Social Distancing: 2 Metre Rule

Munira Wilson Excerpts

Monday 15th June 2020 Commons Chamber

[Edward Argar]

My hon. Friend makes a good point. Through the package of measures we have put in place to protect public health and press down on the transmission of this disease, we are seeking to do exactly that—as the incidence and infection levels go down, to start relaxing those restrictions where we can, step by step and in a cautious way, to allow businesses to operate. It is quite right and understandable that Members have different views on the pace at which we should be going on either one of those, but it is exactly those considerations that this review is looking to investigate.

[Munira Wilson (Twickenham) (LD)]

As the Minister has already acknowledged, as well as the social distancing rules, a rigorous system to test, trace and isolate every case is critical to keeping people safe. The WHO has said that the system has to be proven “robust and effective” before further easing lockdown measures. NHS leaders and leading scientists have said that test and trace is not fit for purpose, and local authorities, which have a critical role in tracing, say that their remit is still unclear and they do not have the critical data they need. When will he ensure that all local authorities have the information they need to support test and trace fully?

[Edward Argar]

I thank the hon. Lady, her party’s spokesperson on this issue. In the first week of its operation, having been stood up pretty much from scratch, this system has performed extremely well, with 67% of those testing positive successfully contacted and responding with the information needed, and 85% of their contacts agreeing to self-isolate. There is more to do—of course there is—but that is a very positive start to this programme, led by Baroness Dido Harding, in its first week of operation. In answer to the second point, it is right that we continue, as we have done throughout, to work hand in hand with local authorities, as well as other public health authorities.

Covid-19: R Rate and Lockdown Measures

Munira Wilson Excerpts

Monday 8th June 2020 Commons Chamber

[Matt Hancock]

That is an incredibly important point, because being able to get a vaccine everywhere around the world is incredibly important to us here at home. Of course, our top priority is access to the vaccine for the citizens of this country, but we are also using our aid budget to ensure that, should a vaccine work and become available, we can not only deliver it here but be good global citizens. As my hon. Friend says, we have put more into this than any other country on the planet.

[Munira Wilson (Twickenham) (LD)]

Professor Edmunds also said yesterday that the R value was largely being driven by outbreaks in care homes and hospitals. Despite the Secretary of State’s statement, we know that there are still some care homes, including in my constituency, where residents and staff have yet to be tested. How can we effectively bring down the R rate without regular testing? Will he commit to regular testing in all care settings, including for the under-65s and those with learning disabilities?

[Matt Hancock]

The hon. Lady is absolutely right that testing in care homes is important. I am very pleased that my team hit their target of ensuring that all elderly care homes had access to tests by Saturday. Almost 9,000 care homes got kits for all their staff and residents to be tested, and the important thing is that that did not show a huge amount of infections that we did not previously know about. I am delighted that David Pearson—who, it is worth the shadow Secretary of State acknowledging, has been working with us throughout this period—will now be taking a leadership role in driving forward this work to protect our care homes further.

Covid-19 Response

Munira Wilson Excerpts

Tuesday 2nd June 2020 Commons Chamber

[Munira Wilson (Twickenham) (LD)]

In view of the Secretary of State’s statement confirming PHE’s findings that being black or minority ethnic is a high-risk factor, what guidance is he providing to the NHS and social care sectors on the rostering of BAME staff in high-risk covid areas? Will his Department be investigating whistleblower claims that BAME locums were disproportionately placed on the rota at Weston General Hospital, which has recently experienced a major outbreak?

[Matt Hancock]

The hon. Lady is right to raise the case of Weston hospital. We have been working hard to ensure that the local outbreak is brought under control, and we are making progress. She is also right, of course, to raise the PHE report that we published today.

The critical next step is to ensure that we understand the drivers of the disparities that are seen in the data and, in particular, that we address the question of the impact, taking into account co-morbidities has such as obesity and the impact of occupation, which are not taken into account in the PHE work thus far. That is the work that the Minister for Women and Equalities, my right hon. Friend the Member for South West Norfolk (Elizabeth Truss), will be taking forward.

