing schemes, that will mean 48 new hospitals by the end of the decade—as my hon. Friend says, the biggest hospital building programme in a generation. The programme is absolutely on track, but I will have to take up the specific hospital in her constituency with the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), who is the hospitals Minister.

[Barry Gardiner (Brent North) (Lab) [V]]

In order to ensure that the Minister is damned if she says no and damned if she says yes, can she confirm whether she believes that pushing the Government response to the pay review into the long grass or sneaking it out during the recess, when Parliament is not sitting, is an adequate and fair reflection of the sacrifices that NHS staff have made to keep our country safe during the pandemic?

[Helen Whately]

As I have said, we are considering the recommendations of the NHS pay review body. This is an extremely important decision for the Government; it clearly has consequences for a very large number of NHS staff. We will be announcing our decision on pay as soon as we can.

[Andrew Gwynne (Denton and Reddish) (Lab)]

Let me start by commiserating with the Minister, who is clearly grabbing a short straw at the moment. I am not sure what the point of this statement actually is. It seems as though pages 2 to 4 have been torn out at the last minute, and she has just read out the preamble and the end, with nothing in between. However, as this is an opportunity to raise NHS issues with her, may I draw her attention to a growing concern for my constituents, which is the difficulty in getting a GP appointment? Is she aware of that growing issue across parts of Greater Manchester and, no doubt, the rest of England? What is she doing about it?

[Helen Whately]

I thank the hon. Gentleman for taking the opportunity to raise that point. I am well aware of it, as my constituents in Kent raise the issue of that challenge in my area, and I know others do the same in many other parts of the country. That is why we are working to increase the number of primary care appointments available to people, knowing that demand is going up and that we must make sure that people’s need for local healthcare, which is so important, is met.

[Jonathan Gullis (Stoke-on-Trent North) (Con)]

Madam Deputy Speaker, it is good to know that you only tick off MPs who can take it; I would not wear a jacket on one occasion on Zoom, so I am appropriately dressed for you on this occasion.

I wish to thank the Minister and the Department of Health and Social Care, because under this Government the Royal Stoke University Hospital has received more than £40 million of investment. Sadly, however, Labour’s legacy in Stoke-on-Trent at the Royal Stoke is Andy Burnham’s disastrous private finance initiative deal, which means that £20 million a year is being stolen from the frontline and going on a hospital PFI debt, meaning that we have had fewer beds than we had before. Does the Minister agree that one way we can help our local NHS is by freeing it of this usuary, so that money can instead go on funding more beds, doctors, nurses and equipment for our fantastic frontline NHS staff?

[Helen Whately]

I agree wholeheartedly with my hon. Friend on that; I am glad that we are able to focus our funding for the NHS on the things that really matter—building new hospitals and supporting the workforce, and, at the moment and in the months ahead, supporting the elective recovery and all the extra work that needs to happen to give people the treatment they need.

[Alison McGovern (Wirral South) (Lab)]

Before I ask my question, may I say to the Minister that she might want to think again about coming to this House and ticking off my hon. Friend the Member for Tooting (Dr Allin-Khan) for her tone and language on NHS pay when she has come to this House to say absolutely nothing at all? Worse still, we hear from the media that the social care announcement is now being pushed to September. Let me give the Minister a second chance: can she confirm at the Dispatch Box right now that when we get that social care plan it will match Wirral Council’s priority of getting every social care worker in this country the real living wage—yes or no?

[Helen Whately]

It is very good to hear that Wirral Council is supporting social care workers in its area. Local authorities are a crucial part of our work in social care reform and they have so many of the direct relationships with the care providers who are providing that social care. We are absolutely committed to bold, ambitious reforms for social care. As the hon. Lady knows very well, we will be bringing those forward during this year.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I ought to conclude the statement here, because we are running way behind time. However, I appreciate that Members have important questions to ask and that the Minister will want to answer them. But I ask for much greater speed and brevity, because otherwise it is not fair to people who are waiting for us to come on to the next item of business. I call Dr Ben Spencer.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

Thank you, Madam Deputy Speaker. Before I ask my question, may I declare an interest, in that my wife works in the NHS?

I thank the Minister for her statement, particularly on supporting our workforce. When I speak to local health leaders they tell me that the workforce are tired—they have been dealing with covid for the past 18 months, and they are worried that they will have to lurch from covid into tackling 150% of the covid backlog. What reassurance can the Minister give health staff working in my constituency that there will be a sustainable transition from dealing with the pandemic to dealing with all the backlog and consequences as a result of it?

[Helen Whately]

My hon. Friend makes an important point, and it is why I am working closely with my hon. Friend the Minister for Health, who is leading oversight of the elective recovery work. We are very much discussing how we can make sure that, with the pressure of looking after people with covid, with winter approaching and with elective recovery, we are looking after our workforce through this period. Of course, looking ahead to the winter, it is important that people get not only the covid vaccination, if they are eligible, but the flu vaccination, so we can try to have as little flu as possible in what may be a challenging winter ahead.

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

Although it is welcome that the Government have launched their new autism strategy, they will need to do more than that to ensure that the 2,000 autistic people and people with learning disabilities currently detained in inappropriate in-patient units can move back into the community. For 10 years since the Winterbourne View scandal, the Government have failed to invest in the high-quality community services needed, and they have done nothing to stop the flow of people into in-patient units from the community.

Will the Minister commit to the funding needed to support all current in-patients in the community? Can she say when the Government will finally bring forward reforms to our social care system so that it provides the support autistic people and people with learning disabilities need?

[Helen Whately]

The hon. Lady refers to the importance of making sure that only those who really benefit from in-patient treatment should be in in-patient units. We know that is often not the case for autistic people, and sometimes those with learning disabilities, who are in-patients. We are working through our “building the right support” programme to reduce the number of in-patients, and we will continue to do so.

[Jason McCartney (Colne Valley) (Con) [V]]

Local services, businesses and schools across my Colne Valley constituency have been severely impacted by absences as a result of staff being pinged. We already know that, from mid-August, those who have been double jabbed will not have to isolate when pinged, but with such a successful roll-out of vaccinations in my part of Yorkshire, why can it not happen now?

[Helen Whately]

I appreciate my hon. Friend’s point, but the fact is that isolation is an important part of our defences against this virus. At the moment, therefore, we have to ask people who are pinged by the Test and Trace app to isolate in order to break the chains of infection.

[Jon Trickett (Hemsworth) (Lab)]

The whole country wants to see a proper pay rise for NHS staff, and we await the Government’s announcement. The central ethos of healthcare through generations and centuries has been the Hippocratic oath, which gives equal value to the lives and health of every single human being, including those over 80 years of age. Will the Minister stand up for the NHS and its core principle by rejecting the Prime Minister’s brutal philosophy of abandoning our older neighbours, friends and relatives?

[Helen Whately]

I do not accept what the hon. Gentleman says. From my position during the pandemic, I can say that we have tried, at every step of the way, to protect those who have been most vulnerable to this virus. It is a cruel virus, and it is particularly cruel to those who have weaker immune systems and those who are older. We have done all we possibly can, including putting over £2 billion of funding, PPE, testing and vaccinations into social care to do our utmost to protect those who are most at risk.

