Antimicrobial Resistance

Maggie Throup Excerpts

Tuesday 7th December 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Gary. I thank my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake) for bringing forward today’s debate, and all hon. Members for their thoughtful contributions. As has been made clear in this debate, antimicrobial resistance is undoubtedly one of the most significant global health challenges that we face today. The covid-19 pandemic has illustrated the substantial impact that major outbreaks of disease can have on society, endangering lives and disrupting public services and the economy. The threat of AMR is no different.

Last year, in England alone, there were over 55,000 cases of resistant infections and more than 2,000 estimated deaths. Across Europe, hospital infections caused by resistant bacteria add £1 billion to hospital treatment and societal costs. In addition, the emergence of multi and extremely drug-resistant strains of infectious diseases threatens to undo years of global effort to tackle them. For example, there are now strains of tuberculosis that are resistant to almost all lines of treatment. TB deaths have increased for the first time in a decade and global targets are no longer on track. As other hon. Members have said, without working antibiotics, routine surgery such as caesarean sections or hip replacements could become too dangerous to perform, and cancer chemotherapy could become prohibitively high risk. As my hon. Friend highlighted, the threat of AMR also extends beyond human health. The implications of AMR for animals and crops threaten food security and trade. It is predicted that the global cost of AMR could amount to $100 trillion without action.

So what are the UK Government doing to tackle this risk? As Members have referenced, in January 2019 the Government set out the UK’s vision to contain and control AMR by 2040. That vision is supported by a five-year national action plan across the spectrum of human and animal health, agriculture, the environment and food. We are halfway through implementing our five-year action plan and have made considerable progress. We are committed to reducing the need for antimicrobials by lowering the burden of infection in our communities, in the NHS, on farms and in the environment—if you don’t get the bug, you don’t get the drug.

We have also taken a series of steps to ensure the appropriate use of antimicrobials, where they are needed, in both humans and animals. Antibiotic use in farmed animals has decreased by 52% since 2014, with a decrease of 79% in sales of veterinary antibiotics that are most critical for human health. Among European nations with a significant livestock farming industry, the UK has the lowest use of antibiotics, and antibiotic consumption by humans reduced by 6.6% between 2016 and 2019.

No new class of antibiotic has been developed since 1987, and the market for antimicrobials is broken, as my hon. Friend the Member for Thirsk and Malton said. To address that, we are testing a new Netflix-style subscription model for antibiotics—a world first. The economic model and evaluation reports for the two antimicrobials in the project have been completed, and the reports are currently undergoing consultation with registered stakeholders, including drug manufacturers. We hope that the first payments under the new model will be made in 2022, and I can reassure my hon. Friend the Member for Thirsk and Malton that we will incorporate the learnings from the pilot project in any new framework for the purchase of antimicrobials in the future.

We maintain a formal dialogue with industry through the joint Government and industry working group on AMR. The group, which has members from the Association of the British Pharmaceutical Industry, the National Institute for Health and Care Excellence and NHS England and Improvement, last met in October 2021, and the next meeting will take place in spring 2022.

I wholeheartedly agree with the point raised by my hon. Friend the Member for Thirsk and Malton on the importance of reporting. That is why a range of annual reports are already published by our partners across Government and their agencies, highlighting progress against the ambitions of the national action plan. The most recent of these, the “English surveillance programme for antimicrobial utilisation and resistance report 2020 to 2021”, was published on 17 November 2021. The report includes national data on human antibiotic prescribing, resistance, antimicrobial stewardship implementation, and awareness activities. The UK Health Security Agency also publishes data on antibiotic prescribing at practice level, and quarterly on the web platform Fingertips.

My hon. Friend the Member for Thirsk and Malton asked for an update on the national action plan ambitions. I will start by exercising caution on the figures in the light of covid-19. In England, however, we have seen an 11.2% decrease since 2019 in healthcare-associated gram-negative engagement. In response to my hon. Friend’s question about death certificate recording, it is important to acknowledge the difficulty faced by medical practitioners in distinguishing whether the cause of death of a patient with a resistant infection was due to the resistance itself, the infection or another cause. However, we will work with professional bodies to enhance the likelihood of AMR being accurately recorded where it can be determined that a resistant organism is responsible for an infection that caused or contributed to death.

Additionally, the Office for National Statistics upgraded its death recording software in January 2020 in order to support codes for AMR and allow analysis of mentions of AMR in death certificate data. We are not only taking action at home but continue to take a global lead in the world’s collective fight against AMR. The UK is committed to pushing the AMR agenda forward through multilateral forums, including as a signatory to the United Nations’ Call to Action. I am delighted that the UK’s special envoy, Professor Dame Sally Davies, represents the UK on the UN Global Leaders Group on Antimicrobial Resistance in order to advocate and advise on AMR globally.

Under the UK’s G7 presidency this year, we have secured ambitious commitments on AMR to balance innovation, access and stewardship for antimicrobials. G7 Health Ministers have agreed to strengthen the resilience of antibiotic supply chains and, with the G7 Climate and Environment Ministers, they will develop sustainable, clean and green solutions for antibiotic manufacturing. The G7 Health and Finance Ministers are working together to strengthen antibiotic development to ensure that there is a sustainable pipeline of new and equitably accessible antimicrobials in the making and building of the UK’s subscription model.

Finally, in recognition of the global effort required to tackle AMR, the UK invests significantly to improve global knowledge, surveillance and understanding of AMR—an issue raised by my hon. Friend the Member for York Outer (Julian Sturdy). The Department of Health and Social Care invests significantly in tackling AMR where the burden is highest, including through the Fleming fund, which improves laboratory capacity for surveillance of AMR, and the global AMR innovation fund, which funds innovative science in neglected areas of AMR R&D. Both of these projects are UK aid funded and are primarily for the benefit of people living in low and middle-income countries.

We also invest UK aid on research into new drugs, vaccines and diagnostics, as well as capacity building, technical expertise and support to relevant programmes, such as strengthening healthcare systems and improving infection prevention and control. Again, I want to thank my hon. Friend for bringing this incredibly important matter to the Chamber and for providing the opportunity to emphasise the necessity of collective domestic and international action if we are to effectively solve the very serious threat that AMR poses to us all.

Public Health

Maggie Throup Excerpts

Tuesday 30th November 2021 Commons Chamber

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

I beg to move,

That the Health Protection (Coronavirus, Wearing of Face Coverings) (England) Regulations 2021 (S.I., 2021, No. 1340), dated 29 November, a copy of which was laid before this House on 29 November, be approved.

[Mr Speaker]

With this we shall take the following motion:

That the Health Protection (Coronavirus, Restrictions) (Self-Isolation) (England) (Amendment) (No. 4) Regulations 2021 (S.I., 2021, No. 1338), dated 29 November, a copy of which was laid before this House on 29 November, be approved.

[Maggie Throup]

In September, the Government set out their autumn and winter plan for fighting the virus, which could be implemented to ensure that the NHS is not overwhelmed. Although we are not implementing the entirety of the plan now, we are taking steps to respond to a potentially potent mutation of the virus. We have taken great steps in our fight against the virus, having delivered nearly 115 million vaccine doses so far, and more every day, with almost 18 million people having also received their booster jab, including me.

[Sir Desmond Swayne (New Forest West) (Con)]

Will the Minister deprecate those public appointees who, notwithstanding the clear proportionate advice of the chief scientific adviser, have been on the airwaves telling people that they should not socialise, to the huge detriment of people’s wellbeing and of an industry struggling to recover from earlier lockdowns?

[Maggie Throup]

I am sure the people my right hon. Friend is referring to will have heard him loud and clear. We all enjoy socialising but, as he will appreciate, we are in a difficult situation. However, we also have personal responsibility.

We are confronted with an emerging threat, which is familiar but not yet well known. The measures that we are putting in place are proportionate, precautionary and balanced, and are being made in response to the specific threat.

Late last week, the challenge arising from the latest covid-19 threat from the variant of concern known as omicron emerged. Public health officials in South Africa shared information on the omicron variant and it was identified as a coronavirus variant of concern. Thanks to our world-leading genomic sequencing experts at the UK Health Security Agency, we were able to identify that some cases of the new variant are present in this country. So far, we have identified 14 cases in the UK and, unfortunately, we expect to find more in the coming days.

[Mr Mark Harper (Forest of Dean) (Con)]

The Minister mentioned the UK Health Security Agency, the head of which my right hon. Friend the Member for New Forest West (Sir Desmond Swayne) was referring to. Dr Harries said two things this morning. First, she said that people should not socialise. Secondly, she also implied—only implied, to be fair—that people should work from home. When the Prime Minister was asked about that, he made it clear that that was not the Government’s position and that people should follow the advice. I listened carefully to the Minister’s answer and I do not think that is quite what she said. Could she be clear that Dr Harries was speaking only for herself, not for the Government?

[Maggie Throup]

As my right hon. Friend said, the Prime Minister said that we are putting these measures in place, about which I will speak more. I cannot speak for any other person who goes on the airwaves.

[Rachael Maskell (York Central) (Lab/Co-op)]

Dr Harries is a public health professional who therefore understands what public health measures need to be taken to secure our wellbeing against the pandemic. Why are the Government not listening to what public health professionals are advising?

[Maggie Throup]

I reassure the hon. Lady that we listen to the advice of health professionals all the time, but today we are debating statutory instruments on face coverings and self-isolation following travel.

[Mr Steve Baker (Wycombe) (Con)]

Is the Minister seriously saying that it is not for Ministers to have any particular view on officials employed in the Department going out and taking a position that is at odds with the Government’s public policy? If it is now the policy that even Department employees can take their own personal positions, we are facing chaos and the overturning of long-standing Government principles.

