Covid-19

Karin Smyth Excerpts

Wednesday 18th November 2020 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I beg to move,

That this House has considered covid-19.

Yesterday, there was an increase of 19,609 cases of coronavirus in the UK, and sadly we recorded 529 deaths. I am sure I speak for everyone when I say that our sympathies and prayers are with each and every family. It is a stark reminder, if we needed one, that we still have a long way to go in beating this disease and seeing our country thrive again.

I know that Members across the House will join me in wishing those who are currently unwell a speedy recovery and thanking all the staff across health and social care and key workers for all they do, but I would also like to mention one or two who do not always get a mention: those working in community health, including our health visitors and our pharmacists, and many of the volunteers who keep many of the shows on the road.

As the Office for National Statistics report on loneliness earlier today showed, these changes are taking a toll on our lives. They are taking a toll on individuals, families and businesses, so the news this week of further successful vaccine trials with Moderna and today’s update from Pfizer have given rise to the very real prospect of an effective vaccine in the near future. While I share that sense of hope with many, we still have some way to go, and we must never lose sight of the challenges that we face at the moment. A vaccine still has to go through a regulatory process, but it is right that the planning of the huge logistical exercise of a vaccine roll-out led by the NHS is now very much under way. Throughout this pandemic we have had to learn, and each week brings further understanding.

As more information continues to emerge on the risks of long covid, for example, we are reminded how this virus can remain a threat. I am sure hon. and right hon. Members will be pleased to hear that the NHS will have a network of 40 long covid clinics in place before the end of this month, bringing together doctors, nurses, therapists and other NHS staff to help those patients suffering from the lasting effects of this virus. That is an example of how our response to the virus has to continue to evolve and strengthen to protect staff, patients and the public, moving with the science as we learn more.

It is hard to overstate how little was known about the virus at the start of the year. We have done many things for the first time, and the learning curve has definitely been a steep one, but looking back, we have come a long way through this difficult year. We have always sought to base decisions on evidence, data and scientific advice, and we have been willing to reflect and adapt as we go. From repatriating individuals from Wuhan in the early days of the pandemic, we have constantly faced and met enormous challenges. In the words of General Sir Nick Carter back in April, distributing personal protective equipment, for example, was

“the single greatest logistical challenge”

in his 40 years of service. However, with others helping, such as the Army, we built those supply chains and responded to demand. In some areas, demand went up by 17,000% for eye protection, for example, and by approximately 4,700% for masks. So far, we have distributed more than 4.9 billion items of personal protective equipment to the frontline, and today we have a four-month stockpile in hand across all nine key lines, with a further 32 billion items of PPE on order. We have regularly delivered to more than 58,000 health and care organisations. I would like to pay tribute to Lord Deighton and his team for their extraordinary efforts in building resilience into the supply chain, to enable us to be as confident as we are today.

I am clear that none of this would have been possible without the incredible collaboration we have seen between industry, social care providers, our NHS, the armed forces and others. Industry and individual businesses stepped up to meet the challenge. At the start of the pandemic, only 1% of PPE was manufactured here in the United Kingdom. By the end of the year, we will be manufacturing 70% of the amount of PPE we expect to use from December to March in all key areas bar gloves. This enormous national effort has put our country on a strong footing today and for years to come. Following the launch of the PPE strategy in September, we are looking at sustainability and initiating a UK production site for gloves.

[Karin Smyth (Bristol South) (Lab)]

I accept that it was an extraordinary time and that extraordinary measures needed to be taken, but as we have heard from the National Audit Office today, tried and tested processes and procedures were not used. Will the Minister say something about that report and why that was the case, why we had 11 ministerial directions by May and whether those lessons have been learnt by her Department and others that fell foul of the procurement procedures?

[Jo Churchill]

The NAO report to which the hon. Member refers highlights that we were acting with “extreme urgency” in a global market where demand exceeded supply. The report states that the situation in responding to the covid-19 pandemic was unprecedented, but that we

“secured unprecedented volumes of essential supplies necessary to protect front-line workers.”

