(2 years, 11 months ago)
Commons ChamberI have had a number of indications from Members who now wish to speak in this debate. As we have finished the main business early, we are able to facilitate that, but I ask Members please to stand and indicate that they wish to speak. They will be called in at least the order that people have come up to me in the Chair.
Order. I remind the House that those who were here from the start of the Adjournment debate—they had to be here for the opening speech by Christine Jardine—are able to make standalone speeches, but anybody else who came in after the opening speech can make interventions, and clearly it is up to the person on their feet as to whether they take such an intervention.
(3 years, 1 month ago)
Commons ChamberOn a point of order, Mr Deputy Speaker. I listened very carefully to what the Minister said in response to the excellent question from my right hon. Friend the Member for Tunbridge Wells (Greg Clark), who chairs the Science and Technology Committee. The Minister said that when the information is available from the test and release pilot in the next couple of weeks, he will come back to the House straightaway.
You will have noticed, Mr Deputy Speaker, as I am sure all Members will, that the House will be in recess at that point, and Ministers are unable therefore to answer written questions, lay written ministerial statements or make oral statements. I therefore ask those on the Treasury Bench, through you, Mr Deputy Speaker, whether the Minister will ensure that the House is recalled to hear that evidence. Of course, the decision point is on 16 August —during the recess. This will be of interest to millions of people in our country who by that point may be self-isolating, so we need a commitment that the Minister will return and the House will be brought back to enable Ministers to be questioned on this important matter. It would be helpful if the Minister can confirm that at the Dispatch Box now.
The Minister is smiling at me. I do not think he wishes to speak. The right hon. Gentleman is absolutely right that the House goes into recess on Thursday and does not come back until 6 September. It is way out of the ability of the Chair to recall Parliament, but I am absolutely certain that those on the Treasury Bench heard what he had to say and will pass it on to the appropriate people.
I thank the Minister for his statement and for answering 29 questions in well over an hour. We will now suspend for three minutes in order to sanitise the Dispatch Boxes.
(3 years, 1 month ago)
Commons ChamberI would like to make it clear that the Liberal Democrats have long supported the aim of integration between health and social care, and the far greater involvement of local authorities in the planning, commissioning and delivery of services. We recognise that the pandemic has forced many of these bodies to work closely together in a much more collaborative way, and that is welcome. However, the Bill pays lip service to social care. It is largely a Bill about NHS reform, with yet another acronym-laden reorganisation that seeks to provide the legislative basis to integrate NHS services, currently in crisis mode, with a broken, underfunded and fragmented social care system. It is a massive power grab by the Secretary of State for political interference in operational and local service reconfiguration decisions and in who runs integrated care boards. The Bill is woefully inadequate in ensuring that the plans and resources are in place to ensure that we have sufficient doctors, nurses and other healthcare professionals and carers to deliver care, both now and in the future. This is all against a backdrop of record waiting lists and staff who are burnt out, stressed and struggling to cope with the third wave of the pandemic while dealing with surging A&E visitors and tackling the enormous backlog of care.
Without meaningful social care reform, this Bill cannot realise its aim of providing citizens with better joined-up care. With over 100,000 vacancies in the workforce, 1.5 million people are currently missing out on the care they need, putting additional burdens on the NHS and, importantly, on 9 million unpaid carers. The Government have promised—at the moment I take them at their word, though they have broken it many times—that they will bring forward social care reforms later this year. So why not delay the Bill for a few months and take account of the new model of social care, rather than doing a half-baked job now?
It really beggars belief when we look back over the past 16 months of the pandemic that the right hon. Member for West Suffolk (Matt Hancock), who was the architect of the proposals, seriously thought that granting himself more powers over the day-to-day running of the NHS was a good idea. We only need to look at the PPE fiasco and the failures of test and trace, both of which were run centrally, to see that handing back power to the Secretary of State is the very opposite of what we need. Allowing him or her to meddle in the day-to-day running of our NHS seems to fly in the face of the desire for more local and regional decision making.
I fully support and endorse the proposals of the right hon. Member for South West Surrey (Jeremy Hunt) on the health and care workforce independent planning proposals. They need to be properly resourced and annually reported to Parliament. Without a workforce plan, without wholesale reform of social care and while waiting lists are skyrocketing and the Health Secretary is embarking on a power grab that is his predecessor’s vanity project, this Bill will fail in its fundamental aim, shared by most Members of this House and health and care leaders—
This is the wrong Bill at the wrong time. To introduce a Bill like this when the covid pandemic is far from over and staff are on their knees shows a lack of understanding of what is needed.
I am concerned that this reorganisation of the NHS is being used as an opportunity to extend the involvement of UK and international private healthcare companies. The Bill proposes that private healthcare companies can become members of the integrated care boards, potentially meaning they will be able to procure health services from their own companies. Under the Bill, ICBs will have only a “core responsibility” for a “group of people”, in accordance with enrolment rules made by NHS England. There are concerns that this evokes the US definition of a health maintenance organisation, which provides
“basic and supplemental health services to its members”.
What is included in the core responsibilities?
Why is there no longer a duty but only a power for ICBs to provide hospital services? What does that mean for the thousands waiting for elective surgery? What about those waiting for cancer and other therapies? For those who say, “What does it matter who provides our healthcare as long as it meets the NHS principles of being universal, comprehensive and free at the point of need?” I say that not only is the Bill a clear risk to those founding NHS principles but there is strong evidence that equity in access to healthcare, equity in health outcomes and healthcare quality are all compromised in health systems that are either privatised or marketised, as the NHS has increasingly become.
That brings me to my third area of concern: health inequalities. It is notable that the Bill places the duties for the reduction of health inequalities with ICBs. The 2012 duty on the Secretary of State and NHS England to reduce inequalities is repealed, showing the clear lack of commitment to levelling up and the reduction of the structural inequalities that have been laid bare by this pandemic and contributed to the UK’s high and unequal covid death toll. With this change, the Secretary of State is ignoring not only decades of overwhelming evidence that clearly shows that health inequalities are driven at national policy level, but the Prime Minister’s commitment to implement the recommendations that Professor Sir Michael Marmot made in his covid review last December to tackle inequalities and build back fairer.
My final point is on social care. As chair of the all-party parliamentary group on dementia, I express my profound disappointment that, 19 months since the Prime Minister pledged to fix the broken care system, it still has not been fixed. The Bill is a missed opportunity to set out the framework for social care reform in the context of an integrated health and social care system. For people with dementia and their family carers, who have suffered disproportionately from covid, this is a real blow. They deserve better. For me, the principle of health and social care—
I am pleased to support the Bill. It is the first significant reorganisation of healthcare in recent years, and only the second since the Conservatives came into office following 13 years of Labour Administrations who reorganised the health services nine times, so we should not be taking lessons from the Opposition on the timing or the fact of putting things right.
The Bill is very substantial legislation that learns lessons from the way in which the NHS has had to work during the covid pandemic. In particular, the flow-through of patients discharged out of the acute sector as a result of much closer working with social care and local authorities is an integral part of creating the new integrated care boards. I very much welcome the fact that they are being established on a statutory footing and that there will be representation from local authorities and a role for health and wellbeing boards to provide local oversight. That is an essential step to allow the healthcare economy across our communities to collaborate effectively, and to remove some of the artificial barriers.
I will touch briefly on three other points. On the measures proposed for reconfiguration, we in Shropshire have been at the wrong end of a protracted reconfiguration process for our acute hospitals. Streamlining the process by which decisions are made will benefit patients. In Shropshire, it has taken several years to reach the point at which decisions can be made, and at every stage obstacles are put in place that add to delay and uncertainty. As a consequence of that, it is hard to attract staff to a system not working as well as it should, and the system has gone into special measures. The provisions to streamline difficult decisions are therefore very welcome.
