(2 years, 2 months ago)
Commons ChamberI chair the all-party parliamentary group on autism, a role I took on after we lost Dame Cheryl Gillan. From her position in this place, she was tireless in highlighting the fact that there is a difference between those who suffer lifelong development disabilities such as autism and those who have mental health conditions, although it is fair to say that those with autism suffer with a higher proportion of mental health conditions. As things stand, 61% of those in mental health hospitals have autism as a condition—that is 1,200 people—and the figure used to be 38%.
I welcome the Secretary of State’s draft mental health Bill. Will he meet members of the all-party parliamentary group to discuss what the Bill will do for those with autism? Can I also parrot the call from the Chair of the Select Committee, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), about the need to review the sectioning of those in mental health provision? There are far too many people languishing, and they need our help.
I agree with my hon. Friend. The reforms that we have set out today in this draft Bill mean that, in the absence of a mental health condition, learning disability and autism will no longer be a reason for people to be detained in a mental health hospital after an initial period of assessment. I would be happy to meet him and his APPG.
(2 years, 6 months ago)
Commons ChamberIt is always a pleasure to follow the hon. Member for Nottingham South (Lilian Greenwood). I join her in thanking the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) for securing the debate, and for all her work as joint chair of the all-party parliamentary group on dementia.
It is real pleasure to contribute to the debate on dementia research in the UK. As the hon. Member for Nottingham South said, Dementia affects around 944,000 people in the UK, which is 1.33% of the population, and also takes them away from us, sometimes too early. It was the leading cause of death in December 2021, when dementia and Alzheimer’s accounted for 12.4% of all deaths. In 2021, when we were rightly fixated on covid and its impact, covid accounted for 5.4% of deaths. Frankly, we do not talk enough about dementia and what it does. Perhaps if we talked more about the impacts, people might join us in pressing for more change. As the hon. Member said, funding for research is relatively low. Cancer attracts three times as much, despite the statistics I have just given.
All that matters very much to me as MP for Bexhill and Battle, because there are 2,413 people in the constituency living with dementia. That is 2.34% of all my constituents. Of our 650 constituencies, mine has the second highest number of constituents living with dementia. I thank everyone, both in my constituency and across the country, who cares for those living with dementia, and I send my best wishes to all those who have dementia. I want to press for more, so that we get a better deal for those with dementia, and for those who are so selfless and give so much in looking after them, whether they are doing so through their employment or because the person they are looking after is a loved one.
On local interaction, I am very lucky, because we have built up a good deal of expertise through our links in East Sussex. My office team have been trained as dementia friends, thanks to the Alzheimer’s Society. That has helped me to engage a lot better with constituents who face personal challenges. When I was first elected in 2015, I went to a specialist dementia care home in Heathfield. We MPs do not get training for that type of thing—or for many other things—so I asked the matron running the unit, “How do I deal with it when something occurs?” Her advice was: “Just go into the same world as them. Don’t be embarrassed; just go there and be part of it.” I have remembered that advice and followed it ever since. We have ended up doing some very funny things, but I have never once felt silly; I felt as though I was engaging and having fun, and that has stayed with me.
I am really lucky with all our care homes and specialist units. I absolutely love to watch young children come from the schools to read to those in the care homes. Of course, some residents have difficulties with their short-term memory, but some of them have an extraordinary long-term memory. I remember one lady in Battle who did not contribute, but then stood up and recited, without a flaw, “I wandered lonely as a cloud”. It was an incredibly moving moment. The children were shocked, and I will always remember it.
Next week, I will visit a local charity, Young at Heart, where there is a lovely connection between young people from schools and preschools, and those who are older.
I myself remember starting to dance with an old lady, and the dance was endless. It was one ballroom dance, then another, a third and a fourth. Finally, the care home attendant had to come and take me away, and he said, “She is a former professional dancer. She will dance with you all afternoon, unless we stop.” Is there a problem that people are scared of folk with dementia? Should we be teaching dementia awareness, which the hon. Gentleman raised, at schools?
The hon. Member is absolutely right. I feel that a lot of us are scared. Actually, a lot of hon. Members are perhaps scared that they are making a fool of themselves, but they are not. They are making their constituents happy that they are there with them. I have done something very similar to the hon. Gentleman. It is right to teach young people about dementia in schools and almost require every single school to have that partnership, to encourage young people to feel as if they can let go. It is an excellent suggestion. I hope the Minister heard it and will take it into account.