[Karin Smyth]

Will the Minister give way again?

[Jo Churchill]

If the hon. Member will bear with me, I will continue.

The NAO report examined potential conflicts of interests involving Ministers and the awarding of contracts and found none. It states:

“we found that the ministers had properly declared their interests, and we found no evidence of their involvement in procurement decisions or contract management.”

The report recognises that there are robust processes in place for spending public money, to ensure that critical equipment got to where it needed to go as rapidly as possible while ensuring value for money. I welcome the report, because we can all learn.

--- Later in debate ---

[Jo Churchill]

I will come on to the area of cancer, in particular. Strides have been made in different ways of treating virtually, so that fewer people go into the hospital setting, and so on. I take the hon. Gentleman’s point about capacity, but that is why the Government have committed to building 40 new hospitals—because there is a need to ensure that sufficient capacity is available across the country for people.

[Karin Smyth]

Will the Minister give way?

[Jo Churchill]

I am going to push on a little bit and then I will give way again.

This enormous national effort has put our country on a strong footing for today and years to come. We are using the best of British ingenuity to help us to deliver in this area. Progress has also been seen in other areas. As the pandemic unfolded, the UK could not call on a major diagnostic industry. From a standing start of about 2,000 tests a day in March, our capacity is now over half a million tests per day. This matters, because it has often been said in this place that in order to beat the virus we need to draw on different parts of our armoury to help to get us through. Testing works. It helps to deny the virus the connections it needs to spread. Mass testing therefore offers us a chance to achieve that on a much bigger scale. We are making progress in city-wide testing in Liverpool. I thank Joe Anderson for his leadership in helping to deliver not only in testing but in other areas too. We are also rolling out a further localised approach to other areas with the help of directors of public health, among others, who know their local areas. Some 83 local authorities have now signed up to receive regular batches of lateral flow tests, which allow for a result to be seen in 15 minutes.

Further, I know that hon. Members will celebrate Monday’s announcement of two mega-labs coming on stream early next year—very high-throughput laboratories, one in the midlands and one in Scotland, adding a further capacity of some 600,000 tests per day. These are massive gains that we are achieving by embracing cutting-edge technology such as automation and robotics and harnessing the best of British industry and academia, meaning that we will not only be able to process more tests but that they can be processed quicker and at a lower cost. The mega-labs will be another powerful weapon in our defence against this deadly virus in order to get back to a more normal way of life, but more than that, they will form a permanent part of the country’s new diagnostic industry. They can help us to respond in the future and build further resilience.

I am excited at the potential for a new diagnostic industry to help to care and deliver across other disease types, not least cancer. Hon. Members will know that, informed in large part by my own experience, I was an advocate of improved cancer outcomes long before I came to this place or took on this role. Early diagnosis is the key to beating the disease, and with bold steps forward in diagnostics, I would like it to make it my mission—I am sure with many others across the House—that we seize new opportunities in cancer services so that covid-19 is not a derailer but an opportunity for a new phase in smarter, faster diagnostics.

--- Later in debate ---

[Alex Norris]

The hon. Gentleman gives a concerning example that shows how the system is struggling in general. I hope that the Minister will address that issue when she winds up the debate, and I will refer more directly to local authority public health shortly.

I do not want to carp on about what is not working without providing any solutions, so I come armed with three things that Ministers could do at a stroke of their collective pens that would radically improve test and trace in short order. First, we must better use NHS lab capacity to turn tests around. I very much welcome what the Minister said about megalabs, which we have eagerly anticipated for some months. However, there has been a large gap in which we have not had that lab capacity, and we will not have it for some time yet. In the meantime, let us put our NHS lab capacity to use in getting tests turned around.

