Sickle Cell Treatment

Janet Daby Excerpts

Wednesday 8th December 2021 Westminster Hall

[Janet Daby (Lewisham East) (Lab)]

There have been some really powerful contributions to this debate, especially from my hon. Friend the Member for Vauxhall (Florence Eshalomi). I appreciate everything that she has shared, including the turmoil and difficulty that was endured when she had to care for her mother. I want to acknowledge that, and show her my appreciation and thank her for her contribution.

I also congratulate my right hon. Friend the Member for Wolverhampton South East (Mr McFadden) on securing this important debate. He knows only too well the need to speak about the experience of children, young people and adults who have sickle cell disease and where they experience health inequalities. People with sickle cell disease desperately need us to raise their profile in this place, and I am so pleased that we are able to do so this afternoon. My right hon. Friend and I have worked hard on this issue together through the sickle cell and thalassaemia APPG.

It is truly shameful that the history of treatment of sickle cell in this country is a story of ignorance and neglect. That disease causes unimaginable suffering, most often to people of African and Caribbean descent, a group of people who already experience medical discrimination. I have frequently spoken out in this place about health inequalities, with specific reference to the impact of sickle cell in diverse communities, and the correspondingly poor investment into care and research. I have heard first-hand stories of the suffering of patients, both their physical pain and the psychological trauma of not being able to afford their medication or their condition not being understood as a student, in the workplace or, indeed, in hospitals. I have heard from people who feel worried about disclosing their illness—about their voices not being heard and their pain not being believed. A young man has told me that he is afraid to attend an A&E department in case he is not believed and treated correctly when he is in a crisis, and that is not the first time that I have heard this. Going into hospital should be about alleviating fears and worries. A hospital should be a place of safety, but that is not the general experience among some people who suffer from sickle cell.

When a doctor or nurse does know how to treat someone with sickle cell, that patient feels confident, but too often, that is not the case. Our nation has already heard about the case of Evan Nathan Smith—[Interruption.]

[Mrs Maria Miller (in the Chair)]

Order. The sitting is suspended for 15 minutes.

--- Later in debate ---

[Mrs Maria Miller (in the Chair)]

Everyone is back now, so I will recommence the debate. Just so that everybody can plan their day, I can confirm that we will end the debate at 4.56 pm. I will call the Front Benchers at 4.24 pm.

[Janet Daby]

Thank you, Mrs Miller. Our nation should know of the case of Evan Nathan Smith, but there were also the deaths of two army recruits during military training. If they had been treated appropriately—all of them—their deaths could have been avoided. One of the young men was aged 21; the other was 31. They were undiagnosed with sickle cell. A coroner warned that their deaths could be repeated without urgent Government intervention. The recent inquiry by the APPG found that the majority of sickle cell patients surveyed had received inadequate healthcare support, adding to their physical discomfort and distress. Our NHS is underfunded, and it needs the resources to train staff to have specialist understanding of sickle cell.

The Government have decided not to fund the research that is so desperately needed and they need to say why that is. Will the Minister give young and old sickle cell sufferers hope for their future by ensuring that training on sickle cell is included in the teaching of medical, nursing and midwifery degrees at all universities and colleges? A further area that needs to be addressed urgently is how to respond to a sickle cell crisis. That information is needed, and these professionals need to know what to do.

A sickle cell crisis is when sufferers experience a severe attack. Their blood cells stick together, and it causes unimaginable pain across their whole body. Sadly, too often medical professionals do not recognise the signs of a crisis. Stigma and stereotyping have a part to play in this, and racial discrimination must come to an end. If necessary pain relief is not given, the condition can worsen and go on to affect internal organs, which causes other medical conditions. At its worse, it leads to death. That can be prevented if the Government have the will to make the necessary changes.

NICE guidelines state that the first dose of pain relief should be administered no longer than 30 minutes after a sickle cell crisis starts. Can the Minister tell me why that target is so often missed? Why does the Care Quality Commission not recommend it as an official guideline? What do the Government intend to do to address this?

