HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (ALL TIERS) (ENGLAND) (AMENDMENT) REGULATIONS 2021 HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (ALL TIERS AND SELF-ISOLATION) (ENGLAND) (AMENDMENT) REGULATIONS 2021

Debate between Justin Madders and Nadine Dorries

Monday 8th February 2021 General Committees

[Ms Dorries]

That was a large number of questions covering a number of points. I know that officials are furiously trying to group them at the moment. I will do my best to answer them as well as I can. If there are any that I do not answer, I give the hon. Member for Ellesmere Port and Neston and my right hon. Friend the Member for Forest of Dean absolute assurance that they will be written to quickly with more detailed answers.

The first point raised by the hon. Gentleman was about why the regulations have come in after the event. Public health underpins what we are doing today. My right hon. Friend’s last question was about this being a public health initiative, and not a stick or a means of taking away people’s freedoms for the sake of it. That is absolutely not what the regulations are about; they are very much a response to the South African variant. We need to do what we can to ensure that people self-isolate when they are supposed to, that they are deterred from gathering in groups and that we do as much as we possibly can, using the instrument of the law, to protect the health of the nation.

Coronavirus is a brand-new virus, and we knew nothing of its biology or pathology when it landed on our shores this time last year. One thing that I have learned since then as a Health Minister is that when the virus mutates—there have so far been more than 10,000 mutations—the figures go in only one direction when they start to rise. They do not rise to small numbers and then suddenly drop off and disappear without very restrictive action, such as that taken in China and other countries where there is a much stronger social contract with the population.

We move very quickly, but the virus moves faster. It would be wrong of us, as a Government, to see a variant such as the South African one and not look at what further public health measures we can put in place now to protect the health of the nation and stop the variant rising.

[Justin Madders]

I am grateful for the Minister’s answer. I only wish that such action had been extended to quarantining international arrivals for the South African variant. Does that explanation also apply to the question of gatherings? Does anything about that variant apply to large gatherings and explain why the regulations were brought in as they were?

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[Ms Dorries]

Our police are very responsible individuals. If they receive a report that somebody is believed to be breaking regulations, or breaking isolation, they will not automatically ask Test and Trace for the individual’s information before they have carried out an assessment of the situation. They would need to clarify for themselves whether a breach was actually taking place, such as a breach of the numbers—for example, if it was not a single-household individual mixing within their bubble. They would have to assess the situation and see if the regulations were being broken. If they were being broken, the police would have the right to revert to Test and Trace to ask for clarification on the individual’s details.

Both my right hon. Friend and the hon. Gentleman are pursuing a definition—as my right hon. Friend knows well—in legal terms within the legislation. I will need to seek legal clarification and write to both of them with the details on that point.

[Justin Madders]

I appreciate the Minister’s valiant efforts to explain how this all works in practice. I think that the answer, as the right hon. Member for Forest of Dean said, is to publish the memorandum of understanding. That is the way that we will all gain clarity on how this all works—I hope.

I will just go back to what the Minister’s colleague, the Minister for Care, said on 19 October last year. When asked if the memorandum of understanding would be published, she said, “It will be.” The Minister seemed to be backtracking a little from that tonight. Can she confirm whether we will actually get sight of it?

[Ms Dorries]

I am aware that it exists as a working understanding, as I said, between DHSC and policing. Obviously I will consider both points about transparency and take them both on board. However, I need to seek further clarification—if, why, legally, and how?—around the memorandum of understanding. The hon. Gentleman’s points have been well made today and have been noted. I will take the process further and explore the options, then get back to him with an answer.

[Justin Madders]

I am sorry to press the point, but one of the Minister’s colleagues said on the record that it will be published and she is now saying that that is not, or might not be, the case. That is not acceptable. We must have things said by Ministers on the record adhered to.

[Ms Dorries]

I completely agree. I have just been informed, in the form of our old notes, that the memorandum of understanding is currently being updated to reflect feedback from the Information Commissioner’s Office and the recent changes made by this SI.