We are fortunate to have local pioneers. Mention has been made of ensuring that people get tested, because early intervention can help a great deal. A year or so ago, I visited a pioneering local memory assessment service based in Bexhill, which supports patients with dementia across both my constituency and the wider East Sussex coast. Dr Stephen French, who leads the memory assessment service, is a GP, which makes the service quite novel. I took part in a memory assessment test and went all the way through it myself, to see exactly what those who participate have to undertake and how difficult it is.
The service has been running for seven years and has proved successful with local residents. What is great about it is that it is a community-based dementia service, so anyone presenting with a memory problem will be seen by their local GP in the first instance. After they have gone through other causes of memory loss, such as depression or circulatory disease, they will be referred to a local dementia specialist for a full assessment, at a GP close to their home. So, they could be having that difficult test with their own GP. That means that those who are already worried about memory loss are able to go into setting with which they are more familiar. It is less intimidating than going to a hospital or mental health hospital, which is where such tests sometimes take place. Unsurprisingly, it means more people will take up the offer and attend the test. That is hugely important for a constituency such as mine, where there are so many people who are impacted.
When the test is positive, that comes as a great shock to both the individual and their family, but with this particular service, two weeks after diagnosis patients receive a visit from a local dementia support worker to see how they are getting on and to discuss the range of support services available to them. Then there is aftercare, followed up by a medical review to see how the patient is coping and to assess the effectiveness of any medication. Their pathway then comes back into their own GP service, so it becomes one of the conditions that they are being treated for.
As well as talking about research, which I will go on to mention, I feel that we have to encourage early diagnosis in a local setting, and we have to take away the stigma of it. That comes back to the point made by the hon. Member for Ochil and South Perthshire (John Nicolson) around interacting. There is also a stigma about going to have the tests. I would encourage any colleague of mine to go and have the test, in the same way that I have. It is incredibly insightful.
Let me return to the main thrust of this debate, which is about research. I agree with the hon. Member for Oldham East and Saddleworth that this debate should be about hope. I agree with her that research will find that cure, and I agree with her that it is a case of “when”, not “if”, but I also agree with her that it requires continued funding of the amazing life science and research sector with which we are blessed in this country. I particularly note the UK Dementia Research Institute, which was set up in 2017. Its main hub is at University College London, but there are six other centres across the UK, funded by the Medical Research Council, Alzheimer’s Society and Alzheimer’s Research UK. It will be doing the job to deliver the moonshot cure that the hon. Member talked about, but it will require a good chunk of the £5 billion committed in the 2021 spending review to go into research on dementia.
I am encouraged by the Government’s track record. In the five-year plan in 2015, the Challenge on Dementia, there was a commitment to spend £300 million by March 2020. In fact that amount was spent by March 2019, and it was £344 million. So the track record is there, but there were some bold pledges in my own 2019 manifesto on what we would do as a party to help deliver that cure for dementia. Let me say to the Minister—I know that he cares deeply about this issue—that if he needs any help at all in trying to strong-arm as much of that budget as possible towards dementia, he will always have a friend in me.
It has been a pleasure to speak in the debate. This is an issue that affects so many of my constituents—so many wonderful people who care or who suffer. I am delighted that we have secured the debate, and have raised the flag for them.
(2 years, 6 months ago)
Commons ChamberThis Government will always listen to the evidence and be guided by it, as they have been today.
Unlike a number of my colleagues here, I did actually vote in favour of these measures back in December. I did so because I felt that it was important that those going into hospital had the reassurance that those caring for them were fully protected. I understand the Secretary of State’s point that the matter has now changed, but I regret that that is so, because I still feel that my vote was the correct one. May I ask my right hon. Friend this specific question just to assist me to get to the right place with him? He mentions that he asked for fresh advice from the health regulators, and no doubt they advised that this was no longer proportionate in these changed circumstances. Did that precipitate a change in the legal position—that being one of the limbs for judicial review—which means that there is a legal requirement for our having to change course as well?