[Maggie Throup]

I reiterate that I cannot speak for other people. I am setting out the measures today that we implemented this morning in a timely fashion, and it is those measures that we are considering. From the Government’s point of view, that is the legislation that we are implementing.

[Jim Shannon (Strangford) (DUP)]

I support what the Minister is putting forward. What happens here will happen in Northern Ireland, as the Minister in Northern Ireland has said that he will follow the instructions and guidelines from Westminster. We are aware of the variant and we are aware at this stage that our vaccinations may be enough to combat it. If we hand wash, distance and wear a mark, surely we cannot do anything other than support the measure. Does she agree that other hon. Members should adopt the same attitude?

[Maggie Throup]

I speak for myself in saying that I have changed my habits with regard to hand washing since the pandemic began, much to the detriment of my skin. We can take simple measures that have been put in place that have no impact on other people but help to protect us and others indirectly.

[Richard Drax (South Dorset) (Con)]

The Minister is being incredibly generous. Can I clear up something for the travel industry and the airline industry? There is an SI on travel restrictions, not least PCR tests on day two, as I understand it. They are not being debated today. Why not and when will they be?

--- Later in debate ---

[Maggie Throup]

Today, we are debating some travel restrictions about self-isolation, but the other restrictions are covered by different legislation and therefore they are not relevant to this debate.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

The Minister mentioned hand hygiene. Is she aware of a study published in The BMJ on 20 November that showed that hand hygiene was as effective as mask wearing? Does she agree that anything we do here needs to be firmly evidence-based? Can she say why we have focused on mask wearing in the regulations and not, for example, if our aim is to improve public health, mandating for alcohol gels in hospitality venues?

[Maggie Throup]

My right hon. Friend, with his medical background, makes a good point that I will take away and look into further.

I will return to my speech. Accordingly, our scientists are investigating omicron to determine, among other things, how quickly it is likely to spread and what the impact may be on the immunity that many of us have acquired through vaccination.

[Mr William Wragg (Hazel Grove) (Con)]

Will the Minister give way?

[Vicky Foxcroft (Lewisham, Deptford) (Lab)]

Will the Minister give way?

[Maggie Throup]

I must make some progress.

[Vicky Foxcroft]

It is on that point.

[Maggie Throup]

I give way to the hon. Lady.

[Vicky Foxcroft]

I thank the Minister for giving way. On the point of immunity, many people who are immunosuppressed are extremely worried. I have asked the Secretary of State on several occasions whether he will consider doing antibody testing so that those people have some idea whether they have any protection or they need to adjust things in their working lives.

[Maggie Throup]

I have heard the hon. Lady talk about that before and I take the point seriously. It is partly about antibodies and partly about T cells; the science behind it is obviously quite complex. I will take that point away and get back to her.

[Mr Wragg]

Will the Minister give way?

[Maggie Throup]

I will give way once more and then I must make progress.

[Mr Wragg]

My hon. Friend is the kindest of Ministers. On the question of the new variant’s severity, I wonder if she has data to hand about whether any of the new cases of omicron in this country that she mentioned have been detected in patients hospitalised with covid.

[Maggie Throup]

I am not aware of that, and it may not be in the public domain due to confidentiality. I must make some progress.

Meanwhile, the Government have responded quickly to introduce a temporary and targeted package of precautionary measures to combat the risk of transmission. The aim of the package is to buy our scientists time to investigate and gather information on the omicron variant, and to continue to build the protection that vaccination provides.

The package comprises the requirement for people to wear face coverings in shops, shopping centres and transport hubs, and on public transport; the requirement for those returning from abroad to take a PCR test by day two and to quarantine until they receive a negative PCR test; the requirement for people to self-isolate if they are identified as a close contact of a confirmed or suspected case of the omicron variant; the addition of 10 countries to the red list; and the requirement that those arriving from those countries in Africa quarantine in a managed quarantine service for 10 days.

Across England, at 4 o’clock this morning, face coverings became mandatory in all shops and shopping centres, which includes supermarkets, banks and close-contact services such as hairdressers, and on public transport.

[Several hon. Members rose—]

[Maggie Throup]

I must continue.

They became mandatory in transport hubs, including taxis and private hire vehicles. From the same time, close contacts with confirmed or suspected cases of the covid-19 omicron variant will be legally required to self-isolate. These measures will remain in place until the end of the day on Monday 20 December. By this point, we will review the measures to see whether they remain necessary. We do not wish to keep any measures of this nature in place any longer than is absolutely necessary. However, these measures are an important step in the fight against the virus, particularly while we wait to discover the full implications of the threat from omicron.

[Mr Clive Betts (Sheffield South East) (Lab)]

The word “mandatory” was used but is that not just a word in the statutory instrument? In practice is it not unenforceable? As Darren Pearce, the manager of Meadowhall shopping centre, said in evidence to the Housing, Communities and Local Government Committee, “The biggest problem we had last time was about trying to get face coverings to be worn. I saw a group of young people going to Meadowhall, saying very loudly, ‘If they ask you, just say you’ve got asthma.’ Then they say, ‘We’ve got asthma. We’re exempt’, and there is nothing anyone can do, is there?” That causes all sorts of tensions with the shop assistants and with other people wearing face masks, who feel that some people are getting away with it. What is the Minister going to do about that situation?

[Maggie Throup]

I find it quite intriguing that the Labour party has been calling for this measure for some time and, now we are introducing it, it is unhappy about it.

[Daisy Cooper (St Albans) (LD)]

Will the Minister give way?

[Maggie Throup]

I must make some progress.

In July, when we lifted most of the remaining restrictions at step 4 across England, we made it clear that our response to the pandemic was not over. The vaccination programme continues to be a huge success and vaccines remain the most important weapon in our fight against the virus. However, as we enter this uncertain time, we must do more and we must do it quickly.

[Mr Harper]

Will the Minister give way on the timing?

[Maggie Throup]

I know I keep saying I will take one last intervention, but I give way.

[Mr Harper]

I am very grateful. I listened carefully to what the Minister said about the timing. The Government have said that they are going to review these measures after three weeks and she is right—on the face masks, the regulations expire on 20 December—but the self-isolation SI has no expiry date, which means it will run all the way until the main statutory instrument expires on 24 March 2022. Why is that?

[Maggie Throup]

My right hon. Friend makes a very good point. I would like to reassure him that we will continue to update the House over the next few weeks, that we will not continue to have these regulations in place for any longer than is necessary, and that—[Interruption.] If I may just finish. The type of regulations he is referring to are reviewed under legislation every four weeks and are more likely to be reviewed every three weeks. I understand his point and I do take it very seriously. I wish we were not in a situation where we have this conflict, but I reassure him that I take his point very seriously and these measures will not be in place for any longer than is absolutely necessary.

[Daisy Cooper]

rose—

[Dr Murrison]

rose—

[Maggie Throup]

I give way to the hon. Lady, who has been trying to intervene.

[Daisy Cooper]

I am grateful to the Minister for giving way. The hon. Member for Sheffield South East (Mr Betts) raised a question about the enforcement of mask wearing. One of the major problems being faced by GPs in my constituency of St Albans is that some people are refusing to wear masks because, “The Prime Minister didn’t have to when he went to a hospital”, so could I ask the Minister how she intends to lead by example when half of her own colleagues are still refusing to wear masks on the Benches opposite?

[Maggie Throup]

As I said earlier, we are mandating the use of face coverings. I think we are in a different situation now with regards to that.

[Dr Murrison]

Will the Minister give way?

[Maggie Throup]

I will allow one more intervention and then I will move on.

[Dr Murrison]

The Minister is really being most generous and I thank her very much indeed. Our right hon. Friend the Member for Forest of Dean (Mr Harper) is absolutely right and I fear that, inadvertently, she has not given the fullest answer that she might have done to this. The fact is that motion 3 on the Order Paper expires on 20 December, yet motion 4 expires on 24 March 2022. Can she explain the logicality of that? I also observe that, given the extraordinary restriction on liberty that this potentially offers, most Members of this House would be more than delighted to return after the House rises for the Christmas recess in order to reaffirm our support for the measures that she has put before the House today.

--- Later in debate ---

[Maggie Throup]

I have listened to my right hon. Friend very carefully, as I did to my right hon. Friend the Member for Forest of Dean (Mr Harper), and I reiterate that we will not keep these measures in place for a day longer than we need to.

[Karl MᶜCartney (Lincoln) (Con)]

On that point, will the Minister give way?

[Maggie Throup]

I must make progress.

Given the potential severity of the consequences of not responding swiftly to this new variant, the Government have taken decisive action to bring back compulsory face-covering wearing in an array of settings. Face coverings are again compulsory in shops and on public transport, unless an individual has a medical exemption or a reasonable excuse.

[Rachael Maskell]

On that point—

[Maggie Throup]

I will continue.

The requirement to wear face coverings is not new. We have asked people to do their bit to stop the spread of the virus before, so we are again asking people to play their part, this time to help slow down any transmission of this new variant of concern.

[Mr Betts]

Will the Minister give way?

[Maggie Throup]

No, I must make progress. I have been very generous with my time up until now.

However, anyone who has an age, health or disability reason for not wearing a face covering need not wear one, and they need not provide proof of their exemption. The Scientific Advisory Group for Emergencies has found that face coverings are likely to reduce transmission through all routes by partially reducing the emissions of and exposure to the full range of aerosols and droplets that carry the virus. This includes those that remain airborne and those that deposit on surfaces.

[Several hon. Members rose—]

[Maggie Throup]

I must make progress.

