Health and Care Bill (Fourth sitting)

Mary Kelly Foy Excerpts

Committee stage
Thursday 9th September 2021 Public Bill Committees

[The Chair]

Thank you. Mary Kelly Foy.

[Mary Kelly Foy (City of Durham) (Lab)]

Q This is for Andy. It is noted that mental health provision has for far too long been seen as the Cinderella service of the health system. Indeed, there is very little in the Bill specifically around mental health. Given the growing number of people suffering with mental ill health and the shortage of services, is there enough in this Bill to satisfy you that mental health will be given parity of esteem alongside physical health?

Andy Bell: It is difficult to tell; the Bill is largely silent on mental health. If we had a system where there was genuinely equal regard for both mental and physical health, we would not have to worry about that, because we would know that the system would treat mental health fairly and equally, and there would be no disparity in the way it was thought about. Unfortunately, all our experience tells us that that is not what happens within many health systems at different levels, from very local to national, so we would like to see some assurances in the Bill.

From our point of view, that could happen in one of two ways. Legislation only gets you so far, but it could place specific duties on both NHS England and integrated care boards—I am being very careful in specifying integrated care boards here—that they must take action to ensure that mental and physical health are given equal regard in their decision making, particularly on resource allocation. We feel strongly that there needs to be a voice for mental health within integrated care boards. That is highly likely to happen within integrated care partnerships, but within integrated care boards we do not have confidence that mental health will be properly represented at the top table where important decisions about resource allocation are made.

We think that would help. There are no 100% safeguards in legislation, but one positive thing we have seen with the 2012 Act is that a clause at the very top of the Act talked about mental and physical health as one of the key purposes of the NHS, and that has been used positively and helpfully to make the case for parity in health systems up and down the country. A few simple words can sometimes make quite a big difference.

[Edward Timpson]

Q This is a question for Ed, building on the fact that you have, I think, fairly extensive experience of working with local authorities and supporting them on governance and scrutiny. Having direct involvement in NHS decision making on funding and so on is a fairly new role for local authorities, and different ICSs will have different sizes and geography; for instance, mine is Cheshire and Merseyside, which is one of the largest—I think it is three or four times the size of some other ICSs. Over and above being involved in the board, for local authorities in larger ICSs, where the emphasis on place could be lost if they are not more fused into the system, how do you think the Bill could help to ensure that that is the case, so that we get the right balance between their involvement in the decisions, based on their knowledge of their own population, and the wider regional decisions?

Ed Hammond: For me it starts with an understanding of what decisions are best made at system level and what decisions are best made at place level. Certainly, I would imagine one of the first things that ICBs and ICPs would need to do, once established, would be to determine how to set up a system-wide framework for ensuring equality and equity in terms of how its health and care service is delivered, and then determine how and where it is most appropriate that more detailed decisions come to be made at place level. Otherwise, the system simply becomes too unwieldy.

There are risks that those partners sitting at that system level will draw decision making into those spaces, rather than pushing it back out to localities, because it is the simplest, in many ways the most efficient and apparently the most co-ordinated way of doing it, but in practice it will not serve the interests of local accountability or better outcomes. That raises the prospect of certain services being delivered in different ways in different localities, depending on the political priorities of different councils, but that is local democracy—that is local government bringing its understanding of the demographics of the populations it serves into the conversation.

I think this can all be made to work if there is sufficient transparency in the system, so that those within and those outside it understand how decisions are being made, on what subjects, and by whom. When you have that clarity, it becomes easier to unpick what is happening at place level. Are decisions being made at system level that would be more appropriately made at a lower level? Is there consistency across the entire system? What does the geography mean for decision making and commissioning, and these kinds of things? It provides assurance, and it provides everybody with more confidence that decisions are being made properly in the interests of local people.