(2 years, 8 months ago)
Commons ChamberOver the past year I have supported some covid measures and voted against others. With that in mind, my constituents may be struggling with the logic of my voting record, but I believe it is straightforward and I hope to exemplify why that is the case.
Where the measures have felt disproportionate to the wider harm, I have voted against their introduction. An example was putting the constituency in differing tiers when hospital admissions were low. Where the hospitals could not cope, I did support lockdowns as proportionate in those dramatic circumstances.
Where the wording of measures felt contrary to the aims they sought to deliver, I voted against their introduction. The 10 pm curfew was a good example of that; everyone piled out of the pub and on to public transport, and the Government eventually conceded, and reversed. That was the same concept that led me to vote against last week’s self-isolation regulations. I could not understand why, when omicron was going to become the dominant variant, we were requiring people to self-isolate; it would have led to a pingdemic. I am glad that the Government are reversing that today and I will gladly support that regulation.
As for the other three, my thoughts are as follows. For face coverings, I voted for the same outcome for retail and public transport last week. I do not want to see face coverings become a permanent feature and I do not want to see them reintroduced in the classroom, but for a limited period of time, in a settings reference, it feels right to me to extend the scope. On NHS workers being vaccinated, I voted for the same outcome for the social care workforce, and will do so again. We know that getting vaccinated reduced the delta transmission rate by 60%. We also know that patients who get vaccinated are not completely protected from serious illness or death. Surely, if care is in the DNA, it is not unreasonable to expect vaccination to be an entry point. If NHS workers believe that their own choices come before the safety of their patients, or if they do not believe that the NHS is about working for covid and working for vaccines, or that the evidence on those is true, I question if they are in the right profession.
For vaccine certification at larger venues, I am genuinely perplexed about the outrage at, at worst, showing paperwork. Last month, I got asked for my passport when I came back into the country. I have to show evidence of purchase when I watch a football match. I was also delighted to be asked for ID showing my age when I wanted to buy a beer, only a month back. What is the issue in temporarily asking someone to evidence vaccination, or a negative lateral flow test, for certain venues? If it keeps people safe, and in jobs because we do not have to put more draconian restrictions on events and hospitality, I am happy to oblige.
The impact of the omicron variant is not known. What we do know is that the doubling rate is two to three days; for delta it was seven days. In South Africa, where the variant emerged, the hospitalisation rate is now rising. Yes, the vaccination rate is lower in South Africa. However, it is also their summer, they have a higher level of antibodies from natural infection, and the average age is 13 years lower than in the UK. These restrictions are limited in time and scope. I ask myself, “What is it that I will not be able to do tomorrow that I could do last week?” The answer is, absolutely nothing. A little more face-mask-wearing. A little more admin to go to the football. If you are an NHS worker and are not going to vaccinate, there are a record number of jobs available for you to work somewhere else.
There is a larger issue at play, which I find infuriating. Over 80% of my constituents have got themselves vaccinated. They are keeping themselves and their communities safe. They are minimising their own impact on the NHS. There are a small minority who are not playing by the same rules, and have the temerity to lecture me on freedom. Let me tell them this: their freedom to remain unvaccinated and then do as they choose is reducing the freedoms of those who have done the right thing for themselves and the wider community.
As a Conservative, I believe that rights are not absolute: they have to come with responsibilities. Being a cavalier for freedoms is what we were sent to this place to be. Being cavalier about the health of the public is contrary to that principle. With that in mind, I will be supporting these proportionate and limited measures this evening.
(2 years, 8 months ago)
Commons ChamberGPs, particularly in rural areas, are finding it difficult and challenging to deliver the booster programme, but will have to deliver the booster in great numbers. Can the Secretary of State look at measures that will speed up the flow for those GP surgeries? Will he send a message to all patients that they will need to be understanding in the next couple of weeks to ensure that the morale of our GPs, who work so hard, is not undermined?
My hon. Friend is right to talk about how hard GPs have worked throughout the pandemic, and about the need to provide greater support. We expect and need them to help with this big new vaccination effort. There are already signs of many people showing that they understand the need for GPs to reprioritise over the next couple of weeks, which is important too.
