Health and Care Bill

Debate between Matt Hancock and Philippa Whitford

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Dr Whitford]

I rise to speak to my amendment 82, which is on legislative consent if the Bill is used in the devolved aspects of healthcare in future. The bulk of healthcare—certainly its delivery through the Scottish NHS—is devolved. Having been on the Bill Committee, I was surprised that in the original version of the Bill there was not one mention in that context of the word “consultation”, let alone the word “consent”.

I do welcome amendments 118 and 121. I recognise that the Minister is trying to work constructively with the devolved Governments, but health is devolved. I am sorry, but after the United Kingdom Internal Market Act 2020, because of how the funds to replace EU funding post Brexit are being used to cut the devolved Governments out of decision making, there is a real fear among the public in Scotland that their health services could be changed in future. I ask anyone who supports devolution in principle to support amendment 82.

[Matt Hancock (West Suffolk) (Con)]

I rise to support new clauses 60 and 61, which relate, like the amendments that the hon. Member for Central Ayrshire (Dr Whitford) spoke about, to the UK-wide application of the Bill.

Health is rightly devolved, and as Secretary of State I worked very closely with Ministers in the three devolved nations, but there are nevertheless areas in which it is vital that the NHS, as a British institution, supports all our constituents right across this United Kingdom. Two areas in particular are critical and, in my view, need legislative attention.

The first area is the interoperability of data. As well as being vital for stronger research, it is necessary not least so that if you travelled to Caerphilly or Glasgow and were ill, Mr Deputy Speaker, the NHS could access your medical records to know how best to treat you. We can see right now, in the application of the NHS app for international travel, what happens without the data interoperability that new clause 61 would require.

--- Later in debate ---

[Matt Hancock]

On the contrary: data protection laws are UK-wide, so it is appropriate that this should be done UK-wide.

The second area is services. For instance, if a new treatment is available to Scottish patients in Edinburgh, which has one of the finest hospitals in the country, and if on rare occasions it is available to a Welsh person in Wales with a rare disease, should that person not be able to benefit from it? Likewise, if a treatment is available in one of the great London teaching hospitals and somebody from Stirling needs it, should they not be able to get it? At the moment, access to such specialist services is available on an ad hoc basis, but it is not broadly available. That is what new clause 60 seeks to address.

[Dr Whitford]

I simply point out that it is available; it is just that funding has to follow from the domestic health board to pay for it. I have sent patients to Leeds for MRI-guided biopsy, and patients used to come to Glasgow to have eye melanoma removed without losing their eye. That already exists.

[Matt Hancock]

It happens on an ad hoc basis, but it is not a right. The NHS is a great British institution, and access should apply right across the board.

Finally, in my last few seconds, may I simply say how strongly I agree with my right hon. Friend the Member for Maidenhead (Mrs May) about amendments 93 to 98?

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Monday 14th June 2021 Commons Chamber

[Matt Hancock]

The goal is that the steps in the road map are irreversible; that is the goal, and I am sure it is a goal that my right hon. Friend agrees with. We have demonstrated repeatedly during this crisis our willingness to take difficult decisions if they are necessary and if they are needed by the data, but it is also important to try to take steps when we can have a good degree of confidence that we will then be able to deliver that irreversible route, as opposed to moving faster than that, which might lead to a reversal. I hope that that explanation is one with which my right hon. Friend and indeed the House can concur in terms of what we mean when we say that we seek an irreversible approach to the road map.

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

While hospitalisations and ICU admissions are, thankfully, not increasing as fast as covid cases, they are both rising significantly, so this delay was inevitable. According to Public Health England, the delta variant appears to be about 50% more infectious and reduces the protection against infection from one vaccine dose to just 33%. As a single dose is therefore less effective, by what date does the Secretary of State expect all adults to be fully vaccinated with both doses and would that not be a more appropriate time for the removal of all restrictions, rather than setting another arbitrary date when younger adults will not be fully protected?

So how did we end up here? Having ignored the Scottish Government policy of all arrivals undergoing hotel quarantine, the Secretary of State then delayed adding India to the UK’s red list at the same time as Pakistan and Bangladesh. He previously claimed it was because of greater positivity rates among travellers from Bangladesh and Pakistan but that is not borne out by the published data. Between 25 March and 7 April the test positivity of arrivals from India was 5.1%, lower than Pakistan at 6.2% but significantly higher than Bangladesh at 3.7%. Was the delay not just because the Prime Minister was still clinging to his plan for a trade visit to India? The whole point of border quarantine is to protect the UK from variants that might be more infectious or show resistance to vaccine-induced immunity, so having allowed the delta variant to enter and become the dominant strain in the UK, does the Secretary of State not recognise that the Government’s border strategy has failed?

[Matt Hancock]

I thought that the right hon. Member for Leicester South (Jonathan Ashworth) on the Opposition Front Bench was Captain Hindsight, but, seriously, this argument is completely divorced from reality. The data that the hon. Lady has just recommended to the House is data about what happened between 25 March and 7 April, and she complains about a decision the Government took on 2 April because we did not know of the data up to 7 April; so she brings to this House information from after a decision was taken and asks why it was not taken into account for that decision, and the answer is because it had not happened yet.

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 8th June 2021 Commons Chamber

[Matt Hancock]

My hon. Friend is quite right. The NHS is one of Britain’s proudest achievements. It operates across the whole of Great Britain and co-operation is ingrained in the DNA of the NHS. I am absolutely determined, as the UK Secretary of State for Health and Social Care, to ensure that, wherever people live in this United Kingdom, they can access the very best of care. If a constituent of my hon. Friend’s in Aberdeenshire needs a treatment that is only available in England because it is so specialised, they should have absolutely every right to that treatment, in the same way that a constituent of mine in Suffolk or a constituent in north Wales should. We have one NHS across these islands, and it is one of the things of which this country is most proud.

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

I am sure the Secretary of State is well aware that the Scottish NHS has been separate since 1948 and has been under direct Scottish Government control for the last 20 years, so there are actually four NHSs. Perhaps I can ask him about some of his decisions that have made it harder for the Scottish and other devolved Governments to fight covid. Last September, he refused to follow Scientific Advisory Group for Emergencies advice for an urgent lockdown, and the six-week delay allowed the more infectious B117 Kent variant to emerge and spread across the UK, driving a second wave more deadly than the first. He has repeatedly claimed to follow the science, so can he explain why he did not follow scientific advice last September?

[Matt Hancock]

Just on this point, this attempt at division within the NHS is deeply regrettable. It is not what people want. It is not what people want in Scotland. It is not what people want anywhere across the country. The NHS is an institution we should all be very proud of. Of course it is managed locally—it is managed locally across parts of England and it is managed under the devolution settlement in Wales and Scotland, as are health services in Northern Ireland, and rightly so—but it ill behoves politicians to try to divide the NHS. It is a wonderful institution that should make us all proud to be British.

On the specific question that the hon. Lady asked, of course we are guided by the science and take all factors into consideration. These are difficult judgments based on uncertain data, and we make the best judgments that we can. That is still the process we are going through, in the same way that the Scottish National party Government in Scotland have recently opened up parts of the rules in terms of social distancing, despite the rise in cases.

We face a challenging decision ahead of 21 June, but that decision is made easier by—indeed, the decision to open up is only possible because of it—the UK vaccination effort. Today marks six months to the day since Margaret Keenan in Coventry was the first person in the world to receive a clinically validated vaccine—the same day as Scotland, the same day as Wales. Since then we have delivered—

[Mr Speaker]

Order. It is not a statement, but an answer that we require. I call Dr Philippa Whitford to ask her second question.

[Dr Whitford]

I think the Secretary of State would find that most people in Scotland were rather glad that their NHS did not come under the Health and Social Care Act 2012 fragmentation. Having ignored the Scottish Government’s call in February for all arrivals to undergo hotel quarantine, he then delayed adding India to the red list. This allowed the more infectious Delta variant, which one dose of the vaccine is less effective against, to enter and become dominant in the UK. Is he not concerned that, if he removes all social distancing completely in the near future, the variant will cause a covid surge among those who are not fully vaccinated?

[Matt Hancock]

As I was saying, Mr Speaker—

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Monday 7th June 2021 Commons Chamber

[Matt Hancock]

On the latter point, I am very happy to look at how the case of my right hon. Friend’s constituent Laura Wilde can fit with the exemptions that already apply for travel for medical purposes, along with the testing regime, to ensure that that is done in a safe way. I am happy to talk to colleagues at the Home Office about allowing that to happen.

On my right hon. Friend’s first point, it is reassuring that there is such a clear breakage of the previously inexorable link from cases through to hospitalisations. That is very good news, and it is why we have this race to get everybody vaccinated as soon as possible. If I can address those people in their late 20s who will be able to book a jab from tomorrow and others who might feel that, in their age group, they are unlikely to die of covid, the honest truth is that the best way for us to get our freedoms back and get back to normal is for everybody to come forward and get the jab. It really matters that we all come forward and do this, because that is the safest way out.

On my right hon. Friend’s specific question about our thinking on the 21 June step 4, not before date, the honest answer, which I will give to any question about this, is that it is too early to say. I tried to give a studiously neutral answer on the TV yesterday, which some people interpreted as gung-ho and others interpreted as overly restrictive. That is the nature of uncertainty, I am afraid. It is too early to say. We are looking at all the data, and the road map sets out the approach that we will take, which is that there is step 4 and then there are four distinct pieces of work, which are reports on what should happen after step 4 on social distancing, international travel, certification and the rest. We will assiduously follow the road map process that has been set out with the five-week gap—four weeks to accumulate the data, then taking a decision with a week to go. The Prime Minister will ultimately make those decisions and announce them in a week’s time.

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

I note that the Secretary of State is still considering ending all social distancing measures on 21 June, but does he not think that that would be dangerous in the face of rising cases of the significantly more infectious delta variant? Would it not be better to adhere to the Government’s mantra of being guided by data and not dates?

While it is welcome that half of adults are fully vaccinated, and Scotland has already started vaccinating those over 18, the Secretary of State must be aware that one dose of the current vaccines only provides 33% protection. Does he accept that that means we cannot rely on single dose vaccination to control this variant without social distancing measures? I and many other MPs repeatedly called for hotel quarantine to be applied to all arrivals in the UK to prevent exactly the situation we now face. He repeatedly claimed that home quarantine was working, but does he not accept that the importation and now dominance of the delta variant shows that is not true? With the current rise in cases of the delta variant threatening the progress made during almost five months of lockdown, does he regret the decision to delay adding India to the red list?

In light of the disruption caused by the shambles of changing Portugal’s classification this week, does the Secretary of State recognise that it has done neither holidaymakers nor the travel industry any favours? Will he now get rid of the traffic light system and tighten border quarantine policy so that we can avoid importing more vaccine-resistant variants and safely open up our domestic economy and society?

The Secretary of State talked today about the UK vaccinating the world, so can he say how many doses the UK has donated to COVAX? Does that mean the Government will support the sharing of intellectual property and technology and the trade-related intellectual property rights—or TRIPS—waiver so as to increase global vaccine production?

[Matt Hancock]

There is quite a lot that needs sorting in that. The first thing I would say is that the hon. Lady complains that I acted on Portugal when we saw the data, yet she complains that I did not act on India before we had the data. She cannot have it both ways. She asked me to follow data not dates, but then asked me to prejudge the data by making a decision about 21 June right now. I am a bit confused about that one, too, because I notice that the Scottish Government have themselves been reopening. That is a perfectly reasonable decision for the Scottish Government, but it is a bit rich then for the SNP spokesman to come to this House and have a go at us for deciding to look at the data over the next week, rather than prejudging that decision. It is quite hard to listen and not respond to explain what is actually going on.

The third point I will make is on international vaccination. Absolutely this country has stepped up to the plate. Of the 2 billion doses delivered around the world, half a billion have been the Oxford-AstraZeneca vaccine, which was developed by AstraZeneca and Oxford, with UK taxpayers’ money. It is, as I put it in my statement, a gift to the world. Of course we do not rule out donating excess doses as and when we have them, but only when we have excess doses, and I am sure the hon. Lady will accept that position is agreed not only by the UK Government, but by the devolved Administrations, because we all want to make sure that the people whom we serve get the chance to be vaccinated as soon as possible. That is our approach.

Finally, when it comes to intellectual property, we support intellectual property rights in this country. We could not get drugs to market in the way we manage to without support for intellectual property, because it is often necessary to put billions of pounds into research in order to get the returns over the medium term. What we did, more than a year ago, was agree with Oxford and AstraZeneca that there would be no charge for the intellectual property rights on this vaccine right around the world, and I am delighted that others are starting to take the same approach. Last month, Pfizer announced that in low and lower middle-income countries, it will not charge intellectual property, but we have been on this for more than a year now, so it is a bit rich to hear a lecture from north of the border.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Monday 17th May 2021 Commons Chamber

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

Covid cases in India began to soar at the start of April, so why were Pakistan and Bangladesh added to the red list at that time but not India? Was it because of the Prime Minister’s planned trade visit? After India was finally added to the red list on 19 April, the restrictions did not take effect until 23 April. How many people arrived from India in those days, trying to escape having to go into hotel quarantine? When I previously raised the issue of applying hotel quarantine to all travellers, the Secretary of State claimed that the current system was protecting the UK; does he now accept that the entry and community spread of the Indian variant shows that that simply is not the case and that having a negative test does not rule out the possibility that travellers are carrying covid?

The Scientific Advisory Group for Emergencies has stated that evidence shows that the B1617.2 Indian variant is up to 50% more infectious than the Kent variant and has advised that, as in Scotland, areas with rising numbers of cases should remain under covid restrictions. The Indian variant has been doubling every week despite lockdown, so why is the Secretary of State ignoring SAGE advice and opening up areas like Bolton that have exponential growth?

Thankfully, the Indian variant does not show significant vaccine resistance, but the Secretary of State must know that it is not possible to outrun the virus through vaccination alone. As those aged up to 35 are not eligible for surge vaccination, that leaves a large pool of unvaccinated people among whom the variant can spread. It will take two to three weeks before even those who receive a vaccine in the coming weeks are protected. Does the Secretary of State not accept that the variant is in danger of surging and that without local travel restrictions it will spread to other areas? It is good news that fully vaccinated people are not ending up in hospital, but just letting the virus spread among young adults could allow the evolution of yet another UK variant.

[Matt Hancock]

I answered those questions in response to the right hon. Member for Leicester South (Jonathan Ashworth). The truth is that when we put Pakistan and Bangladesh on the red list, positivity among those arriving from those countries was three times higher than it was among those arriving from India. That is why we took those decisions and, of course, they were taken before the Indian variant became a variant under investigation, let alone a variant of concern. It is striking that the Scottish Government took the decision to put India on the red list at the same time as we in the UK Government did. It is all very well to ask questions with hindsight, but we have to base decisions and policy on the evidence at the time.

When it comes to how we are tackling the virus in the UK, the hon. Lady is quite right that it is good news—albeit early news—that the vaccines do appear to be effective against the B1617.2 variant. I am obviously pleased about the evidence we have seen but we are vigilant about that. I am glad that the approach we are now taking in Bolton and Blackburn worked against the South African variant in south London. We always keep these things under review, but I think that as a first resort, surge testing, going door to door, ensuring that we find and seek out the virus wherever we can spot it, and putting in the extra resources with the armed services who are supporting us, are the right approaches while we keep this under review. The numbers thus far nationally are still relatively low and, thankfully, we have a very good surveillance operation across the UK so that we can spot these things early and take the action that we need to.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Monday 19th April 2021 Commons Chamber

[Matt Hancock]

We will certainly consider that. I have seen the letter. We have discussed the question. I would add that we have a record number of doctors in this country, in part thanks to the work that my right hon. Friend put in place when he was in my shoes. We have a record number of nurses—more than 300,000 for the first time in the history of the NHS. We do need, of course, to look to the future and ensure that we are preparing for it, as the letter suggests. We also need to ensure that we keep driving the project of delivering 50,000 more nurses in the NHS over this Parliament. I look forward to giving him a more substantive response, but I hear his encouragement to ensure that we take steps in that direction.

