Tuesday 12th January 2021

(3 years, 2 months ago)

Commons Chamber
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Edward Argar Portrait Edward Argar
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My hon. Friend makes a hugely important point. He, of course, has been a huge champion in this House for the cause of mental health. I know that, as we speak, the Minister for Patient Safety, Suicide Prevention and Mental Health, my hon. Friend the hon. Member for Mid Bedfordshire (Ms Dorries), is involved in discussions and meetings about exactly that. There is already support in place, but she is very clear that we need to recognise, in the context of long covid and the impact of this disease, including its indirect impacts, that the future mental health of our nation is hugely important, so my hon. Friend is right to highlight it.

At this Dispatch Box, we have often had occasion to exchange grim statistics: cases, hospitalisations and, sadly, deaths. Of course, behind every one of those numbers is a person—a person with hopes, fears, dreams, families and friends—but I know that the whole House will join me in looking forward to exchanges about perhaps more positive statistics in the weeks to come, of more vaccines given, more people safe and more lives saved.

Before too long I hope we will find ourselves in a situation where we can look at the curve of a graph going up and up not with fear and trepidation about what it means but with tremendous hope, as we look at a graph of vaccines delivered. That prospect is within our grasp, and although we are not yet out of the woods and must not blow it now but must stick to the rules for a little longer until we can be safe, I believe that that prospect should cheer us through the difficult weeks ahead.

Nigel Evans Portrait Mr Deputy Speaker (Mr Nigel Evans)
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I pay tribute to the volunteers in Clitheroe whom I saw on Friday helping GPs to roll out the vaccine there.

Some housekeeping notes. To those MPs who are contributing virtually: we will be able to see the clock on the screens in the Chamber, at the bottom of the right-hand side; you should be able to see the clock as well, and please try to finish before three minutes is up. It is a lot cleaner if you do that. To those contributing in the Chamber, the timer will be on the usual monitors in the Chamber, and there is a three-minute limit on all Back-Bench contributions.

Liz Kendall Portrait Liz Kendall (Leicester West) (Lab)
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I know that the Minister and hon. Members on both sides of the House understand the seriousness of the situation that we now face. Yesterday, the chief medical officer warned that the next few weeks will be the worst of the pandemic, and the chief executive of NHS England said that the virus is spreading out of control in many parts of the country. As the Minister said, there are more than 32,000 covid patients now in hospital, up from 18,000 at the peak of the first wave. In my own hospitals in Leicester a quarter of patients have covid-19. Elsewhere this is 40% or even 50%, and we are preparing for those levels to hit us too.

On top of that, 46,000 hospital staff are currently off work sick with the virus, and the consequences of that are stark. Staff-to-patient ratios in acute and intensive care are stretched to the limit of acceptable levels, if not beyond. All but the most urgent operations are being cancelled in many parts of the country, including for cancer care. Ambulances are queuing for hours outside hospitals to get seriously ill patients into beds and some hospitals are even running dangerously low on oxygen supply.

Dealing with this awful virus, especially the new, more virulent strain, was always going to be extremely difficult, but I do not believe that the severity of the situation we are now in was inevitable. Over the past nine months, the Government have continually changed their message to the public, and have repeatedly been too slow to act, even though we know that the virus ruthlessly exploits ambiguity and delay. At the heart of the problem is the failure of the Prime Minister and some members of the Conservative party to understand that protecting people’s health and the economy is not a zero-sum game, because we cannot get the economy going again if we do not stay on top of the virus.

The individual freedoms that we all hold dear—our ability to learn, work, do business, travel the world and see those we love most—depend on the actions of others. No man or woman is an island. That has always been the case, but covid-19 has thrown our interdependency into sharper relief than ever before. Until the Prime Minister grasps that fact he will continue to make the same mistakes, and many in our country will pay a bitter price.

