Health Protection (Coronavirus) Regulations 2020

Karen Buck Excerpts

Monday 9th March 2020 General Committees

[Jo Churchill]

Liverpool. I will take this moment to put on record how brilliant not only the health service, but the local councils and everybody involved in the self-isolation of individuals at both Arrowe Park and Kents Hill Park have been. However, the need to have a deterrent was made clear during that period. That is why this statutory instrument was brought forward. It was deemed that the powers to invoke section 2A, go to the magistrates and use that route would perhaps take too much time for us to be able to effect what we may—but what, in the circumstances at that time, we did not—need to do. This piece of legislation is there so that we can invoke it.

On the sunset clause, this legislation will drop after two years. That was deemed a suitable period of time, but if during that period it is determined that coronavirus is no longer a threat, the Secretary of State has the power to revoke. The chief medical officer and chief scientific advisers have indicated that we are not totally sure of the trajectory, and it may be that we get another peak later in the year. We therefore have the flex to allow us to invoke these measures. I hope that that provides clarity.

The regulations give public health consultants, public health officers, the Secretary of State and members of the constabulary the power to detain. All appropriate safety measures would be taken if we were to use those powers. The hon. Member for Washington and Sunderland West was rightly concerned for anyone enforcing these measures. Instructions on how people are to behave at the point at which these measures are invoked is covered, with the personal equipment they may need and so on, to ensure that everyone is kept safe. Ensuring population safety and being led by scientific advice is at the heart of the Government’s response to coronavirus.

It may be that we move on from self-isolation and need the regulations for something different. As we move forward, isolation will probably be for different reasons, such as protecting the vulnerable, among others.

I totally understand the hon. Lady’s comments about statutory sick pay and so on, but the Secretary of State answered many of those points during the urgent question earlier. He said that many such challenges have been sorted out, but that some—particularly those for the self-employed—have proved trickier to deal with through the normal channels, because statutory sick pay is normally received from the employer.

[Ms Karen Buck (Westminster North) (Lab)]

The Minister may be coming on to this, although she has moved on from the question she was asked about capacity. What are the resource implications if a small but potentially significant number of people need to be detained against their will? Even if only 0.1% of people needed to be detained, that would have significant implications in respect of where they are detained and how that is enforced, as well as for the police. Will she give us some detail on that?

[Jo Churchill]

On enforcement, the police have powers to take individuals into custody and return them to designated places. Just as we invoked Arrowe Park and Kents Hill Park, we have other facilities around the country to ensure that people can be encouraged to complete their period of quarantine to protect others. That is the point of these powers. It is not envisaged that this would be used for a mass quarantining situation.

Diabetes: Tailored Prevention Messaging

Karen Buck Excerpts

Thursday 24th October 2019 Westminster Hall

[Keith Vaz]

That is extremely important. I support the DAFNE programme and the work being done on the conversion to sugar. That brings me on to the sugar tax—a great achievement of the previous Government. All praise to George Osborne for introducing it.

[Ms Karen Buck (in the Chair)]

Order. I gently encourage the right hon. Gentleman to stay within the topic.

[Keith Vaz]

I will. I hope that was not related to my mentioning George Osborne. We want to thank him for introducing the sugar tax, which has made a huge difference. Sugar in soft drinks has gone down by 28.8%, which is a huge achievement.

We have all praised the great Jonathan Valabhji, but I also want to mention the work of Partha Kar, who only this morning set right the statement by Mr Paul Hollywood on “The Great British Bake Off”, who said that one of the dishes looked like “diabetes on a plate”. I am sure he meant it as a joke, but for type 1s it was a real surprise that someone should speak like that. We desperately need structured education. We have all talked about the three hours of care, but there are 8,757 other hours.

In a few days’ time, we will be launching in Leicester the diabetes log book by the Leicester physician Dr Domine McConnell. I hope the Minister will spare some time to come and read it and perhaps launch it with us. It will give patients a better understanding of how they can record and monitor information. They can keep it with them and take all their readings wherever they go. Far too often, when I visit my GP I cannot remember my last HbA1c reading, and I need to make sure that is done. I realise that it can be done on a phone, but not everyone is able to do that.