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

While the vaccine programmes across the UK are going well, vaccine-resistant variants remain a major threat. I welcome that the Prime Minister has now called off his visit to India due to its devastating surge in covid. Cases of the B1617 Indian variant in the UK are still very low, but they have been doubling every week, despite lockdown, suggesting that like the Kent variant it is much more infectious than the original virus. I therefore welcome India’s being added to the red list to reduce further importation.

Will the Secretary of State not now consider extending hotel quarantine to all arrivals, as travellers from red list countries can currently avoid it by coming via a third country? We have already seen increased numbers of the South African and Brazilian variants in European countries, from where travellers are not placed in hotel quarantine, and more infectious or vaccine-resistant variants could emerge in any country. We simply would not know about it until it was too late.

The pandemic is still accelerating, and as well as causing appalling suffering and death in other countries it clearly poses a threat to the people of the UK. Does the Secretary of State not recognise the need for a more co-operative, global response to covid if we are to bring the pandemic under control and allow a safer return to international travel and commerce?

[Matt Hancock]

I certainly agree with the hon. Lady on her final point, on international collaboration and working together, which, along with the Foreign Secretary and the Prime Minister, we are working incredibly hard on. We are using the UK’s presidency of the G7 and the enthusiasm of the new Administration in Washington to try to drive international collaboration, in particular collaboration among like-minded democracies in favour of an open and transparent, science-led response to pandemics. I hope that she will concur with that approach.

On the new variants of concern, it is important when looking at the numbers to distinguish between community spread and spread connected to travel. By taking the action that I have just announced to put India on the red list, we are restricting yet further the likelihood of incursion from India of somebody with a new variant. However, the majority of the cases that we have seen already in this country have been picked up by the testing that we have in place now for every single passenger entering this country. That is a sign of the system working, and it is now being strengthened.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Tuesday 2nd March 2021 Commons Chamber

[Matt Hancock]

Transparency has played a vital role in our approach to responding to this virus, and I think that is an important lesson from it that should be heeded globally. In terms of the future of the NHS arranged around the ICSs, that transparency will be important, too. There will be a crucial role for the Care Quality Commission, which currently rates hospitals according to, as my right hon. Friend put it, an Ofsted-style rating. It is vital that the CQC has a similar role when it comes to ICSs, and I look forward to working with him and other members of his Committee to make sure that we get the details of that right.

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

Although the number of cases of the Brazilian variant is thankfully small, it is a warning that being tested in advance does not rule out travellers carrying covid. The South African variant is resistant to antibodies in previous covid patients, and there is concern that both variants may be resistant to vaccine-induced immunity and could therefore undermine the success of the vaccination programme.

The Brazilian variant has already been identified outside South America, and the South African strain is present in 35 countries not on the red list. The arrival of the Brazilian strain via both Switzerland and Paris demonstrates the various routes to the UK from high-risk countries and shows how a traveller can avoid the current hotel quarantine system by separating the legs of their journey. Those infected spent several hours in close quarters with other travellers, who would not be subject to hotel quarantine even now.

I assume that the Government are tracing the passengers from the flights, but with genomics taking some time, the window for worrying variants to get a foothold in the UK before they are discovered is significant. The situation would not have arisen with comprehensive hotel quarantine, as advised by SAGE, so why did the Secretary of State agree to such an inadequate system? Can he tell us the view of the Joint Biosecurity Centre? Does he recognise that quarantining just 1% of international arrivals does not protect the UK from these variants, or protect it from those that may evolve in other parts of the world? Will the Government now review their hotel quarantine policy and make it fit for purpose?

[Matt Hancock]

The hon. Lady is completely wrong, and she knows it. Quarantine is in place for 100% of passenger arrivals in this country. In fact, this episode, in which all those we have successfully contacted—all five—have fully isolated and quarantined at home as required, demonstrates that the policy is working. We have further strengthened it and introduced hotel quarantine, and that will no doubt give further reassurance. The hon. Lady’s characterisation is wrong, and some of the descriptions of the organisations involved are wrong as well. I am happy to ensure that she gets a private briefing so that she can understand the situation in future.

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 23rd February 2021 Commons Chamber

[Matt Hancock]

My hon. Friend is absolutely right to make this link, because not only are the vaccines important to keep each individual safe—we saw wonderful data yesterday about how effective they are at reducing hospitalisations and deaths—but the vaccination programme is crucial to the road map out of this pandemic. It is only because of the success of the vaccine programme that we are able to set out the road map in this way. The vaccine is good for the individual, but it is also good for all of us, because by taking a vaccine people are helping to protect themselves and helping all of us to get out of this pandemic situation.

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

The provision of insufficient doses for care home staff to be vaccinated at the same time as elderly residents may have contributed to the fact that only two thirds have been immunised. As well as the convenience, the solidarity of being vaccinated with colleagues has helped to encourage uptake of 94% in Scotland. Will the Secretary of State ensure that staff can get vaccinated when second doses are delivered to care homes?

[Matt Hancock]

Yes, when the vaccination programme goes to a care home, vaccines are offered both to residents and to staff, of course. We want to support the ability of more and more people to access the vaccine, and that includes care home staff. People who work in a care home can now go on to the national vaccination site and book themselves an appointment. Alternatively, when we go to give the second dose to residents, any staff who have not yet taken up the opportunity of a vaccine will have the offer of getting going on the programme. I hope that care home staff and NHS staff across the board will listen to the words of the chief medical officer, who said that it is the “professional responsibility” of people who work in care settings to get vaccinated. It is the right thing to do.

[Dr Whitford]

More vaccine-resistant strains, such as the South African variant, could risk undermining the UK’s vaccine programme. As they could come via any country, does the Secretary of State not agree that all travellers should undergo strict quarantine?

[Matt Hancock]

Yes, I do. All those who arrive in this country as passengers need to undergo quarantine, and we have both the hotel quarantine and home quarantine; all need to be tested; and all the positive test results are sent for sequencing so that we can spot any new variants. This is a critical part of our national defences. The good news is that we can see from the data that the number of new variants in the country is falling and is much lower than it was last month. We obviously keep a very close eye on that, because making sure that we do not have a new variant that cannot be beaten by the vaccine is a critical part of the road map, as set out by the Prime Minister yesterday.

Future of Health and Care

Debate between Matt Hancock and Philippa Whitford

Thursday 11th February 2021 Commons Chamber

[Matt Hancock]

I pay tribute to my predecessor’s work setting up integrated care systems in the first place. In a way, this legislation builds on the foundations that he laid when he was in my job, and I look forward to working with the Health and Social Care Committee on the legislation as it proceeds. We have already had discussions, and I am grateful for the Select Committee’s work so far and the insights it has provided.

The question my right hon. Friend raises about the accountability of ICSs is absolutely central, not just to accountability for the use of taxpayers’ money, but to driving up both the quality of care for patients and the health of the population the ICSs serve. It is critical that we ensure the correct combination of high levels of transparency, the role of the CQC as inspector, and accountability up from the ICS, through NHS England, to Ministers and therefore Parliament, and through our democratic processes to taxpayers. The White Paper sets out at high levels how that accountability will work. The details will be a matter for the Bill. The combination of transparency and clear lines of accountability are vital to make sure that while we use the integration provided for in the Bill to empower frontline staff to deliver care better, they are held to account for the delivery of that care and, critically, the outcomes for the population as a whole whom we serve.

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

Health and social care staff always do their best for their patients and residents, regardless of legislative systems, but I welcome the Government’s recognition of the damage caused to the NHS in England by the Health and Social Care Act 2012, and the proposal to reverse some of its most obstructive and expensive aspects, particularly section 75, which forced the outsourcing of services, promoted competition instead of collaboration, and made pathways more disjointed and confusing for patients, especially those with complex conditions. The devil, however, will indeed be in the detail.

Which model of integrated care is the Secretary of State proposing? Will he merge organisations, including commissioning groups, or, as the NHS would prefer, create new public NHS bodies, similar to the health boards we have in Scotland? When sustainability and transformation partnerships were created, their transformation budgets were quickly used up in covering debts caused by the bureaucracy of the healthcare market, so what additional funding is he committing to bring about this reorganisation? Given the pressure of covid, the backlog of urgent cases, and extensive staff vacancies, how does he plan to create the capacity for staff to carry out such service change? Covid has highlighted the vulnerability of the care system, so what plans are there to integrate health and social care?

Finally, the Secretary of State has highlighted health inequalities, but poverty is the biggest driver of ill health. What discussions has he had with the Secretary of State for Work and Pensions and other Cabinet colleagues about promoting the prioritisation of health in all policy decisions?

[Matt Hancock]

Of course health is an important consideration in all policy decisions. The overall response to the pandemic has demonstrated that.

The hon. Lady is right to raise the issue of integration and to ask what plans there are for the integration of health and social care. Indeed, that is at the core of the proposals, as I set out clearly in my statement, and at the core of the White Paper. The integration of health and social care has improved significantly this year as a result of people having to work together in the pandemic. Fundamentally, social care is accountable to local authorities, which pay for it, and therefore to the local taxpayer, whereas the NHS is accountable to Ministers and central Government. The combination of these two vital public services is a challenge that I think can be addressed through the integrated care systems. We have been working very closely with the Local Government Association in England and the NHS to try to effect that integration as much as possible.

The hon. Lady raises the issue of funding. Of course, the NHS has record funding right now, and rightly so, but these reforms are about spending that money better to improve the health of the population, to allow new technology to be embraced, and to remove bureaucracy. It is not about having to spend more money on a reform; it is about reforming in order to spend money as well as possible.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Tuesday 2nd February 2021 Commons Chamber

[Matt Hancock]

My right hon. Friend knows that we set out in our manifesto, committed in the manifesto and were elected on a manifesto to resolve the long-standing problems in social care. The Prime Minister has set out to the Liaison Committee, of which my right hon. Friend is a member, the timetable on which he hopes that we are able to deliver that commitment. Alongside dealing with this pandemic, we are working to deliver our manifesto commitments, whether on social care or the 40 new hospitals or the 50,000 more nurses. I look forward to being held to account by the Select Committee on Health and Social Care on those commitments.

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

I associate myself with the Secretary of State’s comments on HIV test week, but it is concerning to hear that over 100 cases of the South African variant have been detected in the UK, particularly as they do not represent a single outbreak, but are widely scattered across England. The concern, of course, is that while current vaccines will still give a significant degree of protection, this variant’s resistance to some covid antibodies could reduce their effectiveness, so does he plan to tighten internal travel restrictions to avoid it spreading across the UK as happened with the Kent variant?

Will there be increased random genomic testing of PCR specimens outwith those areas to identify just how widespread it already is? Unfortunately, this is shutting the barn door after the horse has bolted. The Government have been aware of the concern about this variant for some time, and the SAGE advisory group warned that limited travel bans would not be enough to keep out new covid variants and that the only way to stop them would be mandatory quarantine for all arrivals, so why did the Government choose not to follow that advice? This variant is already present in many countries and new, more resistant covid variants could evolve anywhere in the world, so will the Government reconsider their very minimal quarantine plan and extend it to all incoming travellers? As new strains brought in through holiday travel last year contributed to the second wave of covid, is the Prime Minister seriously suggesting that people should go abroad on holiday this summer?

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 12th January 2021 Commons Chamber

[Matt Hancock]

There are very significant pressures on the NHS. On the specific question about oxygen supplies, the limitation is not the supply of oxygen itself; it is the ability to get the oxygen through the physical oxygen supply systems in hospitals. That essentially becomes a constraint on an individual hospital’s ability to take more covid patients, because the supply of oxygen is obviously central to the treatment of people with covid in hospital. As we have a national health service, if a hospital cannot put more pressure on its oxygen system, we take people to a different hospital. I assure the hon. Gentleman that there is no constraint that we are anywhere near on the national availability of oxygen—oxygenated beds. As he knows and as we have seen reported, sometimes patients have to be moved to a different location—as local as possible, but occasionally across the country—to ensure that they get the treatment that they need.

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

Yesterday, the Secretary of State revealed that only a quarter of care home residents in England had been vaccinated against covid, despite being the No. 1 priority group. Can he explain why they were not the first cohort to receive the Pfizer vaccine in December, as was the case in Scotland?

[Matt Hancock]

That is not quite right. I am glad to report that care home residents have been receiving the Pfizer jab. That is harder—logistically more difficult. Looking at the total roll-out of the programme, I am delighted that, as the hon. Lady says, over a quarter of people who are residents in care homes are now able to get the jab, and that number is rising sharply.

--- Later in debate ---

[Dr Whitford]

As the Secretary of State highlighted earlier, primary care networks will play a major role in rolling out the vaccine in England, but we have heard previously from MPs that not all areas are covered by such networks. How does he plan to avoid a postcode lottery and ensure equitable access, with outreach into vulnerable ethnic or deprived communities?

[Matt Hancock]

Some 99% of GP surgeries are members of primary care networks. The very small minority that are not are being dealt with to ensure that we have fair access to vaccines, and they will of course be covered by invitations to the large vaccination sites as well.

I agree strongly with the hon. Lady that it is vital that we reach into and support those communities who may be more distant and harder to reach both geographically and, in some cases, culturally. The NHS is very well placed to do that and is one of the most trusted public services in encouraging those from all backgrounds to take the jab. Pharmacists, too, will play a vital role in the outreach programme.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Wednesday 30th December 2020 Commons Chamber

[Matt Hancock]

I share my right hon. Friend’s desire and the strategy of keeping this virus supressed while we get the vaccine rolled out as fast as possible. One of the other good pieces of news from this morning’s announcement is that we can roll this vaccine out faster because we only need to give the second dose after 12 weeks; that means that we can get the first dose of the vaccine into more people. The data shows that that gives that immunity, so we can get through the protection of the nation faster than we previously could have done.

The points that my right hon. Friend raises about education are of course important. The Education Secretary will set out in a statement shortly the details of how we will manage the very difficult balance between needing to keep children in education as much as possible and ensuring that we do not add upward pressure on the R number and spread the virus any further. I commend to him the Education Secretary’s statement.

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

As chair of the all-party parliamentary group on vaccinations for all, I absolutely welcome the authorisation of the AstraZeneca vaccine. Storage in normal fridges will make it much easier to deliver here, and particularly so in low and middle-income countries, which would have struggled to maintain the cold chain at -70°, as required for the Pfizer vaccine.

Delivering the vaccine will still be a herculean task for all four UK health services, and they will struggle if they are also dealing with surging covid cases. Hospitals in London and the south-east are already reporting shortages of critical care beds and even oxygen, so there is an urgent need to get the new variant under control. Does the Secretary of State recognise that, when dealing with a spreading infection, getting ahead of it is critical? Taking action only once cases in an area are soaring is simply too late to bring it under control. All three devolved nations are already under level 4 restrictions to try to prevent the new variant from getting a grip and getting out of control. Given the greater levels of the new variant in England—as the Secretary of State just stated, cases are rising everywhere—does he not think it is time to put the whole of England under tightened tier 4 restrictions?

[Matt Hancock]

I have just announced the need to move a significant proportion of England into tier 4 restrictions, and I welcome the implicit support for that measure. Where it is possible to keep some of the freedoms that we all cherish, we should do so, and that is the basis for our tiered approach.

I of course welcome the hon. Lady’s support for the roll-out of the Oxford-AstraZeneca vaccine, which will happen right across the UK from Monday. It has been a pleasure working with Jeane Freeman, the SNP Government’s Cabinet Secretary for Health in Holyrood, to ensure that this vaccine, which has been bought, developed and supported effectively by UK science right across the country, can be deployed properly to everybody in the whole of the UK on a fair and equitable basis according to their clinical need. I look forward to working very hard to make sure that happens.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Monday 14th December 2020 Commons Chamber

[Matt Hancock]

First, on my right hon. Friend’s question about the new variant, it is being assessed in Porton Down right now. As I said in my statement, the medical advice that we have is that it is highly unlikely that this new variant will impinge on the impact of the vaccine, but we will know that in the coming days and weeks as the new strand is cultured at Porton Down and then, of course, tests are conducted on it.

My right hon. Friend’s question about Christmas shopping is important. It is recommended that people should minimise travel, unless it is necessary, in a tier 3 area, and should minimise travel, unless it is necessary, to a tier 3 area. We have taken this action to try to protect people and to try to slow the spread of this virus, and that is absolutely the right thing to do.