Scientific evidence also shows that all types of face coverings are to some extent effective in reducing the transmission of covid-19 in all settings. This is through a combination of source control, which limits the spread of the virus from a person, and protection to the wearer. Laboratory data shows that even non-medical masks, such as cloth masks made of two or three layers, may have similar filtration efficiency to surgical masks. As ever, we are guided by the advice of our scientific and medical experts. We will keep these measures under review, and we will take further action if necessary.

[Mr Betts]

Will the Minister give way on the point of exemptions?

[Maggie Throup]

No, I must make progress.

The self-isolation regulations were introduced to provide a legal requirement to self-isolate for individuals who have been notified that they have tested positive for covid-19 or that they are a close contact of a positive case. On 16 August, thanks to the success of the vaccine roll-out, we were able to introduce a number of exemptions to self-isolation for close contacts, including for those who are fully vaccinated or under the age of 18 years old. Given the greater threat that may be posed by the omicron variant, we have reviewed the application of these exemptions. This latest amendment to the self-isolation regulations is targeted at helping to slow its spread. From 4 am today, all individuals notified by NHS Test and Trace or a public health official that they are a close contact of a confirmed or suspected case of the covid-19 omicron variant are legally required to self-isolate for a period of 10 days, regardless of their age or vaccination status.

[Mr Harper]

Will the Minister give way on that one point?

[Maggie Throup]

No; I have been very generous up until now.

Anyone who has been notified as testing positive for covid-19, regardless of the variant, will continue to be legally required to self-isolate. We appreciate that self-isolation is not easy and that it places a burden on people, but we also know that it is highly effective in limiting the spread of the virus. The Canna model estimated the impact of testing—

[Mr Harper]

Will the Minister give way?

[Maggie Throup]

I really must make progress.

The model estimated the impact of testing and tracing and self-isolation on covid-19 transmission from June 2020 to April 2021. During the period of the study, the model found that testing, tracing and self-isolation had a critical impact on identifying cases of covid-19 and reducing onward transmission. The model found that between 1.2 million and 2 million infections have been directly prevented as a result. Additional assistance is available to those who are being required to self-isolate through the range of financial and practical support measures that the Government have put in place.

I am confident that these two sets of regulations represent proportionate precautionary and targeted action in the face of the new covid-19 variant, the risk of which we still do not yet fully understand. [Interruption.]

[Several hon. Members rose—]

[Mr Speaker]

Order. In fairness, I think the Minister has been very generous with her time, and I would say that I am sure we have some capacity to get more speakers in if they so require.

[Maggie Throup]

Together, the impacts of these regulations should combine to help slow down the spread of the omicron variant and give us valuable time to assess how effective our vaccines are as a shield against this new variant. We are committed to reviewing these measures in three weeks’ time, when further scientific analysis should help us determine whether they are still needed, or whether they need to be extended or strengthened to support us in our wider fight against covid-19. I hope colleagues will join me in supporting these regulations, and I commend them to the House.

--- Later in debate ---

[Steve Brine]

I do accept that, and I also accept that the scientists who discovered the variant said on the media at the weekend that this was often a less serious disease than the delta variant. However, notwithstanding the point that I have just made about the people whom it has affected in South Africa—younger, unvaccinated people—given that numbers are so small in this country, I fail to see how we will be any the wiser in three weeks’ time. That may explain why the isolation regulations will apply until next March. Perhaps the Minister can enlighten me, through an intervention now or in winding up the debate.

Finally, let me return to the situation in my constituency. I have raised this matter twice in the House. This morning I spoke to the Winchester City primary care network, which is responsible for some 62,000 people who are on its roll. PCN patients will be contacted if they are in one of the Joint Committee on Vaccination and Immunisation’s groups 1 to 9, if they are clinically extremely vulnerable or if they are over 50, and will have been offered a booster. The PCN expects that process to be complete by 17 December, and by the middle of January it will start to offer the booster to others. From that date onwards the booster will be offered to those aged 18 and over, following the welcome announcement from the Secretary of State during his statement yesterday.

Many of my constituents do not live in the area covered by the Winchester City PCN, but have access to vaccinations at the Badger Farm community centre. If they consult the NHS website, they are offered the opportunity to go to Salisbury, Portsmouth or Southampton. That is not easy access to the booster. In my constituency there is no easy walk-in access to it, and I am inundated by questions from constituents about why they cannot have such easy access in Winchester today. The difference between what is being said on television and by Ministers from the Dispatch Box and the reality of the access available on the frontline is growing, and it is a problem.

[Maggie Throup]

rose—

[Steve Brine]

I know that the Minister has been looking into the matter for me. We have not teed this up, Mr Deputy Speaker, but she is kindly going to intervene.

[Maggie Throup]

I want to reassure my hon. Friend. I heard what he said yesterday, and I have asked my office to look into it further. I will get back to him as soon as I can.

[Steve Brine]

I greatly appreciate that. The Minister is a good friend, and I know she is sincere. This morning I sent her some correspondence between me and the head of the new integrated care system in Hampshire, where we are trying to make progress with this. If “boosterism” works—in the context of covid-19 and this variant, which is where it probably does work—that will be all to the good, but let us get those boosters, and let us make it easy for people to get them.

I will end by reiterating that I am ambivalent about the face coverings regulations, but the isolation regulations concern me greatly. I am concerned about the timing and the conclusion of their application, and about their chilling effect, and unless I hear a very good answer to my question about the definition of “suspected”, I will not support them today.

--- Later in debate ---

[Maggie Throup]

I am pleased to bring this wide-ranging debate to a close. We are now almost two years on from when this virus first emerged in Wuhan. Since then, science and disease have been locked in a battle for ascendancy. For the last year, science has been on top as the global effort on vaccines has dramatically reduced the risk of hospitalisation and death for those who catch covid-19, but we know from the history of previous diseases that they mutate and change, so that vaccinations and treatments become less effective. That is why only one disease, smallpox, has been eradicated, although we are close to eliminating polio, too.

The virus is fighting back, and we must respond. To those who say that the regulations we have debated—the reintroduction of face coverings in some settings and self-isolation requirements for close contacts—are an imposition on our liberties, I agree, but they are a necessary imposition to slow the spread of a new variant and allow science to catch up. However, there is a balance to be struck. Too many restrictions have a crippling effect on social and economic life, as well as adding to the burden of mental illness. For those who say that the regulations we have debated are not enough, I say that they will buy us time to understand this new variant better. That is why they will be reviewed in three weeks’ time.

We will continue to closely monitor all the emerging data on the new variant. We have committed to review all of the measures in three weeks’ time, ahead of the face coverings regulations expiring. Restrictions will not be in place any longer than necessary. We do need to learn to live with this virus, but it is right, in the face of a potential threat, to take balanced and proportionate measures, and we will continue to closely monitor all the emerging data on the new variant. Overall, I would like to reiterate that this will be a moving picture over the coming weeks. We will get a better idea of its nature in the next couple of weeks. Its transmission advantage, vaccine escape and severity of infection are some of the things we are looking at as we observe how the variant develops in southern Africa and the rest of the world, too. Alongside that, the scientists will continue to study it in the lab, but it will be several weeks before we get a clear picture. The most important thing is that the world keeps sharing information and findings as new cases emerge. I thank my hon. Friend the Member for Christchurch (Sir Christopher Chope) for raising an inconsistency in our explanatory memorandum at paragraph 12.3. For clarity, I will read out the section as it was intended:

“Furthermore, the policy will be supported by a communications campaign that will make clear that some people are exempt from these regulations and people should not be challenged by members of the public for not wearing the face regulation.”

I trust that that reassures my hon. Friend on the matter and on the seriousness with which the Government take supporting those who are exempt from these requirements. I will be working with officials to rectify this.

With respect to omicron-positive cases, NHS Test and Trace will work with the positive case and/or their parent to identify close contacts. Contacts from a school setting will only be traced by NHS Test and Trace where the positive case and/or their parents specifically identify the individual as being a close contact. There is likely to be a small number of individuals who will be most at risk of contracting covid-19 due to the nature of the close contact. I reiterate that the direct contact will be by NHS Test and Trace, rather than via the covid app.

My hon. Friend the Member for Winchester (Steve Brine) and my right hon. Friend the Member for South West Wiltshire (Dr Murrison) talked about suspected cases. My right hon. Friend hit the nail on the head: many of the laboratories processing the PCR tests will be able to test for the S-gene dropout and that will give a very good indication of cases of the omicron variant. While it does not provide 100% confirmation, we can get that information very quickly and at the same time the test result is reported and that is ahead of any genomic sequencing.

[Mr Harper]

Will the Minister give way?

[Maggie Throup]

I want to continue as many points have been raised and I was very generous in giving way when opening the debate.

A debate on this subject would not be complete without the Opposition spokesman asking about financial support for those in self-isolation. I reassure the Opposition spokesman that anyone who is legally required to self-isolate as a contact or positive case will be able to apply for a test and trace support payment or practical support such as the medicines delivery service if they meet the normal eligibility criteria. The latest figures show that almost 363,000 people have received a test and trace payment since the scheme began, and over £180 million has been paid out. The help is there.

We have set out proportionate and balanced measures which do not include limiting socialising. It is the Government who set policy and guidance, which is what the public should follow. The Secretary of State updated the House yesterday on the changes to the JCVI guidance for boosters and the NHS will be issuing instructions on how that guidance should be operationalised shortly.

These regulations are precautionary and proportionate, helping to safeguard the gains made by our fantastic vaccination programme, which has seen almost 18 million people across the UK get a booster jab already. The Government have acted rapidly and reasonably to ensure that science retains the upper hand in the struggle with the virus and I commend these SIs to the House.

Question put.

