On a point of order, Mr Deputy Speaker. Could you advise me on how we can correct the record, because the hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey) has distorted what I said only a few minutes ago? Never once did I express any glee at the record number of cases on the SNP’s hands in Scotland. I expressed my concern at what was happening in Scotland. He should withdraw that comment.
Yes, I do agree. The vaccine programme is our wall of protection, and every jab builds that wall higher. As immunity wears off, we need to make sure that people get a booster with a third jab. As we have announced, the boosting programme will begin with the most vulnerable cohorts in September.
Yes, I can give my hon. Friend that assurance. The backlog is already at 5 million, and as I have said today, it is unfortunately going to get a lot worse before it gets better. I think we can all understand why, but today’s announcement will certainly have helped in our march to clear the backlog. My hon. Friend will know that the Government have given significant additional funding, in the billions, to help with that, but there will be a lot more to come in dealing with the priorities, especially cancer.
I am afraid that the previous speaker will be very disappointed, because we are going to have to live with covid, like we have to learn to live with every other infectious disease that exists in the world. Yes, we have tried to suppress it. Yes, we tried to deal with it, but we will have to learn to live with it. Viruses, the hon. Member may be surprised to know, have been around for 400 million years—a lot longer than us. Guess which one is winning the Darwinian race.
When we do have to make decisions, I think one thing is very clear. Up to this point, the aims of the medical profession and the Government’s advisers and the aims of the Government have been broadly similar, but they will have to diverge at some point, because the medical profession will always want to see the rate of infection brought down to the smallest level possible at whatever cost, but the Government have different considerations. The Government need to ensure that the rest of the health service is able to operate properly, that the economy is moving and that the social and wellbeing aspects of the population are looked after. That is why the aims are different.
While I am at it, on a private note, I am sick to death of the Government’s so-called advisers coming on TV and giving their individual views, rather than giving advice to the Government on a confidential basis. If they want to be stars of Sky News, let them leave SAGE and carve their own path.
On what basis will we decide when we have this divergence? The first thing to say is that the variant will not be a reason for keeping lockdown. The variant may be more transmissible, but that is irrelevant if it is not causing more hospitalisations or more deaths. We have already heard from Public Health England that the two vaccines—Pfizer and AstraZeneca—can cope as well as with the new Indian variant as they can with the Kent variant. We do not need to hear about the variant argument, because I do not think it holds water.
What matters is who is being hospitalised, and where. Are the hospitalisations young people who have not yet had the vaccine, who may be at risk because of the increased transmissibility of the new variant, or is it people, as we have seen in some parts of the country, who have been offered the vaccine, but for one reason or another have chosen not to get it? We cannot have the country being held to ransom by any groups who have been offered a vaccine but have chosen not to take it; that is utterly unacceptable.
It seems to me that the essence of the Government’s case—if the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), wants to, he can intervene to confirm it—is this: the Government’s strategy was based on a single vaccine strategy, in the belief that, if enough people got it, the efficacy would be high enough that we could unlock at that point. However, the evidence published by Public Health England yesterday showed that the Pfizer vaccine is 94% effective against hospitalisation after one dose, but that AstraZeneca is only 71% after one dose and takes the second dose to get up to 92%.
It seems to me that the Government are telling us— I wish they would be clear about this—that they need a little more time to get people, especially those on AstraZeneca, to the second dose so that there is the level of protection against hospitalisation that we see with the Pfizer vaccine. If the Government presented their case in that way, it would be an awful lot easier for the rest of us to give the Government our support, because that would be a clear rationale.
We also need a clear assurance that the two-week review point is not a ploy to buy support in the House of Commons, but a genuine review of the data, whereby we will see within a couple of weeks whether the hospitalisation rate is increasing or not. If the Government give us a clear assurance that the two-week point is a real review and that we can achieve the full relief of the lockdown at that point, the Minister might be able to buy a little support from his own Benches this evening.
On a point of order, Mr Deputy Speaker. Would it be possible for you to convey to Mr Speaker that, while we are still operating under the restrictions that we have in Parliament, we need to try to find ways to intervene on contributions that are being made on video? Otherwise, we are unable to challenge the views of the Scottish nationalists, who claim that the problems that they suffer from in the covid pandemic are a result of the United Kingdom Government’s actions, when they themselves have the same powers to deal with them in Scotland, had they chosen to do so differently, but they have not.
We are working on exactly that question. Of course, there is the question in advance of that of the vaccination of 12 to 18-year-olds, on which we are taking advice from the JCVI. We are conducting trials as to what are the best jabs to give, given which two previous jabs people have had, to give them the strongest protection. The third thing we are doing is working with AstraZeneca to develop a vaccine specifically targeted at the variants—that was part of the G7 work and announcements last week. If we can give a flu jab and a covid booster jab at the same time, that would be great. That is also under clinical evaluation, because, obviously, it would make the logistics so much easier over the autumn. Likewise, I am taking advice on which age groups and which groups it should be for: whether it should just be for the over-50s or for everybody; how to vaccinate; what group to put health and social care workers in; and whether there is a special regime for those who live in care homes, as there was in the first round of vaccination, where care home residents and staff came first. All of those are live questions on which we do not yet have answers, but that is the scope of the decisions we need to make ahead of the autumn for the autumn vaccination programme.
I join the hon. Gentleman in congratulating all those involved in the vaccine roll-out, everywhere in the UK. In Scotland, it has been a remarkable effort, with the UK Government working with the Scottish Administration, the NHS across the country, local councils and the armed services—it has been a big team effort, and that has been part of the success of the vaccine roll-out.
The hon. Gentleman asked about three critical areas of the science. Reviews of all three areas are ongoing. They are led by Professor Jonathan Van-Tam, the deputy chief medical officer, whom the hon. Gentleman may have heard of, who is an absolutely brilliant clinician in this space—there are a lot more people involved who are doing excellent scientific work on these questions. That surveillance on immunogenicity, the work on the next-generation variant vaccine and the work on understanding the variants as we spot them is all going on. Public Health England has done a huge amount of work, working with public health colleagues right across the country, and I am grateful to them all.
Yes, absolutely. It was an enormous pleasure to go to the Isles of Scilly on Monday morning. I did not know that I was the first Health Secretary ever to visit the Isle of Scilly, but frankly it is so wonderful that I would really quite like to be back there before too long. The integration of health and social care that my hon. Friend mentions is happening on Scilly. It is important on Scilly, but it is actually a lesson for everywhere. I have discussed it with the new Conservative-led Cornwall Council—the first ever majority Conservative-led Cornwall Council. The team there and on the Isles of Scilly are doing a great job of integrating health and social care. Scilly, in particular, needs investment in its health infrastructure and support because it is more remote than almost anywhere else. We will deliver these things. Throughout the length and breadth of this country, we will invest in the NHS and integrate health and social care. The Isles of Scilly could hope for no better advocate than my hon. Friend.
So many of the allegations yesterday were unsubstantiated. The hon. Gentleman’s most important point was that the Scottish Government, with their responsibilities for social care, had to respond to the same challenges and dilemmas as we did, as did other countries across Europe and across the world. We were driving incredibly hard as one United Kingdom to increase testing volumes. We successfully increased testing volumes, including through the important use of the 100,000 testing target, which had a material impact on accelerating the increase in testing, and because of this increased testing we were able to spread the use of tests more broadly. It was the same challenge for the Administration in Edinburgh as it was here in Westminster, and the best way to rise to these challenges is to do so working together.
I wish to put on the record my support for a robust strategy to tackle obesity, but I question plans to ban broadcasters and online platforms from advertising food and drink that are high in fat, sugar and salt before 9 pm. If the Government are going to have any form of impact, even foods that we consider to be health foods will be covered by the ban. Eggs, cheese and avocado—the list of foods that include those items is endless.
Let us take a look at the ramifications of a ban on TV commercials. I started my retail career with the Pizza Hut chain of restaurants 40 years ago, which is probably long enough ago for me not to have to declare an interest today. Before the pandemic, the UK’s three biggest chains, Pizza Hut, Papa John’s and Domino’s, got 90% of their sales of pizza online and from apps such as Just Eat, Deliveroo and Uber Eats. That is 60,000 jobs directly at risk and tens of thousands more in the supply chain, and that is just three companies in the UK. Do the Government seriously consider that a price worth paying?