[Anne Marie Morris (Newton Abbot) (Con) [V]]

The pandemic has shown the vital need for effective collaboration across health and social care, and the need for individuals, such as nurses, to be able to work flexibly across both systems. What steps have the Government taken to ensure that parity of esteem is achieved across the health and social care workforce, in their training—preferably together—in their work opportunities and in their pay, which should be comparable?

[Helen Whately]

My hon. Friend makes an important point, and we have seen some really effective collaboration across health and social care during the pandemic. We want to continue to build on that. One of the things I am doing is working with Health Education England, which is launching a review looking ahead at how we can go further in bringing together our healthcare workforce and registered staff in the social care workforce.

[Tony Lloyd (Rochdale) (Lab) [V]]

The Minister is quite rightly embarrassed because she can say nothing about NHS pay, but she should be equally embarrassed that she cannot answer the question about parity of esteem for care workers. Over 100,000 care worker vacancies exist in this country. What are the Government going to do to make sure not only that the care workers in post are not exhausted but that people who need care get the care workers that they need?

[Helen Whately]

It is true that the social care sector does face a challenge and has faced a challenge in recruiting people. We are supporting the sector and we have supported the sector during the pandemic. As part of our work on social care reform, we are looking at the workforce to see, for instance, how we can make sure that social care is an attractive place to work, particularly for people coming into the workplace for the first time, and then provide career progression opportunities so that they stick with social care for a long time.

[Antony Higginbotham (Burnley) (Con)]

Access to a GP is now very patchy. Some of my constituents have no difficulty in getting a face-to-face appointment; others find it almost impossible. We all accept that there are new ways of working and some GP appointments can be virtual, but that is not appropriate in all cases. Over the coming months, if not years, if access to appointments does not improve, we will see that tackling the backlog, and keeping pressure off A&E and our ambulance services, will only get worse. What steps can the Department of Health and Social Care take to support and encourage GPs to get back to operating as normal and get patients through the door?

[Helen Whately]

My hon. Friend is absolutely right about the importance of people being able to access GPs and to get healthcare close to home. NHS England has been clear to GPs that they must ensure that they are offering face-to-face appointments as well as remote appointments. In general, practices are taking this approach, and we will continue to support GPs to provide that access over the months ahead.

[Margaret Greenwood (Wirral West) (Lab) [V]]

Last week, the Minister for Health, the hon. Member for Charnwood (Edward Argar), said in response to a question from my hon. Friend the Member for York Central (Rachael Maskell) that

“it is not the intention that ICBs”—

integrated care boards—

“depart from “Agenda for Change”.—[Official Report, 14 July 2021; Vol. 699, c. 474.]

However, given that the Health and Care Bill will revoke the national tariff and places a clear emphasis on a move to tariffs varying by area and other factors, coupled with strict financial controls for ICBs, is it not inevitable that it will undermine “Agenda for Change” and the pay and terms of conditions of over 1 million NHS workers in England?

[Helen Whately]

No, I do not think that is the case.

[Madam Deputy Speaker (Dame Eleanor Laing)]

Finally, we go by video link to Peter Bone.

[Mr Peter Bone (Wellingborough) (Con) [V]]

Thank you, Madam Deputy Speaker; we much appreciate you extending this session.

Before any major change is made in the NHS, there is a full impact assessment done to see how it affects wider society. Would the Care Minister be able to say when last week, when the statutory instrument on compulsory vaccination of care staff was put before the House, she had the opportunity to read the SI, the explanatory notes and the full impact assessment? If there was no full impact assessment, why did the Government proceed in laying it before Parliament?

[Helen Whately]

I was asked about this at the time and during the debate, and I did apologise for the fact that there was an error in the explanatory notes. We have since published an impact statement, and a full impact assessment is going through the formal approval process.

Reports on Seclusion and Restrictive Practice for People with Autism, Mental Health Conditions and Learning Disabilities

Helen Whately Excerpts

Wednesday 21st July 2021 Written Statements

[The Minister for Care (Helen Whately)]

Today we have published two formal responses to independent reports that the then Secretary of State for Health and Social Care commissioned to address and reduce the use of restrictive practice in the care of people with a learning disability or autistic people. The first response is to the recommendations made by the Care Quality Commission (CQC) in its report “Out of Sight - who cares?” published on 22 October 2020. The second response is to the independent interim report by Baroness Hollins reviewing the care and treatment of people with a learning disability or autistic people in long term segregation. A copy of these responses will be deposited in the Libraries of both Houses.

We welcome these reports and strongly support their recommendations. It is our priority to ensure that the rights of people with a learning disability or autistic people are protected and that where needed they receive high-quality care in the least restrictive settings possible.

We have carefully considered these recommendations and are accepting in full or in principle the vast majority, including:

Developing a pilot for a senior intervenor role, which will be focused on reducing the length of time people with a learning disability or autistic people remain unnecessarily in inpatient care in segregation. The pilot will be funded as part of a wider package of £31 million to support learning disability and autism services, to address the diagnostic backlog as a result of the pandemic, and support intervention to prevent children and young people with learning disability, autism or both escalating into crisis.

Working with the Royal College of Psychiatrists to define good practice with respect to admission and discharge protocols, including the development of a clinical contract for admissions.

Supporting the continuation of an independent review process which provides necessary scrutiny in the care and treatment of people who are subject to segregation. The reviews, chaired by independent experts, are aimed at developing bespoke recommendations, offering advice on implementing person-centred care plans and, where appropriate, moving the individual to less restrictive settings.

Working with the CQC to ensure more transparent reporting about the use of restrictive interventions in order to improve practice and minimise all types of force used on patients so that it is genuinely only ever used as a last resort.

Our goal is to ensure that care for people with a learning disability and autistic people is therapeutic and beneficial and that the presumption is always that, individuals can be supported to live fulfilling lives in the community. We remain committed to delivering on the Government’s manifesto commitment to improve how people with a learning disability and autistic people are treated in law and to make it easier for them to be discharged from hospital. The steps we are taking in responding to these recommendations support this commitment and are part of our wider work on Building the Right Support and the Mental Health Act White Paper.

[HCWS227]

National Health Service

Helen Whately Excerpts

Tuesday 13th July 2021 Commons Chamber

[The Minister for Care (Helen Whately)]

I beg to move,

That the draft Health and Social Care Act 2008 (Regulated Activities) (Amendment) (Coronavirus) Regulations 2021, which were laid before this House on 22 June, be approved.

As we head towards a winter where care homes may have to battle with covid and flu, the question we should ask ourselves is this: what more can we do? Over the last year and a half, covid-19 has sadly taken many thousands of lives, particularly the lives of older people and those with underlying health conditions, and particularly the lives of those who need the kind of care received in a care home. There have been more than 40,000 deaths among care home residents. They were mothers and fathers, grans and grandads, brothers and sisters, sons and daughters. Sadly, we have lost some of our dedicated care workers, too: despite all the efforts that have been made by care homes and their staff, local authorities and by us in Government to keep covid out, despite personal protective equipment, despite testing, despite isolation. Throughout the second wave, care homes used 26 million tests and—

[Sir Christopher Chope (Christchurch) (Con)]

On a point of order, Mr Deputy Speaker. I raised a point of order earlier this afternoon about the lack of an impact assessment before the House, despite it having been referred to on 22 June as having been made available. I was informed during the course of that point of order that pressure was going to be put on the Government to explain why there was no impact assessment. It is therefore a source of great disappointment that the Minister has not started off her speech with such an apology and explanation.

