Oral Answers to Questions

Debate between Jonathan Ashworth and Sajid Javid

Tuesday 23rd November 2021 Commons Chamber

[Sajid Javid]

First, I am sorry to hear about my hon. Friend’s constituent Chris and wish him all the very best. She will know that clinical commissioning groups are responsible for commissioning local healthcare services. If the aim of a cosmetic procedure is health rated, such as the need to repair or reconstruct missing or damaged tissue or skin that might come through illness, birth defect or accident, it will be commissioned and seen to by commissioners. She refers to a particular case. If she would like to provide me with more details, I would be happy to take a look.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

At the weekend, the Secretary of State effectively ditched his promise to deliver 6,000 extra GPs. Last week, the Infrastructure and Projects Authority said his promise to deliver 40 new hospitals is “unachievable”. Last night, he whipped a vote that sees poorer pensioners lose their homes to pay for care, while the homes of the richer are protected. Can he tell us which promise is he going to break next?

[Sajid Javid]

I have to say that the right hon. Gentleman is wrong on all three counts. The Government are absolutely committed to hiring more GPs, with over 1,800 full-time equivalent GPs entering primary care in the two years to September 2021. We are seeing success after success in the hospital building programme, with the biggest capital investment programme in hospitals that this country has ever seen. As for our social care programme, this Government are the first in decades to have the guts to deliver, and that is exactly what we are getting on with.

[Jonathan Ashworth]

The Secretary of State’s social care programme is not levelling up when the promise in his manifesto that no one should have to lose their home to pay for care is broken and in tatters after last night.

The Secretary of State’s next promise was to give the NHS “everything” to get through the backlog. With waiting lists growing at pace, ambulances backed up outside hospitals, and cancer operations getting cancelled, what will he do to recruit the staff we need? He is apparently not going to support the cross-party amendment in the name of the former Health Secretary, the right hon. Member for South West Surrey (Jeremy Hunt), tonight, and he failed to win the funding needed for recruitment and training in the Budget, so how will he deliver on his promise to give the NHS “everything” when it does not have the staff to deliver the care to bring waiting lists down?

[Sajid Javid]

Once again, the right hon. Gentleman proves he still does not understand the social care programme that this Government have set out. I think that is deliberate; he chooses not to understand it. For the first time, catastrophic costs are being capped for everyone in the country, regardless of where they live, and the generous means-testing system will ensure that the vast majority of people will benefit and that no one will lose out.

The right hon. Gentleman asks me what I am doing about the workforce. We are making the biggest investment in the workforce that this country has ever seen. Yesterday I announced the merger of Health Education England into the NHS, so that we can have a better joined-up strategy, and we have already set out a 15-year framework to consider the long-term needs of the workforce.

Covid-19 Update

Debate between Jonathan Ashworth and Sajid Javid

Monday 15th November 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for advance sight of his statement. Like him, I express my sympathies and thoughts to all those affected by the terrorist incident outside Liverpool Women’s Hospital, and to put on record my thanks to the emergency services who responded so professionally.

The Secretary of State is right to warn of covid rates up-ticking. The Prime Minister, at his press conference a few moments ago, has just refused to rule out a Christmas lockdown. Only last week, when he was asked about the over-65s being banned from public places if they had not had a booster, the Secretary of State said:

“I can’t rule that out”.

I have to say that that is quite a remarkable statement from Parliament’s biggest fan of Ayn Rand. The Prime Minister himself has warned of storm clouds over Europe.

Nobody wants to see further restrictions and they need not be inevitable. If the Secretary of State wants to avoid plan B—we understand why—will he at least consider introducing better sick pay and widening isolation support, so that those who are low paid can isolate themselves should they catch the virus? Will he consider better support for public buildings by putting in place high efficiency particulate air—HEPA—filter systems, because we know the virus is airborne and we need to reduce opportunities for us all to be breathing polluted air?

Will the Secretary of State go further to fix the stalling vaccination programme? I have put it to him for a number of weeks now that there are pockets of the country where the level of vaccination at second dose is nowhere near where it ought to be. For example, here in the Borough of Westminster only 52% of residents have had their second dose. In areas where the Prime Minister imposed a local lockdown last year as part of his whack- a-mole strategy, the second dose rate is: 61% in my own area of Leicester, 67% in Burnley, 64% in Sandwell and 69% in Bolton. There is a similar pattern in other areas. What is he doing to drive up vaccination rates in those areas, because nobody wants to see localised lockdowns?

The Secretary of State talks about children’s vaccination rates, but the Government promised that every child would be offered a jab by half-term. Two weeks or so on from that half-term, only about a third of children have been vaccinated. Why are we so far behind on children’s vaccination coverage? Pfizer has been given the sign-off for younger children. Can he update the House on where we are on younger children and vaccination?

The Secretary of State will know that the levels of infection in society continue to put immense pressure on the NHS. With intensive care unit beds filling up, staff are exhausted. Chris Whitty, the chief medical officer, just said at the press conference that a number of the women in ICUs are unvaccinated pregnant women, so again, what is the Government’s plan to promote the safety of the vaccine for women who have concerns about fertility?

Some hospitals with the most covid patients, such as those in Birmingham, Leicester and Manchester, are those with the most pressured A&Es. We heard from ambulance chiefs today that 160,000 patients come to harm every year because ambulances are backed up outside hospitals. Thousands of patients will suffer serious harm, with some at risk of permanent disability, and others will die because of the pressures on hospitals. Last week, we heard that patients are waiting, on average, close to an hour for an ambulance when suffering a suspected heart attack or stroke, and all 10 ambulance trusts are on high alert. At what point does the Secretary of State accept that the pressures on the NHS are unsustainable?

After years of flat funding, bed closures, understaffing and deep cuts to social care, does the Secretary of State not accept that the NHS across the piece is in crisis? What is he going to do about it? I know that he will get up and tell us about the extra expenditure and the tax rise that he is imposing on working people, but he failed to secure a new funding settlement in the Budget for the long-term recruitment and training of the staff we need. He failed to secure a funding settlement to fix social care now, when we know that one in five beds is occupied by an older person who could be discharged into social care. As we go into the winter—the “brighter” winter than last year’s, as he described it—can he tell us what his plan actually is to get the NHS through this winter without compromising patient care?

[Sajid Javid]

The right hon. Gentleman stated that no one wants to see any further restrictions, and that is absolutely true. As I set out in my statement, one of the best ways that we can all work towards preventing any kind of further restrictions is by making sure that we keep the vaccine wall strong. Although I did not quite hear him say so in his comments, I assume that he welcomes today’s extension of the booster programme, the second doses for 16 and 17-year-olds and the continuing relentless focus on the vaccination programme.

The right hon. Gentleman mentioned other things that can help, such as sick pay. That is why we are still offering sick pay from day one; we also have the hardship payments. He is right to point to the importance of ventilation, and there is very clear guidance on other measures, whether that means ventilation or mask wearing in certain circumstances. All of that can help, and guidance is out there to help people and organisations to make sure that they have the very best advice.