Similarly, let us look at breakfast cereals. Under these proposals, we will ban the advertisement of some of our everyday breakfast items. The ironic thing is that over 50% of breakfast is no longer bought from a supermarket, but from cafés and greasy spoons around the nation. That immediately puts at risk major brands such as Kellogg’s, which have spent millions of pounds reformulating their products to reduce fat, sugar and salt, yet under the proposals they will be banned from advertising them before 9 pm. Meanwhile, our mainstream TV companies will lose out on approximately £75 million to £100 million of advertising revenue—revenue on which tax is paid in this country.
The Sun reported in March that the Government were considering doing a U-turn on banning online adverts, as evidence showed that it would have little effect. That has instantly created a chasm between mainstream broadcasters and online platforms that contribute little to the financial wellbeing of the nation because they are offshore companies. Millions of small businesses rely on online advertising to promote their businesses in this country, including in Calder Valley. There is absolutely no evidence that the proposed blanket ban for mainstream broadcasters and online advertising would make one iota of difference to reducing obesity, and I urge the Government to rethink these draconian measures.
I would like to begin by congratulating my hon. Friend the Member for Aberconwy (Robin Millar) and the hon. Member for Airdrie and Shotts (Anum Qaisar-Javed) on their excellent maiden speeches. I remember all too well how daunting that is, having made my own maiden speech in the Queen’s Speech NHS debate in January last year.
Since then, our NHS has had the most turbulent of times. I pay tribute to the dedicated healthcare staff in my constituency, working day and night to keep us safe from coronavirus. I pay special tribute to Dr Poornima Nair, a dedicated and well respected GP at the Station View medical centre who died with coronavirus last year. In the House, I have talked about the light at the end of the covid tunnel. Thanks to the success of the UK’s vaccine roll-out, we are now beginning to see that light.
It was a UK grandmother who became the first person in the world to be given the Pfizer covid jab and, from then on, it has been onwards and upwards. The Government’s early focus on securing an extensive vaccine portfolio means that over 57 million doses have been given in the UK. The pandemic has really highlighted the importance of local healthcare and, as I mentioned in my maiden speech, it is one issue that unites every corner of my constituency. That has never been more true. From Bishop Auckland Hospital caring for covid patients to local GP surgeries and pharmacies vaccinating us to get us out of this pandemic, all parts of my constituency have pulled together.
Local healthcare provision matters, and that is why I will never stop banging the drum in this place for improved health services at Bishop Auckland Hospital. I am campaigning to restore the A&E that was lost under Labour, and I am grateful to both the Health Secretary and the Minister of State for Health for meeting me to discuss the campaign. So far, the Government have invested £450 million to upgrade accident and emergency facilities in more than 120 trusts, so I know they understand how vital A&Es are to local healthcare provision, and I hope my ministerial friends will hear me clearly when I say I will continue to fight for the restoration of our A&E in Bishop Auckland.
The Queen’s Speech has healthcare at its heart, and I want to focus on one aspect that is close to my heart and to my politics: mental health. I have talked in the past about my own struggles around mental health. The importance of talking about it cannot be overstated. Every speech, every conversation, every time we talk about our own challenges that we have faced, we chip away at the stigma, but it is clear that talking about mental health alone is not enough. I am glad, therefore, that the Government are pushing ahead with their reform of the Mental Health Act 1983. Work is already under way on improving access to community-based mental health support, with £2.3 billion a year as part of the NHS long-term plan, but I am looking forward to seeing what further changes are proposed. The stigma around mental health needs to end, and every time we talk about it we help chip away at that stigma. Let us press ahead with improving the situation on the ground, improving mental health support and helping to ensure that no more lives are lost through poor mental health.
I am conscious of the local situation in my city. I woke up today to hear that infection rates in Peterborough were the fourth highest in the country. On social media, I was told that Peterborough is “letting down Cambridgeshire”, that we are a joke and that I should be ashamed to represent the people who are breaking the rules. BBC Radio Cambridgeshire told me in a live interview that the Millfield and Bourges Boulevard area was the most intense covid hotspot in the country. That is just down the road from my house, where I live. It was later revealed that this spike was due to a covid outbreak at Peterborough prison. This is obviously regrettable, but it is not a reflection of local behaviour.
For much of the pandemic, figures in Peterborough were below the national average. The rate is indeed falling in Peterborough, albeit more slowly than in other areas. Peterborough is a working city. Many people do not have the ability to work from home; they work in factories and customer-facing jobs. If they do not work, they do not pay their bills or put food on the table. For many, lockdown is misery. People without well-paid jobs that can be done from behind a computer screen, without big homes, without nice gardens and without happy homes are desperate.
I welcome the Prime Minister’s plan, but I do not apologise for saying that opening up fully cannot come soon enough. I hear stories of young people wallowing in dismay, worried about their mental health; of businesses struggling with no income; of self-employed people like driving instructors with mounting debts; of one of my school friends in the entertainment business being forced to take a short-term factory job; and of families giving—often all they have—to local charities in order to feel part of something.
We have this cautious approach to opening up, but there is nothing cautious about keeping the lockdown restrictions in place for one second longer than necessary. It causes poverty, hopelessness and despair. So back to my social media trolls, who often have FBPE in their Twitter handle: I am proud of Peterborough—please show empathy and understanding, and be less judgmental. Let us open up as soon as we possibly can by responding to the data and doing the right thing.
We have had some fantastic news today—some really good news. We have had the Scottish study, which shows that the vaccine is preventing serious illness and that people are not being admitted to hospital in the numbers that they were. We have also heard that the uptake of the vaccine is far higher and that the vaccine is far more effective than anybody had anticipated.
We were told by the Prime Minister that we would be driven by the data, not by the dates, but, sadly, we have the dates, and the dates go on for another four months. Businesses cannot cope with it. Let me give a few examples. A friend of mine can walk around a golf course with his wife, but he cannot play golf with her. There is no sense in that. It is outdoors and it is safe. Golf courses and other outside non-contact sports should be opened up earlier. Hospitality firms spent tens of thousands of pounds on things to make themselves covid secure, but they are not allowed to use them. In the worst weather, we will be able to meet outside, rather than inside in a covid-secure way. That needs to be looked at again, because these businesses are suffering and we will lose many of them.
I want to talk primarily about weddings, which are a big thing in my constituency, as I have a number of wedding venues. Nobody can buy their dresses yet. The mother of the bride cannot get her outfit, her shoes or her hat. Why not? Because weddings are not going ahead. Many couples have already given up their weddings perhaps two or even three times in this past year. They are desperate to get married. They want to have a celebration with their family and friends. The wedding venues have had no money for a year, and we are now talking about another four months before a proper wedding can take place. These businesses are desperate to open up, as are the people who sell the wedding dresses, as are the flower providers, as are the caterers, and as are the suppliers of the wine and the beer. We need them to open up. We need them to be allowed to work again, because if we do not let them open soon, we will lose those industries as well as all the hospitality industries that are so desperate to get going. They are all losing money at the moment. Nothing is covering their costs. They need to be able to get back to work, and all the people whom they have furloughed need their jobs back. I hope that the Prime Minister will look again at where he is going.
It is 12 months since the first cases of covid-19 hit our shores. Back then, I doubt whether many of us could imagine how the virus would affect our lives throughout 2020 and 2021. It has tested our approach to a global pandemic to the full. It has brought out the best in our NHS, our carers and our public services, and in our sense of community, with the many heroes who have stepped up to help others. I get that the situation is unlike anything that Governments have had to deal with in modern times. Decisions are a matter of life and death, and every country has adopted different strategies to deal with covid-19.
It is easy to criticise, and we have got some things right. The approach to trialling and procuring vaccinations, and upscaling roll-out very quickly, is a real success. However, I cannot help but think that we failed to learn from others earlier in the pandemic, and their best practice. I serve on the Home Affairs Committee, and last year we took evidence from officials in Honk Kong, Singapore and New Zealand—three common law jurisdictions that took different, tougher public health approaches early on. They were much quicker at locking down than us, and they all placed strict restrictions on their borders, with enforced quarantine. We knew back then that it was working, which prompts the question why a similar approach was not taken here. For months, our borders have effectively remained open.
We have been lucky so far. The new strains that have been identified still react to the vaccines, but a future strain might not do so. Until we have some control over international spread and global immunisation there remains a risk here in the UK. Life in New Zealand is nearly back to normal: people can gather, kiss, hug, go to pop concerts, fill stadiums, and enjoy life. Our southern hemisphere cousins called it right: tough—very tough—measures at the start; and strict controls at the border to help control the virus in the country and get back to ordinary life more quickly.