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

Many public health experts have questioned the use of Innova lateral flow tests for mass community testing, especially as the manufacturer does not recommend them for detecting coronavirus in people who are asymptomatic. The Secretary of State must be aware of the paper from the University of Liverpool, based on his own Department’s quality assurance programme, which has raised serious concerns about their accuracy when used in the community testing project in Liverpool. A comparison of lateral flow tests with PCR tests in over 3,000 people revealed a sensitivity of just 48%, meaning that more than half of those with the virus would be falsely reassured that they were negative. The test even missed 30% of those with a high viral load—those most likely to be infectious.

I understand the wish to use quick tests for case finding, but surely the Secretary of State should now delay rolling them out to 67 other local authorities and should not proceed with plans to spend £43 billion for a test that is so inaccurate. Would it not be better to focus funding on easier and quicker access to PCR tests? With more than half of all positive cases being missed, does he accept that despite the proposal by Baroness Harding, these tests cannot be used to release people who are contacts from isolation? On the basis of that study, the Liverpool health protection board has abandoned plans to use lateral flow tests to check visitors to care homes, so will the Secretary of State be recommending that local authorities and providers should return to PCR testing for care home staff and family visitors to reduce the risk to the most vulnerable residents?

[Matt Hancock]

I think that this argument against testing is wrong. I think that we should test, test, test, and that is what this Government are doing. We are working very closely with the Government in Scotland, from the same party that the hon. Lady represents, to make sure that we use testing as widely as possible to find people who have this virus. Yes, of course different tests have different characteristics. The lateral flow tests find around 70% of those who are infectious. That means that if we test people who would not otherwise have been tested, we find the positive cases, we can get them to isolate and we can break the chains of transmission. I strongly urge the hon. Lady to go back, to study the details and to back the testing programme that we have in this country.

Coronavirus Vaccine

Debate between Matt Hancock and Philippa Whitford

Wednesday 2nd December 2020 Commons Chamber

[Matt Hancock]

Dealing with the pandemic has been a case of dealing with uncertainty in large degree. Today we have more certainty because we know this vaccine is safe and effective, but just as I said to the hon. Member for Leicester South (Jonathan Ashworth) that we do not know the effect of the vaccine on transmission, so, as my hon. Friend says, we do not know the longevity of its effectiveness.

My hon. Friend is right about another part of public health advice that all of us as local representatives can play a part in promoting: that is, engagement with contact tracing. I will write to him about access to daily data in Essex. Of course we have to wait until the test result comes in, which can sometimes lead to delay, even though the results of the majority of tests done in person now come back within 24 hours, but I agree with him in principle, so let us make it a reality in practice.

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

As chair of the all-party parliamentary group on vaccinations for all, I welcome the authorisation of the Pfizer vaccine and echo the shadow Secretary of State’s call for a public health campaign to encourage uptake. It will naturally take some time before the vaccine is widely available, so we all still need to stick to the rules and ensure that we can test, trace, isolate and support all those carrying the virus.

Last week, the Secretary of State claimed that the pilot project of mass testing in Liverpool was responsible for driving down cases, despite the city having been under lockdown for much of the time. Lateral flow tests miss up to 40% of cases, so the Government’s plan to use them to free people from isolation are causing concern among many public health and screening experts. When will the formal assessment of the pilot be published, and how can he justify already putting out tenders for £40 billion-worth of contracts to extend that approach without scientific evaluation? Would it not be better to invest some of that money in getting the traditional test, trace and isolate system working properly? Six months on, the Serco and Sitel system has still not improved, and over 40% of contacts in England are still not being informed that they should be isolating.

The Secretary of State does not often talk about it, but he knows that it is not testing but isolation that stops the spread of the virus, so if people who are carrying the virus are not isolating, no amount of mass testing will stop the spread. When I raised the King’s College London report last week which found that less than 20% of cases and only 10% of contacts were isolating, the Secretary of State claimed that the Government have data showing much higher compliance. Can he tell us the figures for isolation rates for those with covid and their contacts? People will not stay off work if it means that they cannot feed their family, so is he concerned at reports that many requests for the isolation payment are being refused? How will he ensure that those carrying the virus are financially supported to isolate and reduce its spread?

[Matt Hancock]

The hon. Lady says that I do not talk about contact tracing very much. I was literally answering a question on contact tracing just before her question— I talk of little else. We are publishing further data tomorrow on contact tracing, precisely in response to the question that she asks. She will see that the continued improvement of our contact tracing across the country is advancing further. I cannot say any more than that, because the figures are not being released until tomorrow.

The hon. Lady asked about scientific evaluation. We are constantly scientifically evaluating the work that is going on, especially in Liverpool. That is one of the things that the scientists who work as part of my team, in NHS Test and Trace and in Public Health England do. It is a matter of constant scientific evaluation, but we will not wait until ages after something has finished to do an overly long evaluation. We have to evaluate as we go along, because we are constantly trying to improve the response to this pandemic, and we are constantly trying to learn. I urge her to support the approach of constant learning and constant improvement. We will have to do that through the roll-out of the vaccine too.

[Dr Whitford]

indicated dissent.

[Matt Hancock]

The hon. Lady shakes her head, but that is how we have to deal with a pandemic in practice.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Thursday 26th November 2020 Commons Chamber

[Matt Hancock]

I hesitate to interrupt the love-in between the Prime Minister and my predecessor, but I am grateful for his support—for their support. This is a set of difficult measures, but I think the public understand why we have to take them and why they are necessary.

On the point about getting visiting going in care homes, my right hon. Friend is absolutely right. Sometimes we talk about these tests and this new technology in an abstract way or from a scientific point of view, but it really matters and it really improves people’s lives. Where we can use testing to make visiting safe in care homes, that is an example of the way in which these new technologies can help to get life a little bit back towards normal. Of course, it must be done in a safe way and carefully, but we are now developing the protocols for exactly how that can happen and working hard with the goal that everyone should have the opportunity to visit a loved one in a care home before Christmas.

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

Many scientists have expressed concern that the easing of restrictions at Christmas could lead to another surge of covid cases in January. With cases still over 80% of the level at the start of lockdown, is the Secretary of State not worried that allowing outdoor events of 2,000 participants and indoor events of 1,000 in level 2 high-risk areas could drive up infection rates ahead of Christmas? Although lateral flow testing is very welcome, given how it increases capacity, the Secretary of State previously stated that the mass testing in Liverpool was a pilot and would be evaluated before being rolled out elsewhere. As the city has also been under tight restrictions and then lockdown, how will the impact of mass testing alone be evaluated? How does he plan to counter the lower uptake among deprived communities—the very ones at highest risk, as seen in Liverpool—and with no clinical evaluation yet published, how can he justify putting out contract tenders for an eye-watering £43 billion and rolling out this approach to 67 other areas? Should this strategy not be compared with investing money and energy in getting the traditional test, trace and isolate system working properly? Currently, over 40% of contacts in England are still not even informed that they should be isolating.

Finally, the Secretary of State knows that it is not testing, but isolation, that stops the spread of the virus. If people who are infected or could be carriers are not isolating, no amount of testing will stop viral spread. A study by King’s College London that suggested that fewer than a quarter were isolating when advised was incredibly worrying, so what assessment are the Government doing to clarify current isolation rates and understand the reasons why people may not follow the advice they are given?

[Matt Hancock]

Of course, we are constantly evaluating the impact of people isolating, and how many people isolate when asked to. I would encourage the hon. Lady to look at a broader range of studies than just that one from King’s College, especially those dealing with the self-isolation of those who test positive, for whom the rate tends to be higher.

The hon. Lady asked about the use of these lateral flow tests to have a negative impact on the number of cases in an area. Of course, we have been evaluating this all the way through the study in Liverpool, which is why we can have confidence in rolling out more broadly across tier 3 areas. I included in my statement a high-level assessment of this. The number of cases in Liverpool city region is down by two thirds, but in the city itself, where the testing took place—the testing was of people who live in the city and of people who work in the city and live largely in the wider city region—the number of cases is down by over three quarters. That is one piece of evidence. It is clear that it is the combination of people following the rules and community testing, with appropriate incentives to get people to take up that mass community testing, that can help to make this work. We want to work with local directors of public health to understand how this can work effectively in their areas, precisely to reach those hard-to-reach people whom the hon. Lady mentioned.

Finally, I echo the hon. Lady’s request that we be cautious this Christmas. However, I am delighted that we have agreed an approach across the whole UK, including with the SNP Administration in Edinburgh, with the Welsh Labour Administration and the cross-party Administration in Northern Ireland, because there are so many ties that bind us together and mean that we are stronger as one United Kingdom, working together to tackle this virus.

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 17th November 2020 Commons Chamber

[Matt Hancock]

Throughout the process of the tiered system, we have always looked at a level of granular detail, whether at district council level or, indeed, ward level in some cases, to make sure that we have the appropriate measures in the appropriate places. While it is too early to say exactly how we will proceed from 3 December, that is a commitment that I can make to my hon. Friend.

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

As I have highlighted previously, covid is spread not just by droplets but by airborne particles, so good ventilation is key to reducing the risk of spread indoors, such as in hospitality. On 20 October, the Secretary of State agreed to speak to the Chancellor about removing VAT from ventilation and air-purification systems to make them more affordable. Can the Secretary of State tell us what discussions he has had with the Chancellor and what the outcome was?

[Matt Hancock]

There has been work on promoting ventilation in government. The hon. Lady is absolutely right that ventilation is important and that the scientific evidence on the aerosol transmission of coronavirus has strengthened over recent months.

[Dr Whitford [V]]

If that is the case, can the Secretary of State clarify whether we will hear an announcement from the Chancellor in the near future on supporting the installation of such systems? Even with the good news about potential vaccines, it will be a long time before most of the population are vaccinated, so what is the Secretary of State’s strategy to control covid over the coming year?

[Matt Hancock]

Our strategy is to suppress the virus and support the NHS and the economy until a vaccine can make us safe. Increased ventilation can help to reduce transmission, so it is an important consideration, among many others, for how we tackle this disease.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Tuesday 10th November 2020 Commons Chamber

[Matt Hancock]

I am grateful to my right hon. Friend. He is generous with his words. I also direct his warm words of gratitude to the vaccine’s taskforce, which has done so much work to ensure that we procure and secure the supplies of these vaccines, should they prove safe as well as efficacious. On Sir John Bell’s comments, that option of testing people regularly—not if they are a primary case and have the virus, but if they are a contact—would not be open to us had we not secured the huge capacity for lateral-flow testing that we now have in this country. I very much look to clinicians for advice. Sir John Bell is a highly respected clinician and expert in this area, and I am sure that everybody will want to look closely at that issue.

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

With three and a half weeks left of the current lockdown in England, what does the Secretary of State plan to change so that covid-19 does not get out of control again when restrictions are eased? He mentions the pilot project of population testing in Liverpool, using newly developed lateral-flow tests, but there are not yet published sensitivity or specificity data for those tests. What is the risk of false negative or false positive results? Has the UK National Screening Committee been involved to help assess the risks, benefits, and costs of such mass population testing?



I welcome the progress made on the Pfizer vaccine, but it will take time before it is widely available, and, as the Secretary of State said earlier, we do not yet know if it will reduce transmission, so it does not remove the need to control viral spread using current measures. While I also welcome the expansion of PCR testing, I am sure he recognises that what matters is not just the number of tests available but that testing is part of a test, trace, isolate and support system for it to be effective. Five months on, Serco is still struggling to reach even 60% of contacts, so will he copy the more successful approach of the devolved nations and fund local public health teams to lead contact tracing in their areas?

An effective test and trace system can identify those carrying the virus rather than isolating everyone in a lockdown, but it is isolation that actually breaks the chains of infection. Is the Secretary of State therefore concerned that so few people are isolating when they should? How can that be improved? People will not stay off work if that means they cannot feed their family, so how will he make access to the Government’s isolation payment easier?

[Matt Hancock]

Of course, we are working to ensure that, by us all working together and making sacrifices, we can come out of this lockdown and into the tiered approach we had in place beforehand. That is the goal, and the more that people follow the rules during the lockdown, the more effective it will be. We obviously monitor the data closely on that.

The hon. Lady asked about lateral flow tests and their sensitivity and specificity, which is an incredibly important question. The assessment of the tests we are using in Liverpool and now rolling out elsewhere was made at Porton Down. We then tested 5,000 lateral flow tests alongside 5,000 polymerase chain reaction tests of the same people in the field, and we have a high degree of confidence that they can find people who are infectious. In fact, the lateral flow tests have a lower false positivity issue than the PCR tests, so they are very effective for the right uses, including mass population testing.

The hon. Lady asked about isolation. Of course, isolation is important. I would mention that we have test and trace systems in place across the UK and it turns out that there are differences in how a successful contact is measured. In England, we are much stricter in requiring contact to be a confirmed contact with somebody rather than just sending them a message, which does count as contact in some of the devolved and local systems. It is really important that we measure the same thing, rather than trying to make divisions where divisions do not exist.

Finally, it is vital that people isolate when they test positive or when they are asked to by NHS Test and Trace. I gently say again that the 20% figure is not particularly robust, because it implies that 80% of people are not doing anything to isolate. That is not what the survey found. Nevertheless, we should all urge and require people to follow the rules. When someone tests positive, they must isolate, and contacts must isolate. That is part of our social duty.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Tuesday 20th October 2020 Commons Chamber

[Matt Hancock]

I strongly agree with my hon. Friend, who puts it very clearly: the people of Greater Manchester would expect their local leaders to come to the table. That offer of support for local businesses remains there, alongside the support for strengthening test and trace and enforcement in Greater Manchester. I urge all the leaders of the nine boroughs of Greater Manchester to pick up the phone and work with us to make sure we can deliver this. Of course, that offer remains open for the Mayor if he wants to return to the table.

On the point about the testing in Worthing, I will absolutely look into whether there was a specific problem. The test turnaround times have come down as the capacity has rapidly expanded, and I will make sure I get back to my hon. Friend as soon as possible.

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

While there may be a small minority who do not think of those around them, the majority of people try to follow the advice to reduce the spread of covid. We know that the virus spreads where people are in close contact. This is about not just pubs and nightclubs; it includes those in overcrowded housing, those in exposed jobs where working from home is not an option, and those on zero-hours contracts who simply will not get paid if they are not working. Does the Secretary of State not think it is a bit inappropriate for politicians with well-paid and secure jobs to suggest that rising covid cases in certain areas are just due to some form of misbehaviour requiring tougher penalties?

People want to do the right thing, whether due to restrictions or because they are infected themselves, but sometimes they feel that they have no option but to continue going out of the house. Although in general surveys the vast majority of people say that they would isolate if they caught covid, a study from King’s College London shows that less than 20% of those who develop symptoms go on to isolate. That was associated with financial hardship, social deprivation, having dependent children and working in key jobs that cannot be carried out from home. Why is the Chancellor not continuing the full furlough scheme when we are heading into a second wave and the hardest winter that the NHS will ever have faced? There are still millions of people who have not received any support since March. Does the Secretary of State not recognise that, for those on low wages and in insecure work, the choice between staying at home and feeding their family just does not feel like a choice at all?

[Matt Hancock]

I agree with the hon. Lady that the majority of people try to follow the advice, and that the vast majority of people want to do the right thing. We introduced the £500 payment for those on low incomes precisely to support people to do that. We introduced it right across the UK, working with the Scottish Government, and there are signs that the uptake of that has allowed people to complete isolation when they need to, in order to keep others safe.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Programme motion
Monday 19th October 2020 Commons Chamber

[Matt Hancock]

The approach we are taking, which is working effectively in almost every local area, is to work with local leaders. We are doing that across party lines, whether in Liverpool or Lancashire, as I mentioned, or in South Yorkshire, the north-east and Teesside, where the discussions are collaborative and consensual. That is the way we need to deliver the public health messages that are best delivered with everybody speaking with one voice and all working together to tackle the virus. That is not to mention London, where there has been a similar approach.

I would merely point out that over the past week in Greater Manchester the rate of infection among those aged over 60, which is the group most likely to end up in hospital, has risen from 171 per 100,000 to 283, so it is absolutely vital, from a public health perspective, that we act.

