(4 years, 8 months ago)
Commons ChamberThe hon. Lady has long been a campaigner on this subject. We have made significant progress in terms of expanding access where it is clinically safe to do so. On this, as on so many things, I will make sure that I constantly follow the clinical evidence.
My right hon. Friend knows that for every person who tragically dies from coronavirus, at least one other person has long-term symptoms lasting more than three months, meaning that they have breathlessness and chronic fatigue and often cannot go back to work normally. In his letter to me of 14 September, he said that clinics were going to be set up so that they could get mental health support, face-to-face counselling and rehabilitation. Have those clinics been commissioned, and when will those long covid sufferers be able to access them throughout the country?
(4 years, 9 months ago)
Commons ChamberI will start by answering a couple of factual questions. As I said in my statement, as of 9 am this morning, 51% of these cases have been contacted by the contact tracing system, and their contacts are contacted immediately after the initial contact—concurrently.
The hon. Gentleman asked about the tiering system. Absolutely, extra support will go to areas where there is an increased number of cases. He asked about the criteria in the proposed approach. Of course, we cannot have fixed and specific criteria, because it depends on the nature of the outbreak. For instance, if there was an outbreak in one individual employer, we would not necessarily put the whole local area into local action. We try to make the intervention as targeted and as localised as possible, but sometimes it needs to be broad, as it is in the north-west and across large parts of the north-east. For example, the intervention in the west midlands covers four of the seven council areas of the west midlands, but not the other three, because that follows the data.
The hon. Gentleman asked about the particular IT system in question. The problem emerged in a PHE legacy system. We had already decided in July to replace this system, and I commissioned a new data system to replace the legacy one. Contracts were awarded in August, and the work on the upgrade is already under way. While, of course, we have to solve the problem immediately, we also need to ensure that we upgrade this system, and we have already put in place the contracts to ensure that that happens. In the meantime, it is critical that we work together to fix these issues, which were identified by PHE staff working hard late on Friday night. I want to thank the PHE staff who did so much work to resolve this issue over the weekend.
In answer to the hon. Gentleman’s final question, we need to ensure that we contact trace all those cases as soon as possible. In two days, we managed to get to 51% of them, and that work is ongoing.
The Health Secretary deserves enormous credit for the expansion of testing capacity that he has personally championed, but is not the underlying problem that the Lighthouse laboratories have been, and will continue to be, overwhelmed by demand? Do we not need to think about the structures and, in particular, whether the responsibility for NHS staff testing and care home staff testing should be moved to hospital laboratories and universities, in the way that was advocated this morning by Sir David Nicholson, the former chief executive of the NHS? Sometimes it is tempting to think that, by dealing with the latest problem, we will solve the whole problem, but ahead of winter and the second wave, we need to think about whether these structures are right for what we have to deal with.
The expansion of the NHS testing is, of course, critical as well. The system in question, where the problem was over this weekend, brings together the data both from the NHS systems and from the so-called pillar 2 systems. The challenge was in a system that integrates the two, rather than just on one side or the other, but my right hon. Friend makes a broader point, which is that as we expand the NHS’s capacity as part of the overall expansion of testing, we have to ensure that we use that capacity to best effect. In many parts of the NHS, increasingly, it is NHS testing capacity that is used for NHS staff testing. That system works well, because the test is local and convenient, and we are looking to expand in exactly the sort of direction that he outlines. I urge colleagues away from trying to bifurcate between the two systems. Essentially, we have a whole series of different ways to access a test, and we need to make sure that people get the tests that are easiest to access for them as much as possible.
(4 years, 9 months ago)
Commons ChamberI will support the Government today because, although I fully understand the concerns about parliamentary scrutiny eloquently expressed by my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), the biggest threat that we face as a country is not the erosion of liberty but the explosion of the virus. We now know, as we go forward into a second wave, that for every death directly caused by covid there is at least one death indirectly caused by the disruption to cancer services, the interruption of emergency care and people being discharged early from hospital.
