Ockenden Report

Jeremy Hunt Excerpts

Wednesday 30th March 2022 Commons Chamber

[Mr Speaker]

We now come to the Chair of the Health and Social Care Committee.

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

Today’s report goes beyond my darkest fears. When I commissioned it as Health Secretary in 2016, I was approached by 23 families; we have heard today that more than 200 babies might have been alive today if better care had been provided. I thank Donna Ockenden and her team for an incredibly thorough investigation. I also thank the Health Secretary for his compassionate and comprehensive response to the House today.

Donna Ockenden does not use the word “recommendation”; she talks about immediate and essential actions. What is the Secretary of State’s deadline for the implementation of those actions? That is something that every expectant mother in the country desperately wants to know.

May I gently say to the Secretary of State that while I warmly welcome more midwives and more doctors, that approach is not consistent with voting down today the Lords amendment to the Health and Care Bill that would make sure that we never have those shortages again?

Finally, I pay tribute to Richard Stanton and Rhiannon Davies and to Kayleigh and Colin Griffiths. Richard and Rhiannon came to talk to me about their daughter Kate, who died in 2009; Colin and Kayleigh’s daughter Pippa died in 2016, when I was Health Secretary. Because of the blame culture and the culture of fear in the NHS, it was left to them and many other families to fight for justice. Can this be the last time that we put that burden on the shoulders of bereaved families? Can we build a culture in the NHS that is open and transparent and that accepts that things go wrong, but is hungry to learn from mistakes so that we never again repeat the tragedies?

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 1st March 2022 Commons Chamber

[Maria Caulfield]

I can only reiterate that we have a laser focus on this issue, and that is why we will be bringing forward the health disparities White Paper. I also point the hon. Gentleman to the NHS’s approach of the Core20PLUS5, where it is targeting the most deprived 20% of the population in five clinical priority areas: maternity, severe mental illness, chronic respiratory disease, early cancer diagnosis and hypertension. We will deliver on resolving disparities issues.

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

Today is the first day of Brain Tumour Awareness Month. The Secretary of State kindly wrote to me in January when my mother died from a brain tumour, and Baroness Tessa Jowell, who was much loved on all sides of the House, also died from a brain tumour. Given that it is the biggest cause of cancer death for the under-40s, and we still do not really know what causes them, does he agree that this should be a priority for research, so that we understand as much about brain tumours as about other cancers?

[Sajid Javid]

I once again express my condolences to my right hon. Friend for his loss. He is absolutely right to raise this issue and the need for more research. That is one of the reasons why, back in 2018, we announced £40 million of extra research funding over the next five years. I can tell him that some £9 million of that has already been committed to 10 projects. In addition, the Tessa Jowell Brain Matrix is an exciting new trials platform that will give people with brain cancer access to trials of treatments that are best suited for their individual tumours.

Integration White Paper

Jeremy Hunt Excerpts

Wednesday 9th February 2022 Commons Chamber

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

As one in the long line of former Health Secretaries with scars on their back—to quote Sir Tony, if we are allowed to—from when they tried to integrate the health and care systems, I warmly welcome this White Paper. I think it is more than aspirations. But there are three central elements of the plumbing that we have to get right, and I want to ask the Minister, who I know is very committed to this, for his response.

First, previous attempts to have pooled budgets for vulnerable people have been bedevilled by the fact that the NHS has not wanted to pool its budgets with an underfunded social care system. The grant to local government is still not generous, to say the least. The Select Committee on Health and Social Care recommended an increase of £7 billion a year by the end of the Parliament, but it is actually going up by £2 billion a year. What will we do to overcome the resistance in the NHS to merging budgets with a social care system that is feeling very stretched?

Secondly, it is a very big step forward that everyone will have a single electronic health and care record by 2024, but my simple question is whether the public will be able to access the data. Patients are the best guarantors and defenders of their own health, so they should be able to access everything that professionals can see about them.

My third question is about having a single professional responsible for someone’s care. What is the role of GPs in that? For most members of the public, the central person responsible for their care is their GP. Is it not time to go back to the days when everyone had their own family doctor, instead of a different doctor every time they call the surgery? They might not see the same person every time, but there should be someone at the GP surgery who is responsible for their overall care, whether that is in the health system or the social care system.

[Edward Argar]

My right hon. Friend speaks with typical wisdom and common sense on these issues. I will briefly address each of his three points in turn.

