Testing of NHS and Social Care Staff

Kieran Mullan Excerpts

Wednesday 24th June 2020 Commons Chamber

[Jonathan Ashworth]

The hon. Gentleman is ahead of me in making the points that I was hoping to go on to make. I am not surprised that he has made those points given that he is a Leicester City fan. I am very proud to have Leicester City football club in my constituency— hopefully we will do better next season. He is absolutely right in what he says, because the statistics on cancer are absolutely terrible.

Around 2 million people in England are currently waiting for cancer screening tests or cancer treatment, including chemotherapy. Today, we have a published analysis, which shows that those waiting more than six weeks for diagnostic tests—some of these will be for cancer of course—have increased from 30,000 to 469,000 as a result of the lockdown. Cancer referrals are down 60%, and 1 million people are missing out on breast, bowel and cervical cancer screening. That means that about 1,400 cases of cancer are going undiagnosed every month. In March and April alone, there were at least 500 more deaths from cancer than average, and research from University College London predicts that an estimated 17,915 additional deaths of existing and newly diagnosed cancer patients could occur in England in the next 12 months. That is why resetting our NHS and getting it started again is so vital.

We also know that covid attacks the lungs, so this is an especially frightening time for those with serious asthma, chronic obstructive pulmonary disease and emphysema. One in four people with COPD have had a regular GP or hospital appointment cancelled, or both. Some 24% of people on pulmonary rehab programmes have had their classes cancelled, and 600,000 people with asthma or COPD have missed their annual review. The more we know about coronavirus, the more we know it is also a cardiovascular issue. Those with cardio- vascular problems are the second biggest group of those with an underlying condition dying from covid now, yet about 30,000 elective procedures for heart disease have been deferred. Referrals to stroke units have declined, and excess stroke deaths in care homes are 39% higher than the five-year average. We are making these points not in a spirit of blame, but to re-emphasise the point that lockdown has come with huge costs and will inevitably mean that people will die or develop long-term illnesses unless there is now a plan to get the NHS up, running and working again.

[Dr Kieran Mullan (Crewe and Nantwich) (Con)]

It is important that we are clear as to exactly what the Opposition are calling for today. The motion asks for “routine weekly testing”, with no ifs, ands, buts or qualifications. Yet the hon. Gentleman said in his opening remarks that he is seeking routine testing weekly if it is necessary. So are the Opposition calling for weekly testing, no matter what? Or are they calling for what he said in his opening remarks, which is the possibility of weekly testing?

[Jonathan Ashworth]

We are calling for weekly routine testing, as have many organisations and the Chair of the Select Committee on Health and Social Care. He penned an excellent article in The Daily Telegraph today, and I hope the hon. Gentleman has had time to study it, because it is superb. May I also take this moment to pay tribute to the hon. Gentleman, because I know he has returned to the frontline? I am sure all of us, from across the House, are grateful for everything he is doing on the frontline.

The other point I wish to make on this growing burden of unmet clinical need is that there is a social gradient in this, as always; there is a higher mortality rate among those who are poorer and more deprived. Through all these different conditions, the poorer someone is, the more likely they are to become ill quicker and die sooner. So we need urgent action from the Government to tackle this, and we believe that regular testing of NHS staff is a key part of that.

We also need a broader plan to tackle the growing burden of sickness and unmet need. Our NHS will need more resources. We have had years of financial starvation in the NHS. The Government’s funding plan of two years ago fell short of the annual 4% increase that experts said was needed before the pandemic, and the settlement of that long-term plan is surely inadequate post pandemic. We must remember that we entered this crisis after 17,000 bed cuts and years of budget cuts to capital settlements, which have left hospitals crumbling, reliant on out-of-date equipment and grappling with a £6.5 billion repair bill. NHS land and buildings have been sold off. Last year, more than 890 hectares of NHS land was put up for sale. So we will need large-scale investment in the real estate of the NHS to allow health services to reconfigure to treat covid and non-covid patients alike.

Ministers will say that the NHS will get what it needs, but the reality on the ground is very different. I am sure the Minister for Care will have studied today’s Health Service Journal ahead of the debate and will have seen trust chief executives complaining that the cash that they were promised has not been delivered. They need this cash now if they are to restructure any of their services ahead of the winter. I hope that she will update the House on when those chief executives are going to get the cash they were promised by her Department.