I wish to ask the Government about measures that could reduce such indirect deaths, particularly the introduction of the routine weekly testing of NHS staff, which we have discussed many times in the House—I see the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth) smiling. In fairness to the Government, they have moved on this issue. In July, Chris Whitty told the Health and Social Care Committee that he supported the routine testing of asymptomatic NHS staff in hotspots. I would like there to be such testing everywhere, including in my constituency, where recently we seem to have seen live cases trebling, but even in the hotspots it is not currently happening with any consistency. That is a worry, because up to a fifth of staff in hospitals got the virus during the first wave and up to 11% of deaths of coronavirus patients were caused by patients having caught the virus in their own hospital. That is the context.
I recognise that some hospitals are trying to do routine testing, but it is very difficult for them to do it on a weekly basis when they cannot access pillar 2 testing, so will the Secretary of State ask all hospitals to make weekly testing happen, under their own steam if they can, or with the support of NHS Test and Trace supplying the reagents, or using pooled testing?
My hon. Friend has done a lot of campaigning to highlight that issue, as have Select Committee members from all parties. The Select Committee will publish a report tomorrow that considers that very issue and will be coming back to it.
The Government’s own figures show that at least a thousand additional cancer patients died because of the interruption caused by the pandemic. As we go into a second wave, it does not have to be the same again. The Government have rightly introduced weekly testing for people in care homes; the arguments are exactly the same for our hospitals. Patients need to know that their NHS hospital is safe and NHS staff need to know that they are not infecting their own patients. As we go into this very difficult period, please, will the Government act and make this happen?
(4 years, 9 months ago)
Commons ChamberI am grateful to the hon. Gentleman for his constructive approach in these difficult times. He and I agree that the strategy of suppressing the virus while protecting the economy and education is the right one. In so doing, it is important to act fast so as not to have to act bigger later. I also agree that no one in this House came into office to put in place restrictions like these. He asked about the importance of people following the rules that we have put in place. It is vital that all people follow the rules. The vast majority have done so throughout but, critically, enough have not, meaning that in many cases we have had to make the rules mandatory, rather than relying on people’s sense of civic duty. That is the fundamental judgment behind making self-isolation mandatory, as I announced in the statement.
The hon. Gentleman asked about testing. Of course, we have record testing capacity right now—a record 233,000 tests were done on Friday—and lab capacity will continue to grow. He also asked about the NHS testing capacity, which will also continue to grow. In fact, I had a meeting about that earlier today with Simon Stevens, the head of NHS England. The hon. Gentleman asked about pool testing and saliva testing, which are just two of the many new testing capabilities that we are bringing to bear. He also asked me to ensure that there will be no admissions to care homes without a test. That is our policy: not just no discharges from hospital into care homes without a test, but no admission from anywhere into care homes without a test. That was reiterated in the social care winter plan that we set out on Friday.
I suppose that at the heart of the official Opposition’s response, and at the heart of my response to the hon. Gentleman, is the fact that we are united in wanting to tackle this virus, and in sending the message to everyone across the country that it is critical that we all follow the rules and play our part so that we can suppress the virus while protecting, as much as possible, the things that we love.
I support the measures outlined by the Health Secretary, which regrettably are both necessary and proportionate. Last week, on World Patient Safety Day, the WHO announced a charter for health worker protection, which asks all WHO member states to commit not only to having adequate supplies of personal protective equipment and mental health support, but to ensuring that there is zero tolerance of violence against health workers. Will he commit the Government to signing up to the charter so that, as we go into a second wave, all our brave frontline workers know that this Government and this House stand four-square behind them?
Yes, I will happily sign up to the proposals that my right hon. Friend has set out. As the House well knows, his long-standing and international work on patient safety is very impressive. We must ensure that in these difficult times we protect our care workers and frontline staff—including, if I may say so, the staff at the testing centres—and that we reiterate once again our commitment to patient safety.
(4 years, 9 months ago)
Commons ChamberTo respond to the constructive questions that the hon. Gentleman raised, I welcome his comments on the use of 111 First. The purpose of 111 First is to improve access, including in terms of inequalities in the NHS, by ensuring that people get the right treatment in the right place and easier access if they do need to go to an emergency department, because the emergency department will know that they are coming. It is commonplace now in almost every part of our life to let people know that we are coming. If we are going to do something as important as visit an emergency department, it will help both the patient seeking treatment and the NHS to let them know that they are coming first. That is the principle behind 111 First. It sits alongside 999, which anybody should call in a serious incident.