On pooled and shared budgets, I have to say that I think section 75 of the National Health Service Act 2006 has worked well. When I was cabinet member for health and adult social care at my council—I had more hair then, and it was not grey—I also sat on a primary care trust board as a non-executive member. I had a senior director of that PCT on my management team; we forged a common purpose, recognising that there would be some areas in which NHS moneys were greater than those put in by the local authority and vice versa, but the shared goal was achievable only when we worked together. I think that there is genuinely something to build on, and the ICSs, ICBs and ICPs at the upper level will be the vehicle to move the process forward. When I was doing it, there was a degree of personal relationship moving it forward, rather than necessarily a systematised approach, but I genuinely think that there is a willingness and a recognition of the need for this.

On public access to electronic records, my right hon. Friend’s central point is absolutely right: it is important to recognise that such data is our data and individuals’ data. We must always be wary about doing something to someone, as opposed to in partnership with them. That principle will underpin our approach in this space.

Finally, my right hon. Friend referred to a single responsible professional—not a single point of contact, but someone who brings together an individual’s care. He is right to highlight the importance of general practitioners. May I put on record my gratitude to GPs not only for all their work over the past two years, and for all they do day in, day out, but for the wisdom and care that they bring to addressing their patients’ needs?

Since my right hon. Friend’s time as Secretary of State, there has been a continual drive to increase the number of doctors in our health service. Not all will become general practitioners, but we need to continue to make general practice accessible and to encourage people to choose it as an incredibly exciting and rewarding career. One of the key elements of making what he describes work is building up a body of general practitioners who are able to perform such tasks. I pay tribute to his work; we are continuing that work and building on his foundations. I am grateful for his questions and for his contributions.

Vaccination: Condition of Deployment

Jeremy Hunt Excerpts

Monday 31st January 2022 Commons Chamber

[Sajid Javid]

Once again, I thank the hon. Gentleman for his approach to this policy area and to vaccinations in general. He is absolutely right in the comments he has made on that and the importance of working across the House and working together on such an important issue in the national interest, as he has done. I very much welcome that approach. Not all countries take such an approach to such an important issue, and they have sadly paid a price for that. I believe that one of the reasons we have such high vaccine uptake in this country is the cross-party approach that has been taken, and I thank him once again for that.

The hon. Gentleman is also right to point to the safety and effectiveness of the vaccines, as independently set out by our world-class regulator, the Medicines and Healthcare products Regulatory Agency, and other reputable regulators across the world. No one should doubt the safety and effectiveness of the vaccines. It is because of the success of this country’s vaccination programme that we are able to open up again in the way that we have and to start returning to normal life.

Very importantly for the people we are talking about today—the fantastic people working in the NHS and across social care—one of the key reasons we have been able to keep down the pressure on the NHS in particular is that so many people have come forward and got vaccinated. That is why it remains troubling that some people, in particular in the NHS, still refuse to get vaccinated, even when they know it is safe and effective, and do not do the responsible thing and act in a professional way.

We will keep going to work with those people in a positive way to try to persuade them about the benefits of vaccination and to provide them with the information they need. We will continue with the work of one-to-one meetings with clinicians if necessary and encouraging them to make that positive choice, but it will be about encouragement and helping them to come to the right decision. We will learn and look at what other parts of the UK have done in making sure that we have the very best practice and have learned from each other.

Finally, on the point that the hon. Gentleman raised about sick pay, I understand what he is saying. I just point to the fact that we have kept rules in place to allow sick pay to be claimed from day one, and a hardship fund is in place to give extra support where needed.

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

My right hon. Friend knows that my instinct is to support him in the very difficult decisions he has to take in a pandemic, and I think he is doing an excellent job, but I have some concerns about today’s announcement. I think they may not be shared widely in the House, so I hope colleagues will indulge me if I explain why. Frontline workers have done an extraordinary job in this pandemic, but I have yet to meet a single one who believes that anyone in contact with patients has a right to put them at increased risk by not having a vaccine, unless there is a medical exemption. My concern is that having marched the NHS to the top of the hill and having won a very important patient safety argument, we are now doing a U-turn. What will happen the next time the Secretary of State wants to introduce an important vaccine, for example for flu, and make it mandatory? Is not the real reason that we have made this decision that we have a staffing crisis that the Government have still not brought forward their plans to address? When will those plans be brought forward?

[Sajid Javid]

My right hon. Friend speaks with great experience, and I have the utmost respect for him, especially given the many years he spent successfully running this Department. I understand what he says, and I hope he will understand, having listened carefully to the statement, that when the facts change, it is right for the Government to review the policy and determine whether it is still proportionate. Many things have changed in the past couple of months with respect to covid, but the one big thing that has changed is that since this policy was originally implemented, we have moved from 99% of covid infections being delta to 99% being omicron. That is why we have had to change approach.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 18th January 2022 Commons Chamber

[Mr Speaker]

I call the Chair of the Health and Social Care Committee.