[Mr Deputy Speaker (Mr Nigel Evans)]

Thank you for that point of order, Sir Christopher. The Minister is on her feet and she looks as if she may respond to that point of order herself, as it is not a point for the Chair.

[Helen Whately]

Thank you very much, Mr Deputy Speaker. I was indeed intending to come to that point. I was commencing my speech by giving some further context, but I can respond to the specific point made by my hon. Friend. The impact assessment is being worked on. I will be clear with hon. Members. One of the challenges is that there is significant uncertainty about the level of behavioural change we may see in the weeks ahead from this and other measures, for instance the requirement for vaccination to travel to some countries, which we anticipate will lead to further vaccination uptake.

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

Will the Minister give way?

[Helen Whately]

If my hon. Friend will let me, I will cover his exact point.

I know that some hon. Members may wish to delay this debate, because they wish to review—

[Mr Wragg]

On a point of order, Mr Deputy Speaker. It states in the explanatory notes:

“A full Impact Assessment has been prepared”.

If it has been prepared, it cannot currently be in preparation. So where is it?

--- Later in debate ---

[Mr Deputy Speaker (Mr Nigel Evans)]

That is not a point of order for me, but it could have been an intervention upon the Minister, so let us allow the Minister to give the full response to the points that have been made and perhaps she can include that one from William Wragg.

[Helen Whately]

As I said, the impact assessment is being worked on. That is the current situation. I was explaining one of the challenges in coming to an impact assessment that we can share with colleagues to inform them accurately. I really hear that hon. Members want to have the full set of information for this debate. We face a dilemma: the clock is ticking and each day we are moving closer to winter. I am going to come on to it in the detail of my speech, but one important feature of this proposed legislation is that it gives staff a grace period in which to get vaccinated. The longer we take on this, the more risk there is to having that grace period.

[Mr Mark Harper (Forest of Dean) (Con)]

Will the Minister give way on that point?

[Helen Whately]

In one moment. One thing I can share is evidence that we have on how this kind of policy is working in practice from a large care home provider that is already implementing a requirement for its staff to be vaccinated. It has seen the vast majority of staff get vaccinated, with less than 1% of its workforce choosing not to be vaccinated. We have committed—and the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi) committed to this earlier to the Lords Secondary Legislation Scrutiny Committee—to publishing an impact statement setting out the evidence we have in advance of the Lords debate.

[Several hon. Members rose—]

[Helen Whately]

If my hon. Friends would allow to make a little more progress, I will absolutely take more interventions. However, I am conscious of wanting to set out the context and thinking behind this piece of legislation.

[Mr Harper]

rose—

[Helen Whately]

I may well answer many of my hon. Friends’ questions as I proceed, so I ask my right hon. Friend to let me make a little progress and I assure him I will take interventions.

As I was saying, throughout the second wave care homes used 26 million tests and 1.2 billion items of personal protective equipment, yet still we saw outbreaks in many care homes during the winter and 14,000 deaths from covid among care home residents. But there is one thing now making a huge and crucial difference, a major advance that is unequivocally saving the lives of care home residents and staff from this cruel and pernicious virus, and that is vaccination. I have spoken to residents who were in tears of joy and relief as they were vaccinated, as they at last had their own defence against this virus. So far, the vaccine roll-out to residents and staff in care homes has been a big success story. The Joint Committee on Vaccination and Immunisation made residents and staff in older age care homes the highest priority as soon as vaccines were available, and the NHS hit its target of offering the first dose to all care homes by the end of January, which was a fantastic effort.

[Sir Christopher Chope]

Will the Minister give way?

[Helen Whately]

In one moment. Vaccination teams have made multiple visits to care homes since then and as a result 96% of those living in older age care homes have had their first dose and 93% have had their second dose. Some 92% of residents living in working age care homes have had their first dose and 87% have had their second dose. Take-up among staff has also been strong, with 86% of staff in older age care homes having had their first dose and 75% having had their second dose, and 83% of staff in working age care homes having had their first dose and 72% having had their second dose. Our vaccination teams have gone to great lengths to support and encourage those who have been worried about the vaccination, along with care home managers and care colleagues. I am sure that Members will join me in thanking everyone in the NHS, local authorities and care homes who have worked so hard together to achieve such levels of vaccination.

[Several hon. Members rose—]

[Helen Whately]

I will take an intervention from my right hon. Friend the Member for Forest of Dean (Mr Harper).

[Mr Harper]

I come back to the point about the impact assessment. The document prepared for the House says that a full impact assessment has been prepared. Ministers need to give accurate information to the House, so if that is not correct and is misleading, it should be corrected immediately. It is not good enough to say that something will come along afterwards; we are being asked to vote on these regulations today. There is no urgency—the regulations do not come into force for 16 weeks, until November—so it is perfectly reasonable for them to be taken away and for the impact assessment that has been prepared to be published. If there is uncertainty, share the uncertainty with the House. It is not good enough to expect us to vote on something that is difficult, controversial and complicated and not share with the House the information that the Minister has at her disposal. It is an abuse. It is not good enough.

[Helen Whately]

During the course of this speech, I will share as much information as I can with my right hon. Friend on the rationale behind this, but let me address his point about the timing. He says that it could be done later, but the problem is that, if we do it later, will we suggesting that it is too late for care home staff who have not yet been vaccinated? The point is to give care home staff the time between this being legislated upon and its being implemented in time for the winter, when we know that there is a greater risk of a combination of covid and flu, to get vaccinated, in the knowledge that we are generally seeing an eight-week period between doses.

[Sir Desmond Swayne (New Forest West) (Con)]

The Minister will appreciate that the provisions before us extend well beyond the care home staff. With respect to the 1% of those staff of whom she spoke, in the absence of the impact assessment, if their failure to be vaccinated results in dismissal, who will be responsible for the compensation?

[Helen Whately]

My right hon. Friend asks an important question about how things would work in practice, although I think he is presuming that there is a question of compensation. I expect to see care homes being able to follow a process, and so long as they follow a fair process, there should be no need for the compensation that my right hon. Friend suggests. We will set out guidance, but the point is that there is a fair process in which, for instance, a care home can discuss vaccination with its staff member and, indeed, look at whether there might be an alternative role for an individual if they really do not want to be vaccinated, although I am realistic that there are not that many roles for staff in care homes that do not involve being in the care home. After that, if the situation is still that the staff member does not wish to be vaccinated, the care home must follow a notice period and make sure that it follows a fair process.

[Rachael Maskell (York Central) (Lab/Co-op)]

I want to help the Minister. We are having to make a decision this evening on the balance of risk, but we have not been given the data because the impact assessment has not come forward. The Minister is, in effect, asking us to make a decision on information that we have not yet been able to see. Would it not therefore be more sensible to withdraw this statutory instrument and ensure that we have the right data in front of us, so that we can then make an informed choice?

