International Health Regulations 2005

Mark Francois Excerpts

Monday 18th December 2023 Westminster Hall

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

It is a pleasure to serve under your chairmanship this afternoon, Dame Maria.

I begin by declaring an interest. My wife, Olivia, works as a senior radiographer in the national health service. Throughout the pandemic, she continued to report for duty at her hospital, including, on occasion, knowingly treating patients who were covid positive. I married a good and brave woman, Dame Maria. She does not know I am about to say this: I want to pay tribute to her and all her colleagues in the national health service, who put their lives on the line to save those of many others. They deserve our admiration and thanks from their Parliament.

I have received quite a few emails from constituents on this issue. I have also had strong personal representations from Councillor Ian Ward, who ably represents Lodge ward on Rochford District Council, who feels very strongly—take my word for it, Dame Maria—about all this and has made his views very clear to me as his MP.

For the record, I am all for better sharing of information and intelligence between nations to try to prevent the spread of any future pandemic. Would that the Chinese had done more, and more quickly, to warn the rest of the world about what was coming from Wuhan. I reluctantly accepted the need for an initial lockdown, but I confess that as time wore on, I became increasingly uneasy at the effects of the lockdown, not just economically but socially, and not least the impact on people’s mental health. We are still seeing some of those effects playing out in our schools today, as my headteachers tell me when I visit local schools.

I am now concerned about the potential amendments to the International Health Regulations 2005 being brought about at the behest of the World Health Organisation, not least because the WHO will be given extremely strong powers in any future pandemic. As one constituent put it in her email:

“Almost no-one who is informed believes the…WHO performed anything other than appallingly during Covid, with disastrous results. Yet there seems to be no attempt to reform this unelected, unaccountable organisation, which British taxpayers fund in the millions. On the contrary, a drive is evident to give the totally undemocratic WHO ever more power, ever more of our money and ever less scrutiny.”

That was her opinion, but I think my constituent has a point.

I understand that on 31 May 2022, the delegates of the WHO formally adopted five new amendments to the international health regulations. I further understand that those amendments come into force under international law for all member states within 24 months—that is, by 31 May 2024—unless those member states choose proactively to opt out of them. Of the five new amendments, there is one of particular concern as it would severely compromise the ability of the public to lobby politicians to reject future amendments by reducing the time available before they might come into force. That amendment to article 59 would significantly reduce the time allowed for a country’s leadership to reject IHR amendments adopted at future World Health Assemblies from 18 months to 10 months.

[Andrew Bridgen]

Will the right hon. Gentleman give way?

[Mr Francois]

Forgive me, but the hon. Gentleman spoke at some length; perhaps he will let some of the rest of us have a go.

Up to 300 amendments to the international health regulations are being negotiated and finalised, to be voted on in May 2024 at the 77th World Health Assembly. The amendments being negotiated include: first, amendments to make WHO emergency guidance legally binding—it is currently only advisory—on member states; and secondly, amendments that would empower the WHO director general to single-handedly declare a public health emergency of international concern, giving this unelected, unaccountable individual unprecedented levels of power to dictate UK public health policy and to restrict fundamental freedoms.

[Philip Davies]

Is it not even more extraordinary that that power would be given to that person, given that, as I understand it, the UK voted against his becoming the director general of the World Health Organisation in the first place, and he was China’s man for the job. Does that not make it even more extraordinary that the UK would want him to have those powers?

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[Mr Francois]

It does, although some people favoured by China have been doing very well lately. None the less, I take my hon. Friend’s point.

Thirdly, there are amendments to implement an international global health certification system enabling nations to enforce travel restrictions using tools such as vaccine certificates, passenger locator forms and travel health declarations—all tied, potentially, to a personal QR code. Fourthly, there are amendments that would increase censorship of dissenting voices by mandating systematic global collaboration to counter dissent to official governmental or WHO guidance.

Taken together, the proposed amendments empower the WHO to issue requirements for the UK to mandate highly restrictive measures, such as lockdowns, masks, quarantines, travel restrictions and medication of individuals, including vaccination, once a PHEIC has been declared by the WHO. That is something we should all be very concerned about. We as parliamentarians are guardians of the country’s liberty, so we need to be very anxious about that.

I have been known to raise concerns about the loss of our sovereignty in Parliament before. Section 38 of the European Union (Withdrawal Agreement) Act 2020 states that the will of Parliament is sovereign—and so it should remain. I have a key question for the Minister—I have known him for years; he is a decent man. Will he take the trouble to answer this question very specifically in his wind-up? Otherwise, I will intervene on him. My key question is: could the amendments, even potentially, allow the World Health Organisation to put this country into lockdown without our approval? Yes or no?