We opted for looser lockdowns, polite requests to self-isolate, allowing international travel to continue in large part, an endless cycle of local restrictions, tiers and national lockdowns—but never getting the virus down sufficiently to stop it bouncing back. Tragically, there are over 100,000 dead, each number a real person. The vaccine offers the first ray of light in over 12 months, but it is still not too late to tackle the border issue, alongside a sectoral support package for aviation. The cross-infection of a new mutant strain will set back any progress that we have made in defeating the virus, and that is why I support the motion.
When I saw the motion tabled by the Labour party on covid security at the borders, I was surprised, given the party’s remarks on the subject not so long ago. Only last summer, members of the shadow Cabinet were arguing for the Government’s quarantine measures to be lessened, and they later claimed in the House that those measures were a mere “blunt tool”. Their flip-flopping is a further example of their hollow opportunism, and Labour Members have relied on hindsight in their public statements throughout the course of the pandemic.
Let us look at the facts regarding the Government’s actions. Everyone arriving in the UK is required to isolate in either a hotel or at home. The Government are taking steps to ensure that those returning from high-risk countries do so in compliance with the isolation measures. Those include greater physical checks to ensure compliance during the mandatory isolation period. That was introduced hand in hand with the requirement for each and every passenger from abroad to present a negative covid-19 test result before departing for England. Furthermore, the suspension of all travel corridors is evidence to my constituents of the far-reaching steps being taking to tackle the threat of newly found and ever more infectious variants of the coronavirus.
Let us be clear about the nature of this threat. These measures, which I believe are far-reaching, are vital to tackle that threat, which risks undermining the roll-out of our vaccine programme. Given the world-leading success of our vaccination programme, we must do all we can to protect it. The Government continue to do that by using some of the strongest measures in the world. Those measures have allowed us to deliver a vaccination programme that delivers more than 250 jabs a minute—a daily rate that is higher than anywhere in Europe—and a programme that will have offered everyone in the top four priority groups a jab by the middle of this month. Why would we want to undermine that success?
The United Kingdom is a world leader in so many areas, and we should take pride in our ability to create and manufacture the world’s first coronavirus vaccine, which has already been given to more than 8 million people. Let us work together in the spirit of cross-party co-operation, without party political positioning. We need to move forward with pride in our nation, build back better, and see the global Britain that we have long awaited.
I realise that a number of colleagues have not been able to get into this debate. As I have said, we had a very short time for it. The Front Benchers have agreed to speak for less time than they normally would, and I now call the Scottish National party spokesperson, Neale Hanvey.
I would like to begin by thanking the hon. Members for Oxford West and Abingdon (Layla Moran) and for Central Suffolk and North Ipswich (Dr Poulter) and my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) for securing the debate, and I thank all Members for their very personal contributions.
For thousands, covid-19 is something neither succumbed to nor overcome in a matter of days. For many, it has lasting mental and physical impacts that affect the body many months after initial infection. It is nearly a year since the first case of coronavirus was recorded in the UK, and still very little is known about the debilitating post-covid syndrome. I pay tribute to the LongCovidSOS group and all the online support groups that work tirelessly to raise this issue and support one another.
At this stage, we cannot say with any real certainty what exactly long covid is. Nor we can accurately predict the true number of people suffering symptoms of long covid. The Office for National Statistics has published estimations suggesting that the proportion of people displaying symptoms for a period of over 12 weeks could be as many as one in 10. Let us be clear, this is not a syndrome being experienced by a small minority of people. There is also finite evidence on the best way to treat the condition, which has vastly varied symptoms. Without a clear understanding of exactly what the condition is, this makes it far more difficult for health professionals to manage and support those who are affected by it. With better data collection and further research, and by listening to those living with long covid, we can begin to effectively treat the condition. Will the Minister please outline what work the Government are doing to close this gap in knowledge?
What we do know for certain is that the symptoms of long covid can be severe, completely debilitating and utterly crippling, preventing people from living their normal lives. This impact can have a detrimental effect on people’s mental health, their wellbeing and, as we have heard today, their physical wellbeing. It leaves many unable to return to work months after their initial battle with the virus and causes a great deal of uncertainty in already anxious minds. It is crucial to understand that this stress and anxiety can cause relapses in the condition, as sufferers themselves have told me.
Many people with long covid do not know when or if they will return to work. Without action from the Government, the long-term social and economic consequences of this could be grave. Key workers have an increased risk of catching covid. NHS workers in particular are at least three times more likely to contract it than the general population, and this could wreak havoc on our frontline workforce. What steps are the Government taking not only to protect the NHS workforce further but to ensure that staffing levels are such that patients continue to be treated and the population continues to be vaccinated?
The availability of treatment and care for individuals experiencing long covid must be a matter of immediate concern to the Government, and I urge them to adopt a patient-led approach. Could the Minister please outline what progress has been made on setting up long covid clinics, and what plans the Government have to extend this programme in 2021? There simply cannot be a postcode lottery of service provision for long covid sufferers. No one person’s life is more valuable than another, and the Government must ensure that that is reflected in access to treatment.
Some long covid patients are being denied referral because they never had a positive covid test. For the many people who suffered with covid in the first wave back in March and April and were not eligible for testing at the time, that is proving incredibly frustrating. Will the Minister outline what measures the Government will take to ensure that people do not miss out on much needed treatment, particularly if they fall into the category of people who were unable to have a covid test in the first wave?
The Government have to step up and show leadership. There has to be clear messaging to the public to ensure that they are sufficiently informed about the condition and about where to seek help if they need it. That messaging needs to combat the misinformation about covid that is out there presenting it as a myth or similar to the flu. I would like to pay tribute to the former MP for Leigh, Jo Platt, who, along with LongCovidSOS and support groups on Facebook, is campaigning tirelessly on this issue. As Jo told me, there are no words to describe how covid deniers have made her feel. She said: “For people to seriously deny our experiences has been soul-destroying.” We have to get this right.
It is also essential that healthcare professionals at every level of the NHS are properly trained to treat long covid, distinguishing between the different conditions that fall under the term. This includes frontline mental health workers, as the mental health implications of long covid can be severe. Within an acute crisis, it is far too easy to push longer-term concerns to the periphery. Should the Government continue to do this with long covid, they do so at their peril.
Throughout this crisis, far too many people have felt that their voices have been silenced. For the sake of the health and wellbeing of all those living with long covid, please do not silence them. There is still so much that is unknown about this virus and how it affects us, but one thing that is certain is that long covid should be a matter of serious concern, and without concerted action by the Government we may be living with the consequences of this for many years to come. We are still learning so much more about the impact of covid-19 on our communities, our bodies and our wellbeing. There are thousands of people out there currently suffering with long covid. They are relying on us, and on the Government, to get it right for them.
We absolutely recognise not only the importance of self-isolation, which is critical in breaking the chains of transmission, but that it is not always easy for people to do. We recognise, for instance, the cost of self-isolation, and that is why we introduced a payment of £500 for those who are on low incomes and unable to work from home while isolating. We will continue to make sure that people have the support they need to self-isolate.
The Innova lateral flow tests for covid-19 identify a substantial proportion of those who are shedding viral load due to their covid-19. We of course identify, analyse and publish the evidential basis for the use of these tests, as with the other tests that are used in the national testing programme.
It is a pleasure to speak again today about covid-related matters. To be frank, the supply of the vaccine in South Derbyshire has been slow, but now the area is gearing up. Those in the northern part of the constituency are being invited to the Derby Arena—the velodrome—which I am extremely pleased is up and running, and from the end of this week, we will have a stand-alone centre in Swadlincote. That is an area of 50,000 people, and only those in the top four tranches will be invited as soon as possible. It has taken a lot of kicking and screaming to get to this point, and when we do a national review of how things have happened, we will also need to do a local review. However, we are getting there now.
I would also like to talk about where we need to be going on the mental health side of things, particularly for the people who feel that they have been forgotten about financially. We have sent the Chancellor a couple of new ideas about the directors’ income support scheme and other matters, such as the money coming back from supermarkets. It is not just a financial matter. I am concerned about the mental health of some of the constituents I am receiving emails from, and I will be negotiating again an uplift in mental health services for the people of South Derbyshire who need them in these extraordinary times.