Secondly, as my right hon. Friend the Member for South West Surrey (Jeremy Hunt), the Chair of the Health and Social Care Committee, said, the Bill is somewhat light on workforce, but it does include key measures to speed up the ability of physicians trained in other systems to be welcomed into the NHS or to return to the NHS and if they have retired. I urge Ministers in Committee to look carefully at what can be done—
Order. I am afraid we are under huge time constraints.
This month we marked the 73rd birthday of the NHS, and instead of celebrating it and giving it the homage that it deserves—the NHS, one of the very best things about our country—the Government have introduced a Bill that looks set to ramp up their long-standing attempts to continue to privatise it. I was proud to add my name to the reasoned amendment in the name of my hon. Friend the Member for Coventry South (Zarah Sultana) because we do not need private healthcare companies to sit on boards deciding how NHS funding is spent, further outsourcing of contracts without proper scrutiny, transparency and accountability, or the introduction of a model of healthcare that incentivises cuts and the closure of services.
Forcing NHS staff to implement yet another top-down Conservative reorganisation would take people away from the task of tackling growing treatment lists and coping with rapidly rising covid cases. We need to fill our 84,000 vacancies, and we need a 15% pay rise across the board for our NHS staff. It is hard to see how ordering a reorganisation such as this while ignoring calls for increased funding and a plan for social care could be anything other than disastrous.
This corporate takeover Bill—which is exactly what it is—will put private companies at the heart of the NHS and pave the way to sell off our confidential health data to multinational corporations. Nobody wants that. It will normalise the corrupt contracting that we have seen during the pandemic. The money that we spend on our healthcare should go to the services that we need, not to the pockets of Conservative party donors or corporate shareholders. Over the path of the pandemic, we have seen what this outsourcing and privatisation has meant in practice. Contract after contract awarded without competitive process. People being failed. Failing contracts. Delivery failed on again and again. Now the Government want to open up new ways for that to happen, just as they have done throughout the pandemic.
Let us consider what happened with Track and Trace, which was a complete disaster in the hands of Serco. The system has been so ineffective that, recently, MPs concluded that it had ”no clear impact”—a £37 billion system with no clear impact. After a decade of cuts, it was our NHS and its staff and volunteers who led the vaccination roll-out. That was a success, but it was their success, not the Government’s success. That is a lesson that we can learn about exactly what happens when we give the NHS the funding it needs, but the Bill does nothing to do that. We do not need more overpaid consultants involved the NHS; we need to value the staff we already have, and put in the investment that made the vaccination programme a massive success. We must be clear—
She did.
In response to the hon. Member for Central Ayrshire (Dr Whitford), I am again grateful for her comments and happy to accept her kind invitation to join her on a visit to Scotland.
The right hon. Member for North Durham (Mr Jones) made a very important point. In doing so, he rightly paid tribute to the work in this space done by my hon. Friend the Member for Sevenoaks (Laura Trott) with her recent private Member’s Bill. As the Secretary of State said, either he, I or the relevant Minister will be happy to meet him to discuss it further. My hon. Friend the Member for Meriden (Saqib Bhatti) was right to talk about the need for local flexibility. That is what we are seeking to do.
The hon. Member for Eltham (Clive Efford) asked more broadly about public spending constraints after 2010. He is brave, perhaps, to mention that. I recall the legacy of the previous Labour Government, which the right hon. Member for Birmingham, Hodge Hill (Liam Byrne) summed up pretty effectively in saying,
“I’m afraid there is no money.”
On social care, which a number of hon. and right hon. Members mentioned, we will take no lessons from Labour. In 13 years, after two Green Papers, a royal commission and apparently making it a priority at the spending review of 2007, the net result was absolutely nothing—inaction throughout. We are committed to bringing forward proposals this year. Labour talks; we will act.
The NHS is the finest health service in the world. We knew that before the pandemic, and the last year and a half have only reinforced that. It is our collective duty to strengthen our health and care system for our times. I was shocked, although probably not surprised, that the Opposition recklessly and opportunistically intend to oppose the Bill—a Bill, as we have heard, that the NHS has asked for—once again putting political point scoring ahead of NHS and patient needs. For our part, we are determined to support our NHS, as this Bill does, to create an NHS that is fit for the future and to renew the gift left by generations before us and pass it on stronger to future generations. We are the party of the NHS and we are determined to give it what it needs, what it has asked for and what it deserves. I encourage hon. Members to reject the Opposition amendment, and I commend the Bill to the House.
I apologise to the 30 Members who did not get to speak in this important debate, some of whom are currently in the Chamber.
Question put, That the amendment be made.
(3 years, 1 month ago)
Commons ChamberOn a point of order, Mr Deputy Speaker. I raised a point of order earlier this afternoon about the lack of an impact assessment before the House, despite it having been referred to on 22 June as having been made available. I was informed during the course of that point of order that pressure was going to be put on the Government to explain why there was no impact assessment. It is therefore a source of great disappointment that the Minister has not started off her speech with such an apology and explanation.
Thank you for that point of order, Sir Christopher. The Minister is on her feet and she looks as if she may respond to that point of order herself, as it is not a point for the Chair.
Thank you very much, Mr Deputy Speaker. I was indeed intending to come to that point. I was commencing my speech by giving some further context, but I can respond to the specific point made by my hon. Friend. The impact assessment is being worked on. I will be clear with hon. Members. One of the challenges is that there is significant uncertainty about the level of behavioural change we may see in the weeks ahead from this and other measures, for instance the requirement for vaccination to travel to some countries, which we anticipate will lead to further vaccination uptake.
That is not a point of order for me, but it could have been an intervention upon the Minister, so let us allow the Minister to give the full response to the points that have been made and perhaps she can include that one from William Wragg.
As I said, the impact assessment is being worked on. That is the current situation. I was explaining one of the challenges in coming to an impact assessment that we can share with colleagues to inform them accurately. I really hear that hon. Members want to have the full set of information for this debate. We face a dilemma: the clock is ticking and each day we are moving closer to winter. I am going to come on to it in the detail of my speech, but one important feature of this proposed legislation is that it gives staff a grace period in which to get vaccinated. The longer we take on this, the more risk there is to having that grace period.
On a point of order, Mr Deputy Speaker. To assist the debate, there is a discrepancy between the explanatory memorandum and the explanatory note on the back of the statutory instrument. The note states:
“A full impact assessment of the costs and benefits of this instrument is available from the Department of Health”.
It gives the Department’s address and indeed the website on which the assessment is supposedly published. So is the explanatory note in the instrument correct or not?
Again, this is not a matter for the Chair, but it is certainly a point for the Minister to address. I think it would be helpful if the Minister could directly address that particular issue, which many Members are now raising.
Thank you, Mr Deputy Speaker. There is not a great deal more that I can say on that point. As I have said, the impact assessment is being worked on and we will share it with colleagues as soon as we can. That is all I can say on that particular point.
Further to that point of order, Mr Deputy Speaker. Yesterday, I asked the House of Commons Library to inquire of the Department where this impact assessment was, and the Department informed the Library that it was about to present the impact assessment. It did not say that the assessment was still under preparation. The implication was that it was ready to be given to the House and it was just a matter of time—they said they would do it as soon as possible.
Again, I can only say what I have heard during the debate and apparently the impact assessment is simply not available. This is clearly not the best situation. We can see exactly what it is, but it is what it is.
Thank you, Mr Deputy Speaker.