While most attention focuses understandably on the extreme pressures facing the NHS, the case I want to make is that we cannot protect the NHS if we fail to protect social care. Alongside the need for swift and decisive action, that is one of the most important lessons that should have been learned from the first wave, but once again there are warning signs of pressures building in social care which, I fear, have been downplayed or even ignored. The number of covid outbreaks in care homes has tripled in the past month. Care homes are reporting staff shortages of up to 40%. The latest weekly death rates in care homes are out today: 824 deaths for the week ending 8 January. Those numbers have doubled since November, and are the highest since May.

Ministers must heed those warnings and they must act, not just because after 20,000 deaths from covid-19 so far in care homes we must do everything possible to protect residents, or because care workers and unpaid family carers are physically and emotionally shattered after 11 months at the frontline and deserve more help and support, but because if we cannot keep people safe in their own homes or in care homes, or move them back home from hospital when medically they are able to leave, the whole system will buckle under the strain.

After all the problems earlier this year, with covid-19 patients being discharged to care homes that could not cope, the Government should finally have gripped the issue and delivered a proper plan. Yesterday, we learned that only 118 care homes have been designated as safe to accept covid patients from hospital, although the Government promised in November that there would be at least 500. Understandably, many care homes do not want to take covid patients from hospital, especially as insurers will not cover the associated risks. While the Government have provided indemnity against such claims to the NHS, they have still not done so for social care, despite repeatedly being asked to do so.

This is just one example of the way in which social care social care is still not being prioritised, treated or funded equally with the NHS. Frontline care workers are still chronically undervalued and underpaid. Almost three quarters do not even earn the real living wage, despite doing some of the most important work in society, looking after the people we love most. Millions more unpaid family carers are being stretched to breaking point, trying to look after the people they love. Even before the pandemic almost half of unpaid carers had not had a single break for five whole years, and since the virus millions more families have taken on an even bigger role, but with precious little help and support in return. So I urge the Government to consider what immediate extra support can be provided for social care—for care workers and family carers—over the coming months, when the pressures will be the greatest we have ever seen.

I know that across the country, as the Minister said, the vaccine provides real hope for care workers, care users and families that the nightmare they face can and will end, but we are in a race against time. The Government must leave no stone unturned in their plans to deliver the vaccine to all elderly care home residents and staff by the end of this month, and we will support them in their efforts to do so. However, we really do need to see daily vaccination rates for this group published so we know whether the Government are on course to complete this commitment in just under three weeks’ time.

People need to know when they can start visiting their relatives in care homes once the vaccine has been delivered, because this is currently totally unclear and causing real upset and concern for families across the country—people who have not seen their relatives for months and months on end. Ministers should also set out a more detailed timetable for vaccinating hundreds of thousands of other care workers by mid-February. This needs to include those working with disabled adults as well as older people, those working in home care as well as care homes, workers in supported living and personal assistants employed by direct payments. I think we are going to have to go way beyond the Government’s current plans if we are going to vaccinate family carers aged under 65 as part of priority group 6, as the JCVI now recommends.

The vaccine is the light at the end of a very dark tunnel, and as we begin to emerge, we must resolve to build a better Britain, not go back to business as usual. Nowhere is this more true than for social care. In July 2019, the Prime Minister promised on the steps of Downing Street that he had a plan to fix the crisis in social care. A year later, he again claimed his Government “won’t wait” to fix the problem, yet six months on his plan is still nowhere to be seen, and instead delayed until sometime later this year. In October, the Health Minister in the House of Lords said:

“There simply is not the…political capacity to take on a major generational reform…in the midst of this massive epidemic.”—[Official Report, House of Lords, 28 October 2020; Vol. 807, c. 226.]

That is not good enough, and I would argue that this is precisely the time we need a long-term plan of far-reaching reform to give people hope that a better future is possible after the horrors of covid-19.

We need a social care system that works for older people and working-age adults with physical and learning disabilities, who make up a third of the users and a half of the budget of social care but are still too often ignored. We need a system that fundamentally shifts the focus of support towards prevention and early intervention to help people stay living independently and well in their own homes for as long as possible; a system where social care is fully joined up with but not run by the NHS, so people do not have to battle their way round all the different services, telling their story time and again; and a system that is properly funded after a decade of cuts, so care workers get the pay and training they deserve, families get decent support and there is help from the wider community too.