Draft Coronavirus Act 2020 (Early Expiry) (No.2) Regulations 2021

Maggie Throup Excerpts

Tuesday 30th November 2021 General Committees

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

I beg to move,

That the Committee has considered the draft Coronavirus Act 2020 (Early Expiry) (No. 2) Regulations.

This pandemic has touched every corner of our society and presented huge challenges to us all. The Coronavirus Act 2020 has been crucial to the Government’s approach to maintaining public services, including the NHS, and providing financial support to individual and businesses at this time of need. The Act has enabled the temporary registration of nurses, healthcare professionals and social workers to bolster the workforce. It has reduced administrative tasks that front-line staff have to perform during this time of pressure. It has also allowed the Government to provide an extraordinary level of support to people and businesses impacted by covid-19. That support includes the coronavirus job retention scheme, which supported 11.7 million jobs, and the self-employment income support scheme, which supported almost 3 million self-employed individuals.

As the course of the pandemic continues to change, it is right that we continue to assess the legislative powers that are in place. The Government are committed to ensuring that emergency powers are in place only for as long as they are needed. The most recent six-month review of the Coronavirus Act 2020 in September identified seven provisions, and parts of an eighth, that could be expired. The regulations that we are debating today will expire those provisions. That includes expiring powers under schedule 21 relating to potentially infectious persons, and powers under schedule 22 to issue directions relating to events, gatherings and premises.

Sufficient resilience has been built up within the system to expire power under section 23 to vary time limits in relation to urgent warrants under the Investigatory Powers Act 2016 and, following an amendment to the Magistrates’ Courts Rules earlier this year, and upon expiry of schedule 21, powers under section 56 for live links in magistrates court appeals are also to be expired. We are also expiring powers under section 37 and parts of the provisions under section 38 relating to education, training and childcare. We will retain only those provisions that may be needed to ensure that we have relevant protections for individuals and the sector.

We are also expiring sections 77 and 78, which relate to time-limited powers and so are no longer needed, and a further provision on behalf of Northern Ireland. That means that Parliament will have been able to expire half of the original 40 temporary, non-devolved powers in the Coronavirus Act, ahead of schedule.

The 2020 Act continues to be a critical part of our country’s response to the pandemic. I acknowledge the concerns that have been expressed about how some of the powers in the Act have been used, but the Government have sought to use them appropriately and proportionately, with arrangements in place to ensure accountability, including to Parliament. We are grateful to members of both Houses and to the Joint Committee on Statutory Instruments for their helpful comments.

Following the third six-month review of the 2020 Act, the House confirmed that it was content for the temporary provisions to continue to support the Government’s ongoing response to the pandemic. The remaining provisions in the Act will help to support the NHS, individuals and businesses throughout the months ahead.

The pandemic is not yet over, and we know that there are challenges ahead, which is why we set out the steps we are taking in our autumn and winter plan. The virus has presented the greatest public health threat to the United Kingdom in recent history. I am sure that all hon. Members will join me in extending immense thanks to everyone who has made sacrifices and worked so gallantly in the fight against the virus, including our health and social care workers, all those who have volunteered in their communities, and those who have supported the vaccination programme and continue to do so.

--- Later in debate ---

[Maggie Throup]

I thank the hon. Member for Nottingham North for his constructive contribution to the debate. He is right that the majority of the measures that have been expired had not been used, or used very rarely. The Coronavirus Act 2020, however, continues to be a critical part of our country’s response to the pandemic. It has enabled the Government to provide help and support to people, businesses and our healthcare and public services.

As the hon. Gentleman rightly said, the Act is underpinned by regular and careful reviews and parliamentary scrutiny. We are confident that the Act has been fundamental to facilitating a fast and effective response to the pandemic. During the most recent review, the Government assessed the remaining provisions to identify those suitable for expiry, while remaining mindful of the challenges that we may face over the winter and, as we have found out, the potential emergence of new variants of concern.

The powers outlined in the regulations for expiry are deemed as being no longer needed and each has a clear rationale for inclusion. The hon. Gentleman asked whether we may need to introduce further powers. The 2020 Act is enabling legislation and the majority of the other measures required were brought in under the terms of the Public Health (Control of Disease) Act 1984. I feel that we have got it right in terms of the enabling ability of the 2020 Act.

The hon. Gentleman referred to the expiry of section 77 that allowed for the uprating of working tax credits for 2020-21. Throughout the crisis, the Government have sought to protect people’s jobs and livelihoods while also supporting businesses and public services across the UK. To that end, the Government announced a package worth a total of £352 billion in 2020-21 and 2021-22 to provide that support. The Government were always clear that the £20 increase was a temporary measure to support households most affected by the economic shock of covid-19.

During the recent Budget, my right hon. Friend the Chancellor announced that since restrictions had been lifted, economic growth had exceeded expectations and the labour market was recovering strongly. In the light of that, the Government are focusing on supporting people to move into and progress in work. The Government’s comprehensive plan for jobs is helping people move back into employment, so that they can earn a regular wage, progress and increase their financial resilience.

Workers leaving the furlough scheme and unemployed people over the age of 50 will be helped back into work as part of the expansion of the Government’s plan for jobs, worth more than £500 million. Those on the lowest wages will also be helped to progress in their careers and existing schemes targeting young people will be extended into next year. That assistance is part of the new package of support that could help hundreds of thousands of people into work.

The Government are committed to keeping powers in force only where they are judged to be absolutely necessary and part of the Government’s response to the virus. As the hon. Gentleman said, a number of provisions have never been used since coming into force, and to maintain them on the statute book would be disproportionate considering the progress that we have made. Given the minimal use of the powers and the alternative measures available, the Government deemed it appropriate for the powers under schedule 21 relating to the detention of potentially infectious persons to be expired. Those powers have not been used since October last year, and nor have they been relied on to tackle some of our toughest challenges.

We have strengthened our defences against the virus even further, and therefore it is the right time for the powers listed in the regulations to be expired. The Government retain only those powers that are critical to our response to and recovery from the pandemic. The powers to be maintained include those that allow the temporary registration of healthcare professionals, which will help to support the NHS as we head into winter.

The Government urge everyone to be sensible and responsible and to continue to follow safe behaviours and measures now in place. People should get the covid-19 vaccine and the flu jab where eligible. That will help to protect the progress that we have made and protect the NHS in the months ahead. I commend the regulations to the Committee.

Question put and agreed.

Alcohol Harm

Maggie Throup Excerpts

Thursday 25th November 2021 Commons Chamber

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

I thank my hon. Friend the Member for St Ives (Derek Thomas) for leading on this important debate. There may not have been too many contributions, but those we have had have been really, really valuable. I am very sorry to hear that the hon. Member for Liverpool, Walton (Dan Carden) cannot be here for this important debate. I send my best wishes to him and his family at this very difficult time.

The majority of people drink alcohol responsibly, but we know that there are people who drink at levels which lead to significant harms. Alcohol misuse can have devastating impacts on individuals, families, communities and society. Over the course of the pandemic, we have seen an increase in those drinking at higher risk levels, and, sadly, an increase in alcohol-specific deaths. I would like to take this moment to commend our frontline workers. They have been tirelessly working and supporting people in need in the most difficult circumstances.

Throughout the pandemic, drug and alcohol treatment providers have continued to support and treat people. To ensure treatment services continue supporting people to the highest standards, we have made the largest increase to treatment funding for substance misuse in 15 years. We have provided £80 million of new investment in 2021-22. Some £9.8 million of that uplift has been allocated specifically to increase the availability of in-patient places for medically assisted withdrawal. That is of critical importance for people heavily dependent on alcohol, where rapid withdrawal can be extremely dangerous. The funding is in addition to the money that local authorities already spend on substance misuse from the public health grant.

The Government have agreed to carry forward the recommendations of part two of Dame Carol Black’s independent review of drugs—my hon. Friend the Member for St Ives talked about Dame Carol Black’s report in his speech—and to publish a new drugs strategy later this year. Although the subject of the review was drugs, the implementation of many of its recommendations will also benefit people seeking treatment for alcohol dependency, for example through the introduction of mechanisms such as an improved commissioning standard and a strong focus on building back the workforce. To further improve alcohol treatment, the Office for Health Improvement and Disparities is developing comprehensive UK guidelines for the clinical management of harmful drinking and alcohol dependence. The guidelines should develop a clear consensus on good practice and improve the quality of service provision.

There is clear evidence that growing up in a family affected by parental alcohol dependency can cause significant harm to a child’s wellbeing and damage their long-term outcomes. Thanks to the personal testimony and campaigning from Members here today—I will respond further to the right hon. Member for Birmingham, Hodge Hill (Liam Byrne) later in my speech—we have invested £7.2 million on a package of measures, over four years, to improve outcomes and support for children whose parents are alcohol dependent. Some £5.7 million of that has funded nine local areas to implement innovative and evidence-informed interventions, and will make system-wide improvements to working holistically with these families. Early findings of the programme indicate positive results, for example in the local areas receiving programme funding, and we have seen improved identification of children in need, and more parents starting alcohol treatment. We are actively considering how we share lessons from the programme nationally, and the implications for future policy and practice. To aid that, we have commissioned an independent national evaluation of the programme, expected to be published in spring 2022.

Alcohol harms are not experienced equally across groups. Despite reporting lower or similar levels of drinking, those of lower socioeconomic status experience disproportionate alcohol-related harm. There are also significant geographical disparities, with the highest rates of mortality from alcohol-specific causes seen in the northern regions.

As part of the long-term plan, we have provided national funding to support the implementation of specialist alcohol care teams in the 25% of hospitals with the highest rates of alcohol dependence-related admissions. It is estimated that the programme will prevent 50,000 admissions over five years.