Going back to the point I made before, that is also why some external local accountability is so important, because effective local external accountability can challenge the system on whether the right decisions are being made at the right level, and whether they reflect and are responsive to what the local needs are. Local scrutiny committees are, at the moment, anchored at place level within local authorities. They are well able to publicly draw in the voice and concerns of the public about those kinds of issues, and transmit them to health and care partners so that there is a clear way for those concerns and issues to be responded to.

Health and Care Bill (Third sitting)

Mary Kelly Foy Excerpts

Committee stage
Thursday 9th September 2021 Public Bill Committees

[Dr Philippa Whitford (Central Ayrshire) (SNP)]

I remain a member of the BMA.

[Mary Kelly Foy (City of Durham) (Lab)]

I am a member of Unison.

[The Chair]

Welcome Sara and Chaand. Will you kindly introduce yourselves, please?

Sara Gorton: Good morning. I am Sara—it is pronounced as if it is spelled with an h at the end. I am head of health at the trade union Unison.

Dr Chaand Nagpaul: My name is Dr Chaand Nagpaul. I am a GP in north London. I have been a GP for more than 30 years. I am chair of the BMA UK council. We represent doctors across the UK—more than 160,000. I represent all doctors of all types, working in hospitals, public health, general practice—you name it.

Health and Care Bill (Second sitting)

Mary Kelly Foy Excerpts

Committee stage
Tuesday 7th September 2021 Public Bill Committees

[Dr Davies]

Q Very good. Thank you. As a follow-up question to both panellists, could you comment on the benefits arising from the preventive measures in the Bill on the fluoridation of tap water and obesity?

Professor Maggie Rae: Obviously, from my position as president of faculty, I want more emphasis on prevention, so I am very pleased to see that focus on it, but I do not think it is quite enough yet. I think we would all recognise that part of the reason why we seemed to take the biggest hit on covid in terms of deaths and the effects of the virus was the ill health of our population. We are recognised as having one of the most unhealthy populations in Europe now, and that was not always the case. Yes, it is very pleasing to see the measures on obesity, but we need to recognise that most of the influence could come from the very local level.

I am sorry to say to colleagues and this eminent Committee that we could probably spend the whole meeting talking about fluoridation. I recognise the attempt to tackle the problems of oral health. Children’s teeth being extracted under general anaesthetic is a national disgrace; that money is so wasted in the NHS when we desperately need it to be spent on other health matters, and the time it takes for that operation is so dangerous for children. It is good to have this recognised, but I think it will be quite a slow burn, even with the legislation.

Some areas have tried to implement fluoridation. It has taken them years and they still have not succeeded. Could we perhaps persuade people? As well as focusing on fluoridation, could we have just a small investment in other methods to tackle oral health? One that is really effective, which I used myself as DPH, is simple toothbrushes and toothpaste. Sometimes we think public health measures take a long time, but I can guarantee that if that measure were implemented effectively you could see the changes within 12 months and would also end up saving the NHS a lot of money. I work closely with Councillor Jamieson in his role at the LGA and I hope that he would agree with me.

Cllr James Jamieson: I am going to agree with Maggie. I think that that is a general point we would make. Better healthcare does not start in a hospital; it starts in the community and it starts before you are born. It is about prevention, early intervention, public health, good food and all those things. We welcome measures to support that.

On the point about obesity, I would particularly say that although, yes, it is nice to be able to produce advertising, there is so much more we would like to do. This is not necessarily within the scope of the Bill, so I am not suggesting that, but, for instance, in licensing legislation, being able to take account of public health, which at the moment is specifically excluded, as well as being able to do so in planning legislation as regards where fast food places are and so forth, would be immensely helpful. This is a start; it is a small but positive step.

[Mary Kelly Foy (City of Durham) (Lab)]

Q One of our earlier witnesses touched on the social determinants of health—housing, green spaces, good jobs—being the greatest factor in a person’s healthy life and life expectancy. I am disappointed that there is nothing in the Bill that addresses those fundamental issues. Do you think that there is scope for them to be touched on, as well as in working with local authorities?