My last plug for Leicester before I end is about the pilot that has been put together by the chair of the clinical commissioning group, Dr Azhar Farooqui, and Sue Lock, its retiring chief executive. It allows, on a Thursday, all diabetics to go to the Merlyn Vaz Health and Social Care Centre in Leicester. It is a very important initiative. People can have their feet looked at, their eyes looked at, their blood tested, their lifestyle dealt with—all the things they need to do, on one morning in one place. The opportunity to put that together makes a great difference.

--- Later in debate ---

[Keith Vaz]

I think Ms Buck might object.

[Ms Karen Buck (in the Chair)]

indicated dissent.

[Keith Vaz]

No, she will allow it.

[Keith Vaz]

Could I have just one minute, Ms Buck, given that the hon. Gentleman intervened?

[Ms Karen Buck (in the Chair)]

Earlier, I was advising the right hon. Gentleman not to stray in terms of breadth, not in terms of length.

[Keith Vaz]

Well, I will go on longer, then—excellent! That makes me feel much better.

I hope the Minister will come and visit the Merlyn Vaz Health and Social Care Centre. People like me and the hon. Member for Strangford have to go to eight different professionals to have our diabetes checked. In one visit on one morning in Leicester, people can have it all done, from the top of their head to their feet and everything in between—they can get it all tested.

I will end with an anecdote; I was going to end, Ms Buck, because the House has heard enough from me. I recently saw a film—the hon. Member for Strangford will like this, because it was about the Beatles, and people of our general age will remember them—called “Yesterday”, directed by Danny Boyle. It was about how the internet went down on a particular day, and references to the Beatles disappeared, so nobody knew about them. Nobody knew their songs or who they were. When they typed in “Beatles”, they just got a beetle on the screen.

There is a scene in that film when somebody turns to another person and says, “I’m going outside to have a cigarette.” The person says, “What’s a cigarette?” because the cigarette had disappeared from the internet along with the Beatles. No one could remember it. When we introduced the smoking ban, it had a profound effect on cancer issues. We want to ensure that diabetes is reversed for type 2s and that we are able to manage and help those with type 1. We start that with a war on sugar and changing the way we live. Working together, I think the House can achieve that.

Health Infrastructure Plan

Karen Buck Excerpts

Monday 30th September 2019 Commons Chamber

[Edward Argar]

My hon. Friend is quite right to highlight that in certain parts of the country, including his constituency, geography can present a challenge for the delivery of services. I look forward to his letter and will be very happy to respond and to look into the matter with him.

[Ms Karen Buck (Westminster North) (Lab)]

With a £1.3 billion maintenance backlog, Imperial College Healthcare NHS Trust, which includes St Mary’s, which serves my constituency, faces the largest challenges in the country and has been waiting for years for the approval to go ahead with the St Mary’s development. In recent years, we have seen the Grafton ward closed because of significant structural concerns, with the loss of 32 beds; a ceiling collapse in Thistlewayte ward; the Paterson centre flooded; and floods, electrical issues and drainage issues commonplace across the whole estate. Can the Minister guarantee me that today’s announcement will mean no repeat of these sorts of problems in St Mary’s in the coming months, and how does he feel it will be better served by the £200 million deficit the trust has and the £120 million deficit in our local clinical commissioning groups?

[Edward Argar]

As the hon. Lady will recall, many years ago, when I had more hair and it was not so grey, I sat on Westminster City Council, and St Mary’s was an issue back then that we discussed on various occasions. She is right to highlight it, but I would have expected her to very much welcome the inclusion of Imperial and St Mary’s in the announcement of seed funding to develop their proposals and get the investment they need.

Medical Cannabis under Prescription

Karen Buck Excerpts

Monday 20th May 2019 Commons Chamber

[Jeff Smith]

The right hon. Gentleman, who set out the case very well, is certainly not an old socialist. As we heard from him, there are multiple examples of patients who want to access medical cannabis, and whose doctors want them to access it, but are not able to do so. These are patients who last year were given hope that their pain, anxiety and seizures would end, only to have their hopes dashed and frustrated.