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[Justin Madders]

I am grateful for the Minister’s explanation. It seems that, as we would expect, this decision is based on scientific advice. Would the Minister be able to publish that, so that we can see it in full?

[Ms Dorries]

I am sure that the hon. Gentleman’s request has been listened to—he knows that publishing the advice from SAGE is above my pay grade.

As I said, fixed penalty notices for those caught attending illegal gatherings, such as house parties, of more than 15 people will double for each successive offence, up to a maximum of £6,400. These amendments to the all tiers and self-isolation regulations will provide the police with the enhanced powers that they need to tackle egregious breaches of the law.

Unfortunately, covid-19 has forced us to balance the increasing social contact restrictions with the protection of public health. These decisions are not easy ones to make, but with alarming epidemiological evidence suggesting that the new variant is much more transmissible, urgent action has become appropriate. We will continue to work alongside scientific and medical experts to ensure we have decision making appropriate to the circumstance at each stage of this crisis, and we will review the regulations regularly, assessing them in the light of the latest science and other data. I commend the regulations to the Committee.

HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (ALL TIERS) (ENGLAND) (AMENDMENT) REGULATIONS 2021 HEALTH PROTECTION (CORONAVIRUS, RESTRICTIONS) (ALL TIERS AND SELF-ISOLATION) (ENGLAND) (AMENDMENT) REGULATIONS 2021

Debate between Justin Madders and Nadine Dorries

Monday 8th February 2021 General Committees

[Ms Dorries]

[Justin Madders]

[Ms Dorries]

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[Ms Dorries]

[Justin Madders]

[Ms Dorries]

[Justin Madders]

[Ms Dorries]

[Ms Dorries]

[Justin Madders]

[Ms Dorries]

Ockenden Review

Debate between Justin Madders and Nadine Dorries

Thursday 10th December 2020 Commons Chamber

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I thank the Minister for advance sight of her statement and the personal commitment she has shown on this issue. I too thank Donna Ockenden and her team for their work to date.

Sadly, the report is not the first of its nature, and it is unlikely to be the last. We need to get ourselves into a place, sooner rather than later, where these systemic, almost cultural, failings become a thing of the past. The families have suffered unimaginable pain, and it must not be exacerbated by closed and defensive responses to the tragedies they have experienced.

Today’s statement comes only a fortnight after another damning report on maternity safety—Bill Kirkup’s report “The Life and Death of Elizabeth Dixon”. This is the latest in a long line of reports that show that, across large parts of the NHS, there is still a long way to go before we have the openness and transparency that patients deserve. That is not to do down the hundreds of thousands of staff who do a fantastic job day in, day out, but the report points to the wider problem—it is not a new problem—that when things go wrong, there is too little candour, too much defensiveness and a lack of leadership at the top of trusts; the leadership do not take personal responsibility and put right what has gone wrong.

Once again, we have got to this point only because of the persistence and resilience of the grieving families who have suffered such personal tragedy and refused to accept that what they were told was the end of the matter. I want to put on the record my appreciation of the courage and strength that they have shown throughout, but we really should not expect light to be shone on these issues only because individual families do not accept what they are told.

Senior leadership within trusts has to be much more candid and challenging with itself when faced with these concerns.  These families just want answers and an assurance that nobody else will have to go through what they did, but, too often, they do not get them. The fact that we are now looking at more than 800 cases over a 40-year period, when the original investigation was tasked to look at just 23, must surely tell us that, for a very long time, those grieving families were not being listened to and the necessary lessons were not being learned. That in itself is as much a failure as the individual incidents. With so many more families coming forward and having to relive some of the most difficult experiences in their lives, it is vital that support is offered to them to deal with the consequences of that, so can the Minister assure us that appropriate support is available to all those who need it?

So that we will all be clear now, the Ockenden review will be far larger and take far longer than was originally intended. Can the Minister assure the House that the review has the resources necessary to complete the final report as soon as possible? I understand that the trust has not waited until today to take action, but, inevitably, further recommendations will emerge from the final report. There are also actions for the whole NHS, and a number of specific actions that can be taken across the board now, which the Minister indicated are in fact urgent. I would be grateful if she indicated whether she intends to set a deadline for implementation of the system-wide recommendations and whether she will provide regular updates to the House on their progress.