The APPG report made several recommendations, including guidance for specific NHS trusts to improve their performance. It requested commitments to raise awareness of sickle cell in the medical community, from paramedics to A&E doctors and senior consultants. Professionals from across the public sector also need to be educated in what sickle cell involves, from nursery nurses to teachers and employers. Children, young people and adults with sickle cell need to be understood.

We should investigate whether we can test every baby for this disease. We know that around 300 babies are born with sickle cell each year. If they have not done so already, I ask that the Minister and her team urgently read the APPG report supported by research from the Sickle Cell Society and take heed of the guidance to change practices. Sickle cell patients like Shubby Osoba are describing sickle cell care as a lottery. On some days, in some hospitals, sufferers get the help they need. On other days, in other hospitals, they do not. That is just not good enough.

Over two years ago I asked the then Health Secretary, the right hon. Member for West Suffolk (Matt Hancock) if he would remove the current charge for prescriptions for sickle cell medicines. Some patients are on five different medications a day. For a lifelong illness, that is a heavy financial cost. The right hon. Member for West Suffolk promised to look into this, but all this time later nothing has changed. Will the Minister take forward this measure and relieve patients of yet another burden on their lives?

I also bring it to the Minister’s attention that it is more cost-effective for the public purse to prevent hospitalisation by adding this lifelong disease to the list for free medication than to treat people with this disease in hospital. I am sure Members would agree that prevention is better than cure. In this case, preventing a crisis by free medicine is much cheaper than being in hospital. I impress upon the Minister the need to have a conversation with the Chancellor concerning this issue. So much more needs to be done. On behalf of those with sickle cell and their families, I ask the Minister to respond appropriately to the serious concerns that have been raised by myself and other Members across this Chamber.

[Mrs Maria Miller (in the Chair)]

I remind hon. Members that we need to go to the Front-Bench speeches at 4.24 pm.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mrs Miller. I thank the right hon. Member for Wolverhampton South East (Mr McFadden) for securing this important debate, for all his hard work chairing the sickle cell and thalassaemia all-party parliamentary group and for the report it has put together. It is a crucial report that highlights some of the gaps in the treatment, management and experience of those with sickle cell disease. I also thank the hon. Member for Vauxhall (Florence Eshalomi) for sharing her experience. Hearing first-hand experience of what it is like to have a family member going through a sickle cell crisis and the experience of healthcare is extremely helpful.

Anyone who has read the “No One’s Listening” report cannot fail to be moved by some of the findings. It is such an important issue when we consider that the majority of patients who suffer with sickle cell are black. The tragic death of Evan highlights some of the disparities that are part of this issue. Managing the disease is much more than a physical problem. I thank the APPG and the Sickle Cell Society for the work they have done to shine a light on the challenges facing sickle cell patients. Any failure in care is one failure too many.

I want to reassure all colleagues here that the Government are not just listening; action is taking place right now. I think colleagues will be pleased by some of the changes already made since the report was done, which we want to build on. I am happy to work with the APPG and Members across the House to address the gaps highlighted in the report.

As the shadow Minister, hon. Member for Leicester West (Liz Kendall), said, working with the sickle cell community is vital if we are to address these issues. NHS England is doing that, working with the community to develop a new service. The specifications have outlined a new model of care for the development of 10 haemoglobinopathy co-ordinating centres for sickle cell disease care in England, each leading a network of care and overseeing specialist teams and local centres.

What this means—what many have described in the debate today—is that those specialist centres, which is where patients experience really good care, feel very confident and get great advice, are now able to reach out to local centres and share their experience, so if a patient does not have access to a specialist centre, they can still access that specialist care through their local facilities. That is only just starting, but it is making a huge difference to the experience of patients and in supporting staff, many of whom might never have encountered a sickle cell patient. Some might have, but that might have been a long time ago. Having the support of specialist input is crucial.