Coronavirus and Care Homes

Munira Wilson Excerpts

Tuesday 19th May 2020 Commons Chamber

[Matt Hancock]

Yes, I can reassure my right hon. Friend—I thank him for what he said about the work we are doing in the Department—first, that supplies of PPE into the country and buying around the world have improved significantly, and we have put huge amounts of effort into improving that. Secondly, the supply, once the equipment is in the country, out into the care homes and where it needs to be is improving all the time. The number of care homes reporting that they are within 48 hours of a stock out, which is the measure we use, has been falling and is less than half what it was a month ago, but we of course keep working to get that number down. When a care home is within two days of a stock out, we immediately work to get it the PPE that it needs.

[Munira Wilson (Twickenham) (LD) [V]]

At this morning’s Health and Social Care Committee, Care England said that care staff were suffering a constant cycle of bereavement. With so many deaths in care homes, staff are not only caring for, but comforting those they know well who are dying alone. So will the Secretary of State take steps this week to provide a 24-hour mental health phone line for all care staff, as well as fast-track access to professional mental health services, as is the case for the military?

[Matt Hancock]

I will absolutely look into the proposal that the hon. Member puts forward.

Covid-19 Update

Munira Wilson Excerpts

Tuesday 5th May 2020 Commons Chamber

[Matt Hancock]

Yes, it is a big team effort and all play their part. People have different roles, of course, and people on the frontline have been incredibly flexible in the roles that they play, but all play a critical part and all deserve our support.

[Munira Wilson (Twickenham) (LD) [V]]

In order to test, trace and isolate, to keep people safe and save lives, testing must work properly and be widely and locally available, so I was astonished to hear that yesterday people in my constituency were being sent as far afield as Brighton when we have a testing site right here at the Rugby Football Union in Twickenham. Other key workers tested last week at Twickenham have had their tests lost and no one in the NHS can find them, and we are also hearing reports that people sent home testing kits have no return address to send their completed tests to, yet those tests are being counted. Will the Secretary of State please confirm how people are being prioritised for testing at their local sites, how many tests have been lost—both at drive-through sites and among those sent to people’s homes—and when he thinks we will be doing enough testing to actually move to test, trace and isolate to keep people safe, as so many other countries have been successfully doing for several weeks now?

Coronavirus Bill

Munira Wilson Excerpts

2nd reading & 2nd reading: House of Commons
Monday 23rd March 2020 Commons Chamber

[Matt Hancock]

I will take that up with the Chancellor of the Exchequer.

[Munira Wilson (Twickenham) (LD)]

While we understand that the circumstances are exceptional, there is understandably grave concern about lowering social care standards. We are talking about some of the most vulnerable in our society—the elderly and disabled of all ages. Having the convention on human rights as a back-up could lead to care standards being lowered to a dangerous level, putting those people at risk. Will the Secretary of State outline the thresholds for turning the powers on, and indeed off to ensure that they do not become the new norm?

[Matt Hancock]

The threshold is to do with staff shortages. I say gently to the hon. Lady that I understand her concerns, but in fact the purpose of these measures is precisely the opposite: it is to make sure that when there is a shortage of social care workers, those who need social care to live their everyday life get it and can be prioritised ahead of those who have a current legal right to social care under the Care Act 2014 but for whom it is not a matter of life and death. This is absolutely about prioritising the vulnerable. That is the purpose of the legislation, but I understand her concern, and that is why we put the safeguards in place to ensure that the prioritisation works as intended.

--- Later in debate ---

[Jeremy Hunt]

My right hon. Friend knows, as a clinician— and I am concerned—that in our desire to get PPE out we have not understood the vital role that local authorities play in this. Residents in care homes are extremely vulnerable, and their carers need that equipment, so I very much support his concern about that.

The second area where the Bill needs to do more is testing. A week ago today our strategy changed from mitigation to suppression. I strongly support that change in strategy. Suppression strategies are being followed very successfully in South Korea, Taiwan, Hong Kong, Singapore and China, which appear to have turned back the virus. Here, all our public focus has been on social distancing, but testing and contact tracing to break the chain of transmission are every bit as important, if not more important. Those countries that have turned back the virus rigorously track and test every case and every suspected case, then identify every single person with whom a covid-19 patient has been in contact to take them out of circulation. As a result, those countries have avoided the dramatic measures and some of the economic damage that we have seen in Europe.