The hon. Gentleman asked about the need for extra funding for the NHS, both for winter and for testing. I have just announced £2.7 billion of extra funding for the NHS, and he might have done better to welcome it. He talked about tackling the backlog of cases that inevitably built up in the first peak. The good news is that we are making progress on tackling that backlog and reducing it. Of course, there is an awful lot of work to do, and part of this extra funding will go towards that, alongside the funding to expand our emergency departments, the funding for PPE and the funding for testing that I mentioned in my statement.
The hon. Gentleman asked about PPE for care homes. We have a huge plan to ensure that care homes can get PPE, and the details will be set out shortly in the social care winter plan. He asked about family visits. The challenge of visits to those living in care homes is incredibly difficult, because nobody wants to spread coronavirus, but we also need to ensure that those who live in care homes get the support that they need and deserve.
The hon. Gentleman asked about testing. Of course there is a challenge in testing. The central point is that, contrary to what he said, capacity is at record levels and has increased week on week. The challenge is that demand has gone up faster—[Hon. Members: “No, it’s not.”] Those on the Opposition Benches can say, “No, it’s not,” but they cannot defy the facts. The most important thing for everybody across the country to hear from their elected representatives, if they are interested in helping the country get through this pandemic, is: if you have symptoms, get a test, and if you do not have symptoms, please do not come forward to get a test unless you are specifically asked to. That is what colleagues on both sides of the House need to be repeating to their constituents.
The hon. Gentleman rightly raised prioritisation—I like him, and he raised exactly the right point, which is that we choose to prioritise care home staff and care home residents. Over 100,000 tests a day of the 260,000 capacity are sent to care homes. We could solve other problems by not doing that, but we prioritise those who live in care homes because that is the right thing to do. He asked about areas where there are restrictions. We prioritise putting tests into areas of restrictions, such as Leicester, where there were over 1,000 tests yesterday. This is the core point: when something is provided for free and demand is therefore high, we have to prioritise where we put our national resources. His tone on prioritisation was almost at the point of welcoming it, and welcome it he should. He also asked about universities, and it is important to prioritise testing, where that is clinically appropriate, for universities too.
Finally, the hon. Gentleman asked about today’s contact tracing figures. Again, he played this divisive card that does not suit him at all, talking about the difference between the NHS and the private contractors. What I care about is a good service for the people we serve. The figures announced today are that 83.9% of contacts where communication details were given have been reached and told to self-isolate. That is the contact tracing working—even as the number of cases goes up—to help to control this virus. As we approach winter, I look forward to the two sides of this House coming together in the national interest, not playing these divisive cards that will simply play against the interests of those we serve, who elect us here in order to take our country through difficult times.
Today is World Patient Safety Day, which I had the privilege of launching virtually with Dr Tedros of the World Health Organisation this morning. The changes that the Health Secretary is announcing to A&Es are about patient safety. As Dr Katherine Henderson told the Health Committee, if we go back to crowded A&E waiting rooms, patients will die, so I welcome these changes. May I ask my right hon. Friend specifically about sepsis? Our A&Es have made huge progress in testing people who need to be tested quickly for sepsis when they arrive at A&E. If that is now to be done on the phone—if that is the first point of contact—it is absolutely vital that 111 call handlers are properly trained and their algorithms adjusted to ensure that we ask the right questions on sepsis. Will he undertake to do that?
I wholeheartedly support the points that my right hon. Friend has made. I pay tribute to him for his work in establishing World Patient Safety Day and thank him for his ongoing work in the international arena, both representing our country and driving forward this agenda globally. I entirely agree with his comments about 111 First. It is absolutely critical that both the online and phone systems act to ensure that sepsis is recognised, wherever that is feasible, to ensure that people get the best and safest route to care. I will ensure that that point is registered. We have put in the extra funding, which I have just announced, for 111 to ensure more clinical support for people accessing the service through NHS 111 First. Indeed, I pay tribute to him for introducing 111 in the first place. There is an awful lot of work to do here, but it will undoubtedly help patients to get a better service and help the NHS to deal with the multitude of cases that come its way.