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

The economic impact on areas under the tightest covid restrictions is significant, particularly for the hospitality industry, where many young workers are employed. Covid will be with us for some considerable time, so we need to learn to adapt and live with it as safely as possible. As I have highlighted previously, covid is spread by airborne particles as well as droplets, so ventilation is key to reducing the risk of spread. There are ventilation systems that incorporate antimicrobial technology, which could reduce spread in indoor settings. Last week, I asked the Secretary of State whether he would speak to the Chancellor about promoting their installation by removing VAT and making them tax deductible. He did not answer, so I ask him again: does he recognise the importance of ventilation in the battle against covid? If so, will his Government use their taxation powers to help to make hospitality settings more covid-secure and avoid their being repeatedly shut down?

[Matt Hancock]

Absolutely we will support hospitality businesses and all the sectors of the economy. My right hon. Friend the Chancellor has supported the hospitality industry more than any other. In fact, the UK Government are supporting businesses right across the whole country. When the Scottish Government take action on public health grounds in a devolved way, the UK Government then come in with the economic support. That is yet another example of how much stronger we all are working together. I will take away the hon. Lady’s detailed point and talk to the Treasury. It is, of course, a question for the Treasury rather than for me as Health Secretary, but I just underline the importance of us all working together across Scotland and across the whole of the UK, and of the economic firepower of the UK Exchequer supporting people right across this land.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Thursday 15th October 2020 Commons Chamber

[Matt Hancock]

My right hon. Friend and I share a passion for an expansion of testing capacity in this country. He has long tried to persuade me to set yet more goals for the expansion of testing capacity. I am very glad to say that we have hit every single one that we have put in place, such as the 100,000 in the spring, and we are on track to meet the 500,000 by the end of this month. After that, I very much hope that we can continue to expand testing capacity, and I will look at the idea that he proposes very carefully.

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

I recognise the need for this action, but it is critical that those called on to isolate, whether as individuals or through a lockdown, receive the financial support to do so. Avoiding the social and economic impact of repeated local lockdowns depends on driving down community transmission through testing and tracing every single case and finding and isolating their contacts in the short window before they, too, become infectious.

Tracing systems based on local public health teams, such as in Scotland, Wales and now in some parts of England, have all outperformed the centralised Serco system, which has barely reached three quarters of cases and well under two thirds of contacts. I welcome that local public health teams will now be directly involved in contact tracing in areas of high covid spread, but will the Secretary of State now have them lead contact tracing in all areas across England to help to get the test, trace and isolate system working effectively? Will he ensure that appropriate financial resources are moved to local authorities to fund this?

Unfortunately, the hospitality industry is being hit particularly hard, both by the virus itself and the restrictions to control it. As we now know, covid is spread by airborne particles as well as droplets, and it has become clear that ventilation is key to reducing viral spread indoors. Will the Secretary of State ask the Chancellor to promote the installation of filtered ventilation units by removing VAT and making them tax deductible? In that way, the Government could help the hospitality industry to make its premises more covid secure, rather than having repeatedly to shut it down every time cases surge.

[Matt Hancock]

The hon. Lady talks about the testing system, and the UK-wide testing system is an example of the whole country working together to keep people safe. The UK system provides the majority of tests into Scotland, and it works very closely with the NHS in Scotland, which also provides important testing capacity. That is an example of the local system in Scotland and the UK system nationwide working together for the people of Scotland.

The hon. Lady mentions isolation payments, and I strongly agree with her about their importance. Again, this is a proposal that we have worked on together, with the UK Government providing the funding that is being delivered across England, Scotland, Wales and Northern Ireland. I think the best approach to tackling this pandemic is for people across the whole country to come together, and for the UK Government and Scottish Government to work together, as we do, where an issue is devolved to deliver for the people of Scotland.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Monday 5th October 2020 Commons Chamber

[Matt Hancock]

The expansion of the NHS testing is, of course, critical as well. The system in question, where the problem was over this weekend, brings together the data both from the NHS systems and from the so-called pillar 2 systems. The challenge was in a system that integrates the two, rather than just on one side or the other, but my right hon. Friend makes a broader point, which is that as we expand the NHS’s capacity as part of the overall expansion of testing, we have to ensure that we use that capacity to best effect. In many parts of the NHS, increasingly, it is NHS testing capacity that is used for NHS staff testing. That system works well, because the test is local and convenient, and we are looking to expand in exactly the sort of direction that he outlines. I urge colleagues away from trying to bifurcate between the two systems. Essentially, we have a whole series of different ways to access a test, and we need to make sure that people get the tests that are easiest to access for them as much as possible.

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

The delay in entering almost 16,000 covid cases into Government databases has resulted in last week’s case numbers being totally inaccurate. The Secretary of State says that the updated statistics would not have led to additional measures, but are there any new areas of heightened concern? PHE has blamed the problem on test result files being too big to load on to its central system. Was that, as has been suggested, due to the transfer of data between formats? If the underlying issue was due to the rapidly rising number of positive cases, why was that not anticipated or identified sooner? Can he be sure that something like this cannot happen again?

Just as importantly, this means that none of those cases was registered with the tracing system. While, as the Secretary of State says, people with a positive test got their result and, we hope, self-isolated, they did not get direct advice and they did not give the details of their contacts. From the Government’s data, people with covid report an average of three to four contacts each, so that would represent 50,000 to 60,000 contacts who were not identified and asked to isolate and therefore will have continued to spread the virus. While up to 10 days have lapsed and the opportunity to prevent onward spread may have been missed, the Secretary of State mentions that 51% of cases have been contacted, but on what timescale does he hope to reach all the contacts of those cases? Given that only about 60% of community contacts in England are currently reached, will he involve local authority public health teams in what is now a massive contact-tracing operation?

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Monday 21st September 2020 Commons Chamber

[Mr Speaker]

I welcome back Philippa Whitford.

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

Thank you, Mr Speaker. As the chief medical officer and chief scientific advisers said this morning, the UK is in danger of losing control, as we have seen happen in many countries in Europe. As the Secretary of State has said, we could be facing 50,000 new cases a day by mid-October, leading to about 200 deaths a day by mid-November. No one should be in any doubt that it is a mistake to think that the virus has changed and that it will not kill people if we get back to where we were in April.

I agree utterly with the Secretary of State that we need to take action now, and that action is personal; every single person has the responsibility to stick to the rules—to wear a face covering, wash their hands and keep their distance. I remind Members in this House, because I have been watching it from outside, that that is not always what is on show in this Chamber, and we all have a responsibility to set an example. That responsibility extends to self-isolating, whether we have symptoms, we are proven, we are a contact or we have returned from a high-risk country. If we are meant to be isolating, we need to do it. I really welcome the fact that the Government are finally putting in place financial support for people on low incomes, who might be tempted not to isolate because they simply do not have any other opportunities to feed their family.

However, it is crucial that we have a fast and responsive test and trace system, so I have a couple of questions for the Secretary of State. In recent weeks, he has talked about aiming to have 500,000 tests a day by the end of October. Given the surge we are facing, does he envisage being able to accelerate that and bring it forward? Secondly, on 8 and 15 September he committed to me that he would be increasing funding to expand NHS testing, but, as we heard from the shadow Secretary of State, NHS trusts in England have been told that funding is capped and they are not to expand covid testing. Surely this is resource that we want to use and make available.

[Matt Hancock]

I wholeheartedly agree with the hon. Lady’s comments about the need for action across the UK. We have seen in Scotland, as in England, Wales and Northern Ireland, that the number of cases has, sadly, risen sharply. I welcome her physically back to the Chamber, in demonstrating this unity of purpose across the four nations of the UK. If we can bring forward the goal of 500,000 tests per day from the end of October, of course we will do so; we are pushing that as hard as we can and are on track to meet that commitment. As she says, that is for across the UK, so it includes the tests done by the Scottish NHS. I know that conversations have taken place between the NHS in Scotland and the NHS in England to work on making that happen. We are expanding NHS testing, including the funding. In the funding letter that went out to the NHS for the second half of the financial year—for the cover in winter—we set out that that includes the commitment to support financially the testing done in the NHS in England.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Thursday 17th September 2020 Commons Chamber

[Matt Hancock]

I wholeheartedly support the points that my right hon. Friend has made. I pay tribute to him for his work in establishing World Patient Safety Day and thank him for his ongoing work in the international arena, both representing our country and driving forward this agenda globally. I entirely agree with his comments about 111 First. It is absolutely critical that both the online and phone systems act to ensure that sepsis is recognised, wherever that is feasible, to ensure that people get the best and safest route to care. I will ensure that that point is registered. We have put in the extra funding, which I have just announced, for 111 to ensure more clinical support for people accessing the service through NHS 111 First. Indeed, I pay tribute to him for introducing 111 in the first place. There is an awful lot of work to do here, but it will undoubtedly help patients to get a better service and help the NHS to deal with the multitude of cases that come its way.

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

While personal behaviour and local measures are critical, so is a functioning test, trace and isolate system. Last week the Prime Minister claimed that there was capacity for 350,000 covid tests a day, but I am sure the Secretary of State is well aware that a third of that capacity is antibody testing, which becomes positive only after the infection and is therefore of little use in diagnosing cases or managing outbreaks. Why have the Government not published the daily diagnostic testing capacity since last Thursday? The Secretary of State has promised that there will be 500,000 diagnostic tests a day by the end of next month. Can he confirm that that definitely refers to diagnostic antigen testing, and is he confident that it will be delivered on time?

The current problem appears to be a shortage of laboratory capacity, with the Government now cutting test appointments in many parts of the UK. Does the Secretary of State accept that that causes a danger of new outbreaks not being detected at an early enough stage? With the rationing of test slots, there are multiple reports of people being advised to enter an Aberdeen postcode to obtain authorisation for a test, even though the test will be carried out in the south of England. Does he accept that that will undermine Scotland’s contact tracing system and that incorrect data could give the false impression of a local outbreak in Scotland that does not exist? How does he plan to stop that practice?

Finally, the Secretary of State has previously talked about his moonshot testing project, based on millions of people testing themselves for covid every morning. Can he clarify whether he is planning for such tests to be provided on the NHS, or would individuals be paying for them? If they are on the NHS, given the enormous price tag and the fact that the technology does not even exist yet, should he not focus funding and efforts on getting the current diagnostic testing system working in the here and now?

[Matt Hancock]

Taking those points in reverse order, of course investing in the next generation of technologies is important here and now, because if we do not push forward those technologies that allow us to expand testing, we will always be stuck with the current one. The idea that there is a dichotomy between the two is completely wrong.

On the hon. Lady’s point about an Aberdeen postcode, we already have in place a system to ensure that if someone puts in one postcode but then turns up at the wrong drive-through centre, that will be indicated to the people there, so that problem has been resolved—indeed, it had been resolved before it was first raised in the House.

I hope that, like the Scottish Government, the hon. Lady will reiterate the point that people should come forward for a test when they have symptoms or have been told to do so by a public health professional, and they should not come forward if they do not have symptoms. Working together across the UK is undoubtedly the only way to solve this crisis, to the benefit of all our constituents.

That brings me to the point about testing in Scotland. More tests are being done in Scotland—through drive-through centres, local testing sites and mobile testing centres—than across the rest of the UK per head of population. We over-index the number of tests through those routes that we put into Scotland. Indeed, in the Scottish NHS there is spare capacity that needs to be used. I am working closely with the Scottish Government to ensure that that spare capacity is used, given the enormous demand for tests right across this country. I think that tone of working together is what we need to hear.

Coronavirus

Debate between Matt Hancock and Philippa Whitford

Tuesday 15th September 2020 Commons Chamber

[Matt Hancock]

I think that we will be able to solve this problem in a matter of weeks. In his constituency yesterday, 194 people got their tests. We are managing to deliver record capacity, but as he well knows, demand is also high, and the response to that is to make sure we have prioritisation, so that the people who most need them can get the tests that they need.

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

With covid cases doubling every week, it is clear that laboratory capacity for diagnostic testing is not keeping pace with demand, leading to testing slots being cut. For example, only 70 new covid cases were reported in Scotland yesterday, yet 267 were reported today, many from tests carried out over the weekend. With a reported backlog of 185,000 tests, is the Secretary of State not concerned that results will not be received quickly enough to allow timely contact tracing, and that the delay in data means that new outbreaks will not be identified until they are out of control? Last week, the Secretary of State appeared to accept that additional NHS funding could allow hospital laboratories across the UK to rapidly increase their testing capacity, so can he confirm whether he plans such an approach, and on what timescale?

[Matt Hancock]

Yes, I think it is important that we expand the NHS labs, and that we work across the whole of the UK to get the testing capacity needed. For instance, in Scotland, when there was a surge in demand for tests last month, we diverted more of the UK’s capacity to support people in Scotland, and we currently deliver more tests per head of population in Scotland than in the UK as a whole. In the tone of the hon. Lady’s question, it is absolutely necessary to work together, across party lines, between the Scottish devolved Government and the UK Government, to make sure that we get the support to the people of Scotland as to every other part of this country.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Tuesday 8th September 2020 Commons Chamber

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

I agree that it is indeed critical that everyone recognises the importance of our own personal actions in controlling covid, but we also need an efficient test, trace and isolate system, the first step of which is for people to get access to a test. With UK cases having trebled over the past fortnight, demand has increased and there have been many reports of people being sent hundreds of miles to get a covid test. One of the most extreme examples was somebody in Plymouth being sent by the booking system to the test centre in Inverness.

I understand that demand varies depending on local incidence, but surely it is dangerous to have possibly infectious people travelling long distances when they are unwell and may need to use motor-services facilities on the way. Would it not make more sense to allow covid tests still to be taken locally, and just shift the samples around the UK to the labs with the greatest capacity?

While the commercial pillar 2 testing has increased dramatically since April, the 

laboratories are very centralised, whereas NHS hospital laboratories are far more numerous and based within easier reach of communities. To meet the high demand that is likely this coming winter, will the Secretary of State consider additional funding to the NHS to allow the expansion of its PCR facilities and to maximise pillar 1 testing capacity?

[Matt Hancock]

The answer to that last question is, absolutely, yes. The hon. Lady is quite right that expanding the NHS capacity, as well as expanding the so-called pillar 2 capacity, is right. The SNP spokesperson and I sometimes have robust exchanges but on this, she is completely right. It is an “and/and together” strategy of having the pillar 2 mass testing across the board and the expansion of NHS capacity. I am working as closely as I possibly can with Jeane Freeman, my opposite number in the SNP Government in Edinburgh, to deliver that as effectively as possible right across the UK.

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 1st September 2020 Commons Chamber

[Matt Hancock]

Absolutely. I am glad to hear what the hon. Lady says about the constantly improving integration between the national and local systems. We have worked hard to make that happen, and I am glad to hear that it is happening in Croydon, as it is in other parts of the country. The budgets in that respect are of course important, and we have been clear that financial provision will be made. I cannot make any more definitive statement than that at this stage, but it is of course an important consideration.

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

Since June, the Scottish public health-based tracing system has managed to trace 99.7% of positive cases and almost 99% of their contacts, yet in England the commercial Serco call centres have traced less than 60% of contacts. Will the Secretary of State clarify whether any targets are included in the £10 billion contact with Serco? If so, are they being met?

[Matt Hancock]

If I may correct the hon. Lady, there is no £10 billion contract with any private company. The private companies have been critical in the work to make sure that the whole testing system could be built at the scale that it has been. As I said, the improvements are continuing. We are seeing local engagement, which is critical, and we are seeing testing rolled out right across the UK. For instance, when there was a local outbreak in Aberdeen over the summer, we were able to use UK resources to get huge amounts of testing into Aberdeen, thanks to the collaborative work between the UK Government, who provided the UK testing, and the Scottish Government, who were responsible for the lockdown.

[Dr Whitford]

That does not address the fact that the call-centre system run by Serco has managed to contact only 60% of people’s contacts. Regional Public Health England teams have been working flat out for the past seven months and are tracing more than 95% of the cases with which they deal. Does the Secretary of State really think that the middle of a pandemic is a good time to be threatening the job security of those teams with a huge reorganisation?

Covid-19

Debate between Matt Hancock and Philippa Whitford

Tuesday 1st September 2020 Commons Chamber

[Matt Hancock]

It is my intention to deploy as much testing as possible using the new testing innovations coming on stream and to do so as widely as possible following clinical advice. We have set out the process we propose to use for the current generation of testing capability, but if a new, easier type of test gets over the line, of course we will always keep that under clinical review, being guided always by clinicians.