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

This morning, the Health Secretary is reported in The Times as saying that the NHS can learn from the way in which academy chains are regulated, but he will know that the education system has no national targets, while the NHS uses more national targets than any healthcare system anywhere in the world. Will he look at the role of targets and the risk that they focus managers on bureaucratic numbers, sometimes at the expense of quality of care for patients?

[Sajid Javid]

I very much agree with my right hon. Friend; as the whole House knows, he speaks with considerable experience. We need to do things differently, especially as a result of the pandemic and the challenges that it has created. That requires reform, and we will set out further reforms in due course. He is absolutely right about targets: they can play an important role, but they can also lead to poor outcomes for patients, and all targets need to be properly reviewed.

Midwives in the NHS

Jeremy Hunt Excerpts

Monday 17th January 2022 Commons Chamber

[Siobhan Baillie]

I thank the hon. Gentleman for his intervention. Staffing issues are absolutely crucial and I want to pose a number of questions about them.

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

I congratulate my hon. Friend on securing this debate and on the forthcoming addition to her family.

On the point made by the hon. Member for Strangford (Jim Shannon) about staffing levels, does she agree that one of the most important reasons why we need to fill the staffing shortfalls—the 2,000 extra midwives needed immediately—is that we need to be better at identifying higher-risk pregnancies? Continuity of care, so that people are looked after by the same midwife throughout the pre-natal, birthing and post-natal periods, is an incredibly effective way to do that.

[Siobhan Baillie]

I could not agree more with both interventions. I think we are going to hear more from other Members about continuity of care, which is the way to manage pregnancy and how most midwives want to work. But that can be achieved in many hospitals and many midwife teams only if we have the staffing. Given the numbers at the moment, this is a key issue.

Covid-19 Update

Jeremy Hunt Excerpts

Thursday 13th January 2022 Commons Chamber

[Sajid Javid]

Again, the hon. Gentleman had another fresh opportunity to thank the NHS staff for the enormous work they have been doing not just throughout the pandemic but in December, and especially for everything they have done to boost so many people, but there was not one word of thanks from him.

I was pleased to hear the hon. Gentleman welcome the new self-isolation policy. He asked whether enough tests are available. He might have heard me say earlier that we have quadrupled the number of lateral flow tests available this month to approximately 400 million, which is more than four times the original pre-omicron plan. I was confused by his response to that, because he seemed to be suggesting that we should be subcontracting our covid policy to the US Centres for Disease Control and Prevention. If I heard him correctly, he was suggesting that just because another country—in this case, the US—has changed its policy, we should automatically follow suit and do what it does.

We have just taken back control from the EU. We have just left the European Medicines Agency, and here the hon. Gentleman is, just months later, suggesting we subcontract our policy to another state. That tells us all we need to know about the Labour party’s approach. He suggests we take the same approach as the US, and he of all people should know that while the US might have an isolation period of five days, they have no testing. I do not know whether the hon. Gentleman heard me earlier, but let me remind him: the UK Health Security Agency data shows that approximately 30% of people are still infectious at the end of day 5. That is why we require two tests.

The hon. Gentleman was suggesting that we should have the same policy as the US, which requires no testing, and for everyone to leave isolation at day 5, regardless of whether they have tested or not, and wear a face mask for the last five days. The hon. Gentleman has to decide whether he wants these decisions to be made here in the UK, based on expert UK advice from some of the best advisers anywhere across the world, or to subcontract them to another state.

Finally, the hon. Gentleman talked about the NHS and capacity. He will know that as a result of the omicron emergency, it has sadly been necessary for the NHS to make changes. Of course that has had an impact on electives. The most urgent electives such as cancer care will be protected, and he heard me talk earlier about the deal that has been done at least for the next three months with the independent sector. I hope he supports that and the measures that the NHS is taking to protect capacity.

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

I welcome today’s announcement. We have one of the best vaccine programmes in the world and as a result we can look forward to a time of living with covid with justified confidence. This is a very important step forward.

As the Secretary of State knows, last week the Health and Social Care Committee published a report on what is going to happen now that the NHS is starting to think about tackling the covid backlog. We said that we were worried that that would be derailed by a workforce crisis, with shortages in nearly every speciality throughout the NHS. When is the covid backlog plan going to be published? Will it have details about what is going to happen in areas such as emergency care and general practice social care, all of which have a direct impact on the ability of the elective care programme to deliver? Will it deal with what the Health Foundation says is a shortage of 4,000 doctors and nearly 19,000 nurses who will be necessary for that elective recovery programme? Finally, when is he going to publish the workforce strategy? Will that have independently verified assurance that we are training enough doctors and nurses for the future?