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[Sir Christopher Chope (Christchurch) (Con)]

I, too, thank the hon. Member for Lancaster and Fleetwood (Cat Smith) for setting out the issue, quite succinctly. I also thank her in her capacity as Chair of the Petitions Committee for having allowed us a three-hour debate. A consequence is that once all the Back-Bench contributions have been heard, we will be able to hear in extenso how His Majesty’s official Opposition will deal with this issue. Even more importantly, we will be able to hear the Minister, who I am delighted to see in his place, say exactly what the Government are doing in response to each of the issues raised in this debate, which are of crucial importance to so many of our constituents.

One of the reasons why we are where we are today is that the response to the debate we had on a petition on this subject in April was, frankly, totally inadequate. It was full of generalisations, and vague suggestions that somehow it was all going to be all right in a day. It really was, “Why are you bothering the Government with this trivial material?” This issue goes to the heart of what the House is all about. It is about who is in charge. Are we, as a democratic Parliament, in charge of the laws of our country, and any attempt by the Government to give away control over those laws to an unaccountable international organisation? It is because of that concern that so many people have signed this petition and we are having this debate again today.

If my right hon. Friend the Minister does not address these issues today, people will say that the Government are not taking this seriously. That would be a disaster. Once we have given away these powers to the WHO, which is power hungry—what international organisation is not power hungry? The WHO certainly is—it is very difficult to get them back. There are ongoing discussions about where we stand in relation to international treaties and international law. There is the insidious development, following the recent Supreme Court case, of what is called “customary” international law. That development basically means that a group of outsiders can tell us in this country what is good for us and what is not.

[Mr Francois]

For the avoidance of doubt, will my hon. Friend agree that none of us has argued this afternoon for withdrawal from the World Health Organisation—we might call it Wexit, for want of a better phrase—

[Philip Davies]

Yet.

[Mr Francois]

“Yet,” says another hon. Friend. But we want to be assured that the WHO cannot overrule this sovereign Parliament. That is a fundamental difference, is it not?

[Sir Christopher Chope]

Absolutely; I agree with my right hon. Friend. We do not want to withdraw; there is no need to withdraw from a voluntary organisation that is confined to giving us advice and providing data and information. Who would resent having access to data and information? Indeed, the essence of the relationship between a responsible society and its Government is that the Government should provide information to enable individuals to decide for themselves whether they want to take particular medicines, go on trips to particular countries, be vaccinated in a particular way, or whatever.

I see the proper role of the WHO as providing information to Governments across the globe. Those Governments can then decide for themselves what they like and do not like, having regard to the fact that the WHO’s chairman seems to have been imposed on it by the People’s Republic of China, and was strongly opposed by our Government. It seems very much as though the whole WHO is too beholden to China. The WHO is also beholden to some of its big donors; if one analyses how the WHO is funded, one sees that organisations such as the Bill & Melinda Gates Foundation are significant supporters. He who pays the piper calls the tune. I think that is a good starting point when looking at these things. In the case of the WHO, there is too much evidence that the people paying the piper are calling the tune to too great an extent.

Once bitten, twice shy. Let us remind ourselves what happened during the pandemic. As others have mentioned, the WHO went into the pandemic with a policy of saying that lockdowns were not, and could not be, the right answer to a pandemic for all sorts of reasons. We can now see the adverse consequences that flowed from our country’s decision to have a lockdown, and we can compare that with what happened in Sweden. Then, during the early part of the pandemic discussions, and without any evidence being brought forward, the WHO suddenly changed its advice. Why? There is a suspicion that it was because of undue influence from the pressures that I have been describing. We will never know why it changed its advice. All we know is that somebody who changes their advice like that, without any evidence, should not tell us what to do. We should say, “If you want to change your advice, fine, but why do you change it? We don’t have to follow it.” However, under the proposed treaty amendments, we would have to follow it. That is obviously of great concern, because people can see what happened in the past, and that is potentially a guide to the future.

Even more sinister than the change in advice on lockdowns was the WHO’s approach to finding a treatment for covid-19 patients. There was a lot of evidence to suggest that ivermectin—it was not the only such drug—could be used to really good effect to improve outcomes for patients suffering from covid-19. Strong evidence suggested that treatment with ivermectin might improve someone’s chances of survival by as much as 81%, but the WHO intervened at the behest of certain pharmaceutical companies that were in competition with the producers of ivermectin. It gave very dubious advice, to the effect that ivermectin should be used only in clinical trials.