[Helen Whately]

We live in an uncertain world, but we know that covid is a killer for people living in care homes and we know that the winter ahead of us is going to be challenging both because of the ongoing circulation of covid and because of flu. The question we should put to ourselves today is: what are the steps that we can take to make people safer in the months ahead? This time last year—last summer—infection rates were low, but we did not sit back and say, “In that case, it’s going to be okay for the winter.” We in Government, working with local authorities and care homes, made preparations for the winter ahead. Thank goodness we did make those preparations. Although sadly there were many deaths, had we not put in place the personal protective equipment distribution system, had we not had the level of regular testing that went on in care homes throughout the winter, and had we not had the support with infection prevention and control, I fear that last winter would have been much worse. We know that the winter ahead is going to be another challenging one and we must prepare for it.

[Mr Wragg]

Will the Minister give way?

[Sir Christopher Chope]

Will the Minister give way?

[Helen Whately]

I will make some progress. As the Prime Minister and our chief medical officer have said, even when we are no longer in a pandemic, the virus will remain in some shape or form and we will have to learn to live with it. It will continue to circulate and potentially evolve into new variants, and there is a serious risk of a resurgence of flu and other seasonal infections. A combination of covid and flu may be unpleasant for many of us, but it will be life threatening for those who are most vulnerable.

[Sir Christopher Chope]

Will the Minister give way on that point?

[Helen Whately]

We must ask ourselves: what more can we do to protect those who will be most vulnerable?

--- Later in debate ---

[Mr Deputy Speaker (Mr Nigel Evans)]

Again, this is not a matter for the Chair, but it is certainly a point for the Minister to address. I think it would be helpful if the Minister could directly address that particular issue, which many Members are now raising.

[Helen Whately]

Thank you, Mr Deputy Speaker. There is not a great deal more that I can say on that point. As I have said, the impact assessment is being worked on and we will share it with colleagues as soon as we can. That is all I can say on that particular point.

[Sir Christopher Chope]

Further to that point of order, Mr Deputy Speaker. Yesterday, I asked the House of Commons Library to inquire of the Department where this impact assessment was, and the Department informed the Library that it was about to present the impact assessment. It did not say that the assessment was still under preparation. The implication was that it was ready to be given to the House and it was just a matter of time—they said they would do it as soon as possible.

[Mr Deputy Speaker]

Again, I can only say what I have heard during the debate and apparently the impact assessment is simply not available. This is clearly not the best situation. We can see exactly what it is, but it is what it is.

[Helen Whately]

Thank you, Mr Deputy Speaker.

The Scientific Advisory Group for Emergencies recommends that 80% of staff and 90% of residents should be vaccinated in any care home, at a minimum, to provide protection against outbreaks of covid. While the majority of care home workers have now been vaccinated, our most recent data has told us that only 65% of older-age care homes in England were meeting that safe minimum level, and the figure fell to 44% in London. That is why the instrument is being put forward today. It means that, by November, subject to parliamentary approval and a subsequent 16-week grace period, anyone entering a Care Quality Commission-registered care home in England must be vaccinated unless an exemption applies. That will apply to all workers employed by the care home, those employed by an agency and volunteers in the care home. Those entering care homes to undertake other work, for example, healthcare workers, tradespeople, hairdressers and CQC inspectors, will all have to follow the regulations.

The introduction of this policy has not been taken lightly. We have consulted extensively, including with a wide range of valued stakeholders, and used their feedback to inform this legislation. We recognise that some people feel that workers should have freedom of choice about vaccination, while others do it as a duty of care to protect the people most at risk. I know from speaking directly to people who receive care and to those who have relatives living in care homes that, although they might not be sure about requiring all care workers to be vaccinated, they are sure that they, individually, want to be cared for by someone who has been fully vaccinated. Many people have little choice about who cares for them.

[Mr Wragg]

The Minister mentions feedback, but the draft explanatory memorandum states that

“a majority (57%) of respondents did not support the proposal”.

How, therefore, does the feedback show that there is support for it?

[Helen Whately]

We have reviewed the huge number of responses to the consultation. Not everybody who responded supported the proposal—as my hon. Friend says, 57% did not—but it was interesting that the picture in care homes was fairly even between those who supported it and those who were concerned.

One thing that we are already seeing is that some care homes are bringing in the policy themselves.

[Mark Jenkinson (Workington) (Con)]

Will the Minister give way?

[Helen Whately]

I may pre-empt my hon. Friend’s point. I know that hon. Friends have asked why the Government need to bring in the policy if some care homes are doing it themselves. The problem is that we could risk a situation in which someone fortunate enough to be living in a care home that has required vaccination for its workers is highly protected against the virus, but someone less fortunate, in a care home in which far fewer staff are vaccinated, is unfortunately at much greater risk. That is not an inequality that any of us should be comfortable with.

[Jim Shannon (Strangford) (DUP)]

If we take a vote tonight, it will set a trend, set down a marker and point the direction not just for this place, but for the whole United Kingdom; I mention Northern Ireland in particular. Before we make the decision, may I ask whether the Minister has had any opportunity to talk to the regional, devolved Minister, Robin Swann, to gauge his opinion on how the legislation will affect us?

[Helen Whately]

The hon. Member is right: I know that other parts of the United Kingdom are watching what we are doing here in England. There are regular conversations between the Department of Health and Social Care in England and the other Administrations. Also relevant is the international situation: other countries have either done what we are doing or are looking very hard at it. In fact, France has just announced that it will require vaccination for health and social care workers on a faster timeline than the one we propose.

Never again do we want to be back in the situation of having covid outbreaks across hundreds of care homes, with those who live and work in them losing their lives to this virus. Vaccination is a safe and effective way of preventing the spread of covid. The majority of care home workers have already taken up the vaccine, and it is essential that all care home workers who can have the vaccine do so in order to protect those in their care.

The original scope proposed in the consultation was to apply the policy only to care homes that look after older people, but following the consultation it became clear that there was a compelling case to extend the obligation to all care homes that provide care to the most vulnerable, for example young adults with learning disabilities. There was also significant support for broadening the scope of the policy to include all those who come into contact with residents, and there was support for including all those who enter care home residences in any capacity.

[Sir Graham Brady (Altrincham and Sale West) (Con)]

Will the Minister give way on that point?

[Helen Whately]

I will proceed, and I may answer my hon. Friend’s question as I go.

We listened to the responses and made the decision to apply the policy to all people working inside care homes, unless they have a medical exemption or are not eligible for vaccination—under-18s, for instance. There are further exemptions, including people providing emergency assistance or undertaking urgent maintenance work, and family or friends visiting. Guidance will be published that gives more detail about the exemptions, which will reflect the green book on immunisation and clinical advice from the JCVI.

[Sir Graham Brady]

Can the Minister explain why the draft regulations do not distinguish between those workers who actually come into contact with residents and those who do not?

[Helen Whately]

My hon. Friend asks a reasonable question. We consulted on exactly that point. There are two reasons relevant to the breadth of the policy, which covers not only care workers, but others coming into the care home, such as hairdressers, health professionals and tradespeople.

When somebody, including a tradesperson, comes into a care home, they might spend significant time in the care home, move around and move from room to room, so they might be a significant infection risk to the care home. They might also move between one care home and another, particularly if they are a specialist who serves multiple care homes. We know there is a risk when individuals are moving between care homes, so there is a clinical case for the regulations.