(4 years, 9 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
Let us hear from the Chair of the Health and Social Care Committee.
A week ago today, the Secretary of State told the Health and Social Care Committee that he expected to have this problem solved in two weeks. Since then, in my constituency, two Farnham residents have been sent to Bristol for their tests, a councillor has been sent to the Isle of Wight for her test and a teacher who tested positive had to wait a week for her results. Is the Secretary of State, given the efforts that his Department is making, still confident that in a week’s time we will have this problem solved?
I think that we will be able to solve this problem in a matter of weeks. In his constituency yesterday, 194 people got their tests. We are managing to deliver record capacity, but as he well knows, demand is also high, and the response to that is to make sure we have prioritisation, so that the people who most need them can get the tests that they need.
(4 years, 9 months ago)
Commons ChamberThe hon. Gentleman was rather better when he was supporting the Government action in the first part of his response. He cannot seem to decide whether he is in favour of more testing, or against it. All we get is complaint after complaint, rather than support for his constituents and the people of this country in our quest to get through this virus.
First, on who is eligible for a test, precisely as I said and as he literally read out, if you have symptoms, get a test. If you do not have symptoms, you are not eligible for a test, unless specifically asked for one. [Hon. Members: “If in doubt!”] Yes, if you have symptoms and are in doubt about whether those symptoms are coronavirus, get a test. If you do not have symptoms, do not get a test. That has not changed. It is exactly the same. What has changed is that the hon. Member for Leicester South (Jonathan Ashworth) does not know whether he is coming or going.
The hon. Gentleman does not seem to understand that the way in which we build a huge project like our testing, which is at record levels, is to back all the horses. Once again, he complained about businesses supporting us in our roll-out of mass testing. That divisive approach is wrong. We support universities, businesses and the NHS to deliver more testing; we do not support the totally confused approach of the Opposition. He does not know whether he is in favour of or against more testing.
The hon. Gentleman asked about the money, and £500 million has thus far been allocated to this project, but more is likely. He asked about staff testing in the NHS. As he well knows, we follow clinical advice, but always keep it under review. Finally, he asked about schools. The policy on schools is that, if somebody tests positive, that bubble needs to self-isolate. A bubble is defined as those who are in close contact within a school setting.
I will end on a point on which we agree strongly. On this, World Suicide Prevention Day, all of us are united in support of the mental health services provided across this country, and of all those who are working hard for those with mental ill health or at risk of suicide. That is a project on which all of us are on the same side and working together to support people.
As someone who has long campaigned for mass testing, I warmly welcome the ambition behind Operation Moonshot—and the implied characterisation of the Health Secretary as this country’s answer to Neil Armstrong. However, 10 million is a huge target. Could he give the House some idea of the proportion of that 10 million that is dependent on new technologies and the proportion that we can get to with existing technologies? Mass testing is so important to getting the country back to running as normal, and while we all want those new technologies, it would be helpful to have an understanding of how much expansion we can expect on the technologies we already have.
That is an extremely clear and strong position from the Chair of the Select Committee. Of course we are expanding the current technologies. We have a plan, when we are on track for it, to get to 500,000 tests a day by the end of next month, on the current technologies. On the next generation of technologies, I am not going to put a figure on it because it depends on the technologies coming off. The very nature of backing new technologies is that we do not know which ones are going to be verified. That is why we have so many that are being piloted and so many with whom we are working. We have tests right now in Porton Down being verified. We want this to go as fast as we can, and we want it to go as large as we reasonably can, but we do not put a specific figure on it—we put all our weight and support behind this project, which will have the positive benefits that my right hon. Friend so eloquently sets out.
(4 years, 9 months ago)
Commons ChamberI will certainly answer the questions posed by the hon. Gentleman, but as for his proposal to dismantle the testing system that we have built so painstakingly over the past six months using not only the NHS and PHE, but all the testing capacity of the nation, that is one that I and the British people will reject. We need to build our capacity, and we need to build on what we can do. We have built one of the biggest testing capacities in the world over the past six months, and I will reject all narrow, partisan calls to dismantle a testing capacity that is working.
