(2 years, 11 months ago)
Commons ChamberI am grateful for my hon. Friend’s important question. As we now accept the recommendation from the chief medical officers of England, Wales, Scotland and Northern Ireland, it is also right for us to look at the question that she raised. I will happily write back to her after this statement.
The Minister will be aware that some estimates suggest that a staggering 900 million days of face-to-face schooling have been lost since the start of the pandemic. In that context, I welcome the Government’s decision today, but children’s vaccination is only one part of the puzzle—so are improved ventilation, funding for air purifiers in classrooms and, in some crowded environments, continuing with face coverings. Given that two Department for Education Ministers are sitting on the Front Bench alongside him—the Minister for School Standards, the right hon. Member for Bognor Regis and Littlehampton (Nick Gibb) and the Under-Secretary of State for Education, the hon. Member for Chelmsford (Vicky Ford)—will he press his colleagues to provide that funding for schools so that they can remain open safely for as many children as possible? Will the Government give us a cast-iron guarantee that we will not see any school closures this winter?
I am grateful for the hon. Lady’s support for tonight’s decision. The Department for Education is rolling out, I think, 300,000 carbon dioxide monitors. It is very important that ventilation is very much part of what we do as we transition this virus from pandemic to endemic status.
(2 years, 11 months ago)
Commons ChamberUrgent Questions are proposed each morning by backbench MPs, and up to two may be selected each day by the Speaker. Chosen Urgent Questions are announced 30 minutes before Parliament sits each day.
Each Urgent Question requires a Government Minister to give a response on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
It pains me to have to stand at the Dispatch Box and implement something that goes against the DNA of this Minister and his Prime Minister, but we are living through difficult and unprecedented times. As one of the major economies of the world, our four nations have done an incredible job of implementing the vaccination programme. This is a precautionary measure to ensure that we can sustainably maintain the opening of all sectors of the economy.
I almost feel sorry for the Minister because he really is struggling to defend this policy. However, he has failed to answer the fundamental question posed by my right hon. Friend the Member for Orkney and Shetland (Mr Carmichael) about this deeply illiberal, discriminatory and unnecessary policy: will this House get a vote on the implementation of covid vaccine passports—yes or no?
There will be appropriate parliamentary scrutiny, as I have said today and in the past.
(2 years, 11 months ago)
Commons ChamberThis is an incredibly difficult area, but let me try to describe the challenge here. To keep industries such as the nightclub industry open and sustainable, especially in the next few months, we have to look very seriously at how we keep them safe and not have super-spreader events. We have seen other countries having to shut down nightclubs the moment they reopen them. The worst thing for the industry is to open and shut, open and shut, which is why we are looking to introduce a covid certificate by the end of September for domestic use in large gatherings indoors, especially where we have seen mass spreader events.
The Minister will be aware that there are 3.7 million clinically extremely vulnerable people in this country who had to shield for many months. Many have continued to shield or take far greater precautions than the rest of us since restrictions have eased, and they have had very slow and inconsistent guidance at times. Will he prioritise that group in totality by prioritising booster jabs for the whole group, not just for the half million most at risk? We really need to keep the most vulnerable people safe.
(3 years, 1 month ago)
Commons ChamberWell, I welcome the fact that so many of my hon. Friend’s constituents have received their vaccination. Where there are problems with the data, I am sure he will know that the vaccines Minister, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi) is very assiduous on these specific matters. I will raise with him the examples. It may well be that the Minister will get directly in touch with my hon. Friend and resolve the situation.
I start by echoing the remarks of the Minister and the right hon. Member for South West Surrey (Jeremy Hunt) regarding Lord Stevens. He happens to be a constituent of mine, but he has also been a phenomenal chief executive of the NHS and I hope he will be making some well-informed interventions on the Health and Care Bill in the other place.
The statement rightly applauds our NHS staff and says how much we owe them. It says that the Government will give them all that they need. Words and clapping are cheap. Where on earth is the widely reported and trailed pay deal announcement that was expected today? Does the Minister really believe that the 1% pay rise, which is actually a pay cut, is giving NHS doctors and nurses what they need? Is that really a just reward for their sacrifices of the last 18 months?
I agree that pay for our NHS workforce is clearly very important. That is why we are considering the recommendations of the pay review body and we will make an announcement on pay in due course.