We also heard from providers responding to the consultation that they want a consistent approach for people who enter a care home to work, and these regulations will make it more straightforward for them to implement that.

[Dr Luke Evans (Bosworth) (Con)]

I am grateful to the Minister for giving way. On making sure there is equity, where does she believe the duty of care falls, given these regulations?

[Helen Whately]

My hon. Friend makes a really important point. Throughout the pandemic, the Government and I have felt our responsibility to protect those living in care homes from covid as best we can. We can try to do that by extending to them the protection of being cared for by people who are doubly vaccinated, knowing as we do now, from the increasing evidence, that being vaccinated not only protects the individual but reduces the risk of transmission.

[Several hon. Members rose—]

[Helen Whately]

I will sum up, as I know other colleagues wish to makes speeches.

I put on record my sincere thanks to care workers across the country, not just for their work throughout the pandemic but for all they bring to our health and care services. People working in care homes have played an incredibly important role in caring for those most at risk from this terrible virus. The vaccine is working, with more than 14,000 lives saved so far. It is only right that we take every possible step to protect those most at risk.

As I said at the outset, we must all ask ourselves what more we can do to protect care home residents, and these regulations are what we can do.

[Mark Jenkinson]

On a point of order, Madam Deputy Speaker. I seek your advice on whether the vaccination figures cited by the Minister, which are more than a month out of date, might have inadvertently misled the House. Her earlier figures on the vaccination status of care home staff and residents suggest it simply is not possible for the figures both to have reached the SAGE threshold and to be as low as the House was informed.

--- Later in debate ---

[Helen Whately]

I thank hon. Members for their contributions and the questions they have put to me during this debate. I welcome the consensus on the importance of protecting care home residents. This debate is about how best we do that and the level of evidence needed in order for us to take the steps to best protect those vulnerable residents. The problem we face is that the clock is ticking towards winter, and to a potential combination of covid and flu to which we know care home residents will be extremely vulnerable. The problem with inaction and waiting for more time is that inaction costs lives.

I have heard—I assure my hon. Friends on this—the strength of feeling about the impact assessment, and may I say that I apologise to my hon. Friends for the error, particularly in the explanatory notes to the regulations? I have done my utmost, as I did in my opening speech, to set out for hon. Members the situation with the impact assessment, and there is nothing further I can say on that now.

[Mr Harper]

I do not know what other colleagues feel, but I find it offensive that, because we have expressed concerns about these regulations, it is somehow implied that we want to do away with or risk the lives of people in care homes. These regulations do not come into force for 16 weeks. There is ample time to take them away, review them, publish the impact assessment and get this House to make a decision, and protect people before the onset of winter. To suggest that Members want to do otherwise and that we are suggesting inaction that would put their lives at risk is offensive, and I urge the Minister to withdraw it.

[Helen Whately]

No offence was meant on my part. The problem with what my right hon. Friend is suggesting is that, if there is a substantial delay—for instance, in the autumn—in bringing through this legislation, that leaves care workers who have not yet been vaccinated with very little time in which to get vaccinated, and that is why we are bringing this forward now.

[Rachael Maskell]

Will the Minister give way?

[Helen Whately]

I am sorry, but I am conscious of the time left.

Several hon. Members have argued that we should continue the current approach to increasing uptake and indeed do more. Of course, we will continue to support care workers to take up the vaccine, but, as flagged by my hon. Friend the Member for Winchester (Steve Brine), the question is: how long do we give that? The vaccination of care home workers in England began in December last year, about eight months ago. We did take a similar approach to that in Scotland mentioned by the hon. Member for Central Ayrshire (Dr Whitford), where staff were vaccinated alongside residents in care homes. NHS teams went into care homes multiple times to offer the vaccination to staff. Indeed, we saw that that was effective and more staff took up the vaccination on subsequent visits. We also opened the national booking system to care home staff early on, before there was wider availability to everybody. We have worked with communities who have been particularly concerned and hesitant about vaccination. There have been materials in multiple languages. We have worked with faith groups. Local authorities have worked closely with care homes, alongside NHS vaccination teams, particularly care homes that have had lower vaccination rates. A huge amount has been done to raise the levels of uptake among care home staff.

We then have to ask ourselves the question: what more can we do? The No. 1 reason care home staff have given us for not yet being vaccinated is that they want some more time. Well, this gives them some more time through the summer in which to get vaccinated. Some care homes, as I have mentioned, are already doing this. One example is the Barchester care home group, which has over 16,000 staff. The vast majority, over 99%, have chosen to be vaccinated. Fewer than 0.5% have chosen not to be vaccinated. But the problem, if we leave it to care homes that are on the front foot to do this, is that others will be left behind and we will see inequality, where some residents are fortunate to be cared for in a care home where all the staff are vaccinated, and others will not be so safe. That leaves us with inequality for those care home residents, who will remain at greater risk. We know that the vaccination not only protects individuals, but reduces the risk of transmission.

Some hon. Members have raised the concern that care workers are being singled out in some way. That is not the case at all. This is about the setting of care homes, where we know there is the greatest risk and the greatest vulnerability to covid. This is about protecting individual residents in those care homes by requiring the vaccination of people who enter those care homes to work—so not only care home staff but NHS staff who enter care homes. This is about protecting residents in those care homes. Fortunately, at the moment, the rates are lower than they have been during peak times, but even in some of the recent outbreaks we have seen in care homes, the index case has been an unvaccinated staff member. That just emphasises the importance of us having high levels of vaccination among staff.

My hon. Friend the Member for Workington (Mark Jenkinson) asked me about the data I referred to earlier, the SAGE data on minimum levels and the extent to which that is being achieved by care homes. I shared the most recent data that I have. What we do know is that there are still hundreds of care homes that have not yet met that safe threshold, which is a minimum threshold for avoiding outbreaks in care homes.

I say to my hon. Friends that the question before us is: what more can we do to protect those who are vulnerable in care homes? This is what we can do and I commend the regulations to the House.

[Sir Charles Walker (Broxbourne) (Con)]

On a point of order, Mr Deputy Speaker.

Oral Answers to Questions

Helen Whately Excerpts

Tuesday 13th July 2021 Commons Chamber

[Mr Clive Betts (Sheffield South East) (Lab)]

What steps his Department is taking to ensure that unpaid carers can access the support they need to provide care to family members.

[The Minister for Care (Helen Whately)]

We recognise how much carers do and the huge demands that caring places on them. We have made carers a priority group for covid-19 testing and vaccination, funded carers’ organisations and asked local authorities to meet their duties to identify and support carers. We have also provided guidance and funding through the £1.5 billion infection control fund to support the reopening of day services.

[Kerry McCarthy]

I have been contacted by a Megan, a young carer in my constituency, and I have been in correspondence with the Minister about the lack of guidance for young carers on the gov.uk website. We got the Government to remove an outdated linked to a Barnardo’s service that had closed at the end of March, but they have not replaced it with anything, which has left a vacuum in where young carers can look for advice and support. Can the Minister ensure that there is adequate, up-to-date information on the gov.uk website and that young carers have somewhere to turn to when they need help and support?

[Helen Whately]

I thank the hon. Lady for her question and her correspondence on this. She makes a very important point and I will make sure of that.