To those who are not familiar with too much of the detail, I commend a book by Dr Pierre Kory, a distinguished physician and epidemiologist—I think he is an epidemiologist. He certainly deals with pulmonary and critical-care medicine; he is a specialist in that. He was in charge of the Front Line COVID-19 Critical Care Alliance, and produced a book called “The War on Ivermectin”. It was a war, organised by the WHO, against a remedy for covid-19, because, obviously, the whole vaccine development programme was premised on there being no cure for covid-19, and no effective treatment for it. In the absence of such treatment, it was legitimate for experimental vaccines to be brought into play without undergoing the full process set out in the Licensing Act 2003, because there was there was nothing else. We were in the desperate situation of there being no other way out. Actually, however, there was a lot of evidence to suggest that ivermectin—

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[Preet Kaur Gill (Birmingham, Edgbaston) (Lab/Co-op)]

It is a pleasure to serve under your chairship, Sir George, on this debate responding to the e-petition 635904, which relates to the International Health Regulations 2005. It is wonderful to see so many of the public in attendance.

I thank my hon. Friend the Member for Lancaster and Fleetwood (Cat Smith), who is Chair of the Petitions Committee, for opening the debate. I also thank the right hon. Members for Wokingham (John Redwood) and for Rayleigh and Wickford (Mr Francois) and the hon. Members for Shipley (Philip Davies), for North West Leicestershire (Andrew Bridgen), for Devizes (Danny Kruger) and for Christchurch (Sir Christopher Chope) for their contributions. I was in the debate responding to a similar petition regarding the draft treaty on pandemic prevention, preparedness and response in April; I hope hon. Members who were also in that debate will forgive me for retreading some similar ground.

The covid pandemic was one of the most surreal and seismic events of our lifetimes. Hundreds of thousands of people died here in the United Kingdom and millions more were extremely ill. There are perhaps two million people still living restricted lives, who are now in their fourth year of shielding because they are clinically vulnerable to the virus—we should not forget them. As our economy and public services still recover, it is vital that we learn lessons and take steps to strengthen our resilience for the future, and I hope that the inquiry taking place at the moment will be a valuable resource in that respect. Our NHS was badly prepared, the Government’s handling of public health measures was chaotic, and we jumped in and out of lockdowns. Some measures, such as guidance issued to care homes and eat out to help out, were raised as concerns by Members of this House, including myself.

As we discuss the petition, we must recognise the international dimension of the pandemic, too. Deadly infectious diseases do not respect borders. It is therefore squarely in our interests to co-operate with other nations and support efforts to co-ordinate the global public health response. The lesson of the pandemic was that no one is safe until everyone is safe, so it is clear that global co-operation on pandemics and biological threats needs to be strengthened. Labour absolutely supports the principle of legally binding international health regulations that define the obligations of countries in handling pandemic-level threats. That is critical to our national health security.

The international health regulations under discussion have of course existed in various forms since the 1960s. The latest iteration came into force in 2007. As they stand, the regulations obligate the 196 state parties to develop national core public health capacities for the detection, assessment, control and reporting of public health events. At some international ports, airports and ground crossings, they require parties to notify the WHO of serious diseases with risk of international spread. They set some of the human rights and other protections for any of us travelling abroad—protection of personal health data, for example. Those requirements are hardly controversial, apart from the fact that they were not on their own sufficient to prevent the spread of covid-19 around the world. That is why we think they must be strengthened. Climate change and globalisation mean that biological threats are only becoming more common, and future pandemics could be deadlier than covid-19. If another epidemic strikes with that same infectious potential, we must ensure that we are better prepared.

The subject of debate today is how amendments to the international health regulations and the pandemic accord under negotiation at the World Health Organisation might actually impact the United Kingdom’s public health policy in the future. Earlier I mentioned some of the measures taken by the UK Government during the pandemic, ranging from interventions like eat out to help out to the three national lockdowns. The variety of those policies and how they compare with some of the other 195 countries who are also signed up to the international health regulations shows that the UK and other countries were able to exercise considerable discretion in their domestic responses to the pandemic.

It is important to emphasise this fact: the e-petition we are discussing asks for Parliament to vote on amendments to the IHR, which are being negotiated alongside the draft text of the pandemic accord that we debated here in April. It raises concern that Parliament has not voted on an amendment to which the UK Government agreed and that was adopted at the World Health Assembly last year. That is a process-related amendment under article 59 of the international health regulations, which reduces the time for future amendments to come into force to 12 months. Of course, until any such future amendments are agreed, it will have no impact on the United Kingdom.