I will not go on for long because there are lots of speakers, and some people have missed out in these debates. I will wrap up now by saying a huge thank you to our shopworkers, frontline services, NHS, ambulance people and everyone who keeps the show on the road. It has been a massive community effort. In South Derbyshire, we have rapid lateral flow tests and we will have the sites for the vaccines. That will make a huge difference to everyone’s feeling about finding a way out. I end with my grateful thanks for everything that everyone is doing.
I greatly appreciate the chance to contribute my local experience, Mr Deputy Speaker.
In my constituency, two more people died yesterday, thousands have caught the disease and it is getting worse, even in the remotest depths of rural Somerset. We face a vicious enemy that attacks without warning and has the power to exploit even the smallest human error. Let down our mask or hug the grandchildren, and we could—I am sorry to say it—die. No one likes lockdown, but obeying the rules is vital, and so is setting a positive public image.
It is a great pity that Somerset County Council is still planning to run public surveys about local government reform, while the daily death toll across the county continues to rise. The Government gave Somerset an extra £32 million to tackle covid; £10 million—I repeat, £10 million—went straight into the council’s reserves. It even had the barefaced cheek to shift almost £0.5 million into a savings fund for its own carparks. What a cheap trick! Words fail me at the lack of decency and care for people’s real interests and needs.
We all know that Ministers have long-term plans to reform local government, but it is no time for the county council in Somerset to be cooking the books to make themselves look like financial wizards. As for the county council wasting time on surveys, which it is now planning to do right through January and February, how dare it treat us with contempt? It will be pestering people who are frightened by a disease that is still spreading fast.
The county has put the districts in an impossible position. They would much prefer to leave this alone until such time as the pandemic is over, but the county council insists on wasting public money and running consultations, and the districts are seriously expected to carry on as though nothing has happened. The Government need to take the lead to completely freeze this whole local government reform programme.
So far, worldwide, almost 2 million human beings have been killed by covid. In this country, the death toll tonight is more than 82,000—the population of my constituency. One day, our descendants may ask, “What did you do in the pandemic?” I really do not believe that any self-respecting Minister will want to admit responsibility by saying, “I pushed ahead with local government reform.” It is irrelevant. It is an unnecessary sideshow while so many of our residents are desperately trying to protect their own lives and those of their loved ones.
We hope and pray for a swift roll-out of the new vaccines. Some teething problems are inevitable, and in Somerset there are elements that have been delayed, so I have a positive and constructive suggestion for the Minister. Why not report vaccines in the same way as infections: area by area, week by week, day by day? We would like to know exactly how many jabs have been given across our county and who is getting them. If the Minister could do that, it would make all our lives easier.
I think the hon. Member will probably agree with me that what is galling for so many people is the £10.5 billion of contracts given out without proper tender processes and without transparency, if we contrast that with the 3 million people in this country—people who have been self-employed for a short time, company directors of small limited companies and many others—who have been completely excluded from support. A small fraction of that amount of money would have kept food on their tables and a roof over their head.
It is a pleasure to serve under your chairmanship, Mr McCabe. I start by thanking the hon. Member for North Warwickshire (Craig Tracey) for securing this important and timely debate and for his excellent introductory speech. He made a number of important points, some of which I hope to return to, and I hope he gets a positive response to his very helpful suggestion on the gathering of data. I also thank all the other hon. Members for their contributions today, and I will go through some of the highlights of those.
My hon. Friend the Member for Barnsley East (Stephanie Peacock) spoke about the need for a cancer recovery plan, which I think we all agree on, and addressed the important point about widening health inequalities and the startling differences in the availability of screening depending on where people live. I agree with her that improvements to the cancer outcomes datasets are an important part of beginning to understand how those disparities work out.
We heard from my hon. Friend the Member for Easington (Grahame Morris); I pay tribute to the work he does on the all-party parliamentary groups in this area. He mentioned the Catch Up With Cancer campaign and drew attention to the backlog, which, of course, many hon. Members have raised today. He also raised the availability of radiotherapy, which, in his own words, he bangs the drum on consistently in this place, and we pay tribute to his persistence.
The hon. Member for High Peak (Robert Largan) made an important point about the availability of mobile screening units and the hon. Member for Strangford (Jim Shannon) , who always speaks with such knowledge on this subject, made some important points about clinical trials and charities, which I hope to be able to return to if time allows.
It was a pleasure to see the hon. Member for Southend West (Sir David Amess) find his spiritual home at last; it is the equivalent of Gary Neville turning out to play for Liverpool, but he is welcome all the same. We have a vacancy in the shadow health team for a Parliamentary Private Secretary at the moment and, if he shows the promise that he demonstrated in his speech today, I think we may be able to find a role for him on this side of the House.
The hon. Gentleman made, as my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) did, an important point about some of the people who are not here today, including the hon. Member for Chatham and Aylesford (Tracey Crouch), who we heard this morning in business questions speaking about her frustration at not being able to participate in this debate. I am sure it would have been enhanced by her presence, given her current battle, alongside the former Member—still our friend—for Dewsbury, Paula Sherriff. I am sure the whole House sends both of them our very best wishes.
I want to speak about the impact the pandemic has had on the early diagnosis of cancer in general, as many Members have referred to already. We know how important early diagnosis is to improving chances of survival and in successful treatment. As we heard, Cancer Research UK estimates around 3 million people are waiting for breast, bowel or cervical screening, and there were over 1.2 million patients waiting for a key diagnostic test by the end of August this year. As my hon. Friend the Member for Easington mentioned, we know from Macmillan’s latest report that there are currently around 50,000 missing diagnoses; that compares to a similar timeframe for this time last year, and means 50,000 fewer people have potentially not been diagnosed with cancer.
We know significant amounts of capacity had to be created during this pandemic, and that meant the cancelling of planned operations, large numbers of patients being discharged back into the community, and staff and patients having to be protected from the transmission of covid-19. What those changes also meant is that, thankfully, intensive care did not have to be rationed so that only covid-19 patients were treated. However, it also caused the shutdown or reduction in many other non-covid services, which, combined with drastic changes in patient behaviour, has led to us facing this huge backlog today. We know that stricter infection control measures—which are absolutely necessary—mean that the backlog of care will probably take much longer to clear than we would like.
My hon. Friend the Member for Dulwich and West Norwood and other hon. Members referred to the Breast Cancer Now report, and how the number of people referred to see a specialist declined dramatically from April. There is an estimate that across the UK, there have been 107,000 fewer breast cancer referrals, and a backlog of almost 1 million women requiring screening has built up during this time. Some of those women may well have been living with undetected breast cancer, and some may still be. Every month that that situation continues, more women could be missing out on the best chance of getting an early diagnosis and the best chance of beating the disease. It is vital—and something that we have been pushing for for a long time—that we get a clear sense of how we are going to tackle that backlog, because it is so important.
The hon. Members for Wakefield (Imran Ahmad Khan) and for Crewe and Nantwich (Dr Mullan) mentioned the importance of mammograms. As we know, they are a key tool in early detection. There is a plan to send open invitations for screening from September to March of next year. That has caused some concern among cancer charities, because some of the research shows that the number of women who make appointments is significantly lower than those who actually attend timed appointments. There is a fear, sadly, that this could actually worsen the persistent decline we have seen in recent years of the uptake of breast cancer screening. We are particularly concerned about the impact that will have on some groups where uptake is already low, such as those living in deprived communities and some BAME groups. We heard a little bit about the impact on BAME groups from my hon. Friend the Member for Dulwich and West Norwood, and both she and the hon. Member for Winchester (Steve Brine) very powerfully put into words the additional mental toll that this disease has during this time, on top of everything else that people ordinarily face when they have received such a diagnosis.
Several hon. Members mentioned the impact of covid-19 on secondary breast cancer patients. It is still, sadly, the case that around 11,500 people—women, mainly—die from breast cancer each year. Most of those are to do with secondary breast cancer, and as we have heard, it is not something that there is a cure for at the moment. It is estimated that around 35,000 people in the UK are living with secondary breast cancer. As the general population ages and people live longer, numbers will continue to increase, so it is really important that we get a better understanding and response to secondary breast cancer. We also need to look at this issue from the patient’s perspective.
I want to mention my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams), who wanted to speak in today’s debate but could not. She wanted to pay tribute to one of her constituents, Jo Taylor, and to METUP UK, which focuses on making positive changes for everyone with metastatic breast cancer. Its “busy living with mets” campaign calls for increased awareness of secondary breast cancer, because catching it earlier leads to better outcomes. It is also campaigning for better access to drugs, clinical trials, radiotherapies and surgical pathways.