[Sajid Javid]

First, I thank my right hon. Friend for his support for the changes that the Government have announced today. He is right to raise the importance of the workforce, especially when it comes to dealing with the backlog. He may know that since September 2020, 20,000 more clinicians have been working throughout the NHS, but we do need to plan properly for the NHS workforce in the long term. The Government are working on a workforce strategy and I look forward to discussing that with him and the members of the Committee that he so expertly chairs in due course.

Vaccination Strategy

Jeremy Hunt Excerpts

Wednesday 12th January 2022 Commons Chamber

[Maggie Throup]

I thank the hon. Gentleman for his measured approach. We have seen throughout the pandemic that everybody working together gets us where we need to be, which is making sure that people are safe.

The hon. Gentleman asked a few questions about the current vaccine programme and the uptake rate. I am delighted that about 80% of people over 18 have now been boosted, which is a fantastic achievement. Over 90% of the population aged 12 or over have had their first dose and 83% have taken up the offer of a second. I reiterate that the offer of a first and second dose is always there. If people have not yet come forward for their first dose, it is not too late: they can go to a walk-in centre or make an appointment through the national booking service or their GP to get that all-important vaccine.

With regard to 12 to 17-year-olds, the school-age immunisation service has started to roll out again this week. People can also take the out-of-school offer through the national booking service or the walk-in sites. The hon. Gentleman mentioned a case where somebody had to travel 50 miles. We did look into that situation, and it was not quite right. We have been in touch with that member of the public, and the situation has been resolved.

Housebound patients are the responsibility of the primary care network or the clinical commissioning group, depending on the local scenario. Every housebound patient has been offered their booster vaccine now, but if the time was not quite right, or any Member has taken up such a case with their CCG and not had a solution, I would be happy to take the case up on their behalf.

The hon. Gentleman talked about the ambition not just to vaccinate the UK but to make sure that people globally are protected. I am delighted to announce that, as of the end of last year, we donated 30 million doses, partly through COVAX and partly through bilateral agreements, which is a great achievement, and we have a commitment in place for 100 million doses by the end of June this year.

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

This country has one of the best vaccination programmes in the world and the very best in Europe. We should remember that the foundations were put in place when, at the height of the first wave, the then Health Secretary bought 400 million doses of vaccine that we did not even know would work. That has meant that we are now emerging sooner and more broadly than nearly anywhere else. But that success was also because a lot of GPs in the NHS were diverted away from their normal work into the vaccination programme, and that has come with costs in terms of the other treatments they are not able to deliver. When will we see a workforce plan that takes account of the new responsibilities for vaccination that the NHS will have? When will the budget for Health Education England be agreed, because two and a half months before the next financial year we still do not know what it is? Will the workforce plan have independent forecasts so that we can make sure we are training enough doctors and nurses for the future?

[Maggie Throup]

I thank my right hon. Friend for his question. He has made it his ambition, as has the Department, to ensure that we have the right workforce in place. He raises a really good point about the vaccines and how we continue to administer them—not just the covid vaccine but the flu and other vaccines that we have throughout our lifetimes. We have learned an awful lot from rolling out the covid vaccine programme, and like my right hon. Friend I commend the vaccine taskforce for having the foresight to look beyond what some other countries did, to make sure we had the vaccines in place when we needed them.

We do need to look again at how we maximise what has been such good will. In terms of the vaccinators who have come forward, some were not trained as vaccinators before. As I travel around some of the vaccine sites, I meet people from all backgrounds who have taken up the challenge to come forward and become vaccinators. The other day, I actually met a builder who is now a vaccinator, and he is loving every minute of it. I also thank the volunteers who have come forward and made sure that this programme has been so effective. It is about bringing together what we have learned in this programme over the last year to make sure that we can roll out other programmes in an effective manner.

Covid-19 Update

Jeremy Hunt Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

First, may I say that I heard your request, Mr Speaker? I am happy to take that up with you directly, if that is okay. I thank the hon. Gentleman for his support of the need to accelerate the booster programme. I join him, as I am sure the whole House does, in expressing condolences for the individual who was the first in this country to die with the new variant.