The right hon. Gentleman is right to emphasise the importance of second doses. I think he would welcome the fact that we as a country have got to a place where almost 88% of people who are eligible have had at least one dose and almost 80% have had their second dose. Clearly, there is a gap there, and a huge amount of work by the NHS and others is going into filling that gap. Also, people who have still not even had a single dose remain eligible; our offer of vaccination is evergreen. We are offering the vaccination in vaccination centres, walk-in centres and the temporary vaccination vans, and that is all part of making sure that the vaccines are as accessible as possible. He may well also have noticed the huge communications programme. All the latest data is showing that that is having a huge effect in allowing more people to come forward to access the vaccines if they are eligible.

Vaccination of 12 to 15-year-olds, which he mentioned, is hugely important, and that is why I referred to it in my statement. One million 12 to 15-year-olds out of a total cohort of around 2.3 million, if I remember correctly, have received the vaccine, as have almost 60% of 16 and 17-year-olds, and we have today’s offer of second doses.

The right hon. Gentleman also mentioned the importance of pregnant women in particular coming forward. The MHRA, our independent regulator, could not be clearer about the safety and efficacy of the vaccine for pregnant women. It clearly helps to protect them. We could not make that message clearer but I am glad that he raised it, because it gives us another opportunity to say so in the House.

Lastly, the right hon. Gentleman mentioned winter pressures. We can all see that there is significant pressure on the NHS at the moment, especially on A&E and other emergency treatment. Many of the challenges of the winter are still to come. I emphasise the importance of the flu vaccine programme—the largest that this country has ever seen, which is hugely important for getting through the winter—and the extra funding in the second half of this year. There is £5.4 billion in extra funding both for the NHS and for social care, because they are inextricably linked, especially in terms of their funding; for example, hundreds of millions are going into the discharge programme. That is all part of giving the NHS the support that it needs this winter.

Covid-19 Update

Debate between Jonathan Ashworth and Sajid Javid

Tuesday 9th November 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for, as always, timely advance sight of the statement.

Vaccination saves lives—it is the best protection against this deadly disease and helps to cut transmission—and we of course want to see NHS staff vaccinated. As has been pointed out many times before, there are already categories of staff for whom a hepatitis vaccination is expected. We will look carefully at the regulations and the equality impact assessment, but I urge the Secretary of State to proceed with caution, because the NHS is already under the most intense pressure this winter; waiting lists are close to 6 million; there are more than 90,000 vacancies across the NHS; and the Chancellor failed to allocate in his Budget funding for training budgets to train the medics we need for the future. There will be anxiety at trust level that a policy, however laudable in principle, could exacerbate some of these chronic understaffing problems. We simply cannot afford to lose thousands of NHS staff overnight.

We do welcome the fact that the Secretary of State has listened to representations from organisations such as NHS Providers and others about delaying the implementation of this until after the winter; we welcome that. None the less, there are still organisations, such as the British Medical Association, that have raised concerns about the practicalities of implementing this policy. Helen Stokes-Lampard of the Academy of Medical Royal Colleges has said that mandatory vaccination is neither “necessary” nor “proportionate”. Will he agree to meet the royal colleges, the BMA, and the relevant trade unions to agree a framework for how this policy will be implemented? Will he outline to the House what success looks like for this policy? Some of the 10% of NHS staff who are not vaccinated include those with medical exemptions, those who are on long-term sick, and those who could not get the vaccine first time round because they were ill with covid. Will he tell the House: what is the actual number of NHS staff who should be vaccinated, but who have not had the vaccine? What is the actual number? In other words, what then does he consider a success? What does full vaccination across the NHS look like for him? Is it 94%, 95%, or 96%? What are we aiming for here? What is his target?

The aim of this policy is presumably to limit those with covid coming into contact with patients, but one can still catch and transmit covid post vaccine, so will the testing regime that is in place for NHS staff—I think it is twice a week at the moment—increase in frequency? Furthermore, thousands of visitors go onto the NHS estate every week, so will visitors to hospitals be asked whether they have had the vaccine or have proof of a negative test?

What analysis has the Secretary of State done of those who are vaccine hesitant in the NHS workforce? What targeted support has he put in place to persuade take-up among those groups? He refers to trusts where take-up is around 80%, so what specific support has he put in place to help those trusts drive up vaccination rates? We know from society more generally that there has been hesitancy, for example, among women who are pregnant and who want to have a baby. That has meant that a significant proportion of those in hospital with covid are unvaccinated pregnant women. A large proportion of the NHS staff workforce are women of a similar age, so is this one of the issues as to why there is hesitancy in certain pockets across the NHS? Will he therefore look at a large-scale campaign to reassure pregnant women of the safety of the vaccine and look at launching an information hub, perhaps a dedicated phoneline, to offer clear advice to women and their partners who might have concerns?

Finally, on vaccination more generally, I do not want to see—I do not think that anyone across this House wants to see—anymore lockdowns imposed on cities such as my own in Leicester, or across Greater Manchester, or Bradford, but in many of these areas, vaccination rates are not good enough. Leicester has a vaccination rate of just around 61%, Bradford 63%, Bolton 69%, and Bury 71%. Generally, on children’s vaccinations, we are only at 28%. On the boosters, there are still around 6 million people eligible for a booster who have not yet had one. The Government’s own analysis shows that people over 70 who are dying from covid or hospitalised should have had a booster, but have had only two jabs.

With Christmas coming, which will mean more mixing indoors at a time when infection rates are still high—one in 50—we are facing six crucial weeks. What more support will the Secretary of State offer now to local communities, such as Leicester, Bolton, Bury and Bradford, to drive up vaccination rates, because nobody wants to see those local lockdowns again.

[Sajid Javid]

I thank the right hon. Gentleman for his approach to this matter and to issues around vaccination in general. There is no doubt that the general consensus in this House, across parties, has played a vital role in building confidence in vaccines among our citizens, and, once again, I thank him and his party for their approach to vaccination.

The right hon. Gentleman has raised a number of questions. He suggested caution in this approach and he was right to do so. I hope that, from what I have already shared with the House today and what I will continue to share, he will feel that we are taking that cautious approach. For example, if Parliament supports this move, there will be a grace period so that those in the NHS and social care who have not yet chosen to take any vaccine will have plenty of time to do so.

The right hon. Gentleman asked about meeting healthcare leaders. He will not be surprised to hear that, probably like him, I meet healthcare leaders all the time and will continue to do so. I am more than ready to listen to them. Following the consultation that we have had on this so far, we would like to know what further suggestions they have, especially around implementation and take-up.