Of course, with the increase in demand for tests that we have seen in the past few days, there have been challenges, which we have acknowledged, and we are working day and night to fix them. The long-term solution, using the new technologies that are coming on stream, is a critical part of ensuring that we can expand testing capacity still further.
I am afraid that the hon. Gentleman got into a bit of a muddle on contact tracing, saying that under 70% of contacts are traced. That is simply untrue and below the number that we publish weekly—we published the latest figure last Thursday.
Some of the hon. Gentleman’s questions were sensible. On schools, he is quite right that having clear guidance on how we approach schools and on what schools should do in the event of an outbreak is important. That guidance has been published and sent to schools. In the first instance, of course, a school should work with their local director of public health to minimise the impact of an outbreak.
The hon. Gentleman also asked about financial support for those who have to self-isolate, and we have put that in place. We have rolled that out in areas of the north-west, and we are watching the progress effectively.
The hon. Gentleman rightly asked about Leicester, where, of course, he has both national responsibilities and a local interest. The local lockdown in Leicester has resulted in a significant drop in the number of cases, and we will take a formal review of the measures in Leicester on Thursday. I will be certain to talk to him in advance of that and take his local intelligence and views into account.
The hon. Gentleman asked for a plan for higher education. An enormous amount of work has been done with all universities to ensure that the sector can open safely in the coming weeks.
Finally, I am glad that the hon. Gentleman started his response in a constructive form in respect of the measures that we must take in Bolton. I have communicated with the Mayor of Greater Manchester and he has had a briefing from the official team—that has been offered. The statutory responsibility of course lies with Bolton Council, with which we have been working very closely to put into place measures that in essence build on the measures that Bolton Council has been putting in place. I put on the record my thanks to those in Bolton Council—its leader, David Greenhalgh, who has been doing an excellent job, as well as the director of public health and the chief executive—because it has been a difficult challenge in Bolton.
Thankfully, what we have learnt from this sort of local action elsewhere in the country is that we do not see large-scale numbers of people travelling to other areas nearby where there is a problem. We have not seen that yet. Of course, we remain vigilant on that and on all these measures, but I am sure that the people of Bolton will understand how significant this problem is and will follow the guidance and, indeed, the new laws that we will bring in to back up the proposals we have made today.
I thank the Secretary of State for his public recognition of the terrible symptoms that many people face many months after their coronavirus bout has ended; his words will give great comfort to the 60,000 people who have been suffering for more than three months.
On testing, it is important to recognise the step change that we have seen and the massive increase in the volume of testing that is now taking place. Will the Secretary of State give the House some sense of the confidence he has that, with the increased testing and the local lockdowns that are now being rightly pursued, we will be able to follow the low infection levels seen in South Korea, Taiwan, Singapore and Hong Kong, and not see the increases we have seen in France and Spain and have to go back into another national lockdown?
The Chairman of the Health and Social Care Committee precisely sets out our goal. Some countries—not only in the far east but closer to home—have seen a rise in cases, especially among younger people, and taken action that has turned the curve. That is particularly true in, for instance, Belgium, which we were very worried about a month ago: the case rate came right down when Belgium put a curfew in place. We are taking local action here, and our approach to local action has been commended by the World Health Organisation.
Of course, the responsibility is on all of us. I know that this is a riff that we talked about a lot in March, April and May, as the cases were coming right down, but we all have a role to play in this, because the local action and the test and trace—actions that we take in Government and with local authorities—are only the second and third line of defence. The first line of defence, for everybody in this Chamber and all our constituents, is to follow the social-distancing advice. We will be stepping up the communications and making sure that people are reminded very clearly of the rules, and we will also be taking action to step up enforcement, to make sure that we can keep this virus under control until we can build up both the mass testing capacity and ultimately, as I mentioned in my statement, the vaccine on which the scientists are doing great work, although all vaccine work is uncertain until we get clarity from the regulators that a vaccine is safe and effective to use.