[Mr Clive Betts (Sheffield South East) (Lab)]

When the Select Committee on Housing, Communities and Local Government went to Germany about four years ago to look at its social care system, we saw that people entitled to public funding for social care could either pay the public authorities or care agencies to deliver it. Alternatively, for a slightly reduced amount of money, they could pay their family members, which meant that the person receiving care got the care they wanted, family members got paid for their efforts and the public purse actually saved some money. In reforming the social care system, would the Minister look at introducing elements of the German system into our system in this country?

[Helen Whately]

The Secretary of State has already said that we are working on our plans for social care reform, and we will be bringing them forward later this year. Of course, as part of those plans we are considering unpaid carers.

[Sally-Ann Hart (Hastings and Rye) (Con)]

  If he will make a statement on his departmental responsibilities.

--- Later in debate ---

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con) [V]]

  In vitro fertilisation treatment is a lifeline for many people desperate to conceive. My constituent Sarah Barker dreams of being a mother, but sadly suffers from an infertility problem. Sarah is being refused IVF treatment on the grounds that her partner already has a daughter from a previous relationship. Her petition to stop denying women fertility treatment for this reason has already reached almost 13,000 signatures. Does my hon. Friend agree that treatment for infertility should be available based on the medical needs of the women involved, and not affected by the partner that she has fallen in love with having a child from a previous relationship?

[The Minister for Care (Helen Whately)]

I thank my hon. Friend for raising this question and the situation of her constituent. What I can say is that we expect clinical commissioning groups to commission fertility services in line with National Institute for Health and Care Excellence guidelines, so that there is equitable access across England. We are aware of some variations in access, and we are looking at how we can address that. Very specifically, CCGs should not be using criteria outside that NICE fertility guidance.

[Helen Hayes (Dulwich and West Norwood) (Lab)]

  Many of my constituents who are extremely clinically vulnerable due to conditions such as blood cancer are terrified that, from 19 July, the Government are effectively abdicating responsibility for keeping them safe in public. There is evidence that more than two thirds of people do not understand that vaccines are not always effective for people who are immuno-compromised or the importance of wearing a mask to protect others and to alleviate anxiety. Can the Secretary of State not see why it would send a much clearer message to keep masks on public transport mandatory, rather than leaving the safety of clinically vulnerable residents to chance?

Motor Neurone Disease (Research)

Helen Whately Excerpts

Monday 12th July 2021 Westminster Hall

[The Minister for Care (Helen Whately)]

It is a pleasure to serve under your chairmanship, Ms Cummins. I thank the hon. Member for Linlithgow and East Falkirk (Martyn Day) and congratulate the petitioners on securing this important debate. I pay particular tribute to the petitioners and to the charities, the MND Association, MND Scotland and My Name’5 Doddie Foundation, for leading the campaign that has brought us here today. I also thank all hon. Members who have spoken so powerfully, sharing the stories of people suffering from this cruel disease and adding their voices to the petitioners’ campaign.

The petition was started in the name of Doddie Weir, the Scottish rugby legend, who has been an inspirational figurehead, campaigning for a world free of MND, since he revealed in 2017 that he was suffering from the disease himself. I had the good fortune to meet, virtually, Doddie and others with MND at a recent roundtable event and I, too, was inspired by their campaign for a brighter future for people living with MND. Doddie’s charity, My Name’5 Doddie Foundation, works tirelessly to raise funds for research into a cure and to provide grants to people living with MND. I want to express my immense gratitude to Doddie and to everyone living with MND for giving their voices to this campaign and sharing their experiences of this awful disease and their hopes for the future. I know that people living with MND will be listening to the debate today and looking for hope. It is to them and to the more than 100,000 people who stand in solidarity with them that I address my remarks.

MND is a brutal condition that has a devastating impact on those who are diagnosed, and on their families and loved ones. As the petition has highlighted, MND can progress very rapidly, and tragically there is currently no effective treatment and no cure. We still do not know exactly what causes motor neurons to die off. Although a small percentage of cases are genetic, the majority of people with MND have no family history of the disease. There is only one drug treatment for MND, and it may slow the disease’s progression for some people. The lifetime risk of developing MND is as high as one in 300 people.

We are making great strides in research, which I will talk about shortly, but we still have a way to go in our research to understand the disease mechanisms and to identify effective treatments. Before I address that progress and our plan to accelerate MND research, I want to speak about how the Government are currently supporting people with MND. Through specialised services delivered by the NHS, people with MND are receiving treatment and support to ease their symptoms and to support their continued independence for as long as possible. That includes the prescribing of complex communication devices to help people with MND to communicate as effectively as possible; offering non-invasive ventilation to support respiratory function; and delivering personal care and support for the needs of the individual.

In 2019, the National Neurosciences Advisory Group published a toolkit for improving care for people with progressive neurological conditions, including MND. That toolkit is helping commissioners to improve the pathways for people with MND, enabling quicker and more accurate diagnoses, services that are more co-ordinated, flexible and responsive to the rapidly changing needs of the patient, and improved choice in end-of-life care for people with MND. That is so that people with MND receive the best possible care. However, although the NHS is delivering that specialised treatment and support to people with MND, we know that it is not the same as a cure.

In recent years, researchers have made major advances in our understanding of MND. For example, we now know more about the types of MND that have a genetic cause, for which gene therapy might be an effective treatment. Although that accounts for only about 10% of people with MND and we still need treatments for the remainder, it is an important development. Researchers are also making progress in the development of the MND register and MND biobanks—data resources that are aiding researchers in understanding the disease. Through the development of novel biomarkers, scientists have more effective ways to monitor responses to treatment in clinical trials; and through innovative and flexible trial designs, researchers are able to conduct faster and cheaper trials, which will deliver potential new treatments to patients more quickly.

I can assure hon. Members here today that this Government are committed to supporting research into MND. I have heard the request from campaigners for Government to invest £50 million to create an MND research institute, and I understand why petitioners are asking for this. However, ring-fencing funding for particular diseases can stop great science. That is why the Government make funding available for researchers in all areas to apply for. Awards are granted in open competition and determined by the quality of the science. Through those funding mechanisms, the Government are supporting a wide range of research into MND.

In 2019-20, UK Research and Innovation, through the Medical Research Council, spent £16 million on MND research. That included research that aims to increase understanding of the causes and genetic mechanisms of MND and amyotrophic lateral sclerosis—ALS—a form of MND. For example, scientists at the UK Dementia Research Institute are working to increase understanding of the root causes of ALS and frontotemporal dementia, and to identify ways of protecting brain cells from damage. There is significant overlap between the genetic causes of MND and some types of dementia, which is why the UK Dementia Research Institute, funded in partnership with Alzheimer’s Research UK and the Alzheimer’s Society, has made significant investment in MND research.

At the Francis Crick Institute, which is co-funded by the Medical Research Council, Wellcome and Cancer Research UK, researchers are working with stem cells to investigate the earliest molecular events of MND. With support from the Department of Health and Social Care, the National Institute for Health Research is directly funding MND research, for instance the Lighthouse phase 2 study, which is a clinical trial of a drug repurposed from the treatment of HIV. This study, involving 300 people with MND, will test the effectiveness of the repurposed drug in improving survival rate, function and quality of life for people with MND.