Strong leadership, challenging poor workplace culture and ring-fencing maternity funding are all key to improving safety. On tackling the poor workplace culture that exists in some trusts, it is clear that there is still a long way to go. It is concerning to see a report this morning that the review into bullying at West Suffolk Hospital, which was originally due to be published last April, is now not due until next spring. It is also clear that there is a pressing need to reinstate the NHS maternity safety training fund. That money was vital for safety and makes a big difference to care, so can the Minister commit to reinstating that training fund?

Can the Minister also advise what action is being taken to ensure that we have enough staff in all maternity units, and will the Government commit to legislating for safe staffing levels? More widely, can she set out what is being done to tackle the estimated 3,000 midwife vacancies that we currently have? We cannot ignore the fact that some of the problems created by this culture will be exacerbated and will continue if we do not solve the staffing and resourcing crisis in the NHS, and these issues will continue to compromise patient safety.

Finally, it is understandable if families who are currently receiving care at the trust are anxious. Can the Minister provide them with some reassurance today that they will be safe and well looked after?

[Ms Dorries]

I thank the hon. Member for Ellesmere Port and Neston (Justin Madders) for his, as always, constructive and reasonable tone in his response. Yes, I can assure him that the resources are in place, and have been guaranteed to be in place. As for the deadline, it is 2021. I cannot give an exact month. It was really important to me—I believe that Donna Ockenden has mentioned this in her report a number of times— that the first 250 cases were evaluated so that we could take the learning from those cases and introduce it as quickly as possible. In that way, we could identify what had gone wrong so that we could prevent it from happening again in the future. That is why we have produced the report in two stages. We know the findings of this interim report and the recommendations that have been identified by Donna and her team can be put in place. The second stage of the report will appear before the end of next year—certainly in 2021. I will, as the hon. Gentleman requests, and personally if he requires it, update the House on what is happening with the report.

With regard to the maternity safety training fund, we secured £9.4 million in the spending review. It cannot be underestimated, in this time of covid, what a huge achievement that was. The money will not go into the old format of the maternity safety training fund, because we do not believe that that worked as well as it should have done. Much of that money was used to backfill the staff, who then, unfortunately, did not attend training. We did not get the best results—the biggest bang for the buck.

What we, as a Department, are doing now is directing that £9.4 million to where it is needed most and to where it can be spent in the most effective manner to produce results in maternity safety. That work is ongoing now in the Department, and I hope to be able to update the House and the hon. Gentleman very soon on how that money is being spent and what results we expect to see in return for the expenditure.

I did not anticipate the hon. Gentleman’s question about midwives. I do not have the exact number, because the figure rises every day. None the less, we are recruiting new nurses—I think the figure was 12,000 when I last gave a statement to the House—some of whom will be recruited to become midwives. So, yes, work is under way on the workforce and on nurse recruitment.

Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) (Amendment) Regulations 2020 Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) (Amendment) (No. 2) Regulations 2020 Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place and on Public Transport) (England) (Amendment) Regulations 2020

Debate between Justin Madders and Nadine Dorries

Monday 21st September 2020 General Committees

[Ms Dorries]

I will not take any more interventions, and we will now move on. Covid marshals will be subject to their own SI shortly, but this Committee is about three SIs on face coverings. I will keep to the point of face coverings, which is what I am here to address. I am not here to debate an SI on covid marshals.

I have set out why we felt it necessary to do as we did after the guidance. We were also receiving information that people were happy with wearing face coverings, and, from public compliance and people wanting to keep themselves safe, it was obviously the right thing to do at that time.

[Justin Madders]

The Minister is absolutely right to say that she has been generous in taking interventions, both today and on previous occasions. I want to try to understand what she has said about the delay. She has talked about the science evolving, and of course we accept that. However, virtually all retail was open by mid-June, and yet the regulations did not come in until 24 July. I am trying to understand why there was such a delay between those two dates.