As the hon. Member for North Warwickshire mentioned in his opening comments, the national cancer patient experience survey tells us that the experiences of patients with secondary cancer differ greatly. It has identified gaps through the taskforce in the support and services offered to people, including variation in access to clinical nurse specialists, patchy provision of information, patients’ psycho-social needs not being met, and a lack of prompt and timely access to palliative care services.
As we have heard from several hon. Members, clinical nurse specialists play a critical role in co-ordinating care, providing information and helping people to manage their diagnosis and treatment better. In fact, Breast Cancer Now reports that the support of a clinical nurse specialist is the single most important contributing factor to people’s positive experience of care. That is particularly important for secondary cancer patients, who are often on lifelong treatments and have complex needs as a result. Its importance was acknowledged in the long-term plan, with a commitment that by 2021—it is only six weeks away now—all patients, including those with secondary cancers, will have access to a clinical nurse specialist or support worker.
It is very important that we get to a point where everyone is able to take advantage of the expertise that a clinical nurse specialist provides. Prior to the pandemic, the workforce was already overstretched and under pressure due to increased demand and persistent shortages across the workforce. A report by the Public Accounts Committee was highly critical of the Government’s approach to the workforce, finding that the long-term plan was not supported by a detailed workforce plan. Of course, the removal of the NHS bursary in 2017
“signally failed to achieve its ambition to increase student nursing numbers.”
Before I conclude, I want to echo what the hon. Member for Strangford said about the importance of charities in this sector. We know there is a great deal of concern in the sector. I know that some support was announced by the Government back in April, but it falls well short of what was suggested by the associations involved, and only a few have been able to benefit from it. I hope the Government will listen to the sector and look again at what additional financial support can be provided, because we know that clinical trials provide a vital opportunity for patients to access new treatments, which are always in development. We know it is particularly important for patients with secondary breast cancer. We hope that is something the Minister can take on board today, and I look forward to hearing her response.
I pay tribute to all those in my own constituency who have helped our community through the pandemic—the medical and emergency staff, other key workers, our volunteers, and the neighbours who have made all the difference.
I want to say a few words about how we can ensure that public confidence in our policy remains high, but first I will make a few comments on the current lockdown. I reinforce my hon. Friend the Minister’s point that when we leave the national lockdown on 2 December, we are not going into a national free-for-all in the run-up to Christmas. Ministers must make it very clear that we are transitioning back to a regional tiered system, because over-optimism, just as if people believe that a vaccine coming means they do not have to obey the rules, would be very dangerous for public health.
But if we are going to move successfully back to the tiered system, we have to deal with some of the illogical rules that still exist despite the best efforts of Ministers. This is not frivolous—it is important in getting people to conform to the restrictions that are in place. For example, we want people to play sport, so do we really believe that a spaced round of golf is more dangerous to public health than people attending a supermarket? When it comes to religious observation, is it credible that people who go to church for private worship who are properly spaced are a greater danger than the same number with the same spacing who take part in a service? These issues are important to a lot of people out there. The Government need to deal with some of these illogicalities if we are to deal with conformity.
There is something that Ministers can do immediately, and that is about free testing for families of key workers. I have a constituent who is a key worker who has been sent home because her son has also been sent home from school to isolate. She cannot go back to work until her son has a negative test, but he does not qualify for free testing. In other words, she must pay to get her son tested before she can go back to a key occupation. That cannot be the right way to treat our key workers. I urge the Minister to look as quickly as possible at how we deal with these key members of our society.
May I ask the Minister to look again, through the Treasury, at those who were remunerated through dividends? Many of those people are hard-working and decent, not tax dodgers. They were able to get by for a short period of time, but as the lockdown goes on, it is becoming impossible for them and they are facing absolute undue hardship. I urge the Government to look again at them.
My main comments relate to our great maxim in medicine—do no harm. That means that the patient must not be worse off from the cure than they were from the original disease. This is a dilemma facing all Governments. How do we protect public health while ensuring the economic viability by which the funding for public services is generated? So far, the public remain very supportive of the Government’s position, but that cannot be guaranteed. Recent controversies over the use of data have made it more difficult for the Government simply to say that they are following the science. Sadly, there is growing resistance to the concept of lockdowns, which is inevitable as economic concerns rise to the fore. It is utterly irrational to say that one is against all lockdowns, because that needs to be a decision taken on the basis of the evidence at the time. However, we need to understand the anxieties and the frustrations if the Government want to keep their options open and retain credibility with the public.
So how can Parliament play its part in that process? Covid-19 is not just a health issue; it is also an economic issue, affecting welfare and employment and our personal and social wellbeing. And of course there is no such thing, actually, as “the science”; rather, there is a range of scientific views, and we need to understand what that range is and the weight given to the respective parts of it if we are to have faith in the outcome of the judgments that have been made.
Our current Select Committees are very good at looking at departmental functions and policy, but they are very vertical and do not look across the whole of Government. In 2012, after the banking scandal, David Cameron set up the Parliamentary Commission on Banking Standards; it was a full parliamentary Committee of inquiry involving both Houses. I believe we need the same now: senior but temporary, cross-party and with both Houses. Of course, the reaction from the Front Bench is likely to be, “No more scrutiny”—I have been there and done that; I have been on the Front Bench and know what all those arguments are—but I think it would be a mistake and something the Government would come to regret, because such a Commission would help show that across the whole of Government, advice and data had been properly scrutinised. It is an opportunity to reinforce public confidence as we face the covid pandemic into 2021.
Finally, there is another reason why we should have such a set-up. This will not be the last pandemic we face. In the era of globalisation, when in normal times, for example, we have 700,000 people in the air at any one time, we will face further pandemics, and although this has been a tragedy for every single case, it has not been a particularly lethal pandemic by historical standards. We must set up the structures that we will need to deal with future pandemics, and we need internationally to work out the protocols we will put in place when we have the emergence of new viruses and the metrics we will use to measure that, because we cannot have the disorganised and shambolic international response that we have had to this particular pandemic. Meanwhile, at home we need transparency, with all the evidence scrutinised, if we are to maintain public confidence and see off the political opportunists and the conspiracy theorists, and, with that transparency, we need that scrutiny in this House and we need it urgently.
I am not responsible for the hon. Gentleman’s speech, but I know that he will be conscious of the number of people who wish to contribute to this debate. I know him to be a fair man and we are coming now to exactly the same timings of the other Front-Bench contributions, so if he could come to a conclusion, that would be really useful.
The hon. Gentleman makes a good point. The World Health Organisation’s group of experts has already provided recommendations to countries about which populations should be prioritised. They include frontline health and care workers at high risk of infection, older adults and those at high risk throughout the population—people who are suffering from conditions such as heart disease and diabetes. As the second phase rolls forward and more doses are produced, the vaccine should go to groups at less risk of being infected or suffering badly.
I will finish there. This is an exciting opportunity, which we should not let go of. We should keep on top of this. Let us all hope that maybe in a few months’ time we can all be here celebrating the distribution of at least one—and perhaps more than one—vaccine that will help us out of this situation.
I hoped I had been clearer that I was not calling for a curtailment of any of the safety steps. However, with eight people dying every hour, delay has consequences too. What is not acceptable is that the standards for safety in the UK may be slightly different from the standards around the rest of the world. I was asking for a coming together so that we can have that agreed consensus on safety.
It is a pleasure to serve under your chairship for the first time, Mr Dowd. I am grateful to the hon. Member for North Herefordshire (Bill Wiggin) for initiating today’s debate on this topic. Timing is everything in politics, and his is clearly spot-on. Similarly, a rare political skill is the ability to make the complex comprehendible, and he really did that in his setting out of the debate. I do not know who is watching, but I did plug this debate when I was on Sky News at lunchtime, so I hope a few people are, because that was the best explanation that I have heard, and certainly the best one that can be distilled into about 15 minutes, of just how rigorous the process is. I hope people will take from that explanation the reassurance that although we are keen for the vaccine to succeed, there is a rigorous process. It has not been retrofitted to fit the vaccination’s journey, so we should have some confidence in that.
