Draft Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023
Neil O'Brien Excerpts(1 year, 3 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)
I beg to move,
That the Committee has considered the draft Health and Social Care Information Centre (Transfer of Functions, Abolition and Transitional Provisions) Regulations 2023.
It is a pleasure to serve under your chairmanship, Mrs Latham, and I hope that your throat feels better soon.
To make sure that everyone has the right version of the statutory instrument, I draw the Committee’s attention to the correction slip for the SI, which amends two points:
“Page 3, regulation 5(3)(a): omit “annual”
Page 22, regulation 63(a): “paragraph (b)” should read “paragraph (a)”.
The regulations are intended to transfer the statutory functions of the Health and Social Care Information Centre, which operates as NHS Digital, to NHS England, and to wind up NHS Digital. They do that in a relatively straightforward way, using the powers in the Health and Care Act 2022, which allow regulations to transfer the functions of certain bodies to others. Part 1 of the schedule amends primary legislation - chiefly the Health and Social Care Act 2012, which established NHS Digital and set out its statutory functions. Those key functions are transferred to NHS England, unless there is an equivalent function which NHS England already has, or a function is no longer needed, for example, the provisions relating to the board and governance, which will no longer be needed once NHS Digital is abolished.
There are also consequential and transitional provisions, replacing references to the NHS Digital, called the Information Centre, with NHS England in primary legislation, and part 2 of the schedule similarly amends secondary legislation.
The transfer is taking place in response to the recommendations of a November 2021 review entitled “Putting data, digital and tech at the heart of transforming the NHS”. That important review was commissioned by the Government in 2020 and conducted by Laura Wade-Gery, interim chair of NHS Digital and non-executive director of NHS England. The review’s goal was to ensure that the centre of the NHS is able to provide the right leadership and support to integrated care systems to use digital and data more effectively to deliver improved patient outcomes. It called for a realignment of the organisational responsibilities for digital transformation of the NHS, to deliver a new operating model. To achieve that, a specific recommendation was made to consolidate the functions of NHS Digital into NHS England, with an intent to merge legally once legislation enabled that, to help tackle the problem of digital remaining in its own silo and to ensure better alignment with service delivery.
The review’s recommendations were fully accepted by the Government in November 2021. The Secretary of State for Health and Social Care announced on publication of the review that NHS Digital’s functions would be transferred to NHS England as soon as legislation allowed. This SI is the legislation needed to make that happen.
We want to see the excellent work of NHS Digital continue, but we want that to happen within a single central organisation that takes responsibility for all elements of digital transformation and data. As things stand, the functions will transfer unchanged in effect. The transfer, will, however be a critical milestone in making sure our work on digital, data and technology is better aligned with service delivery and patient needs.
We will, of course, be transferring all staff and assets to NHS England at the same time via a separate transfer scheme. The transfer will reduce duplication, bringing the NHS’s national data and technology expertise together into one organisation.
We know that people recognise the value of their data in helping to improve the outcomes from the health service and from social care, but they also want to be reassured, quite rightly, that their personal data is safe. NHS Digital has been an extremely effective guardian of public data, and we will ensure that NHS England, in taking on NHS Digital’s functions, upholds the highest standards of data protection and transparency. The regulations transfer all of the existing safeguards for data, and add to them, by requiring NHS England to have regard to statutory guidance on how it protects people’s data and to report annually specifically on how it has exercised the functions being transferred to it by the SI. Those are new requirements compared with what NHS Digital had to do.
The guidance will recommend NHS England establishes processes and procedures for obtaining independent advice when exercising the transferred data functions. The arrangements for obtaining independent advice should support oversight and scrutiny of the relevant functions of NHS England’s board. NHS England will act transparently, publishing all procedures for when the Secretary of State requests data, or an outside body makes a request, and will publish details of organisations that have been allowed access to data, along with the purpose for that access and the data they have used.
People can have confidence that NHS England will uphold the highest standards of data management, including how it stores, manages, processes and allows access to data. The regulations ensure that by transferring the existing statutory framework of protections and then building on them, and I commend them to the Committee.
Neil O'Brien
Some excellent questions have been asked. My hon. Friend the Member for Amber Valley asked about the vision that the proposal is part of. It is certainly the case that there is a process of simplification of organisations, of which the transfer is another major step. The Health and Social Care Act 2022 also gave Ministers powers of direction over NHS England that did not exist before. None the less, that basic operational independence and structure still stands, so there is change but not a wholesale one compared with the 2012 arrangements.
My hon. Friend the Member for South Thanet asked a really important question about interoperability across the UK. As well as trying to promote that in the NHS, a piece of work is being done by the Department for Levelling Up, Housing and Communities and the Cabinet Office about comparability of data not just in health, but across the work of Government. I am sure that my hon. Friend would find that interesting.
The Opposition spokesman, the hon. Member for Denton and Reddish, asked who we have discussed the transfer with, and the answer is that we have discussed it with the devolved Administrations, the Information Commissioner’s Office, the National Data Guardian, medConfidential and, of course, NHS England and NHS Digital. The staff of those latter two organisations have been fully consulted and know all about the plans. In terms of the speed of the merger, the powers in the SI come into effect immediately, so that the merger can take place towards the end of the month.
I am trying to remember the hon. Gentleman’s other question—
Neil O'Brien
Absolutely. All the staff know about what is happening and have been consulted fully about the streamlining.
The SI will bring together NHS Digital and NHS England. It will not only preserve existing safeguards around people’s data but will establish slightly stronger ones. Effectively, it will deliver the preservation of the existing regime governing data protection as we bring the two organisations together and it will create all the efficiencies that that process will enable. I commend the regulations to the Committee.
Question put and agreed to.
Sudden Unexplained Death in Childhood
Neil O'Brien Excerpts(1 year, 3 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)
I am grateful to my right hon. Friend the Member for Spelthorne (Kwasi Kwarteng) for securing the debate on this incredibly important issue. It is the first debate of its kind in this House and he made a number of important points, which I will address.
The first point was about raising awareness, which is something that the debate itself does. We recognise the devastation to families caused by the sudden and unexpected death of a child. Each death is a tragedy and that we are unable to offer the families an explanation for the child’s death after what will have been a long and potentially invasive process, including a coroner’s investigation, must compound the family’s confusion. For the death to be unexplained just adds to the trauma.
I thank hon. Members for some powerful speeches and interventions, including those from my hon. Friends the Members for Warrington South, for Runnymede and Weybridge (Dr Spencer), for South West Hertfordshire (Mr Mohindra), for Witney (Robert Courts) and for Keighley (Robbie Moore), and the hon. Members for Westmorland and Lonsdale (Tim Farron), for Oldham East and Saddleworth (Debbie Abrahams), for Hammersmith (Andy Slaughter) and for Lancaster and Fleetwood (Cat Smith), as well as hon. Members who have listened but not been able to speak today.
I acknowledge the advocacy work of the organisation SUDC UK, which is raising the profile of the issue and providing valuable support for families. We all share the same end goal, which is to reduce the risks of sudden unexplained death in childhood, and I welcome the contributions that have been made to today’s debate.
As has been mentioned, there has been a reduction of around 70% in the number of unexplained deaths in infancy since the early 1990s. The risk factors are well recognised and the steps that parents can take—safer sleeping practices or stopping smoking—have formed clear messages for years. We are still sponsoring more research on infancy to help reduce those risks further.
Andy Slaughter
The Minister mentioned sudden infant death syndrome. One of the asks that has come from both sides of the House has been whether the Department and the NHS can give the same priority to SUDC as it gives to SIDS in terms of education, research and provision of information to the public.
Neil O'Brien
That is exactly what we want to do. We are committed to the health service learning from child deaths. In 2019, the Government published the “Child Death Review Statutory and Operational Guidance (England)”, advising NHS trusts on how they should support, communicate with and engage with families following the death of someone in their care. Listening to bereaved families and ensuring clear communication is integral to the process, and putting clear support in place is a top priority. That guidance sets out the full process that follows the death of a child in England. It builds on the statutory requirements set out in “Working Together To Safeguard Children” and clarifies how individual professionals and organisations across all sectors involved in the child death review should contribute to reviews.
It is important that when a child dies, bereaved parents should be supported to understand the child death review process and how they are able to contribute to it. The family should be assigned a key worker to act as a single point of contact for the bereaved family, who they can turn to for information and who can signpost them to sources of support. The hon. Member for Lancaster and Fleetwood mentioned one particular, excellent way to do that.
Each local authority area has a child death overview panel that is responsible for reviewing information on all child deaths, looking for possible patterns and potential improvements in services, with the aim of preventing future deaths. This process enables us to act quickly to address local failings within the system.
The first step towards understanding the problem is to get the data. In 2018, NHS England supported the establishment of the national child mortality database to reduce preventable child mortality in England. The NCMD records comprehensive data on the circumstances of children’s deaths and is the first of its kind anywhere in the world. The child death review process aims to ensure that information regarding every child death is systematically captured and submitted to the NCMD to enable learning to prevent future deaths.
In December, the NCMD published its report into sudden and unexpected deaths in infancy and childhood. The Government are grateful to the NCMD for its important research, which is a significant step forward. Of the 204 unexpected and sudden deaths of children reviewed by child death overview panels in 2022, 32 were classified as unexplained. The report highlighted that both explained and unexplained deaths in this age group were associated with a history of convulsions, but that association still needs further research, which I will come back to later.
The NCMD provides evidence for investigation, responding to deprivation, housing and other potential risk factors, which the hon. Member for Denton and Reddish (Andrew Gwynne) asked about. Housing Ministers are already strengthening the powers of the regulator of social housing to tackle unsafe homes, and introducing a decent home standard for the private rented sector for the first time ever, which will make sure that privately rented homes are safe and decent.
My right hon. Friend the Member for Spelthorne asked how we will improve medical education, and the report recommends consistent national training on the child death review statutory process and on sudden unexplained death in childhood. Sudden deaths of children over 12 months of age are not well understood, especially where those deaths remain unexplained. As I have outlined, child death overview panels will continue to develop their processes following the publication of the child death review statutory and operational guidance, and they will be supported by the NCMD and work with relevant professional bodies where appropriate.
We are modernising healthy child programme resources to improve available evidence for health and other professionals who work with children. This will include stronger evidence on safer sleep and sleep hygiene for older children, and NHS England is also making commitments to improve knowledge. The children and young people programme is reviewing the patient information made available, so that it is relevant and appropriate. This will involve a review of all NHS-commissioned information, including on febrile seizures. NHS England is also conducting a review of the leaflet that is handed out when a child dies, which will provide further information on sudden unexpected death in childhood.
The hon. Member for Lancaster and Fleetwood asked specifically about the NHS website. The team are reviewing the information with patient groups, so that it is appropriate.