South Korea has avoided national lockdown, despite having a worse outbreak than us; Taiwan introduced temperature screening in malls and office buildings, but kept shops and restaurants open—it has had just two deaths. In Singapore, restaurants remain open and schools are reopening, although working from home is discouraged. Again, in Singapore, there have been just two deaths. Ten days ago in this country, we went in the opposite direction, and stopped testing in the community. How can we possibly suppress the virus if we do not know where it is? So far, we have had 281 deaths, tragically. According to the modellers, there is about one death per 1,000 cases, which means that we have just under 300,000 cases in this country. According to the same modellers, the number of cases is doubling every five days, which means that at the end of next week we will have about 1 million cases or more in this country. Unless we radically change direction, we will not know where those 1 million cases are.

The Prime Minister talked about expanding testing from 5,000 to 10,000 to 25,000, which is welcome. He even talked about 250,000 tests a day, which would be more than anywhere in the world—I welcome that ambition, but ambition is not the same as a national plan, and we have not seen a national plan on testing.

[Munira Wilson]

The right hon. Gentleman may have seen reports today that some care providers are refusing to take patients being discharged from hospitals because those hospitals are unable to test them before discharge. Quite understandably, care homes are concerned about admitting patients who may be carrying the virus, given the other vulnerable people there. Does he agree that as testing is ramped up, not only health and care professionals but patients being discharged should be a priority?

[Jeremy Hunt]

I am very worried about that. A doctor in my constituency told me of exactly the same problem, and of course, the risk is that hospitals then fill up and do not have the space to treat people who urgently need hospital treatment.

We have an ambition to increase testing to 25,000 tests a day, but at the moment we are still only testing between 5,000 and 8,000 people every day. On Saturday, we tested 5,500, which is no significant increase on a week ago. It is not just South Korea that is testing more than us per head of population—Germany, Australia and Austria are as well. Now is the time for a massive national mobilisation behind testing and contact tracing.

If we have the antibody test, now is the time to become the first country in the world that says, “We are going to test every single citizen.” Now is the time to introduce weekly tests for NHS and social care staff, to reduce the risk of them passing on the virus to their patients. If the Francis Crick Institute in London is doing any research into anything other than covid-19 right now, it should stop—we need it to be designing tests. If the Sanger Institute in Cambridge is still decoding genomes, it should not be—we need it to process covid-19 tests.

And it is not just the science. Contact tracing is manpower-intensive, yet Public Health England has just 280 people devoted to this. We probably need 280 people in every city and county in the country. Every local government official doing planning applications, every civil servant working on non-corona issues and volunteers all should be mobilised in this vital national task.

As we have heard, testing is vital for NHS staff who are desperate to get back to work. Here is one tweet from a midwife called Katie Watkins, who speaks for so many:

“I know this is happening all over but had to call in sick for my clinical shift on labour ward today as my husband spiked a temperature last night. I feel fine and yet cannot go to work... Where are the tests for #NHS staff?? I could be helping but instead sat at home.”

Testing is also vital for the economy. If we are going to have a year of stop-go as we try to protect the NHS if the virus comes back, testing and contact tracing allows an infinitely more targeted approach and way to control the spread of the virus than economic measures that are much more blunderbuss and do much more damage. This Bill could help that by giving the Government powers to require any pharmaceutical company in the country to manufacture tests and any laboratory in the country to process those tests. It could stop the scandal of £375 tests being available to wealthy people in Harley Street when, in a crisis, every spare test should be used by NHS staff to get them back to work.

This Bill could help with something else being done very successfully in South Korea and Taiwan: the use of mobile phone data. In those countries, they look at the mobile phones of covid patients to identify other phones that they have been nearby when that patient was infectious. That has civil liberty implications, but in this national emergency, being able to do that would save lives, so those powers too should be in the Bill.