To reflect on the two Back-Bench contributions, when the hon. Member for Strangford (Jim Shannon) referred to it being bit of good news, = he was speaking for all of us. He mentioned the groups that will be prioritised, and I think there will be a high level of consensus on that. Hopefully, it is something that we will settle on very quickly. I was cheered by the hon. Member for Henley (John Howell), who talked about the Council of Europe and the World Health Organisation, because those are exactly the sorts of fora that we need to engage with to get an equitable distribution around the world. It is hard for all of us; this is why political consensus is so important. It is hard for us to tell our constituents why we feel there needs to be a global distribution when people are so desperate to get their lives back to normal, but we know there is both a moral and a pragmatic obligation to do that. The organisations that the hon. Gentleman talked about are exactly the places for those conversations.
On the politics of this, it is really important that we do not mess around or be mischievous with the idea of the vaccine. There is a big public conversation about this. Any look of doubt from us would be magnified significantly. As community leaders, we have a responsibility to say that we trust the process. The outcome is whatever the outcome is, but the process itself is a proper one that we trust. That is certainly what hon. Members will see from the Opposition.
Yesterday’s news on the progress and the efficacy of the vaccine will have cheered all of us. I know that the Government are on record with regard to doses from that particular provider, but when we add in the AstraZeneca-University of Oxford one and the Moderna one, might the Minister be able to tell us how many pre-orders have been put in place for the vaccinations? That would help us to gauge the scale. I know the Government have laid the pitch for the roll-out through the changes to the human medicines regulations, and significant changes were made, including giving the Medicines and Healthcare Products Regulatory Agency the powers to grant temporary authorisation pending the granting of a licence.
I was grateful for the time that the Minister gave me with her and the deputy chief medical officer to talk about those changes, but when will there be a parliamentary opportunity to do so? We need to demonstrate that we have scrutinised this properly because the public want to know that we are talking about these things to the fullest extent. That would also allow us to address the point about immunity from civil liberty that the manufacturers and healthcare professionals are seeking, which is not surprising, but there are important and significant qualifiers around that not extending to sufficiently serious breaches. Will the Minister explain what a sufficiently serious breach would look like, or when we might have an occasion to talk about that further?
On vaccine hesitancy, it seems there are distinct phases. We have the anti-vax movement, which is about the substance of vaccinations to an extent, but it also about a broad range of other things. As our constituency mailbags will reflect, there is also a group of people who are hesitant, which is entirely understandable. They want to know that any vaccination, whichever one it is, is a safe one, but it is telling that last year the WHO had vaccine hesitancy in its top 10 threats to global health—up there with a future pandemic. That is something that we need to be aware of. We know that such speculation and the stuff that moves online at an incredible pace can really damage the process. For example, in Denmark in 2013 there were false claims from a documentary about the HPV vaccine, which led to a decline in uptake among some of the cohorts from levels of around 90%. Similarly, between 2014 and 2017 in Ireland, vocal attacks on the HPV vaccine from the anti-vaccine lobby led to a drop in take-up from 70% to 50%. These things matter. One thing that best counters them is proactive, positive health promotion campaigns. I am keen to hear whether the Government plan to talk about these things to educate the population ahead of time, but, again, it something that we all need to buy into, share and push out on a cross-party basis.
An area where I think there might be a little more room for divergence is delivery. We do not know what the future holds for the vaccine or when things will pop up, but it is reasonable to say that we expect one, and we know the scale of our population, so we have no reason not to have significant plans. When the Health Secretary was pushed on it this afternoon, he said that there were plans, but he was less forthcoming on what they were. I am keen for more detail. Whether it was PPE at the early stage of the pandemic or test and trace, frankly, throughout it, such big-scale planning and logistical exercises have not gone flawlessly. Qualifications could be made when they were being done for the first time, but we cannot repeat those mistakes now that we are, I hope, learning from what has happened.
Again, the Health Secretary has talked quite a bit today in the media and the Chamber about the importance of general practice. As I understand it, the BMA’s GP committee, NHS Improvement and NHS England have agreed an enhanced service for general practice to lead this process. That is good. People will want to see this delivered through the NHS rather than a private company, whether because they believe in its efficiency, as I certainly do, or whether in general they think that will reflect best in the population. That is a wise thing to do.
I understand that it is optional for practices to sign up, so may I get more detail from the Minister on that? If take-up is not good enough, will an alteration be considered? I also want to understand what assessment has been made about GPs’ capacity and workload. As I understand it, the programme requires participants to deliver at least 975 vaccinations over a seven-day period from each designated site—that will require 12-hour days seven days a week, including bank holidays. GPs are already busy, so I am keen to know about what assessments have been made about prioritisation.
I do not have enough time to talk about this properly, but I turn finally to the point made clearly by the hon. Members for Henley and for North Herefordshire: we have to come to an equitable settlement globally, too, and to play a leading role in global organisations as we do so.
I thank the hon. Gentleman for his intervention, and I will come to precisely that point in due course.
I supported the first lockdown, and I support the current restrictions, but we need a way out that works, irrespective of the invention of a vaccine. We need a way out that supports people to take their own decisions and respects free choice but, as the hon. Gentleman said, we must also protect society from an infectious disease. Such a system needs to be sustained for a long time, and those measures will need to be in place for a long time.
It is easy to criticise, but it is more difficult to put forward other options. We therefore need a debate about what a plan B could look like. We started with a national lockdown, but that was too blunt. We rightly moved to targeted measures, which are better, but still not great. The geographical area is too large, and people do not live their lives by local authority boundaries. The next logical step is to shrink the geography further—to the household or individual—and to have a system that allows people to make decisions for themselves regarding their own risks and the people they come across socially or at work.
We must use our testing capabilities in a targeted, risk-based manner, so that those at high risk, should they choose to, can shield and have support to do that. Those at low risk would be able to live their lives more freely, should they choose to do so. At the same time, we must ensure that things do not spiral out of control, with broader measures and restrictions available in reserve if needed. We must invest in our NHS surge capacity, and carry out research into vaccines and treatments.
The challenge, of course, is how we support those at medium risk, or those who live or work with high-risk individuals, and we need to have that debate. Lockdowns are not a cure for covid. They only regulate the pressure on the health service and, important as that is, in time they can, and will, be worse than the disease itself. We need to have that difficult debate and there is no easy solution. While I suggest that we wait for the phase 3 trials of vaccines, which come out imminently, we must start putting flesh on the bones of a plan B, based on individual choice, and consider a pilot in the UK. To get through this pandemic, whatever we do will be difficult. Difficult decisions have to be made, and more difficult decisions remain to be made.
The Government and the whole of British society have made an amazing response to covid and to the challenge that we have faced. We knew very little about it at the beginning, but we have evolved and adapted with time. Society now is so different—who would have believed at the beginning that we would be in this position now, sanitising our hands every time we went into a shop, wearing masks and socially distancing?
We know far more today than we did then, and we understand the impact and cost of covid, but we are also in an increasingly good position to understand the cost of the lockdown. We hear figures about millions of cancer screening appointments and tens of millions of GP appointments not being taken up, and we understand far better that in the weeks, months and years ahead there will be a huge cost from the lockdown, but the details have not been adequately explained to the British people as a whole or to right hon. and hon. Members of Parliament. We heard moments ago about colleagues asking questions—quite reasonable, quite straightforward questions—and getting a six-word answer.
I have written to the Secretary of State to raise concerns about Bolton, which has been in a particularly difficult position with a rather severe lockdown. Constituents tell me about the impact on their mental health, their physical health and their ability to get treatment—it has a cost. I wrote to the Secretary of State on 29 September to raise concerns that in Bolton borough 20,000 fewer people than last year have had a referral from a GP to hospital. Serious treatments have not been taken up as a result. This is serious—it is life and death—for my constituents, and I think it is replicated around the country.
I have yet to receive a response to my letter, but I do have an answer to my written question about what action has been taken in relation to the 20,000 fewer referrals from GPs to hospitals this year than last. The answer that came back was:
“No specific assessment has been made.”
That is 20,000 people in Bolton as a whole whom GPs think should have a hospital appointment of one form or another. I do not know how many of that 20,000 would be in the category of life or death, but I suspect a very significant number. I suspect that this would be replicated right across the country. To get a six word answer —“No specific assessment has been made”—to cover that 20,000 is disappointing to say the least. It is also covering a health time bomb that will explode. That is already happening at the moment. Far more needs to be done so. Will my hon. Friend commit to delivering a covid lockdown health impact assessment for every constituency around the country?
Yes, the UK Government will be providing the funding so that the devolved Administrations are able to put similar support in place. My right hon. Friend the Chancellor of the Duchy of Lancaster spoke to the First Minister of Wales over the weekend to ensure that in Wales people can get the level of support that we are introducing in England.