[Ms Karen Buck (Westminster North) (Lab)]

Like many hon. Members, I have had parents contact me recently who are desperate to obtain treatment for their children. They have said to me that, if anything, the situation has got worse since the guidelines were issued and they completely fail to understand how that can be. Is that my hon. Friend’s experience? Can we convey to the Minister today that there is a powerful sense that hope was raised and has been dashed?

[Jeff Smith]

My hon. Friend makes a key point. Those hopes were raised. People were promised medicine but that promise has not been delivered upon. It is a source of great frustration.

NHS: North-West London

Karen Buck Excerpts

Wednesday 24th April 2019 Westminster Hall

[Ms Karen Buck (Westminster North) (Lab)]

It is a pleasure to speak under your chairmanship for the second time today, Sir Christopher. I congratulate my hon. Friend the Member for Hammersmith (Andy Slaughter) on securing this short but important debate. He was quite right to use the word “bittersweet” in the context of the collapse of the “Shaping a healthier future” strategy. It was sweet, in that it lifted a shadow from Charing Cross Hospital. There has been a continuing surge in A&E admissions over many years, during which we have consistently been told that a strategic approach to health services should be about reducing such admissions and replacing them with services in the community. That is a principle that I think everyone would agree with, and the lifting of the shadow is a good thing, but as we have heard from other hon. Members, it is clear that the strategic shaping of healthcare in north-west London remains very much in doubt.

I will focus on St Mary’s Hospital in Paddington, which is just outside my constituency but is the main hospital for it. It is the major acute provider for north-west London, and one of the four major trauma centres in London, with a 24/7 A&E department. It is a hospital very dear to my heart—it saved my life once, and I gave birth there—and it is held in very high regard among my constituents. Quite rightly, it has a terrific reputation for clinical care; we should never miss an opportunity to record our admiration for the staff, who deliver healthcare so superbly to the public.

None of that should blind us to a very grim reality, which is that St. Mary’s Hospital is very old. In some instances, it is quite literally falling down. It is now 14 years since the Paddington health campus proposal finally collapsed, which was the first vision of the redevelopment of St. Mary’s Hospital. Here we are in 2019, with the collapse of “Shaping a healthier future”, and we are still frozen in terms of a major redevelopment for St Mary’s.

In January 2018, Imperial College Healthcare NHS Trust gained full planning permission for the first phase of the redevelopment of St. Mary’s, which is a new eight-story out-patient and ambulatory service building on the site. The trust submitted the outline business case for the investment required to NHS Improvement, NHS England and the local commissioning groups. Under those plans, the trust is looking to house most of the St Mary’s out-patient and ambulatory services in the new building, but this has been on hold since January 2018. It is not an academic issue; the failure to gain funding and approval from key stakeholders for the redevelopment programme is a key risk on the trust’s corporate risk register, because the conditions of St Mary’s Hospital have deteriorated so much. Planning permission has only two years left.

While we are waiting for the funding to be put together for the redevelopment of the hospital within that timescale, the structural issues in the hospital have become absolutely and imminently challenging. The structural problems in the Cambridge wing at St Mary’s resulted in two wards being out of use, with no possible value-for-money structural solution. There is a £1.3 billion backlog maintenance liability across the five hospitals, including St Mary’s. As we have heard, the backlog is the biggest in the country, and St Mary’s has the largest in the trust. In fact, 30% of all high-risk backlog maintenance in the NHS in England is at Imperial College Healthcare.

I just mentioned one of the wards that has been out of action, and St Mary’s maternity services had to be temporarily relocated due to a lift fault in September 2018. The Grafton ward closed due to significant structural concerns, with the loss of 32 beds in May 2018 and no possible structural solution. A ceiling collapsed in the Thistlethwaite ward. The Paterson Centre was flooded and closed for two weeks, with the loss of activity and 20 surgical beds in 2017. Floods, electrical issues and drainage problems are commonplace across the buildings and services at St Mary’s. The hospital simply cannot wait, yet everything is now frozen.

