Public Health

Debate between Huw Merriman and Philippa Whitford

Tuesday 30th November 2021 Commons Chamber

[Dr Whitford]

We 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.

[Huw Merriman (Bexhill and Battle) (Con)]

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.

[Dr Whitford]

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.”

NHS Winter Crisis

Debate between Huw Merriman and Philippa Whitford

Wednesday 10th January 2018 Commons Chamber

[Dr Whitford]

There will obviously be lots of bandying around of figures, and talking about the four-hour target and the achievements and the numbers, and, as I have said, it serves as a thermometer to look at the entire system from the patient turning up at A&E to their going home. That is what this is a measure of, and it is there to flag up concern. While we will be getting that data, we do not need it; we have already seen ambulances 12-deep, and have already heard that 75,000 patients are stuck in ambulances for between half an hour and an hour, and 17,000 stuck for more than an hour. As was mentioned by the right hon. Member for North Norfolk (Norman Lamb), who is no longer in his place, this means that those ambulances are not available to respond to other 999 calls, which endangers patients.

[Huw Merriman (Bexhill and Battle) (Con)]

I think the hon. Lady for giving way, and I apologise if she was still answering the point made by the hon. Member for Dewsbury (Paula Sherriff). I accept her point that many of those who are in A&E need to be in A&E, but the reality is that admissions to A&E have gone up 20% over the past 10 years to 6 million per year. Does she agree that more interventions could be made by GPs to prevent some of those admissions from being made and to allow people to be looked after in their own homes?

[Dr Whitford]

I am not 100% sure whether the hon. Gentleman meant attendances at A&E or admissions, which is what he said—

[Huw Merriman]

Attendances.

[Dr Whitford]

Attendances at A&E tend to be higher in the summer, when kids are on bikes and trampolines, and up trees. It is admissions that are higher in winter, when A&E is dominated by people who are sick. Of course we want primary care and the 111 system to work, so that people do not use A&E as a first port of call, but the problem comes when that all gets too complicated and patients cannot work out where they should go. That is when they go to A&E. It is important to make it really clear where they should go to address which problems.

Having seen the crisis last year, when there was no flu, snow or ice to blame, I believe that there are underlying structural problems. The target was met comfortably until 2013, when the Health and Social Care Act 2012 changes kicked in and NHS England started to become fragmented and to be based on competition instead of co-operation. I would welcome the establishment of a cross-party group here to work on this, so that we did not always have to have these debates, but it would have to look at the structure and unpick what has been done to NHS England in the past four and a half years. Carrying on breaking it apart will not provide a solution.

State Pension Age (Women)

Debate between Huw Merriman and Philippa Whitford

Thursday 7th January 2016 Commons Chamber

[Huw Merriman]

I absolutely take that point, but it would be naive not to recognise that as we live and expect to live healthier lives, we not only can but want to work for longer.

[Dr Philippa Whitford]

Will the hon. Gentleman give way?

[Huw Merriman]

No. I will make some progress, if I may.

The question remains: what, if anything, can be done to lessen the impact on those who will now have to work for longer before qualifying for their state pension, particularly those who it can be demonstrated were not notified over time, as they should have been?