I implore the hon. Gentleman to support all those who are working so hard to deliver the tests that people need. Every other question on testing is, “Can we have more tests, please?” and we hear stories about just how much these tests are needed. I think we should be there supporting the people who are doing the testing.
My hon. Friend is absolutely right. Of course, as an emergency doctor himself, he knows more than almost anyone in this House about the needs of emergency care, not least because he spent lockdown working on the frontline of our NHS. I know that everybody is grateful to him for that. I know that the £9 million expansion to Leighton Hospital, which he and I visited in November or December, is much needed, and I hope that it brings good benefits, but it is also critical that people listen to my hon. Friend’s wise words.
The last bit of the question was a bit broad. Not all my assertions have been wrong, but I do learn and try to learn. Indeed, I have discussed openly some of the things that went badly and wrong judgments, as well as things that have gone well. I have referenced, for instance, the fact that when we first brought in guidance on funerals, it had the impact of too many people staying away—spouses who might have been married for 50 years. We changed that, because it was an error. Absolutely, the learning culture is important. It is important that it is set from the top, and I am happy to be open about the errors that I have made—others can be open about their errors—and learn. I also think it is important to be robust where you think you have made a decision correctly.
Yes. I think the whole House will join me and my hon. Friend in thanking all carers, paid and unpaid, in this Carers Week. This Carers Week is so different from normal because of what has happened during coronavirus. One of the things we have seen during coronavirus is that people have got together to celebrate and thank our carers right across the board. He is absolutely right to raise the point that he does, and I will certainly look into it.
The right hon. Gentleman has shrewdly interpreted the stance I am taking. Throughout all this, given the way in which the virus has spread so rapidly, its reproduction rate and the mortality rate, I have always urged the Government to take a precautionary principle approach to every decision that they make. I have been a bit sceptical about some of the behavioural modelling that has been used. Let me give him a quick example. Before the Government banned mass gatherings, we were told by Ministers and officials—I hope that no Minister takes this is a personal criticism; I certainly do not mean it in that way—that there is no point in banning a football match with 70,000 people in the stadium, because the person with the virus is not going to infect the other 70,000 people in the stadium and that if we stop them going to the stadium to watch the match, they would all go to the pub to watch it and infect more people there. I am sure he has heard that example.
I am very proud to represent Leicester City football club, and all the football fans—or a large proportion of them—go to the stadium before the match, and go to the stadium after the match—[Hon. Members: “Pub!”] I beg your pardon, they go to the pub. They go to the pub before the match, and they go after the match—[Interruption.] Some of them do avoid the stadium, actually. I am sure that the right hon. Member for South West Wiltshire (Dr Murrison) sees the point I am making. Some of these behavioural models do not always, it would seem, reflect how humans behave. Given that, Ministers and Governments should follow a precautionary principle at all times. That is why Labour is now urging Ministers to come forward with their plans to enforce compulsory social distancing. There are different models in different countries—we have France, Spain and Italy, New Zealand, where they did it overnight, Greece, and Germany, where, other than families, they have banned more than two people from meeting outside the house—but we think that the time has come for the United Kingdom to go down this line. We would encourage the Prime Minister to come forward with plans for how he thinks that this should apply to the UK.
The hon. Gentleman makes a good point, and I totally agree that that is an absolute disgrace. I hope that the Government will look into that, because although foodbanks should not be necessary in this day and age, we know that they are vital and I hope that the Government can resolve that swiftly.
I was originally answering the point made by the right hon. Member for South West Wiltshire so long ago: we would support the Government if they came forward with such proposals, but suppressing and defeating the virus is about more than just so-called lockdowns and enforcement. We need more testing, we need more contact tracing and we need more isolation to break the chains of transmission. The World Health Organisation has famously instructed the world to test, test, test—and we agree. Labour has called for testing for the virus to be carried out in our communities on a mass scale, starting with NHS and care staff as a priority. We urge the Government rapidly to scale up testing and we thank all NHS lab staff and PHE staff who are working so hard.
For example, could the Government consider what is happening in the Republic of Ireland, where there are 35 community testing facilities in operation? They have six more planned, and the largest, in Croke Park stadium in Dublin, provides a drive-through service that tests 1,000 people a day.
I agree. I hope that the Minister might make some reference to this issue when she sums up later. We are respectfully saying to the Government: let us work together to ensure that we can offer the financial security that all our citizens need, whether we are talking about taxi drivers in Glasgow, or the people who provide bed-and-breakfast accommodation and guest houses in my constituency, whom I am asking to shut their doors. It is important that we provide the financial security that they all need.
It is impossible to overstate the scale and seriousness of this health and economic emergency. None of us has witnessed or experienced anything like this before. It is no exaggeration to say that the covid-19 threat is the biggest challenge that we have faced since the second world war. That is the frame of mind that all of us should be in. It is for that reason—the extremity of this time—that we welcome the measures in the Bill. They are the measures that we need to fight this virus. The breadth of measures contained in this legislation reflect the enormity of the challenge across these islands. They also include bespoke provisions for Scotland to reflect our different legal system. For the public looking on today, it is crucial that we explain fully the powers that are being discussed and sought, and the reasons for them. They include additional public health measures to assist with the containment or mitigation of the spread of disease.
Give me some time and I will. The part of the world I live in, the highlands, needs the powers in this Bill if we are to protect our population, and I know that the same goes for the constituencies of many other right hon. and hon. Members, not least the hon. Member for St Austell and Newquay (Steve Double), whom I know has been outspoken on this in the past few days.
Let me put on the record the challenge we are facing. The Highland Council landmass is 25,656 sq km, and of course that area does not include Argyll, the Northern Isles or the Western Isles. That Highland Council area makes up 32% of the landmass of Scotland and 10.5% of the UK landmass, yet we have one acute hospital, in Inverness. For many, that hospital will be more than three hours’ drive from home. Just think about that. If a hospital in an urban area has an issue with capacity, people can often be transferred to another hospital, but we do not have that opportunity in the highlands, as we have that one hospital. I am asking everyone who is thinking about coming to the highlands to think about that threat to our NHS.
I have been working with the NHS and talking to the police, and on the back of what we have been witnessed over the weekend I would like, with the forbearance of the House, to read out a press release from the chief executive of NHS Highland yesterday. It stated:
“As a community we in the Highlands, Argyll and Bute are friendly, welcoming and hospitable to the thousands of visitors we get all year every year. However, we are currently in a situation that has never been experienced before and for the first time we are making a plea for you to stay away.
We have heard that there are many people using campervans/motorhomes to make their way to the Highlands and Argyll and Bute as a way to self-isolate during this period. Please don’t.
National advice is quite clear that we, as a nation, need to stay at home, self-isolate and stop all non-essential travel. This includes using our area as a safe haven.
We have asked our communities in NHS Highland to do everything they can to stay safe. This includes self-isolating, working from home (where possible), and limiting their contact with the outside world.”
That is a very clear and a very stark message.
That is the height of irresponsibility, and Amazon and anybody else who would behave in that way needs to think again. Of course there are companies that are engaging in best practice. I have had a number of complaints from people in the highlands about those who have not been doing the right thing, but let me thank Highland Experience Tours, which has suspended all its activities and sent its drivers home. The hon. Member for Ilford North (Wes Streeting) mentioned Sykes Cottages, and I have to disagree with what he said, because its behaviour has been absolutely reprehensible. Let me read to Members what Sykes Cottages sent to me on Saturday. It said, “Given concerns surrounding the current outbreak, it is understandable that people want to arrange private accommodation in more remote locations to distance themselves from larger towns and cities. The latest Government advice does not prohibit travel in the UK. We are continuing to provide a service for customers.” That is a service to customers to come from the urban areas; it is deliberately creating the circumstances whereby their customers should come to self-isolate in an area where we have limited public health capabilities. That simply is not good enough.
I am delighted to say that, under pressure, the site has now relented and is stopping new bookings in the highlands and islands over the next few weeks, but it has sent a considerable number of people up to the highlands who are there today. The site should be delivering immediate advice to all those guests that they should return home to their place of origin.
I give the same message to those with holiday homes and second homes in the highlands: “Do not come to the highlands. Do not put additional pressure on our public services. We will welcome tourists back to the highlands once this emergency is over, but do not threaten the health of our constituents.” In my district, like in many rural areas, 35% of the population is aged over 65. We have to think about the needs of those living in such areas.