The right hon. Gentleman specifically asked me about the NHS take-up. The take-up throughout the NHS in England is 93% for the first dose and 90% for two doses, which leaves, I think, 103,000 people in the NHS who are unvaccinated—in other words, they do not have even one jab. As he will understand, it is hard to know what portion of that number will take up the offer of vaccination. If we look at what has happened in care homes since that policy was announced, we can see that there was a significant fall in the equivalent number, and I think that we can certainly expect that here, but, as he has suggested and as came through very clearly to the consultation, it is about making sure that people are encouraged to take a positive choice. From what I said earlier, I cannot be clearer that no one should scapegoat or single out anyone in the NHS or in social care who has, at this point, for whatever reason, chosen not to get vaccinated. This is all about working with them positively, making sure that they have the information that they need. In answer to his question of what more will be done to help people make that positive choice, I say that, as well as information, one-to-one meetings will be offered to everyone who is unvaccinated, if that is what they want. They will have the opportunity to meet clinicians and others to allay any concerns they may have. That includes, of course, those who are pregnant or thinking of one day becoming pregnant. The right hon. Gentleman was right to raise that, too.

Lastly, on the vaccination programme overall, I think the right hon. Gentleman will agree that, as a country, we have done remarkably well. Almost eight out of 10 people over the age of 12 are double vaccinated. That is one of the best vaccination rates in the world, but, as he and others have said, we still need to be working hard to do better. There are still too many people who have not taken up an original offer of a vaccine. We also need to make sure that, for those who are eligible for a booster shot, it is made as easy as possible for them. Some of the recent changes to the booster booking system have led to a phenomenal increase in booster shots—more than 10 million throughout the UK—and the number is growing all the time.

David Fuller Case

Debate between Jonathan Ashworth and Sajid Javid

Monday 8th November 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for advance sight of his statement and for its content, and I welcome what he has announced today.

This is an unspeakably vile and horrific crime, and across the House our thoughts and hearts go out to the families of Wendy Knell and Caroline Pierce, and to the families of those with deceased loved ones. Those 100 victims—we are talking about the corpses of 100 women —were, as has been reported in the press, violated in the most monstrous, vile and sickening way. Will the Secretary of State confirm that all the families impacted will have immediate access to the psychological counselling and support that they need? Will NHS staff at the hospital, many of whom will themselves be devastated, also have access to appropriate counselling and support?

I welcome the announcement of an inquiry, and I pay tribute to local Members of Parliament across Kent and Sussex who have spoken up on behalf of their communities in recent days. In particular, the right hon. Member for Tunbridge Wells (Greg Clark) said over the weekend that authorities and politicians must

“ask serious questions as to how this could have happened and…establish that it can never happen again.”

I agree, and that is why an inquiry is so important.

Will the Secretary of State offer some precision as to when the terms of reference will be published? Fuller was caught because of a murder investigation, which in itself prompts a number of questions about the regulation of mortuaries. The Human Tissue Authority, which regulates hospital mortuaries, reviewed one of the mortuaries in question as part of its regulatory procedures. It raised no security concerns, but found a lack of full audits, examples of lone working, and issues with CCTV coverage in another hospital in the trust. Will the inquiry consider—or perhaps this is the remit of the Secretary of State—the Human Tissue Authority’s standards, the way it reviews hospital mortuaries, and how those standards are enforced? Will the inquiry recommend new processes that the Secretary of State will put in place if it is found that a mortuary fails to meet the high standards for lone workers, for security and for care?

The NHS has asked trusts to review their procedures; I welcome that. Will the Secretary of State ensure that all mortuaries document and record the access of all staff entering a mortuary, and will he ensure that standards for CCTV are enforced and that CCTV is in place comprehensively across all mortuaries? There are, of course, other premises where dead bodies are stored, such as funeral directors, that do not fall under the regulatory remit of the Human Tissue Authority, so will its remit be expanded, or will the inquiry look at regulation for other premises where bodies are stored?

When our loved ones are admitted into the hands of medical care, that is done on the basis of a bond of trust—that our loved ones will be cared for when sick and accorded dignity in death. That bond of trust was callously ripped apart here. I offer to work with the Secretary of State to ensure that something so sickening never happens again.

[Sajid Javid]

I very much welcome the right hon. Gentleman’s words and his offer to work together on this. I most certainly would like to take him up on that. I think the whole House would want to see us all working together on this.

I reassure the right hon. Gentleman that there is comprehensive support rightly available to all families and friends that have been affected. As I said a moment ago, every family of the known victims has been contacted directly by family liaison officers. They are in touch, and that support will continue for as long as necessary, including dedicated caseworker support, a 24/7 telephone support line and whatever counselling and support of that nature is needed. That includes support for staff in the NHS and elsewhere, where staff will also be affected.

On the terms of reference, that is something that I and my Department will work on with Sir Jonathan. I have already started discussions with him on that, and I am sure that he will want to have discussions with others, including families, their representatives and the Members of Parliament who represent those families.

The work that Sir Jonathan will do will be broad in its nature. I think it has to be, because, as the right hon. Gentleman rightly alluded to, it has to go beyond just hospitals. There are a number of settings that rightly need to be looked at, including, for example, local authority mortuaries, private mortuaries and other settings, such as undertakers. I think the inquiry should be open to all of that, and I think we would want to see that reflected in the terms of reference.

Lastly, the right hon. Gentleman referred to recommendations around access, documentation and CCTV. He is right to raise all those issues. I want to be careful not to pre-empt the final outcome of what is an independent inquiry, but I am sure all those issues will rightly be looked at.

Oral Answers to Questions

Debate between Jonathan Ashworth and Sajid Javid

Tuesday 19th October 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

If I may, Mr Speaker, I will, with your indulgence, take a moment to express my deep sadness at the loss of James and David and my utter shock at what we saw this weekend, but also to remember David as someone who was always smiling, who always encouraged me, particularly as a rookie MP when my office was just down the corridor from his, who always asked after my children and who always gave me tips. I sometimes get in a bit of trouble for being friends with Tories, but I will hugely miss David and James and send my condolences and sympathies to their friends and families.

I also welcome the new Ministers to the Treasury Bench. In recent weeks we have seen a patient at Preston wait over 40 hours for a bed, we have seen a child with mental health problems wait nearly 48 hours for a bed at Ipswich A&E, we have seen ambulances backed up outside hospitals—in Norfolk a patient died of a heart attack waiting in the back of an ambulance—and we have seen ever more patients, who cannot bear the wait for surgery, paying for operations. This is an NHS not just under pressure, but under water. What is the Secretary of State personally going to do to avert a winter crisis of misery for patients?

[Sajid Javid]

I agree with every word the right hon. Gentleman said about our friends and colleagues, James and David, but I hope his friendship with me will not get him into trouble—I hope I have not given that away. He is right to ask about the huge pressure the NHS is facing, and all our constituents are seeing that wherever they live. It is picking up over the winter. Winters can usually be tough for the NHS but this winter will be particularly tough and the Government have set out the reasons why: the pandemic is still ongoing; and this flu season will, I think, be particularly tough, which is why we are having the largest flu vaccination programme alongside the covid programme this year. We are doing a lot alongside the vaccination programmes, especially in terms of resources. We have put an extra £34 billion into the NHS and care for this year, including much more funding for diagnostics such as the community diagnostics hubs that I announced a couple of weeks ago, in which we invested 350 million. We will very shortly set out with the NHS a detailed programme for the winter and how we can better deal with the pressures.