Finally, please do not take my word for it on testing. Dr Tedros Adhanom, the director general of the World Health Organisation, and virtually every epidemiologist at the World Health Organisation makes the same point: it is not possible to “fight a fire blindfolded”; social distancing measures and hand washing will not alone extinguish the epidemic; and

“our key message is: test, test, test.”

I know that time is short, but I want to touch briefly on two other issues. Some good points have been made about social care this afternoon. The Bill replaces local authorities’ duty to meet care needs with a power to meet care needs, except when it is a breach of human rights. Bluntly, there may be less provision of social care as a result. We understand in this House why that may be necessary, but if it lasts as long as a year, that will mean more pressure, not less pressure, on hospitals. If there was any lesson from my time as Health Secretary, it is that we need to invest in social care as well as in health. We need to ensure that these new measures do not have the unintended consequence of putting yet more pressure on hospitals that are already on the point of falling over.

My final point is on mental health. Under the measures in the Bill, someone can be sectioned not by two doctors, but by one, and that doctor does not have to know the patient. I understand why we have to take these measures, but obviously it causes huge concerns in the mental health community that someone could be locked up on the say-so of a doctor who does not even know them. I want a commitment from the Government that all cases will be reviewed on the basis of the current procedures as soon as this virus is behind us, and certainly within the first three months.

I end my remarks with a tribute to frontline staff, not from me, a politician, but from an eight-year-old constituent of mine called Tamsin. She says:

“I really want thank all the doctors and nurses who are working so hard to look after all the sick people…they are all risking their own lives to try and stop the coronavirus instead of being safe at home. I’m missing my Nana, Gamma and Grampy a lot because they have to be isolated at home but if they get sick they will need the doctors and nurses to help them get better. Doctors and nurses are amazing.”

Tamsin is right. We must not let them down.

Covid-19

Munira Wilson Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

Yes, most people recover within seven days of first showing symptoms—most people, not all. Many become very ill, but for most people this is a mild to moderate illness, and the vast majority of the evidence is that once they have recovered, the illness does not come back for some time. Of course, all the evidence is kept constantly under review.

[Munira Wilson (Twickenham) (LD)]

Will the Secretary of State clarify some details of his answer to the hon. Member for Tooting (Dr Allin-Khan) regarding testing of our frontline healthcare workers and, just as important, our frontline social care workers? Our services are stretched to the max already. We cannot afford to have those who do not need to self-isolate self-isolating, potentially multiple times if they do not know whether they have had the virus.

[Matt Hancock]

I entirely understand that point. I want to get testing to everyone who needs it as soon as possible.

Coronavirus

Munira Wilson Excerpts

Wednesday 11th March 2020 Commons Chamber

[Matt Hancock]

Yes, absolutely. My hon. Friend has brought that to my attention before. We have done research into it, and we are working with over two dozen commercial companies that have tests of this kind. In fact, I had a meeting on this today.

[Munira Wilson (Twickenham) (LD)]

I welcome the Secretary of State’s focus on social care. Will he clarify how much of the additional spending in today’s Budget will go into social care? Will PHE issue protective equipment to careworkers? His statement referred to adult social care. There are many sick children in this country who are reliant on care. Will he ensure that children’s needs are not overlooked? I wrote to him about that earlier this week, and I would welcome clarification.

[Matt Hancock]

As the hon. Lady knows, guidance is coming out this week. She is right about the importance of protective equipment, and of course, we are taking that into account. The Chancellor set out that more money will be available in social care if it is needed—and I expect that it will be—and announced a total of up to £5 billion for the NHS and social care, while saying that his door is open should more be needed. These are all very important considerations, and the guidance will be out shortly.

Oral Answers to Questions

Munira Wilson Excerpts

Tuesday 10th March 2020 Commons Chamber

[Helen Whately]

My hon. Friend will be aware that already some of the funding that adult social care receives is through a council tax precept, but I would be delighted to meet him as part of the cross-party talks we have initiated to address the challenges in social care.