Yesterday, 88-year-old Moira Edwards, the first person to be vaccinated in one of the new NHS mass vaccine centres, spoke for many of us when she said that she could not wait to give her family a hug. I know that that is exactly how I feel. This pandemic has proved once again just how important our families are, but it has also exposed the fundamental flaws in the system of social care on which millions of families depend. The reality of modern family life is that more of us will need care, and need to care, as we all live for longer. So if we want to provide dignity and security for older and disabled people, and if we want to help families balance their work and caring responsibilities, and offer more than 1.5 million low-paid care workers hope for a better future, transforming social care must be a national mission. Labour Members stand ready to play our part in one of the biggest challenges facing our country, but it depends on Government action, which they must take—and now.

Nigel Evans Portrait Mr Deputy Speaker (Mr Nigel Evans)
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Order. Just to remind everybody in the Chamber that we now have a new one-way system, so Members enter via the door in front of me, and exit via the side doors or behind me—do not enter behind the Speaker’s Chair. I call Sir Peter Bottomley. There is a three-minute limit.

Peter Bottomley Portrait Sir Peter Bottomley (Worthing West) (Con) [V]
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I thank the hon. Member for Leicester West (Liz Kendall) for her response to the Minister’s introduction to this important debate. I take as the theme words from the annex to the Joint Committee on Vaccination and Immunisation advice, which said that we had to

“maximise benefit and reduce harm”.

Before I make some suggestions that are intended to be helpful to the Government and to the JCVI, I wish to read out a few words that have arrived just now from one of my mature constituents:

“My husband and I were advised on Saturday evening…that the vaccination was available to us on Sunday”—

late afternoon—

“We attended the…Health Centre at that time.

We are writing to say how pleased we were to be offered the jab so quickly and by the way we were looked after at the centre…The staff were very efficient and helpful and made the whole event as stress free as possible.

All credit to all concerned especially those at the Barn Surgery.”

That has been typical for many of the 2 million or so who have already been vaccinated or had their first jab, and we hope it will be true for many, many more.

Let me discuss the problems. I was disappointed to hear that dental staff were not originally allowed to get the vaccination, as they were not directly employed by the NHS, even though they were NHS service providers. I hope that situation has been changed. I feel strongly about another small group, those with motor neurone disease, because of friends of mine who have had the condition. In Northern Ireland, people with that condition were immediately regarded as extremely vulnerable, although that was not necessarily so in England. Perhaps the Minister will say, either in this debate or at some other stage, whether or not that is so.

There are those whose absence from work makes a big difference to the service for the rest of us, and I would argue that reasonably healthy people in their 70s, such as me, can delay our vaccination so that younger people who are not critically vulnerable but whose work is critical to those who are vulnerable, such as the police and education staff—teachers and their support staff—can be vaccinated early. That will mean that they do not have to stay off work when there is some sort of threat around. I hope that the JCVI will find some way of bringing vaccinations for them forward as fast as possible.

There are other issues that I can go back over when an inquiry is held, but now is not the time to go into them in detail. However, I commend the wise family doctors and wise hospital doctors who from January a year ago were telling me things that would have made a significant beneficial difference had the Government picked them up earlier—or the NHS had picked them up earlier, because this is not all about the Government.

I want to talk about the excluded—those who do not have regular jobs, those who were properly paid income as directors. They have been excluded for too long—

Nigel Evans Portrait Mr Deputy Speaker
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Order. The time limit has gone. I am terribly sorry, Sir Peter, but we have to move on. The clock is not on the next speaker, the Front-Bench spokesperson for the Scottish National party, Dr Philippa Whitford.

--- Later in debate ---
Chris Green Portrait Chris Green (Bolton West) (Con)
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I thank the Minister for Health for the way in which he opened the debate, with a sense of respect for people with all sorts of opinions on this matter. We ought to be able to reflect different views as part of a healthy debate. I pay tribute to my right hon. Friend the Member for North Somerset (Dr Fox), who is not here at the moment, for speaking about the importance of the use of data, and ensuring that it is not manipulated or abused.