(3 years, 1 month ago)
Commons ChamberLike hundreds of thousands of other school children, my seven-year-old daughter is out of school at home today, self-isolating. I am sure that the Minister will agree that children have paid far too high a price in this pandemic in their mental health and in their education, missing out on school. Yet only last week, Professor Whitty said that we may see new restrictions in five weeks’ time, which is just before schools return. The Department for Education issued new guidance to schools, saying that they must be prepared to deliver remote education in the autumn. Today, the Minister said that we will not vaccinate all teenagers. What guarantees will this Government provide to pupils and parents across the country that schools will reopen in September fully and safely, and will stay open? Will he rule out any further school closures?
We and the devolved Administrations have accepted the advice of the Joint Committee on Vaccination and Immunisation to vaccinate vulnerable children, those children who live with vulnerable adults, and 17-year-olds close to their 18th birthday. The committee is, however, keeping the situation under review and looking at more data emerging from other countries, including the United States of America, on whether we should vaccinate all children. I reassure the hon. Lady that children will have two supervised tests on their return and that testing will continue until the end of September. A combination of that and vaccinating at scale all adults helps us to control transmission. Double-vaccinated people reduce transmission rates by about 50%.
(3 years, 1 month ago)
Commons ChamberWith that, I want to listen to this particular hon. Member.
The Secretary of State referred to Lord Stevens and what the NHS has asked for in trying to get rid of things that stand in its way. Something that it has not asked for is a massive power grab by the Secretary of State, which is in the Bill and will lead to political interference in day-to-day operational and reconfiguration decisions, which may not always be in the best interests of patients. Why does he think that that is a sensible way forward and something that the NHS wants?
Clinical decisions should always be made by those with clinical expertise—I think everyone in the House would agree on that—and that should be independent of any outside interference. The Bill does nothing to alter that. What it does is recognise that the NHS is one of the public’s top priorities. We spend over £140 billion of taxpayers’ money on the NHS, and it is right that there is proper accountability for that spending to Ministers and therefore to the House. I think that most people would welcome that.
I would like to make it clear that the Liberal Democrats have long supported the aim of integration between health and social care, and the far greater involvement of local authorities in the planning, commissioning and delivery of services. We recognise that the pandemic has forced many of these bodies to work closely together in a much more collaborative way, and that is welcome. However, the Bill pays lip service to social care. It is largely a Bill about NHS reform, with yet another acronym-laden reorganisation that seeks to provide the legislative basis to integrate NHS services, currently in crisis mode, with a broken, underfunded and fragmented social care system. It is a massive power grab by the Secretary of State for political interference in operational and local service reconfiguration decisions and in who runs integrated care boards. The Bill is woefully inadequate in ensuring that the plans and resources are in place to ensure that we have sufficient doctors, nurses and other healthcare professionals and carers to deliver care, both now and in the future. This is all against a backdrop of record waiting lists and staff who are burnt out, stressed and struggling to cope with the third wave of the pandemic while dealing with surging A&E visitors and tackling the enormous backlog of care.
Without meaningful social care reform, this Bill cannot realise its aim of providing citizens with better joined-up care. With over 100,000 vacancies in the workforce, 1.5 million people are currently missing out on the care they need, putting additional burdens on the NHS and, importantly, on 9 million unpaid carers. The Government have promised—at the moment I take them at their word, though they have broken it many times—that they will bring forward social care reforms later this year. So why not delay the Bill for a few months and take account of the new model of social care, rather than doing a half-baked job now?
It really beggars belief when we look back over the past 16 months of the pandemic that the right hon. Member for West Suffolk (Matt Hancock), who was the architect of the proposals, seriously thought that granting himself more powers over the day-to-day running of the NHS was a good idea. We only need to look at the PPE fiasco and the failures of test and trace, both of which were run centrally, to see that handing back power to the Secretary of State is the very opposite of what we need. Allowing him or her to meddle in the day-to-day running of our NHS seems to fly in the face of the desire for more local and regional decision making.
I fully support and endorse the proposals of the right hon. Member for South West Surrey (Jeremy Hunt) on the health and care workforce independent planning proposals. They need to be properly resourced and annually reported to Parliament. Without a workforce plan, without wholesale reform of social care and while waiting lists are skyrocketing and the Health Secretary is embarking on a power grab that is his predecessor’s vanity project, this Bill will fail in its fundamental aim, shared by most Members of this House and health and care leaders—
Order. The hon. Lady’s time has run out.