[Jonathan Ashworth]

The Secretary of State mentioned the pandemic, but he must surely be concerned that yesterday we recorded close to 50,000 infections, and on every single day of the last three weeks 10,000 children have been diagnosed with covid. The booster programme is stalling with charities describing it as a “chaotic failure”, and only about 13% of children have been vaccinated. His wall of defence is falling down at just the point that vaccination is waning, so may I suggest that he ditches the complacency and fixes the vaccination programme now?

Covid-19 Update

Debate between Jonathan Ashworth and Sajid Javid

Tuesday 14th September 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for advance sight of his statement. Like him, I want to send my condolences to the Prime Minister and the wider Johnson family at this difficult time.

Infection levels today are actually higher than they were at this time last year, so the test of the Secretary of State’s plan A and plan B is whether we push infections down, minimise sickness and save lives, keep schools open, protect care homes, maintain access to all care in the national health service, and avoid a winter lockdown. He has talked about a plan B. Can he tell us what level of infection and hospitalisation would trigger plan B? Yesterday, Downing Street briefed about a lockdown as a last resort. What, then, is the first resort in combating the virus to avoid a winter lockdown? Will the Secretary of State rule out today local and regional lockdowns like we saw in my city of Leicester, in Bolton and in parts of West Yorkshire last year?

On vaccination, last night we had confirmation of a vaccine programme for children. We welcome and support that. The Secretary of State has now confirmed a booster jab as well. Again, we welcome and support that. But how will he boost vaccination in those areas of the country where vaccine take-up remains relatively low? For example, in Bradford, second doses are running at about 65%, in Wolverhampton at 65%, in Burnley at 69%, and in my own city of Leicester at 61%. What support will be made available to those areas, or others, so that they can boost vaccine take-up?

Vaccinating children is often justified, in my view wrongly, on the basis of its impact on adults and wider transmission. But children and young people would actually benefit further if vaccination rates were increased among adults. Among younger adults—25 to 30-year-olds—it is running at about 55% on a second dose, and among 30 to 35-year-olds at 68%. So what is the Secretary of State going to do to vaccinate more younger adults? What campaign is he going to run to get those vaccination rates up?

What is the plan for those who are immune-suppressed and have shielded throughout this crisis? For example, 1 million cancer patients cannot produce an immune response to vaccines. Will they be offered the prophylactic antibody treatments that are now available, or will they be expected to shield further throughout the winter?

The Secretary of State is right to raise flu and seasonal viruses, but he will know that the Australian flu season has been minimal. That is good for Australia, obviously, but it impacts the ability to collect samples to make an appropriate vaccine for the strain that might hit us. Is he confident of the effectiveness of the flu vaccine to match this year’s strain?

On Test and Trace and wider diagnostics, we are likely to see more flu and RSV—respiratory syncytial virus—and more common colds and coughs. These are viruses with overlapping symptoms to covid, and an increasing range of symptoms is associated with covid as well. Will he look at multiplex testing, which as well as diagnosing whether someone is covid positive also diagnoses flu and RSV? The Academy of Medical Sciences has recommended this.

The Secretary of State said that PCR testing will continue free of charge through autumn and winter. I think that is the first time that a timeframe has been put on free PCR testing. Is he suggesting that we will move to a different system for PCR testing from next spring and summer, where perhaps people will be expected to pay for a test? Could he clarify the Government’s thinking on testing next spring and summer and the rest of the year?

Isolation rules have changed, understandably, but we still need tracing systems. So will local authorities get the resources they need to do contact tracing? For those who need to isolate still, will local authorities have more money in their funds to pay isolation payments? We know that it is such a struggle for those who are low-paid, on zero-hours contracts and so on to isolate.

The Secretary of State has talked about mask wearing and working from home, but he has not talked about ventilation so much. We know that the virus is airborne. We know that workplaces have legal standards about the quantity of fresh air and purified air that is appropriate, so what will he do to drive up ventilation in workplaces and to support public buildings to install the relevant air purification kits, so that people are not effectively breathing in contaminated air?

The Secretary of State did not mention social care. One of the most devastating consequences of failing to protect care homes or to put that protective ring around them was the tragic number of deaths in care homes. The infection control fund ends on 30 September for social care. Will it be extended?

On vaccine passports, will the Secretary of State clarify what exactly the Government’s position is now? What are the Government actually proposing? What will they ask the House to decide? On Sky, he said he was not ruling vaccine passports out. On the BBC, he said he was ruling the idea out. He is now saying they will keep it in reserve. Yesterday, Downing Street said that vaccine passports are a “first-line defence” against a winter wave. What exactly is the position? Rather than zig-zagging all over the place on vaccine passports, can we just get clarity and can the House make a final decision on whether or not we think they are an appropriate intervention?

[Sajid Javid]

The right hon. Gentleman asked a number of questions, so I will quickly plough through them. We have made clear that plan A is absolutely our focus. It is the situation we are in. Vaccines remain a critical part of it, as do testing and surveillance. I thank him for his support for our vaccine programme, including his comments yesterday. He also asked me about plan B. It is absolutely right that the Government have a contingency plan, and the trigger, so to speak, for plan B, as I mentioned in my statement, would be to look carefully at the pressures on the NHS. If at any point we deemed them to be unsustainable—if there was a significant rise in hospitalisations and we thought it was unsustainable—we would look carefully at whether we needed to take any of those plan B measures. That would be informed by the data, and of course we would come to the House at the time and make the appropriate response.

It is really important to emphasise, as we cannot do enough, the importance of vaccines. We now know from data just yesterday from the Office for National Statistics that, in the first half of this year, 99% of those who died from covid-19 sadly were not vaccinated. That highlights the importance of vaccination.

The right hon. Gentleman asked about people who are immuno-suppressed. He will see that we set out more details on that in the plan we have published today, including treatments that either are currently available or may soon be available. I have mentioned the antivirals taskforce, which is doing great work. There are a number of possible new treatments, and it is something in which the UK is very engaged. He will know that, for those immuno-suppressed people who can take the vaccine, just last week, we announced a third dose as part of the primary treatment. That again is a reminder of the action we are taking. Our advisers are constantly looking to see what more we can do.

The right hon. Gentleman asked about the flu risk. It is a significant risk this year, not least because, for reasons we are all familiar with, there was not much flu last year. There is a lot less natural immunity around in our communities, and the flu vaccine, which is being deployed not only in the UK, but across Europe, has less efficacy than normal, but it is still effective and a worthwhile vaccine, and that is why we will be trying to maximise uptake with the biggest roll-out programme and communications programme that this country has ever seen for the flu vaccine.

On diagnosis, the right hon. Gentleman made a good point, and it is something that we are looking at with covid and flu jointly. On testing arrangements, I think I have set them out clearly in the statement. We have no plans to change the current arrangements, but of course we keep that constantly under review. However, as long as those tests are needed available free for the public, that will be the case. But as I say we will keep that under review.