(2 years, 8 months ago)
Commons ChamberWe are still seeing hospitalisations and deaths in people who are doubly vaccinated. The reason we are delivering boosters in all four health services is because that immunity is waning. What we are concerned about with omicron is that if it is able to immune escape, it could push us backwards. Therefore, we simply do not want it to become re-established and undermine the achievement that vaccines have made.
The British Medical Journal review, to which the right hon. Member for South West Wiltshire (Dr Murrison) referred, showed that masks had as big an impact as hand hygiene, so surely we should do both. Neither of them has a major economic impact. We are not talking about locking down. We are not talking about shutting businesses. We are talking about everyone trying to protect everyone else, so that they can continue to be active and continue to be out in society.
It is important to remember that even if our current vaccines were shown to be less effective against omicron, they would not have no impact. We already see that impact on delta with regard to spread: the reduction is only about 50% but it has markedly reduced hospitalisation and death. We would therefore still hope for that with omicron, so pushing vaccination and encouraging people to get boosted remains as important as it always was. Delta is still by far the most dominant variant circulating in the UK.
There is no evidence as yet of differing symptoms or severity, but one of the weaknesses of the data from South Africa is that the initial outbreaks were in students. Young people tend to get milder infections and we do not yet know what omicron will be like in an older or more vulnerable population.
We have one advantage in the diagnosis of omicron: the S gene, which is one of the three genes that common PCR tests look for, is missing. That means that rather than having to wait for genomic testing, which takes quite a long time, we get a heads-up or an early warning on the PCR test. There is a sub-group with S-gene dropout, which means that the chances are that it could be omicron. Those patients could be warned and their samples can then be sent for full genomic testing. In Scotland, a retrospective review of recent PCR results looking for S-gene dropout has identified the nine patients with omicron. I assume that similar work is happening in the other nations across the UK. In contact tracing of the nine patients, there is no evidence of a connection to either COP26 or the South Africa rugby game, but tracking continues.
PCR testing is, therefore, even more important. Lateral flow tests—which, hopefully, we are all doing regularly before coming here—cannot detect variants. It is a simple yes/no that someone does themselves, with no access to take further analysis. Lateral flow tests had been allowed as part of travel testing. In the Netherlands, 600 passengers arriving from South Africa were tested and one in 10 were found to have covid—an incredibly high incidence and much higher than we have anywhere in the UK—and a fifth of those cases were already omicron. Omicron is not just in southern Africa or in the UK. As a result of the use of lateral flow tests, it is probably already more widespread than we think. It is therefore welcome that today the Government returned to PCR testing for travellers rather than lateral flow tests, and that they are quickly re-establishing quarantine, but people should have a PCR test before they travel. It is rather like shutting the stable door if we find that someone is positive when they have just spent eight hours on a plane with hundreds of other people.
Is the hon. Lady not concerned, as I am, that there is too much emphasis on PCR testing for tracking variants of concern? During a three-week period in July, there were 500,000 PCR tests, of which 7,000 were positive for covid. Only 5% of those 7,000 were tested for variants of concern, so this is not quite the silver bullet on variants of concern that she might hope it would be.
I was not claiming that it was, because genomic testing takes a couple of weeks generally and it is therefore too late for someone to isolate. What I am saying is that with this variant, as in alpha but not in delta, the missing S gene means that on that initial test—which takes six hours or until the next day, or whatever it is—we already get a heads-up that we are dealing with an omicron case. We can go on to do the genomic analysis, but we can say to the patient, “We think you have this variant. You need to isolate thoroughly and for longer.”
Yesterday, I intervened on the Secretary of State and during his statement he repeated to me:
“we will not keep measures in place for a day longer than necessary.”—[Official Report, 29 November 2021; Vol. 704, c. 679.]
With that assurance in mind, I thought I would come to listen to this debate and speak on behalf of the transport sector, which relates to my Select Committee, willing to support these measures as proportionate measures in circumstances where we do not know whether the new variant will have an impact on transmissibility and on our vaccine effectiveness. On regulations 1340, on face coverings, I can get there in that regard because they expire on 20 December and they are well set out. I have concerns about the way the transport sector is somewhat singled out, albeit with retail, as perhaps being an unsafe setting, whereas hospitality is marked differently. If we put £10 billion into the rail network alone just to keep it going, sending out a message that it is a less safe setting than a pub or restaurant will not be the way to give people confidence to get back on to that network which we need to survive.