We are also committed to supporting the most vulnerable in our society. This year, we are delivering up to £52 million for substance misuse treatment services for people sleeping rough, building on the £23 million in 2020-21. That will fund evidence-based drug and alcohol treatment and wraparound support to improve access, including for those with co-occurring mental health needs.

The Government believe that people have a right to accurate information and clear advice about alcohol and its health risks, enabling people to make informed choices about their drinking. As a result, we continue to educate the public, ensuring that people are aware of the health risks of alcohol through local and national programmes, such as the Better Health campaign and the Drink Free Days app.

An alcohol risk assessment is a mandatory component in the NHS health check so that people are given advice on cutting down if their drinking is putting their health at risk. To ensure that people have all the information they need at the point of purchase, we will shortly consult on whether mandatory calorie labelling should be introduced on pre-packed alcohol and alcohol sold in the out-of-home sector. The consultation will also seek views on mandatory provision of the UK chief medical officer’s low-risk drinking guidelines and a drink-drive warning. The hon. Member for Nottingham North (Alex Norris) talked about the impact that drink-driving can have on families. Respondents to that consultation will have the opportunity to provide suggestions for further labelling requirements that they would like the Government to consider.

I will take the opportunity now to address the issues raised during the debate. My hon. Friend the Member for St Ives talked about foetal alcohol spectrum disorder, and I reassure him that we take that very seriously. We have asked NICE to produce a quality standard in England for FASD to help the health and care system to improve the diagnosis and care of those affected, based around the Scottish intercollegiate guidelines network—SIGN 156—standard. To help improve support for those living with its consequences, we have funded five voluntary organisations in 2020-21, and we are analysing the evaluations to be taken into account for further policies on FASD.

The right hon. Member for Birmingham, Hodge Hill shared his moving and personal experiences of being a child and a grandchild of an alcoholic. I thank him for his openness. He talked about stigma and the importance of sharing experiences. I am sure that, by sharing his experience today, he will have made a difference to so many people, and I thank him for that.

The right hon. Gentleman asked about a number of other issues, including the strategy, as the hon. Member for Nottingham North and the hon. Member for Linlithgow and East Falkirk (Martyn Day) did. The Government have committed to publishing a new UK-wide cross-Government addiction strategy, which will focus on creating further opportunities to tackle and address addictions, such as alcohol and drugs as well as gambling-related harms, in a comprehensive and joined-up way. As I said, alcohol and drug addiction are far too often intrinsically linked, and we are committed to tackling that.

[Liam Byrne]

I wonder whether the Minister could share with the House her forecast timeframe for that addiction strategy and, in so doing, perhaps recognise that there are significant differences between addiction to drugs and alcohol, not least because one is legal and the other is illegal.

[Maggie Throup]

I thank the right hon. Gentleman for that intervention. I am sure he will appreciate that Dame Carol Black’s report acknowledged that there are differences, but they are intrinsically linked as well. I fully take his point that one is illegal and the other is illegal, and that will be taken into consideration.

My hon. Friend the Member for St Ives, the right hon. Member for Birmingham, Hodge Hill and the Scottish National party spokesman, the hon. Member for Linlithgow and East Falkirk, talked about the minimum unit price. The Government continue to monitor the impact of the minimum unit price as evidence emerges from Scotland and Wales. Although some evidence has been published by Public Health Scotland relating to the impact of MUP, further important components of the evaluation are not scheduled for release until 2023, including the impact on alcohol-related admissions and deaths.

Another important issue raised in the debate was the relationship between domestic abuse and alcohol addiction. The Domestic Abuse Act 2021 will mean better protections for victims and more effective measures for going after perpetrators. We are reflecting the importance of joined-up domestic abuse, mental health and substance misuse services in supporting statutory guidelines.

Let me briefly address the issue that the hon. Members for Linlithgow and East Falkirk and for Nottingham North raised about amendments that were not made to the Health and Care Bill. Alcohol has not been included in the advertising restrictions in the Bill, mainly because the Government have existing measures in place to protect children and young people from alcohol advertisements. The 2019 and 2020 consultations on advertising restrictions on less healthy food and drink did not consult on including alcohol in the restrictions, either online or on TV. Finally, alcohol products are not available for children to purchase, so they do not have the same level of exposure to them.

In closing, I reiterate the Government’s commitment to supporting those who are most vulnerable to and at risk of alcohol misuse. I am confident that our strong programme of work under way to address alcohol-related harms, the increased funding for treatment providers and the recommendations in Dame Carol Black’s review that we are taking forward will all further support people who are experiencing alcohol dependency and alcohol-related harms, as well as those on whom they have an impact.

Oral Answers to Questions

Maggie Throup Excerpts

Tuesday 23rd November 2021 Commons Chamber

[Jane Hunt (Loughborough) (Con)]

8. What steps his Department is taking to roll out the covid-19 vaccination to 12 to 15-year-olds.

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

We have vaccinated more than 1.1 million 12 to 15-year-olds since roll-out began. Vaccine clinics have been held at around 3,500 schools, with 800 more to be visited next week, and there are more than 240 out-of-school vaccine sites in operation. To bolster the roll-out, since 22 October vaccination bookings for any 12 to 15-year-old in England can be made through the national booking service to attend a vaccination site outside school hours. I take this opportunity to thank everybody involved in making this programme so successful.

[Jane Hunt]

Humphrey Perkins School in my constituency had carried out all the necessary preparations ahead of its anticipated roll-out of the vaccine prior to the autumn half-term, but on the day before, it was informed that the roll-out would be postponed until 30 November. Please could my hon. Friend set out the reasons for this delay, and can she confirm that this date will not be pushed back again as this could have an impact on transmission between local adults, among whom cases have increased recently?

[Maggie Throup]

In late September, the Leicestershire Partnership NHS Trust school age immunisation service devised an updated schedule for covid-19 and flu vaccinations comprising the remaining schools to be visited. This was to address some operational challenges, reduce the need to postpone sessions at short notice and offer the best experience to the young people receiving vaccinations. All affected schools were notified as soon as possible. As my hon. Friend said, the service will be attending Humphrey Perkins on 30 November, when eligible students with consent will be offered both the flu and the covid-19 vaccines. West Leicestershire clinical commissioning group has confirmed to me that this date will not be moved.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

Wales has now joined Scotland in having vaccinated more than half of all 12 to 15-year-olds, Scotland’s figure being 57.7% in comparison with England’s 36.3% of eligible pupils. Given that 10 to 19-year-olds have maintained the highest rate of infections in recent months, what steps are the UK Government going to take to follow Scotland’s lead and improve vaccination further in this age group?

[Maggie Throup]

As I said earlier, we have already vaccinated over 1.1 million 12 to 15-year-olds since the roll-out began, which to me is a huge success. We have opened up the national booking service, and provided more opportunities for youngsters to come forward whether within the school environment or outside the school environment. We always look at every opportunity to ensure complete accessibility for people to get their vaccine.

[Chris Green (Bolton West) (Con)]

9. What steps his Department is taking to increase the number of carers in the adult social care sector.

--- Later in debate ---

[Chris Loder (West Dorset) (Con)]

11. What steps he is taking to ensure booster doses of the covid-19 vaccine are available to all eligible people in West Dorset.

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

We have delivered more than 15.3 million booster doses in the UK, and we know there is a strong demand for boosters in Dorset. The NHS has worked hard to deliver boosters and third doses at all 18 primary care networks in Dorset, providing them across a number of sites. Additional provisions are also in place for those who are housebound, elderly, or in care, to ensure that they get their booster.

[Chris Loder]

I thank my hon. Friend for her answer. Almost a third of constituents in West Dorset are over the age of 65. While I welcome very much the Secretary of State’s announcement this week that he is rolling out the booster to those over the age of 40, I am afraid that, in the county town of Dorchester and the second town of Bridport particularly, it is still very difficult for the elderly to receive their vaccine boosters. Will my hon. Friend help urgently with sorting this issue by arranging walk-in centres so that we might address it rapidly?

[Maggie Throup]

The Department of Health and Social Care and the NHS keep the covid-19 vaccine programme under constant review in order to ensure that there is sufficient capacity across the country. There are more vaccination sites than ever before in England, including hundreds of walk-in centres. A lot of planning goes into ensuring that those sites are distributed to meet the level of demand, and there are measures in place to ensure that boosters are accessible for all in West Dorset, but I will look into this matter further on behalf of my hon. Friend.

[Ben Everitt (Milton Keynes North) (Con)]

12. What assessment he has made of the effectiveness of the roll-out of booster doses of the covid-19 vaccine.

Randox Covid Contracts

Maggie Throup Excerpts

Wednesday 17th November 2021 Commons Chamber

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

I am pleased to be able to close this debate on behalf of the Government. As my hon. Friend the Minister for Care and Mental Health said earlier, the Government are not intending to vote against the Humble Address. We will review what information we hold in scope, come back to Parliament and deposit it in the Library of the House, which is in line with the Government’s established stance on responding to Humble Addresses.

I am, however, grateful for the opportunity that we have had to address the important issues raised today: questions of how, as a country, we can rise and meet the challenges that we face, how we can ensure we have a system that is not only fast but fair, and how we can learn lessons from this most challenging period in our history. One of the most important lessons I take from it is that when we work together, we can do incredible things. We can build a testing capacity almost from scratch, we can reach millions of people in a single day, and we can save lives on a massive scale. Imagine what would have happened had we not worked with so many incredible partners to deliver these efforts—because no one can do it on their own, especially in such unprecedented circumstances, so it is the duty of a responsible Government to work with anyone who can deliver. The NHS has been phenomenal, our hospitals have been phenomenal and local government has have been phenomenal, but so have those in the private sector. We could not have come this far without them.