A number of Members have quite rightly called for more research, and the report calls for further research into SUDC to better identify modifiable factors. My officials have contacted their counterparts at the University of Bristol to discuss potential research priorities, and I am happy to continue that dialogue with Members of this House and others, to scope further research priorities. Such research will help us better understand what can be prevented. The National Institute for Health and Care Research welcomes funding applications for research into any aspect of human health, including sudden unexplained death in childhood, and NHS England will be working with the NCMD to track trends in modifiable factors further. Their work will help to raise awareness across professions and identify key areas for research. My officials are also in contact with the chief nursing officer in England about any opportunities linked to the CNO’s research strategy. I look forward to hearing experts and parents’ suggestions on research, so that we all have better data on prevalence and a shared understanding of risks around gender, ethnicity and other characteristics.
Someone would have to have a heart of stone to not be moved by the contributions to today’s debate. By raising awareness and developing the understanding of modifiable factors, we can provide better information to parents and professionals, and help to reduce the risks, so that more families will not have to suffer in the same way.
Derek Twigg (in the Chair)
I call Kwasi Kwarteng to wind up. You have a bit more time than we originally envisaged.
NHS Dentistry: Salford and Eccles
Neil O'Brien Excerpts(1 year, 4 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
Let me start by congratulating the hon. Member for Salford and Eccles (Rebecca Long Bailey) on securing this important debate. I share her frustration and am aware that some areas in the country face serious difficulties with access to NHS dental care. She used some powerful examples, which are exactly the kinds of things that we are trying to fix.
As we recover from the pandemic, activity is going back up again and we want it to go up faster. Dentistry is an important part of the NHS. We are committed to addressing the challenges that NHS dentistry faces in some parts of the country. We are continuing to take important steps to improve access for patients. There are variations around the country, which was already an issue before the pandemic.
The specific risks from covid in dentistry, for obvious reasons given the nature of the treatment—looking down people’s throats and breathing in the same air—resulted in the need to reduce the amount of care that could be delivered, in line with infection prevention and control measures to keep patients and the workforce safe. The pandemic placed further pressure on the system. However, NHS dentistry provision has been increasing gradually and safely. I am pleased to say that NHS England asked all dental practices to return to 100% of their contracted activity in July this year. Many practices are already delivering at that level and, in some cases, beyond. I will go on to talk about delivering beyond.
To support the industry during this testing time, we took unprecedented action and provided over £1.7 billion in income protection, to ensure that NHS dentist capacity was retained and services were provided and available after the pandemic. We made an additional £50 million available for NHS dental services at the end of last year, to increase capacity in NHS dental teams. Appointments were given to those in most urgent need of dental treatment, including vulnerable groups and children. As a result of that funding, I am pleased that say that an additional 1,110 patients were seen in Salford. To support the provision of urgent care, more than 170 urgent dental care centres remain open across the country. One of those centres is in the Salford locality, as the hon. Lady knows.
Across the nation, the system is recovering and delivery of dental care is increasing. In 2021-22, 24,272 dentists performed NHS activity—an increase of 539 on the previous year. In the 12 months to 30 June this year, 5.6 million children were seen by an NHS dentist, compared with 3.9 million children in the same period the previous year. That represents a 43% increase.
John McDonnell (Hayes and Harlington) (Lab)
There have been reports in a number of our constituencies of almost a dental health epidemic. Can the Minister explain whether there will be targeted resources for a number of our constituencies where there is such a high level of child dental ill health?
Neil O’Brien
I am exploring how we can best target the places with the most acute problems. There are problems in a lot of different places, and we are thinking about that actively at the moment. I will come back to that as I make progress.
Madam Deputy Speaker (Dame Rosie Winterton)
Order. I gently say to the hon. Gentleman that if he wanted to intervene, he ought to have been here right at the beginning, because it is the hon. Lady’s Adjournment debate, and it is about Salford and Eccles? I leave it to him to decide whether he wishes to intervene.
Neil O’Brien
I am happy to take whatever interventions are appropriate.
We know that there are still further improvements to be made. Although I am pleased that over 75% of the patients who tried to get a dental appointment over the last two years were successful, this is not back to the level that we were seeing pre-pandemic, which was 92%. That is why in July and in our plan for patients, which the hon. Lady mentioned, we announced some improvements to the 2006 contract to ensure that patient access was improved, although I want to reassure her that we do not regard those as the end of the story; they were a stepping stone.
Those changes included: making sure that dentists were remunerated more fairly for complex work, which will improve access for patients; implementing a minimum value of £23 for each unit of dental activity, boosting incomes in the places where the UDA value is lowest; and enabling dental practices to deliver up to 110% of their contract levels, to increase activity and allow those practices that are delivering NHS care most effectively to deliver more. This effectively takes away the cap that has been in place since the 2006 contract, which the hon. Lady mentioned.
This package will increase and improve access to dental care for patients across the country. We have already taken action to implement these changes, including through regulations that came into effect on 25 November. The changes have all been decided with careful consideration, working collaboratively with the dental sector. The Department has worked with the General Dental Council on legislative proposals that will make registration processes for dental professionals qualified outside the UK more proportionate and streamlined, making the process to join the UK workforce more efficient for dentists from overseas. These changes are another way in which we are seeking to improve access for patients.
Finally, to make it easier for patients to find dentists taking on new patients, we have made it a requirement for NHS dentists to update their information on the NHS website, which has historically been out of date, but of course we are looking to go further to ensure that those appointments are there. These changes are just the beginning. They are the necessary first steps of our work to improve NHS dentistry. These are the measures that we can take immediately, and they will have a noticeable impact, but we will go further.
Looking forward into the new year, we have been working with NHS England and the sector on further changes to improve access. Our priorities for this next phase of reform include: improved access to urgent care for patients who need to see someone immediately; better access to care for new patients; and further workforce and payment reform. We aim to take the necessary steps to implement these changes next year, but I am keen to seek every opportunity to take action wherever I can, and ahead of those reforms we are also actively considering what support we can offer to help patients who do not currently have access to the dental system and those who are not attached to a practice, who have the worst access. We are also considering how the recruitment and retention of dentists can be improved, particularly in the parts of the country where the need is greater. We are also thinking further about how overseas qualified dentists can be supported to start working in the NHS more quickly.
I am strongly committed to improving our NHS dental system wherever I can for all those who need it. The hon. Lady has set out a powerful case today on why we need to go further, and we will go further. I thank her for raising this important debate, and I hope that she will be reassured that although the reforms we have made so far will make a difference, they are far from being the end of the story, and that we will continue to take action to improve access to NHS dentistry across the nation.
Question put and agreed to.
Eye Health
Neil O'Brien Excerpts(1 year, 4 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)
It is a pleasure to serve under your chairmanship, Mr Sharma. I thank the hon. Member for Strangford (Jim Shannon) for bringing forward this important debate. He has been a strong advocate for eye health for a long time. He speaks from huge knowledge and personal experience, and I listened to his speech with great interest. Given that health is a devolved matter, a lot of my response will focus on England, as he suggested. I understand that the devolved nations are facing similar challenges. We are always interested in sharing ideas and working with our counterparts, in answer to the question asked by the hon. Member for Motherwell and Wishaw (Marion Fellows).
There are 2 million people living with sight loss, and that is predicted to double to 4 million by 2050 as a result of an ageing society. Sight loss is often preventable, and that is why prevention and early detection, along with access to diagnosis and timely treatment, are key. One of the best ways to protect our sight is to have regular sight tests. The hon. Member for Strangford rightly underlined why that is so important with his powerful story about the tennis ball-sized tumour that his constituent had taken out.
When combined with early treatment, sight tests can prevent people from losing their sight. That is why we continue to fund free NHS sight tests for many, including those on income-related benefits, those aged 60 and over, and those at risk of glaucoma and diabetic retinopathy —two of the main causes of preventable sight loss. More than 12 million NHS sight tests were provided to eligible groups in 2021-22. We also provide help with the cost of glasses and contact lenses through NHS optical vouchers. Eligible groups include children and those on income-related benefits. The NHS invests over £500 million annually to provide sight tests and optical vouchers.
The risk factors for sight loss include ageing, medical conditions such as diabetes, and lifestyle factors such as smoking and obesity. We are taking action to reduce obesity and smoking. Smoking rates in England are already the lowest in history, and we remain committed to going further to be smoke free by 2030. We are working to drive down the number of people who take up smoking, and we are supporting those who wish to quit. We are also working with the food industry to ensure that it is easier for people to make healthy choices, and we are supporting adults and children living with obesity to achieve and maintain a healthier weight.
Turning to the medical conditions that lead to sight loss, diabetic retinopathy—a common complication of diabetes—is a potentially sight-threatening condition. The diabetic retinopathy screening programme now provides screening to over 80% of those living with diabetes annually. Between 2010 and 2019-20, the number of adults aged between 16 and 64 who are registered annually as visually impaired due to diabetic retinopathy has fallen by 20%, meaning that it is no longer the main cause of sight loss in adults of working age. The screening programme has played a major role in that.
Jim Shannon
I thank the Minister for his helpful response. The target of providing retinopathy screening to 80% of those living with diabetes has been achieved. Are there any plans to try to reach the other 20%? I am diabetic. I had my retinopathy test about four weeks ago; I get it every year. I know the encouragement and confidence that testing gives people once they know they are okay. Are there any ideas for how we can get to the other 20%?
Neil O'Brien
Absolutely. As the hon. Gentleman says, we are keen to constantly drive that rate up, and we can talk more offline about the different things that we can potentially do to drive it up even further. The healthy child programme recommends eye examinations at birth, six weeks and age two, and school vision screening is also recommended for reception-age children.
The hon. Member for Strangford raised a question about a special school, which I will address specifically. The NHS long-term plan made a commitment to ensure that children and young people with a learning disability, autism or both who are in special residential schools have access to sight tests. NHS England’s proof of concept programme has been testing an NHS sight-testing model in both day and residential schools, and it is currently evaluating its proof of concept as part of programme development, which we expect to conclude towards the start of 2023. The evaluation will then inform decisions about the scope, funding and delivery of any future sight-testing model. I reassure the hon. Gentleman that, at present, absolutely no decisions have been made; we are waiting for the evidence that that programme is generating.
I turn to secondary care. Once an issue with eye health is detected, it is vital that individuals have access to timely diagnosis and any necessary treatment. The NHS continued to prioritise those with urgent eye care needs throughout covid-19. However, we acknowledge the impact that the pandemic has had on our ophthalmology services, as it has had on other care pathways. Our fantastic NHS eye care teams are working hard to increase capacity and provide care as quickly as possible. We have set ambitious targets to recover services through the elective recovery plan, supported by more than £8 billion over the next two years, in addition to the £2 billion elective recovery fund and the £700 million targeted investment fund announced last year.