In terms of infection control in social care settings, a substantial amount of funding is available. We have already made available for this financial year some £34 billion of funding in total for the NHS and the care system for a lot of these extra measures. That is a huge amount of funding. Much of it is going to essential work, such as infection control, and we will ensure that what is needed is there.

The right hon. Gentleman’s last question was about vaccine certification. I think I have made the Government’s position clear. It is not something we are implementing. We are not going ahead with any plans for that. For any Government to do something like that, it would be such a big decision, and it would have to be backed up by the evidence and the data. That evidence is not there, and I hope that we will never be in the situation that it is. To keep it in reserve is the right thing to do.

Health and Care Bill

Debate between Jonathan Ashworth and Sajid Javid

2nd reading
Wednesday 14th July 2021 Commons Chamber

[Sajid Javid]

The right hon. Gentleman has raised an important matter. There are issues surrounding the cosmetic surgery industry, and I know that he has spoken eloquently about them in the House before. I do not necessarily agree that this Bill has to be the vehicle for any change, but if he wishes to discuss the matter further, I should be happy to meet him in due course, because it is important and it does require a fresh look.

Whenever the NHS is subject to change, it is tempting for some, who should actually know better, to claim that it is the beginning of the end of public provision. We know that that is complete nonsense, and they know it is nonsense, but they say it anyway. So let me very clear: our integrated care boards will be made up of public sector bodies and those with a social purpose. They will not be driven by any private interests, and will constantly make use of the most innovative potential of non-NHS bodies.

The spirit of this Bill is about holding on to what is best about the NHS and removing what is holding it back. That is something that we all want, and I am looking forward to a mature debate—[Laughter.] Perhaps that is too much to ask in this Chamber with this Opposition Front Bench, but I hope for, and I think the public expect, a mature debate on the Bill and on how we can achieve these sensible changes together.

In that spirit, the second theme of the Bill is cutting bureaucracy. As we have been tested during these past months, we have looked at the rules and regulations through new eyes. It has become increasingly clear which of them are the cornerstone of safe, high-quality care, and which are stifling innovation and damaging morale. It is that second group of rules and regulations that the Bill strips away, removing the existing procurement regime and improving the way in which healthcare services are arranged. Yes, this is about how we deliver better value for the taxpayer, but fundamentally it is about how we can free up NHS colleagues to deliver better care. We know that patients are better served when experts are free to innovate unencumbered by unnecessary bureaucratic processes. That is why the Bill will repeal section 75 of the Health and Social Care Act 2012, giving the NHS the flexibility for which it has been asking. I know that this is a point of agreement with the Labour party—

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

We said it 10 years ago.

[Sajid Javid]

The Labour party said it not just 10 years ago but in 2015, 2017 and 2019—in all those manifestos—so I am sure that its members agree with this direction. [Interruption.]

Covid-19 Update

Debate between Jonathan Ashworth and Sajid Javid

Monday 12th July 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for advance sight of his statement. I join him and others across the House in paying tribute to the England side. They did indeed unite the country, and we are proud of each and every one of them. Of course, those players did take the knee to show they were taking a stand against racism. Labour again offers them our solidarity and joins with others in condemning utterly the racist, vile abuse that we have seen in the last 24 hours.

We want to see the economy reopen in a balanced, safe and sustainable way. That means maintaining certain mitigations to contain the speed at which infections are rising, to help reduce transmission and to help to limit the numbers exposed to the virus before they are fully vaccinated. Instead, the Secretary of State has taken a high-risk, fatalistic approach, trying to game what might happen in the winter and deciding that infections are going up anyway. Instead of caution, he is pushing his foot down on the accelerator while throwing the seatbelts off. He admits that that could mean 100,000 infections a day, which means potentially thousands suffering debilitating long covid and that, as more cases arise, more may escape, with the threat of a new, more transmissible variant emerging.

Two weeks ago, the Secretary of State justified unlocking by suggesting that it would make us healthier. Today, hospital admissions are running at more than 400 a day and there are now 393 people in intensive care units, up by more than 100 since the start of July. Of course, significant increases in admissions have a knock-on effect on the NHS’s ability to provide wider care. He says that infection rates will not put unsustainable pressure on the NHS, but last week cancer patients at Leeds were having their surgery cancelled and ambulance trusts across the country were reporting some of their busiest days ever. The 111 service is under intense pressure.

At the weekend, the Secretary of State warned that the elective waiting list could rise as high as 13 million. Perhaps he could therefore define what he means by “unsustainable pressure”. What does he predict that hospital admissions will peak at? He has told us he expects 100,000 infections, so how many hospital admissions does he expect? Does his confidence mean that there will be no extra resources for the NHS this summer to get through this summer wave? He again highlights vaccination, but why are vaccination rates slowing down? What will he do to drive up rates among younger people, which are still at only about 56% of 18 to 24-year-olds? When will we begin vaccination of adolescents? Other countries are doing it—why are we not?

To rely only on vaccination as infections climb is the approach of the one-club golfer. The Secretary of State needs to put other measures in place as well. First, Labour would continue with mandatory mask wearing. I notice that his tone has shifted in the last week or so and now his view is that it would be irresponsible not to wear a mask in a crowded room. Surely it is equally irresponsible for the Government to abandon mandatory mask wearing.

Secondly, on working from home, yesterday Susan Hopkins from PHE suggested that for the next four to six weeks at least people should try their best to work from home, so will the Secretary of State guarantee that anyone who wants to continue working from home will have the right to do so?

Thirdly, we know how important fresh air is. Germany has funded air filtration systems in public buildings. Last week, the Secretary of State referred to the infection control funding given to social care, but that was not for ventilation. There are British firms that manufacture air filtration and ventilation units, so let us support those firms and British jobs, and offer grants to premises to install air filtration units. Will he also use the summer to install air filtration systems in every school?

Fourthly, as more virus circulates, more people will be exposed, more people will become ill and more will have to isolate, but some people still cannot isolate because of their finances, and those with caring responsibilities for someone who has had to isolate can also be financially penalised. Furlough is beginning to be withdrawn, so financial support for isolation will become even more urgent. Will the Secretary of State ensure that those who need to isolate can access adequate sick pay and support?

Fifthly, to get through this third wave and flatten the curve, we will need ongoing testing, and contact tracing will need extra capacity. Will the Secretary of State give local authorities the resources to lead the enhanced retrospective and forward contact tracing they need to do, and will he now abandon the proposed charges for lateral flow tests, which he is set to introduce?

Finally, when the Secretary of State was appointed, he said that any easing on 19 July would be, in his word, “irreversible”. Other countries have thought the same with their road maps, yet Israel has reintroduced masks, and the Netherlands reopened nightclubs and had to close them again after two weeks. Is it still his view that the 19th is terminus day and that everything he has announced today is irreversible, or does he agree that it would be more sensible to have regular review dates in place through the summer as we deal with this third wave and rising infections?