When we look at the situation today, it is easy to forget just how far we have come.

Back in March 2020, we could process just a few thousands of tests in a day; now we can process millions. That we have achieved this is no accident. In respect of developments from testing kits to processing, logistics to lateral flow devices, those partnerships between the NHS, industry, academia, local government and so many others have made the difference—and contracts with companies such as Randox have been some of the essential building blocks without which we would never have built what is now one of the largest testing networks in the world.

Randox laboratories have carried out over 15 million tests for covid-19. More than 730,000 positive cases have been identified under Randox contracts, which meant that those people could self-isolate, protect others, and help to bring the pandemic under control. An independent assessment gave a positive assessment of Randox’s performance. It exceeded their contract targets, hitting 120,000 tests in a single day in March 2021.

[Karl Turner]

Would the Minister like to comment on the fact that 750,000 testing kits that were put into care homes were no good at all? What has she to say about that?

[Maggie Throup]

In a statement on 18 July 2020, the Secretary of State informed the House that a batch of swab test kits were not up to the usual high standard. As a precautionary measure, they were withdrawn, and replacement kits were supplied as soon as possible.

[Tony Lloyd]

The Minister is making a case for the partnership among our universities, our health service and the private sector. She has spent some time praising Randox, whose coffers were stuffed with money. Does she think it would be a good idea to stuff our university research facilities and our NHS testing labs with the same amount of money?

[Maggie Throup]

I visited Nottingham University recently to see the amazing work being done there. Obviously, continued support for our universities is imperative. I know that they do amazing work, as do our hospital laboratories.

We should celebrate these achievements, not criticise them. I want to reassure the House that there have always been strong safeguards behind these contracts, and that they are awarded in accordance with the Public Contracts Regulations 2015. We monitor all contracts and suppliers closely, as would be expected. We judge them against key performance indicators, and we publish contract award notices for all the contracts awarded to provide test and trace services, consistent with the regulatory requirements.

[Dawn Butler]

It seems as though the Minister may have missed the whole debate and just come in at the end, because she has failed to take up some of the conversations that we have had during the debate. Can she confirm that the public did not pay for the test kits that Randox threw away?

[Maggie Throup]

Obviously those details were in the contracts, but I am sure that they conformed with the key performance indicators.

All the contract award notices can be seen on Contracts Finder. We have nothing to hide, Madam Deputy Speaker —nothing at all. The House, and the public, can see what taxpayers’ money has been spent on. We have applied exactly the same criteria, standards and processes in the case of Randox as we have in all other cases. Randox has never been an exception, and we utterly reject the idea that it has received any kind of special treatment. Our partnership with Randox is simply a reflection of the situation in which we found ourselves in March 2020, facing a global pandemic of unknown and unprecedented proportions and acting as a responsible Government should. We worked against genuine fears that we would run out of vital testing equipment, that we would not have the capacity to test people and that the deadly virus might continue to spread from person to person, silent and undetected.

We engaged with Randox and many others. Not only was Randox a UK-based business, but its early laboratory-based PCR testing capacity for covid-19 was capacity that we have been able to use for the whole of the UK. We have fought this pandemic as one United Kingdom. Working with Randox was the right thing to do, it was the responsible thing to do and, quite simply, it was a decision that has saved many thousands of lives.

I will address one issue brought up by a couple of Opposition Members, and reassure them that Arco was awarded contracts for PPE. I thank Arco for its contribution in providing life-saving PPE that we needed at that time.

[Karl Turner]

The reality is that Arco went directly to various NHS branches to offer its services to supply. It was blocked from any formal route. It was not on the VIP list. That is the reality.

[Maggie Throup]

I reiterate that Arco was awarded contracts for PPE.

Of course, that does not mean there are no lessons to be learned, and I can reassure the hon. Member for Blackburn (Kate Hollern) that the public inquiry will be an important learning moment for us all. We are already making changes: we published our procurement Green Paper last December, we updated our commercial guidance on the management of actual and perceived conflicts of interest in May, and we are implementing the recommendations from the first and second Boardman reviews into improving procurement.

The real lessons, however, are just what we can achieve when we all get behind a shared mission, to protect the British people and to protect the NHS. That is a mission-driven way of working that has seen us work beyond the traditional boundaries and achieve remarkable results. We have tested millions of people for covid-19 and kept millions more safe. I am very proud of that, and so too, I believe, are the British people.

Question put and agreed to.

Resolved,

That an Humble Address be presented to Her Majesty, that she will be graciously pleased to give directions that there be laid before this House the minutes from or any notes of the meeting of 9 April 2020 between Lord Bethell, Owen Paterson and Randox representatives, and all correspondence, including submissions and electronic communications, addressed or copied to, or written by or on behalf of, any or all of the following:

(a) a Minister or former Minister of the Crown,

(b) a Special Adviser of such a Minister or former Minister, or

(c) a Member or former Member of this House

relating to the Government contracts for services provided by medical laboratories, awarded to Randox Laboratories Ltd. by the Department for Health and Social Care, reference tender_237869/856165 and CF-0053400D0O000000rwimUAA1, valued at £133,000,000 and £334,300,000-£346,500,000 respectively.

Royal Assent

[Madam Deputy Speaker (Dame Eleanor Laing)]

I have to notify the House, in accordance with the Royal Assent Act 1967, that Her Majesty has signified her Royal Assent to the following Acts:

Telecommunications (Security) Act 2021

Social Security (Up-rating of Benefits) Act 2021.

Tobacco Control Plan

Maggie Throup Excerpts

Tuesday 16th November 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Bone. First, I thank my hon. Friend the Member for Harrow East (Bob Blackman) for securing this important debate and for sharing his personal story with us. I also thank members of the all-party parliamentary group on smoking and health for their tireless work on tobacco control, as well as the APPG on vaping for their work.

The UK is rightly recognised as a world leader on tobacco control. That is because it has invested in a range of interventions over the past two decades, including a strong regulatory framework that has led to, among other things, the introduction of standardised packaging, the end of tobacco displays, and protection from the harms caused by second-hand smoke. Thanks to those interventions, smoking rates in England are down to a record low of just under 14%. However, although we celebrate that success, there are still around 6 million smokers in England, and therefore there is more to be done.

[Sir Charles Walker]

As we have heard, addictions are very powerful, and if we want to get to a smoke-free 2030, we need to break the link between a nicotine fix and smoking lit tobacco.

[Maggie Throup]

I could not agree more with my hon. Friend. The burden of tobacco harms is not shared equally: smoking rates are far higher in poorer areas of the country, and among the lowest socioeconomic groups. Alongside the tragedy created by illness and early deaths, the NHS bears the heavy financial burden of £2.5 billion every year from smoking. In 2019-20, smoking was responsible for nearly half a million hospital admissions and around 64,000 deaths.

The Government have set the bold ambition for England to be smoke free by 2030. To support that ambition, we have been building on the successes of our current tobacco control plan. We will soon publish a new plan with an even sharper focus on tackling health disparities. That new plan will form a vital part of the Government’s levelling-up agenda and will set out a comprehensive package of new policy proposals and regulatory changes, to enable us to meet our smoke-free 2030 ambition.

We are, of course, carefully considering the recommendations of the all-party parliamentary group on smoking and health. Our new tobacco control plan will look to further strengthen our regulatory framework. We are exploring various regulatory proposals, including those put forward as amendments to the Health and Care Bill. We will conduct further research and build a robust evidence base in support of such measures, and will include the strongest proposals in the new plan.

One continuing concern is that one in 10 pregnant women are still smokers at the time of delivery, which is something that the Government are determined to tackle. The maternity transformation programme contains some important measures, and we have made a commitment under our NHS long-term plan that pregnant mothers and their partners will be offered NHS-funded treatment to help them to quit. I know that issue is close to the heart of my hon. Friend the Member for Harrow East. Our new plan will continue to have a strong focus on pregnancy and will encourage more innovation and new approaches to help mothers to quit.

The evidence is clear that e-cigarettes are less harmful to health than smoking. It remains the goal of the Government to maximise the opportunities presented by e-cigarettes to reduce smoking while managing any risks. Our regulatory framework enables smokers to use e-cigarettes to help them to quit, but we do not want to encourage non-smokers and young people to take up those products. In the current tobacco control plan we have actioned the MHRA to help bring medicinal e-cigarettes to the UK market. On 29 October, the MHRA published updated guidance to encourage manufacturers to do so.

Stop-smoking services remain at the heart of our tobacco control strategy, producing high quit rates of 59% after four weeks. Since 2000, they have helped nearly 5 million people to quit. We have protected the public health grant over the course of the spending review, to ensure that local authorities can continue to invest in stop-smoking services and campaigns specific to their areas. We will continue to support local authorities to prioritise those services.

The UK has been recognised as a global leader in tobacco control. We are proud to be a member of the World Health Organisation framework convention on tobacco control. My officials played an active role in the ninth conference of the parties—COP9—last week, and reaffirmed our commitment to deal with the global tobacco pandemic. It was a robust meeting, with more people attending than ever. In my video statement to COP9, I set out the UK commitment to having comprehensive tobacco control policies, including a strong regulatory framework for e-cigarettes. Our commitment to the WHO FCTC is further demonstrated through the overseas development funding we contribute to the FCTC 2030 project, which is now entering its sixth year. That project directly supports the implementation of the WHO FCTC in 31 low and middle-income countries, helping to reduce the burden of death and disease from tobacco.