Even more remarkable as regards reducing health inequalities is the absence of any detail, duty or provision to tackle alcohol harm and tobacco control, which of course are the greatest factor in determining a person’s life expectancy—and further down the line they have the greatest impact on local authorities’ social care bills. Do you think they should be included in more detail in the Bill, with a duty to reduce health inequalities rather than just having “regard” to reducing them?

Cllr James Jamieson: I think we need to be cognisant of the fact that this is a Bill providing a framework. I completely agree with the comments made about health inequalities, good housing, green space and all those things—absolutely. I am a full advocate of the idea that health is three quarters determined by somebody’s environment and choices, and probably only a quarter by what the NHS does. That is really important. My slight concern is that if we get very prescriptive in legislation, it limits the ability to do the right thing.

The really important thing about this legislation is all the guidance and so forth that will come out of it, and where the funding goes. Our preference is to say, “Try not be too prescriptive in the legislation, but really engage with local government and public health on the guidance that comes out of this legislation.” A real priority has to be better places, better communities, better jobs, less pollution and all those things, but I do not think that that is something for legislation; I think it is very much about getting the guidelines right, and they will be different in different parts of the country. The issues that might be faced in a rural area are very different from those faced in an urban area. I do worry that if legislation is too prescriptive, it hampers rather than helps.

Professor Maggie Rae: Would you mind if I added some comments please, Chair?

[The Chair]

Please do.

Professor Maggie Rae: Just building on those comments from Councillor Jamieson on what I think is a very important question, there is a line in the Bill saying that the ICSs have to take note of advice from directors of public health. If we want ICSs to be population health organisations, we have to make sure that the legislation is strong enough to ensure that the advice is acted on. Our directors of public health have been highly trained and are able professionally to identify the needs of the population, identify where the health inequalities are and make sure that they can provide the ICSs, in terms of both the NHS-side board and the partnership board, with all the evidence they need about what will make a difference. It is the action that will make a difference and improve those outcomes that we all want. It would be very helpful to ensure that the Bill, if possible, is more explicit about that advice and which source it is coming from. We have worked very closely with the legislative team and the Bill team. I do not think anyone could fault the amount of hours they have spent discussing with stakeholders the details of the Bill, and Councillor Jamieson is also right that we cannot have everything in the Bill, but we want a true population-focused organisation.

That has to be the change that this legislation brings; it has to be an enabling legislative framework. We then need to ensure that the guidance, and, most importantly, the assurance process, allow some of the public health expertise to determine whether it is fit for purpose. It is possible that these organisations, and the excitement of the changes, could result in our having a more place-based population focus, but that will only be the case if we get it right and take account of those wider determinants such as education and housing—all the things that contribute to good health.

Social Care Reform

Mary Kelly Foy Excerpts

Wednesday 23rd June 2021 Commons Chamber

[Helen Whately]

I thank my hon. Friend, and I recognise the situation right now. That is one reason why we are providing £3.8 billion in grants for adult and children’s social care this financial year, which has gone up from £3.5 billion in the previous financial year. Of course, looking ahead in our reforms, we do have to make sure that the way social care is paid for is fair across the country.

[Mary Kelly Foy (City of Durham) (Lab) [V]]

I was a carer for my daughter Maria for almost 27 years, so I know the demands that carers face every single day caring for those they love. Does the Minister really believe that £67 a week carer’s allowance is a fair amount for round-the-clock care, and will this amount be raised under the Prime Minister’s “prepared” plan for social care?

[Helen Whately]

I pay tribute to the hon. Member for the hours, the love and the effort that she has put into caring herself. She knows, from her own experience, the experience of carers across the country and what it takes in time, physical effort and emotional effort.

Carer’s allowance is not intended to be somebody’s income; it is intended to support people with some of the costs of caring. It is primarily led by the Department for Work and Pensions, but I can say that I am committed to ensuring that there is support for unpaid carers and family carers, and, as I said earlier, ensuring that, as well as caring for and looking after others, those individuals should be able to have time for themselves to lead their own lives.