[Ms Dorries]

I revert to the substantive point: we were constantly easing regulations at the same time as we had issues to do with Leicester. We had areas in the country where rates were rising at the same time as we had national easement. It is very complex, but at the time it was felt that the public had complied and were wearing masks to go into shops and public places. However, we felt it was important, as footfall increased and we had spikes in other parts of the country, that we introduce guidance nationally for people to wear masks.

I will answer some of the shorter points that the hon. Gentleman raised. He asked me how many people had received FPNs: it is eight to date. I am not aware of what fines were charged, and whether they were on the ladder or went up to the full amount, but eight FPNs have issued so far. I was also asked why we are not legislating for handwashing.

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[Ms Dorries]

No. It is incredibly difficult to legislate for people to wash their hands. However, given how compliant and how willing the public have been to wear face coverings—we only have to see how many people are carrying hand sanitisers, and how responsible and conscientious the public have been—I am not sure there will ever be any need to legislate for handwashing. That would be an incredibly difficult piece of legislation, and I am sure the hon. Member for Ellesmere Port and Neston agrees that that is not where we want to go.

The hon. Gentleman brought up the question of staff in various areas. I go back to my previous answer to the right hon. Member for North Durham: it is not compulsory for shop or supermarket staff to wear face coverings, although we strongly recommend that employers consider their obligations, where appropriate and where mitigations are not in place. It is also important to mention that the list of where to wear face coverings and where the exemptions apply is not exhaustive; it is something that is reviewed almost daily. We listen to representations from Members on both sides of the House, and from organisations and individuals, about where they think the exemptions should apply, and what else should be included in the list. This is a constantly moving feast. The fact that we are here today is not the end of it—the process will continue. Businesses are already subject to legal obligations to protect their staff, so a safe working environment is what we expect of everywhere where staff are employed and where members of the public come on to the premises.

The hon. Member for Ellesmere Port and Neston mentioned face coverings in schools. I will mention universities as well; I know that his son has gone back to university this week. The Department for Education has updated its guidance recently on wearing face coverings in schools, following, as I am sure the hon. Gentleman is aware, the World Health Organisation’s statement about children over the age of 12. However, the Government’s absolute priority is to get children back to school and keep them in school.

The Department’s guidance sets out that face coverings should be worn by staff, by visitors and by pupils when moving around the school. They should be worn in further and higher education settings indoors, such as in corridors and communal areas where social distancing cannot be maintained. However, as we discussed last week, obviously that does not apply when people are eating, because it is difficult to eat with a mask on—it is not practical. Schools are not included in the regulations before the Committee, with the exception of an exemption for pupils of religious schools receiving educational provision in a place of worship.

It is important that university students can start the new term and the campuses can remain open. Again, education is an absolute priority, and it is also an important thing for students’ mental health and wellbeing. It is important that these things are done safely and we have been working closely with universities, and the sector, to help them to prepare for their intake of students, which, as Members know, is staggered from the beginning of September to almost the end of October, depending on where the university is, and which years are going back there.

Universities have introduced a number of measures such as staggered term times and staggered returns. There have been some assertive information notices across universities, such as “Don’t kill your nan”, and requirements about where students should wear face coverings. We have helped universities to make campuses safe by reiterating the face covering message throughout to students, including where they should wear them. Again, there is an impression that students will completely disregard all the social distancing regulations. I am not saying that they will be perfect, but universities have stepped up to the plate and are doing their bit. I am not sure which universities are providing disposable face coverings, but I think that the message about what students should be doing will be put out strongly to them.

The Government’s aim, with all the regulations and all that we are doing about face coverings, is to achieve as high a compliance rate as possible. We are incredibly impressed with the public’s response and the compliance so far.

[Justin Madders]

Will the Minister say a little about the distinctions between pubs and social clubs? As I and my right hon. Friend the Member for North Durham have explained, that is an important issue for our constituencies, and we want to understand that distinction.