In addition, the National Haemoglobinopathy Panel has been set up to run a national multidisciplinary meeting and to provide clinical leadership and co-ordination for those haemoglobinopathies co-ordinating centres, so that patients’ cases can be reviewed by a national group of specialists, and recommendations and support can be fed in.

NHS England also provided funding last year and this year to develop and update a national register—a database of UK patients with red cell disorders. Previously, although testing has been available for babies to identify whether they have sickle cell, that has never been fed into the NHS. With the new register, GPs and hospitals can all identify who in their local communities has sickle cell, and they can start to plan resources and services accordingly. Hopefully, no one will slip through the gaps, and when a patient turns up at A&E they will be identified as a sickle cell patient without having to explain all the issues that they face.

[Janet Daby]

I thank the Minister for what she is saying about the list that will be created for babies. Will there be a similar list of professionals in certain areas who have experience of working with sickle cell patients? The Minister is saying that the list will be set up retrospectively, but it would be good to know what resources are already available.

[Maria Caulfield]

The hon. Member makes an excellent point. The HCCs—the 10 specialist networks that have been set up around the country—will do just that. People will be registered, so that anyone who lives where there is a sickle cell community but no specialist provision is available can feed in and advice can be passed back and forth. This is the start of the process of making that happen in practice. There has not yet been an evaluation because the service is very new, but it is expected that when it publishes the results of its activity a significant improvement in standards will be seen. The results will be used to target areas of concern. We will see where improvements have been made and where improvements still need to be made. Once the service starts to report back, I think colleagues will be pleased with the progress.

The education and awareness of medical professionals was raised by everyone in the debate, and was highlighted in the “No One’s Listening” report. Health Education England has recently made improvements to the medical curriculum in relation to sickle cell and thalassaemia, and now the curriculum has, as core competencies, modules on those. Health Education England has held discussions with royal colleges to ensure that the curriculum is delivered to all four nations.

There are now two e-learning modules with sickle cell content—NHS screening programmes and the maternity support worker programme—and other e-learning programmes on wider areas, such as anaesthesia, radiology and pain management, are also including sessions on sickle cell. We are making some progress on that, but for me, as someone who has worked in healthcare, that education needs to be ongoing. It is great for people to get some education when they are students, but if they do not come across a sickle cell patient for five or six years, that learning might be at the back of their mind. We also need to focus on ongoing education.

NHS Blood and Transplant is working really hard to improve the service experienced by patients. Given that, until recently, blood transfusions were one of only two treatments for these conditions, much work has been done on that. NHS Blood and Transplant submitted, I believe, evidence to the report and described a number of areas in which it is involved that could be improved. Some of that is being worked on right now, including improving matching of more donors of African descent, improving co-ordination of care and improving consistent access to red cell exchange services. Some work is being done specifically on that area.

As has been mentioned by many colleagues, we know that sickle cell disease is particularly common in people with African or Caribbean family backgrounds. Health inequalities are made much worse if someone has sickle cell or has experienced covid, and we know that in maternity, women from black and Asian ethnic groups have disproportionately negative outcomes. I am meeting the Equalities Minister fairly soon to look at the specific areas of health where black communities in particular are disproportionately affected and have poorer outcomes. I am happy to update colleagues—we are very keen to look at those areas—and to work jointly with the Equalities Minister to improve outcomes in those areas.

The Office for Health Improvement and Disparities, launched this October, plans to tackle health disparities across the UK. The NHS Race and Health Observatory has also developed a new evidence-focused remit to tackle ethnic health inequalities, and sickle cell is one area that it is looking at. Coinciding with the launch of the APPG report in November, the observatory appointed a sickle cell expert, Dr Carl Reynolds, to drive forward work in this area. He is reviewing the evidence that contrasts sickle cell care with other rare genetic diseases, to examine the robustness of sickle cell patient care pathways within the NHS. That work will additionally support the work of other organisations and build on many of the report’s findings.