Tobacco Control Plan

Mary Kelly Foy Excerpts

Thursday 10th June 2021 Westminster Hall

[Mary Kelly Foy (City of Durham) (Lab)]

I beg to move,

That this House has considered recommendations for the forthcoming Tobacco Control Plan.

It is a pleasure to serve under your chairmanship, Mrs Miller. In December, the Minister confirmed to Parliament that the Government will publish a new tobacco control plan this year, setting out measures to deliver the smoke-free 2030 ambition in the 2019 prevention Green Paper. I welcome this announcement: as a former chair of the Gateshead tobacco control alliance, this issue is close to my heart. In my own area of County Durham, adult smoking prevalence is 17%, compared with 13.9% nationally, and rising to 27% among people in routine and manual occupations. Some 16.8% of mothers smoke during pregnancy, compared with 10.4% in England, and smoking in County Durham has an annual cost to society of approximately £122 million.

The Secretary of State himself stated that the “extremely challenging ambition” of a smoke-free 2030 will not be delivered by business as usual. The new report from the all-party parliamentary group on smoking and health sets out the evidence-based recommendations needed to achieve that ambition. Smoking is responsible for half the difference in life expectancy between rich and poor, and the impact is passed down through generations, with those who grow up in smoking households far more likely to become smokers. With 1,500 people dying from smoking-related diseases every week, and less than a decade to go to achieve a smoke-free 2030, there is no time to waste.

However, this will not happen without investment. That is why the key recommendation of the APPG’s report is for a smoke-free 2030 fund, requiring the tobacco industry to pay for tobacco control. This is the “polluters pay” approach that the Government committed to considering in the 2019 prevention Green Paper. As such, can the Minister assure me that the proposals put forward by the APPG on smoking and health will be considered as part of the forthcoming control plan? In particular, will the Government deliver on their commitment to consider a US-style “polluter pays” approach to fund the tobacco control measures needed to deliver a smoke-free 2030?

More investment is needed, because the huge gap in smoking prevalence between those in routine and manual occupations and those in other occupations is stubbornly persistent. Ending smoking would lift around 450,000 households out of poverty, including more than 250,000 million children and 140,000 pensioners, concentrated in the most disadvantaged parts of the country. That would not only benefit the health and wellbeing of individuals but inject money into local economies, which would show just how serious the Government are about the levelling-up agenda.

Smoking is linked to almost every indicator of disadvantage, and those indicators overlap different communities. Smokers in routine and manual occupations or who are unemployed are also more likely to live in social housing and to be diagnosed with mental health conditions. The Government have been unsuccessful so far in reducing the inequality gap in smoking and need to redouble their efforts to achieve a smoke-free 2030 for all. There is a clear need for a national strategy that targets investment and enhanced support at disadvantaged smokers.

Unfortunately, smokers from deprived communities with higher smoking rates tend to be more heavily addicted than those from more affluent areas. Analysis of Government data shows that in 2019 nearly half of England’s smokers were in routine and manual occupations or were long-term unemployed. They are just as motivated to quit as other smokers, but it is harder to succeed when smoking is more commonplace and cheap, illicit tobacco is widely available.

Regional tobacco control programmes have been effective in tackling these disparities, as shown by the example of Fresh in the north-east, which is the longest-running—indeed, the only surviving—regional office of tobacco control. When Fresh was founded in 2005, smoking prevalence in the north-east was over 20% higher than the national average for England, and the disparity was growing. Since then, the north-east has seen the greatest decline in smoking prevalence of any region: smoking prevalence in the north-east is now only 10% higher than the England average. However, the regional work done in the north-east and elsewhere has been limited by cuts to the public health grant for local authorities since 2015-16. This led to the closure of the regional offices in the north-west and the south-west, and funding in the north-east has been significantly reduced. New funding streams are needed.