I also have concerns about what happens on the buses, given what I witnessed today. That may well have been because people had not tuned into this debate and did not realise that these regulations had already come into force. People are still getting on board without a face covering. Despite the powers given to drivers to ensure that they do not do so, there is no questioning and on they go. Not only does that wind people up, but it leaves others thinking, “What’s the point in bothering? If not everyone is wearing a mask, what’s the purpose of anyone wearing one?” However, I can get there on those regulations because of the unknowns that we need to deal with.
One of the wonderful things about coming into this Chamber is to be educated. I might make the point that my hon. Friend the Member for Winchester (Steve Brine) has made: perhaps more of us can come here and be educated. I have grave concerns about the issues around regulation 1338, on self-isolation. If the aim is for us to be covered for no longer than is necessary, why do they have no end date and default to 24 March? The impact of these regulations is even greater than our having to wear a face covering for longer periods because, as has been mentioned, we could well be back to “pingdemic” territory.
I emphasise that the regulations mean that, regardless of a vaccination having been given, one has to self-isolate for a period of time if there is a suspicion that one has been in contact with someone who has the omicron variant. Right now, and perhaps for the period up to 20 December, I can understand that the suspicion would perhaps be linked, as the transmission rates are slower to build—one would hope that would be so for the next few weeks—to whether one had been in contact with someone who had been in South Africa, or something on those lines. If, however, we move to 24 March and the variant has spread fast but, as we hope, it has not had a negative impact on the vaccine, we could see the default option being, “I have come into contact with somebody who has covid. I did not know whether they had omicron or not, because that does not tell me that. Therefore, I must be cautious, as we are always told to be. Therefore, I must self-isolate.” Then we could see the whole country being pinged again, as it has been before.
The situation could even be worse than that. If it turns out, as is currently being discussed in South Africa, that although the strain may transmit quickly it may not have the same impact as even the delta variant, stopping people being out and about may make things worse, because they will not get the antibodies that we want them to get. Surely those on our Front Bench are aware of that. The beta variant was a variant of concern, and the amber-plus regulations were brought in, as there was a concern that beta would have been worse against the vaccine than delta. It turned out that one dose of AstraZeneca was more effective against the beta strain than two doses of it were against delta. So variants of concern can quickly turn out not to be a concern at all.
That is why we must make sure that our legislation stops and is flexible and nimble, yet these regulations will roll on until 24 March. That is what our job in this place is about; I can agree in principle that there is a need to take measures, but I cannot vote for legislation that does not actually do what I believe the Government intended it to do. There are options, and they can be used right now. The Minister could stand at the Dispatch Box and find a way to reassure those of us who have the same concern. Alternatively, the default option for me is to vote against this legislation, not because I disagree with the principle, but because I disagree with voting for legislation that I know to be poor, badly drafted and not to meet the intention. Surely we should not be stubborn and pig-headed when legislation does not work; we should fix it or we should vote against it.
I have one last point to make in relation to a motion that I thought would be before us but is not—one that deals with the restrictions on travel and the introduction of PCR testing. Yesterday, the Secretary of State also reassured me that PCR testing would not be expensive and that we would not be at the mercy of unscrupulous providers, as we saw happen during the summer. A wise person just told me about an incidence of a three-hour PCR test, which many will need to take in order not to have to self-isolate—that is good for the economy—costing more than £200. Why are these regulations being laid under the negative procedure? We need to be discussing that legislation and finding the pitfalls, as we have with the regulations before us—I applaud my colleagues for doing so this afternoon—yet they are not even being brought forward.
I wish to return to the point I made earlier, and I wonder whether my hon. Friend shares my genuine concern. As he said, we are here today because of a variant that has been discovered. More variants are going to be discovered and the cost of the PCR test will make people think carefully about going abroad, and that is going to have a devastating impact on the high street, travel agents and holidays. Does he agree that this issue has to be taken as a whole, and that it cannot be separated out so that every time there is a variant we say that we have to shut everything down?