I will just touch on research and treatment. As, I think, the right hon. Member for Wolverhampton South East said, a new drug has been developed, and recommended by NICE, for sickle cell disease—the first in more than 20 years. It is expected to reduce the number of times that a patient will end up in A&E and go through a crisis. Research is vital to develop new drugs and improve treatments, and I want to reassure colleagues that funding is available.

The National Institute for Health Research has £1 billion per year set aside for research, researchers on any condition can apply for funding from that pot. It is often the case that researchers for rare diseases such as sickle cell do not come forward with proposals because there tend to be far more researchers and clinicians for better-known conditions, and far more charities driving researchers forward to apply for research funding. Not only funding, but help and guidance is available. If there is research that clinicians or academics want to do in this area, we are very keen to see them come forward and apply for that funding. If they are not successful, they will receive feedback as to why that was. Funding is available; it is not ringfenced for any particular condition, so researchers on all conditions may apply.

In conclusion, I again thank all members of the APPG for their hard work on behalf of the sickle cell community, but also for their important report, which highlights many of the discrepancies and gaps that sickle cell patients have been facing. Deaths such as Evan’s, simply because of a lack of care and expertise when he was admitted to hospital, are unacceptable, and we want to change that. I think that today’s debate really highlights how much work there is to do

Health and Care Bill

Janet Daby Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Mary Kelly Foy]

I thank the hon. Gentleman, and I will address that issue.

New clause 5 would close another loophole in the law, which allows the free distribution of e-cigarettes and other consumer nicotine products to children under 18. The Government rejected the proposal, saying that there was no evidence of a serious problem, but the Minister sympathised with the argument for preventive action. Prevention is precisely our intention. Fixing this loophole is an appropriate application of the precautionary principle.

New clause 6 would remove the limitations on the ban on flavourings in tobacco products. That ban currently applies only to characterising flavours. The new clause would extend the flavour ban to all tobacco products, as well as to smoking accessories, including filter papers, filters and other products designed to favour tobacco products. In Committee, the Minister claimed it was unclear how a ban could be enforced in practice, as it would include a ban on flavours that did not give a noticeable flavour to the product. I suggest that he seek advice from Canada on this point, where a complete ban on flavours is already in place and has been highly effective.

The new clauses on the tobacco levy would give powers to the Secretary of State to implement a “polluter pays” levy on tobacco manufacturers. The Minister dismissed this in Committee as a matter of taxation for the Treasury to consider. However, we are not proposing additional taxation. Our new clauses are modelled on the American user fee and on the pharmaceutical pricing scheme in the UK.

[Janet Daby (Lewisham East) (Lab)]

Does my hon. Friend agree that prevention is much better than cure, because so many adult smokers have a terrible experience when trying to give up, and it comes at a huge cost to their health?

[Mary Kelly Foy]

I thank my hon. Friend for that intervention. A theme throughout these new clauses is that most people start smoking when they are children or when they are young, and most of them say that they wish they had never started. The new clauses would tackle young people’s access to tobacco-related products.

Covid-19 Update

Janet Daby Excerpts

Monday 12th July 2021 Commons Chamber

[Sajid Javid]

My hon. Friend is right to raise this. As she says, the rate of vaccination that we have achieved in this country is the envy of the world. We want to make sure that is maintained. We definitely want to make sure that more young people are coming forward. The walk-in clinics that have popped up around the country, and the mass vaccination events that have been taking place in parts of the country, are part of that. We are also looking actively at other ways to promote the importance of vaccination.

[Janet Daby (Lewisham East) (Lab) [V]]

A schoolteacher recently told me that some families cannot afford to self-isolate. If we are learning to live with the virus, why has the Secretary of State for Health and Social Care refused to introduce proper financial support to self-isolate, to ensure that those who test positive can safely self-isolate at home?