Secondly, we should give control and resources to local authorities to run the tracing operation. They know our communities and already have a local presence. They are a trusted voice and, crucially, they do this routinely. They do this already. Admittedly, that is on a smaller scale—perhaps related to an outbreak of food poisoning linked to a takeaway—but they do it effectively. Let us support them to do it fully. Thirdly, we must develop a proper package of support for those who need to isolate—that is self-evident. Those three things could be done immediately, and we would all be better off if they were.

We have seen the consequence of failure and of a test and trace system that is struggling, and that is another lockdown. This time last year we were banging on doors in the cold and the rain, and none of us supported the lockdown because we want to keep family members away from each other, or to shut businesses in our community or anybody else’s. However, the failure to break the transmission rate of the virus leads us there.

There are two important things that I wish the Government would communicate more. This is not a choice between lockdown and the economy; it is not a choice between lockdown and non-covid healthcare treatment in the NHS. We must have the lockdown for those purposes, and the longer we delay putting restrictions in place, the worse are the long-term impacts on our economy. If we do not introduce regulations to reduce the transmission of the virus, the greater are the pressures on our hospitals, and the less likely they are to be able do other treatments. Those things are not in tension; they are very much complementary.

The failures of test and trace may have led us to a lockdown, but that lockdown buys us time to sort out problems in the system. We must see progress. Lockdowns alone will not tackle or eradicate the virus, but they buy us time to put in place the things that do. We have now had two weeks of lockdown, but we have not heard about what is improving in the test and trace system, or what will be better, including in the next two weeks. Ministers really need to say this today, so we can be sure and confident that the time is being used wisely. Otherwise, when we leave lockdown, this will all recur again, something that none of us wants.

We are all very wary of Christmas. Depending on which newspaper Members read, they may have woken up yet again to see that the Government’s plans, this time regarding yuletide festivities, had been briefed out to national newspapers. Putting aside the discourtesy to the Speaker and Deputy Speakers, to all of us and to this place in general, that is all well and good, but those plans are only going to be feasible if the right efforts are put in place now and this time is used wisely.

It also ought to be stated that this lockdown is longer and more painful than it needed to be because, once again, the Government acted too slowly. The scientists told them they needed to lock down, as did we, but for two weeks the Prime Minister disregarded reality, which meant that the situation worsened. That has meant that the lockdown will be longer and harder, and also meant that we lost the benefits of the school holidays. These are mistakes that cannot be repeated in the future.

As we exit lockdown, the Government need to be honest with the British people—not in off-the-record briefings to mates in the media, but to the British people—about what will come next, both at Christmas and in the return to a tiered system. I know from our experience in Nottingham that trying to negotiate restrictions was painful, even when we wanted them at the beginning of October as our infection rates increased precipitously. We could not get the initial restrictions we wanted, because the Government were moving to the tiered system and it did not fit their timeline. We then managed to get into the tiered system at tier 2; the next day, the Government said that they wanted us to move into tier 3 and were going to call us, which they did not for a further week. Eventually, we had the painful negotiations about what that actually meant for Nottingham: we brought those restrictions in on the Friday, and by the Saturday, the national lockdown had leaked out. The system has not worked for Nottingham, so we need to know that in any return to a tiered system, the Government are going to work much more quickly and in a more agile manner. Every day wasted is a day when the virus thrives, so we need to be better upon exit.

Turning to the vaccine, we strongly welcome the Government’s efforts in this area: they were right to pre-order doses across a wide portfolio, and they were also right to back British. With our excellent research and our proud record in this area, we should be in the vanguard of it, and patriotic about our efforts to tackle this global issue. Last week, I responded on behalf of the Opposition in an excellent Westminster Hall debate on the covid-19 vaccine, secured by the hon. Member for North Herefordshire (Bill Wiggin), the day after the news broke that the Pfizer-BioNTech vaccine had achieved success in a phase 3 study. Since then, we have heard similarly positive news about the NIH-Moderna vaccine candidate, which is likely to be followed by other candidates, whether that of the University of Oxford and AstraZeneca, the candidate referenced by the Minister, or candidates developed elsewhere. I understand that overnight, there have been further promising developments for a Chinese candidate.