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

Is the Secretary of State aware that some people are being refused home-testing kits because the credit-checking company TransUnion has not found their names on the public version of the electoral register? Can he explain why he contracted this American company to verify people’s identities and what he will do to resolve the issue? He still has not addressed the poor performance of Serco, which has failed to trace 40% of contacts and apparently did not even have contact details for over 2,500. This compares poorly with the public health-based systems of the devolved nations, which are managing to trace 90% or more. Instead of breaking up PHE, will he not provide it with the necessary resources to develop a public health-based tracing system for England, too?

Finally, Chris Whitty says it is not possible to open up everything and keep the virus under control. While it is really good to see the number of deaths from covid falling, the number of new cases in the UK is currently higher than when we had to go into lockdown in March. If getting children back to school is his Government’s priority, why are they pushing people back into offices at the same time?

[Matt Hancock]

I have addressed several of those points already in questions. The idea that, instead of the large-scale national system working together with local contact tracers, we should disparage one part and praise the other—this divisive approach proposed by the SNP spokesperson—is wholly wrong and would lead to things getting worse, not better. Instead, we need to work together to improve the system, in the same way the Scottish Government and the UK Government worked together to provide testing capability right across Scotland.

On the arrangements for the future of PHE, we look around the world for the best way to ensure we have systems at a national level that can respond to the virus, in the same way we put in place the Joint Biosecurity Centre, when we worked closely with the Scottish Government, the Welsh Government and the Northern Ireland Administration to ensure the best possible system—for instance, when cases move over a border. Some of the best systems in the world, such as the German system, have an institute dedicated to infectious disease control. I am convinced that the enormous amounts of extra money we are putting into health protection, along with the extra support going in and the clarity and dedication of the new National Institute for Health Protection, will be a step forward. I pay tribute to all those who have worked in PHE and right across the board to keep people safe during this crisis.

Coronavirus Response

Debate between Matt Hancock and Philippa Whitford

Monday 20th July 2020 Commons Chamber

[Matt Hancock]

Yes. That is a really important point, and we monitor those data all the time. I am glad to say that the latest data are a little bit better than my right hon. Friend suggested, but the point is still important. The main cause of the gap is people who are asymptomatic and therefore do not know they have the virus and do not come forward for testing. We are going to ramp up our communications to make clear that, if in doubt and if people think they might have the symptoms, they should come forward and get a test. We are also going to ramp up our asymptomatic testing of high-risk groups, which he and I have had exchanges about before. I am grateful for what he said about the 100,000 testing target. Of course, he will recognise that I am as delighted as he will be that the Prime Minister set me a new target on Friday to hit half a million by the end of October, so there is my summer sorted.

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

I, too, welcome the progress being made regarding vaccine development by research centres and companies across the UK, including Valneva in Scotland, but a widely available vaccine is still some way off. In the meantime, avoiding the social and economic impact of repeated local lockdowns depends on driving down community transmission. Professor Dominic Harrison, public health director of Blackburn with Darwen Council, has highlighted that only half of contacts are being traced by the central system and called to be given information in individual covid cases so that their contacts can be traced and isolated in the short window before they, too, become infectious.

In the covid statement last Thursday, I again raised the issue of delays in providing individual test results to local public health teams. The Health Secretary said he could not answer so many questions from me, so he chose not to answer any. To make it simple, I will ask only one. Postcode information was utterly insufficient, so by what date can he guarantee that every single director of public health in England will receive the identifiable details of all new positive cases on a daily basis?

[Matt Hancock]

If they have signed a data protection agreement, today.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Thursday 16th July 2020 Commons Chamber

[Matt Hancock]

I would be very happy to meet my right hon. Friend and Professor Tim Briggs, who does an incredible job. He is a brilliant public servant, who has done great work on the Getting It Right First Time programme. As my right hon. Friend knows better than almost anybody, the unjustified variation in performance between different hospitals within the NHS is a huge issue across the board, because if the standards in every hospital were the same as the standards in the best hospital, the performance of the whole would be so much higher. That is exactly what the Getting It Right First Time programme was designed to deliver. It was instigated by him, and I would be very happy to listen to what both he and Professor Briggs have to say.

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

Directors of public health in England are still complaining they are not getting the information they need. They only started to get area data from late June, when it became clear that Leicester had had 900 cases in less than a month. Within a week, Leicester was back under lockdown. The Prime Minister has described this as his “whack-a-mole” approach to controlling covid, but does the Secretary of State recognise that for the people of Leicester it has felt just as bad as the national lockdown?

I have raised many times the issue of test results from the UK Government labs not being sent to general practitioners or local public health teams. Is it true that that was not even specified in the contract? Even after Leicester, and despite covid being a notifiable disease since 6 March, local authorities and health protection teams in England are still being sent only anonymised area data, which is of little use to identify clusters, and only on a weekly basis, which is far too slow. Does the Secretary of State not accept that public health teams need daily data, with work and home postcode details, so they can spot an outbreak, and that they need individual test results, so they can isolate all those involved to break the chains of infection and prevent the further spread of the virus?

The Secretary of State rarely mentions isolation, but surely he knows that that is what actually breaks the chains of infection. That should be isolation of affected individuals, however, not our whole society or a whole city. The test and protect system in Scotland has been up and running since the end of May and disrupted a cluster of just 12 cases in the south of Scotland. That is the level of detail required to drive an elimination strategy.

The Secretary of State says that local lockdowns will be the cornerstone of his ongoing strategy, but how does he plan to deal with the social and economic impacts? Will he not join the devolved and Irish Governments in following an elimination strategy to avoid repeated local lockdowns? When does he envisage having a fully functioning test, trace and isolate system in place across England?

[Matt Hancock]

I am terribly sorry that I am not going to be able to answer all the points that were made. All I can say to the hon. Lady is that I will send her an update on the data that, in England, local directors of public health get, because there has been a huge amount of progress since many of the situations that she described.

I bow to no one in my desire to use data to make policy and to get the best data out. We have been getting better and better data out to local areas. We have been publishing more and more data. Many of the hon. Lady’s comments were out of date.

Coronavirus

Debate between Matt Hancock and Philippa Whitford

Tuesday 7th July 2020 Commons Chamber

[Matt Hancock]

As I mentioned, we have put in place the procedures for regular testing of NHS staff, and those procedures are underlined by the clinical analysis. There is a difference between social care and NHS staff, not least because the impact of coronavirus, in terms of its prevalence, has been higher among social care staff in care homes. We must ensure that such decisions are clinically led, but of course I keep the issue under review and take the comments from the Chair of the Health and Social Care Committee very seriously.

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

I welcome the fact that the UK Government website has now been corrected to add the 80,000 missing covid cases in England, and gives a more accurate picture of the epidemic. Compared with Scotland, England currently has six times the number of new cases per head of population, and nine times the deaths. Even without a second wave, it is estimated that the current level of covid infections would lead to 27,000 additional deaths by next spring. Does the Secretary of State consider that level acceptable? Scotland, Northern Ireland, and the Republic of Ireland are following covid elimination strategies to drive down circulating virus, and reduce the risk of repeated lockdowns. Will the Secretary of State explain what his strategy is going forward?

[Matt Hancock]

Yes. Our strategy is to drive the virus right down, and as I said in my opening statement, the latest figures show just 352 new cases recorded in the previous 24 hours. We have been working closely with the Scottish Government, and giving them as much support as we can, for instance to get testing up and running. I am glad that right across the UK, we are succeeding in ensuring that the virus is increasingly under control.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Monday 29th June 2020 Commons Chamber

[Matt Hancock]

The regime for testing NHS staff, which will apply in Leicester and right across the board, is the one recommended by clinicians. The SIREN study starts with an antibody test, but then has regular swab testing, including at weekly frequency. There is regular testing to find out if people have the virus, and also a test at the start to find out if they have had it. That not only ensures that they are kept safe and finds out if they have the virus, but supports the immunology research to find out if people who have antibodies can catch the virus a second time. We are doing it that way in order to get the practical benefits and the research benefits.

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

Naturally, I too am delighted that Scotland has had no deaths for four days and only five cases today.

Public Health England began publishing combined data from commercial as well as NHS labs at the beginning of this month. Since then, it has become clear that Leicester has had far more covid cases than it was previously aware of, with almost 900 over the last three weeks. This data is published only weekly, however, which is of no use for tracing contacts or the early identification of an outbreak.

The Secretary of State tends to focus on the number of tests, but does he accept that it is actually tracing and isolation that stop the spread of the virus? How does he expect local public health teams to identify an emerging outbreak if they cannot access accurate data, and how can they manage one if they are not sent individual test results in realtime? When will he be able to guarantee that test results are sent immediately to GPs and local public health teams, so that they can trace contacts and isolate patients?

The lack of accurate data can also affect Government decisions. On 10 May, when the Prime Minister eased lockdown across England, almost 40,000 positive cases from the commercial labs were not included in the data of the four nations. Even now, the UK Government website claims that there have been just over 160,000 covid cases in England, despite Public Health England reporting that there have actually been 240,000. Does the Secretary of State really think it safe to go ahead with opening pubs and restaurants across England when there have been 50% more cases than previously reported? If the UK Government were aware of this much higher incidence, why have they knowingly been publishing false information on their website?

[Matt Hancock]

I think the best way to explain that is that all the data we have on Leicester has been made available to Leicestershire County Council. I pay tribute to Ivan Browne, director of public health at Leicester City Council, who has done a superb job through this. All the data available to us is available to him. Indeed, I can commit to the House that we will publish all the data on test results, in order to ensure that the wider public, as well as directors of public health, are able to access that data.

The hon. Lady frequently tries to divide the testing system between those tests done in hospital labs and those done in the labs that we have built over the past few weeks. That is the wrong approach—it is only because we managed to build those labs that we have such large testing capacity across the UK. Those tests from the lighthouse labs are available in Scotland, Wales and Northern Ireland, as well as England. I pay tribute to the work of those labs, which have done so much to deliver what is now an extraordinary testing capability that we can bring to bear on specific problems, such as this one in Leicester.

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 23rd June 2020 Commons Chamber

[Matt Hancock]

I am not sure I agree with my right hon. Friend’s figures in terms of the assumptions that underpin them. We have had this discussion and this exchange before. There are a whole number of asymptomatic cases. The critical thing about Test and Trace is to find as many of the asymptomatic cases, and as many of the positive test result cases, as possible. We need to do that over time by expanding the programme.

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

While a proximity app would assist in identifying casual contacts, many people were concerned that a centralised model would harvest their data. In the trial, this one failed to detect 96% of contacts. So why did the Secretary of State persist so long with an app that simply did not work on the majority of phones?

[Matt Hancock]

I am afraid the hon. Lady is wrong. The trials in the Isle of Wight showed that the app worked on Android phones, but was blocked from working effectively on Apple phones; hence we are now working with Apple and Google, as we have been over the past few weeks, to find a system that can be effective. But I will not sign off on an app where we do not know and have not been told by some multinational company what it is recommending to people because, after all, the critical thing that matters in test and trace is that people isolate to break the chain of transmission.

[Dr Whitford]

I would gently suggest that iPhones are actually quite common, so it is important that it does work on iPhones. The boss of Serco has admitted that its contact tracing system will not be fully functioning until the autumn, and we find that actually local public health teams are carrying out the vast majority of contact tracing, so would Government money not be better spent reversing five years of budget cuts to public health?

[Matt Hancock]

It is very strange taking these questions from the SNP spokesman, given that I am working with the SNP Government on resolving exactly these problems in Scotland, and maybe the SNP would do better to focus there. In response to the second question, honestly, we have put £300 million of support into local directors of public health to tackle this pandemic, and I know that her colleagues in the Scottish Government are working hard with local authorities in Scotland as well in exactly the same way.

Coronavirus

Debate between Matt Hancock and Philippa Whitford

Wednesday 17th June 2020 Commons Chamber

[Mr Speaker]

We are now heading to the SNP spokesperson, Dr Phillipa Whitford, with some extra time.

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

I, too, welcome the positive outcome of the recovery trial showing the contribution of dexamethasone—a drug that is cheap and accessible across the world.

Despite claiming to be well prepared for this epidemic, the Secretary of State has struggled to provide sufficient personal protective equipment to NHS staff in England. He has now awarded £350 million of PPE contracts, but can he explain why £108 million of that was awarded, without being advertised, to Crisp Websites Ltd, which trades as PestFix, a small pest extermination company? Why was such a large contract awarded to a company with no expertise in trading or supplying any PPE, let alone highly specialised equipment for NHS staff? How do the Government think that such a small company, with only £18,000 of registered assets, can manage the cash flow required to procure £108 million-worth of PPE? Is this not just a reprise of the Seaborne Freight scandal—the ferry company with no ships?

[Matt Hancock]

No. We have enhanced, under the leadership of Lord Deighton, the supplies of PPE across the whole United Kingdom. I work very closely with the SNP Government on this matter. We have made sure that PPE is now available, in large part, across the whole NHS and social care workforce, and for all those others who need it. Demand for PPE rose exponentially across the world in this crisis. It was difficult for a time—there is no point denying that—but we have made huge strides in ensuring that we now have long-term contracts in place. I am really glad that the supply and distribution of PPE is much wider.

Covid-19: R Rate and Lockdown Measures

Debate between Matt Hancock and Philippa Whitford

Monday 8th June 2020 Commons Chamber

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

The R number is close to one across England and may even be above that in some areas. As the R number reflects lockdown changes made a couple of weeks ago, does the Secretary of State not accept the need to assess the impact of sending people back to work and school before making further changes to lockdown?

With Serco admitting that its tracing system will not be fully operational until September, would the Secretary of State not have been better investing in public health systems instead of a private company with no expertise? Why are the test results from the commercial labs still not being sent to local GPs and public health teams to allow contact tracing? Finally, we all recognise the economic impact of lockdown, but does he not accept that the worst thing for the economy would be a second wave needing a second lockdown?

[Matt Hancock]

As a clinician, the hon. Lady will recognise that taking into account all the evidence of the rate of transmission is incredibly important, and I think that it is an error and it is wrong and it is beneath the normal standards of her questioning to focus on just one report, rather than on all the reports. I hope that when she speaks to people in Scotland and across the whole country, she will take into account all the evidence, rather than just focus on one report. I urge her to do that, because it is important for the public communications.

The other point I would make is that the NHS test and trace programme is being built at incredible pace. The Prime Minister committed that we would get it up and running for 1 June, and we have delivered that, and that it will be world class, and we will deliver that, but we could not deliver it without the public and private sectors working together. I think the divisiveness that comes through from the other side is a real mistake in these difficult times. Instead, everybody should be working together.

Coronavirus and Care Homes

Debate between Matt Hancock and Philippa Whitford

Tuesday 19th May 2020 Commons Chamber

[Matt Hancock]

I entirely agree. We have seen much better partnership working in most parts of the country during this crisis. The partnerships between local authorities, with their statutory responsibilities, and, as my right hon. and learned Friend mentioned, all parts of the NHS, with its statutory responsibilities—clinical commissioning groups, trusts and the integrated care systems—is very important. They have worked much better over the last few months than they had hitherto. We need to make sure that that coming together—in a very difficult circumstance, which has broken down boundaries—continues. I look forward to working with him and others in making sure that the boundaries that exist in social care can be brought to the ground.

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

The London School of Economics reported that there were over 23,000 excess deaths in care homes in England and Wales, but only 12,000 were put down as due to covid. How does the Secretary of State explain the other 10,000? Testing of care home staff is critical to reduce the spread, but how will he improve the return of results to local GPs and public health teams? Concerns have been raised that a quarter of tests are false negatives, which could send staff with the virus back into care homes and hospitals. It is a difficult sample to take, so is any comparison being made between self-administered tests and those carried out by healthcare staff? Finally, where is the Green Paper that was promised in 2017?

[Matt Hancock]

On the point about tests, absolutely, work was done to assess the difference in efficacy between professionally administered and self-administered tests, and it found that their efficacy was very similar and not significantly different. That is why across England and Scotland, and indeed the whole UK, we use home tests, which are an important part of our testing regime.