Neil O'Brien
I give way with pleasure to the hon. Lady, who has been hot-footing it from a funeral to attend the debate. I will seamlessly fill in, so she can catch her breath. I congratulate her on making it here.
Marsha De Cordova
I honestly thank the Minister for giving way. I have just got here from the funeral of a dear friend, Roger Lewis, who, as a totally blind man, was also a strong advocate for a national plan for eye care in England and the devolved nations. I congratulate my dear and honourable friend, the hon. Member for Strangford (Jim Shannon), on securing this very important debate.
As many Members will know, I currently have a Bill calling for a national strategy for eye health in England. We need to ensure that eye care provision is joined up across England to reduce avoidable sight loss but also, more importantly, to end the fragmentation of services. Is the Minister willing to meet me to discuss some of the provisions in the Bill, to ensure that we can create an eye care pathway that ensures that nobody who is losing their sight—or has already lost it—will go through the pathway without the right support and timely treatment?
Neil O'Brien
I am grateful for the hon. Lady’s intervention, and I will be happy to meet her. It sounds like there is an important connection between where she has just been and this debate. I am extremely happy to meet her to talk about that.
I will continue setting out our strategy. I have already talked about screening in primary care, and I was setting out the sums of money that we are investing—the £8 billion plus the £2 billion—in elective recovery following the pandemic. NHS England has been supporting NHS trusts to increase capacity in surgical hubs, and the independent sector has also been used to increase the delivery of cataract surgery, in particular. In 2021-22, nearly half a million cataract procedures were provided on the NHS, which is actually more than before the pandemic, so that is recovering.
Beyond recovering from the pandemic and looking to the future, hospital eye care services are facing increasing demand. As a number of hon. Members have pointed out, ophthalmology is already the busiest out-patient speciality, and the predictions are that the demand for services will increase by 30% to 40% over the next 20 years as the result of an ageing society.
To help address these challenges, NHS England’s transformation programme is looking at how technology could allow more patients to be managed in the community and supported virtually through image sharing with specialists in NHS trusts. Current pilots for cataracts and glaucoma are allowing primary care practices to care for these patients and refer only those who need to be seen by specialists. The learning from these pilots will feed into any possible future service model. That could allow us to use the primary care workforce to alleviate some of the secondary care pressures.
I am delighted that the NHSE has appointed the first national clinical director for eye care, Louisa Wickham, who will oversee this work programme. I am aware that the APPG on eye health and visual impairment has called for there to be one Minister responsible for primary and secondary care services. I can confirm that my portfolio covers both those areas, so I will be taking an active interest in the development of that transformation programme and strategy.
A number of hon. Members have raised questions about the workforce, and we acknowledge that there are challenges across the system, including in ophthalmology. NHS England is developing a long-term workforce plan that will consider the number of staff and roles required and will set out the actions and reforms needed to improve workforce supply and retention. We have already invested in growing the ophthalmology workforce with more training places in 2022, but there is more to do. We are also improving training for existing staff so that they can work at the top of their licence.
Research is an area that the hon. Member for Strangford is interested in, and I was extremely sorry to hear from the hon. Member for Tooting (Dr Allin-Khan) about her keratoconus. That is one area where, fortunately, research and new treatments are coming online, so research is hugely important. While we have effective treatments, particularly for macular disease, we absolutely cannot rest on our laurels because medicine continues to evolve. We recognise that research and innovation are crucial to driving improvements in clinical care and improved outcomes for people living with sight-threatening conditions. The £5 billion investment in health-related research and development announced in the 2021 spending review reflects the Government’s commitment to supporting research into the most pressing challenges of our time, including sight loss.
Over the past five financial years, the National Institute for Health and Care Research has invested more than £100 million in funding and support for eye conditions research, and many of the studies focus specifically on sight loss. The NIHR Moorfields Biomedical Research Centre has recently been awarded £20 million from the NIHR for another five years of vision research, allowing it to continue its mission of preserving sight and driving equity through innovation. Through the NIHR, England, Scotland, Wales and Northern Ireland work together on a range of research topics, and the devolved Administrations co-fund several research programmes.
To assess how well interventions are achieving their intended aims, it is important that we track their impact, which hon. Members have mentioned. The public health outcomes framework’s preventable sight loss indicator tracks the rate of sight loss per 100,000 population for three of the most common causes of preventable sight loss: age-related macular degeneration, glaucoma and diabetic retinopathy.
We are making progress. The indicator shows the impact that the new treatments have had on the rate of sight loss due to age-related macular degeneration. Despite an ageing population, the rate of sight loss in 2019-20 was 105.4 cases per 100,000, down from 114 per 100,000 in 2015-16, so there has been an improvement on macular degeneration. The open availability of this data provides a valuable resource for integrated care boards to draw on in identifying what is needed in their areas and for local democratic accountability for any variation in performance against public health outcomes.
Jim Shannon
The answers are very helpful. One thing that all three Members referred to was the waiting list, and those who lose their eyesight just because they have been on a waiting list for diagnosis, examination and investigation. I know the pandemic created lots of problems in relation to the waiting list. Does the Department intend to have a strategy that will reduce the number of people on waiting lists to ensure that those waiting for a diagnosis retain their eyesight?
Neil O’Brien
I mentioned earlier that one of the main goals of the huge £8 billion plus £2 billion investment is in elective recovery because, as the hon. Gentleman said, the pandemic has had a huge impact. We have already cleared the number of people waiting for two years. The next milestone is to clear those waiting 18 months and then to work through the plan and bring down the numbers using that additional money over time, reducing those waiting the longest first and then steadily reducing the number of people waiting in total.
I acknowledge the importance of good vision throughout life, and especially as we get older. I hope that what I have outlined today provides some reassurance that we acknowledge the ongoing challenges faced by eye care services and are taking action to address them.
Advertising Restrictions on Less Healthy Food: Delay in Implementation
Neil O'Brien Excerpts(1 year, 4 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
The Government are delaying the implementation of the introduction of further advertising restrictions on TV and online for less healthy food and drink products until 1 October 2025.
Due to a delay to Royal Assent of the Health and Care Act 2022, and recognition that industry needs more time to prepare for the restrictions, in May 2022, Government announced a year delay to the implementation of these restrictions to 1 January 2024.
However feedback from industry and the regulators is now clear that there is insufficient time to prepare for implementation on the previously announced date of 1 January 2024.
This is because ahead of implementation there are a number of steps that need to be taken including: a Government consultation on draft regulations that are required to set out the details of the advertising restrictions, such as the definition of product categories in scope of the advertising restrictions and the definition of the exemptions for small and medium enterprises, audio only content and services connected to regulated radio; the subsequent making of such regulations; a consultation from the statutory regulator (Ofcom) on the designation of a frontline regulator; the possible designation of a frontline regulator by Ofcom; and publication of guidance to support business compliance with advertising restrictions, following consultation on such guidance from the frontline regulator.
Through discussions with key stakeholders it is clear that this process cannot be delivered by January 2024.
We have listened carefully to the concerns raised by advertisers, broadcasters and regulators about the importance of having sufficient time with these documents to fully prepare and restructure their advertising. We also recognise that businesses need time to reformulate their products. This is why we have decided to delay implementation of this policy until 1 October 2025.
Parliament included a power in the Health and Care Act to delay implementation of the advertising restrictions if necessary. We will be utilising this power to amend the date of implementation for the advertising restrictions by secondary legislation, which we are laying today.
To illustrate our commitment to this policy, we are also launching a consultation on the definitions included in secondary legislation, to provide detail to that included in the Health and Care Act. This consultation will run for 16 weeks, until 31 March 2023.
This consultation will not be inviting opinions on the policy or looking to deviate from anything announced in the consultation response in June 2021—it will be to confirm the clarity of the definitions used and that the text in the secondary legislation is fit for purpose.
Addressing obesity remains a priority for the Government. Having a fit and healthy population is essential for a thriving economy and we remain committed to helping people live healthier lives.
New regulations on out of home calorie labelling for food sold in large businesses including restaurants, cafes and takeaways came into force in April 2022 and restrictions on the promotion by location of products high in fat, salt or sugar came into force in October 2022.
[HCW433]
Government PPE Contracts
Neil O'Brien Excerpts(1 year, 5 months ago)
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Dawn Butler (Brent Central) (Lab)
I have a few points for the Minister of State, Department of Health and Social Care, the hon. Member for Colchester (Will Quince), who is no longer in his place. The National Audit Office did not have all the paperwork it needed to give a full and correct report. Therefore, when the Minister kept quoting the National Audit Office saying that due diligence was done on all companies, that is not correct. Also, the NHS published weekly consumption data during the pandemic, so the question is: how on earth did we come to buy five times more PPE than we actually needed? It makes no sense. There is a lot of evidence and paperwork on the Good Law Project website, just for the Minister’s reference.
The coronavirus pandemic has been a nightmare for everyone. It was a time of national pain and loss, and for some it was unspeakable. People lost loved ones, as I did, and it was also financially damaging for the country. It is absolutely shocking and unforgivable that some people saw this crisis as an opportunity to seriously line their own pockets, making money out of the misery we all went through. Let us be clear: this money is not free money. This money comes from working people through taxation, and the Government have been pickpocketing the working class to fund the lifestyle of the rich.
We still do not know the true extent of the misuse of public money, and that is why this motion is important. Even though I and many others have been asking questions for three years, what comes back from the Government is really quite sparse. We are having to piece together the information, and that is not good enough from a Government. They need to be transparent and honest, and the public deserve to know who was given public funds, how many had links to the Conservatives and what they were paid for. I often ask, “What were they paid for? What kind of PPE? How many, and how many did we receive?” The Minister never comes back with that information, so if the Minister has the facts and figures, broken down for each company, I would appreciate if he put that in the Library. According to the Minister last week, some companies were paid for PPE even though we had enough PPE in stock. I said, “Was that deliberate?” and he said yes. I think that is really quite strange—if we have enough PPE, why are you giving people more PPE?
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
The hon. Member claims that we bought five times too much PPE. This is not the case. We did have 20% excess capacity against a worst-case scenario that, thankfully, did not materialise. But just to be clear to her, it is not the case, as she keeps saying, that we bought five times too much PPE. That is simply not the case.
Dawn Butler
I thank the Minister for that intervention. So can he just clarify: if the NHS was given weekly stats on how much PPE was needed, how come there is so much PPE in storage, which is costing £750,000 a day to store? Does the Minister want to come back? Oh, the Minister of State has walked in at the right time.
Neil O’Brien
The Minister of State did actually give the House some updated figures on that point. It is not the £750,000 figure the hon. Member just quoted. On this point, it is not the case that we bought five times too much PPE. She keeps saying that. It is not the case.