Before winding up this important debate, I would like to put on the record, as I always do and as I know the shadow Minister does, our gratitude to all the staff in the NHS, social care and local government, and other key workers, for everything they have done in recent months. This Bill is evolution, not revolution. It supports improvements already under way in our NHS and it builds on the recommendations of the NHS’s own long-term plan, laying the foundations for our recovery from this pandemic. This Bill is backed by not only the NHS, but so many others working across health and care. A joint statement from the NHS Confederation, NHS Providers and the Local Government Association reads:
“we believe that the direction of travel set by the bill is the right one.”
It notes that working in partnership at a local level is “the only way” we can address the challenges of our time. The chief executive of Age UK has said that ICSs are to be embraced and made as effective and inclusive as they can be, and the King’s Fund is calling for us to press ahead. The list goes on; the NHS wants us to press ahead, and in the words of Lord Stevens, “The overwhelming majority of these proposals are changes the health service have asked for.” So it is vital that we in this House do right by them and by patients at this critical juncture. It is the right time for this Bill. We legislate, Opposition Members obfuscate. I remind the shadow Secretary of State of his 2017 manifesto, which stated:
“We will reinstate the powers of the Secretary of State for Health to have overall responsibility for the NHS.”
With this Bill, we put increased accountability for the Secretary of State at the heart of this, yet now the shadow Secretary of State no longer seems to agree with himself and characterises his own proposals as “meddling”. I know that he is dextrous in his politics and in his policy position, which is probably why he has survived under multiple Leaders of the Opposition, but this is stretching it a bit.
We have sought, in getting to this point, to work on a collaborative basis at every stage, and hon. Members can be reassured that we will continue to adopt that approach in the weeks ahead as we proceed with this Bill, when we hope it goes into Committee. My right hon. Friend the Secretary of State set out in his opening remarks his willingness to listen. In particular, he highlighted that in the case of ICS boundaries no decision has yet been made. As he set out, we are determined to embrace innovative potential wherever we find it. That is quite different from many of the accusations we have heard here today. I know it is tempting for some—even when they know better, and they do—to claim that it is the beginning of the end for public provision. It is not and they know it. They know it is scaremongering rather than reality. They know that there has always been an element of private provision in healthcare services in this country, and they should know that because, as the Nuffield Trust said in 2019:
“The…evidence suggests the increase”
in private provision
“originally began under Labour governments before 2010”.
The shadow Secretary of State should certainly know that because he was a special adviser in the Treasury and in No. 10 at that time.
With regard to the implementation of the Bill, the NHS itself wants, subject to legislation, to move at pace to implement statutory arrangements for ICSs by April 2022. That is why NHS England is beginning preparatory work, including publishing an ICS design framework. Further work, including on integrated care board design and consideration of appointments and staff from CCGs will take place, after Second Reading, of course; this is all subject to the passage of the Bill.
Let me turn to some of the specific points raised by hon. and right hon. Members. The hon. Member for York Central (Rachael Maskell) asked about “Agenda for Change”. I can reassure her that it is not the intention that ICBs depart from “Agenda for Change”. The Bill’s drafting and wording is in line with existing arrangements for other NHS bodies with regard to “Agenda for Change” and translates it into this context. However, I am always happy to discuss that with her further if she wishes. Her suggestion that this was conceived, as she put it, in a bunker is quite simply not the case. Indeed, all the stakeholders, including the NHS, have said that this is one of the most collaborative pieces of legislation development they have seen.
Turning to the workforce, as my hon. Friend the Member for Winchester (Steve Brine) said, we cannot legislate to address workforce challenges but we can and we will look very carefully at the recommendations of the Select Committee and of my right hon. Friend the Member for South West Surrey (Jeremy Hunt).
While we do not always agree on everything, the hon. Member for Twickenham (Munira Wilson) made sensible points, although I would slightly tease her that she argued against the principle of the Secretary of State taking powers in reconfiguration and shortly afterwards her hon. Friend, the hon. Member for Westmorland and Lonsdale (Tim Farron), intervened on him asking him to do exactly that.
She did.
In response to the hon. Member for Central Ayrshire (Dr Whitford), I am again grateful for her comments and happy to accept her kind invitation to join her on a visit to Scotland.