The hon. Lady asks about the increased number of deaths, sadly, that there have been in care homes. She is absolutely right that there has been an increase. We analyse the causes of all the different factors that may have had an impact, which is something our clinical advisers are looking at. The same is true in Scotland, and I am sure that the Scottish medical advisers are looking into the same. When it comes to a Green Paper, at the moment we are working on crisis response, and I think that is the appropriate thing to do.

Covid-19 Response

Debate between Matt Hancock and Philippa Whitford

Monday 18th May 2020 Commons Chamber

[Mr Speaker]

I am pleased to say that we have reconnected with the SNP spokesperson, Dr Philippa Whitford, who has 90 seconds.

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

I welcome that eligibility for testing is being widened to all symptomatic cases as the first step towards a test, trace and isolate approach, but does the Secretary of State agree that the system should have been in place before lockdown was eased? Without it, how can he know that the crowded public transport systems that we saw last week are not already leading to a rise in infections? The Secretary of State prides himself on having ramped up testing, but we know that many thousands of those are just in the post, so will he clarify whether those tests are counted again when they are actually carried out?

The Royal College of GPs has highlighted the difficulty in getting test results back from the Deloitte regional test centres. As it is contact tracing and isolation that stop the spread of the virus, how will the Secretary of State speed up results and ensure that they are fed back to GPs and public health teams, who are critical to detecting and controlling local outbreaks? The UK still has more than six times the number of new cases per day than when the lockdown was brought in. Does he not think that that is still too high to be sending people back to work and school?

[Matt Hancock]

We have been working very closely with the SNP Scottish Government on testing, so I am slightly surprised at some of the questions from the SNP spokeswoman. Of course the tests are not double-counted. There has been a ramp up in testing capacity. I am very glad to see in Scotland that testing capacity is now starting to rise—in the latest figures, it was up to around 5,000. I work very closely with my SNP opposite number on making sure that everybody has the very best capacity. The contact tracing system was also stopped in Scotland. The reason was that the number of cases right across the UK became very high. We needed social distancing to bring that number down. Now that that number is coming down right across the UK, contact tracing is once again effective. That is the reason we are bringing it in now, and I am pleased that we have hired 21,000 contact tracers in England to ensure that we can get it going. Therefore we are on track for the current proposed 1 June changes. That date is dependent on making sure that everything is right, and that it is safe to make the changes then.

Covid-19 Update

Debate between Matt Hancock and Philippa Whitford

Tuesday 5th May 2020 Commons Chamber

[Matt Hancock]

Yes, I am happy to look into all different ways of having safe working practices within the NHS and more broadly. Within the NHS, infection control is a critical piece of work. My hon. Friend is right to raise the point that this is a matter not just for acute hospitals—where, of course, it is mission critical—but for all parts of the NHS, including pharmacies, which increasingly have screens to make sure that there is a lower impact of transmission from customers to staff.

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

At least 140 health and care staff in the UK have lost their lives to covid-19, and we should pay tribute to them, but analysis of more than 100 of those tragic deaths has highlighted that there were not any among staff in critical care units, which are the most dangerous setting. Does the Secretary of State recognise that that shows the effectiveness of full PPE? He claims to always follow scientific advice, but NERVTAG, the new and emerging respiratory virus threats advisory group, advised him last June to add gowns to the stockpile, so why did he not do that? Why did Public Health England produce PPE guidelines for the whole UK that did not recommend gowns for staff looking after covid patients?

[Matt Hancock]

We are absolutely guided by the science. It is a very important principle of our overall response, and hence we upgraded the PPE guidelines a few weeks ago to include the use of gowns. The guidance is always looked into as we learn more and more about the virus. The plans that we had were not plans for a particular virus, but for the threat of a pandemic. We have learned more and more about this virus, which is novel and only came into being December last year, hence, as the science changes, so the scientific advice to Ministers is updated, and Ministers update decisions.

Covid-19 Response

Debate between Matt Hancock and Philippa Whitford

Wednesday 22nd April 2020 Commons Chamber

[Matt Hancock]

We are ramping up our testing capacity and our capacity for contact tracing in a matter of weeks. We will have it ready to ensure that we can use that capacity as and when the incidence of transmission comes down. It is not tied to the specific decision that we are required by law to take in just over two weeks’ time. The effectiveness of test, track and trace to keep the reproductive rate of the virus down is determined by the incidence in the community, and our goal is to get to a point where we can test, track and trace everybody who needs it.

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

Like all MPs, I pay tribute to health and care staff across the UK. Particularly in view of the key role of care workers and in recognition of their contribution, will the Secretary of State undertake to ensure that they are paid at least the real living wage, as has been the case for some years in Scotland?

Like everyone, I welcome the stabilisation of covid cases, but does the Secretary of State accept that the testing and contact tracing must be in place before any easing of the lockdown, to avoid resurgence and a second peak? Will he achieve 100,000 tests a day by next week? If not, when? How accurate are the tests? A 25% false negative rate has been reported.

I know the Secretary of State is a fan of phone apps, so I am glad to hear him recognise the need to increase public health staff both to conduct and co-ordinate contact tracing. Will he reverse the 20% cut in public health funding in England since 2015, to ensure that those staff can be recruited now?

Finally, when I raised the issue of asymptomatic spread on 11 March, the Secretary of State claimed that it was rare, but actually it accounts for about 50%. How is he taking that into account in his covid strategy?

[Matt Hancock]

The hon. Lady asks a number of questions. First, on the living wage, all health and social care staff in the UK are paid the living wage, because that is the law. I am very proud that we introduced the living wage, which has led to a significant rise in pay, especially for people in social care who were on the minimum wage previously. She asks about asymptomatic transmission. The scientific evidence shows that asymptomatic transmissions occurs, which is one of the very significant challenges that this virus presents. She also asked about test, track and trace. I absolutely agree that that is a critical part of keeping the spread of this virus low. The lower the number of new cases is, the more effective test, track and trace is. We are therefore building now the capacity for the very large-scale contract tracing necessary to go alongside the large-scale testing—the 100,000 tests at the end of this month that I mentioned in my statement—and the technology that can help us to do that.

Covid-19

Debate between Matt Hancock and Philippa Whitford

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

The measures on shielding are specifically for those who have significant health conditions and will be contacted by the NHS. They are not for the generality of over-70s who are healthy, for whom the guidance is the same as that for people of working age, except that we strongly advise, as opposed to advising. That is for their own protection, because the over-70s, and especially the over-80s, are at significantly higher risk of mortality—of dying from this virus.

The other points made by my hon. Friend are welcome. He made a very important point about rent, which featured in the discussions that we had earlier today. I have been talking about it to those at the Treasury and to the Secretary of State for Work and Pensions. Many banks have already taken action on mortgages.

My hon. Friend’s point about the availability of drugs is, of course, critical. We have a very comprehensive drug supply chain system that we understand well, thanks to the planning that we have done over the last couple of years. Thus far we have not seen shortages beyond those that already existed before the virus, such as the one that we debated in the autumn in the context of HRT, but of course we keep the position under constant review.

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

The Secretary of State will be aware of the concern about why the UK Government’s approach was such an outlier until now, including the talk about herd immunity, when it is not clear that any immunity from this virus is long-term. The UK is now facing an exponential rise, and I therefore welcome what the UK Government have said about decreasing all non-essential contact, as I think that it is critical to slow down and limit the spread of the virus.

The briefing from the Prime Minister talked about not providing emergency services for large gatherings, but can the Secretary of State clarify whether the Government are advising against or forbidding mass gatherings? I welcome the talk about increasing testing capability, but the briefing talked about only testing those in hospital and key workers. In Scotland, surveillance testing in practices that monitor disease in the community is continuing. Will that also be the case here in England?

Following the confusion over the weekend and, indeed, the comments that he has just made about healthy people over 70, will the Secretary of State clarify what exactly is the advice for people over 70 who live in their own homes or in care homes? Are they meant to be staying at home, or are they simply meant to be decreasing contact? In particular, is the Secretary of State discussing with social care providers lengthening the time of each visit so that there is time for the careworker to take precautions? He says that the healthy should go to work, but what if they work in a club? What provision is being made for socially vulnerable people such as the homeless or those who have no recourse to public funds, such as refugees or asylum seekers? We on these Benches welcomed the measures in the Budget, but when will the devolved Governments know exactly how much funding they will have to mitigate the economic impact of this in the three devolved nations? Finally, what further changes will be carried out in the Houses of Parliament to ensure that core services continue without increasing the risk to, in particular, older Members of both Houses?

[Matt Hancock]

We do not support mass gatherings. We have advised against unnecessary social contact, so it goes without saying that we do not support mass gatherings.

The hon. Lady asked about surveillance testing. Across the UK, we have one of the biggest coronavirus surveillance operations in the world. Of course it happens in Scotland, but it happens throughout the UK. She also asked about Parliament. I understand, Mr Speaker, that you have been having discussions today about how Parliament will operate, but I think the whole House will be sure, in our collective decision, that although Parliament may have to operate differently, it must remain open.

Coronavirus

Debate between Matt Hancock and Philippa Whitford

Wednesday 11th March 2020 Commons Chamber

[Matt Hancock]

I want to make two comments in response to my right hon. Friend. First, I want slightly to correct the point about the deputy chief medical officer, who said that in the next couple of weeks we may see the numbers starting to rise fast to their peak. We do not expect numbers to peak in the next fortnight. We expect them to continue to rise after that. The peak would be in a matter of a couple of months, rather than a couple of weeks. This is a marathon, not a sprint. Secondly, the World Health Organisation declaring this afternoon that the virus is globally now regarded as a pandemic indicates that the WHO thinks it will spread right across the world, and that will have a significant impact on the way in which countries around the world will now take forward their plans. Of course, the expectation that this may well happen was all within the plan that we set out. We will be discussing that at the Cobra meeting tomorrow.

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

I echo the good wishes to the hon. Member for Mid Bedfordshire (Ms Dorries).

I welcome the declaration to keep Parliament open, but surely we should be looking at core functions, at who comes into the House and at what we do in the House. I have to say that I was a bit disappointed to have several hundred of us jammed into the voting Lobbies on Tuesday. That is just not a good idea. There are ways of working that would still allow Parliament to stay open.

With cases having increased by 13 times outside China in just two weeks, the virus has of course been declared a pandemic by the WHO, which describes its concerned at “levels of inaction”. It calls for quicker and wider testing so that milder cases are diagnosed quickly, isolated and the spread reduced. We have seen the speed of change in northern Italy over a matter of a couple of weeks, so should we not be thinking about the delay phase? Containment and delay are a continuum; it is not a switch between one and the other.

We see large leisure events still continuing. They are not critical, so should we not be decreasing them? Do we know yet whether children are spreaders? We know they do not catch the virus, but do they spread it? That would be central to any decision about closing schools, and obviously closing schools would have an impact on NHS and social care staff.

I welcome the announcement in the Budget of funding to support people on sick pay, but will the Secretary of State clarify whether this will be provided to people who do not have sick pay in their contract? That is exactly who we were concerned about when we raised this point.

How quickly will all three devolved Governments hear about the extra funding that they are going to get, since it is urgent for them to take action as well? There has been talk about bringing doctors back from retirement. Is there a discussion with the General Medical Council about relicensing doctors, and about providing Crown indemnity for doctors who may have retired within the last year or two? The UK is already outside the European Centre for Disease Prevention and Control, so will the Government now at least rethink leaving the pandemic early warning and response system?

[Matt Hancock]

The hon. Lady asked some important questions about how Parliament will function. Matters of how we work are of course for Parliament—for the Leader of the House, the Speaker and the Commission, all guided by the science. They are in constant contact with Public Health England to get the very best advice. As for when we are voting, this disease passes in very, very large part from people who have symptoms, and we may not have symptoms. What really matters is making sure that as soon as people have symptoms potentially of coronavirus, they get in contact with 111 or Public Health England.

The hon. Lady asked for more testing. We are absolutely ramping up the testing capabilities. We have been commended on the approach we are taking by international bodies; she mentioned the WHO. She asked about children. One of the good pieces of news about the virus is that it does appear to have a much, much less significant impact on children. On the GMC and indemnity, absolutely —both those issues will be addressed in the Bill, and we are working very closely with the GMC.

The hon. Lady asked about collaboration and work with the European Union. We still remain within the European Union data transfer capabilities. Most of this data is being transferred—frankly, it is being published. We are being as transparent as possible. This week, we brought out a new website in order to be as transparent as possible about all the cases in the UK. Most European nations are taking exactly that approach.

Coronavirus

Debate between Matt Hancock and Philippa Whitford

Tuesday 3rd March 2020 Commons Chamber

[Matt Hancock]

My right hon. Friend raises an incredibly important point, and the answer to the question is yes. We are putting out further advice and guidance to the health system, to the NHS, to GPs and to hospitals today. That will go out from Keith Willett in the NHS.

On the point about the kit needed to keep health workers safe: yes, we are putting in place the actions to ensure that it is available at the right moment when it is needed. There are some GP surgeries that do not have that equipment yet, but we are putting in place the actions needed to ensure that they have it as and when it is needed. As my right hon. Friend knows, the number of cases right now is relatively small. It is 51, as of 9 o’clock this morning. The protective equipment is there, so that for each of these cases we can get right on to them, but if the virus becomes more widespread, of course more and more NHS settings right across the country are going to need that sort of equipment.

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

I welcome the plan, although I have to say that I would have welcomed receiving the briefing yesterday that the shadow Secretary of State mentioned, which I did not receive. The plan lays out a reasonable worst case scenario, and it is clear about the three time phases. Research is of course ongoing, but this will help to prepare the public for decisions that may have to be made down the line. At the moment, containment is based on self-isolation of cases, contacts and those who have travelled to risk areas, but with the spread elsewhere in the world, it is becoming harder to define risk areas. With regard to north Italy, the chief medical officer talked about those with underlying conditions perhaps interpreting the advice more stringently and not travelling, so will the Government either discuss with insurance companies or even consider legislation to make underlying conditions an acceptable reason to cancel a holiday, so that people can get their money back rather than putting themselves at risk?

I agree with the Secretary of State regarding asymptomatic workers and sick pay, but there are staff who have no sick pay in their contract, and some protection has to be given to them. He referred to the seven-day period for self-certification, but isolation is for 14 days, and we do not want people turning up at their GP surgery halfway through that period. Can that be looked at? One issue that I have come across is an employer telling a member of staff returning from a holiday in Tenerife that they should not come to work for two weeks, but the employer does not wish to pay them for that period. We need to look at that, even if it is not health advice but an employer stipulation expecting people to have no income.

As we move into delay, we see that children are not particularly vulnerable to catching this. However, as with other coronaviruses, they may well spread it. Do we have evidence for how much they contribute to transmission, as that will affect decisions on school closures?

What preparations are being made for the long haul? Previous coronavirus outbreaks have lasted not just for a few months but for over a year, so we could be dealing with this next winter. If we move into mitigation, the situation will reverse and it will be about protecting the vulnerable and early discharge to home care. That might require the changing of staff from hospitals and care homes to work in the community, so are the Government in negotiations on such matters as legal responsibility and liability?

The Secretary of State quite rightly talked about what the public should be doing, but should we not already be thinking about stopping shaking hands and about working from home, if possible, without an economic impact? That would also help the climate emergency. Containment moves into delay without a border, so should we not be thinking about trying to get ahead of the curve?

[Matt Hancock]

We have been briefing colleagues as much as possible. Clearly, the CMOs’ time is incredibly valuable at the moment. We have worked with the Scottish Government on this plan; it was signed off by both the First Minister and the CMO for Scotland. In fact, it has been developed with the Scottish Government, the Welsh Government and the Government of Northern Ireland, so ultimately it is a multi-party plan.

The hon. Lady made the point about seven-day certification. That is indeed the sort of reason why we are holding this area under review and there is work ongoing, including on the points she has raised. She also asked about shaking hands. The medical advice is that the impact of shaking hands is negligible; what really matters is washing hands. Our public health advice will remain clear and based on the science—what matters, more than anything else, is that people wash their hands for 20 seconds or more, using soap and preferably hot water. That is the core of the public health advice.