Smokers can successfully quit only if they are motivated to make an attempt to quit. Sustained mass multimedia behaviour change campaigns are the most impactful and cost-effective way to provide that motivation. The US Government’s “Tips From Former Smokers” campaign was funded by tobacco manufacturers through the USA’s user-free scheme, which raises $711 million annually from the tobacco industry. The Food and Drug Administration campaign led to over half a million sustained quits in three years, and it was associated with healthcare cost savings of $11,400 per lifetime quit.

Such campaigns have an immediate impact and can be targeted with precision at disadvantaged smokers, yet investment in behaviour change campaigns has fallen year on year in England. This has coincided with a significant decline in the number of adult smokers who have tried to quit. In 2008, 40% of adult smokers in England had tried to quit within the previous year; by 2018, that had fallen to just 30%. Over the same period, funding for mass media campaigns fell by over £20 million.

Behaviour change campaigns need to be targeted at key groups and communities to reduce socioeconomic inequalities. The effectiveness of national campaigns can be significantly enhanced when they are supplemented by targeted regional campaigns. Regional funding for stop-smoking behaviour change campaigns in the north and midlands would support the levelling up of some of the more deprived regions of England. These are the regions with the highest rates of smoking, combined with the lowest gross disposable household income. Supporting smokers in these regions to quit will prevent people’s hard-earned incomes from going up in smoke, lifting thousands of households out of poverty and providing a boost to local economies.

Modelling by University College London for the all-party parliamentary group on smoking and health estimates that a sustained national behaviour change campaign aimed at deprived smokers, combined with regional campaigns in the north and midlands, would result in an additional 1 million quit attempts, 179,000 successful quit attempts and 45,000 more ex-smokers in C2/DE occupations in England by 2030. The investment required is estimated to be about £28 million a year, which the tobacco manufacturers could easily afford to pay from their £900 million profits in the UK—and more than three quarters of the public want the tobacco manufacturers to pay for those measures. Does the Minister agree that targeted investment to tackle high rates of smoking among our most deprived communities is vital to delivering the Government’s levelling-up agenda?

Sadly, illicit tobacco is more accessible to children, and as it is cheaper than legally sold tobacco it reduces the incentive for adult smokers to quit. In 2018-19, the total tax revenue lost because of illicit tobacco was estimated by Her Majesty’s Revenue and Customs to be £1.9 billion. The illicit trade is heavily concentrated in the more deprived communities, contributing to higher smoking rates. Addressing that disparity requires tackling both the supply and demand for illicit tobacco in communities where it is endemic.

In the north-east, there have been dedicated multi-stranded programmes of work in place since 2007 to reduce the supply and demand as part of a broader activity to reduce smoking prevalence and improve the population’s health. Such programmes drive a strategic approach to tackling illicit tobacco at local, regional and national level. One programme was described as follows:

“an exemplar of partnership working…and…deserves to be widely disseminated”—

a recommendation supported by the National Audit Office. Unfortunately, that has not yet been possible owing to lack of funding, and the funding in the regions where it does exist is under threat because of cuts to public health budgets. Fresh and the Greater Manchester health and social care partnership have estimated that it would cost approximately £5 million annually to roll it out across England.

As the Minister said at the launch of our report, we need to get HMRC to do more to tackle illicit tobacco. Just £5 million for a highly effective regional programme is peanuts and would return far more in lost revenue than it costs. Will the Minister commit to discussing with HMRC how funding can be found for the illicit tobacco partnership to extend cover to all the regions of England to reduce the use of illicit tobacco, which is endemic in poorer communities in every part of England?

We are delighted that the Minister was able to attend the launch of the report by the APPG. I know how passionate she is about the issue. I look forward to hearing her response to our report and recommendations. I am confident that if the Government can embrace our recommendations in the forthcoming tobacco control plan, we will be well on the way to a smoke-free England by 2030.