We urgently need advice from the Minister on how we will proceed. Should there be a further structural problem of the kind that we have already seen, it would not only be an imminent risk to patients, but would take out chunks of capacity from an already highly stretched hospital, which will have repercussions across the whole of north-west London. We simply cannot go on like this. I hope the Minister will give us an indication of how the St Mary’s maintenance backlog, structural programme and redevelopment will proceed.

Oral Answers to Questions

Karen Buck Excerpts

Tuesday 26th March 2019 Commons Chamber

[Jackie Doyle-Price]

I have corresponded with my right hon. Friend and the hon. Member for Leicester South (Jonathan Ashworth), but I am more than happy to meet them to discuss that issue. From my perspective, services for people with ADHD are a bit of a Cinderella and I would like to do my best to address that, working with colleagues across the House.

[Ms Karen Buck (Westminster North) (Lab)]

With a throwaway answer to the right hon. Member for Chelsea and Fulham (Greg Hands), the Secretary of State has just pulled the west London strategic health framework, which has governed the delivery of hospital and community services for most of the last decade, absorbed tens of thousands of hours and cost hundreds of millions of pounds. Why has he not thought it appropriate to bring forward a statement so that the many of us who are concerned with this issue have an opportunity to interrogate the many very serious implications that this has for the delivery of healthcare across west London?

[Matt Hancock]

The hon. Lady and the hon. Member for Hammersmith (Andy Slaughter), who is sitting next to her, have run, over a number of years, totally inappropriate scare stories about what they said were potential changes to A&E in west London as part of “Shaping a healthier future”. It has been one of the worst aspects of local parliamentary campaigning and I am absolutely clear that the changes in A&E in west London as part of “Shaping a healthier future” will not happen. However, there are elements of “Shaping a healthier future” that are about more community services and treating more people in the community. We look forward to working with the local NHS on those parts of the proposal.

NHS Long-term Plan

Karen Buck Excerpts

Monday 7th January 2019 Commons Chamber

[Matt Hancock]

My hon. Friend is absolutely right. The community hubs being developed in many different parts of the country are critical in bringing together support and enabling early intervention. The adage that a stitch in time saves nine is almost as old as “prevention is better than cure,” but both are equal in their wisdom.

[Ms Karen Buck (Westminster North) (Lab)]

Money might not be everything, but transforming a service against a background of real-terms cuts is almost impossible. The Central London clinical commissioning group is in the middle of a 13% real-terms cut, the West London clinical commissioning group is having an 8% real-terms cut, real-terms cuts are being made in mental health services, and Westminster City Council has cut 31% of its funding for social care. Can the Secretary of State indicate whether inner-London residents will see any benefit as a result of this plan?

[Matt Hancock]

As I said a moment ago, local allocations will be published in the coming days.

Integrated Care

Karen Buck Excerpts

Thursday 6th September 2018 Westminster Hall

[Dr Paul Williams]

In the short time the Minister has left, will he will address the invitation he was given categorically to rule out integrated care providers being private sector organisations? Does he accept that the language he has used—he said the NHS will continue to be free at the point of use—increases concerns about private sector provision?

[Ms Karen Buck (in the Chair)]

Order. Minister, in responding, will you be mindful of the time and the need to leave the Chair of the Select Committee a couple of minutes to respond?

[Stephen Barclay]

Indeed I will, Ms Buck.

I draw the hon. Gentleman’s attention to the Committee report, which states:

“There is also little appetite from within the private sector itself to be the sole provider of…contracts…There are several reasons why the prospect of a private provider holding an ACO contract is unlikely…Integrated care partnerships between NHS bodies looking to use the contract to form a large integrated care provider would have an advantage over non-statutory providers that are less likely to have experience of managing the same scope of services”.

The hon. Gentleman himself referred to the desire not to rule out GP-led organisations, which are independent. He also mentioned GP-led organisations becoming NHS bodies. I am happy to meet him to explore exactly what he means. It is not the Government’s intention for private firms to run ICP contracts.