During that debate, colleagues and I raised the challenges and considerations that need to be addressed to make sure that this is handled and executed well. I will not repeat those contributions in the level of detail we went into then—they are on the record in Hansard for people to read. However, the theme was that we cannot repeat the slowness or logistical challenges that we saw early in the pandemic with regard to the procurement of personal protective equipment and testing: no Nottingham people being sent to Llandudno or Inverness for their healthcare this time, please, Minister.

As we have done throughout the pandemic, we on the Opposition Benches will work constructively with the Government to support viable vaccines being secured, ensure the right groups are being prioritised, develop an effective delivery programme, counter vaccine hesitancy—that is critical—and continue to support these efforts globally. A failure on any of those points will undermine the whole process, so it is absolutely crucial that we come together, and I am sure that Ministers will welcome that.

However, I want to briefly reference a point that my hon. Friend the Member for Bristol South (Karin Smyth) made regarding the NAO report. Again, we understand—as that report did—that the Government were having to do things that would normally take 18 months’ worth of planning in hours and days, and that comes with some efficiency trade-offs. However, we did not hear clearly enough in the Minister’s opening statement a sense that that has been reflected upon, and we did not hear what will be different in future to make sure those mistakes are not repeated.

[Karin Smyth]

I appreciate my hon. Friend having picked up on the point I made. The Minister very carefully read out a statement in reply to my question about the Government’s response to the NAO report. I am concerned that she was saying that the Government stand by what they did in that period, and do not think that the way in which those contracts and large procurement processes were handled was a problem. It may be that the Minister wants to correct the record, but if that is the case, does my hon. Friend agree that that is deeply worrying?

[Alex Norris]

I heard the point that the test had been clear that nothing wrong had been done, which, frankly, is a very low bar. I do not think anybody would say that there was nothing that happened in the early procurement phases that we would not perhaps want to change or do better later. I hope that the Paymaster General in winding up might reflect on that.

Perhaps this is the best place to say that the announcement on long covid will be very much welcomed by a lot of people, including my good friend Jo Platt who has been campaigning on this for many months, as well as living with her long covid. This is a story for lots of people up and down the country, across all our constituencies, who are living with the after-effects of this horrible virus over and over again. The act of knowing that they are being heard, as well as the 40 clinics, will be a real tonic to a great number of people, so we very much welcome that.

I turn to inequalities. At the beginning of the pandemic, we talked about the virus being a great leveller, not distinguishing between us depending on our lives, our jobs and our postcodes, but nine months on we know that to be patently untrue. Sixty per cent. of those who died were living with disabilities. Those of Bangladeshi heritage are twice as likely to die as those who are white British. Those of Chinese, Indian, Pakistani and black Caribbean ethnicities are 10% to 15% more likely to die than I am. Mortality rates in the most deprived communities are more than twice those of the least deprived communities. This pandemic has shone a light on our inequalities, whether that means the inequality in work, in housing or in income, and these inequalities have had tragic consequences for some and, in the aggregate, are catastrophic for all of us.

When we beat this virus, which together we will, what comes out of it must be a fair settlement that recognises these inequalities as bad and tackles them head-on. That is why it is already concerning to see again—of course, leaked to national newspapers—that the overseas aid budget is the first on the chopping block. In 2010, the Government chose to target those who had the least to pay for a crisis that they did not cause, and these reports are a sign that maybe this is the plan again. We will not let them repeat this in 2020. It simply would be hugely unjust.

Before I finish, I would like to take this opportunity to thank our incredible NHS and social care staff for all they have done for us. They are truly the best of Britain. Similarly, the pandemic has revealed the key workers all over our communities and all over our economy, so this week, during Respect for Shopworkers Week, I would like to say a special thank you to those working in our shops, keeping us fed, but still facing rising violence and abuse every day. The Government should take better action to protect you—the Government could, of course, adopt my private Member’s Bill and I encourage them to do so—but whether it is that or through another mechanism, we will fight for you until they do.