[Mrs Maria Miller (in the Chair)]

Before I call the next speaker, I should say that I shall be moving to Front-Bench contributions at 2.35 pm. I suggest an informal five-minute time limit to enable all colleagues to make their contributions. I call Bob Blackman.

--- Later in debate ---

[Mary Kelly Foy]

I thank you, Mrs Miller, the Minister and right hon. and hon. Members for their contributions to the debate. I am so pleased that there is cross-party support. I just want to reiterate that in order to go some way towards reducing inequalities, levelling up and increasing healthy life expectancy—especially in poorer communities—we must implement this plan.

Motion lapsed (Standing Order No. 10(6)).

A Plan for the NHS and Social Care

Mary Kelly Foy Excerpts

Wednesday 19th May 2021 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab) [V]]

I must admit that I greatly enjoyed the Health Secretary appearing to argue that our health and care sectors need to recover after a decade of Tory government—I could not agree more. The covid-19 pandemic has served to expose the damage done by Tory austerity and privatisation to our NHS and social care sectors. They are understaffed and underfunded, while existing staff are overworked and underpaid. However, unlike the Health Secretary, I do not think that further privatisation is the answer, even if he and his pals are already drooling at the thought of selling off the NHS to every Tom, Dick and Tory donor.

It is clear that our health and social care sectors are in crisis. Before the pandemic, there were over 100,000 NHS vacancies, while a quarter of staff were more likely to leave than in the year before. The Government’s plan to address that is to give NHS staff another real-terms pay cut. Added to that, there are an estimated 112,000 social care staff vacancies. Again, with zero-hours contracts and median pay of just £8.50 an hour, I do not think there is any great mystery behind that shortage. However, the social care crisis goes beyond staffing. Age UK estimates that there are 1.5 million older people not receiving the social care support they need. Councils have had their budgets slashed by nearly 50% on average since the Tories came to power, with around £8 billion taken out of social care budgets since 2010, so is it any surprise?

We desperately need a plan for social care that relieves the pressure on unpaid carers and widens access to adult social care where it is needed, yet the Government appear clueless. This crisis requires a dynamic Government: a Government who are ready to accept the ideological failures of austerity and privatisation, who are willing to invest in publicly-run health and social care services, and who reward the workers who staff them. Instead, the promised plan for social care is still missing, private healthcare firms are being welcomed with open arms, and workers face pay cuts and poverty wages.

The Health Secretary speaks about the prevention agenda, but the main cause of ill health is not obesity alone; it is poverty. He can talk about levelling up, building back better and the rest of their buzzword bingo, but until the Government address insecure work, low wages and welfare reform, health inequalities will continue to grow. The Government need to wake up to the health and social care crisis, because the effects are already being felt by real people—the people this Government promised to help.

Health and Social Care Update

Mary Kelly Foy Excerpts

Thursday 18th March 2021 Commons Chamber

[Matt Hancock]

Yes. We did fund the science from the start, and we worked collegiately to make that happen. I can confirm that there is no impact on the road map timetable from the news on supply, because we remain on track in terms of the targets that we have set out.

[Mary Kelly Foy (City of Durham) (Lab) [V]]

If there are indeed issues with vaccine supply, it does not make sense that countless manufacturers across the world are unable to produce covid-19 vaccines, treatments, diagnostics and other health technologies because of intellectual property restrictions and pharmaceutical monopolies that prevent open technology sharing. Will the Government now commit to supporting a waiver of covid-19-related patents at the World Trade Organisation, or is artificially limiting vaccine supply official Government policy?

[Matt Hancock]

I am very happy to provide the hon. Lady with a briefing, because she should be very proud of her country. AstraZeneca is providing the Oxford vaccine free of charge—it is not charging for any intellectual property rights—right around the world. That is not true, as she implies, for all the vaccine companies, but she should be really, really proud of ours.