[Sajid Javid]

The hon. Lady will know that we have in place financial support for those who need it and who are asked to self-isolate. It is something that is important. It continues to be important, and it is something that we will keep under review.

Covid-19

Janet Daby Excerpts

Tuesday 25th May 2021 Commons Chamber

[Nadhim Zahawi]

I can certainly give my hon. Friend that assurance. We have an independent regulator here in the MHRA and, of course, Public Health England, and we have a yellow card system where adverse incidents are recorded—they can be reported directly by a GP, a clinician or the person themselves. All that data is published and people can access it on their MHRA website, or google it and see it. An incredible part of the success story of the vaccination programme is that sharing of data, which has led to the highest level of vaccine acceptance among adults in the world. The figures suggest that about 90% of all adults say that they will take the vaccine, or are very likely to take the vaccine.

[Janet Daby (Lewisham East) (Lab) [V]]

What steps are the Government taking to ensure that the UK is a leader in the global response to tackling covid-19, especially given the fact that we are not safe until everyone is safe?

[Nadhim Zahawi]

When the Prime Minister set up the vaccines taskforce he gave it two priorities: first, to discover the vaccines that would work, in order to contract for them or to manufacture them in the UK; and secondly, to work out how to help the rest of the world, which is why we were the first country to put £548 million into COVAX and very much establish COVAX, which now has more than 450 million doses, the bulk of which are Oxford-AstraZeneca, which is our gift to the world. Some 98% of the COVAX jabs that have been delivered and have protected people have come from Oxford-AstraZeneca. Pfizer has also been doing the same thing: from day one its chief executive, Albert Bourla, spoke about vaccine equality, and Pfizer is offering vaccines at cost to low and middle-income countries.

Black Maternal Healthcare and Mortality

Janet Daby Excerpts

Monday 19th April 2021 Westminster Hall

[Janet Daby (Lewisham East) (Lab) [V]]

I am pleased to be speaking today on such an important but also disturbing issue. I commend my hon. Friend the Member for Streatham (Bell Ribeiro-Addy) for sharing such a personal, moving story that is so relevant to the debate.

Every death in maternity is a tragedy, but it is wrong that we are having to speak on the issue of black women dying during pregnancy or soon after giving birth in the UK. It is unacceptable that the disparity exists between women from different ethnic backgrounds. It is most distressing that when a mother dies, a child or children are left motherless, not to mention the loss to their partner or spouse and to the wider community. Too many unanswered questions need to be asked, and too many changes need to be made, and that is why we request that the Government work with the NHS to improve maternal health outcomes of black women, women of mixed heritage and Asian women.

As we have already heard, compared with white European women, black women in the UK are four times more likely to die in pregnancy and childbirth, women of mixed heritage are three times more likely to die, and Asian women are two times more likely to die. African women are 83% more likely to suffer a near miss in childbirth, and black Caribbean women are 80% more likely to do so. That is all happening in the UK. It is shameful and outrageous. How and why is it happening? It is a huge concern regarding equality of care. Why are non-white women’s experiences so different compared with those of white women? Change needs to happen, and it is this Government’s responsibility to make the change happen.

These babies are 121% more at risk of stillbirth. Their life chances are limited before they are even born. Do these little black lives matter? I think they do, and I know that many Members in this Chamber agree with that. Immediate interim changes and safeguards need to be put in place now for these vulnerable women to protect their lives: the lives of the mothers and children.

I call on the Government to implement the recommendations in the Joint Committee on Human Rights report on black maternal health, “Black people, racism and human rights”, to ensure that all health professionals record and identify those who are most at risk of poor outcomes, so that protective factors are implemented. I also call on the Government to ensure that there is increased support for at-risk pregnant women. I ask the Secretary of State for Health and Social Care to introduce a plan and target to improve maternal outcomes for black women. Professor Maggie Rae, president of the Faculty of Public Health, has said:

“This year’s coronavirus pandemic has brought this disparity even more starkly to the fore, and we must not lose sight of the actions that are required to address systemic biases that impact on the care we provide for ethnic minority women.”