In any case, the principles that protect our national sovereignty will remain. The democratically elected Government are responsible for negotiating, signing, ratifying, amending and withdrawing from international treaties under their prerogative powers. Any legislation, if necessary to implement the regulations, would have to go through the proper parliamentary process. No international treaty can, by itself, change United Kingdom law. As for the future amendment, it makes sense that, as the only international treaty on infectious diseases, changes to the IHR are considered alongside the draft text for the pandemic accord. Of course, as negotiations are still under way, nothing is agreed until everything is agreed.

[Mr Francois]

If what the hon. Lady says is true, why has Parliament just spent two weeks arguing about Rwanda? Can I ask her a direct question? She has heard many concerns expressed from the Conservative Benches about these proposed amendments. With the exception of the hon. Member for Lancaster and Fleetwood (Cat Smith), who introduced the debate, not a single Labour Back Bencher has even been present, let alone contributed. Here is the question: would a future Labour Government be minded to accept the spirit of those amendments to the WHO treaty or to oppose them? Our position is very clear. What is the hon. Lady’s?

[Sir George Howarth (in the Chair)]

Order. I understand that feelings are running high and people have areas that they want to explore, but I hope that any further interventions are brief.

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[Preet Kaur Gill]

I think that I have made my position really clear, hence my question to the Minister. Our constituents want reassurance that the Government would not sign up to anything that would compromise our ability to take domestic decisions on national public health measures. Nothing has been agreed. Today is an opportunity to hear from the Minister about how those negotiations are going forward and what amendments have been accepted. I also want to hear from the Minister.

[Mr Francois]

On that point, will the hon. Lady give way?

[Preet Kaur Gill]

I am not taking any more interventions. The reality is that although the pandemic is over now, the threat is not over. We must never leave our country with such a soft underbelly again. We strongly support efforts to strengthen the international legal framework to prevent, protect against, control and respond to cross-border health threats. It is squarely in our interests and integral to our security to encourage other countries to commit to do the same.

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[Andrew Stephenson]

The IHR are working well. However, as a number of my hon. and right hon. Friends said in the debate, there has been lots of criticism of how they worked. As the hon. Gentleman will remember, our right hon. Friend who is no longer in this place—Boris Johnson, the former Prime Minister—was one of the leading voices in saying that we should update the IHR, because we surely need to learn lessons and move forwards.

I believe that there is mutual interest—interest for us and for other countries—in working together. One example is delivering a sensitive surveillance system providing an early warning of potential threats to inform decisions that national Governments will make during public health events and emergencies.

[Mr Francois]

The House has already heard that we may have to vote on the amendments, along with others, by the end of May 2024. It is possible that by then we will already have had a general election. The House has heard very plainly from the hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) that the Labour party would be minded to support all the amendments; when we challenged her, she stopped taking interventions. Labour would back these amendments if it was in government. What would the Conservative party do?

[Andrew Stephenson]

I thank my right hon. Friend for that point. I genuinely believe that a lot here is in all our interests, and I do not want to turn this into a party political ding-dong. I genuinely believe that having us in Government leading the negotiations and getting them settled before any general election is firmly in the UK’s national interest, because I believe that we will deliver a treaty that is in the interests of all our citizens and respects national sovereignty. However, I very much hope that an incoming Labour Government would do the same. That is one of the reasons why I believe that we need to make rapid international progress to agree any revisions to the IHR—because I believe that we are in a good place to do that now and should move swiftly, rather than kicking it into the long grass. The last pandemic taught us that trying to make things up as we go along was not the best course of action. Laying some good foundations and providing some better certainty on how things will be dealt with is the best way forwards.

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[Andrew Stephenson]

I think that that was covered in the previous debate and has been covered by various Ministers. We have been clear from the outset of the process that we will not agree to any amendments that cede UK sovereignty. If the UK Government accept an IHR amendment that we have negotiated with our international partners, then, depending on the context of that amendment, changes to international law may be required. In those instances, the Government would prepare any draft legislation, and Parliament would vote on it in the usual way.

It is important to remember that, in and of themselves, IHR amendments and the new pandemic accord do not change the power of UK law. If required, we would ourselves change UK law through our sovereign Parliament, to reflect our international obligations under the IHR amendments. Let me be clear: in all circumstances, the sovereignty of the UK Parliament would remain unchanged and we would remain in control of any future domestic decisions on national public health measures.

[Mr Francois]

I thank the Minister for giving way so often. To be clear and to follow on from my earlier question, he has put on the record that we have a right to opt out of any amendments with which the UK does not agree. That is reassuring. On that basis, if an amendment were to be voted on by the WHO to say that it could impose a lockdown on the United Kingdom without our approval, will the Minister give a commitment that we would opt out of it?