The Scientific Advisory Group for Emergencies recommends that 80% of staff and 90% of residents should be vaccinated in any care home, at a minimum, to provide protection against outbreaks of covid. While the majority of care home workers have now been vaccinated, our most recent data has told us that only 65% of older-age care homes in England were meeting that safe minimum level, and the figure fell to 44% in London. That is why the instrument is being put forward today. It means that, by November, subject to parliamentary approval and a subsequent 16-week grace period, anyone entering a Care Quality Commission-registered care home in England must be vaccinated unless an exemption applies. That will apply to all workers employed by the care home, those employed by an agency and volunteers in the care home. Those entering care homes to undertake other work, for example, healthcare workers, tradespeople, hairdressers and CQC inspectors, will all have to follow the regulations.
The introduction of this policy has not been taken lightly. We have consulted extensively, including with a wide range of valued stakeholders, and used their feedback to inform this legislation. We recognise that some people feel that workers should have freedom of choice about vaccination, while others do it as a duty of care to protect the people most at risk. I know from speaking directly to people who receive care and to those who have relatives living in care homes that, although they might not be sure about requiring all care workers to be vaccinated, they are sure that they, individually, want to be cared for by someone who has been fully vaccinated. Many people have little choice about who cares for them.
I am grateful to my hon. Friend for bringing that information to the attention of the House.
I will bring my remarks to a conclusion, because Mr Deputy Speaker wants to make sure that we get everybody in. My final point is that, coming back to the consultation that took place, it is very clear that most of the people responding did not support these proposals. They were very concerned about them; certainly, the care homes and those involved in the sector who I have heard from are very concerned about them. The proposals do not command wide support, so I say to the Minister that I would listen to the concerns that are being expressed, take these proposals away, and come back with some well-thought-through proposals to secure the support of the House. If she presses them to a vote today, I regret to say that I will be forced to vote against them.
I can guarantee that everybody will get in: there is a five-minute limit.
I agree with my hon. Friend. There are perfectly rational arrangements that could allow particular residents to insist on only a vaccinated carer being in attendance.
I want to focus in the brief time available on a specific point: the importance of respecting religious freedom. Lime Tree House in Sale in my constituency is one of only two Christian Science care homes in the country. The rights of Christian Scientists were protected by the Labour Government when the Care Standards Bill was introduced in 2000. The then Minister, Lord Hunt of Kings Heath, gave an explicit assurance in the House of Lords:
“Perhaps I may say right at the start that the Government have no intention of preventing or discouraging people from being cared for in accordance with the principles and practices of the Church of Christ, Scientist. The Care Standards Bill will not mean that Christian Science houses or their visiting nurse services will have to give medical treatment to their patients, or do anything else which would go against their religious principles...The Department of Health will consult and work with the Church of Christ, Scientist, to ensure that regulation by the commission is compatible with the church’s principles and practices.”—[Official Report, House of Lords, 28 March 2000; Vol. 611, c. 741.]
Christian Scientists responded to the consultation in May. Since then, they have written to the Minister and indeed the new Secretary of State—obviously, that was very recently—but have not received a response. Clearly, there is no provision in the legislation to protect this important principle.
May I ask the Minister when she responds to give an absolute assurance that the principle of religious freedom will be respected by the Government, as it was by previous Governments? Will she undertake either to introduce an amended statutory instrument in the House or, if not, will she commit to including matters of conscience in the exemptions provided for in the measure? I am talking about two small care homes, a handful of residents and a situation in which both residents and carers might prefer not to have a medical intervention inflicted on them against their will, but a very big principle is at stake.
I remind Dr Evans that I will interrupt him briefly at 7 o’clock to put the motion on deferred Divisions to the House so that we can have live votes on this and on the terrorism motion.
My hon. Friend has pre-empted the rest of my speech, in which I will hopefully try to address some of that. It is about recognising the parity between professions. We heard the hon. Member for Tooting (Dr Allin-Khan) talk about the professional recognition we need for social care. That is imperative. We have covered that in the Health and Social Care Committee, and our report is very clear that we need that parity of professional standards. We have heard time and again that people have gone above and beyond in their duty.
I am a realist on this, and I want the Government to draw people’s attention to the fact that there could be difficulties. It is going to cause a problem when there are 16 weeks’ consultation, and there could be an exacerbation of problems with the workforce. I also urge the Government to pick up on what other Members have said and encourage people to take up vaccination in the first place.
Fundamentally, however—perhaps this is what it comes down to for my hon. Friend the Member for Wycombe (Mr Baker)—this comes down to a duty of care to the looked-after. I ask Members to imagine that it was their grandmother, grandfather, father or mother being cared for. I would expect Members to say that they wanted the best possible protections for that individual in the institution where they were resting.
Order. Sorry, we have to leave it there. Four minutes each. I call Dr Ben Spencer.
On a point of order, Mr Deputy Speaker.
I am afraid that the point of order will have to come after the Division. I am sorry.
Question put.
On a point of order, Mr Deputy Speaker. I was the Chairman of the Procedure Committee for seven years. It is absolutely incumbent on Government not to mislead the House and to behave honourably at all times. This explanatory memorandum is a parliamentary paper laid many days ago. This has been well rehearsed in this Chamber, but it needs to be rehearsed again. It clearly states:
“A full Impact Assessment has been prepared and will be submitted”—
not is being prepared; “has been prepared”. Through your good offices, Mr Deputy Speaker, may I ask that Mr Speaker and the Clerk of the House conduct an investigation into this memorandum to ascertain whether the House has been misled by the Government and whether the Minister’s conduct at the Dispatch Box was good enough this afternoon?
I thank the hon. Gentleman for his point of order. As I said earlier, it is a totally unsatisfactory situation, irrespective of whether anybody has been misled by the statement in one of the official documents. Those on the Treasury Bench will have heard the point of order and will make absolutely certain that it gets through to the Department. I will, as the hon. Gentleman has asked, raise it with Mr Speaker at the prayer meeting tomorrow morning.
On a point of order, Mr Deputy Speaker. It always used to be the convention in this place that if a Minister was unable to answer all the questions raised in a debate, they would offer to write to hon. and right hon. Members whose questions had not been answered in the time available. Bearing in mind the cavalier way in which Ministers seem to be treating the conventions of the House, I wonder whether it is within your offices to be able to put pressure on the Government to restore that convention as a matter of courtesy.
I look particularly at my hon. Friend the Member for Altrincham and Sale West (Sir Graham Brady), who had a pertinent question that could have been answered in two words. It was not answered and I am sure his constituents, on behalf of whom he speaks, will feel aggrieved about that. Why cannot this place restore some sense of reasonableness and good manners?
I thank the hon. Gentleman for his point of order. I have been a Member of Parliament for 29 years and many times, at the end of a debate, Ministers have said they cannot deal with each point that has been raised. We were under time pressure today, as has been pointed out by a number of Members, and therefore a number of questions have gone unanswered. Again, those on the Treasury Bench will have heard the point of order and will bring it to the attention of the Minister in order that she is able to answer the questions that went unanswered in her summing up.
(3 years, 1 month ago)
Commons ChamberOrder. There are five more Back Benchers wanting to contribute, as two have dropped out. The wind-ups will start at precisely 3.59 pm, with two contributions of eight minutes. The vote is then expected at 4.15 pm. Could Members please be mindful of the length of their contributions?
It is a pleasure to rise to speak in the debate this afternoon. I shall start by wishing all my English constituents, my English staff and even my English colleagues the best of luck in this evening’s semi-final. I do hope that England are successful in bringing football home to the island on which the modern game of football was created. Of course, like all the best things in the modern world, the modern game of football was invented in Scotland. Maybe next time, in Qatar in 2022, we will see the World cup going home to its real home at Hampden Park in Glasgow.