From the very beginning the Government have had a clear plan for how we leave this awful cycle of lockdowns, and it has always been through vaccinations. That goal is now being delivered. We are at a very early stage of the process and it may be lumpy, but there is that commitment to have 13 million of the most vulnerable people in the country at least offered the vaccination by mid-February. The vast majority of those people will take up that offer. In fact, 85% of people expressed an opinion that they wish to take up the vaccination if it is offered. We can see a clear way out once those first four cohorts have the vaccination by mid-February, with two more weeks in order for the vaccination to take its full effect.

With that success, we should all expect to see a reduction or a lightening of the load in terms of the lockdown. People have carried this burden through all this time, since March last year; they need to see the light at the end of the tunnel, and the lightening of the lockdown restrictions following the success of the Government’s vaccination programme. Many of my constituents are enthusiastically looking forward to their vaccinations, especially in Horwich, where they are looking forward to the use of Bolton Wanderers’ football ground, the Macron stadium, for this purpose. Hopefully the Minister will be able to comment on whether the ground is going to be used for the inoculation programme. The Royal Bolton Hospital and Wrightington, Wigan and Leigh NHS Foundation Trust are doing an enormous amount of good work. I pay tribute to everyone working in shops, the council, hospitals or care services for the work that they are doing. But with the first goal of delivering the vaccination, we also need to see the lightening of the lockdown load.

The third goal—to get the hat trick—ought to be consideration of whether we need to renew the Coronavirus Act 2020. By renewing it, we set out for many people a fear that lockdown will be resumed in the autumn. By not renewing it, we are telling people, “You can resume your education. You can start your business again. You can feel confident of getting that health treatment,” and we get that recovery going.

Nigel Evans Portrait Mr Deputy Speaker (Mr Nigel Evans)
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I call Catherine West next, but Jim Shannon ought to be on standby, because we have a problem with the following speaker’s video link.

Catherine West Portrait Catherine West (Hornsey and Wood Green) (Lab)
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It goes without saying that we must use this opportunity to thank all our public health workers, as well as our journalists and broadcasters. My favourite is Victoria Macdonald from Channel 4, who seems to portray the pain and suffering, and yet the strength and solidarity of our health workers; a huge thank you to all our broadcasters and journalists, who are doing such a good job of keeping us informed.

I regret that the Government did not tackle soon enough a review back in the summer of what went wrong in the first wave, which in my view has led to our being in a third wave. Had we had an effective review in the summer and, for example, introduced testing in schools on 1 September, we might not be in the situation that we are in now.

On the question of long covid, I am on the all-party group, with many Members from across the House. We know that there is not a proper care pathway. I think of a 40-year-old constituent of mine who has not recovered, even though he suffered from covid last April. It is now coming up to 10 months and he still has not seen a specialist because he was never in accident and emergency and within a proper care pathway. We must urgently address that dreadful long-covid syndrome, which is affecting so many people who are recovering from covid.

I put on record my regret that we did not tackle the isolation strategy with enough energy, and with enough understanding of the lives of people who work in insecure roles, who desperately need to be compensated, whether for taxi driving or being a security guard. In all those insecure jobs, they need to be paid to stay at home. I also put on record, as many have in the debate, the 3 million excluded. It is probably more than 3 million. The work of the all-party group is very important, but it is particularly the creative sector that is terribly affected by the covid crisis. It has been going on for several months. People feel that there is no way out and they are feeling absolutely desperate.

In particular, I ask the Minister, first, whether nurseries will stay open. If they do, will nursery nurses be put forward for early vaccinations? Will dentists be higher up the list? They are very at risk because of their work, in terms of the covid germs. No. 3 is optometrists and then, of course, other professionals such as teachers. Also, prisoners, prison officers and prison educators are very much at risk of covid. Will the Minister please take back to the Justice Secretary the question of whether classes in prisons should be going ahead at the moment? I would not want anyone not to be protected from this terrible virus.

Nigel Evans Portrait Mr Deputy Speaker (Mr Nigel Evans)
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We are just going to see whether we have the electrics sorted out at Sir Geoffrey’s place.