I turn to the hon. Gentleman’s questions. First, he asked about testing capacity. I would like to share more information with the House. There is no shortage of tests held by UKHSA—tens of millions of tests are in stock and millions are arriving each week. The limiting factor, because of the hugely increased demand—I am sure hon. Members understand why demand has suddenly surged—is the ability to deliver tests. The current arrangements with Royal Mail alone are not enough, but new arrangements have been reached with Amazon and other delivery methods. There will still be many hundreds of thousands—record numbers—delivered each day, but also the number of access points is being increased, including many more through pharmacies, and we are rapidly looking at other access points. The hon. Gentleman is right to raise this, but I hope he and others understand that there has been a huge surge and increase, and this is not just about the number of tests available but getting them through and delivered; both are equally important.

The hon. Gentleman raised the issue of the booster programme timing. He is right that just a couple of weeks ago the plan was to give everyone a booster before the end of January. That was after the change in advice from the Joint Committee on Vaccination and Immunisation that the dosing gap should be reduced to three months and that it should now include everyone over 18. For the reasons I have explained and that the Prime Minister shared in his national broadcast yesterday, we want to bring that forward. That involves working hard with the NHS, which has done phenomenal work already to reach four in 10 adults with boosters and in the vaccination programme in general.

This is asking a huge amount of our colleagues in the NHS, and it is our joint view that we can try to offer adults a chance to get boosted by the end of this month. That does not mean every single person can necessarily get that booster; it requires them to come forward and take up the offer as well as everything going right in this huge expansion plan. But again, I hope the hon. Gentleman can respect that the NHS is doing everything it can, with the full support of every Department of Government, and is throwing everything at this to offer as many opportunities as it can and the maximum possible capacity for delivering on that commitment.

The hon. Gentleman also talked about the challenges facing the NHS. I remind him and the House that this year the Government have put an extra £34 billion into the NHS and social care, £5.4 billion of that in the second half of this year, and over the next three years there is a commitment to at least £8 billion extra going into the largest catch-up fund the NHS has ever seen. In the last year almost 10,000 nurses and almost 3,000 doctors have joined the NHS; the NHS is increasing workforce and capacity, is looking at new ways to do electives, and is putting a huge amount of effort into its electives programme and its non-covid work as well.

Finally, I do understand what the hon. Gentleman said on adult social care and the limit on visitors, and it is important to get the balance right. We all know the problems and the sad deaths not long ago in care homes with this pandemic, and it is right to take balanced measures to protect people in care homes. We are working with, and listening to, those who run care homes and trying to take a balanced approach that allows visits to take place but also protects vulnerable people.

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

One year and five days ago the UK administered the first properly approved covid vaccine in the world, and the Government are absolutely right to focus on immunisation, but Israel approved booster jabs for all adults in September, France approved jabs for teenagers in June, both long before us, and the United States has already approved jabs for five-year-olds, again long before us. Is the Secretary of State worried that our regulators, having been the nimblest in the world, are now taking too long? They are brilliant scientists and they are rightly totally independent, but what can he do to speed up this crucial decision making in a pandemic?

[Sajid Javid]

My right hon. Friend makes an important point, from experience. We can be proud of so much of what our regulators have achieved and done. As he said, we were the first in the world to approve a covid-19 vaccine, but he is right to challenge on this and ask what more can be done, especially in light of the circumstances we face. The JCVI is not a regulator but it is an important part of the approvals process, and I hope he will also commend its swift response since the emergence of omicron in changing the rules around boosters.

Covid-19 Update

Jeremy Hunt Excerpts

Wednesday 8th December 2021 Commons Chamber

[Mr Speaker]

I call the Chair of the Select Committee, Jeremy Hunt.

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

Disappointing though the statement will be for many people, the Secretary of State has my full and unqualified support. This is not a choice between more and fewer restrictions; it is a choice between taking action early to protect a future lockdown and making such a lockdown inevitable. We all hope that the omicron variant is milder than delta, but if it is not, a failure to act now could cost many lives.

I want to ask the Secretary of State about the social care sector. I know that he will say more about it later this week, but he will have seen the estimate from NHS Providers that 10,000 beds—over 10% of all NHS hospital beds, and more beds than are currently occupied by covid patients—are occupied by people who are fit to be discharged but cannot obtain a care package. Will he provide funds to ensure that all those patients can be discharged, so that the NHS can be ready for any potential spike in new cases?

[Sajid Javid]

I thank my right hon. Friend for his support for the statement. He is right to emphasise that by taking swift, early and proportionate action now, we can potentially avoid further restrictive measures in the future. As I have said, there will be a statement on social care later this week, but I can also give him the assurance that he seeks: the statement will include further measures to help with the discharge of hospital patients who are clinically ready to be discharged.