[Rachael Maskell]

I am grateful to the Minister for outlining all the research that is being done. However, the benefit of a virtual research institute would be co-ordination, to ensure that there was real focus on bringing about a real resolution for people with MND. Having a piecemeal approach will not provide the real focus that is required. Will she recognise that and therefore reflect on the ability to bring forward such a proposal in the comprehensive spending review in the autumn?

[Helen Whately]

I thank the hon. Member for her point; I will come on to say a bit more about that, and I assure her that I have absolutely heard her argument. However, I am addressing as I go some of the comments and questions raised by hon. Members during the debate, one of which was a request for some examples of research. I have just mentioned one, but there are a couple more that I want to give.

At the NIHR Sheffield Biomedical Research Centre, researchers are trialling the safety and efficacy of a drug called tauroursodeoxycholic acid, or TUDCA, as a treatment for people with ALS. The NIHR is also funding research to enhance support and care for people with MND, with ongoing studies looking at nutrition, diet and therapies to improve psychological health.

Over the past five years, the Government have spent almost £60 million on research into MND and we are currently working on ways to boost this research even further. The hon. Member for Linlithgow and East Falkirk and other colleagues asked about the total figure of nearly £60 million over the five-year period from 2015-16 to 2019-20. That includes research funded by the Government—through both NIHR and UKRI—focused solely on MND; research on MND and frontotemporal dementia, the causes and mechanisms of which have a substantial overlap with MND; research on neurodegenerative conditions that have many commonalities with MND; and spend on research infrastructure within NIHR, supporting MND studies. I hope that that provides some greater clarity on the research spending. In addition, the Government fund research on the structure of the nervous system, cell biology and genetics, and mental processes such as learning and memory. UKRI supports that research with around £30 million of funding per annum.

[Mr Steve Baker]

I am listening to my hon. Friend the Minister with great interest. Of course, following the relative merits of these different programmes is slightly beyond my capabilities in biological science, much as I try. May I invite her to meet the proponents of the research proposal—it compares business as usual, if I may call it that, with the potential results of the proposal —so that she can hear directly from them the advantages that could be gained from it?

[Helen Whately]

I would be delighted to meet the proposers. I was just coming on to talk about a recent roundtable that I hosted, together with the NIHR Sheffield Biomedical Research Centre, which focused specifically on boosting MND research. It brought together researchers, charities, people with MND and funders to consider ways that we could boost research into MND. Government officials are now working with those who attended that roundtable to take things forward, and to encourage and support MND research proposals.

On the particular point about a research institute, applications for funding for research infrastructure, just as for research itself, can and should be made to NIHR or UKRI as appropriate. Bids can win funding through that process, which includes peer review and evaluation. A strong case for this institute has clearly been made in the debate. I am happy to meet my hon. Friend the Member for Wycombe (Mr Baker), and I assure all who are listening that the Government are working with MND charities and researchers on ways we can boost research.

I end by again thanking the petitioners for bringing this issue to the forefront. MND has an enormous impact on individuals and families, and I pay tribute to everyone across the country who is supporting people diagnosed with the condition, and to the incredible and life-changing research that is being undertaken. The Government are committed to working together with the MND community to catalyse further investment and to accelerate progress so that, one day, we will achieve a world free from MND.

Covid-19: Effect on Retirement Communities

Helen Whately Excerpts

Thursday 1st July 2021 Westminster Hall

[The Minister for Care (Helen Whately)]

It is a pleasure to serve under your chairmanship, Mr Efford. I thank the hon. Member for Strangford (Jim Shannon) for securing the debate and for his fantastic speech setting out both some of the challenges and the wonderful things that the sector has done during the pandemic, while looking ahead and setting the tone for the conversation about wider housing supply challenges and opportunities. I also congratulate the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) on her first Westminster Hall debate. She was extremely articulate speaking to us remotely.

The pandemic has clearly been a huge challenge across the whole of our society, but the sheltered retirement housing and housing with care sector has faced the challenges of the past 18 months and truly risen to them. Managers, support workers, carers and other staff have gone the extra mile for those they support, and I have heard personally how hard those providers and their staff have worked, supporting the wellbeing of residents during the pandemic. I thank all those organisations and their staff for their amazing work throughout the pandemic.

Sheltered retirement extra care housing provides a home to hundreds of thousands of—often vulnerable—older people across the country. Having the right housing options helps older people stay independent for longer, continuing to live as part of a wider community in their own home, with the care they need close at hand when needed, but still—as so many of us want for as long as we possibly can—living behind their own front door, as my right hon. Friend the Member for Staffordshire Moorlands (Karen Bradley) said, with their own furniture, for instance. These things make a difference to someone’s quality of life.

During the pandemic, the Government’s focus has been on ensuring that those most vulnerable to covid have had help and support to get through these difficult times, including specific help for those living in the residential settings that we are talking about.

The retirement and housing with care sector itself put in place tons of measures to protect the more vulnerable residents and to look after frontline staff, such as closing down communal facilities; suspending activities; restricting access in and out of communities; issuing PPE; restricting in-person visits; and often, regular and increased cleaning.

My right hon. Friend talked about the retirement village in her constituency, Bagnall Heights, which has done a fantastic job of job of protecting its residents from covid by controlling who came in and out; arranging the PPE they had; extra cleaning; going shopping for residents so they did not have to take the risk of leaving the area; supporting the vaccination effort; lots of testing; and organising some fantastic socially distanced activities to keep up morale, which has been so hard during this time. She says that staff worked all hours to do that. It was clearly a great job by manager Sue Clarke and owner David Vincent, whom she mentioned. I congratulate them and the many others I have heard of who have gone to those lengths to protect residents and to support them through such a difficult time.

As hon. Members mentioned, we have engaged regularly with the retirement housing sector over the past year or so, and all the intelligence we have received, as was particularly mentioned by the hon. Member for Strangford, is that infection and death rates related to covid in that housing sector have thankfully been lower than we might have feared considering the relatively older and more vulnerable residents living in the sector. The measures we have put in place have clearly been effective in protecting those more vulnerable residents. However, as we have recognised today, there has also been a downside: the impact on the overall health and wellbeing of older people of, for instance, limits to socialising and communal activities; restrictions on visits; and not being able to get out and about as usual. In fact, a serious thing that happened, particularly earlier on, was residents sometimes not having access to healthcare or doctors as normal. As the hon. Gentleman said, life was completely different. As we have talked about, retirement housing providers worked really hard to get that balance between protecting their residents from infection, trying to maintain as much of the quality of life of their residents as possible and trying to maintain social contact.

The hon. Gentleman talked about technology being part of that, as did the hon. Member for Airdrie and Shotts, and about how Zoom calls have replaced visits for some; some people have actually found that they see more of their family via Zoom than when a long trip is required. We all agree that there is no way that a Zoom call actually replaces being physically together with people; it is not the same as coming together for a meal or a cup of tea and having a hug. However, it has been better than nothing. We all want things to get more back to normal, and we welcome the fact that that is happening.

The Government targeted our support at the sector; we have broadly worked hard for the last 18 months to support the social care sector. It is a hugely diverse sector, as hon. Members have talked about today, ranging from care homes and nursing homes to extra care housing, retirement housing, shared lives and shared accommodation. So there is huge diversity in the sector, which we have sought to support in different ways.