[Andrew Stephenson]

I can give a categorical reassurance to my right hon. Friend that that is a red line for the UK Government. We would never allow the World Health Organisation to impose a lockdown in the UK. That is a clear red line for us. I cannot think of any Minister who would agree to such a request.

I can confidently say to my colleagues—as someone who campaigned for Brexit and who has helped to deliver Brexit in this place—that I am passionate about this country’s sovereignty. I believe that the Government’s position needs to be crystal clear and it is one that I endorse. We support the member state-led process of agreeing targeted amendments to the IHR and the new pandemic accord for the sake of global health preparedness, but we will not agree in any circumstances to provisions that would cede sovereignty to the WHO. That includes the ability to make decisions on national public health measures, whether lockdowns, which we just mentioned, or vaccine programmes.

Mental Health In-patient Services: Improving Safety

Mark Francois Excerpts

Wednesday 28th June 2023 Commons Chamber

[Steve Barclay]

I very much agree on that. The hon. Lady speaks powerfully of the importance of engaging with those with experience—the charity sector, the families and those directly impacted by the decisions taken in in-patient mental health facilities. She makes an extremely pertinent point and it is very much part of the approach we are taking.

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

I thank the Secretary of State for mentioning our great friend Sir David Amess. I am sure that, if he were still with us today, he would welcome this statement, as do I, as does his successor and, as is clear, as do all other Essex MPs. The Secretary of State has done the right thing and should be commended. EPUT has been a troubled organisation for some time, although I believe that its chief executive, Mr Paul Scott, is genuinely trying to turn it around. As we look back to find out what went wrong—some things clearly went very badly wrong—will the Secretary of State work with the chief executive, providing support and resources, not just to make sure this does not happen again, but to try to help EPUT improve in the future as well as examine the past?

[Steve Barclay]

I know that my right hon. Friend was particularly close to Sir David and is uniquely qualified to speak of his interest and involvement in these issues. I am happy to give him the reassurance that he seeks on working closely with the chief executive and the leadership team there. I know from my engagement with colleagues across the House that they will be closely involved in this in the weeks and months ahead.

Health Services: Southend West

Mark Francois Excerpts

Wednesday 6th July 2022 Commons Chamber

[Anna Firth (Southend West) (Con)]

Let me begin by saying what a huge pleasure it is to be holding my first Adjournment debate since my election in February—and on such an uneventful day! Let me also thank Mr Speaker for granting a debate on a subject that is so important to everyone in Southend West; and I am particularly pleased to see that we still have a Minister here to respond to it.

Making Southend West healthier is my absolute priority, and I want to say a huge thank you to all our brilliant local NHS workers. Their incredibly hard work is an inspiration to us all, and it is no exaggeration to say that our country would simply not function without them. However, it was very clear during my election campaign that, sadly, our local healthcare system was simply not up to scratch. Since my election, my mailbox has been dominated by problems with our hospital, with our ambulance service, with 111 and with GPs. Literally every day I receive complaints from constituents, and I have promised to do something about it.

There are four issues that I want to focus on this evening. The first is Southend University Hospital. The hospital lies right at the heart of my constituency, and the tower—which I had the pleasure of abseiling down earlier this year for charity—dominates the local skyline. The hospital now has 670 beds, serving as the main healthcare centre and accident and emergency department for around 330,000 people. Just over 4,500 staff work around the clock to provide the best possible care to local residents. However, the hospital is hampered by its setting, on a fairly small plot of land right in the centre of the city. There is no room to expand, so the hospital really has to make the most of every spare bit of space available.

The small site of the hospital is mirrored by the limited size of the A&E department, which can safely admit around 55 people within a 24-hour period. According to hospital staff, they regularly have to deal with between 120 and 150 people daily. This is quite simply unsafe. The Minister will know that the Care Quality Commission rated the Department as “requires improvement” late last year. Understandably, my hon. Friend the Member for Castle Point (Rebecca Harris) is keen that patients from her constituency are encouraged to attend Basildon A&E instead of Southend.

Clearly, the number of people the A&E department has to deal with has consequences for treatment waiting times. Statistics last month showed that more than a third of patients needing the most serious A&E care waited more than four hours to be seen. The lack of space in the A&E wing also means that ambulances regularly have to queue up for several hours outside the hospital to discharge their patients. Indeed, it is not unusual to see what effectively amounts to a temporary field hospital of 15 ambulances in the car park.