World Social Work Day

Janet Daby Excerpts

Thursday 18th March 2021 Westminster Hall

[Janet Daby (Lewisham East) (Lab) [V]]

I thank the hon. Member for Ruislip, Northwood and Pinner (David Simmonds) for having secured this significant debate. I am not used to being so high up on the call list, but I very much appreciate it.

For as long as I have been involved in children and family social work, I have only ever known children’s services to be under immense pressure. I say this because unless a person is part of this area of work, the crucial role of children and family social work can be easily misunderstood, and not enough politicians understand children and social services. That is probably why there are so few of us taking part in this afternoon’s debate, which is disappointing. These services have been undervalued and not invested in for many years; they have been cut year on year.

I became a children and family social worker in 1995. I first worked in the emergency duty team, then went on to work with children in need before moving to work in a looked-after children’s team. The red tape and bureaucracy have increased, and the majority of social workers’ time is spent at the office, completing reports and filling in forms, as legislative and policy changes have been made. Obviously, those changes have often been in the best interests of the child, but they have meant that social workers have been increasingly kept away from spending more time with the child.

In my seven years’ experience of working for a local authority, there were five reorganisations. This can be really distressing for staff—having to be re-interviewed and, in many cases, seeing their posts being deleted, changing, or even moving buildings. When support is removed and cuts are made to admin posts or specialist workers’ posts, all of this adds to the caseload of the social workers. Where social workers’ posts are cut, caseloads increase, and what is often overlooked is where the children are in this: the child is supposed to be paramount, but less time is spent with the child.

All of this needs to be rethought, and there needs to be a whole new way of thinking about how to do children and family social work. Every time the Government make cuts to local authorities and the NHS, children’s service provision is affected—the cut is passed on to the child. Fewer social workers and managers and increased caseloads mean less time and less interaction with the child, and less support for them and their families. Cuts also mean a lack of resources and longer waiting lists, causing delays.

I have nothing but admiration for social workers—children and family social workers and social workers across social care sectors within our society. They have one of the most highly stressful jobs. They must be valued, and to value them we must invest in them.

For someone starting in their role as a social worker, it is about supporting families to be healthy, to be happy and to stay together as well as is possible, though sometimes that is not possible. I remember the case of a complex and lovely young person; I had been her social worker for more than three years, but when she turned 16, I was told I had to transfer her to the young persons’ team. She protested vehemently and was vile to me verbally due to the loss, but I completely understood. I knew she was hurting and did not want that level of separation. That is a concern because as legislators we should be flexible. We need to have her and other children’s best interests in mind, and sometimes that means being flexible with our services and ensuring they are not lost while we are focusing on what is best for our institutions or sometimes for the team.

There was another boy I worked with; he was five years old and I worked with him for three years. I remember when I became the senior social worker, he said to me, “If you are becoming the senior social worker, does that mean you’ll still be my social worker?” His case shows the lack of flexibility sometimes within the service. I should have been able to carry on being his social worker, and he should have had continuity of the support he was enjoying at that time. Social services should not be built around institutions; they should be built around the child. We need to ask us ourselves whether the welfare of the child is really paramount, or whether we need to rethink how we do children and families social services. We really need to get this right, because we want children in need and in care to grow up to be well adjusted and to have a bright future.

As I have already stated, the social work profession has always been under immense pressure, but the pandemic has made that even worse. The social work profession is in crisis. Working conditions have got worse compared with what I knew them to be before. The British Association of Social Workers found that 77% of social workers who responded to the survey on working through covid-19 felt that the lockdown restrictions had made it much harder to safeguard adults and children. Many respondents felt there was a definite increase in people being referred to social services. Capacity was already stretched, but the past year has brought it to breaking point. Social workers must be protected from burning out. They have valuable views on how services can be transformed for the better, and they must be part of framing a more effective service for the future.