The right hon. Member for North Durham (Mr Jones) made a very important point. In doing so, he rightly paid tribute to the work in this space done by my hon. Friend the Member for Sevenoaks (Laura Trott) with her recent private Member’s Bill. As the Secretary of State said, either he, I or the relevant Minister will be happy to meet him to discuss it further. My hon. Friend the Member for Meriden (Saqib Bhatti) was right to talk about the need for local flexibility. That is what we are seeking to do.
The hon. Member for Eltham (Clive Efford) asked more broadly about public spending constraints after 2010. He is brave, perhaps, to mention that. I recall the legacy of the previous Labour Government, which the right hon. Member for Birmingham, Hodge Hill (Liam Byrne) summed up pretty effectively in saying,
“I’m afraid there is no money.”
On social care, which a number of hon. and right hon. Members mentioned, we will take no lessons from Labour. In 13 years, after two Green Papers, a royal commission and apparently making it a priority at the spending review of 2007, the net result was absolutely nothing—inaction throughout. We are committed to bringing forward proposals this year. Labour talks; we will act.
The NHS is the finest health service in the world. We knew that before the pandemic, and the last year and a half have only reinforced that. It is our collective duty to strengthen our health and care system for our times. I was shocked, although probably not surprised, that the Opposition recklessly and opportunistically intend to oppose the Bill—a Bill, as we have heard, that the NHS has asked for—once again putting political point scoring ahead of NHS and patient needs. For our part, we are determined to support our NHS, as this Bill does, to create an NHS that is fit for the future and to renew the gift left by generations before us and pass it on stronger to future generations. We are the party of the NHS and we are determined to give it what it needs, what it has asked for and what it deserves. I encourage hon. Members to reject the Opposition amendment, and I commend the Bill to the House.
(3 years, 1 month ago)
Commons ChamberIt is a pleasure to follow the right hon. Member for Forest of Dean (Mr Harper), and I pretty much agree with everything he had to say. I wish to preface my remarks on these regulations by making it abundantly clear that I and my Liberal Democrat colleagues unequivocally and strongly support vaccination, and would urge everybody who is eligible to be vaccinated. We know that vaccines are safe, effective, and save lives, and for those on the frontline—whether working in social care or in the NHS—vaccination is critical. If I had a loved one in a care home, of course I would want maximum protection for them, and therefore would want all staff to be vaccinated. The question we as legislators have to grapple with is whether coercion is the answer, and what might be the unintended consequences of mandating vaccination for some of the lowest paid and most undervalued workers in our society, and for a sector that is on its knees.
As we have heard, the care sector is facing chronic staff shortages, and making vaccines mandatory has a real potential to exacerbate those acute shortages. The Government must do much more to convince and persuade care workers to get vaccinated. As many experts have said and as we have heard already, coercion is usually ineffective or, worse, counterproductive, and risks eroding trust in the sector. Indeed, the care sector has a long history of being overlooked and underfunded. Some 1.6 million social care workers earn less than the living wage; a quarter of the workforce are on zero-hours contracts; and there is a lack of any progression or career prospects. There is a real concern that those who are vaccine-hesitant may simply leave the profession rather than get vaccinated, particularly as we know that there are serious shortages in other sectors—such as hospitality—that are offering more competitive pay.
With 1.5 million older people currently not getting the care they need, already overstretched staff will become even thinner on the ground. Care providers, many of whom are already in a fragile state as a result of the pandemic, could find themselves having to deal with the costs of tribunals and legal challenges as a result of individuals losing their jobs. What support and resource is being provided to the sector to implement this policy?
Coercion is not an effective way to overcome hesitancy. Compulsory vaccination is a blunt tool for a complex issue, and research has highlighted that pressuring care workers can have damaging effects leading to the erosion of trust, worsening concerns about the vaccine and hardened stances on refusing vaccination. Indeed, digging into the detail shows that the rate of uptake may not be as bad in some places as it initially seems. The data is somewhat encouraging in that there is a significant disparity in the percentage of staff who have taken their first jab and not their second. For instance, Wandsworth has the lowest uptake rate, with 70% of staff having had their first jab but only 53% having had their second. This could indicate that Government and NHS initiatives are bearing fruit, and that mandating vaccination could therefore be premature. Alternatively, it might suggest there is a problem with trying to get care workers back to have their second jabs. This all suggests a much more complex picture, for which this blunt tool is not the answer. As others have said, we risk going down a slippery slope to chip away at people’s rights and freedoms to make their own health choices. This decision sets a precedent and must not be taken lightly.