The national guidance states that patients arriving at an accident and emergency department by ambulance must be handed over into the care of A&E staff within 15 minutes. Shockingly, the average handover time for a person arriving by ambulance at Southend Hospital is 84 minutes, which is five times the national target. The worst day at Southend this year was 11 April, when the average handover time was 178 minutes. That is nearly three hours, and 12 times the national guideline. Of course, some patients wait considerably longer. One of my constituents contacted me last month to tell me that he had spent six hours in the back of an ambulance in agony, and one 79 -year-old constituent had to wait eight hours in severe pain before being seen. If this is happening in the spring and summer, I dread to think what the situation might be in winter.

This brings me to my first ask of the Minister this evening. The hospital trust, led by Anthony McKeever and the outgoing chief executive officer, Clare Panniker, has put together a plan for a major clinical reconfiguration of the Mid and South Essex integrated care system. This reconfiguration has been fully costed at £118 million and the funding was first promised in Parliament in 2017. Southend is the major beneficiary of this funding envelope, with £51 million also promised in 2017 for the development of, among other things, a new emergency care hub at Southend Hospital. This would go a long way towards addressing the critical issues with space and flow in the emergency department. It would also see additional inpatient wards and new and refurbished theatres in the hospital, as well as myriad other essential medical services.

This scheme is ready to roll, but for one big stumbling block. Approval of £8.4 million in capital enabling funding is needed to allow the development of the full business cases necessary to unlock the whole £118 million programme, and it is still awaited. In May, the Minister reconfirmed at a meeting with Essex MPs that these crucial enabling funds will be expedited. Sadly, this has not yet happened. Will he please confirm tonight the release of the £8.4 million of enabling funding needed for these essential upgrades at Southend Hospital? In the words of Cuba Gooding Jr., when will he “Show me the money”?

Problems with people waiting absurdly long times for an ambulance to arrive are not unique to Southend. This year we have already had debates in this place on delays everywhere from Cornwall to Shropshire to Ellesmere Port. One elderly woman in my constituency waited 12 hours for an ambulance to arrive after falling at home and fracturing her hip. Another 86-year-old waited six hours while suffering from sepsis.

What makes the situation in Southend unique is our rapidly ageing population. The results of the 2021 census, published last week, show that the average age in Southend is 20 years older than in England as a whole. The number of people aged 70 to 74 has risen by 37% in the past 10 years, and we now have nearly 2,000 people aged over 90. As my predecessor was so fond of saying, we have the highest concentration of centenarians in the country, which has implications for the ambulance service. Older people are more likely to have urgent medical conditions that can be dealt with only by having an ambulance come to them.

I am pleased to say that, since I was elected, we have seen some real changes. Working with my neighbouring colleagues, my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois) and my hon. Friend the Member for Castle Point, whom I thank for being here to support me this evening, we have held many productive meetings with the new chief executive of East of England Ambulance Service, Tom Abell, including another one only this afternoon. I am delighted that we will be receiving a net increase of 111 ambulance staff, and that the 11 new ambulances promised to us in March are already on our roads.

There will be no real benefit to the people of Southend West from these new ambulances if, when they arrive at the hospital, they cannot be discharged. The elderly lady with a broken hip I mentioned earlier, after waiting 12 hours at home for an ambulance, had to wait outside the hospital in that ambulance for another four hours. Sadly, her story is far from unique.

My second ask of the Minister this evening is exactly the same as my first. Will he release the £8.4 million of enabling funding needed to improve Southend Hospital’s emergency department?

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

The heroic efforts of our paramedics—I use the word heroic deliberately—are being hampered because they cannot discharge a critically ill patient into Southend Hospital if there is no bed available. An ambulance in the hospital car park with a critically ill patient cannot go back out to help other ill patients.

My hon. Friend is entirely right so, as a neighbouring MP, I join her in pleading with the Minister for this vital £8.4 million. Like my hon. Friend the Member for Castle Point (Rebecca Harris), who is also in the Chamber, I would be grateful if the Minister could show all of us the money.

[Anna Firth]

My right hon. Friend makes an important point. While ambulances wait in the hospital car park, another person is waiting at home with a broken hip or something similar and is unable to be picked up.

The 111 service in Mid and South Essex is run by Integrated Care 24, and the service answered 30,396 calls from patients in June. One of the most baffling things about the 111 service is that if a call has not been triaged by a clinician within an hour, an ambulance is automatically dispatched as a fail-safe. In June alone, 100 ambulances were auto-dispatched in Mid and South Essex, which is an average of 3.1 a day, due to delays in patients being triaged. In May, I met an ambulance crew who had been auto-dispatched to treat a 12 year-old child with tonsillitis as the case had not been triaged by a clinician within an hour. The ambulance crew were as surprised as the mother that they had been sent to attend a child with tonsillitis. On average, each ambulance call-out costs the taxpayer about £350. On those figures, we could be spending nearly £500,000 annually in Mid and South Essex alone on unwanted and unnecessary ambulance call-outs. Were that situation to be repeated at every hospital trust throughout the country, we would spend tens of millions of pounds on unnecessary ambulances. Will the Minister commit to reviewing the system that causes ambulances to be auto-dispatched?