The shadow Minister talked about guidance. We have worked to provide guidance for the range of settings in the sector, but it has not always been easy, simply because of the diversity and the different circumstances that exist. Nevertheless, our support has included the provision of testing, which my right hon. Friend the Member for Staffordshire Moorlands said was clearly being used regularly by Bagnall Heights, and that was good to hear. There has also been access to PPE and all the particular support to settings that are more like care homes, where residents live in closer proximity and receive more care than in other settings.

Also, this year frontline health and social care workers, including those providing care in retirement communities and extra care housing, were prioritised for the vaccine by the Joint Committee on Vaccination and Immunisation in cohort 2. We are now in a great place, where the vast majority of people in those settings—both residents and the staff working there—have had not just one vaccination but two.

We continue to listen to and work with the sector, and to work with local authorities as well, on how we can support this part of society as we come through the pandemic. Although life is getting closer to being back to normal, as the shadow Minister rightly said, there have been long-term consequences from the relative isolation that people have lived in, and from their not being able to get out and about to participate in normal activities. We do not know all the consequences yet, but we know that getting back to normal brings its own challenges, too.

I will pick up on a particular question from the hon. Member for Strangford about future pandemic readiness. He made a really good point that we have seen that this kind of accommodation helps people to be protected from the risk of an infectious disease, for example because of separate housing units and that sort of set-up.

Looking ahead, however, we know that there will be opportunities to look back, to reflect upon and to learn the lessons of the whole experience of the pandemic. Of course we learn as we go, but actually taking the time to reflect is something that is still ahead of us. The Prime Minister has committed that there will be an independent inquiry established on a statutory basis, and that will begin its work next spring. I have no doubt that it will lead us to making sure that we are ready for future pandemics, looking across the wide range of settings where people are more vulnerable to infectious diseases.

This debate has also been a really rich conversation about housing provision more broadly for older people and the sort of provision that we want to have across the country. Housing will be part of our social care reform proposals, which, as hon. Members know, we have committed to bringing forward later this year. It is totally right that housing is so much a part of that work. The homes that we live in, and the environments and communities around us, have a huge impact on our health, wellbeing and quality of life. I want people to be able to live in the home of their choosing for as long as possible and as independently as their age and their health condition will allow.

We know that living in a home that is safe, so that it allows someone to keep living independently, not only improves someone’s quality of life but helps to prevent them from having an early admission to hospital and helps them to be transferred back out of hospital to go home. For many people, it can mean that they may never need to move into a residential care home setting, or at least delay it. However, we should all be clear that care homes and nursing homes are an important part of the mix of accommodation, and there is absolutely a time and a place when that setting is the right thing for people.

[Jim Shannon]

The right hon. Member for Staffordshire Moorlands (Karen Bradley) asked a question, Minister, which I will repeat. How can the health and social care reform work in partnership with the retirement communities, so that they can devise a strategy? I ask that because there are two Departments involved. The right hon. Lady made the point, and I just reiterate and reinforce it, because she and I both want to see that happening.

[Helen Whately]

I thank the hon. Member for his point. I completely agree. I will come to that, if he will just bear with me. I will continue, but I will pick up on exactly that.

As a Government, we know that we need to review housing holistically, looking at existing stock, which is clearly the vast majority of the housing in the country, as well as new builds, and looking at the wide range of housing options that we want to be available to meet all the health and care needs of our population—the growing number of people who are living longer and what that means for us. Whether people are living with or without home care support, it is important that we remember that not everyone will want or be able to stay in their current, lifelong home. That means that we need to think very broadly about having the right specialist housing options, including those with extra levels of care and support.

In England, both my Department and the Ministry of Housing, Communities and Local Government provide capital grant subsidy to assist with delivery of specialist and supported housing for older and other more vulnerable people with care and support needs. Speaking for my own Department, we provide funding to build specialised housing, through the care and support specialised housing fund, for older people and adults with learning and physical disabilities and mental ill health, and £71 million has been provided for that fund in 2021-22. Furthermore, 10% of delivery under MHCLG’s £11.5 billion affordable homes programme will be used to increase the supply of much-needed specialist and supported housing for a range of people with care needs, including older people.

That is what we are doing now, but I think that we are in agreement in this debate that we need to do more and we need to increase the supply of retirement housing and extra care housing and have a broad range of the kind of housing that helps people to live with their own front door—in their own home—for longer. Therefore I am working with MHCLG Ministers, and my officials are working with those officials, on how we can best achieve that. We are working across Government and also working with stakeholders, with the sector, on how we can achieve it. We are indeed considering the proposal for a taskforce, which was referred to by my right hon. Friend the Member for Staffordshire Moorlands. Yes, the partnership approach is absolutely one on the table.

I will come to a conclusion, but I want to say that one highlight of this debate for me has been hearing about the mother of the hon. Member for Strangford. It is a highlight because it is a reminder to all of us that this is about people. It is about real people and about their homes, which matter so much. I have been to brilliant homes; I have been to wonderful specialist retirement communities. I have been to housing and care settings and everything in-between. We need a mix of provision, and we need that mix so that individuals like the hon. Member’s mother, family members of all of us, whether it is grans, grandads, mothers, fathers, brothers or sisters, and, in due course, we ourselves have the homes that we need where we can live the best possible life and live our life to the full for as long as we can.

[Clive Efford (in the Chair)]

We have until a quarter to 5, but this will be a summing-up, not another speech—[Laughter.] I just point that out gently. I call Jim Shannon.

Designated Settings: Indemnity Support (September extension)

Helen Whately Excerpts

Tuesday 29th June 2021 Written Statements

[The Minister for Care (Helen Whately)]

Further to my written statement on 25 March 2021, I am tabling this statement for the benefit of hon. and right hon. Members to bring to their attention the undertaking of a contingent liability. This relates to an extension of the designated settings indemnity support (DSIS), which offers targeted and time-limited state-backed indemnity arrangements to care homes registered, or intending to register, as “designated settings”, and which are unable to obtain sufficient insurance cover.

On 18 January 2021, the Minister for Covid Vaccine Deployment announced in a written ministerial statement, and accompanying departmental minute, provision of these temporary indemnity arrangements under the DSIS. The DSIS includes cover for clinical negligence, employer’s and public liability where a care provider seeking to become a designated setting is unable to secure sufficient commercial insurance, or where an existing provider has been operating without sufficient cover. Employer’s and public liability is covered under the new coronavirus temporary indemnity scheme; clinical negligence is covered by the clinical negligence scheme for trusts. The DSIS is supervised by DHSC and administered by NHS Resolution, and, to date, has proved to be an effective package of support to designated settings.

DSIS initially provided cover for designated settings until the end of March 2021 and was subsequently extended for a further three months until the end of June 2021. Following a further review of DSIS, it will now be extended until 30 September 2021, in order to maintain the current level of support for these vital settings. This extension will benefit current DSIS participants, as well as any additional settings who may wish to apply for the support and who meet the criteria for inclusion. We will review the progress of the support ahead of this end-date.

I regret that in this circumstance, due to the need to ensure that there are no gaps in DSIS cover after the current 30 June end-date, the normal 14 sitting days for consideration has not been possible. A departmental minute will be laid in the House of Commons providing more detail on this contingent liability.

[HCWS130]