Dawn Butler
I suppose the facts will reveal themselves when the Minister shows us all the paperwork, leaves it in the Library and then we can go through the facts, the stats and the figures together. I look forward to that. We heard earlier today—[Interruption.] The Ministers are going through some figures now. I really think that, to resolve all of this, and to not even have this debate and conversation, they should put all the paperwork in the Library, we can all go through it together and that is what is needed.
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
To make sure that I get to them, I want to respond to some of the important points made by Back-Bench Members at the start of my remarks. The hon. Member for Kingston upon Hull East (Karl Turner), who is sadly no longer in his place, mentioned Arco not getting a contract. My understanding is that it did get a contract, so we should resolve what is correct.
The hon. Member for Argyll and Bute (Brendan O’Hara) mentioned the two different contracts for PPE Medpro, and it is important to be clear that one of those contracts was delivered—the PPE was delivered and that was fine—and one did not, and that is the one we are taking enforcement action on. With all these contracts, we are just as keen as everybody else to make sure that we get good value for money for taxpayers and we enforce whenever things have not been delivered.
The hon. Member for Blaenau Gwent (Nick Smith) called for the publication of details of companies that were in the high-priority group and then got contracts, which is something that happened in November 2021. I slightly disagree with one point that the hon. Member for Bradford West (Naz Shah) made: the argument that we should not have had any contracts with firms that had not previously been PPE suppliers. Of course lots of new firms were coming into the market, and part of our drive to get more UK supply relied on that very point.
Neil O’Brien
I am just going to complete my tour of people’s contributions.
The hon. Member for Brent Central (Dawn Butler) said that we should donate and reuse PPE, and I am pleased to tell her that that is precisely what we are doing. The hon. Member for Edinburgh West (Christine Jardine) said that we are in the middle of a major cost of living issue, and she is absolutely correct. That is why we are spending £55 billion on energy support, why we have the £900 payment for 8 million poorer households and why we are raising the national living wage to a record level—that is worth about £1,600 for a full-time worker.
The hon. Members for Blackburn (Kate Hollern) and for Llanelli (Dame Nia Griffith)—
Several hon. Members rose—
Neil O’Brien
I will give way, but I am trying to respond to everyone’s points first. If Members can hold on, we will get there.
As I was saying, those two Members both made the point that we wanted to get more UK producers making PPE. The Minister of State, Department of Health and Social Care, my hon. Friend the Member for Colchester (Will Quince), has already made the point that we have gone from 1% of FFP3 masks being made in the UK to 75%. I should also mention our work with Moderna to get more development and production of vaccines happening in the UK as part of that exciting deal.
The hon. Member for Glenrothes (Peter Grant) said that one potential supplier had been incandescent with rage because they did not get a contract. That is the system working. People were being turned down for contracts; 90% of those who went through the—[Laughter.] Madam Deputy Speaker, I am desperately trying to respond to all the points. [Interruption.]
Madam Deputy Speaker (Dame Eleanor Laing)
Order. Give the Minister a chance to respond to all the questions. I have tried to give enough time for that, so let him get on with it.
Neil O’Brien
Thank you, Madam Deputy Speaker. I am keen to reply to them. The hon. Gentleman said that only 3%—
Neil O’Brien
I am literally responding to the hon. Gentleman. He talked about only 3% not being reusable and implied that some of the other things were only fit for servicing a car. To be clear, some of these things have a different clinical use. For example, the NHS tends to use and wants to use aprons on a roll when there is the choice, where we have a normal PPE market. What we do therefore is use the flat-pack ones that we had and donate them to care homes. Self-assembly visors are not preferred in the NHS because they take a bit of time to assemble, so we give them to dentists and the like.
We have heard two different uses of the words “writing off” in this debate, and it is important to be clear about the difference between these two things. Some people talk about “writing off” for things that are not usable, and only 3% of what was purchased is in that category. Then there is a different accounting use of “writing off”, which is something we have to do; we bought a load of PPE because we needed it in the middle of the pandemic and it was more expensive at that time—it was worth more then than it is now. That is the accounting meaning of “writing off”. Let us be clear about those two different uses.
Several hon. Members rose—
Neil O’Brien
There are so many questions that I do not know who to give way to, but I think I should start with the hon. Member for Blaenau Gwent.
Nick Smith
I thank the Minister for giving way. He attributed comments to me that I did not make, and I just want to put that on the record. I do have a question for him: does he accept that excessive profits have been made on the back of some of these PPE contracts?
Neil O’Brien
I am about to explain the due process that we went through and the incredibly forensic work that our civil servants did. Just to be clear—again, for the benefit of the House—Ministers did not make decisions on contracts. Officials, as usual, made the decisions on contracts. I will talk more about the process that we went through in the very short time that we have remaining.
During the dark days of the pandemic, we had a collective approach that saw hundreds of millions of life-saving vaccine doses delivered, the largest testing infrastructure in Europe established from a standing start and the distribution of tens of millions of items of PPE. It was a uniquely complex challenge even in normal times, but a particular challenge when the entire world was trying to get these goods. [Interruption.] Opposition Members might want to have the courtesy to listen to the answers of the questions that they have asked—a strange approach.
We delivered 20 billion items to the frontline and to our broader workforce—we are still in fact delivering 5 million items a months. That was enough to deliver a response to a worst-case scenario, which, fortunately, did not emerge. That is why we have that 20% excess stock that I mentioned earlier. It is simply not the case, as one hon. Member mentioned, that we had five times too much PPE. However, let us remember the context. It was the former Leader of the Opposition, the right hon. Member for Islington North (Jeremy Corbyn), who said that it was a “matter of safety” and of patients’ safety. We agreed, which is why we acted. It was the shadow Health Secretary who said:
“Our NHS and social care staff deserve the very best protective clothing…and they urgently need…it.”
We agreed. It was the current shadow Chancellor who called for a
“national effort which leaves no stone unturned”.
That is exactly what we did. [Interruption.]
Neil O’Brien
What did the hon. Member for Brent Central say there? [Interruption.] No, she does not want to repeat it.
Let me be clear, Madam Deputy Speaker: at every point in the procurement process, the process is rightly run by our brilliant commercial professionals. Ministers are not involved in the procurement process; Ministers are not involved in the value of contracts. Ministers are not involved in the scope of contracts, and Ministers are not involved in the length of contracts. That is something echoed by the National Audit Office, whose report concluded that the Ministers had properly declared their interests and that there was
“no evidence of their involvement in procurement decisions or contract management”.
The role of Ministers was exactly what we would expect. Approaches from suppliers were passed on to civil servants for an independent assessment. Let us again look at the scale of the effort: 19,000 companies made offers, around 430 were processed through the high-priority group, and only 12% of those resulted in a contract for 51 firms. That group was primarily about managing the many, many requests that were coming in to Ministers from people across the House and from people across the country who were desperate to help with that national challenge of getting more PPE, and there had to be a way of dealing with them. To be clear, due diligence was carried out on every single company, financial accountability sat with a senior civil servant, all procurement decisions were taken by civil servants, and a team of more than 400 civil servants processed referrals and undertook due diligence checks. It was a huge operation run by the civil service, and I thank them for their work in getting our NHS the PPE that it needed.
Let me be clear, I will not stand here and say that there are not any lessons to be learned; of course there are. But we should be clear about what those lessons are. Despite the global race to get PPE, only 3% of the materials sourced were fit for purpose, but we have built more resilient supply chains. We are implementing the recommendations of the Boardman review of pandemic procurement in full. I have mentioned the growth of UK procurement of face masks and of vaccines.
In closing, I wish to thank all of those who have been involved in this important conversation. We should be rightly proud of what was achieved during those dark and difficult days at the start of the pandemic, operating in conditions of considerable uncertainty. We were in a situation where, literally, there was gazumping going on. If people did not turn up with the cash, things were removed that they had bought from the warehouses. That was the global race that we were in to source these things. The 400-strong team of civil servants who led this process did a remarkable job from a standing start of sourcing the goods that we needed.
During this debate, we have heard a number of deliberate obfuscations of the different things that Ministers and officials do. To be clear, all of these decisions went through an eight-stage forensic process that was run entirely by officials and it did not get anyone a contract to go into this high-priority group. It was simply about managing the sheer number of bids for contracts that were coming in to people across this House. At the time, although memories are very short and the barracking on this continued—
Sir Alan Campbell (Tynemouth) (Lab)
claimed to move the closure (Standing Order No. 36).
Question put forthwith, That the Question be now put.
Question agreed to.
Main Question accordingly put and agreed to.
Oral Answers to Questions
Neil O'Brien Excerpts(1 year, 5 months ago)
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Scott Benton (Blackpool South) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
In July, we made some initial changes to the reformed system to support NHS dentistry. We have invested an extra £50 million, reformed the contract to create more UDA—unit of dental activity—bands to better reflect the fair cost of work, and introduced a minimum UDA to help practices where the levels are low, allowing dentists to deliver 110% of their UDAs to provide more treatment. The number of dentists doing NHS work last year was up 2.3% but we are working on plans to go further.
Scott Benton
The changes made to the dental contract last week were a step in the right direction, but they fall some way short of the holistic reform required to help the estimated 25,000 of my constituents who do not yet have an NHS dentist. Will the Minister consider a change whereby the NHS funds subsidies to underprivileged areas such as Blackpool, thereby allowing NHS practice to offer a greater financial incentive to attract new dentists into those areas?
Neil O’Brien
Absolutely; my hon. Friend and I have talked about this. We are looking urgently at payment models and measures to address areas that are struggling to attract the right workforce. The commissioning of dentistry will be coming down to a more accountable local level in April, and we need to build on that.
Mary Kelly Foy (City of Durham) (Lab)
My constituents in Durham have told me tales of DIY dentistry, missing teeth, children in pain and the unfairness of only being able to access dental care if they can afford it. Things should not be this way. The British Dental Association does not accept that the Government’s new plans go far enough to halt the decay in NHS dentistry provision. Will the Minister tell me when the Government will put in adequate funding and reform so that people in Durham can get the dental care that they need and deserve?
Neil O’Brien
As well as increasing the number of dentists doing NHS work and the amount of work being done, we are taking further steps to look to the longer term and build NHS dentistry. The number of dental school places is up from 810 in 2019 to 970 in 2021, but of course we want to go further. We are making it easier for dentists to come to the UK to practise. In fact, we laid draft secondary legislation on 11 October to give the General Dental Council more flexibility to do that. Around the country, plans are advancing for centres for dental development to provide not only additional dentists but hygienists and other nurses.