I do agree with that, and it is a good point for me to end on. Let us look at not just the consumer, but those who work in aviation. Some 5,000 jobs have been lost on a monthly basis since February 2020 in that area; this has been an absolute disaster for the aviation and international travel sector, and for those who want to trade around the world. We had just started to see the easing of restrictions, with no damage to public health at all. My right hon. Friend is right to say that we need to learn lessons. It is okay for us to take tentative steps perhaps this once, on a limited basis, but we cannot keep shutting down parts of the economy every time there may be a variant of concern. Otherwise, to quote the Prime Minister, we will never “live with” this virus.
(2 years, 9 months ago)
Commons ChamberI said earlier that, out of the 100 million commitment that the UK has made to international donations, over 20 million have already gone and been delivered, and another 10 million are about to go.
The return of PCR testing will be met with some apprehension by the international travel sector, which has just been getting back on its feet, but it will at least be cheered by the Secretary of State’s statement that we will not keep measures in place for a day longer than is necessary. Can I ask the Secretary of State to ensure that the providers of PCR tests are those that will actually give accurate, good-value testing back to the public, and that we will not see some of the issues that arose over the summer repeat themselves?
My hon. Friend makes a very important point. I know he rightly takes a close interest in this; we do want to minimise any impact on our excellent transport and travel sector. He is right to raise the importance of making sure that PCR tests are available, the pricing is correct and the Government website where providers are listed is properly monitored so that anyone who breaks the rules is delisted.
(2 years, 9 months ago)
Commons ChamberMy hon. Friend is absolutely right to make those points, and I can give those assurances. The police have informed my Department that all the families of all the victims have been contacted. They all have family liaison officers. That support and other support, such as counselling and mental health support, if required, and the 24/7 telephone line that I referred to, will remain in place for as long as is necessary. Indeed, if she and other Members of Parliament who have constituents who are affected think that there are other ways to provide support, of course we would be willing to do that.
I thank the Secretary of State for his words and his action; it is much appreciated, as is the solidarity shown by the shadow Secretary of State, the right hon. Member for Leicester South (Jonathan Ashworth). I also thank my right hon. Friend the Member for Tunbridge Wells (Greg Clark) for leading the local MPs on this difficult matter.
The nation has been absolutely appalled and horrified by the actions that we have heard about, and none more so than the people in Heathfield, where Mr Fuller was arrested at his family home. They are good people who have been shocked by what they have found out. My constituents use the Maidstone and Tunbridge Wells NHS Trust. It is an excellent hospital, run by some brilliant management and fantastic staff. Will the Secretary of State make sure that those staff and management have all the support that is needed to ensure that patients receive their ongoing care?
Yes, I can give my hon. Friend that assurance. His local hospital does some excellent work in supporting local people in all their health needs and has done so for a long time. I have no doubt that this news will be incredibly distressing to all the people who work in the hospital, and they will get the support that they need. The other support that is necessary for the hospital to continue with its good work and care will remain, and will remain very important.
(2 years, 11 months ago)
Commons ChamberI know that the international travel sector will welcome the framework. Given that it will come out on 1 October, will that give colleagues, and indeed Select Committees, the opportunity to feed in their ideas on behalf of their constituents? Will the Secretary of State entertain the idea of moving to lateral flow tests, which are cheaper, with only the small proportion of positive cases needing to take a PCR test?
(3 years, 1 month ago)
Commons ChamberThe hon. Lady raises an important issue. We have seen, sadly, that through the pandemic, because of various inequalities up and down the country, some people have suffered a lot more than others. It is an important point, and we need to do more—we all collectively need to learn from this. I give her the assurance that I know that Public Health England and the chief medical officer are looking into it and will report to Ministers shortly.
I welcome the Secretary of State’s statement, but may I ask for clarity? On the legal requirement to wear face coverings, including on public transport, he stated that
“we will advise this as a voluntary measure for crowded and enclosed spaces.”
Should that be “crowded enclosed spaces”? Does he intend to put out guidance? What will he do to ensure that private operators cannot mandate it outside that guidance?
I can tell my hon. Friend that the guidance is really asking people to use their common sense. If there are many other people around them, particularly if those people might be more vulnerable—older people, let us say, or groups who for some reason may be unvaccinated—we are really just saying, “Use your common sense.” I think that everyone in Britain will do just that. In private settings, it will be up to private businesses—shops, for example—to decide what they wish to do.