The hon. Lady mentioned working from home. There is an incredibly important point about timing written into the plan. There are actions that we may need to take in future that it would not be appropriate to take now. We are not advising people to work from home now, but we do not rule out doing so in future if that might be more effective clinically, given the disruption it could cause.

Medicines and Medical Devices Bill

Debate between Matt Hancock and Philippa Whitford

2nd reading & 2nd reading: House of Commons & Money resolution & Money resolution: House of Commons & Programme motion & Programme motion: House of Commons & Ways and Means resolution & Ways and Means resolution: House of Commons
Monday 2nd March 2020 Commons Chamber

[Matt Hancock]

Yes, that is right. This Bill empowers us to be able to move faster. Essentially, it empowers the UK to build a life sciences regulatory framework that is the best in the world—of course, working with EU partners, but also with partners from right around the world—and all with the intention of getting the most innovative products, as quickly as possible and as cost-effectively as possible, into the NHS. That is the goal of the entire Bill. It is a benefit of Brexit, but it is also worth doing in its own right.

The measures to strengthen innovation with respect to diagnostic tests again strengthen patient safety, because they strengthen the role of the Medicines and Healthcare Products Regulatory Agency. This includes, for instance, allowing us to legislate to create a comprehensive statutory register of medical devices in the UK. Such a register could be held by the MHRA, and we would make it compulsory to register a device along with information such as who manufactures and supplies it. This would mean that the MHRA could conduct post-market surveillance of devices in the UK, making it easier to trigger device recalls where a safety concern arises.

Indeed, we will enhance patient safety by giving the MHRA a new power to disclose to members of the public any safety concerns about a device. This was not possible while we were part of the EU. Previously, if an NHS trust raised a concern about a device and asked if similar reports had been received elsewhere, too often the MHRA was restricted in sharing that information; nor could it always routinely share information with the Care Quality Commission or other NHS national bodies. This Bill gives us the ability to share vital information about reporting patterns with the NHS family, and where necessary with the public, with enforcement powers that will be proportionate, transparent and suitably safeguarded.

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

I do not recognise the Secretary of State’s description that it was not possible to inform NHS bodies of concerns about machinery or devices. In my 33 years on the frontline, we received daily information about anything that was considered a danger or a failing, so I do not recognise that.

[Matt Hancock]

In some cases it was possible to share that information but not in all cases, and it will be possible now. I have no doubt that the hon. Member, like others on the frontline, will have received some information, but the MHRA is currently limited in the information that it can share with other NHS bodies. We are removing the limits on that information sharing, which of course needs to be done appropriately, but should not be set in primary legislation.

Our goal is this: we want the UK to be the best place in the world to design and trial the latest medical innovations. This Bill gives us the powers we need to make that happen. It will mean that the NHS has access to the most cutting-edge medicines and medical devices, with enhanced patient safety; it will help our life sciences seize the enormous opportunities of the 2020s, supported by a world-leading regulator; and it will help us pave our way as a self-governing independent nation. I commend the Bill to the House.

Coronavirus

Debate between Matt Hancock and Philippa Whitford

Wednesday 26th February 2020 Commons Chamber

[Matt Hancock]

There has been a roll-out to a wider number of laboratories, and we are working through plans for wider commercial diagnostic testing. We are working with around a dozen private companies, and using private diagnostic testing companies, not least because globally there is a search for a “by the side of the bed” testing capability. At the moment, all testing is done in labs, which means that someone has to take a swab to the lab and get the result. We want testing capabilities that involve a bit of kit by the bedside of the patient, so that tests can be run onsite. There is a global search for that capability, but it does not yet exist. We are putting funding and support into making that happen, and I hope we will soon get to that solution.

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

Worldwide we are looking at about 80,000 cases of coronavirus. That is 10 times the number that we saw with SARS, which suggests it is a very infectious condition. Will the UK Government liaise with international partners to ensure accurate reporting? It is critical to map the spread of coronavirus, and there will be a danger that some countries under-report because they are afraid of economic impacts. Has any consideration been given to using thermal detection technology at Heathrow, and for that to be spread across more sites? We can no longer think that this only involves people who come from a few countries—people follow different routes, and almost everyone coming in would need to be screened.

As the Secretary of State said, there is only a small window of opportunity when it is possible to prevent or contain the initial spread of coronavirus. As I have previously said, I am concerned about not self-isolating asymptomatic people, particularly when we are aware that the case that spread the condition to others in the UK involved someone who was not significantly symptomatic. We do not know what the prodromal phase of coronavirus is, and people could be spreading the condition without our knowledge. The advice must be clear.

Does the Secretary of State recognise the confusion there is that those returning from certain parts of north Italy must self-isolate, even if asymptomatic, but those coming from China do not need to self-isolate if asymptomatic? That is causing confusion and we may end up behind the curve. If containment is to work, we must be ahead of the curve. Self-isolating does not count as illness, so will the Government send a clear message to employers, so that those who are advised to self-isolate will still be paid or receive sickness cover? Otherwise, there will be people who feel that they must go to work, because they simply cannot afford to have no income for two weeks.

The Secretary of State suggested that he would not go to wider northern Italy, and the Chief Medical Officer suggested that people with health conditions should not go there. Travel insurance kicks in only when the Foreign and Commonwealth Office gives clear guidance. Will that guidance be changed to state that people should not be travelling to wider northern Italy, and other areas, so that people are not disadvantaged by not having travel insurance if they choose not to put themselves, and indeed all of us, at risk of the disease spreading?

[Matt Hancock]

The hon. Lady is right with regard to concerns about under-reporting, especially in some countries. I am afraid I do not recognise some of her clinical observations, and I do not recognise the idea that we should change travel advice between China and Italy. We should base travel advice on expert clinical evidence. I am very happy to ensure that she receives a full briefing from medical experts, so that she can get the clinical points right.

On thermal detection, rather like stopping flights this is against clinical advice. The clinical advice is not to undertake thermal detection, because we get a lot of false positives. Indeed, the only country I know of in Europe that undertook thermal detection at the border was Italy and that is now the scene of the largest outbreak.

Finally, the hon. Lady made a very important point about people in work and self-isolation. Self-isolation on medical advice is considered sickness for employment purposes. That is a very important message for employers and those who can go home and self-isolate as if they were sick, because it is for medical reasons.

Wuhan Coronavirus

Debate between Matt Hancock and Philippa Whitford

Tuesday 11th February 2020 Commons Chamber

[Matt Hancock]

This is a very important strand of our prepare and mitigate policy to ensure that should things get worse here the NHS is fully prepared. The NHS has the capability now to cope with the very highest level of intensity and isolation with 50 cases, and the capability to expand that to 500 cases without an impact on the wider work of the NHS. If the number of cases gets bigger, we will of course need to take further steps. As my right hon. Friend knows from his time in my shoes, extensive plans are already in place for how they should happen if we reach that eventuality.

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

I, too, welcome the Secretary of State’s statement, and we support the use of powers to maintain isolation, as they are critical for the health and safety of other people in the country. I would, however, also support their being transparent and proportionate. I also welcome that the four chief medical officers across the UK are working together on this issue.

The Government are advising symptomatic returnees from the high-risk countries, but should that not be all people returning from high-risk countries? We simply do not know what the prodromal part of the incubation period is, nor how infectious someone actually is before they have any symptoms at all. I have to say that I was surprised to see the bus drivers, who were driving those on their way to quarantine, sitting in the front seat in shirt sleeves besides someone in full hazmat gear. That seemed to me to send out a rather strange message.

It is also advised that only those from Hubei province should self-isolate even if asymptomatic, but we see from the cases in France that this is spreading very quickly, and we already have 40,000 cases across 28 countries. Therefore, if anyone is flying and going through airports, there is the risk of spread, from simply being on an aeroplane with someone coming from China.

I welcome the funding for vaccine research and the expansion to 12 test centres across the four nations, but what publicity campaign is planned to educate the public upfront not to go to their GP and not to go to accident and emergency, where they will actually spread it to someone else? I understand that the information is there on the Scottish NHS inform system or 111, but if someone is not looking maybe we need to be proactive about the message.

Finally, the UK is no longer part of the European Centre for Disease Prevention and Control. While we are able to take part in the early warning and reporting system during transition, we are no longer part of the decision making or central procurement of vaccines. How much of that system is the UK still able to be part of at the moment during transition and in the long term? Does that perhaps raise up the agenda some of the areas of co-operation that need to be sought with European Union agencies?

[Matt Hancock]

I am grateful for the broad support expressed by the hon. Lady. I am also very grateful for the work of the devolved authorities in Scotland, Wales and Northern Ireland, and the work of the four CMOs across the UK, who have worked very closely together on what is a public health emergency.

To answer the hon. Lady’s specific questions, all those returning from any of the named countries, which I reiterated in my statement, should, if they are symptomatic, self-isolate. We are taking all measures that are deemed to be effective on the clinical advice. As a clinician herself, I am sure she will recognise the importance of following the epidemiological science wherever possible to make sure we take steps that will be effective and proportionate to the scale of the challenge.

The hon. Lady also asked about the monitoring of those returning on flights. We have enhanced monitoring in place for all those returning, as I said. She also asked about a publicity campaign to get the message across about what people can do—people should wash their hands and follow the advice in the “catch it, bin it, kill it” tissue-use campaign—as well as the important message that the first thing that someone should do is call 111. We have a very significant publicity campaign and I will double-check that that is being co-ordinated with the devolved authorities—I think it is but I will double-check, because that is very important.

Finally, to answer the point about the bus drivers, that decision was again taken on clinical advice to promote the safety of the passengers and balance all the considerations that needed to be taken into account.

NHS Funding Bill

Debate between Matt Hancock and Philippa Whitford

2nd reading & 2nd reading: House of Commons
Monday 27th January 2020 Commons Chamber

[Matt Hancock]

Yes and yes; my hon. Friend anticipates my whole section on Mr PFI sitting over on the Opposition Front Bench. During his time in the Treasury, the hon. Member for Leicester South, managed to sign off some of the worst PFI deals. [Interruption.] The hon. Gentleman sighs, but I do not think he understands the damage he has done.

This Bill confirms that spending on the NHS will rise from £115 billion last year to £121 billion this year, to £127 billion, then £133 billion, £140 billion and £148 billion in 2023-24.

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

To clarify the point, are the Government committed to buying out the PFIs that are currently a burden on health boards and trusts?

[Matt Hancock]

We absolutely will be looking at doing that where we can. Unfortunately, that is difficult to do, because, over time, and especially during the time that the hon. Member for Leicester South was in the Treasury, the legals on these PFI deals got tighter and tighter. There are 106 PFI deals in hospitals and we are going through them. We will work towards making them work better for patients, and if that means coming out of them completely, I will be thrilled.

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 29th October 2019 Commons Chamber

[Matt Hancock]

We will see shovels in the ground, I very much hope, from next year. I pay tribute to my hon. Friend, who has campaigned endlessly for these improvements to the hospital in Redditch. There is no better supporter of Redditch than her. She has badgered me endlessly, met me formally and bumped into me on the campaign. Every time I see her, she says, “Can we have the improvement to the hospital?” and the answer is yes.

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

The Secretary of State says that the NHS is not on the table, but President Trump and his trade officials have been very clear that they will seek to more than double drug prices, driving up the bill from £18 billion to £45 billion a year. What discussions is the Secretary of State having, and does he accept that this is why devolved Governments must have input in trade deals?

[Matt Hancock]

The NHS is not on the table in any trade deal. Medicine pricing and drugs pricing is not on the table in a trade deal. Let me bring the hon. Lady’s attention to this quotation from the former US trade general counsel, Stephen Vaughn, who said that if the UK really is determined to make no changes at all on pharmaceuticals, we can absolutely hold that position and that that has nothing to do with them. Quite right —we do hold that position; they are off the table.

The National Health Service

Debate between Matt Hancock and Philippa Whitford

Wednesday 23rd October 2019 Commons Chamber

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

Before I start my speech, I would like factually to correct the Secretary of State, who claimed that Barnett consequentials in Scotland are not passed on. I reassure him they are all passed on. He talks about the figures as a percentage. Scotland spends £185 a head more on healthcare and £157 a head more on social care. Of course it is a smaller percentage but, in actual cash, Barnett consequentials are all passed on. I would be grateful if he would either improve his maths or stop repeating this narrative.

I really welcome some elements of the Queen’s Speech, particularly the Health Service Safety Investigations Bill. I was asked to serve on the Joint Committee, which I felt did an incredible job, but we completed that job last July; approaching a year and a half on, sadly, the Bill has still not come forward. I hope it will not be too tardy from this point.

[Matt Hancock]

It is in the other place at the moment.

[Dr Whitford]

Okay; I welcome that. However, I would suggest that the Healthcare Safety Investigations Bill is about looking at mistakes after they have happened. I invite the Secretary of State again to look at the Scottish patient safety programme, which is more than 10 years old and has reduced hospital deaths, including post-surgical deaths, by over a third because the aim is to prevent harm in the first place.

I welcome the Secretary of State’s reference to whistleblowers, but it is not just about having guardians in hospitals. It is critical that the Public Interest Disclosure Act 1998 is reformed. Only 3% of employment tribunals are successful. All Members who have dealt with any cases on this issue will know that the wreckage of whistleblowers’ careers acts as an absolute brake on people coming forward. You can say what you like, but they are faced with the question, “Do I speak up and risk my career, my family income and my home?” It is not just a matter of paying lip service to this issue; we actually need change.

I welcome the ending of the private finance initiative, which was originally brought under a Conservative Government, but was really accelerated, I am afraid, under Gordon Brown. We are now facing the fact that £13 billion-worth of hospitals in England will have cost £80 billion by the time they are paid off. I call on the Secretary of State not just to end the PFI going forward, but to look at whether these contracts could be ended and renationalised to avoid another £55 billion having to be paid over the next 30 years. This problem is UK-wide, so we were saddled with these contracts in Scotland as well. There are health boards across England that are spending up to 16% of their income on their PFI contracts, and that obviously undermines patient care.

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 18th June 2019 Commons Chamber

[Matt Hancock]

My hon. Friend makes an important point, one that we have frequently discussed. As he knows, I am married to an osteopath, so I do recognise the value that osteopaths bring to all of us.

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

Research shows that the ratio of registered nurses to patients is one of the most important factors in patient safety, so members of the Royal College of Nursing are calling on the Secretary of State to follow Wales and Scotland and to bring in safe staffing legislation. What is his answer to them?

[Matt Hancock]

Of course we need to have the right number of nurses. We need to make sure that we also put in the funding. If the SNP Government in Scotland had put the same funding increases into the NHS in Scotland, there would have been half a billion pounds more there over the last five years. So let us start with getting the money in that we are putting in in England, but is not fully being reflected by the SNP Government in Scotland.

[Dr Whitford]

The SNP in Scotland spends £185 a head more than England, so the Secretary of State should check his figures. At over 11%, the nurse vacancy rate in England is more than double that in Scotland. Whereas student nursing numbers have increased every year in Scotland, there are 570 fewer nursing students this year in England. Is it not time to follow Scotland’s approach, reintroduce the nursing bursary and end tuition fees?

[Matt Hancock]

I am not going to let the SNP spokesman get away with this. Normally, she brings a thoughtful contribution to health debates, but she said that there is more spending in Scotland per head. The truth is this: the increase in spending in England over the last five years is 17.6%, but in Scotland the increase is only 13.1%. That represents half a billion pounds less: the increase in spending that we have seen in England that they have not seen in Scotland. She should recognise that fact.

Listeria: Contaminated Sandwiches

Debate between Matt Hancock and Philippa Whitford

Monday 17th June 2019 Commons Chamber

[Mr Speaker]

I hope the hon. Member for Stone (Sir William Cash) will not be saddened by the fact that he is not yet a member of the Privy Council. After all, he is a Staffordshire knight, he has served his constituency without interruption in this House for 35 years, and I remind the House that the hon. Gentleman has a whole chapter named after him in the late Hugo Young’s estimable tome on Britain’s relationship with Europe. There is a chapter in the name of Mr Bill Cash.

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

I, too, would like to express our sympathies with the families of the five patients who lost their lives, but also the four who remain critically ill. Obviously, we do not know what outcome they face.