Mary Robinson (Cheadle) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
We are taking action on public health across the board. The £3 billion that we are investing in the drugs strategy will create an extra 50,000 places in drug treatment. We have doubled the duty on cigarettes since 2010 and brought in a minimum excise tax. We now have the lowest smoking rate on record and will go further. The £300 million that we are investing in Start for Life means new or expanded family hubs in 75 local authorities. We are taking action right across Government, from the £55 billion that we are investing in energy support to the measures that we are taking through at the moment to crack down on non-decent housing.
Peter Gibson
Levelling up is not just about jobs and infrastructure; it is about healthcare too, and dentistry is a key part of that. However, Darlington faces the potential closure of its surgery, which serves 7,000 patients, because the current system of NHS dentistry makes the business case for that surgery unviable. What will my hon. Friend do to ensure that we level up dental services so that my constituents can get the services that they need?
Neil O’Brien
My hon. Friend and I have discussed this, and we are due to meet again shortly. I repeat my offer to speak both to that practice and to local partners so that we can tackle this crucial problem.
Mary Robinson
Research by the University of Manchester adds to the significant body of evidence showing that addressing disparities in healthcare is key to levelling up. Inequalities have resulted in a 30% productivity gap in the north, which can be attributed to poorer health. Will my hon. Friend outline how the Government are working to address this and to ensure that residents of the north are not at a health and care disadvantage?
Neil O’Brien
I saw that important report, and we have to tackle the problem from both the health end and the economic end. Spending on health in the north grew from £36.5 billion in 2018-19 to £52.6 billion in 2020, so there is significant investment in health and preventing ill health in the north. Economic activity stops people sliding into a cycle of ill health and worklessness, and we are working jointly with the Department for Work and Pensions to roll out more disability employment advisers in jobcentres. The underlying key is to tackle and prevent ill health, hence the £3 billion drug strategy and the measures on smoking, energy and housing.
Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)
I will give the Minister a good example of health inequality. Until quite recently, we had a perfectly good consultant-led maternity service based in Caithness. Following the Scottish Government’s rubber-stamping decisions, pregnant mothers now have to make a 200-mile return journey to Inverness to give birth. That glaring inequality is despicable. I hope His Majesty’s Government will share best practice with the Scottish Government on tackling this problem.
Neil O’Brien
I am always keen to work constructively with the Scottish Government. This sounds like a serious problem. My right hon. Friend the Secretary of State set out how we are using our health and capital spend more efficiently, and unfortunately this is an example of where it is not happening in Caithness.
Helen Morgan (North Shropshire) (LD)
It is well documented that people in rural areas have worse health outcomes than people in urban areas. One driver is that the most vulnerable people lack access to the services they need. Will the Minister consider working with his colleagues in the Department for Transport to figure out how the most vulnerable people can access the healthcare they need?
Neil O’Brien
We are rolling out community diagnostic centres to bring services closer to those who need them, and we are investing in 21,200 extra people working in general practice to make sure that rural services, as well as services in the rest of the country, are improved.
Andrew Gwynne (Denton and Reddish) (Lab)
In 2019, the Tories promised to extend healthy life expectancy by five years, but on this they are failing. In the last year, the health disparities White Paper has disappeared, the tobacco control plan has been delayed and they have chickened out on implementing the obesity strategy because the Prime Minister is too cowardly to stand up to his Back Benchers. Health inequalities are widening as a consequence. Does the Minister plan to revive any of these strategies, or have the Conservatives completely given up on prevention?
Neil O’Brien
I have already talked about some of the things we are doing to crack on with improving public health and narrowing inequalities, but I will add some more. We are driving up blood donations from shortage groups and vaccine uptake in areas with the lowest uptake. I mentioned the extra £900 million for drug treatment, taking the total to £3 billion over three years. I will not repeat all the things I mentioned but, across the board, we are working at pace to improve public health and narrow health inequalities.
Margaret Ferrier (Rutherglen and Hamilton West) (Ind)
Sir Greg Knight (East Yorkshire) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
As well as making it more attractive to practise in the NHS, the number of dental school places is up from 810 in 2019 to 970 in 2021, making it easier for qualified dentists to come to the UK. We are putting through secondary legislation on that and encouraging new centres for dental development.
Sir Greg Knight
Is the Minister aware that there is a particular problem in Bridlington in my constituency, where an increasing number of residents are finding it not just difficult to access NHS dental care, but impossible to do so? Recently, a dental practice in the town has closed. Will he agree to meet me on this matter to see what can be done to resolve the issue, hopefully sooner rather than later?
Neil O’Brien
Of course, I would be keen to meet to try to address those issues and to build on the work that we are doing nationally.
Rachael Maskell (York Central) (Lab/Co-op)
York has had a dental desert for years. It is six years now to see an NHS dentist and the Government have made no change to improve that situation, or to bring more NHS centres into my area. In March, dentistry will be moving into integrated care systems and integrated care boards. How are they going to solve the problem?
Neil O’Brien
One problem has been that having large, remote regional commissioning for dentistry has meant that it is more unlikely that specific local problems will be picked up. That is why we are taking the step that the hon. Member has described. She is now complaining about it, even though it is a measure to get more local accountability over the way that services are commissioned.
Michael Fabricant (Lichfield) (Con)
Mary Robinson (Cheadle) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
My hon. Friend is so right. I praise her work with the APPG and I know many colleagues will want to attend. Whistleblowers can save lives and improve healthcare, as I have seen in my own constituency, and she is right to be pressing on this matter.
Bob Blackman (Harrow East) (Con)
Neil O’Brien
Whatever format our next steps forward are set out in, we will be pushing forward very quickly and aggressively on this. This year, we are putting £35 million into the NHS to support our services for everyone who goes in to stop smoking. We have doubled duty on cigarettes and brought in a minimum excise tax. Women who are pregnant now routinely get a carbon monoxide test. National campaigns such as Stoptober have now helped 2.1 million people to quit smoking. We are also supporting a future medically licensed vaping product as a quitting aid. We will be pressing forward at the greatest speed.
Alexander Stafford (Rother Valley) (Con)
Neil O’Brien
That is something that we are working on very actively. As well as financially supporting GPs to roll out new and better ways of managing their appointments, we are looking at what criteria we expect from GPs. We already set out some moves in our summer action plan, but we will be looking further at preventing the lamentable situation my hon. Friend describes of people being asked to ring back or being held in long phone queues. That is not acceptable.
Karl Turner (Kingston upon Hull East) (Lab)
Dr Rupa Huq (Ealing Central and Acton) (Ind)
In a case that is sadly all too typical, a GP in Ealing, who has seen their patient list go up from 3,000 to 9,000 in the last decade, had plans approved for expansion, but NHS estates now will not cough up. What are the Government doing to support doctors in inadequate premises who cannot increase their patient lists to expand and modernise in the current climate?
Neil O’Brien
The total activity done by GPs was about 7% up in October compared with the previous year. We are actively looking at the way that capital works and the contributions of section 106 and the local integrated care board, to ensure that, as well as having those 2,300 extra doctors and 21,000 extra staff, GPs also have good facilities to work in.
Robert Courts (Witney) (Con)
Access to dentistry is an acute issue for West Oxfordshire. Can Ministers explain what they are doing to help rural areas such as mine, and can we meet to discuss it further?
Neil O’Brien
I have mentioned the fact that the number of NHS dentists was up 2% to 2.3% last year, as well as the extra £50 million and the reforms we have made to the contract, but we will go further. We want to address those areas, and particularly rural areas, where more provision is urgently needed.
Patricia Gibson (North Ayrshire and Arran) (SNP)
The chair of the Royal College of General Practitioners has expressed concerns about patients with chronic conditions such as asthma, diabetes and even serious mental health conditions refusing sick notes because they cannot afford time off work. What discussions has the Secretary of State had with Cabinet colleagues about the adequacy of statutory sick pay during this cost of living crisis?
World AIDS Day
Neil O'Brien Excerpts(1 year, 5 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Neil O'Brien)
Let me start by congratulating all Members from across the House who have taken part in what has been an incredibly informative and high quality debate. Let me join others in congratulating the hon. Member for Brighton, Kemptown (Lloyd Russell-Moyle), on a speech that mixed huge personal experience and knowledge, years of advocacy and successful campaigning, and a huge number of insights.
I undertake to look at numerous issues raised by the hon. Member, but to pick just a few, he asked about: the bureaucratic barriers stopping syphilis testing from being added to the opt-out testing that we already do for HIV and hepatitis B and C; some of the risks around the shift to online clinics; people on PrEP being tested regularly; and the promising experiment by the Terrence Higgins Trust with saliva testing for HIV. He raised a number of other points, including the important issue about patent waivers. There was a huge amount in his speech to take away and look at.
The same is true of other hon. Members. My right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) made hugely important points about women and girls, and gave some incredibly striking and harrowing statistics. She made important points about the barriers to testing, particularly among minority groups. We can learn from the way that we are tackling that problem in other fields, including in covid vaccination work.
The hon. Member for Strangford (Jim Shannon) gave us insights on what is happening in Northern Ireland, such as the role of the Public Health Agency there and what it is doing on PrEP. He talked about the role of the church in his constituency and the connection between Swaziland and Strangford, which might surprise outsiders. He talked of the work of the Positive Life charity in Northern Ireland, which I commend.
My hon. Friend the Member for West Bromwich East (Nicola Richards) spoke powerfully about her constituents’ experiences of stigma. She made the important point that, as a high prevalence area, it should be considered for the expansion of opt-out testing. A similar point was made by the hon. Member for Slough (Mr Dhesi) and my hon. Friend the Member for Heywood and Middleton (Chris Clarkson). I join my hon. Friend in commending the work of Middleton Health Centre.
The hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) talked about some important lessons that we can learn. We are keen to learn across the UK about the rollout of PrEP in Scotland. On the roll-out of our world-leading vaccination campaign against mpox—one of many issues raised by the hon. Member for Denton and Reddish (Andrew Gwynne) in his speech—we are talking to that relatively small number of clinics that have had to deliver the huge majority of the campaign about its impact financially and on their day-to-day work.
World AIDS Day is an invitation to underline our commitment to tackling HIV, to show our support for people living with HIV and to remember those we have lost to AIDS. I am proud of how far we have come: from the stigma and the sidelining of the past, which a number of Members have mentioned, to where we are today thanks to collaborative efforts and the commitment of the Government, together with HIV patients, their friends and family, campaigners, medics, researchers and the health and care system at all levels.
Today, when diagnosed early and with access to antiretroviral therapy, most people living with HIV in England can expect a near-normal life expectancy. People diagnosed with HIV can expect to receive world-class, free and open-access HIV care. That has been a result of our collective and collaborative partnerships. However, despite successes, HIV has not gone away. There is still more that we should do. That is why last year, this Government published their commitment to end new HIV transmissions in England by 2030 through the HIV action plan. That plan is the cornerstone of our approach in England to drive forward progress and achieve our bold ambitions.