Maternal Mental Health

Mary Kelly Foy Excerpts

Wednesday 10th March 2021 Westminster Hall

[Mary Kelly Foy (City of Durham) (Lab) [V]]

I thank the hon. Member for Richmond Park (Sarah Olney) for introducing this debate. I declare an interest as co-chair of the all-party parliamentary group on cerebral palsy

Maternal mental health has been one of the hidden impacts of the pandemic. Being a new mam is a special time for any woman. However, it can also be overwhelming and generally challenging. In normal times, many women receive support from their family and friends, who are there to offer invaluable guidance. However, for the past year, the public health restrictions needed to tackle covid-19 have meant that many women have had to make this journey on their own.

I had my first child, Maria, at 21. The advice from my mam was crucial in spotting the missed stages in her early development, which enabled her cerebral palsy diagnosis to come much sooner than it otherwise would have. I cannot put into words how valuable her support was following such heart-rending news. It was thanks to my family and friends that I felt confident enough to go on and have two more children.

It strikes me that if Maria had been born during this pandemic, the personal support I received from my mam and health visitors would have been much more limited. My heart truly goes out to those who have become mothers during the pandemic. I cannot imagine the impact that isolation is having on their mental health. I worry that sadly some may choose not to extend their families in future.

The pandemic has particularly affected those whose babies have received neonatal care, with more than 90% of parents who responded to a Bliss survey saying that they felt more isolated due to having a baby in neonatal care during the pandemic, and 70% saying that their mental health was negatively impacted as a result of their experience. The situation has not been helped by the fact that Bliss research also found that psychological support for parents experiencing neonatal care was inconsistent at best. Around half the parents said they were not offered mental health support during or after this care.

The impact of negative maternal mental health goes beyond the parent and is not limited to the short term. As we have heard, the first 18 to 24 months of a baby’s life are critical in their development, and the stress and trauma of poor maternal mental health has the potential severely to impact a child’s life chances.

In parts of the north-east, where my constituency is located, existing health inequalities mean that some children begin their lives with inferior life chances to those from less deprived regions. We simply cannot afford to place further obstacles in the way of their development and risk losing a whole generation. As a result of the pandemic, we are facing a potential mental health crisis in Britain and maternal mental health is significant.

It is unreasonable to suggest that, as a society, we could experience a collective trauma on this scale without it impacting on mental health. Inevitably, that will be challenging, especially when the existing foundations of mental health care in the country are already weak. It was therefore incredibly disappointing that health services were absent from the Chancellor’s Budget last week. He could do with learning that the damage to public health from the pandemic will not fix itself.

It seems fitting that the debate is happening in the week in which International Women’s Day falls. Not only have women consistently stepped up to the plate during the pandemic, with little to no reward, but they have shown resilience in coping with one of life’s toughest challenges—becoming a mam. We owe it to the women in our constituencies to have the best mental health support out there, for what is undoubtedly one of the most beautiful yet challenging life experiences they will face.

Covid-19

Mary Kelly Foy Excerpts

Monday 14th December 2020 Commons Chamber

[Mary Kelly Foy (City of Durham) (Lab)]

With the Health Secretary’s announcement today, there will rightly be a lot of focus on the spread of covid-19 in the UK and the questions it raises about the effectiveness of the Government’s tier system, as my hon. Friend the Member for Kingston upon Hull West and Hessle (Emma Hardy) pointed out powerfully. However, I want to use the debate to raise the impact of covid-19 across the world. Last week, the People’s Vaccine Alliance—a collection of organisations including Oxfam, Global Justice Now and Amnesty International—called for the pharmaceutical companies that are developing covid-19 vaccines to share their information and to waive their intellectual property rights to all vaccines, tests and treatments until the threat of the virus has abated. To do so would massively increase the global supply of vaccine doses and save countless lives. Now is not the time to put profit before people, and I would like to make clear my support for this proposal.