Since my election in 2017, I have become well used to the SNP’s tactic in Opposition day debates of mixing rank opportunism with righteous indignation and manufactured grievance. But today, we have seen the gall and the sheer brass neck of the Scottish National party. It takes some beating for the party in government in Scotland, the party responsible for public health north of the border, to come here to this place and put forward a motion on, of all things, covid-19 in the week when Scotland was declared by the World Health Organisation to have six of the top 10 covid hotspots in Europe.
I was now going to launch into a few well-constructed jokes about the Cabinet Secretary for Health disapparating, grabbing his invisibility cloak and using the Floo Network to get to the Harry Potter Studios in Watford. However—I mean this sincerely—everybody at all levels of all the Governments in the United Kingdom has been under immense pressure over the past year and a half, and who can begrudge any Minister in any position of responsibility taking some time to spend with their family, who have borne the brunt of the pressure they have been under? So I will refrain from attacking the Cabinet Secretary for Health, and I hope he enjoys the precious time he gets to spend with his children over the next few days.
This is not a laughing matter. Scotland is already leading the continent in terms of drugs deaths, but we are now leading it in terms of covid cases contracted, and this is putting at real risk Scotland’s own freedom day on 9 August. This is under a party whose leader claimed that the strategy north of the border was to eradicate covid. That would be incredible; we would be the first country in the world to do it. The SNP seems to be having about as much success in achieving that aim as it does in improving educational standards in schools, meeting the R100 broadband roll-out deadline, establishing Welfare Scotland or developing a new farm payments system. No wonder it scrapped the Scottish Qualifications Authority, for if there was an examination in good government, the Scottish National party would get a “must try harder” and a big F.
The reverse Midas touch of the SNP is quite incredible to behold, but this is incredibly serious. We have heard Scottish National party Members talking this afternoon about test and trace. They call it the failing test and trace, but I think it is a world-leading test and trace system. Let us compare it to how test and protect is operating north of the border. Test and protect is operating at its slowest-ever rate, and in the week ending 27 June, only 29% of positive individuals were interviewed within 24 hours of appearing on the case management system. If we are to escape from these awful restrictions that everybody on these islands is living under, we must have a functioning test and trace system. Again, the SNP must try harder.
It is true that vaccination in Scotland for covid-19 continues apace, even if the roll-out has slowed in recent weeks, and we are of course forever grateful to our amazing NHS workers—in my case, in NHS Grampian—and to the volunteers and the armed forces for their tireless efforts and the speed at which they are building the wall of protection that will get us back to normal. But there is a certain irony that the one part of the covid response that is working well in Scotland at the minute is the part that is solely as a result of Scotland being part of our United Kingdom. It is because this UK Government took the decisions they did, moved at the pace they did and invested what and when they did that we are leading the world in terms of vaccination, allowing us to dream of a day when masks are something we save for guising at Halloween and when we need never again use that awful term “social distancing”. Not that we would know any of that from a party that is reluctant even to use the full name of our world-leading Oxford-AstraZeneca vaccine, should it in some way indicate that the people of Scotland are benefiting from our working together as one United Kingdom.
I could accept all that. After more than 10 years of being in Scottish politics at some level or another, I would expect all of that from a party for whom taking responsibility is anathema—indeed, I have concluded that the Scottish National party wants to take Scotland back into the EU only because, without Westminster, it needs somebody else to point the finger of blame at for its mistakes—but this motion really takes the biscuit. It takes the hypocrisy that we are so used to from the Government in Edinburgh to whole new levels—and, for me, whole new levels of incredulity.
For a party that refuses to deliver on a manifesto commitment to hold a public inquiry into covid in Scotland to come down here and call for a covid inquiry in this place, and for a party that wants to see an end to the UK, and that uses every single opportunity afforded to it to emphasise the differences between our two nations to seek to break up this country, suddenly to suggest that it would be untoward or improper for the Scottish Government to hold their own inquiry before the UK Government did the same, is quite a change of tack, particularly when that party usually grabs any chance to show that it is leading the United Kingdom or moving faster in some way.
That party has also come here today to complain about the process for issuing emergency covid-19 contracts. As has been said, this country, along with every country and every Government in the world, was dealing with an unprecedented situation a year and a half ago. We were moving heaven and earth to protect the British people the length and breadth of our country. We know that Governments moved faster to try to protect people, because the Scottish Government did exactly the same thing. They awarded over a billion pounds in covid contracts without tender and with no competitive process, including, but not exclusively, for call centres, PPE, housing and care contracts, IT support, hand sanitiser and consultancy work.
It is astounding to hear SNP Members complain that MPs came to this place and represented to the Government companies, organisations and individuals in their constituencies who had ideas, mechanisms or inventions that could ease the pressure on the NHS and save lives. Surely Members of Parliament are supposed to represent businesses and individuals in our constituencies who could help in a crisis. That is certainly what I did when an individual caught me at a rather inopportune moment. I happened to be giving blood at Aberdeen Royal Infirmary in Foresterhill when a constituent recognised me from across the room and started telling me all about his great idea for a new ventilation system. He had me tied to the spot, I am afraid, and I was all ears. I went on to represent his company and his ideas to Ministers. I have no idea whether his idea or invention was successful, but I know that I did what I should have done and took that idea to the people who could make a difference, so that it could save lives in this United Kingdom.
Goodness me, was I quite amazed to hear SNP Members raising the use of private emails to conduct Government business? That from the Scottish National party, whose leader’s office last year advised people that the First Minister would use only her party email address and that urgent matters should be sent only to her private SNP account, not her Government account. That from the Scottish National party, whose Ministers now seem to communicate exclusively by Signal and whose use of public money to further their own political ends is blatant and routine.
The time for inquiries will come. There will undoubtedly be questions for senior members of both Governments, who were thrust into an impossible and unprecedented situation and urged to act quickly and urgently for the public good. However, this House, and indeed this country, should have no truck with, and should take no lectures in good government from, a party that is failing Scotland and failing the Scottish people and whose arrogance in power grows by the day. There is less than five years until the next Scottish election. For the sake of my country, it cannot come a day too soon.
There is less than 10 minutes left and there are three people to contribute, so—
I did try to indicate, but please be mindful of that if we want to get everybody in.
This pandemic has been a time of extreme hardship and suffering for millions of people. In my constituency in east Leeds, many have lost loved ones, and others, who were struggling to make ends meet even before this crisis, have fallen into deeper poverty. But it has been a very good crisis for some—for British billionaires, who increased their wealth by £100 billion in the last year; for outsourcing giants such as Serco, pocketing money that should have gone to our public services; and for those with friends in high places in the Conservative party who have got their hands on huge covid contracts.
The one sure-fire way to make money over the past 18 months has been to be a mate of a Tory Minister. Access to the so-called VIP lane made someone 10 times more likely to win public contracts. Ministers have been found to have broken the law with contracts. A world-leading anti-corruption body says that one in five Government covid contracts has corruption red flags. Over £800 million in covid contracts went to donors who had given the Tories £8 million in total—a very good return for those in the know, with the inside track. Those super-rich donors hand over huge funds and expect public contracts and favours to come their way in return. The Conservative party, I am afraid, is up to its neck in it.
Because the Tory party is using the system to help super-rich donors with covid contracts, it thinks that that is what other people are up to, too. We have seen a Tory MP this week implying that the British Medical Association’s medical advice to wear masks is because of lobbying from mask manufacturers, and Ministers have admitted that they are refusing proper sick pay because they think that people out there would abuse the system. Is that not telling? It is a telling insight into Ministers’ thinking: the assumption that everyone else is as dodgy and corrupt as they are—that is why Ministers think that.