We will also need real investment in rehabilitation services for those suffering from covid. The more we know about this disease, the more we know that those coming out of hospital are probably doing so with significant long-term chronic conditions. They are going to need support, be it respiratory, neuromuscular or psychological. Community health services are going to see a huge peak in demand now that many have moved out of the community health sector.

Crucially, to reset services—this comes to the point that the hon. Member for Crewe and Nantwich put to us—we need to ensure that care can be delivered safely, which is why we believe that a mass-testing infrastructure for staff is now so important. We know that around a fifth of covid infections in hospitals are caught in hospital settings. Given the levels of significant asymptomatic and pre-symptomatic transmission, we need a proper targeted testing strategy as well. All healthcare workers should be tested regularly—weekly—because a study from Imperial suggested that that would reduce transmission in healthcare settings by up to a third.

--- Later in debate ---

[Dr Kieran Mullan (Crewe and Nantwich) (Con)]

I want to begin by thanking all the staff at Leighton Hospital, which serves my constituents in Crewe and Nantwich, who were so welcoming to me during my time on the wards recently. Because I am an MP and because I have a public profile, I have received a lot of thanks for going back, when actually the real thanks and gratitude should go to those staff who are there day in, day out full-time.

I know coronavirus presented a very real risk that was not an ordinary part of the job, but one of my key aims in this place is to get across to all Members of this House that the day-to-day stresses many face working in public services are there all the time. NHS staff often go above and beyond, and take decisions and carry a weight of responsibility that would be quite alien to most people. I want to use the recognition of the incredible work of NHS staff at this time to highlight the need to continue with this recognition going forward. We are at risk of finding it increasingly difficult to recruit and retain staff, as the rest of our modern workforce sees shifts towards a better work-life balance and flexibility in their employment.

We know that testing and tracing is key to the battle against coronavirus. We also know that health and social care settings are going to be the area that will need particular attention. In fact, I saw during my brief time back treating patients that, as services begin to look more like they did before coronavirus, the challenge for health and social care providers will increase in some ways. For a period, the task was clear and focused. Almost everything being done was geared towards treating coronavirus patients and keeping as many people as possible safe. Now, individual staff and managers need to weave steps to contain coronavirus throughout the increasing return of normal services. Organising wards into covid and non-covid is actually a simpler way of managing the flow of patients when that is the primary and overriding concern. When we reach the point of needing to be vigilant and to isolate individual patients among the delivery of normal services, that presents unique challenges of its own.

It is important that, wherever possible, normal services do return, because we know there is increasing evidence that diagnoses have been missed or delayed. This was an unfortunate inevitability of the clear and necessary message to the public about being careful in making use of the NHS at the height of the pandemic. So we must see how we can target messages. There is an increasing tendency to rely on social media online advertising for our public health messaging, and we need to use media that are going to best reach the at-risk groups for not seeking health advice.

On delivering rapid and ongoing testing, I feel compelled to challenge the narrative that the Secretary of State in Whitehall can click his fingers and instigate a flawless testing regime across the many thousands of individual wards, units, GP practices, treatment centres, care homes and in-home care providers that make up our health and social care sector. Clearly, the long time in opposition and the loss of so many previous Labour Secretaries of State for Health from their Benches have led to amnesia among the Opposition about the reality of instituting national approaches uniformly in the NHS. Any guidance is sent to hundreds of thousands of staff and is interpreted by them individually and locally by their managers.

Weekly testing is not a magic bullet. We must not let there be any distraction from the key and overriding concern that keeping outbreaks contained is most importantly about individual NHS staff and patients maintaining social distancing as much as possible within healthcare settings, because without that, even with regular testing, we will lose groups of staff from frontline services at times when we cannot afford to do so. We must not underestimate the enormous task a weekly testing regime would place on the NHS. There needs to be clear evidence for its benefits over other approaches. I note that the British Medical Association and others have said the same thing—that actually the evidence base for a mandatory weekly approach is not necessarily there. I hope, when responding, the Opposition spokes- person, the hon. Member for Tooting (Dr Allin-Khan), will spell out exactly what evidence they feel they have that means weekly testing is the one and only way to do it.