We have come far in the first year since its publication. The UK met the UNAIDS 95-95-95 targets for the first time in 2020: 95% of HIV-positive individuals were diagnosed; 99% of those diagnosed were receiving treatment; and 97% of those receiving treatment were being virally suppressed. I am pleased that the number of people being newly diagnosed with HIV in England continues to fall. The latest data on HIV diagnoses shows that 2,955 people were diagnosed with HIV in England in 2021—a 33% decline compared with 2019, when the Government first made their commitment to end all new HIV transmissions in England by 2030. We are conscious of the need to avoid flatlining or slowing the pace in any way. We are still understanding the impact of the covid pandemic and the things that happened during that period, but there has been progress.
Those successes have been underpinned by clear national leadership and strengthened partnership working. I am grateful to Professor Kevin Fenton, the Government’s chief adviser on HIV, who has been chairing the HIV action plan implementation steering group, involving the key partners in the delivery of the HIV action plan, including local government, the NHS, and our voluntary and community sector. The steering group has met quarterly throughout the year to monitor progress on our commitments and ensure that appropriate action was taken to keep us moving forward with our objectives. Within the remit of the group, they have established specific task and finish groups focusing on key priority areas for action, such as improving equity and access to HIV drug prevention—PrEP—and addressing workforce challenges, among others.
We are also thankful for the work of the UK Health Security Agency, which excels as a world-class leader running high-quality data collection and surveillance systems to help us to better understand and address the challenges on HIV. Those have enabled us to truly understand developments, emerging issues and where we can have the greatest impact with our prevention efforts, and add to our growing repertoire of world-leading British innovation, systems and technology.
Of course, none of this could have been possible without the brilliant efforts of our local government, NHS and voluntary and community sector partners to deliver the highest-quality healthcare tailored to the needs of their local populations. We know through their work that different areas face different challenges, and we remain committed to helping level up outcomes for the whole population across the country.
A key priority, therefore, of the Government’s approach is to ensure that all under-served populations benefit equally from improvements in HIV outcomes. A range of important suggestions have been made in this debate about how to go further. The approach includes scaling up our prevention efforts and increasing access to PrEP. We have already invested £33 million to roll out PrEP access across sexual health services over the past two years. PrEP is now being commissioned as a routine service through the public health grant.
In delivering against these commitments, UKHSA has now developed and published a monitoring and evaluation framework to support local authorities, sexual health services and other key stakeholders to inform continuous service development in PrEP commissioning and delivery, using the existing available data. I am sure many of the people involved in delivery of those services will have followed this debate with great interest and noted some of the challenges posed by different hon. Members.
Lloyd Russell-Moyle
One of the problems is that the Department does not collate data on the average wait times for sexual health clinics or the availability of stocks for PrEP appointments in those clinics. Without that data, we rely on voluntary organisations to make freedom of information requests and report periodically. Having a baseline set from the Department would make a big difference and help us to understand areas that are struggling to roll out PrEP versus areas that maybe are not. Is that something the Minister could take back to the Department? I understand why in the past we have been nervous about publishing data on sexual health issues, but now is the time when we can be a bit more open about that and maybe publish that data, or collate it if that is not already done, so we can start to target our actions.
Neil O'Brien
That is certainly something I will take away and look at. As the hon. Gentleman points out, there are a number of challenges in doing that and in unpicking the activities of sexual health services on different diseases, and he has already alluded to some of the risks. However, I will certainly undertake to go away and look at that important point.
We know there is still more to do to improve PrEP access for key groups and we are in the process of developing a plan for provision of PrEP in settings beyond sexual and reproductive health services, to help us to reach those who are underrepresented—something a number of hon. Members have called for. Our efforts are also focused on scaling and improving testing levels in targeted, high-risk populations, including in black African communities, to be able to reach those 4,500 individuals who we believe are living with HIV but unaware of their status.
As part of implementation of the action plan, NHS England is investing £20 million over the next three years to expand opt-out HIV testing in A&E departments in the local authority areas across the country with the highest prevalence of HIV and across the whole of London. As a number of hon. Members have pointed out, it is a proven effective way to identify new HIV cases, as it promotes testing on admission to hospital of anyone who has not previously been diagnosed with HIV, therefore rapidly helping to identify the virus. Some 33 A&E departments are now live, delivering that important initiative.
We also took the opportunity to link the initiative to the hepatitis C elimination programme, backed by a further £6.85 million, to provide hepatitis B and C testing as well. As several hon. Members alluded to, NHSE published its report on the first 100 days yesterday, describing the progress, challenges, results and learning from the first period of this initiative.
Those very early findings show the benefits of the approach: more than 200,000 HIV tests were conducted over just the first 100 days of opt-out testing across London, Manchester, Salford, Blackpool and Brighton, which meant that more than 600 people were identified with a previously unknown blood-borne virus. Of those, 128 people were newly identified as living with HIV and an additional 65 people living with HIV who were previously diagnosed but were not under the care of an HIV clinic were also identified.
This approach is important to ensure everyone living with HIV can access testing and rapid linkage to treatment and care, allowing them to live a long and healthy life. Moreover, 325 people were newly identified with hepatitis B and 153 people were newly identified with chronic hepatitis C virus; a further 50 were found who had disengaged from care for both diseases and seven people were identified who had previously cleared the hepatitis C virus.
We will be considering the initial evidence from the first year of testing alongside the data on progress towards our ambitions to decide how and whether we further expand this programme. We are in the very early days of evidence on this, but I must say that evidence is extremely encouraging. I hear what hon. Members across the House are calling for, given the success of that programme in its first 100 days, but we need further evidence as it develops.
We redoubled our efforts to increase HIV testing throughout the country during National HIV Testing Week, which took place in February this year. Results are promising: 30% of the almost 25,000 users who ordered an HIV and syphilis self-sampling kit during the campaign had never tested before, and a majority of the campaign’s target audiences reported having taken some kind of preventative action as a result of the campaign.
We know there is still more we need to do to achieve our ambitions. The HIV action plan monitoring and evaluation framework developed by UKHSA, published today, will explore in detail the inequalities and gaps in HIV prevention, testing and care and other indicators of the progress required to achieve our shared ambitions and will help inform our progress. Our actions continue to be closely monitored by the HIV action plan implementation steering group, which includes key delivery partners such as local government, the NHS and the voluntary and community sector, to ensure we remain on track to meet the 2025 and 2030 objectives. The Secretary of State will report annually to Parliament on progress towards our objectives.
World Aids Day gives us the chance to reflect on progress and challenges, being accountable for what we have done over the past year and where we need to continue improving. But, most importantly, it gives us the possibility of coming together to restate our collective commitment to continue working together to end new HIV transmissions in England by 2030 and to finish the race.
Draft Food and Feed (Miscellaneous Amendments) Regulations 2022
Neil O'Brien Excerpts(1 year, 5 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
I beg to move,
That the Committee has considered the draft Food and Feed (Miscellaneous Amendments) Regulations 2022.
It is a pleasure to serve under your chairmanship, Mr Sharma. The statutory instrument is made under powers in the European Union (Withdrawal) Act 2018. It follows on from the previous EU exit instruments in the field of food and feed safety made since 2019. The Government’s priority is to ensure that we continue to maintain the same high standards of food and feed safety and consumer protection that we have established. The principal changes introduced by the instrument will ensure that national and GB-wide legislation continues to operate effectively following the UK’s exit from the EU.
The purpose of the instrument is to amend national England regulations in the fields of articles in contact with food, extraction solvents and animal feed to remove cross-references to European Union directives and correct other EU exit-related inoperabilities. The instrument also addresses a range of remaining deficiencies in retained direct EU legislation in the field of food and feed safety and hygiene, to ensure the continued operability of that legislation after exiting the EU.
The instrument will also address inoperabilities that have arisen as a consequence of previous deficiency amendments made pursuant to the European Union (Withdrawal) Act 2018. It will extend the tolerance period of three withdrawn genetically modified organisms for a further three years until 31 December 2025, to align with the correction of a deficiency in retained EU regulation 619/2011. It will provide for a time-limited transitional period for edible insects specific to Great Britain. This will permit qualifying edible insects to remain on the market in GB after 31 December 2023, while applications for novel food authorisation are considered by the appropriate authority.
Let me be clear that the instrument does not introduce any changes that will impact the day-to-day operation of food or feed businesses. Nor does it introduce any new regulatory burden. The essence of the existing legislation is unchanged.
It is important to note that the devolved Governments have some shared and devolved legislative responsibilities in relation to food law. Both Scotland and Wales have provided their consent for the instrument. Amendments introduced by the instrument do not apply to Northern Ireland. In accordance with the Northern Ireland protocol, EU regulations will continue to apply; however, the Northern Ireland Department of Health has been briefed. We have engaged positively with the devolved Governments throughout the development of the instrument, and their ongoing engagement has been warmly welcomed.
I reassure hon. Members that the overarching aim of the draft regulations is simply to provide continuity for businesses and ensure that high standards of safety and quality for food and feed regulation continue across the UK. They do not affect the essence of existing legislation. Having effective and functional law in this area is key to ensuring that high standards of food and feed safety are continued. I ask hon. Members to support the amendments proposed in the instrument, to ensure the continuation of effective food and feed safety and public health controls. I commend the draft regulations to the Committee.
Neil O’Brien
To take some of the important questions raised by the Opposition in reverse order, the hon. Member for Cambridge is right that there are no substantive changes on edible insects. It is already the case that the pictograph does not need to be used; only the “do not eat” wording is mandatory. A consultation was carried out to allow stakeholders to consider the proposal to remove the requirement to use the pictograph. We shared the consultation widely and did not receive any responses on that particular point, although we will of course review the implementation of the change to ensure that there are no negative impacts.
On the original point raised by the hon. Member, this is indeed a technical SI. The legislation as it stands is workable. He was right that the point is that, although relying on cross-references to lists in EU directives is legal and operable, an issue arises if any further amendments would require the creation of a separate list in domestic regulations. We would then have two lists, which would run the risk of creating confusion. That is the core of what the SI is about, and on that basis I commend it to the Committee.
Question put and agreed to.
Covid-19: PPE Procurement
Neil O'Brien Excerpts(1 year, 5 months ago)
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Urgent 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
Angela Rayner (Ashton-under-Lyne) (Lab)
(Urgent Question): To ask the Chancellor of the Duchy of Lancaster if he will make a statement on the due diligence and performance management performed on the public procurement of personal protective equipment during the covid-19 pandemic.
Thank you, Mr Speaker. I will try to stay in my lane.