In addition to the sites I have mentioned, Cottages.com is refusing to allow cottage owners to cancel bookings without a penalty, which is simply not good enough. As this is now in the public domain, I hope all these providers will now think about their responsibilities.
As I have mentioned, some providers are behaving more responsibly. HomeAway has guidance on its booking site for giving refunds to those who cancel, but I will read one last email from somebody living in the Lake district:
“My family and I were due to take up a holiday home rental from the 28th March. We will stay away and remain in the Lake District where we live.
However you might be interested to learn that the owner of this holiday home, let through HomeAway, is refusing (at present) to cancel my booking, refund my payment of £957 or move my reservation to next year. He maintains that Skye is an ideal place to self-isolate…and as the home is available he is refusing to refund the total of my booking fee.”
[Interruption.] I can hear an hon. Member shout, “Shocking.” Skye, or anywhere else in the west highlands, is no place for anyone to self-isolate, and I hope this cottage owner, and others who are behaving in such a reprehensible manner, changes their ways.
Of course, it is not just those who are providing accommodation. Everyone knows about the Harry Potter films and the attractions of the rail line from Fort William to Mallaig. The steam trains, which operate on a regular basis, are due to start on 6 April. What on earth is the Jacobite steam train company thinking? These train trips, along with every other visitor attraction in the west highlands, must close, and they must close today.
This is my message to anyone thinking of coming to the highlands: “You will be made welcome when this is over but, for the time being, stay at home. If you are in the highlands now, please go home. The Scottish Government have already announced that ferry traffic will be prohibited for those on non-essential journeys, but you have the ability to return home today. Please do so.”
This Bill includes badly needed powers to allow more health and social care workers to join the workforce. That includes removing barriers to allow recently retired NHS staff and social workers to return to work, as well as bringing back those on a career break and bringing in social work students to become temporary social workers. It has to be said that the number of doctors, nurses and carers already seeking to re-register to help in this emergency has been one of the most uplifting stories of this crisis. The Bill allows that process to become much easier. Its provisions also allow for the relaxation of regulatory requirements within existing legislation to ease the burden on staff who are on the frontline of our response.
The next few weeks and months need simply to be about saving as many lives as possible. Try as we might to save these lives, unfortunately the truth is that this virus will inevitably end up with many of our people dying before their time. That terrible reality is why it is right that this legislation includes special arrangements and provisions to manage an increase in the number of deceased persons with respect and dignity.
Finally, something my party has raised repeatedly since the early stage of this crisis is the economic interventions required to help our people though this emergency period. I note that the legislation includes provisions to support the economy, including on statutory sick pay, that are aimed at lessening the impact of covid-19 on small businesses. While we have welcomed many of the measures brought forward by the Chancellor, we have put it on record that more needs to be done. The self-employed and the unemployed, whom we talked about earlier, need to be considered. They are under pressure and they need to know that we have got their backs. They need the security of a guaranteed income. We now have an opportunity to overhaul and fix the universal credit system—ending the delays, uprating the level of support and scrapping the bedroom tax. If we are to fight this virus together, we must ensure that everyone is supported equally and that no one—no one—is left behind.
The emergency and extensive powers in this legislation have rightly raised questions and concerns, many of which we have heard this afternoon. The imposition of measures that will significantly alter individual liberties deserves full and frank scrutiny, no matter the context. We know that the Bill sunsets after two years. However, there are serious concerns over the two-year period and the scrutiny of this measure. I know that aspects of the Bill and amendments to it will be discussed at later stages. I hope that the Government will look carefully at the safeguards of regular reporting, review and renewal if it is required.
I congratulate the hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey) on his maiden speech. I pay tribute to him for the passion he expressed for his community and to all those whose maiden speeches we have heard so far tonight.
I speak in this Second Reading debate on NHS funding to acknowledge that this Conservative Government are committed to delivering record funding for the NHS to secure world-class healthcare. However, healthcare is not just about how much money goes in—it is also about how it is spent. I welcome the Bill’s intention, which is to provide financial certainty to secure improvements on prevention and detection, as well as the treatment of patients. I believe that the focus on prevention should apply to every new baby life coming into our world. Even though a hospital may be state of the art, as my local Buckland Hospital in Dover is, if proper procedures are not followed, avoidable deaths and serious injury are the result. World-class healthcare is therefore also about leadership, standards and strong procedures. It is about culture—accepting responsibility when things go wrong, ensuring that there is accountability when life is unnecessarily lost, and showing compassion to those who have suffered when mistakes are made.
I would like to take a moment to share an avoidable and sad event with the House. An experienced mother attended Buckland Hospital in Dover last January after becoming concerned about changes in the movement of her baby at 36 weeks. The baby was well developed at over 7.5 lb. The mother was in a higher-risk category, having miscarried before, as well as having other gynaecological factors. At the hospital, she was put on the standard foetal baby monitoring under the supervision of a long-standing midwife. The midwife had a student with her that day.
The mother reports that during the monitoring process, the midwife left the mother and baby at times in the sole care of the student, that the student was having difficulties getting a reliable reading and that this was raised with the midwife on more than one occasion. The reading continued to be unreliable and incomplete. However, the midwife decided to stop the foetal monitoring and signed the monitoring sheet, noting that it was a defective and poor-quality reading, before discharging the mother and baby. Baby Tallulah-Rai Edwards died shortly thereafter, within 48 hours of being discharged from hospital. She died of hypoxia, which is suffocating to death in the womb because of a lack of oxygen.
Tallulah-Rai’s mum, Shelley, and her dad, Nicholas, have come to my surgery to ask me to raise with the Minister their serious concerns about the avoidable death of Tallulah-Rai. In doing so, I acknowledge the dignity and tenacity with which Tallulah-Rai’s family have looked for answers so that other families do not experience such a loss.
Tallulah-Rai’s parents maintain that she died as a result of inadequate foetal monitoring at Buckland Hospital, which is part of the East Kent Hospitals University NHS Foundation Trust. There can be no doubt that mum Shelley should not have been sent home on 23 January 2019 without the proper procedures being followed and completed. This was confirmed in writing by a very senior consultant at the trust.
This incident is all the more shocking because the unnecessary death of Tallulah-Rai was far from an isolated incident. Last Friday saw the conclusion of the coroners’ inquest on baby Harry Richford, a death in 2017 at another east Kent trust hospital. I pay tribute to my right hon. Friend the Member for North Thanet (Sir Roger Gale) for his sympathy and support for baby Harry’s family, as well as their dignity in their distress and their desire to ensure that lessons are learnt from the unnecessary and tragic death of their baby son.
Inadequate foetal monitoring and wider problems in local maternity services have been highlighted in the inquest proceedings as well as in Care Quality Commission investigations in 2016 and 2018. Indeed, there was even a damning secret report commissioned by the trust as far back as 2015, which has only recently come to light. As one of the local Members of Parliament in east Kent, I cannot be fully assured that foetal monitoring in every case, and without exception, is being conducted to the right standards in our local hospitals, nor can Tallulah-Rai’s parents, Nicholas and Shelley. They know that nothing can bring their baby daughter back, but they want changes to the law and the administration of healthcare to ensure that no other parent suffers an unnecessary loss.
They want to see, first, immediate action taken at our local maternity services, so that there is no risk of another baby dying where inadequate foetal monitoring is an issue, or procedures are not followed, or there is unclear or inadequate advice to patients. This cannot wait for a lengthy public inquiry—it needs action now. Secondly, the culture of the trust should be made subject to a further and detailed review. Tallulah-Rai’s parents are still trying to get answers about their daughter’s death, yet in the latest draft report to them, more than a year on, the trust has not even bothered to get their baby’s name right. The trust needs to stop hiding behind paperwork and process; it should take responsibility right now so that Tallulah-Rai’s family can mourn and move on. Thirdly, they want the right to a coroner’s inquest to be extended to all baby deaths, whenever that death occurs, be it before or after the birth date. I know that the Government were bringing forward changes to this before the election and I ask the Minister for an update on how the measures are being progressed to ensure that there is a right to an inquest in these circumstances.
This important Bill provides record funding for the NHS, but money is not everything. Effective management and oversight, responsibility and accountability, and diligence, respect and compassion are all essential features of a world-leading healthcare service. I hope that the Minister will support me and my hon. Friends from across east Kent as we look for urgent and immediate improvements locally to give mums and dads-to-be the greatest possible confidence in our maternity services right here and now.