There were also calls for more capacity to focus on tackling violence against women and girls. That issue has come up in the public spotlight after the tragic events of the past few weeks, but it is something social workers are constantly dealing with. Social work practice frameworks must reflect the areas in greater need of attention, and local social services must have the ability to specialise in the problems affecting their communities—for example culture-specific discrimination or gender-based violence.

With problems in staff retention and growing caseloads, social services remains in crisis. Earlier this week, on the Justice Committee, I spoke to the chief executive officer of the Children and Family Court Advisory and Support Service, who said that we need to rethink and to reinvest in children’s services. I absolutely agree with her.

Covid-19

Janet Daby Excerpts

Monday 22nd February 2021 Commons Chamber

[Janet Daby (Lewisham East) (Lab) [V]]

I am grateful to speak in today’s debate. I extend my thanks to healthcare staff and volunteers up and down our country for their invaluable help with the roll-out of the vaccine. I say that especially to everyone at Downham healthcare centre in my constituency, where I saw the roll-out in action, and it was managed superbly.

In this debate, I will raise concerns about the position of the NHS. The NHS is in crisis. Intensive care units are still overflowing with seriously ill patients who have coronavirus. Doctors are having to make crucial decisions, and many patients with other illnesses are not able to have their appointments.

Prior to the pandemic, I spoke in the Chamber—physically, not virtually—about the nursing shortage. Before covid hit, the shortage of nurses was 100,000, and it was getting worse due to the lack of Government funding for student nurses and the uncertainty for nurses coming from the EU to live and work in the UK. We still have an enormous lack of nurses in hospitals, and there is also a lack of care staff to work in care homes.

Existing staff are overworked and underpaid, and the pandemic has exposed the decline in our health services after a decade of Tory cuts. Furthermore, areas of NHS hospital services are being privatised and given to private contractors, when the work can be done just as well by NHS staff when the money is reinvested into the NHS.

The National Audit Office has shown that the total accumulated debt of NHS providers was almost £11 billion in March 2019. While the Chancellor announced a 10-year plan for NHS support in January 2019, not all healthcare professionals have found this adequate. There are no plans to cover the cost of workforce training and expansion and, crucially, the cost of public health work.

It is purely the efforts of all those staff in the NHS—the doctors, nurses, porters, cleaners, cooks and administrators —that have kept and keep our NHS going, but they need more. We need a health service that is thriving and not struggling to survive. We need a long-term recovery plan that closes the financial holes, and we must prioritise mental health services, which are known as the poor relative to the NHS. Mental health services and CAMHS are needed more than ever as the country begins to recover from the effects of the pandemic, and I truly hope that the Health Secretary and his Ministers are listening to what needs to change and will act on it.

Vaccine Roll-out

Janet Daby Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

I am delighted that my hon. Friend is volunteering in a vaccination centre; that is terrific. This is a big national effort, and he is playing his part. Some 49,000 vaccinations had been done in Nottinghamshire as of 17 January. Clearly we still have to do more, but we are making very significant progress. As I said, the rate-limiting factor is the amount of supply that we get into the country, rather than, for instance, the enthusiasm of GPs in the NHS or, indeed, the number of volunteers who have stepped forward such as my hon. Friend.

[Janet Daby (Lewisham East) (Lab) [V]]

A constituent of mine, Mr Clive Tombs, recently reached out to me regarding the crisis facing the London ambulance service. He told me that no one he knows in the service has had a vaccine, despite their being on the frontline of exposure to the virus. At the same time, we have seen pictures of ambulances lined up for hours waiting to get into A&E departments. Clive suggested that, with some co-ordination from the Department, arrangements could be made for ambulance staff to receive vaccines from hospitals while they are waiting in the queue—if there is a surplus and to prevent wastage. Has the Secretary of State considered that possibility? Does he agree that that is a humble suggestion from Clive when, in fact, frontline ambulance staff should be prioritised for the vaccine?