(4 years, 10 months ago)
Commons ChamberI will answer as many of the hon. Gentleman’s questions as possible. His first question about the effectiveness of NHS Test and Trace is very important. He is right that we are investing in public health teams, and so we should. As we discussed in Health questions earlier, it is important to have the combination of the national system and the local one. It is also important that we communicate to people that it is important to engage in testing and contact tracing for those who test positive and their contacts. It is important to be able to communicate to people so that they get those messages, and we will do that in whatever way is effective to get those messages across.
The hon. Gentleman asks about the importance of mass testing. I bow to no one in my enthusiasm for mass testing and am glad that he supports my drive for it. He might remember the exchanges we had some time ago when I rather stuck my neck out in pushing for mass testing when we needed to get to hundreds of thousands of tests. We now need to increase the number of tests again.
The hon. Gentleman mentions both saliva tests and pool tests; we are trialling both of those. As with vaccines, to which I shall come briefly, we will only use testing that is validated and for which the results are safe, so it is important that we use the world-class facilities that we have at Porton Down to make sure that tests are validated before we use them in public. Saliva testing and pool testing are both options that we are working on.
Local lockdowns are working. Local action, taken jointly between national and local government, is having an effect, as the hon. Gentleman knows well from Leicester, where the case rate is right down. We do publish the data on which such decisions are made. In fact, from last Thursday, we now publish data at lower-super-output-area level, which is the lowest level in terms of how local the test results can be reasonably published. We also provide extensive data to directors of public health.
It is important that all elected officials are engaged in the process of making lockdown decisions, so, as we set out the week before last, we require councils to seek consensus with local elected officials, which includes colleagues in this House. For instance, if your area, Mr Speaker, were under consideration for the need for intervention, we would require your local council to seek consensus with you—although that consensus is not always possible, and there have been a couple of examples where it has not been—and would then make as targeted an intervention as possible. We want to get to the point at which everybody is on the same side in the battle against the disease. I am glad to say that in nearly all council areas the process has worked well. I urge all council leaders to work to engage with their local MPs and with colleagues from across the House to make sure that colleagues’ views are taken into account in trying to seek consensus.
The hon. Gentleman makes the point that a vaccine must be deployed only when safe and effective, and he is completely right. He and I are as one, along with every single Member of this House, in our abhorrence at the anti-vax people who peddle lies, and in our abhorrence at the anti-test people who similarly try to argue that testing is somehow wrong when it is not. In the UK, a vaccine will be deployed only when it is safe and signed off by the regulator. The UK health regulator, the MHRA, is one of the finest regulators in the world. It is robust, independent and technically brilliant. People should know that we will sign off a vaccine only when it is safe. Having said that, we will also work incredibly hard and give all the resources that the vaccine development teams need to try to get a vaccine over the line as quickly as possible.
The Secretary of State has made impressive progress in making testing available to everyone with covid symptoms, but I wish to press him on the availability of tests for people who are asymptomatic. Will he confirm that it is the Government’s intention to introduce regular weekly testing for NHS staff, teachers and other people who are in regular contact with the public and who could potentially transmit the virus? Even if it cannot be done right away, is it the intention to do that as soon as possible? Surely that is the best way to reassure patients that their hospital is safe and parents that their kids’ school is safe.
It is my intention to deploy as much testing as possible using the new testing innovations coming on stream and to do so as widely as possible following clinical advice. We have set out the process we propose to use for the current generation of testing capability, but if a new, easier type of test gets over the line, of course we will always keep that under clinical review, being guided always by clinicians.
(4 years, 10 months ago)
Commons ChamberThe ongoing problems in maternity units in Shrewsbury, Telford and east Kent hospitals have shown that independent, blame-free investigations into baby deaths have never been more important. Will the Secretary of State confirm that it is still the Government’s intention to put the healthcare safety investigations branch on to a statutory footing, and that those plans will remain in the Queen’s Speech later this year?
Nobody has done more for the cause of patient safety in this country than my right hon. Friend. We are seeking to put the health service investigatory branch into law at the earliest legislative opportunity. He will know that, as a Minister, I could not possibly pre-empt what Her Majesty might say in a few months’ time in the other place, but I will say that, in the same way that we introduced the Health Service Safety Investigations Bill just before the election, it is our full intention to legislate for it at the earliest chance.