In conclusion, now more than ever we must stand together as a country, as families and as communities, and show once again that at a moment of national crisis, the British people always rise to the challenge, support those who need it and pull together. That involves not only recognising successes, but assertively tackling the failures that have held us back during the pandemic. If we address these, we will beat this virus.

--- Later in debate ---

[Karin Smyth (Bristol South) (Lab)]

Back in March, when our worst fears were confirmed and the first lockdown hit, I thought that some aspects of the UK Government’s response would be taken as read. I worked in public health and emergency planning before entering this place, and I know at first hand what a response should look like in the most basic terms and what it should feel like. I expected usual processes to function and best practice to kick in, and for muscle memory and accepted norms to initially, at least, shape our response. And I expected all that to happen underpinned by Government support.

I accept that the extraordinary nature of those months, as the Minister said in opening this debate, was unusual, However, as the National Audit Office report states, there were 11 ministerial directions. I do not accept that the virus was unexpected: the scenario planning was based on a threat of this type. I do not accept that the NHS was prepared: the Government were consistently warned that running at 95% capacity was not sustainable. And I do not accept that the way in which the response was led is beyond scrutiny.

What we heard from the Dispatch Box earlier was worrying, and I hope that the Paymaster General will clarify the situation when she winds up the debate. Essentially, the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), said, “Nothing we have done was corrupt.” However, issuing a ministerial direction is serious. It is about regularity, propriety, value for money and feasibility —and these contracts do not stand that test. One of the contracts for free school meals, for example, was with Edenred, a French company. There was no formal tender process under the emergency regulations, despite existing processes and companies being able to provide those critical school meal vouchers back in early spring. That took so much time and energy from schools in my constituency. It affected vulnerable children and that is totally unacceptable.

We may not be able to scrutinise the Government as we should because we passed the Coronavirus Act 2020, but the Select Committee on Public Administration and Constitutional Affairs, of which I am a member, will continue to do its job. I hope the Government will consider a more open and transparent way of operating in the coming months and that they will look at our report—the Minister gave evidence to the inquiry—in order to learn some of the lessons of what we should have used from the Civil Contingencies 2004. I am afraid time precludes me from talking about that in more detail, but we should return to that in this place.

I said in July that I hoped that we had turned a corner and that there would be more local work and a more local response. I genuinely thought that we might, but we have not, have we? As my hon. Friend the Member for Nottingham North (Alex Norris) has outlined, we will continue to try to make positive suggestions, but it remains the case that people in Bristol South are being disproportionately hammered by covid compared with other parts of the country. For the young and the very old, those on low incomes or in insecure work, those living in houses in multiple occupation, those from black and minority ethnic communities, those from multi-generational households, the cooks, cleaners and retail and hospitality workers, and those who rely on the Government, their inequalities are being exacerbated. This is made worse by the fact that the Government have lost time and wasted valuable knowledge that they could have used locally to manage the system better.

On the Select Committee on Public Administration and Constitutional Affairs, our inquiry has shown that the disconnect between the local and the national has been deeply problematic. In early May, we heard evidence from Sir Ian Diamond of the Office for National Statistics about how we could have utilised much of the data that is available much better, but again the Government have been too slow, and we need them to try to be much better. I think lessons are being learned, but I do not think they are being learned by Ministers and the Cabinet; the political direction and leadership are desperately worrying. We want the Government to do much better, and it is not too late to reset—it really is not. Our lives and our families depend on it, but it is crucial that the Government build back trust and admit where they have got things wrong. People will understand that. We need to empower local capacity and knowledge to lead the work, shape local solutions to the challenge, and deliver on the ground so that we can all have our lives back.