[Munira Wilson (Twickenham) (LD)]

There are numerous reports of people with symptoms of coronavirus being refused a test by 111 because they cannot name an individual who has been diagnosed with the virus. Yesterday the Secretary of State’s ministerial colleague, the noble Lord Bethell, said about 111 that there must be people who had had “bad experiences”. Will the Secretary of State confirm whether it is indeed policy not to test those with symptoms who cannot be contact traced, or whether many people are simply having a bad 111 experience?

[Matt Hancock]

The 111 protocols are of course driven by the clinicians. I will look into the specifics of the case that the hon. Lady mentions was raised in the other place yesterday, but we keep those protocols under constant review—not least as the epidemiology of the virus changes as the number of cases increases—to ensure that we have the very best advice.

Health Inequalities

Munira Wilson Excerpts

Wednesday 4th March 2020 Commons Chamber

[Dr Whitford]

If the right hon. Gentleman waits to hear the rest of my speech, I will highlight some of the differences in child poverty.

We have seen life expectancy for those women falling, but when we look at healthy life expectancy, the gaps are even bigger. Time spent in poor health is increasing, and that of course puts pressure on the NHS and care services. We in this Chamber are always discussing the pressure that the NHS is under. Emergency admissions in areas with low life expectancy are double the numbers in wealthier areas. Women in deprived areas will now spend two decades or more of their life in poor health. Improving the healthy life expectancy by at least five years was actually a policy in the industrial strategy, so that people could be active and engaged in the economy, but what we have seen is an adverse effect both on health and health equality.

We know that someone’s health for most of their life is determined in the early years, even starting when their mother is pregnant. Child poverty is central to this and it is rising. It is defined as children in households with less than 60% of median income. England had child poverty down to 27%, but it is now 31%. Scotland had it down to 21%, and it is now 24%. That is because welfare changes are taking place right across the UK. Poverty is decided in this Chamber; it is not decided anywhere else, and the Scottish Parliament, as we have heard, spends a lot of energy on trying to mitigate it.

As we know, housing costs are a major contributor because of the shortage of housing. This is a rising issue among the poorest: 38% of the poorest will spend 30% or more of their income on rent or housing. That figure was 28% 10 years ago. The Scottish Government have built 87,000 affordable houses, and that is part of why our child poverty level is lower. It is the housing impact. In the 2015 general election, the Conservatives promised 200,000 starter homes. They built precisely zero.

Some 4 million children are growing up in poverty, and that will affect their whole lives. Whenever the issue is raised at the Dispatch Box, we are told that unemployment is down and that people must work their way out of poverty. We are told that that is how we change things, yet two thirds of those children already have a working parent. The problem is that all of this drives ill health.

[Munira Wilson (Twickenham) (LD)]

Does the hon. Lady agree that children living in poverty are more likely to suffer mental health issues? They face a double whammy, as the Children’s Commissioner recently found, in that there is also a postcode lottery in spending on children and young people’s mental health, which varies between about £15 and £200 per person, depending on the area.

[Dr Whitford]

I totally accept that, and actually, children in low-income families have three times the rate of mental health problems. Three-year-olds in a household with an income of less than £10,000 have two and a half times the chronic diseases, and by the time they start school, we find that the poorest children have over a year’s gap in vocabulary. It is important to try to balance that. That is one reason that the Scottish Government are investing in early learning for all children—all three-year-olds and four-year-olds and vulnerable two-year-olds—and also have put in a pupil equity premium that allows the school to have additional funding to try to meet the challenge where they are serving poorer communities.

The problem starts before the child is born. A woman carrying a female child is carrying her grandchildren, because the eggs in a female are formed in the womb. That means that if that mother is badly nourished, she will be affecting health for the next two generations. That needs to be changed, which is why we have invested. We have the best start grant, which goes to the pregnant woman at birth, when the child starts nursery and when the child starts school. There is also food support, because we need to change this right at the start of life.

Health and wellbeing should be an overarching priority for any Government and for all their citizens, regardless of where they live. This requires a “Health in all policies” approach, not saying, “Clean air is DEFRA’s issue.” We need this as a cross-government policy whereby every decision is checked to see whether it will improve the physical, mental and environmental wellbeing of the citizens the Government are responsible for.