Finally, I come to GP waiting times. GPs are at the heart of so much of our health system, and they have traditionally been the first port of call for people who have minor or recurring illnesses, but since the covid pandemic we have had a tsunami of complaints from people who are not able to see their GP. According to a poll by Survation, 47% of people in Southend West experienced problems booking a GP appointment in the past year—that is nearly 50% of people who are trying to see their GP. Every week, I am contacted by at least three constituents who are struggling to get a GP appointment. Generally, the complaint is that patients are in an endless loop of calling their practice in the morning and being told that there are no appointments available and they should call back in the afternoon, only to be told then to call again the following day—and they go round the buoy again. In one case, it took a constituent five weeks to get an appointment with his doctor. At West Road surgery, in my constituency, there are currently three-week delays for urgent blood tests. I have also received many reports of GPs delaying the return of medical forms to the Driver and Vehicle Licensing Agency and of delayed referrals to specialists. One constituent who had suffered a minor injury to his head and needed to see a GP for a check-up and bandaging had to call an ambulance and attend A&E because no appointment was available. This simply adds to the pressures I spoke about earlier in this speech.

Some surgeries in my constituency are attempting to innovate by bringing in an e-consult system, but they are doing so without writing and explaining the new system to their patients in advance—I am told there are no funds from the clinical commissioning group for such a letter. Not surprisingly, that is adding to the levels of frustration and anxiety. Besides, this online system is not suitable for many of the most elderly and vulnerable people in my constituency, who do not have access to the internet. Nationally, 54% of over-75s are not online, and the figure for the city of Southend is 8%, so we are talking about 12,000 people who have never even used the internet.

What my constituents need and deserve is to be able to visit their doctor, and that brings me to my final ask this evening. We can implement all sorts of clever systems to reduce waiting lists, but what we really need is more GPs and more appointments. Will the Minister please let me know what is being done to recruit more doctors in Southend, and what is being done to encourage them to increase the number of in-person appointments available?

I started this evening’s speech on a positive note by thanking our brilliant health workers, and I want to conclude on a similar one. We have some brilliant initiatives locally that are already making people in Southend West healthier. Southend University Hospital is piloting an innovative enhanced discharge service, a collaboration between Southend-on-Sea City Council, Southend clinical commissioning group and the hospital. This is helping people to get home when they have been in hospital, and it is a brilliant therapy-led assessment service that really puts people at the heart of ongoing care. I am delighted that the Government have praised the scheme, and I look forward to it being extended. I would like to take this opportunity to invite the Minister to come and visit the hospital; he and his ministerial colleagues—whoever they may be—are always welcome to come and visit.

My hon. Friend the Member for Rochford and Southend East (James Duddridge) would raise the case for a Shoebury health centre if this debate covered the whole of Southend, but I know the Minister is already aware of his passion and support for such a proposal. I fully support this endeavour and indeed would welcome one of these in Southend West as well.

To conclude, my main asks this evening are as follows. What is being done to recruit doctors in Southend, and what is being done to encourage them to increase the number of GP appointments available? What is being done to reform the 111 service to ensure ambulances are not auto-despatched needlessly? Most importantly, will the Minister please confirm tonight the release of the £8.4 million of enabling funding that is so vitally needed to improve the Southend emergency department?

North East Ambulance Service

Mark Francois Excerpts

Monday 23rd May 2022 Commons Chamber

[Maria Caulfield]

The hon. Lady is quite right that the reports in the newspaper this weekend were absolutely shocking. The cases highlighted were not about ambulances not attending, but about mistakes that happened at the scene. What is more concerning is that those facts were not necessarily shared with the coroner and that families were not told either. That is more concerning to me than the actual events, because when there is a suspicion that the facts are not known, it prompts fears about what else is not known. I therefore take that extremely seriously and will be following up later today, and with the Secretary of State, to see what steps we need to take to reassure families further.

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

Some of us who have been here for a while can recall that we desperately tried to warn the last Labour Government that big was not always beautiful and that regionalising the ambulance services would not work well because they were too large and too remote. Nevertheless, they pressed on. But we are where we are. The East of England Ambulance Service has some very deep-seated problems, despite the best efforts of the paramedics, although thankfully not quite as horrendous as this case. Will the Minister, when she has a moment, announce a review into the operation of all regional ambulance trusts to improve their performance across the whole country? If that cannot be done, can they be broken up into smaller, more effective units? The current system is not working.