[Sajid Javid]

The right hon. Gentleman started by saying that he supports a balanced approach in a sustainable way, and that is exactly what I have set out today from this Dispatch Box. That is the Government’s approach, so I agree with him. We as the Government have set out the detail, but I am still not sure what his plan actually is. However, given that he set out those objectives, I hope he can support this plan. He talks about the risks that are involved, and I have been very up front about that. The Government have been up front: there is no risk-free way forward. Opening up is not without risk, but ongoing restrictions are not without cost, and I hope he appreciates that.

The right hon. Gentleman raised a number of questions, and one of his first was about hospitalisations. As I have said, case numbers are going up and we expect them to continue going up, but the most important difference today versus the last wave is vaccination—the wall of defence that our country has built—which has meant that hospitalisations, although they are rising as case numbers rise, are rising at a rate that is a lot slower than before. I have set out specifically regarding test 3 in a road map that we believe the pressure, with all the data we are seeing at this point, is not unsustainable for the NHS.

The right hon. Gentleman talked about vaccinations, and I am pleased he is highlighting that, especially for more young people to come forward. As I mentioned in my statement, we are ahead of the plans we set out when step 4 was temporarily pushed out by four weeks. He also asked about the vaccination of children. He knows that we have a group of expert science advisers—the Joint Committee on Vaccination and Immunisation—and this is something it is actively looking at. At some point, we will reach a final decision, but I hope he will agree with me that we should take the scientific advice on that and consider it very carefully before making such a move.

On air ventilation units, some of the £90-plus billion extra the Government have provided to the health and care system during the course of this pandemic has of course gone on air ventilation units, and we should continue to support that. A lot of extra funding has also gone to people to support them financially if they are asked to isolate, and it is important that that is both kept under review and continues to be taken seriously.



The right hon. Gentleman mentioned lateral flow tests and something about charging for them. That might be his policy, but it is not this Government’s policy. I do not know where he has got that one from, but we have no plans to charge for lateral flow tests.

Lastly, 19 July is a step forward on our road map. As we have clearly set out, the pandemic is not over, but it is a very significant step forward. The right hon. Gentleman talked about reviews. I have just said that we will have a review in September to make sure that we are properly set up for autumn and winter.

Covid-19 Update

Debate between Jonathan Ashworth and Sajid Javid

Tuesday 6th July 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I thank the Secretary of State for advance sight of his statement. This morning, he warned that he expected infections to hit 100,000 a day. Will he confirm that he is saying that will be the peak? By his expectation, when will we hit it? Infections at 100,000 a day will translate to around 5,000 people a day developing long-term chronic illness—long covid. What will the long covid waiting list look like by the end of the summer?

The Secretary of State justifies allowing infections to climb by pointing to the weakened link between hospitalisation and deaths, and saying that we are building a protective wall. But the wall is only half built. We know from outbreaks in Israel and research that the delta variant can be transmitted through fully vaccinated people, even if they do not get sick.

Indeed, data in the last 24 hours or so from Israel’s Ministry of Health points to the Pfizer vaccine being just 64% effective at stopping symptomatic and asymptomatic transmission of the delta variant. Sadly, being double jabbed means a person is still a risk to others, yet the Secretary of State is releasing controls on transmission at a time when infections are rising. Hospitalisations will rise, too, given what we know he is doing.

Can the Secretary of State tell us the percentage of intensive care beds, and general and acute beds, that need to be occupied before, in his view, wider NHS care is compromised? We have heard him in the last week or so tell us that he wants to unlock because he rightly wants to focus on the monumental NHS backlog, but the rising hospital admissions that are baked into the plan, into the path he has chosen, will mean operations cancelled, treatments delayed and waiting times increased. Will he now be clear with patients, who are waiting longer and at risk of permanent disability, that the increase in hospital admissions will mean they have to wait longer? What is his assessment of the waiting list, and what will it hit by the end of the summer?

I understand the rationale for the Secretary of State’s announcement today, but I have to tell him again that the biggest barrier to an effective isolation policy has been not the inconvenience but the lack of financial incentive to stay at home. If we are to live with this virus, the days of people soldiering on when unwell are over. Sick pay is vital to infection control. Will he please now fix it?

Getting back to normal, which we all want to do, depends on people feeling safe. Does the Secretary of State appreciate that those who are immunocompromised, or for whom the vaccination is less effective, will have their freedoms curtailed by ditching masks on public transport? Blood Cancer UK warned yesterday that people with blood cancer will feel like their freedoms have been taken away when mask wearing lifts. What is his message to those with blood cancer? It is not good enough simply to say that people should travel or go to the shops at less busy times.

Of course, the Secretary of State understands the importance of masks. I have now read his Harvard pandemic paper, to which he likes to refer. He praises the use of masks in this paper, but he also warns:

“Changing course in policy making…is an essential feature of good policy making. Yet, politicians find it hard”—

because of—

“the tendency for decisions to become psychologically and emotionally anchored.”

Well, I agree with him, and I hope he still agrees with himself. Let us have a U-turn on mask wearing. Yes, let us have freedom, but not a high-risk free for all. Keep masks for now, fix sick pay and let us unlock in a safe and sustainable way.

[Sajid Javid]

Let me turn to the right hon. Gentleman’s questions. First, he asked about infections. As I said yesterday from this Dispatch Box, we expect infections to continue to rise for the time being, for the reasons I set out yesterday. By 19 July, when we enter step 4, the advice we have received and the modelling suggests infections could be as high as 50,000 a day, double what they are now. Beyond that, as he says, we believe infections will continue to rise. As the modelling goes out further, it is less certain, but infections could go as high as 100,000 a day. I have been very up front about that.

What I have also been very clear about is that the reason we can make the decisions that we have made, as set out yesterday and today, with the decision just announced on self-isolation rules for those who are double vaccinated if they come into contact with someone who is infected, is because of the vaccine. The vaccine has been our wall of defence. Jab by jab, brick by brick, we have been building a defence against this virus.

Although no one can say at this point that the link between cases and hospitalisations has been definitively broken—there is not enough evidence for that—there is enough evidence to show us that the link between cases, hospitalisations and deaths has been severely weakened.

The right hon. Gentleman asked how many hospitalisations there have been or there may be. What I can tell him will help to demonstrate how this link has been severely weakened. In the last 24 hours, there have been approximately 27,000 reported new infections, and the total number of people in hospital in England with covid-19 is just under 2,000. The last time we had infections at that level, we were certainly above 20,000. That is a demonstration of how much the link has been weakened. In making sure that it stays that way, we of course want to see more and more people getting vaccinated. We have announced a booster programme that will start in September, to make sure that the immunity that comes from the vaccine remains.

The right hon. Gentleman also rightly talked about non-covid health problems, which a number of hon. Members have raised. I would like him to try to understand that one reason why so many people who wanted to go to the NHS with non-covid health problems such as cancer, heart disease and mental health problems but were prevented from doing so, is the restrictions that we had in place. The restrictions caused many of those problems—for example, the right hon. Gentleman should think about the mental health problems that have been caused by the restrictions. If we want to start dealing with non-covid health problems, we must start easing and moving away from the restrictions because of the protection that the vaccine has provided us. As the shadow Health Secretary, the right hon. Gentleman should be just as concerned about non-covid health problems, as I am, as he is about covid health problems.