Leaving the EU: NHS

Karen Buck Excerpts

Thursday 22nd March 2018 Westminster Hall

[Mr Bradshaw]

Not that I recall. Maybe when the Chair of the Committee, the hon. Member for Totnes (Dr Wollaston), contributes she will have better recall than me. The unanimity of the evidence we heard was very striking indeed.

As well as pursuing the closest possible regulatory alignment, one of our strongest recommendations to the Government is that they must be much more open and clearer about their Brexit contingency planning for a no-deal scenario.

We note and welcome the Prime Minister’s most recent statement that the UK will seek associate membership of the European Medicines Agency—although, given that, it is tragic that we are losing the EMA headquarters from London to the Netherlands. We also welcome the recognition shown by both the Health Secretary and his Lords Minister in their evidence of the importance of continued regulatory alignment with the rest of the EU. We noted that that was in contrast to the Foreign Secretary’s statement that medicines regulation is one of the areas where he would like to see the UK diverge from the EU. I am pleased that the Health Secretary at least won that argument.

However, we have serious concerns about the Government’s lack of a strategy for a no-deal scenario. The Government are still saying that they want a pick-and-mix, cake-and-eat-it relationship with the EU in the future. The image the Prime Minister used in her speech was of three baskets: full alignment in some areas, full divergence in others and something in between for the rest. But if the other 27 EU countries have made anything clear throughout this process, it is that that option is not available. We can have a Norway-style relationship, or we can have a Canada-style relationship, but we cannot have Canada-plus-plus-plus or Norway-minus-minus-minus. It is our choice.

I wish the Government well in their endeavours to achieve their pick-and-mix deal, but given the strong likelihood, if not certainty, that we will not get that, either Ministers will need to do the sensible thing and concede on the customs union and single market, or we will face the danger of crashing out on World Trade Organisation terms. Let me just spell out what our witnesses told us that would mean.

First, it would mean the seizing up of our medicines and medical equipment supply chains. We export 45 million patient packets of medicines a month to other EU countries and import 37 million. Any customs, regulatory or other barriers to this trade will affect supplies. Radioisotopes, for example, are vital in the diagnosis and treatment of cancer. They have a very short lifespan. Their smooth importation from the continent is time critical. The British Medical Association has warned that any disruption to this trade could lead to the cancellation of patient appointments, operations and vital radiotherapy treatment for cancer. Medicines and medical equipment would also become more expensive and there would be delays in getting them licensed and available for British patients. Switzerland gets access to new drugs 157 days later than the EU; Canada, six to 12 months later.

Secondly, we would suffer a further haemorrhaging of NHS staff who are EU nationals, exacerbating the staffing crisis that the NHS and social care face.

[Ms Karen Buck (Westminster North) (Lab)]

My right hon. Friend has made a powerful case about the risks of crashing out with no deal. Does he agree that uncertainty is a crucial factor in the NHS’s problems? Individuals want to plan their own lives, and the NHS wants to plan its staff. Many staff have said to me that they are concerned about the settled status process—when it will go live, what it will involve and whether it will be able to process applications quickly—and are making decisions on that basis.

[Mr Bradshaw]

My hon. Friend is absolutely right. The uncertainty not only bedevils business decisions, but is having a huge effect on the NHS, the pharmaceutical industry and the staff in all these sectors.

NHS Winter Crisis

Karen Buck Excerpts

Monday 8th January 2018 Commons Chamber

[Mr Dunne]

I agree that prevention is an important part of the long-term solution to improve healthcare outcomes for the population. I believe we are on the cusp of some significant technological advances that will allow more treatment to take place at home and more diagnostic tests to be taken without the necessity of attending acute facilities. Oxfordshire is a good leader in that.

[Ms Karen Buck (Westminster North) (Lab)]

Of 106 emergency beds at St Mary’s in Paddington, 105 were in continuous occupation over Christmas. Not long ago, a ceiling collapsed in a ward in that hospital. It is coping with a £500 million maintenance backlog—the biggest by far in the country. Will the Minister meet me to discuss how St Mary’s Hospital will be assisted to cope with funding a maintenance backlog that, if things went wrong at the time of these pressures, would cause an absolute calamity?