[Maria Caulfield]

I hear my right hon. Friend’s concerns. I am happy to look at his concerns for his own particular ambulance service and discuss them further.

Oral Answers to Questions

Mark Francois Excerpts

Tuesday 29th October 2019 Commons Chamber

[Mr Speaker]

I say to the right hon. Member for Rayleigh and Wickford (Mr Francois) that when we stood against each other in Conservative student politics in 1986, I was the candidate of the right and he was the candidate of the left. Some things change over the years.

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

Mr Speaker, you won. Although we have not agreed on everything in the 18 years I have been in the House, I say most earnestly, from one midget to another, that I wish you a long and happy retirement.

Following the question of my hon. Friend the Member for Southend West (Sir David Amess), I point out that the individual he mentioned moved from being the accountable officer of the Southend CCG to the accountable officer of the Thurrock CCG. It was a sideways move for which he trousered a fifth of a million pounds of public money, which should have been spent on patients. Do not just cap the payment, sir, make him pay it back.

[Matt Hancock]

Again, we have the powers in primary legislation to claw back contractual redundancy payments. Nobody is keener to ensure the careful expenditure of taxpayers’ money than my right hon. Friend. The matter has been raised very powerfully by the voices of Essex in this question time.

Oral Answers to Questions

Mark Francois Excerpts

Tuesday 19th February 2019 Commons Chamber

[Matt Hancock]

The hon. Gentleman is right. When we put a large amount of money into a service, we of course need more people to deliver it. That is most acute in mental health, which is getting the biggest increase in funding—£2.3 billion of the £20.5 billion overall. I assure him that the Minister responsible for mental health and suicide prevention, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), is working night and day to ensure that we attract the people we need to deliver the services that our people deserve.

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

May I ask a question in memory of my late friend Stephen Horgan, who died a few years ago from a rare form of blood cancer with just a few months’ notice? In his memory, I am a now a supporter of Bloodwise, an excellent charity that raises awareness of rare cancers. Asking on the charity’s behalf, will the new workforce plan for the NHS include clinical psychologists, particularly those with cancer knowledge, to make the absolute best use of the welcome new resources, which I am sure Stephen’s family also welcome?

[Matt Hancock]

Yes, my right hon. Friend puts it extremely well, because he reminds us of who we are here to serve when discussing questions of health and of cancer. He is right to raise this matter, and I can absolutely confirm what he asks for: we will deliver in Stephen’s memory and in the memory of others who have died. That is what gives us the strength to carry on and try to deliver and improve services for everybody.

Prostate Cancer

Mark Francois Excerpts

Wednesday 6th February 2019 Commons Chamber

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

On that point, I had the privilege of attending an event that the Minister addressed a couple of weeks ago, and I was struck by the passion with which he spoke about this subject. I entirely endorse what my hon. Friend has said about the Minister’s commitment. In passing, I congratulate my hon. Friend on securing this very important Adjournment debate, and may I assure him that, when it comes to fighting prostate cancer, this is something on which he and I see absolutely eye to eye?

[Simon Hoare]

I am grateful to my right hon. Friend. I think we both stand at roughly 5 feet 6 or 7 inches, although I might be slightly taller than him when he is in his stocking feet. I get his reference and it is delightful to see eye to eye with him.

Oral Answers to Questions

Mark Francois Excerpts

Tuesday 20th March 2018 Commons Chamber

[Mr Hunt]

I reassure the hon. Gentleman that we are conscious of the importance of a good outcome to the Brexit talks for universities, including Queen’s University Belfast, for precisely the reason raised by the hon. Member for Stockton South (Dr Williams) earlier. There are excellent research links with universities all over the world, but it is particularly important that we carry on working with European universities.

[Mr Mark Francois (Rayleigh and Wickford) (Con)]

2. What support his Department is providing to children who need sports prostheses.

[The Minister for Care (Caroline Dinenage)]

Since 2016, the Government have invested £750,000 to fund the provision of sports and activity prostheses for children and young people on the NHS. We have also invested a further £750,000 in a new National Institute for Health Research child prostheses research collaboration to drive improvements in technology. I can confirm that that funding will continue, and we will announce more details shortly.

[Mr Francois]

I thank the Minister for that reply. The centre at Headley Court provides world-class support for our servicemen who unfortunately lost limbs in Iraq or Afghanistan. It does incredible work. What lessons have we learned from Headley Court that we are able to transfer into the NHS?