The right hon. Gentleman also asked me about the immuno-suppressed. Again, he and other colleagues are absolutely right to raise this issue. The vaccines are there to protect everyone, including many people who are immuno-suppressed but who can take vaccines. For those people who cannot take vaccines, the fact that the rest of us do helps to protect them. We would them to take the same precautions that they would usually take in winter—for example, trying to protecting themselves against colds, flus and other viruses. I also encourage people to ensure that they are in contact with their GP to see what other measures or precautions they might be able to take.

Lastly, the right hon. Gentleman asked me about masks. He referred to a paper that I authored before I took this position, but he should understand that it is a strange question for him to ask. There is a role for masks in dealing with a pandemic, particularly when we have no wall of defence against it. When we have a vaccine, when that vaccine works and when we have the best vaccine roll-out programme in the world, we need to start moving away from restrictions, including on masks.

Covid-19 Update

Debate between Jonathan Ashworth and Sajid Javid

Monday 5th July 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

I start by paying tribute to our NHS on its 73rd anniversary and thank again our extraordinary health and care workforce. The best birthday present they could have, of course, is a fair pay rise, not the proposed real-terms pay cut that is currently on offer.

We all want to see these restrictions end. Lockdowns are a sign of policy failure and I hope that, when the Secretary of State makes the final decision next week, it will be based on the data, the modelling and the Scientific Advisory Group for Emergencies advice, but let us be absolutely clear about what he is talking about today. When only 50% of the total population across England are fully vaccinated and another 17% are partially, his strategy, as he indeed was gracious enough to concede, accepts that infections will surge further and continue to rise steeply, and accepts that hospitalisations will continue to rise until they reach a peak—presumably later this summer. Some of those hospitalised will sadly die, and thousands upon thousands of mostly children and younger people, but others as well, will be left exposed to a virus mainly because they have no vaccination protection—we also know that even double-jabbed people can catch and transmit the virus—and many of them will be at risk of serious long-term chronic illness, the personal impact of which may be felt for years to come.

Even though vaccination may have broken the link with mortality, there are still questions about the link to morbidity. As part of the Secretary of State’s strategy of learning to live with covid, will he spell out today for the British public what that actually means? How many deaths does he consider are acceptable when we are living with covid? How many cases of long covid does he consider acceptable when we are living with covid? Given that we know that covid can escape and evolve when the virus circulates at high rates, what risk assessment has he done on the possibility of a new variant emerging? Will he publish it?

The Secretary of State says that every date for unlocking carries risk and that that is why we need to learn to live with covid, but we should not have to take a high-risk approach. We should be pushing down risk. Indeed, we mitigate risk across society all the time. We do not just accept other diseases; we take interventions to try to prevent them. Why is he therefore collapsing all mitigations completely when he knows that covid rates will continue to rise? He will be aware that Israel has reintroduced its mask mandate because of the delta variant, so why is he planning to bin ours? Masks do not restrict freedoms in a pandemic when so much virus is circulating. They ensure that everyone who goes to the shops or who takes public transport can do so safely, because wearing a mask protects others. If nobody is masked, covid risk increases and we are all less safe. He must understand that those in the shielding community are particularly anxious. Why should they feel shut out of public transport and shops because he has abandoned the mask mandate? That is no definition of freedom that I recognise.

Who else suffers when masks are removed? It is those working in shops, those who drive the buses, those who drive taxis and those who work in hospitality—it is the low-paid workers who have also been without access to decent sick pay. Many of them live in overcrowded accommodation. It is those who have been savagely, disproportionately impacted by the virus from day one and now the Secretary of State is asking them to bear the brunt of the increased risk again. Will he explain why he thinks abandoning masks is a sensible proposal to follow?

Given that people will still need to isolate, as the Secretary of State recognised, and that test and trace will still be in operation, will he accept that living with the virus will mean that, more so than ever, those who are sick will need to isolate themselves from the rest of society? Will he therefore ensure that they are paid proper sick pay and isolation support to do it? Does he agree that it has been a monstrous failure of the past 15 months that isolation support has not been in place?

Now, masks are effective because we know that the virus is airborne. The Secretary of State could therefore further mitigate covid risks by insisting on ventilation standards in premises and crowded buildings. He could offer grants for air filtration systems. Instead, all we get is more Government advice. Ventilation in buildings and grants to support air filtration systems do not restrict anyone’s freedoms. Indeed, they would probably help get back into school some of those 400,000 children who have been off school because of covid.

Yesterday, the Secretary of State said that he believed the best way to protect the nation’s health was to lift all restrictions. I know he boasts of his student years at Harvard studying pandemics, but I think he may well have missed the tutorial on infectious disease control because widespread transmission will not make us healthier. We are not out of the woods yet. We want to see lockdown end, but we need those lifesaving mitigations in place. We need sick pay, local contact tracing, continued mask wearing on public transport and ventilation in buildings and schools to prevent further illness. I hope, when the right hon. Gentleman returns next week, he has put those measures in place.

[Sajid Javid]

I thank the right hon. Gentleman for his comments. First, I think he started by asking for reassurance on whether the final decision on go or no go for 19 July, which we will make on 12 July, will be informed by the very best expert data. Of course it will be, just as every decision has been informed in that way. I am only about a week into the job, but I must say that I am incredibly impressed by our scientists, medical advisers and Public health England. I take this opportunity to pay tribute to all they have been doing.

Turning to the right hon. Gentleman’s second point about the link between cases and hospitalisation and death, that is absolutely central to the next step we are taking. Case numbers are high. As I said, they will go significantly higher and we need to be ready for that, but what is far more important is how many people are ending up in hospital and how many, sadly, are dying. That is where the vaccines have worked, alongside the treatments we now have that we did not have a year or so ago. That has meant that the link between cases and deaths has been severely weakened. The last time we had 25,000 new cases a day, we had around 500 deaths a day. The level now is a thirtieth of that. I know the right hon. Gentleman will welcome that and understand that there is no absolutely risk-free way to move forward, but we need to start returning things back towards normal and learning to live with covid.

The right hon. Gentleman asked about masks. Again, we have taken the best public health advice. He will know from what I have said that, although we will remove all legal requirements for anyone to wear a mask in any setting, we expect people to behave sensibly and think about others around them. The guidance will be there. If one is on public transport—let us say on a very crowded tube—it would be sensible to wear a mask, not least to show respect for others. However, if you are the only person in a carriage late at night on the east coast main line, then you can choose much more easily not to wear a mask because there is hardly anyone else around. We expect and trust people to make sensible decisions. That is the way we should move ahead.

The right hon. Gentleman asked about compensation and sick pay. He knows that many measures are in place and we will continue to keep them under review.