That leads me to my final point. In part, we have arrived at this situation precisely because the care sector has been overlooked for so long. It has long been a Cinderella service and a poor relation to the NHS, and yet again, we see that this legislation applies only to care home workers and not NHS staff, so it feels discriminatory to many in the care sector. I come back to where I started. I want to protect the most vulnerable, but I fear that these measures will do more harm than good and that we risk a mass exodus of staff from an already overburdened, overstretched and underfunded sector.
In March last year, when my Liberal Democrat colleagues in the other place and I were asking searching questions of Ministers about testing and PPE to protect care homes, there were no answers. The truth is that the tragedy we have seen unfold in our care homes throughout the pandemic resulted in thousands of excess deaths because the protective ring that Ministers talked about went in far too late. This legislation we are being asked to support is a reaction to Government inaction and failure to protect care homes, and they continue to drag their feet on reforming the sector properly. Coercion and an assault on fundamental rights and liberties should not be the response to this. We must encourage, empower and support people to make the right decision to get vaccinated, and we must pay and value our heroic care staff properly, rather than pointing the finger of blame at them.
(3 years, 1 month ago)
Commons ChamberIt is precisely for the reasons my right hon. Friend sets out, and for other reasons, that we have already reviewed the rules on self-isolation. That is why we have announced that there will be a change from 16 August. We will keep them under review.
For the 3.8 million clinically extremely vulnerable people, the prospect of a so-called freedom day next week is actually anything but. They and many clinically vulnerable people, such as pregnant women, are living in fear of what living with covid means for them. Last Monday, the Secretary of State promised me that guidance was forthcoming. Last Wednesday, Members in the other place and charities met his ministerial colleague Lord Bethell and officials, who admitted that this was not good enough and that something more had to be done. Can the Secretary of State tell us today what support and guidance will be forthcoming and when, or is he pursuing a survival-of-the-fittest policy, whereby the most vulnerable will be thrown to the wolves?
This is one of the most important issues. As the hon. Lady says, many people are immuno-suppressed or severely clinically vulnerable. It is important that at every stage of dealing with this pandemic we are thinking of them and having them at the front of our mind. That is what I believe we have done. Of course, when people in that category are able to take the vaccine they should, but not all are able to do so. She asks about advice, and I can tell her that we are publishing it today.
(3 years, 1 month ago)
Commons ChamberYes, I can give my hon. Friend that assurance. He is absolutely right to raise this issue. As we develop our plans, we are absolutely thinking about all those more vulnerable cohorts and the impact that there may be on them. That is why when we set out the details of step 4 regarding those who are immunosuppressed there will be new guidance, and GPs will be able to use it in working with those patients.
It is clear from comments made by the chief medical officer, the Prime Minister and the Secretary of State over the past 24 hours that, in their view, it is better to have a third wave of covid now than it is in the winter when the NHS is struggling. Will the Secretary of State please confirm explicitly whether that is the policy aim of the Government and, if so, will he confirm the estimate of his officials of how many excess deaths and additional cases of long covid that that third wave will result in?
No one wants another wave of covid cases. As the hon. Lady will have heard, what is different this time, as we sadly see cases rise, is the vaccine. The link between case numbers and hospitalisations has been severely weakened, as I have set out to the House in quite some detail, and that is what matters.
(3 years, 1 month ago)
Commons ChamberI thank the Father of the House for his kind comments. He may have heard me say earlier that the Education Secretary will talk much more tomorrow about the action we will be taking around schools and educational settings, including the removal of the bubble requirement from 19 July. He made an excellent point about working not just across the United Kingdom—despite what the hon. Member for Central Ayrshire (Dr Whitford) said a moment ago there is great co-operation between us, which will continue—but internationally, both through our leadership of the G7 and the COVAX alliance.
The Secretary of State will be aware that, compared with the rest of the population, double vaccination provides a much reduced level of protection for clinically extremely vulnerable people with compromised immune systems. He will also be aware that pregnant women in their third trimester are considered clinically vulnerable. Many people in such groups are anxious about what today’s announcements mean for them. Will he confirm what advice is being published for the clinically extremely valuable? Specifically, will he consider allowing pregnant women to have their second jab after 21 days?
There will, of course, be people who are sadly more vulnerable to this virus who will be concerned about step 4. I entirely understand that caution and anxiety, and we will publish further guidance along the lines that the hon. Lady mentioned. As for her question on second doses for pregnant women, I will have to take advice on that.