Polls show that huge swathes of the population believe that the Conservative party is corrupt, and the stench of corruption has grown ever stronger through this crisis. They have been using a crisis where tens of thousands have died needlessly as a money-making scheme for their mates and their super-rich donors. The link between big money and our politics has been exposed more than ever during this crisis. Of course, many will hope to get their reward with directorships and comfortable jobs when they leave this place, but this is rotten to the core. It is undermining confidence in our democratic system and we need to put an end to it.
To resume his seat no later than 3.59 pm, I call Neale Hanvey.
On a point of order, Mr Deputy Speaker. Could you advise me on how we can correct the record, because the hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey) has distorted what I said only a few minutes ago? Never once did I express any glee at the record number of cases on the SNP’s hands in Scotland. I expressed my concern at what was happening in Scotland. He should withdraw that comment.
The Prime Minister demonstrated today a complete lack of comprehension of the fundamental principles of infection management. Kate Bingham’s achievement in bringing vaccines to market I have rightly celebrated in this place and Westminster Hall, but it is not the only game in town. The Prime Minister has bet the farm on vaccines, but the control and suppression of this virus relies on robust surveillance, treatment and control measures. All of that is at risk of being undone, with £3 billion wasted on tests that are absolutely unreliable. The Innova lateral flow device scandal presents a significant concern across three specific domains: public health, the impact on the domestic diagnostic sector, and a lack of contracting transparency and mounting concerns about chicanery.
On Monday 21 June, at the Dispatch Box, the Under-Secretary of State for International Trade, the hon. Member for North East Hampshire (Mr Jayawardena), boasted that the Government were “unleashing the potential” of the constituent countries of the UK “by backing British industry”. During that contribution, he derided China for “trade-distorting practices”. The experience of the domestic diagnostic industry differs significantly from that rhetoric. During a covid briefing on 29 June hosted by the Minister for Prevention, Public Health and Primary Care, it was asserted that the Government’s position on the United States Food and Drug Administration’s class 1 recall of dangerous and deadly Innova tests was attributed to the FDA’s over-reliance on the manufacturer’s data. Furthermore, it was asserted that the UK Government are utilising public resources at Porton Down in efforts to disprove the Chinese manufacturer’s own data, which suggests that these tests are unsuitable for asymptomatic screening and have been ever thus, and are not endorsed as sensitive to the prevailing delta variant. On 15 March, in a tweet to UK firms Omega Diagnostics and Mologic, Lord Bethell, the Minister for innovation and public health, promised 2 million daily lateral flow—
On a point of order, Mr Deputy Speaker. Could you advise me, as you did my hon. Friend the Member for West Aberdeenshire and Kincardine (Andrew Bowie), how I correct the record? I did not at all blame Scottish fans. I said that personally I was happy for them to travel and to celebrate. The point I made, sir, was that SNP Members were saying that it was our fault that Scotland now has the highest rate of covid in Europe, but had they wanted to do something they could have stopped fans travelling.
That is not a point of order for the Chair, and I hope that this device will not be abused.
The record is clear, and the hon. Member should reflect on his remarks. When the Scottish people look at it in totality—the cronyism, the corruption, the mishandling of the pandemic, and the bringing of the Johnson variant to our shores—they will say that they have had enough. The people of Scotland will vote for independence.
Please observe covid regulations when voting.
Question put.
(3 years, 1 month ago)
Commons ChamberI would like to congratulate Secretary Sajid Javid on his new appointment.
Other hon. Members have rightly raised this very important issue, and my hon. Friend is right to draw attention to it once again. It is something that I have focused on from day one on the job. That is why I have asked for fresh advice on it. As he knows, that decision was made with the data that was available at the time. Clearly, data is changing all the time, and we must ensure that we keep that under review for exactly the reasons that he has just set out. As I say, I have asked for advice on that and will hopefully be able to say more on it as soon as possible.
I thank the Secretary of State for Health for his statement. In his first outing in the new role, he has responded to 31 questions in one hour, so thank you very much.
(3 years, 2 months ago)
Commons ChamberI take the hon. Gentleman’s point and will elaborate on it as I make progress. As presented, the plan is to collect the data first and think about the problems second, but the information is too important and the Department’s record of failed IT is too great for it to be trusted with carte blanche over our privacy.
There is also the so-called honeypot problem. Data gathered centrally inevitably attracts actors with more nefarious intentions. The bigger the database, the greater the incentive to hack it. If the Pentagon, US Department of Defence and even Microsoft have been hacked by successful cyber-attacks, what chance does our NHS have?
Order. As we are coming towards 5 o’clock, I will just go through the following technical process.
I have come to the House today to answer this debate because of the importance of the subject matter and the importance of getting this right. I recognise and acknowledge the chequered history that my right hon. Friend the Member for Haltemprice and Howden (Mr Davis) described, and I see that chequered history as one of the reasons that the NHS does not yet have the modern data architecture that it needs. Previous attempts—both the national programme for IT and care.data—have failed, so people have shied away from tackling this problem in a modern, secure and agile way.
I have come to demonstrate and to argue that there is no contradiction between high-quality security and privacy of the data held in a health system and the use of that data to save lives, because in a well-structured, well thought through system, both are enhanced. I profoundly believe that. I think that my right hon. Friend does too, and I agree with him when he says that we agree on aims; the key is the path. I agree with him, too, that the proper use of data has the potential to save hundreds of thousands of lives if we use it as safely as possible but also allow for the insights in the data to be discovered in order to promote better healthcare, better discoveries and the better operation of the NHS.
If someone did not believe that before, they could not have failed to be persuaded by it if they have looked at the experience of the last 18 months. We discovered that an old, cheap drug, dexamethasone, helped to reduce the likelihood of someone dying if they ended up in hospital with covid, and as a result it has saved around a million lives across the globe. We discovered that in the NHS because of the data that we have and because of a well-structured, high-quality data architecture project to find out which drugs worked.
We know that the NHS will operate better if different parts of it can compare their performance better. We also know that patients want their data to be used better, because the frustration expressed to me so frequently by patients who are asked over and over “Who are you and what’s wrong with you?”, when that data should be available to the clinicians who need to see it, is palpable. And we know that the clinicians in the NHS want high-quality use of data so that they do not waste so much time on outdated IT and can treat the people in their care better. All these things matter, and they will save lives.
The current GP data service, GPES—the general practice extraction service—is over 10 years old, and it needs to be replaced. The project that my right hon. Friend referred to, GP data for planning and research, is there to unlock the intrinsic benefits of this data, but that must be done in a way that maintains the highest possible standards of security. The goals of this, and the outcomes when we get it right—I say when, not if—are that it will reduce the bureaucracy and workload for GPs, it will strengthen privacy and security, and it will replace around 300 separate data collections with one single collection.
If I may take my right hon. Friend back to 2018, I piloted through this House the Data Protection Act 2018, in which we brought the GDPR into UK law and strengthened provisions for data security. You may remember that, Mr Deputy Speaker, because you may have received a few emails about it at the time from companies asking whether you were still happy for them to hold your data. You could have replied, “No.” In fact, I came off quite a few lists I was no longer interested in receiving emails from because I was reminded that I was still on them and that I could opt out. I think the time has come for a similar approach—an update—to the way we think about health data in this country that puts security and privacy at its heart and, in so doing, unlocks the insights in that data and allows us to hold the trust of the citizens we serve.