Covid-19 Update

Debate between Jonathan Ashworth and Sajid Javid

Monday 28th June 2021 Commons Chamber

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

Can I just say at the outset that, despite our fierce political differences, my dealings with the previous Secretary of State, the right hon. Member for West Suffolk (Matt Hancock), were always courteous, respectful and professional, and I wish him well in resolving his personal difficulties.

I welcome the right hon. Member for Bromsgrove (Sajid Javid) to his place and thank him for advance sight of his statement. He will find working with the NHS and social care staff both inspirational and rewarding, and I hope he will agree to make arrangements for them to receive a fair pay rise and not the real-terms pay cut that is currently pencilled in.

Today, the Secretary of State has let it be known that the 19 July reopening will effectively go ahead. He told the news this morning that there is “no going back” and that lifting restrictions will be “irreversible”. A word to the wise: I have responded to a lot of these statements these past 15 months, and I remember Ministers telling us there was “nothing in the data” to suggest that 21 June would not go ahead. I remember children returning to school for one day before the January lockdown. I remember, “It will all be over by Christmas”. I remember, “We will send it packing in 12 weeks”.

Well, we have seen around 84,000 cases in the past week—an increase of around 61%. Today, we have seen the highest case rate since January. If these trends continue, we could hit 35,000 to 45,000 cases a day by 19 July. That will mean more long covid—the Secretary of State did not mention more long covid—and it will mean more disruption to schooling. For some, it will mean hospitalisation, and we know that even after two doses, someone can catch and transmit the virus, so what is he going to do to push infections down? Vaccination will do it eventually, but not in the next four weeks.

I want to see an end to restrictions and our constituents want to see an end to restrictions, but I hope the Secretary of State’s confidence today about 19 July does not prove somewhat premature or even, dare I say it, hubristic. Can he confirm that by “irreversible” he is ruling out restrictions this winter? Has he abandoned the plan that the previous Secretary of State and officials were drawing up for restrictions this winter?

Increased infections will impact on the ability of the NHS to provide wider care. Today, the Secretary of State has promised to give the NHS everything it needs to get through the backlog, so will the hospital discharge and support funding be extended beyond this September, or will trusts have to make cuts instead? How does he define getting through the backlog? When will the NHS again guarantee that 95% of patients will start treatment within 18 weeks of referral? We know thousands are waiting too long for cancer care, so when will the NHS meet its cancer target that 96% of patients wait no longer than a month from diagnosis to first treatment? When will he give primary care the resources to meet the challenge of the hidden waiting list of over 7 million patient referrals that we would have expected since March 2020?

Given the pressures on primary care, is it still the Secretary of State’s plan to press ahead with the GP data transfer? To be frank, Mr Deputy Speaker, if the Department cannot keep its CCTV footage secure, how does he expect it to keep our personal data secure? Will we see a plan to fix social care, or is today’s Telegraph correct when it reports that he, the Secretary of State, is of the opinion that we are completely at the wrong stage of a Parliament to launch a new social care strategy? Is that really his view? Given the pressures across the whole of the healthcare service, will he abandon the ill-thought-through top-down reorganisation of the NHS that the previous Secretary of State was set to embark on?

Finally, given the recent questions of propriety around covid contracts, the Secretary of State will understandably want to present himself as a new broom. Can he confirm that he will not use a personal email account to carry out Government business? Can he explain why the social care Minister has been using a personal email account to carry out Government business? Why was the Minister for Innovation, the noble Lord Bethell, using his personal email account to discuss the awarding of Government contracts, and why did he have meetings with a firm that won a contract but not declare it? Can he tell us whether he maintains confidence in that Minister? Is it not time that that particular health Minister was relieved of their ministerial responsibilities as well?

[Sajid Javid]

First, I thank the right hon. Gentleman for his comments and for what he said about my predecessor.

On the right hon. Gentleman’s questions, he started by rightly pointing out the incredible work that our NHS staff across the country have been doing, even before the pandemic, but especially, I think we would all agree, throughout the pandemic. I heard about that myself this morning during my visit to St Thomas’s Hospital talking to staff—doctors, nurses, consultants—and hearing directly about the challenges they faced at that time but also the challenges they continue to face. I wanted to hear from them what more the Government can do, whether on recruitment or resources, and what more help can be provided. So it remains an absolute priority. Of course, it is absolutely essential that, when the pay settlement process is complete, that is a fair process. Of course, it absolutely will be and it will be a fair pay settlement.

Turning to the right hon. Gentleman’s next question about the timing of the move to step 4, I set out, I think clearly in my statement, the Government’s plan and the rationale for that plan. I point out that what is at the heart of this is the vaccination programme and the excellent work that has been done by many across the country: the volunteers, doctors, and nurses. I visited a vaccination centre today, as well as St Thomas’s Hospital. Excellent work has also been done by the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi). More people are getting vaccinated. We are seeing clear evidence that we are breaking the link—this is absolutely crucial—between the number of cases of people getting infected by covid-19 versus those who sadly end up in hospital or even, in some cases, lose their lives. The more evidence we see of that, the more confident it can make us that we will put this pandemic behind us. That is what gives me confidence about the date of 19 July. With all the data I saw yesterday—I sat down and discussed it with the experts and my colleagues—it is very clear that we are heading in the right direction, and I am very confident about that date of 19 July.

The hon. Gentleman rightly asked about the backlog. The focus, for all the right reasons, of the NHS and social care system on dealing with the pandemic has, sadly, seen a significant backlog of cases build up. The Government have already provided record amounts of funding to try to deal with some of that backlog. In total to deal with the pandemic, some £92 billion of extra funding has been put into the NHS and social care system, and much of that is targeted at the backlog. It will be an absolute priority—it was for my predecessor, and it certainly will be for me—to see how quickly we can deal with that and what the best and most efficient way is to do so. Just today, on my visit to St Thomas’ Hospital, I heard some excellent new ideas from people on the frontline. We will certainly be listening to them as we set out further plans.

The hon. Gentleman also asked about social care, and I should warn him not to believe everything he reads in the press—and I think he should know that. Social care remains an absolute priority for this Government, and for me. The Prime Minister himself has rightly made some very clear commitments on social care, and we absolutely intend to meet them. When it comes to reform, of course we are committed to the Bill on NHS and social care reform, which my predecessor has talked about at the Dispatch Box. If hon. Gentleman sits down with me, perhaps I can persuade him a little of the virtues of that Bill, and I am sure I can convince him that it is essential. If, like me, he believes that what matters most are the patients—we want the people who go into hospital feeling unwell to be seen quickly and efficiently and to get better—the people in our social care system, and having better integration, then he will believe in the virtues of that Bill. I hope, eventually, he can come to support the Bill and do the right thing.

Lastly, the hon. Gentleman asked me about my Ministers. I have such a fantastic ministerial team—all and every single one of them. It is not just a question of confidence; it is a group of Ministers who are incredibly talented and who have delivered both in this House and in the Lords. Having led five Departments previously, I have had some considerable experience of working with Ministers, and this is one of the best teams I have ever had.