I will now address some of the issues raised by right hon. and hon. Members. My right hon. Friend the Member for South West Wiltshire (Dr Murrison) talked about restrictions imposed during covid. Covid has highlighted the health disparities across the country. Our ambition to be smoke free by 2030 will play a major role in tackling those disparities. I would like to reassure my hon. Friend the Member for Harrow East that I am conscious of the urgency of the publication of the tobacco control plan. However, I am determined that the plan will have robust and effective measures. He also highlighted measures that the APPG would like to see included. Along with my officials, I am looking carefully at each measure put forward.

Tobacco taxation was raised by my hon. Friends the Members for Harrow East and for Broxbourne (Sir Charles Walker), as well as the hon. Member for North Antrim (Ian Paisley). That is a matter for Her Majesty’s Treasury. However, the Department continues to work with HMT to assess the most effective regulatory means to support the Government’s smoke-free 2030 ambition, which includes exploring a potential future levy.

[Ian Paisley]

Will the Minister give way?

[Maggie Throup]

I am a bit short of time.

On raising the age from 18 to 21, we know how important the period between the ages of 18 and 21 is for those who may experiment with tobacco. We will include a focus on protecting young people and adults from the harms of tobacco within our tobacco control plan. As I have already indicated, I am ambitious for our new plan.

On the Health and Care Bill, at this stage we do not feel that it is the right Bill for the suggested measures without a full assessment. Members should rest assured that they will be fully considered as the tobacco control plan is finalised.

The hon. Member for City of Durham (Mary Kelly Foy) and my hon. Friend the Member for Rugby (Mark Pawsey) asked about the post-implementation reviews. The Department will publish its response in the coming months. I make no excuse for the delay. We had more than 5,000 responses to that review, and that was coupled with the pressures that my Department has experienced on covid-19. I reassure colleagues that it is on our agenda and we will publish in due course.

The hon. Member for City of Durham also asked about the investigations into menthol. The Office for Health Improvement and Disparities is investigating a range of cigarettes to determine if the flavour of menthol is noticeable. Once that study is complete, we will explore whether further action is needed against companies that have breached regulations.

My hon. Friend the Member for Rugby asked a number of questions. I understand that the ONS will publish smoking prevalence data for 2020 next month.

As I have already said, COP9 was one of the best attended conferences of the parties so far. I understand that there was a real buzz and an appetite to address the harms from tobacco and implement the framework convention on tobacco control, which I am sure will be welcomed by everybody in the room.

My hon. Friends the Members for Rugby and for Northampton South (Andrew Lewer) spoke about e-cigarettes. The Government are clear that we only support the use of e-cigarettes as a tool for smokers who are trying to quit, not as a route for people to take up smoking by another means. Our approach to e-cigarettes has been and will remain pragmatic and evidence-based.

My hon. Friend the Member for Northampton South talked about the environment that those who are attempting to quit find themselves in. Vaping is not covered by the smoke-free legislation. It is down to individual businesses to determine how they consider the guidelines.

I extend my thanks to hon. Members for their participation in today’s debate. It has been very constructive and there is clearly cross-party support. I reiterate the Government’s commitment to a smoke-free 2030. As we build back better from the pandemic, our aim is to make smoking truly a thing of the past and level up society.

Draft Food (Promotion and Placement) (England) Regulations 2021

Maggie Throup Excerpts

Monday 15th November 2021 General Committees

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

I beg to move,

That the Committee has considered the draft Food (Promotion and Placement) (England) Regulations 2021.

It is a pleasure to serve under your chairmanship, Mr Stringer. This statutory instrument introduces restrictions on promotions of less healthy products sold in-store and online in England. It requires businesses in England with over 50 employees to restrict promotions of less healthy products. Promotions of less healthy products will be restricted by location, which will apply to store entrances, aisle ends and checkouts, and their online equivalents. Promotions of less healthy products will also be restricted by volume price, which will restrict buy-one-get-one-free and three-for-two offers. The restrictions apply to the products that are of most concern in relation to childhood obesity, while allowing the healthiest products within categories in scope to be excluded.

The aim of this policy is to reduce the overconsumption of products that contribute to children being overweight or living with obesity. We aim to achieve this by shifting the balance of promotions towards healthier options and maximising the accessibility of healthier promotions.

The instrument applies only to businesses in England. However, Scotland, Wales and Northern Ireland have been engaged throughout the consultations. Subject to Parliament’s approval, the regulations will come into force from 1 October 2022. The Government announced their decision to introduce legislation to restrict promotions in our healthy weight strategy in July 2020. These regulations and other proposed measures will support people in achieving and maintaining a healthy weight. The policy will play a vital role in ensuring that we achieve our ambition of halving childhood obesity by 2030.

Obesity has huge costs to society. The indirect cost to the UK economy of obesity-related conditions is an estimated £27 billion each year. Improving poor health outcomes is a key part of the Government’s levelling-up agenda. Children living in the most deprived areas are more than twice as likely to be obese than those living in the least deprived areas. We know that tackling obesity will have a positive impact on children’s health, and may therefore help in improving health disparities across the country.

The covid-19 pandemic has highlighted the impact that obesity can have on people’s health. People who contract covid-19 are more likely to suffer worse symptoms and are at increased risk of dying if they live with obesity. This demonstrates why tackling obesity is an immediate priority to support individuals and the NHS. Data shows that children and adults in the UK are consuming too much sugar, saturated fat, salt and calories. However, they are not consuming enough fibre, fruit and vegetables.

The shopping environment plays an important part in the way that products are marketed to us, with simple factors such as the location of products significantly affecting purchases. UK food and drink promotions reached record levels in 2015 and were the highest in Europe, with 40% of the food and drink people purchased being on promotion. The latest data shows that we buy almost 20% more as a direct result of promotions. Less than 1% of food and drink products promoted in high-profile locations are fruit or vegetables. Research shows that promotions can influence food purchases and often determine eating habits. Currently, such offers tend to be widespread for less healthy, processed and treat-type products, at the expense of healthier choices.

Children are vulnerable to the techniques used to promote sales. Although promotions appear to be mechanisms to help consumers to save money, the data shows that they increase consumer spending by encouraging people to buy more than they had intended. Consumers typically do not stockpile their extra purchases to take advantage of the lower price; instead they increase their consumption.

Some businesses already have policies in place to restrict promotions. While we are grateful for their action, such commitments are not implemented consistently or at scale, so they do not support a level playing field for either businesses or consumers.

The introduction of legislation will help to ensure that healthier food is more accessible, ultimately saving families money and supporting people to lead healthier lives. We recognise that smaller businesses may find implementing the restrictions more challenging, which is why we are requiring only medium and large businesses to restrict promotions. Guidance to support the regulations is being developed with input from businesses and local authorities, and will be published to support implementation after Parliament has approved the regulations. We understand that the change is significant and want to ensure that businesses are supported to comply.

One in three children leaves primary school overweight or obese, and around two thirds of adults are above a healthy weight. The need for action is clear. We know that people struggle to choose healthier options in the face of endless prompts to consume less healthy food. We are tempted to buy foods that are not on the shopping list, but hard to resist. These promotion restrictions mark the start of a change in this environment to empower people to make healthier choices.

--- Later in debate ---

[Maggie Throup]

I thank the hon. Member for Nottingham North for his contribution and support and my hon. Friend the Member for Sittingbourne and Sheppey for his query.

The hon. Member for Nottingham North asked several questions. On the cost to the consumer, as I said in my speech, promotions tend to be a mechanism to help consumers save money, but data shows time and again that they increase consumer spending by encouraging people to buy more than they intended and to buy items that they did not intend to purchase, which also increases their consumption.

On enforcement, the Government are committed to ensure that enforcement of regulated policies is proportionate and fair and to support local authorities and the judicial system with any additional costs they incur as a result of enforcing these powers.

On striking a balance, this is about trying to support the consumer while also supporting businesses, which is why we felt it was fair to exempt smaller and microbusinesses and apply the regulations to medium and larger businesses only, basing the definition on floor space as well. That approach is more measured than having something apply across the board. It is important that we get this right, as the hon. Gentleman said, to ensure that we have an impact on the nation’s health while allowing businesses to implement the measures proportionately.

The hon. Gentleman asked about implementation and the guidelines. Obviously, we will publish the guidelines once the legislation has been passed, and it is important to ensure that we continue to involve the different parties to get things right. There has been a lot of engagement already, and we must ensure that it continues.

My hon. Friend the Member for Sittingbourne and Sheppey asked about prepacked products. Such products have the contents printed on their packaging, whereas it is hard to know the contents of some non-prepacked products. Once again, this is about taking a measured approach.

As the hon. Member for Nottingham North said, this legislation is part of a range of measures that form part of our healthy weight strategy, which will empower people to live healthier lives. They want to do that, and the strategy will help them. This policy is a critical part of that strategy.

Our published impact assessment shows a positive net present value for the policy, outlining how the health benefits outweigh the costs to business, which I hope reassures the hon. Gentleman. Our estimates show that the policy will have a net benefit to society of around £7 billion pounds over the next 25 years. The location restrictions alone would provide NHS savings of over £4 billion pounds. It is estimated that an average person will consume 50 to 70 fewer calories a day as a result of the restrictions. Small reductions in calorie intake, sustained over time, can help to address the significant incidence of overweight and obesity. We are committed to making the healthier choice the easy choice for families.

I understand that these are novel requirements, and we want to ensure that we are supporting businesses to implement them. We took the decision to extend the implementation date from April 2022 to October 2022 as we believe that strikes the best balance between allowing businesses enough time to prepare while not significantly delaying the health benefits, so the implementation date has already been extended once. We will continue to work closely with stakeholders in preparation for implementation, as I have indicated, and further evaluate the impact of the promotion restrictions to ensure that they achieves the health benefits and policy aims effectively.