As the shadow health spokesperson highlighted, these sandwiches were sold to 43 trusts, and while there have been no cases since 25 May, the incubation period of listeriosis is 70 days, so will surveillance of those 43 trusts continue alongside the Health Secretary’s investigation?

The Food Standards Agency published a report in 2014 about the dangers of hospital food. It cited 32 failures, including sandwiches spending hours outside fridges, and fridges often not being cold enough. Indeed, it has been highlighted that hospital sandwiches have been the commonest source of listeria outbreaks over the past two decades.

As the Health Secretary says, simple cases are often a matter of people being unwell for a few days, but listeria poses a major threat to pregnant women, who may lose their child, and is life-threatening for people who are already ill. Will the Health Secretary therefore pay particular attention in his review to why on earth people who were seriously ill or frail were being fed sandwiches? Someone who has no appetite and is recovering from illness is simply not going to be tempted by a pack of sandwiches. That really makes the case for bringing food preparation in-hospital and producing tempting meals, because nutrition is critical to recovery.

[Matt Hancock]

I entirely agree with and endorse what the hon. Lady has said. She is quite right to point out that a meal has to be appetising as well as nutritious. The best hospitals deliver that, and I would like that practice to be much more widespread.

I reassure the hon. Lady that the 2014 report by the Food Standards Agency was, as I understand it, looked into in great detail and assurances have been made that what it raised has, correctly, been followed through. Obviously, that was before my time as Health Secretary but I have taken advice on precisely the point she raises and I have been assured that what was necessary happened. I am open-minded, however, on what may have happened and what more needs to be done, and the review will absolutely look into that question.

Finally, the hon. Lady is absolutely right about the incubation period. We remain vigilant. Because listeria is a notifiable disease, Public Health England is told of every case and is able to analyse the links from every new case to existing cases. Notification of most cases takes place after the fact, given the nature of the disease, but we are then able to find genetic links, where they exist, and find out whether different cases have the same source.

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 7th May 2019 Commons Chamber

[Matt Hancock]

I agree entirely and enthusiastically with my right hon. Friend. The need to improve services in the NHS just to bring them up to the best that is in the NHS is vital and urgent. We can lift the quality of care that all our constituents get simply by learning from the best. We have schemes such as the “getting it right first time” programme, which is brilliant at teaching hospitals how to do things the way the best hospitals do them, and we want to see more.

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

A recent report in the British Journal of Surgery demonstrates that the introduction of the Scottish patient safety programme resulted in a 36% drop in post-surgical deaths. Will the Secretary of State join me in congratulating all the surgeons, anaesthetists, theatre teams and ward staff who achieved this, and would he like to visit Scotland and see the programme in action?

[Matt Hancock]

I always love visiting Scotland and would love to come and see this programme in action; I have heard and read about it. In improving quality across the NHS, we need to improve the ability of the NHS to look everywhere—outside the NHS in England, as well as at other hospitals—to find and emulate best practice.

Social Media and Health

Debate between Matt Hancock and Philippa Whitford

Tuesday 30th April 2019 Commons Chamber

[Matt Hancock]

Yes, my hon. Friend is absolutely right. In fact, the cumulative effect of posts on mental health, in particular eating disorders, came up in the discussion yesterday. We have to look at what the social media companies call the density of content—I think my hon. Friend put it rather better as the cumulative impact of lots of different posts. Social media companies’ algorithms are powerful enough to understand that and pick up on it. We need rules in place so that action can be taken when it is spotted by those algorithms.

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

I too welcome the statement, the two summits that have already been held and, in particular, the announcement of funding to Samaritans. However, the scale of the task is absolutely huge. The scale of the donation to Samaritans is actually quite small by comparison both with that and with the profits the companies make. They are expected to make profits of £50 billion just this year. It is important to talk about preventing the promotion of eating disorders, self-harm and suicide, and I welcome that approach.

As chair of the all-party group on vaccinations for all, I particularly welcome, in World Immunisation Week, the Secretary of State talking about anti-vaccination. As the shadow Secretary of State said, the drop in uptake is caused not just by online, but by complacency. People have forgotten that measles is a killer. It used to kill 2.5 million people a year across the world. We have seen an outbreak in Europe, where 82,000 cases have led to over 70 deaths. It is important that we tackle misinformation. It is also important that we make it easy for busy mothers to get their children vaccinated by having health visitors and district nurses who try to help. It is partly that that has allowed Scotland to keep the rate above 95%, but we, like everywhere else, are still seeing that rate drip down and fall by 0.5% or 1%.

On the online harms White Paper, I welcome the talk about a regulator. I hope it will actually be a regulator and that there will not be voluntary or self-regulation. I would like to know when it is actually going to happen. Like many other pieces of proposed legislation, it is still in the long grass and the situation is urgent.

[Matt Hancock]

The regulation of online harms will indeed be statutory. As I said, we are in the middle of a consultation on how, rather than whether, to put that in place. I am sure the hon. Lady will want to feed back, although I know her SNP colleagues in the Scottish Government in Edinburgh have been kept abreast of developments.

The hon. Lady raises complacency and financial resources. I will address both points. She is absolutely right that part of the problem is a complacency about some killer diseases, partly because we have hardly known them in this country for generations. As I said in my statement, measles is a horrible disease and a killer; it is deeply unpleasant. So, too, is rubella. Rubella might be hardly noticed by a pregnant woman. There might be a rash for three or four days which comes and goes, but the impact on the baby is permanent and very, very serious. On measles, rubella and other diseases, we have to be absolutely clear with the public about the consequences not only for their children but, even worse, for vulnerable children and adults who, maybe because they are immunosuppressed or very young, cannot have the vaccination. Their lives are directly threatened by a parent who chooses not to vaccinate. We need to be very clear and stark about that.

The hon. Lady mentions that the social media companies have contributed to Samaritans. That was Samaritans’ ask for this stage of putting together the organisation and experts it needs to provide clarity on the boundary of what is and is not acceptable in this space. I would, of course, be perfectly prepared to go and ask for more if more is needed. What is more, we are bringing forward a digital services tax. Historically, the global tax system has not worked well in taxing such companies fairly, because of the nature of how they make their money. We have worked for years to try to get a global consensus on how to tax them. We are now clear that we will bring forward the tax next year in the UK, regardless of whether we can get global consensus.

Access to Medical Cannabis

Debate between Matt Hancock and Philippa Whitford

Monday 8th April 2019 Commons Chamber

[Matt Hancock]

Characteristically, my hon. Friend makes an excellent point. The clinicians consider that there is a much less evidence on THC, as opposed to CBD. I have therefore instructed the National Institute for Health Research to do the research. Doing the research will of course require some cases where the drugs can be legally tested. I had already put that in place, and I am telling the House about it today.

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

I am glad this urgent question has moved from the Home Office to Health, where it should be, but one has to ask why drugs are being seized when they are no longer illegal—that is what changed in November.

In medicine, we use many controlled drugs, such as heroin, morphine, ketamine and diazepam which have a street value, but that has never stopped them being used in medicine. The problem is that the way cannabis was treated for 50 years means we have had almost no research and almost no experience.

The problem is also that expectations were raised in November, as if every GP would be able simply to write a prescription, but a prescription for what? We have to have a pharmaceutical quality of drug so that we know exactly how much CBD and how much THC we would be prescribing. That is not yet generally available. It is important that we look, through the Government, to get that pharmaceutical grade licensed, with reliable formulations.

This issue is under inquiry in the Health Committee, and we have heard from patients who were advised to go to Holland to get drugs, costing them £30,000 per visit. That is unacceptable. The Government will have to stimulate research, and I am grateful that calls for research are going to go out. However, we need specialist centres in paediatric neurology for children with epilepsy, we need adult neurology for multiple sclerosis, and we need pain specialists for chronic pain.

These preparations are unlicensed; that means there has been no testing on their efficacy—whether they work—and on whether they are safe. That is quite scary for doctors, particularly as if it is an unlicensed drug, they have to sign a form to say that they accept personal liability. I can tell the House that that is quite intimidating, as I have done it myself. The Government need to push for centres of excellence to help to stimulate the research they say they are calling for. That is the only way we will get randomised controlled trials, and get the answers that will lead to these drugs being licensed, rather than our just having a temporary fix for now.

[Matt Hancock]

In an outbreak of cross-party unity, I agree entirely with the hon. Lady. The approach she has taken is incredibly sensible; it is also the one that has been recommended to me by my clinical advisers. We need to ensure that we take an evidence-based, pharmaceutical-grade approach to prescription. I will take away her idea about centres of excellence, because I entirely see the point there. In the case of most drugs, it is the pharmaceutical industry that pushes for, and pays for, the randomised controlled trials. In this case, because the industry is in a different shape for other reasons, it is we who are making this happen, and we are pushing it as fast as we can

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 19th February 2019 Commons Chamber

[Matt Hancock]

I have already given the assurance that if everybody does what they need to do, I am confident that supplies will be unhindered. In the case of insulin, the stockpiles are already double what we requested. However, on the point about the deal, the hon. Gentleman has a really important point about ruling out no deal being the best thing for people’s supply of medicines. He knows as well as I do that if we want to rule out no deal, we need to vote for a deal, so he and everybody in this House should vote for the deal.

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

The serious shortage protocol statutory instrument would allow pharmacists to dispense alternative drugs when there is short supply, but, crucially, without consulting a GP. The problem is that they cannot access patients’ records and might dispense a drug that has previously caused serious side effects. Is the Secretary of State really expecting such extensive shortages that phoning a GP will be impractical?

[Matt Hancock]

This change is to respond to the shortages that happen from time to time regularly in the NHS. Given that the supply of 12,300 drugs is typical across the NHS, there are always some logistical challenges. This protocol is to try to ensure that we can respond to those challenges as well as possible. Pharmacists are highly trained in what they do and perfectly able to carry this out as proposed.

[Dr Whitford]

The problem is that the key issue is not consulting the GP. The medical legal responsibility for any problems normally lies with the prescriber, yet the General Medical Council was not even consulted on this SI. Does the Secretary of State really think that such a significant change should be pushed through with a negative resolution and no scrutiny and debate?

[Matt Hancock]

Well, it is getting scrutiny and debate now. The change that is being proposed is about making sure we can get people the drugs they need. Of course the responsibility is on the pharmacist to ensure that it is the appropriate drug and, if necessary, that the GP is involved. However, it is absolutely right that we make changes to ensure that we have an unhindered supply of medicines whenever there are shortages—whether that is to do with Brexit or not.

Oral Answers to Questions

Debate between Matt Hancock and Philippa Whitford

Tuesday 15th January 2019 Commons Chamber

[Matt Hancock]

We are working to ensure that the prioritisation of not just medicines, but medical products and other things needed for the health of the nation, is taken into consideration. There is detailed work under way that is clinically led; the medical director of the NHS is heavily engaged in that work and works very closely with the Department on it. I am very happy to go through the details of my hon. Friend’s constituency case to make sure that that is also being dealt with appropriately. I am glad that, because she does not want no deal, she will be voting with the Government tonight.

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

Legislation was passed two years ago so that the Secretary of State could end profiteering by some drug companies. Now drug shortages after a no-deal Brexit could mean soaring costs across UK health services, so why have the Government not set the regulations from this legislation so that we can use the powers and avoid a black market in medication?

[Matt Hancock]

We have already taken action to ensure that the cost of drugs is reduced. I am very happy to write to the hon. Lady with the extensive details of the agreements that have been made. The legislation is indeed important; so, too, is working with the drugs companies to make sure that we keep those costs down and yet also get the drugs that people need.

[Dr Whitford]

As the precursors of medical radioisotopes have a half-life of less than three days, they cannot be stockpiled. I have frequently asked the Government how they will maintain a steady supply if there is a no-deal Brexit. Can the Secretary of State answer—and please don’t say “Seaborne Freight”?

NHS Long-term Plan

Debate between Matt Hancock and Philippa Whitford

Monday 7th January 2019 Commons Chamber

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

I note that the Secretary of State referred to the Churchill Government in 1944, but had he looked at Hansard he might have seen that Churchill cited the Highlands and Islands Medical Service, which was the first national health service in 1913.

I welcome the long-term plan, but the integration to which it aspires is going to be frustrated if there is no reform of the internal market and the fragmentation continues. The Secretary of State cites the funding, which he describes as 3.4% per year. That is actually just back to what the NHS received prior to 2010. He talks about a million extra patients. With this enormous increased demand, does he not think that it would be more honest to describe funding per head, rather than just a total? Scotland spends £163 more per head. Perhaps he should aspire to spend the money on the patients and then perhaps the NHS would keep up.

Again, like the previous funding agreement, the funding is focused only on the NHS, with cuts to public health, no extra money for health education and still no Green Paper on social care. I totally agree that prevention is better than cure, so will the Secretary of State reverse the cuts to public health? In his own letter, which was circulated, he emphasised reducing cancer deaths, yet there was no mention of prevention at all. That is the best way to reduce cancer deaths. Public health is crucial, smoking cessation is crucial and tackling childhood obesity is crucial, so will he liaise with his colleagues in the Department for Digital, Culture, Media and Sport and set a nine o’clock watershed on advertising rubbish foods?

I agree with the aim of improving screening. Last year, the Government agreed that they would reduce the bowel cancer screening age from 60 to 50. Can the Secretary of State tell us when that will actually happen? Does he recognise that it will mean a bigger need for endoscopists and radiologists? So will he fund Health Education England to provide them and to provide the other doctors, nurses and staff that the NHS will need to deliver this long-term plan?

[Matt Hancock]

My response is yes on the cancer screening—it is in paragraph 3.53. I want to return to the point that was made by the hon. Lady and by my right hon. and learned Friend the Member for Rushcliffe (Mr Clarke) about the link to social care. Of course that is critical. The plan has a section on the link to social care and the social care Green Paper will then tie into the plan. Of course, the two come together and the Green Paper on social care will be provided soon.

Gosport Independent Panel

Debate between Matt Hancock and Philippa Whitford

Wednesday 21st November 2018 Commons Chamber

[Matt Hancock]

My hon. Friend is absolutely right that the number of complaints and concerns raised is not the material factor. A complaint that is actively welcomed and then acted on by management is merely part of the improvement process of any organisation. We should be open to them, welcome them and see them as an important part of the continuous improvement of NHS trusts, which is how many successful organisations see them. As I set out in the statement, medical examiners will be introduced from next April, but I am happy to give her more details of that whole policy.

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

I, too, welcome the Secretary of State’s statement and the proposals in it. As he says, these 450—possibly even 650— deaths were not accidental, but deliberate.

I welcomed the Secretary of State’s attendance at our event yesterday, when we discussed the need for a just and learning culture in the NHS. Obviously, he heard the stories that were related during the event: stories of patients who had lost their lives, and families who have ended up spending their entire lives fighting for justice or change, so they have suffered over and above their bereavement. Staff were obviously not listened to. One witness compared a whistleblower with someone reporting to the police, or a state witness, and pointed out how shocked we would be if the police tried to shut that case up. Whistleblowers should be welcomed as people giving evidence against wrongdoing or failure.

I particularly welcomed the Secretary of State’s comment about reform of the Public Interest Disclosure Act 1998, which I think needs to be replaced. I think we need legislation that gives definite protection to people who come forward. As one who has been a clinician for more than 30 years, I can tell the Secretary of State that the long trail of clinicians who have reported concerns and then had their careers ended lies there like a threat to every whistleblower who thinks of speaking up.

If patient safety and the ability of people to speak up in safety are not enshrined in the NHS, we are all under threat. I am sure that not just the hon. Member for Leicester South (Jonathan Ashworth) but Members in all parts of the House would work with the Secretary of State to reform the legislation here and inspire the culture change that is needed in the NHS itself. I certainly would.

[Matt Hancock]

I agree with an awful lot of what the hon. Lady has said, and I appreciate the wisdom that she brings to this issue with her clinical experience.

The need for a just culture in the NHS is very clear, and the Gosport report makes it clearer still. A just culture means that, yes, there is accountability, but the accountability is established with the intent that the system will improve and people will learn; that people can come forward with concerns rather than covering them up; and that when concerns are expressed, they are welcomed.

I am also pleased about the hon. Lady’s attitude to potential legislation. I look forward to working with her, and, indeed, learning from some of the improvements that have been made in Scotland, to try to ensure that we can get this right.