The Parliamentary Under-Secretary of State for Health and Social Care (Neil O’Brien)
Sourcing, producing and distributing PPE is, even in normal times, a uniquely complex challenge. However, the efforts to do so during a pandemic, at a time when global demand was never higher, were truly extraordinary. Early on in that pandemic, our priority was clear: to get PPE to the frontline as quickly as possible. All of us in this House will remember that moment, and how desperate we all were to see PPE delivered to the frontline.
During the course of the pandemic—nearly at its peak—400 staff were working on sourcing protective equipment, and tens of billions of items were sourced. We worked at pace to source new deals from around the globe, and we always buy PPE of the highest standard and quality, and at the best value for money. Over the course of the programme, due diligence was done for over 19,000 companies, and over 2,600 companies made it through that initial due diligence process.
With huge demand for PPE all across the world, and with many countries introducing export bans, our risk appetite had to change. We had to throw everything behind our effort to protect those who protect us and those who needed it most. We had to balance the risk of contracts not performing and supplies being priced at a premium against the crucial risk to the health of frontline care workers, the NHS and the public if we failed to get the PPE that we so desperately needed.
As well as due diligence checks, there was systematic price benchmarking. Prices were evaluated against the need for a product, the quantity available, how soon it was available and the specification. Many deals were rejected or renegotiated because the prices initially offered were not acceptable.
There are always lessons that we can learn from any crisis, but we must not lose sight of the huge national effort that took place—I thank the officials who worked on it—to protect the most vulnerable while we tackled one of the greatest threats to our public health that this nation has ever seen.
Angela Rayner
Thank you for granting this urgent question, Mr Speaker. I welcome the Minister to his place—I think this is the first time we have met at the Dispatch Box—but to be honest, to his defence of due diligence I would say, “What due diligence?” Last night, documents seen by The Guardian revealed yet another case of taxpayers’ money being wasted, with a total failure of due diligence and a conflict of interest at the heart of Government procurement.
In May 2020, PPE Medpro was set up and given £203 million in Government contracts after a referral from a Tory peer. It now appears that tens of millions of pounds of that money ended up in offshore accounts connected to the individuals involved—profits made possible through the company’s personal connections to Ministers and the Tories’ VIP lane, which was declared illegal by the High Court. Yet Ministers are still refusing to publish correspondence relating to the award of the Medpro contract, because they say that the Department is engaged in a mediation process. Can the Minister tell us today whether that mediation process has reached any outcome, and what public funds have been recovered, if any? Will he commit to releasing all the records, both to the covid-19 public inquiry and to this House, once the process is completed?
Rightly, there are separate investigations into Baroness Mone’s conduct, but the questions that this case raises are far wider. It took a motion from the Opposition to force the Government to release records over the Randox scandal. Will they agree today to do the same in this case without being forced to do so by the House? Can the Minister say now what due diligence was performed when awarding the Medpro contract?
Today’s reports concern just one single case, but this Government have written off £10 billion just on PPE that was deemed unfit for use, unusable, overpriced or undelivered. Worse, Ministers appear to have learned no lessons and to have no shame. As families struggle to make ends meet, taxpayers spend £700,000 a day on the storage of inadequate PPE. Can the Minister confirm whether the Government’s new Procurement Bill will still give Ministers free rein to hand out billions of pounds of taxpayers’ cash all over again?
Mr Speaker
Order. Can we please stick to the rules of the House on time limits? I do not make the rules; the rules are meant for us all. This is happening too often.
Neil O’Brien
The right hon. Lady asks two main questions, the first of which is what we are doing on PPE Medpro. It has been widely reported that it had an underperforming contract. Let me set out what we do in such cases. The first step is to send a letter before action, which outlines a claim for damages. That is followed by litigation in the event that a satisfactory agreement has not been reached. To answer the right hon. Lady’s question directly, we have not got to the point where a satisfactory agreement has been reached at this stage.
On the high-priority group, let us be clear about what it was and what it was not. Approximately 9,000 people came forward. All Ministers will have had the experience of endless people ringing them up directly to try to help with the huge need that there was at the time. Many of us, as Back Benchers, will have been approached by constituents who were keen to help and needed to be referred somewhere. All that the route did was handle the huge number of contacts coming in to Ministers from people offering to help. Let me be clear that it did not give any kind of successful guarantee of a contract; indeed, 90% of the bids that went through it were not successful. Every single bid that went through the route went through exactly the same eight-stage process as all the other contracts—it looked at the quality, the price and the bona fides of the people offering to produce.
On the point about PPE that has not been useful, I set out in my answer the extraordinary context in which we were operating. There was a global scramble for PPE. People were being gazumped: goods would be taken out of the warehouse if people could turn up with the cash quicker than them. It was an extraordinary situation in which we had to act in a different way. Loads of us will remember standing up in this House and saying to Ministers, “What are you doing to get more? More, quickly!” That was the context in which we were operating.
Sir Christopher Chope (Christchurch) (Con)
Does my hon. Friend agree that if we had not wasted billions of pounds of taxpayers’ money on PPE, we would not have to increase taxes as much as we are doing? What has happened to the £122 million that was spent on 25 million gowns supplied by the company referred to earlier? Those gowns were not fit for purpose and were never used.
Neil O'Brien
That was the underperforming contract that I referred to in my previous answer, and I set out the process that we go through when we take action on underperforming contracts. There is the initial letter before action, and then a process in which we look to see if a satisfactory agreement can be reached. If not, that leads on to litigation. Of course, there was wasted PPE—my hon. Friend is absolutely correct about that—but I have already set out the context of the global scramble and the huge amount of PPE that was successfully delivered, saving lives and protecting workers in our NHS.
Brendan O'Hara (Argyll and Bute) (SNP)
From the moment we learned about the existence of this VIP lane for the politically connected, it was almost inevitable that it would come to this. This get-rich-quick scheme to fast-track cronies, politically connected pals and colleagues was never going to end well. I suspect that today’s revelations, however shocking, are simply the tip of a very large iceberg—an iceberg that could yet sink this ship of fools.
Transparency International UK has flagged as a corruption risk 20% of the £15 billion given out by the Tories in PPE contracts at the height of the pandemic. As we have already heard, they are spending £770,000 every single day to store much of that useless equipment in China. One Tory politician who had absolutely no background in PPE procurement personally made millions from those contracts, so do the Government plan to investigate proactively how many others like that are in their ranks, or are they content to sit there and watch this dripping roast of sleaze, corruption and scandal unfold on its own?
Neil O'Brien
Of course we take action whenever we find underperforming contracts, and I have set out how we do that. We are working our way through that. I say simply to the hon. Gentleman that we were all desperate to get PPE for our health and social care workers and for everybody who was responding to the pandemic. Inevitably, some of those contracts were not going to perform, and we are now taking action against all those underperforming contracts. On the idea that the “politically connected”, as he says, had some sort of greater success, they were our constituents—they were getting in touch with all of us, they had to be referred on somewhere, they had to be managed and they went through the same process as every other contract.
Mr Peter Bone (Wellingborough) (Con)
I think there is a little rewriting of history here. At one stage in the pandemic, getting PPE was the most important thing, and I remember Members on both sides demanding quicker action from the Government. The Minister has explained the situation fully, and I regret that the Opposition are making political points from what was actually a great success in protecting our NHS staff. Does the Minister agree with me or with that lot?
Neil O'Brien
My hon. Friend is completely correct. Some have short memories. Many of us stood up in this House to chivvy Ministers, asking, “Why aren’t you going faster? Why don’t you do more? Take the risks, get the stuff—we need it.” That was the priority. Many Members want it both ways: they criticised us at the time for not going fast enough or taking enough risks, and now they do not accept that we are going through all the contracts that did not perform.
Jon Trickett (Hemsworth) (Lab)
Is it not clear that slack management in the Department led to get-rich elements of the British ruling establishment taking money from the NHS at a time of national crisis? Their watchword was “greed” rather than “public service”. Where is the right hon. Member for West Suffolk (Matt Hancock)—I have notified him of my intention to mention him—who was in charge of the NHS when all this was going on? Is he still in Australia getting his £400,000 for eating unspeakable parts of the anatomy of various beasties?
Neil O'Brien
I cannot comment on the latest goings-on in the jungle but the answer to the hon. Gentleman’s point is the same as I have given before: there is a clear process, which every PPE supply bid, regardless of where it came from, went through.
James Wild (North West Norfolk) (Con)
During my time as a member of the Public Accounts Committee, we have looked closely at the procurement of PPE. The National Audit Office found that
“ministers had properly declared their interests”,
and that Ministers were not involved in procurement decisions. Is the reality not that the civil servants making these decisions were doing their best to secure PPE supplies for the NHS and the frontline in the face of a global pandemic? While we need to learn lessons from how this was handled, some of the people commenting here seem to forget the intense pressure we were under at the time.
Neil O'Brien
My hon. Friend is completely correct. When Mrs Justice O’Farrell went through these cases, she noted in her summing up that given the time-sensitive nature of the work, it was not irrational for the Department to decide that it was prepared to take more risk than usually would be acceptable, because of that extraordinary context that is so quickly forgotten in the questions we are hearing in the House today.
Christine Jardine (Edinburgh West) (LD)
The Minister has made much of the context of the time and the speed and the calls for PPE, but what my and, I am sure, everybody else’s constituents wanted was PPE quickly and appropriately. Earlier this year the High Court ruled that the Government’s VIP lanes were not only inappropriate, but unlawful, and in breach of the obligation of equal treatment. Does the Minister appreciate that constituents across the country are calling for an explanation? Will he back the Liberal Democrat amendment to ban VIP lanes for all future Government contracts?
Neil O'Brien
I have set out the challenge. We had a situation where MPs and Ministers were all being contacted by constituents who were desperate to help and who either had contacts with suppliers or were suppliers themselves of PPE. They could see on the TV every night the desperate need for PPE, and they were keen to help in that huge national effort. I have talked about the scale of the operation to supply and source that PPE in the extraordinary circumstances we were in. A way had to be found to manage all those contacts we were getting. All of us were getting in touch to try and offer help, so a way had to be found to manage all these things, and that is what I have described this morning. All these things, to reiterate, went through the same rigorous process as every other contract.
Ruth Cadbury (Brentford and Isleworth) (Lab)
The Minister says that lessons will be learned about Government procurement from this PPE scandal. Will he look at the contracts that the Home Office has for accommodating and feeding asylum seekers, which are ripping off the hotels and the food suppliers, causing asylum seekers to live in malnutrition and squalor? These contracts have many of the same characteristics—vast profits and executive salaries, and an opaque network of subcontractors run by people who may not pass fit-and-proper tests—
Sam Tarry (Ilford South) (Lab)
Today’s revelations show further evidence that the Government’s VIP lane was possibly criminal and was exploited by Members of the Government party. Will the Minister today commit to publishing in full the names of the Ministers, MPs or officials who referred firms on to that fast-track lane? Stop being evasive. We need to know what corruption happened.