Our ambition is to halve childhood obesity by 2030 and reduce the gap in obesity between children from the most and least deprived areas. All of us need to get behind that ambition and play our part in making and facilitating healthier decisions, providing healthier options, and creating healthier environments. I commend the draft regulations to the Committee.

Question put and agreed to.

Covid-19 Update

Maggie Throup Excerpts

Monday 15th November 2021 Written Statements

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

The UK’s covid-19 vaccine programme continues to protect the nation against the virus. As of 13 November, 50.5 million people have now received their first covid-19 vaccine dose and 46 million have had their second dose. Over 12.6 million of the most vulnerable have also received a third dose/booster vaccine to keep them as safe as possible over the winter months.

The independent Joint Committee on Vaccination and Immunisation (JCVI) has published further advice on the covid-19 vaccination programme. Her Majesty’s Government (HMG) has accepted this advice and all four parts of the UK intend to follow the JCVI’s advice.

Children and Young People aged 16 to 17:

The JCVI has provided further advice on the vaccination of those aged 16 and 17. 16 to 17-year-olds included in phase 1 of the adult vaccination programme, 16 to 17-year-olds who are household contacts of immuno-suppressed individuals, and those aged 17 and nine months or over are already eligible for a second dose of covid-19 vaccine. The JCVI has now recommended a second dose of vaccine be offered to all remaining individuals between 16 and 17 years of age 12 weeks after their first dose. The preferred vaccine for all those aged under 18 remains Pfizer/BioNTech.

Expansion of the COVID-19 booster vaccination programme to all those aged 40 to 49 years:

The JCVI has recommended expanding the covid-19 booster vaccination programme by offering all adults aged 40 to 49 years a booster vaccination, six months after their second dose.

The booster vaccination should preferably be undertaken with either the Pfizer/BioNTech vaccine, or a half dose of Moderna vaccine.

This announcement follows the advice published on 14 September which recommended booster vaccinations be given to individuals who received vaccination in phase 1—cohorts 1-9.

With deployment of the extended booster vaccination offer imminent, I am now updating the House on the liabilities HMG has taken on in relation to further vaccine supply via this statement and the Departmental Minute containing a description of the liability undertaken. The agreement to provide indemnity with deployment of further booster doses to the population increases the statutory contingent liability of the covid-19 vaccination programme.

Given the proximity between receiving JCVI advice and deployment, we regret that it has not been possible to provide 14 sitting days’ notice to consider these issues in advance of the planned extension to the booster programme in the UK.

Deployment of effective vaccines to eligible groups has been and remains a key part of the Government’s strategy to manage covid-19. Willingness to accept the need for appropriate indemnities to be given to vaccine suppliers has helped to secure access to vaccines, with the expected benefits to public health and the economy alike, much sooner than may have been the case otherwise.

Given the exceptional circumstances we are in, and the terms on which developers have been willing to supply a covid-19 vaccine, we along with other nations have taken a broad approach to indemnification proportionate to the situation we are in.

The covid-19 vaccines have been developed at pace, however at no point has safety been bypassed. The Medicines and Healthcare products Regulatory Agency approval for use of the currently deployed vaccines clearly demonstrates that these vaccines have satisfied, in full, all the necessary requirements for safety, effectiveness, and quality. We are providing indemnities in the very unexpected event of any adverse reactions that could not have been foreseen through the robust checks and procedures that have been put in place.

I will update the House in a similar manner as and when other covid-19 vaccines or additional doses of vaccines already in use in the UK are deployed.

HM Treasury has approved the proposal.

[HCWS392]

Giving Every Baby the Best Start in Life

Maggie Throup Excerpts

Tuesday 9th November 2021 Commons Chamber

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

I thank the hon. Member for Richmond Park (Sarah Olney), my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) and the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) for securing this important debate. I also thank all hon. Members for their important contributions; it has been a very worthwhile, informative and forward-looking debate.

Ensuring that every baby gets the best start in life is of central importance to the Government. The critical 1,001 days of a child’s life lay the building blocks for lifelong emotional and physical health. By investing in supporting the youngest members of our society and the families who care for them, the Government will deliver on their ambition of levelling up health outcomes across the country.

The health and wellbeing of parents and carers is important for the healthy development of their babies. Approximately one in five mums and one in 10 dads experience mental health problems during the 1,001 critical days of their baby’s life. Poor mental health can impact on their parents’ ability to bond with their baby and meet the baby’s emotional needs. Later development is heavily influenced by the loving attachment that babies have to their parents or carers, and there is a wealth of evidence that poor parental mental health can lead to worse outcomes for young children.

It is vital that parents and carers have access to the help and support that they need to give their baby the very best start in life. The Government’s vision is for every parent and carer to have access to high-quality universal services in their local areas. That is set out in, “The best start for life: a vision for the 1,001 critical days”, published by the Early Years Healthy Development Review in March. I thank my right hon. Friend the Member for South Northamptonshire for that inspirational work. Thanks to her dedication, the Government are delivering on six priority action areas that will realise that vision.

First, we will ensure that all parents and carers have access to clear information about the Start for Life offer and family services in their area that they can access virtually and physically. Secondly, we are championing family hubs and working with local authorities to make them a place where families can access universal Start for Life services.

Thirdly, we are designing digital, virtual and telephone services around the needs of families with babies, including digitising the red book. Fourthly, we are developing a modern, skilled workforce to meet the changing needs of families with babies. We are doing that by looking at new ways to support, train and retain the skilled professionals that we need.

Fifthly, we are working across the system to ensure that local services are high quality, considering how improved data can enhance the evaluation of outcomes and how inspection and feedback from parents and carers can drive excellence. Finally, we are working with local areas to encourage them to nominate a leader with responsibility for Start for Life services and ensuring that Start for Life is at the heart of policy making at a national level.

Alongside the Early Years Healthy Development Review, the Government are implementing a wide range of policies to improve child health. That includes the most ambitious child obesity plan in the world, the transformation of children’s mental health and maternity services and a world-leading immunisation programme.

Investing in the 1,001 critical days is the most important long-term investment that we can make. Failure to invest in that critical period comes at a great social and economic cost. Adverse experiences at the start of life are linked to negative outcomes later in life, as a number of hon. Members have mentioned. It is estimated that late intervention amounts to a cost of £17 billion a year in England and Wales. Investing in prevention and early intervention is a much better use of taxpayer money. That is why the Budget announced a £500 million investment package to transform support for babies and families.

The Government will invest more than £80 million in expanding the network of family hubs, improving access to a wide range of integrated support services for families with babies and children. A further £10 million will support local authorities to publish clear Start for Life offers, helping parents and carers to understand the services available to them locally, while £100 million will be invested in rolling out bespoke parent and infant mental health support, helping to nurture parent and infant relationships and improving access to support for new and expectant parents.

There will be £50 million available to local authorities to establish multi-component breastfeeding support services in line with local needs, ensuring that parents receive the help that they need where and when they need it. There will be £50 million to fund evidence-based parenting programmes, which will support parents and carers to have positive interactions with their children. Seventy-five upper-tier local authorities in England will benefit from this funding. The evidence and learning from this investment will help to improve services across England where they are most needed.

An additional £10 million will be available to trial and evaluate innovative workforce models in a small number of local authorities. This will enable local authorities to bring together and train staff under the clinical supervision of health visitors to provide babies and families with the high-quality, timely support that they need. It will also support future workforce reform.

[Alison Thewliss]

Will the Minister give way?

[Maggie Throup]

I am short of time, so I will continue.

Some 300,000 of the most vulnerable families will be supported with an extra £200 million boost to the Government’s supporting families programme, which helps families through complex issues that could lead to family breakdown. In addition to the £500 million investment to transform support for families, the Government will provide more than £2 million per year to continue the holiday activities and food programme, providing healthy food and enriched activities for disadvantaged children in England and delivering our flexible childcare fund commitments.

Before I draw my remarks to a close, I would like to address some issues that have been raised this afternoon. The hon. Member for Richmond Park raised the issue of health visitors. As I have outlined, £10 million has been allocated to trial and evaluate new workforce models. The specific number of health visitors and case- loads is a locally determined decision based on local health needs, so the number and ratio of health visitors support staff will vary. She also raised perinatal mental health, which has been recognised in the spending review with £100 million allocated to rolling out bespoke parent-infant mental health support.

My right hon. Friend the Member for South Northamptonshire rightly stated that babies’ needs should always be at the heart of our work. She also highlighted some new ways of working that have developed as a result of the pandemic, from Camden’s Bump to Baby programme to Parent Talk, and the benefits that physical and virtual support can offer in reaching out to even more families.

My hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates) said that we are building back better for babies. She was quite right. I welcome her support for family hubs and her recognition that they will provide support and services from conception to the age of 19 and to parents and carers.

The hon. Member for Newcastle upon Tyne North also asked about family hubs. In the Budget, as I said, the Government announced a further £82 million to create a network of family hubs. Each of the 75 selected local authorities will receive transformational funding to support the change process of moving to a family hub model.

My hon. Friend the Member for East Worthing and Shoreham (Tim Loughton) brought a great deal of experience to the debate, as did the hon. Member for Washington and Sunderland West (Mrs Hodgson) and my hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds). The hon. Member for Pontypridd (Alex Davies-Jones) raised the important issue of breastfeeding. I am delighted that the Chancellor has announced £50 million to establish multi-component breastfeeding support services in line with local needs.

[Alex Davies-Jones]

Will the Minister give way?

[Maggie Throup]

I must finish; I am sorry.

In conclusion, we will continue to work across the whole Start for Life system to improve health and development outcomes for our youngest citizens. We must do everything in our power to support all families to give their baby the very best start in life.