The way I think about that is this. Current law considers that citizens do not control their health data, but the NHS does. For instance, GP data is controlled by GPs. However, the approach we should take is that citizens are in charge of their data. It is our data. The details of my bunion are a matter for me, and me primarily. I will not have anyone in the NHS tell me whether I can or cannot disclose the details of my bunion—it is going fine, thank you very much for asking. It matters to me, even though it is a completely uncontroversial health condition, but, as my right hon. Friend set out, for many people their health data is incredibly sensitive and it is vital that it is kept safe.
On the question at hand, the programme—GP data for planning and research—will be underpinned by the highest standards of safety and security. Like my right hon. Friend, I am a huge fan of the progress and advances we have seen in trusted research environments. Those are the safe and secure places for bringing together data, where researchers can access the data or, more accurately, the insights in the data while maintaining the highest standards of privacy.
I, too, am an enormous fan of Dr Ben Goldacre and his team. The OpenSAFELY project has shown the benefits that TREs can bring, because they allow us to support urgent research and to find the insights in the data while protecting privacy. During the pandemic, the project was absolutely fundamental to our response. In fact, it existed before the pandemic, but really came into its own during the pandemic. For instance, it was the first project to find underlying risk factors for covid-19. OpenSAFELY was the first project around the world to find statistically and significantly that obesity makes it more likely that someone will die of covid. That was an important fact, discovered through this project and without disclosing anybody’s body mass index in doing so. That is therefore the approach that we will take.
I can tell my right hon. Friend and the House that I have heard people’s concerns about using dissemination of pseudonymised data. We will not use that approach in the new GPDPR. The new system will instead use trusted research environments. All data in the system will only ever be accessible through a TRE. This means that the data will always be protected in the secure environment. Individual data will never be visible to the researcher, and we will know, and will publish, who has run what query or used which bit of data. The question was asked: who has access to what data, and who knows about it? The answer is that we should all know about it and that people should have access in a trusted way, but to be able to find insights in the data, not people’s individual personalised data itself.
I hope that that will help to build trust. It will mean a different way of operating for data researchers, but I disagree with my right hon Friend that it will allow us only to get 80% or 90% of the research benefit. A well structured TRE allows us to find more insight from the data, not least because the data could be better curated, and therefore more people can spend more time finding the insights in the data, rather than curating it over and over again. The dangers that come with the dissemination of pseudonymised data are removed.
It will take some time to move over to the new system, hence I have delayed its introduction, but we have also made that delay to ensure that more people can hear about it. That is the other reason that I came to the House today: I want people to be engaged in the project. People are engaged in their health like never before, and in their health data like never before, in part because of the pandemic. If we think about the NHS app, which is no doubt in everyone’s pocket—it is certainly in mine—if we think about the covid app, which has been downloaded 25 million times, we have never seen people more interested in their health data. We have never seen a greater connection, and we should use that to make sure that consent, when it is given, is given fully and properly.
I can assure the House we have an extremely high benchmark for who can access data. We have put in place a rigorous and independent approvals process, and audits are carried out to make sure the data is only being used for legitimate purposes. We will make sure that the right data can be accessed by the right people at the right time, but only by the right people at the right time. Both sides of that—that it can be accessed by people who need to see it, but only by the people who need to see it—are critical to getting this right.
On the question of the giving of that consent, it is crucial that we ensure that there is enough knowledge and understanding of these changes, that people are brought into the process, and that people know they have an opt-out. The research is clear: the majority of people are keen to allow their data to be used to help to save other people’s lives, but they want to know they have an opt-out and are reassured if they have one, even if they stay opted in, because they know then that it is based on their consent.
This important programme will have an opt-out system. We are strengthening the opt-out system already, and we will take the time to work with those who are enthusiastic about using data properly, with those who ensure that questions of privacy and security are put to the fore, with the public and, of course, with clinicians to make sure that we strengthen this programme further in terms of its security and privacy, yes, but also in terms of the outcomes we can get from the data, so that we can find new treatments to help save lives.
This is an important programme. The use of data in the NHS will have a huge impact on the future of health and care in this country, and we want to take people with us on this mission. We have developed this policy together with doctors, patients and experts in data and privacy, and more than 200 prominent scientific and medical researchers have endorsed a statement of support for this mission, but we have decided to take some extra time to consult further and to be even more ambitious about what we want to deliver, with a new implementation date of 1 September.
One of the central lessons of the pandemic is that data makes a difference, so let us keep working to take this programme forward, learning the lessons of the crisis, so that we can build back better and use data to save lives.
And the Secretary of State’s bunion.
Question put and agreed to.
(3 years, 2 months ago)
Commons ChamberI understand the point that the right hon. Gentleman is making. It is in some ways similar to the flu point. We do not just glibly accept smoking. We take measures in society to try to push down rates. I do not think the House would want to go as far as to ban smoking outright, despite what any of us might feel as individuals about smoking, but we do what we can to push down smoking rates because we want to reduce the poor health outcomes from smoking. That is what we will have to do with covid. We will have to put measures in place to mitigate the negative effects of covid, which I would argue is about allowing people to isolate themselves with proper sick pay, doing things around ventilation, giving local authorities more responsibility, perhaps to inspect premises without proper ventilation standards in place, and obviously resolving some of the issues around contact tracing that still have not been resolved 15 months on. So I do understand the point that the right hon. Gentleman is making, and he makes it well, as always in this place.
Before I was taken off course, I was quoting some of the health organisations. The point is that, given where we are now in our response to the virus, I believe that we should listen to those health professionals and take into account what they are saying. Delaying the road map by four weeks will hopefully relieve the pressures on hospitals, which is why we are prepared to support the restrictions tonight in the Lobby. I fear that lifting all the restrictions now could be akin to throwing petrol on a fire, so we will support the Government. But, of course, we should not be here. We are only here because over the last eight weeks we have failed to contain the delta variant and have allowed it to become dominant.
I have always tried to keep our dealings with the Secretary of State civil in public and private, but that is not so, it seems, for the Prime Minister. The right hon. Gentleman is now forever branded as “hopeless” Hancock by his own leader. Our constituents watching the news tonight will know that the Government have failed to protect our borders, that they have allowed this variant to take off and that restrictions are being extended, and I have no doubt that many of them will repeat the Prime Minister’s expletive-laden sentiments about the Secretary of State tonight.
We are being asked to endorse these restrictions because the Government failed to prevent this variant from reaching our shores. Rather than red-listing the delta variant when that was needed, they gave it the red carpet instead. Let me remind the House what happened. On 24 March, India’s health ministry warned about a so-called double mutant variant. On 30 March, The BMJ warned that India’s cases had taken a sharp upward turn since March and that India had the third highest number of confirmed cases and deaths from covid-19. On 1 April, the original B1617.1 was designated as under investigation. By 2 April, the Government had put Pakistan and Bangladesh on the red list, but not India. By this time, cases were running at close to 100,000 a day in India and thousands of people were returning to the UK from India. The Secretary of State justifies his position by saying that he did not have the data, but he should have acted on a precautionary basis. When he could see that the virus was raging, with 100,000 cases a day in India, he should have immediately put India on the red list, because the one thing that we know about the virus is that if we do not get ahead of it, it quickly gets ahead of us.
The House is being asked to extend these restrictions, but there are a number of pressing issues. First, many of us have been contacted by business people in our constituencies who are deeply concerned about the extension of these restrictions. For my constituency in Leicester, which has been living under a form of restrictions more severe than other parts of the country, other than perhaps parts of Greater Manchester, this has been particularly devastating. I hope that the Government will be putting in place full support for businesses such as mine in Leicester and Greater Manchester and elsewhere.
The second issue, which we have touched on a little bit, is whether these restrictions will ever end, or whether the Prime Minister has trapped us in Hotel California, where we can never leave. He has talked about 19 July as the terminus date, but the explanatory notes themselves say that the four tests will apply on 19 July, and that these four weeks will be used to gather more data.