Neil O'Brien
I have good news for the hon. Member. We published the information about who referred in which contracts in November 2021.
Clive Efford (Eltham) (Lab)
I heard what the Minister said earlier about the process and how meticulously it was followed for every company that applied for contracts during covid. What is it about the individuals or companies that had associations with the Conservative party or Ministers that made them so adept at getting through the process?
Neil O'Brien
As I said, 90% of them did not get a contract, so it was not that they were being given some sort of guarantee of a contract. That scheme was a way of managing the contacts that were happening with Ministers. They were being directly contacted by MPs from across the House and all sides of it. There had to be a way of understanding what was happening with each of those bids, because otherwise it would have been completely overwhelmed. To reiterate: all the bids went through exactly the same process—not done by Ministers, but by civil servants—of checking the quality, the price and whether they could realistically deliver. There was no difference in the process that they went through.
Owen Thompson (Midlothian) (SNP)
These are issues that many Opposition Members in particular have been raising for a long time. My Ministerial Interests (Public Appointments) Bill, now in its third iteration, has its Second Reading next Friday. Given the current situation, and given that my Bill would help to address some of the issues of transparency, can the Minister assure me that the Government will now incorporate that into their programme?
Neil O’Brien
I will look closely at all the suggestions that the hon. Member makes. I have not had a chance to look at the Bill, but I am sure that we are always in the market for constructive ideas.
Ian Lavery (Wansbeck) (Lab)
At the same time as the Government were being obstructive and deliberately attempting to block Northumbria Healthcare NHS Foundation Trust in the north-east from providing PPE from a factory of its own, people who were closely connected to the Government were making millions from PPE. Minister, is that just a strange coincidence?
Neil O’Brien
The people who came through the high-priority route were not politically connected people, except in the sense that they were being referred by MPs across the House. I do not know the exact details of the north-east supplier that the hon. Gentleman mentions. If he gets in touch, I will be happy to take that up and provide him with a full explanation of what the issue was with that bid for a contract.
Jim Shannon (Strangford) (DUP)
I thank the Minister for the answers he has given. There was a heavy use of direct award contracts to purchase PPE items. As of April 2021, £371 million had been paid for PPE direct award contracts in Northern Ireland. Does the Minister agree that, in hindsight, there should have been better insight into the supply chains of this PPE, where it came from and who was making it, given the reports that PPE contracts were given to Chinese firms using labour schemes?
Neil O’Brien
The hon. Gentleman always makes constructive suggestions, and today is no exception. He knows that we have an ongoing inquiry into the lessons that can be learned and a dialogue with the Health and Social Care Committee about many of these issues. Given its heritage, Northern Ireland was an important supplier of textiles and PPE equipment. Inevitably, given the global balance of production, a lot of items did come from China, as he says, but as part of the lessons learned, we should be thinking about domestic supply.
Sarah Owen (Luton North) (Lab)
We have all seen the shameful Guardian front page this morning, but the front page that sticks in my mind is the one showing nurses in bin bags—not PPE on the frontline, but bin bags. This was at a time when Luton Borough Council was facing another cut of £11 million. People are struggling, so why are this Government not lifting a finger to get our money back? They could start by releasing the records after the mediation process.
Neil O’Brien
The hon. Lady’s question takes us back to that extraordinary moment when we had a huge crisis of PPE, and we were desperate and doing every conceivable thing we could to get the PPE that those nurses needed; that is what I have been referring to in my answers this morning. It is just not true that the Government are not lifting a finger to get the money back. We have a process, and there is a substantial team in the Department working on it right now.
Gavin Newlands (Paisley and Renfrewshire North) (SNP)
The Minister said that constituents contacted many of us looking for the ability to access contracts to aid PPE procurement. He told the hon. Member for Ilford South (Sam Tarry) that the information was published last year. Can he confirm for the House how many Conservative MPs were able to provide access to the VIP fast-track line, and how many Opposition MPs were able to? It is a fairly simple question.
Neil O’Brien
I do not have that information to hand, but I have a seat on the edge of Leicester, an important textiles town, and I had loads of constituents get in touch with me to ask, “Where can I go?” We sent them on to a mailbox, and after they were in that mailbox, they went through the usual process that every other supplier went through.
Mr Tanmanjeet Singh Dhesi (Slough) (Lab)
For Tory peers and other chums of the Conservative party to have been profiteering at taxpayers’ expense from shoddy, unusable PPE, especially through the VIP procurement lane, at a time when people were locked down in their homes and tens of thousands of people, including my loved ones, were dying is absolutely sickening, shameful and unforgiveable. Given that The BMJ estimates that the Government have written off approximately £10 billion in unusable, undelivered or shoddy PPE, will the Minister take the opportunity to apologise to bereaved families for the amazing lack of integrity at the heart of the whole process?
Neil O'Brien
I set out earlier what the high priority route was and was not: it was absolutely not a guarantee of any kind of contract; it was a way of managing the huge numbers of contacts and offers for help that we were all receiving. It delivered something in the order of 5 billion items of PPE, all of which helped to save lives and protect workers in our NHS and social care settings. Of course, we had to take up those offers of help and respond to them when people wanted to help in the middle of a huge national and global crisis. We had to process those offers, but they were processed in exactly the same way as every other bid for a contract.
Alison Thewliss (Glasgow Central) (SNP)
After Lord Agnew resigned, he wrote in the Financial Times:
“Fraud in government is rampant. Public estimates sit at just under £30bn a year. There is a complete lack of focus on the cost to society, or indeed the taxpayer.”
The Economic Crime and Corporate Transparency Bill, which is currently in Committee, is full of holes and the Government have refused sensible requests by the Opposition to fill those holes. Will the Minister reconsider those amendments in the light of the rampant corruption in Government?
Neil O'Brien
We keep all those things under review, but the Economic Crime and Corporate Transparency Bill is part of addressing some of the issues that the hon. Lady is concerned about. We are blurring together two different issues slightly—[Interruption.] Let me finish the point. Lord Agnew was talking about the loan scheme, but that relates to the same issue of the need for pace, which all hon. Members were calling for at the time. There was a need to get loans out to small businesses, which saved tens of thousands of jobs in my constituency and, I am sure, her constituency as part of the huge and unprecedented £400 billion spend to preserve lives and livelihoods.
Dame Nia Griffith (Llanelli) (Lab)
BCB International in my constituency, which is an accredited bona fide pre-pandemic supplier to the Ministry of Defence, adapted production lines to produce a range of PPE. It supplied the Welsh Government and other public bodies such as the police, yet in spite of repeated attempts, it did not get a look in—or even a reply—from the UK Department of Health and Social Care. Today, we might have heard why. Despite the shoddy way that he was treated, its managing director Andrew Howell has offered to meet the appropriate personnel to discuss any possible low-cost, legal and easy solutions to maintain British supply security of essential equipment. Will the Minister now facilitate that meeting?
Neil O'Brien
I mentioned that due diligence was done on more than 19,000 companies—a huge number of companies and people got in touch to offer to help—but let us continue that conversation. I am happy to talk about the particular issue that the hon. Lady raised.
Geraint Davies (Swansea West) (Lab/Co-op)
The Welsh Labour Government received £874 million for PPE as its population-proportionate share, but spent only £300 million—about a third of the money given. That suggests, says Cardiff University, that the UK Government could have saved £8 billion, or £300 a household across the UK, had they used public authorities, health authorities and councils instead of private profiteering contractors known to Ministers. Will the Minister look carefully at the Welsh model and, in future, use the public sector rather than private sector cronies known to Ministers such as the former Health and Social Care Secretary, the right hon. Member for West Suffolk (Matt Hancock), who is out in the jungle making more money for himself?
Neil O'Brien
Inevitably, a huge amount of the PPE that is produced in the world is produced by private companies. There is no world in which we could avoid the use of private companies to supply PPE.
Peter Grant (Glenrothes) (SNP)
My colleagues on the Public Accounts Committee are at an important evidence session this morning, otherwise I have no doubt that many more of them would be here. The report on PPE contracts, which was unanimously agreed by the Committee earlier this year, stated:
“At no point was consideration given to the extent of the profit margin that potential suppliers would be taking on payments for PPE. Neither was consideration of any potential conflicts between individuals making referrals through the VIP lane and the companies they were referring. We”—
the Public Accounts Committee, unanimously—
“are therefore unsurprised to see the reports of excessive profits and conflicts of interest on PPE contracts.”
Yet if today’s Guardian reports are correct, the extent of lobbying of Cabinet Ministers, one of whom is back in the Cabinet, by a senior Conservative politician went significantly further than the Public Accounts Committee was aware of at the time. Can the Minister confirm that the reports of additional lobbying in today’s Guardian are accurate and, if they are not accurate, can he come back with a statement to confirm that?
Neil O’Brien
I read the same article as the hon. Gentleman. I notice that it did not lead to a contract—the case that was mentioned in The Guardian—but more generally, absolutely, there are many lessons to learn about this process. However, we were having to pay, in some cases upfront, for PPE because, as part of the global scramble for PPE that I have described, if we were not prepared to go that extra mile, we would simply not have had the PPE and we would have had more nurses without the vital protective equipment that we all needed.
Alan Brown (Kilmarnock and Loudoun) (SNP)
I am sure that many MPs on this side of the House had no idea that a VIP lane existed for PPE contracts, but even if I did know about a VIP lane for referring contracts, if a constituent came to me and said, “Alan, I have never worked in a PPE environment. I’ve never ordered it before, but I’ve got a great plan. I can order it from China. Just refer me to a Minister”, I would not have done that because it would be impossible to do proper due diligence. So it beggars belief that this Government accepted recommendations from companies with no involvement and no expertise in PPE contracts, and still awarded these billions of pounds of contracts. Instead of mediation with PPE Medpro, is it not the case that a full investigation is needed and, if the Government are not going to do it, surely we need a public inquiry into PPE procurement.
Neil O’Brien
We are prepared to litigate whenever a company did not provide. There is a process, which I set out earlier. In many cases, there were people who did have important contacts in China and in other countries where PPE was being produced, and it was important to pursue all those leads because we needed to have that. But, to the hon. Gentleman’s point, due diligence had to be done and was done on all those cases in the same way. I have talked about the scale of the challenge and the 19,000 companies on which due diligence was initially done, and the huge drop-off between that number and the 2,648 companies that actually made it through that filter. So we can see in the difference between 19,000 and 2,648 that there was a huge amount of filtering done by the team of 400 people who were working so hard to try to get the PPE that we needed to the nurses and doctors in our NHS.