Through an analysis of data collected by Airfinity, the People’s Vaccine Alliance has highlighted the dangers that an unequitable distribution of coronavirus vaccine poses. Its work has revealed that 67 of the world’s poorest countries will be able to vaccinate only one in 10 of their population. In contrast, wealthier countries have acquired enough doses to vaccinate their population three times over, while Canada could potentially vaccinate its population of five times over. All in all, the most well-off states that make up just 14% of the world’s population have bought 53% of the doses of vaccines most likely to be successful. It is so disheartening, and arguably dangerous, that 96% of Pfizer’s doses have been acquired by wealthy nations. While it is welcome that 64% of the Oxford AstraZeneca vaccine has been made available to developing nations, it will still only be enough for 18% of the world’s population. This is clearly not right.

Covid-19 has, sadly, shone a spotlight on the susceptibility to ill health of those in the most deprived communities, as well as the disproportionate impact of coronavirus on the world’s poorest. In the UK, those in our most deprived communities have been about twice as likely to die as those in the least deprived. With this in mind, it cannot be right that the wealthiest countries have enough doses to vaccinate more than their entire population while the most impoverished nations are unable even to vaccinate their healthcare workers and their most vulnerable. In times of crisis, it is easy to panic and to look after our own, but the reactionary response is rarely the best one. In the UK, we are no more deserving of the lifeline that a vaccine offers than any other nation. In order to uphold our human rights obligations, we must ensure that there is equal access to vaccines across the world. However, an equal sharing of vaccine resources is not just morally correct, it is also beneficial to the UK. As the director of Frontline AIDS said:

“This pandemic is a global problem that requires a global solution. The global economy will continue to suffer so long as much of the world does not have access to a vaccine.”

As a country, we cannot look to end this crisis simply by eliminating the virus within our own borders, because for as long as it exists, public health will be at risk and economies will be weakened.

I remind this House of our obligation, as a wealthy country, to the rest of the world. I urge nations from around the world to reject the pull of vaccine nationalism and to consider the world’s most vulnerable. To those who say, “We must put British interests first”, I say that beating this virus and reducing global poverty is a British interest. We must remember that when it comes to covid-19, none of us are safe until all of us are safe.

Covid-19 Vaccine Roll-out

Mary Kelly Foy Excerpts

Tuesday 8th December 2020 Commons Chamber

[Matt Hancock]

The UK has put more money into the international search for a vaccine, and the distribution of a vaccine to the countries that otherwise would not be able to afford it, than any other state of any size, and we should be very proud of that. The way that we have managed the Oxford-AstraZeneca vaccine is to ensure that it is available on a not-for-profit basis, essentially, worldwide. We have taken this approach because, to put it exactly as my hon. Friend did, nobody is safe until everybody is safe. This is a global pandemic and we need to address it globally. That is the only fundamental way to solve this for the long term. In the short term, what we all need to do is keep following the rules.

[Mary Kelly Foy (City of Durham) (Lab)]

The vaccine is indeed welcome news, but until it is fully rolled out, the north-east will continue to be harmed by the lack of economic support that accompanies tier 3 restrictions. The Health Secretary stated that the restrictions were based on

“cases among the over-60s; the rate at which cases are rising or falling; the positivity rate; and the pressures on the local NHS.”—[Official Report, 26 November 2020; Vol. 684, c. 1000.]

Can he therefore tell me precisely what level these figures will have to be at for the north-east to be moved into tier 2?

[Matt Hancock]

We consider all those figures, and because we consider them alongside special factors such as whether there is an outbreak, we do not put a specific figure on that, as the hon. Lady well knows. But what we have done is put in more economic support than almost any other country in the world, as the International Monetary Fund has recognised. We have tried as best we possibly can to support people through what has been an incredibly difficult year. We have not been able to save every job, but with the economic measures of support for business and the furlough scheme in place, we have put in very significant support. But the best support that people in the north-east, and elsewhere in the country, can have until this vaccine is rolled out is to continue to follow the restrictions that are necessary and then, if they get the call from the NHS, take that vaccine.