[Matt Hancock]

Frontline ambulance staff absolutely are and should be prioritised for the vaccine. They are in category 2, and we have to make sure that that happens. I will take away Clive’s idea, work on it and get back to the hon. Lady to see what progress we can make.

Covid-19: Dental Services

Janet Daby Excerpts

Thursday 14th January 2021 Commons Chamber

[Janet Daby (Lewisham East) (Lab) [V]]

Thank you, Mr Deputy Speaker. I congratulate my hon. Friend the Member for Putney (Fleur Anderson) on securing the debate. She has been a persistent advocate for dental care during the pandemic.

We are all aware of the widespread impact of the coronavirus pandemic. A&E departments are overwhelmed, intensive care units have been described as warzones, and essential operations, for example on cancer patients, are being postponed at great cost. In the midst of the sprawling crisis, the effect on dentistry has been overlooked. People have not received the essential dental care that they need, and dental practices have experienced crippling blows to their finances during the pandemic.

The Association of Dental Groups has found that dental practices in England suffered from an average of 45% losses in 2020. Dentists are crying out for Government support, but the Chancellor’s recent announcement applies only to the hospitality and retail sectors. Dental practices will receive no grants and no business rates exemption. The Government need to act so that it does not have a negative effect on our economy.

The ADG found that 35% of business owners expect to employ fewer staff next year, with some planning redundancies. We will lose practices from our high streets, and communities will be deprived of the care that they need. That needs urgent Government intervention and attention. The Department of Health and Social Care must work with other Departments to provide business support grants and relief. Additionally, dentists are still not acknowledged to be critical care workers in this lockdown—a matter that has already been mentioned by other Members, and that the Secretary of State needs to review. Patients have also had to—

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. Sorry, Janet; 4.42 pm has been reached. I do apologise. We move on to the Front-Bench contributions. I call Alex Norris.

Long Covid

Janet Daby Excerpts

Thursday 14th January 2021 Commons Chamber

[Janet Daby (Lewisham East) (Lab) [V]]

I thank the hon. Member for Oxford West and Abingdon (Layla Moran) for arranging this important debate, which I hope will raise awareness of the issue, and cause the Government to reassess the rate of sickness benefit and to invest in research.

Long covid can affect anyone who has caught the virus. It is another one of those invisible illnesses that people cannot see, and many still do not know it exists. Constituents, friends and family have reached out to tell me of their physical and mental struggles with long covid. Persistent breathing problems and coughing, fatigue, dizziness, chest pains and insomnia are some of the things that have been mentioned to me. Even getting a diagnosis has been challenging, with people having to go through all manner of scans and tests. The lack of explanations and solutions has led to support groups being created online, where people with long covid can connect with one another and share their difficulties. But not everyone has online access and not everyone is able to communicate their experiences. Low public awareness of long covid leaves sufferers feeling even more isolated. I would be grateful to hear from the Government how they will raise the profile of this illness.

The NHS is desperate to help these patients, but it needs help from the Government to do this. The Government need to ring-fence funding for research into the illnesses and find treatments. People with long covid also often find their ability to work seriously affected. The economy suffers from this section of the workforce being incapacitated. Sick pay is £95.85 per week. My constituent’s rent in a shared home is £900, with bills, each month they are short of more than £500, and their situation is not dissimilar to that of others, which means that the sickness pay rate is inadequate.

Another constituent asks me:

“How much longer is our society going to keep treating people with illness as a burden? How long are people going to face such hard decisions just to keep living?”.

Although I cannot give my constituent all the answers they need, I, along with colleagues today, call on the Government to recognise this illness, commit to reassessing the sick pay rate, and fund research treatments to cure and help sufferers with long covid.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I realise that a number of colleagues have not been able to get into this debate. As I have said, we had a very short time for it. The Front Benchers have agreed to speak for less time than they normally would, and I now call the Scottish National party spokesperson, Neale Hanvey.