[Ms Dorries]

I believe that social clubs were part of the original discussion. I shall find out why they were not included. I cannot guarantee that I will be able to write to the hon. Gentleman about that tomorrow, as before, but I apologise and I shall get back to him and provide an answer.

The Government have always been clear that the highest priority in managing this national crisis is protecting our public and saving lives. Face coverings and public compliance in wearing them is a part of that endeavour. I am satisfied that the additional premises included in the amending regulations are necessary, reasonable and proportionate. The amending regulations offer further clarity for members of the public on where they should wear a face covering, exempt further categories of person and update the penalty structure to maximise compliance with the policy. Our guidance has consistently set out to the public that, to protect themselves, they must continue to follow social distancing measures, wash hands regularly, adhere to the isolation guidance and wear face coverings where appropriate. The current guidance from the Government states that people should also wear a face covering in enclosed public spaces, where social distancing is more difficult to maintain and where people might come into contact with others whom they do not normally meet.

Today has provided an opportunity for the Government to hear people’s concerns through the contributions made during the debate. Parliamentary scrutiny is a vital part of the regulation-making process, and I am pleased to have been able to set out the content of the regulations to the Committee. I hope that the Committee has found the debate informative and that it will join me in supporting these amending regulations.

Question put and agreed to.

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) (Amendment) Regulations 2020 (S.I. 2020, No. 839).

The Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) (Amendment) (No. 2) Regulations 2020

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) (Amendment) (No. 2) Regulations 2020 (S.I. 2020, No. 882).—(Nadine Dorries.)

The Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place and on Public Transport) (England) (Amendment) Regulations 2020

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place and on Public Transport) (England) (Amendment) Regulations 2020 (S.I. 2020, No. 906).—(Nadine Dorries.)

Health Protection (Coronavirus, Wearing of Face Coverings in a Relevant Place) (England) Regulations 2020

Debate between Justin Madders and Nadine Dorries

Monday 14th September 2020 General Committees

[Ms Dorries]

This is the decision. That is what we are here debating—the decision to introduce the wearing of face coverings in public places. We have taken the decision; that is what we are doing right now.

I was asked why we were so slow to react to the wearing of face masks. It is because, to come here and introduce legislation, we needed evidence that wearing face masks works. As I think the hon. Member for Blackley and Broughton said, this is a new virus—globally, not just for the UK—and all over the world countries have taken their own decisions on the basis of whatever evidence they could gather over a short period and in a short timeframe. We have now got to the point where we believe the evidence is such that wearing a mask will provide protection even if the wearer is asymptomatic, not showing symptoms of coronavirus and not coughing. Therefore, we are introducing the regulations.

[Justin Madders]

I am grateful to the Minister for giving way. I appreciate that these things do take some time, but it is the case, is it not, that recommendations were made on 11 May about the wearing of face coverings, but they did not become law until 24 July? What is the reason for that long delay?

[Ms Dorries]

I want to be absolutely clear myself before I give a response, so I will come back to the hon. Member on that in the morning.

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[Ms Dorries]

It was an honest offer, and I will ensure that the hon. Gentleman receives that information.

[Justin Madders]

I thank the Minister for giving way, and I promise that I will not intervene again.

What we have heard today from various Members is clear evidence of why it is important that regulations are debated before they become law. There is a whole series of questions in relation to covid marshals, in particular, and their powers and training and the data protection requirements that we are not able to answer. The point has been made by several Members that it is really important for public buy-in to the concept of those marshals that the powers are clear and they have democratic consent because they have been transparently debated, so can the Minister make a commitment today that any new powers given to marshals, whoever they end up being, will be debated in this House before they become law?

[Ms Dorries]

No, I cannot; I apologise. I will obtain the list of those who have the authority and ensure that the hon. Member for Warwick and Leamington has that tomorrow. The hon. Member for Ellesmere Port and Neston, I am sure, was trying his hand when he asked his question. He did so knowing very well that that is not something that I can commit to.