Even with the vaccination programme going ahead and going further—I, like the Secretary of State, have had my second jab rearranged and am looking forward to it in a couple of weeks’ time—there will still be a large proportion of the population who have had one jab or no jab and who will still be vulnerable to catching the virus, and the virus can still exploit that opportunity to transmit.
It was the Secretary of State himself who said some weeks ago that
“Delta can spread like wildfire”
among those who have not had a jab. That will mean further disruption to people’s lives, more people needing to isolate and more people suffering from long covid. When I put these points to him on Monday, he said that the logical conclusion of that is that restrictions remain in place forever. On the contrary, the logical conclusion of that is that we put the other measures in place that will allow us to push down infection rates. I am talking about basic infection control measures such as sick pay and isolation support. A total of £38 billion has been allocated to testing and tracing, and yet the numbers using lateral flow tests have gone down six weeks in a row. This is because we do not have proper sick pay for people. Moreover, anecdotally, we are also hearing that more people are deleting the app from their phones.
We will support these restrictions tonight, and we hope that the Secretary of State or the Minister can give us a commitment that they will come to the House in two weeks’ time and give us an update on that data. We hope that the Secretary of State will give us a commitment to put in place the other measures that will help push down infection rates, but the sad truth is that we have to push forward these restrictions again for another four weeks, because the Secretary of State was indeed hopeless and failed to contain the delta variant.
We will have a four-minute limit immediately, but I think that that will be reduced later on. We have had a few withdrawals, so please do not assume that everybody is here on the list. Of everybody contributing, there are only four contributing virtually today, so everybody else is physical, which is very pleasing for the Chair. The four-minute limit is for Back-Bench contributions only.
It feels a little like groundhog day—another month, another debate on covid regulations—yet we really should not be here having this debate today. For people and businesses up and down the country, this four-week delay to fully restoring our freedoms is a huge and very costly blow, yet the sacrifices that continue to be demanded of the British people are not being coupled with the support that they need to do the right thing. That is why Liberal Democrats will not be voting with the Government tonight on the public health provisions. While we support the motion on continuing the hybrid proceedings in this place, I gently ask the Minister why the Government think we as Parliament need to continue meeting in a hybrid way whereas councils up and down the country have been forced to meet in person, often at great cost when they are already under huge pressure.
As my Liberal Democrat colleagues and I have been saying for the past six months, the way to restore our freedoms must be three-pronged: vaccination; test, trace and isolate; and robust border controls. The point has already been made countless times that the reason we are here is that Ministers undoubtedly failed completely on the last of those three points by putting India on the red list far too late, for political reasons, allowing the delta variant to be seeded into the community. Even once the Secretary of State recognised it as a variant of concern, we know there was a 17-day delay in designating it as such, which meant that surge testing commenced far too late. That cannot happen again.
The situation we find ourselves in was avoidable. Ministers must take full responsibility for having to delay the lifting of restrictions next week, and part of that responsibility is to support people to do the right thing. With businesses on their knees, jobs are at risk and many of the self-employed have yet to get a penny of support. The hospitality, events, weddings, culture, tourism and travel industries are on their knees. Even after domestic restrictions are lifted, we know that the travel sector will have to continue to bear the brunt of restrictions, given that the biggest threat to our full reopening in the UK will be variants brought back in through international travel, so the complete lack of a bespoke package of support for those industries beggars belief.
If we want to restore our freedoms fully next month, as the Prime Minister has promised us, and allow our economy to thrive again, it will be critical to test every potential case, trace every contact and support self-isolation. Experts have been calling for better financial and practical support for the past year, and finally the penny dropped earlier this month for the former head of Test and Trace that supported self-isolation was the missing piece. Even so, there has still been no comprehensive package announced to pay people their wages to self-isolate, provide accommodation if necessary and support those with caring responsibilities. That is the way to break chains of transmission and stop new outbreaks in their tracks, and it is an awful lot cheaper than blanket restrictions.
Learning to live with this virus, as I believe we absolutely must, requires a proper strategy and an action plan—not hoping for a fair wind. It means bringing together the UK’s world-leading genomic sequencing capability with traditional public health test and trace at a local level, coupled with the right support. Our public health directors up and down the country are crying out for that. They will continue to be our frontline in managing this virus as we learn to live with covid. Let us give them the tools they need and not be back here again in a month’s time asking for a further delay—or, worse still, be asked to reintroduce restrictions months down the line.
I call Dame Andrea Leadsom—congratulations on your well-deserved recognition in the Queen’s birthday honours list.
I will make absolutely certain that the right hon. Member’s request is presented to Mr Speaker and I am sure that he will respond in his usual fashion.
The pandemic has been a massive challenge to the British Government. I happen to think that, given the uncertainties that they have faced, the Prime Minister and senior Ministers have done a pretty good job. In terms of the vaccination programme, they have certainly proved to the world that Britain can go alone and do a lot to safeguard its population when it uses its science and its ability to get things done.
When the road map was unveiled, I thought to myself, “At least that stops me voting against the Government again”— until we get to the point when the Government have delayed opening up. I do think that this is a matter of balance and judgment. My view is that most of the senior Ministers who took this decision need a damn good holiday. If we look at the data and at what is happening in the country, the restrictions are totally out of kilter with the sense of the problem.
Let me take the south-west of England. There are 5.6 million people in the south-west of England.
Order. Sir Robert, can you please face the Chair? Your voice is not being picked up by the microphone and Hansard cannot hear you.
There are 5.6 million people in the south-west of England. There are 23 people in hospital. There are two in ICU. In Dorset, where there are nearly 1 million people, we have one person in hospital. Yet there are hundreds of couples who want to get married, businesses that want to be viable, and people who want to get their lives back in order. I just think that the balance is wrong. Most of the population have now been vaccinated. We may not totally break the link with people going into hospital, but there are more than 100,000 beds in the NHS. One per cent. are taken by covid patients. Now it might go up to 2%. We already have experts on TV saying, “In order for the NHS to catch up, we may well have to keep restrictions for longer.” I think that is unacceptable to the British people. As a Conservative, I am perfectly willing to accept restrictions when hundreds and thousands of people are dying and we are dealing with a virus that we do not understand, but we have sort of got to the point where we have won the battle. There will be variants. There will be challenges, but we have to get on with normal life.
The points made by my right hon. Friend the Member for North Somerset (Dr Fox) are perfectly right. If it is simply that we need to get second doses in—if that had been explained—we might be a little more relaxed. If we look at the explanatory notes, though, we will see that we have a review of data in two or four weeks’ time, and not necessarily a release date. We need to get people’s freedoms back. We cannot save everybody, but what we have done is save thousands and thousands of lives. Now we need to safeguard employment, safeguard businesses and safeguard people’s personal relationships.
I began by saying that the Government have done a pretty good job and that the vaccine programme is outstanding, but we have to now take the dividend from that to get people back to normal life. When they queued up with their enthusiasm to get that jab in their arm, they thought that that meant that things would get back to normal. They did not expect that they would be in further restrictions which would go on and on and on. I think we should have lifted all restrictions on 21 June. I hope and I pray that, in two weeks’ time, the Government will look at the data again and set people free.
On a point of order, Mr Deputy Speaker. I wonder whether you could help me in regard to social distancing. There is not a single Labour Member on the Opposition Benches. There are no SNP; there are no Liberal Democrats; there are no Plaid Cymru. Of course there are the DUP. Would it be appropriate, because the Conservative Benches are packed, for half of us to move over to the other side of the House to improve social distancing?