Maternity Services: East Kent

Debate between Justin Madders and Nadine Dorries

Thursday 13th February 2020 Commons Chamber

[Ms Dorries]

I thank my right hon. Friend for his comments and suggestions. In response to his call for an independent inquiry, last night I asked my officials to look into sending the independent Healthcare Safety Investigation Branch back in to do a deep dive into historical and existing cases at the trust. I want to reiterate that the trust is a safe place for any woman who is pregnant or giving birth. We have some of the very best people and clinicians working in that trust right now.

I would just like to add that NHS England and NHS Improvement are themselves commissioning an independent review into East Kent maternity services, so my right hon. Friend’s question has been answered. That is the news I have just been given. We are taking this situation very seriously. We will publish the findings of the HSIB and CQC reports in due course, because we take this matter—I personally take this matter—very seriously.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

Our thoughts go out to all the families, including the family of Harry Richford, who have endured unimaginable heartbreak because of avoidable and preventable failings at the trust. Harry Richford was aged just seven days when he died. His death was described by the coroner as “wholly avoidable”. This was a wholly avoidable tragedy and not, as the trust originally said, “expected”. After Harry died, the trust refused to refer the case to the coroner and it was only the persistence of the family that led to the inquiry.

The trust will now receive special support to help turn things around, but can the Minister outline exactly what that support will be, by whom and where the funding is coming from? Why has it taken us so long to get to this point? It was reported earlier this month that despite evidence in a report by the Royal College of Obstetricians and Gynaecologists back in February 2016, the same mistakes were made in subsequent years. We need an explanation for why those warnings four years ago were allowed to go unnoticed and unaddressed. I understand that the trust will not be put into special measures and it seems that the chief executive and the medical director will be staying in post. However, given the trust’s failure to deal with those identified failings at the first opportunity, there must surely be questions about the local leadership. Can the Minister outline whether anyone in the trust will be held personally accountable?

Once again, we are unfortunately hearing about another tragedy where the culture has exacerbated the pain suffered by the family: denial, obfuscation and a staggering lack of transparency. Why is it that these issues only come to light because of the persistence and bravery of the affected families? We need to create a culture within the NHS where safety concerns can be raised by trained staff at all levels, free from fear so that issues are dealt with quickly. Perhaps the biggest concern we have is that we do not know the true number of avoidable maternity deaths at the trust.

I would like to join Harry’s family and other Members in calling for a full independent inquiry. I understand that the HSIB deep dive will address matters to some extent, but I do not think it is the full transparent inquiry that the parents deserve and demand.

[Ms Dorries]

I thank the hon. Gentleman for his collaborative tone on this issue. I think he may have missed my last comment, which was that NHS England and NHS Improvement will be commissioning an independent inquiry. That has been decided this morning, so that will happen.

On the hon. Gentleman’s first question about what is happening to support the trust now, NHS Improvement is in there. As I said, the chief midwife, Jacqueline Dunkley-Bent, has sent in some of the best midwives, obstetricians and neonatologists in the country from outstanding trusts to support the trust. They are having twice-daily huddles on the wards, which is where multi- disciplinary teams get together and discuss on an ongoing and regular basis what is happening on the wards, what disciplines are involved and what measures are being taken. We have fresh eyes looking at the cartography that measures foetal heart rates and contractions. We have a second pair of eyes reading those cartography read-outs, so it is not just down to one midwife.

A huge amount of support has gone into the trust. As I said, it is today a safe place for anyone to give birth. We are also asking HSIB to go in to do that deep dive to look at historical issues. Whether that will continue in light of the fact that NHS England is commissioning an independent inquiry is something I need to find out when I leave the Chamber. However, I want to reassure the hon. Gentleman and everybody that this is an issue that I take very, very seriously.

Babies bring joy and happiness when they arrive, and every family—every mother, every father and, indeed, every grandparent—is entitled to know that when they or their relative is in hospital, the delivery will happen in a safe environment, with the very best care. I can say that that is the case at East Kent now, and I—we all—will strive to make sure that it is the case at every hospital.