I think, Peter Bone, if you look around, even on the Conservative Benches there are a few green ticks, so please stay where you are. I call Jim Shannon.
(3 years, 2 months ago)
Commons ChamberI join the hon. Gentleman in congratulating all those involved in the vaccine roll-out, everywhere in the UK. In Scotland, it has been a remarkable effort, with the UK Government working with the Scottish Administration, the NHS across the country, local councils and the armed services—it has been a big team effort, and that has been part of the success of the vaccine roll-out.
The hon. Gentleman asked about three critical areas of the science. Reviews of all three areas are ongoing. They are led by Professor Jonathan Van-Tam, the deputy chief medical officer, whom the hon. Gentleman may have heard of, who is an absolutely brilliant clinician in this space—there are a lot more people involved who are doing excellent scientific work on these questions. That surveillance on immunogenicity, the work on the next-generation variant vaccine and the work on understanding the variants as we spot them is all going on. Public Health England has done a huge amount of work, working with public health colleagues right across the country, and I am grateful to them all.
I thank the Secretary of State for his statement today and for responding to 31 questions in just over one hour.
Before we move on to the next statement, we will suspend for three minutes.
(3 years, 3 months ago)
Commons ChamberI am going to push on, I am afraid.
The Queen’s Speech on 11 May confirmed our intention to take that measure forward through the health and care Bill, and the Government aim to publish the consultation response as soon as is practicable. Many people objected to the sugar drinks industry levy, saying that it would mean a decline in sales. Five years on, we have seen a decline of around 44% in sugar in soft drinks. Revenue raised has often been diverted into sports activities in schools and so on, and sales have risen to over 105% of what they were in the beginning.
Information helps the consumer; it also helps manufacturers and retailers to look at diversifying their products, and much of the customer research, including the McKinsey report—I think it was put out by the Food and Drink Federation, but it might have been the British Retail Consortium—shows that this is the direction in which customers want retailers and manufacturers to go.
We want to take this measure into alcohol labelling, as well. As we know, each year around 3.4 million adults consume an additional day’s worth of calories each week from alcohol, which is the equivalent of an additional two months’ worth of food a year. Despite that, the UK drinks industry is not required to provide any information on how many calories each drink contains, and up to 80% of adults have no knowledge at all.
Action to ensure that people can make an informed, educated choice is what we want, and we will be publishing a consultation shortly on the introduction of mandatory calorie labelling on pre-packed alcohol and on alcohol sold in the on-trade sector. Once again, it is interesting to note that this labelling happens to a large degree with most low-alcohol content drinks and in many own brands, so the measure is merely about ensuring that customers can feel fully informed.
Turning to weight management services, on 4 March, we announced £100 million of extra funding for healthy weight programmes to support children, adults and families to achieve and maintain a healthier weight. More than £70 million of that will be invested into weight management services made available through the NHS and local authorities, enabling some 700,000 adults to access the support that can help them lose weight. It includes digital apps, weight management groups, individual coaches and specialist clinical support.
There has been a fantastic response from local authorities to the planned roll-out of these services. It shows the widespread need and support for helping people achieve a healthier weight and is an example of the importance of partnership in action. The remaining £30 million will go to: funding initiatives to help people maintain that weight, because we know that weight lost can often be quickly regained; giving access to the free NHS 12-week weight loss plan app; continuing the Better Health marketing campaign to motivate people to make healthier choices; improving services and tools to support healthy growth in early years and childhood; and helping up to 6,000 families and their children to grow, develop and have a healthier lifestyle and weight. In addition, we will invest in helping people access the weight management services and support they need through a range of referral routes across the health system.
We are also looking at incentives and incentivising healthier behaviours. We have committed £6 million to developing a new approach to health incentives. The aim is to support people towards adopting healthier behaviours. That work will be supported by Sir Keith Mills, who pioneered reward programmes such as air miles and Nectar points. It will look at the best innovation to motivate people drawn from not only the public sector, but the private sector.
Since it is critical that a child has the best start in life, we are also working to improve infant food and the information around it. We will consult shortly on proposals to address the marketing and labelling of commercial food and drink products for infants and young children—to reiterate what Dame Sally Davies has said, there is the halo effect, where we think what we are purchasing for our children is healthy, but potentially it is not—so that parents and carers can have clear and honest information that aligns with advice on the products that they feed their children and babies, giving every child the best start in life.
We are not alone in working to address the challenges of obesity; it is pretty much a global problem. The effect of collaboration internationally is critical for us all to learn. The UK has established effective working partnerships with, for example, Mexico, Chile and Canada, as well as international organisations such as the World Health Organisation. I have had discussions with some of my counterparts across the world, including those leading on measures such as health incentives. Through partnerships we share best practice and ensure our interventions are based on experience and the evidence.
Tackling obesity and helping people to maintain a healthy weight is, as I have said, an extremely complex issue, and that is reflected by the wide range of action we are taking. Of course, we would like to move more quickly and have a magic solution, and there is more that we want to do, but I recognise the scale of the policy we are bringing forward. It is a far-reaching and radical plan to reduce obesity in our society; I do not want us to carry on being second in a league table in which we should not be proud of being second.
The high prevalence of obesity in adults and children has been decades in the making. It is going to take time to see results from our interventions, and we may want to go back and change some of them. There is no single fix and no single point of responsibility. We all have a part to play and it is vital for us all—Government, Parliament, industry, employers, the health service, the wider public sector and all of us as individuals—to work together. I am really looking forward to what I anticipate will be a very varied set of contributions this afternoon.
There will be a three-minute limit on all Back-Bench contributions from the very beginning.
I thank the hon. Gentleman for that contribution. Philosophically, I believe that the state has a responsibility to act when we acknowledge evidence that we have an environment that promotes poor health in this way, so that it goes beyond our personal choices and the way in which we want to lead our lives to things that swamp us. I reject his characterisation of a hierarchy. I would consider the impact that it has on the public and, indeed, the pressures it creates. As for alcohol, I would absolutely support stronger alcohol strategy proposals from the Government, as I would an updated and refreshed version of the tobacco control plan, which we have been waiting on for many months. Again, I would not establish a hierarchy, but I think we can act in those areas and that we ought to.
The hon. Gentleman recognised the support that I had given so far, but I am afraid that that is now about to change—it is not just because of him, I promise. On calories on menus, we have seen the instrument. The impact assessment is comprehensive—it has five different options, 235 paragraphs, four annexes—yet eating disorders are afforded one mention covering three paragraphs before being discarded in a fourth. I do not think that that is sufficient or that due regard has been paid, and I hope that the Minister will revisit it. Alongside my hon. Friend the Member for Tooting (Dr Allin-Khan), I am seeking to bring together stakeholders who reflect a full range of views on this topic to forge a solution that realises important health benefits for one group but is not injurious to another section of society. I hope that the Minister is still in listening mode on the matter and might seek to do something similar.
That leads me to what I am saddest about with this strategy; the Minister knows about it, because I have raised it with her many times. Rather than having just an obesity strategy, we ought to have a healthy weight strategy. Eating disorders are increasingly common and can blight people for their whole lives, and their lives and voices are missing from the strategy. I have thought about this for a long time—since last July—and I think we can guess why that is: talking about eating disorders inevitably challenges us to talk about mental health services in this country, and of course, the Government are not keen to do that, as it would offer a reckoning of their leadership in this area over the previous decade. Access to high-quality mental health services of all kinds is too rare. People wait too long and the oft-repeated promises about a parity of esteem approach have not led to meaningful action. That gets worse when we talk about child and adolescent mental health services. The evidence is irrefutable that the root of challenging behaviours around food is at that time in life, but, as every right hon. and hon. Member knows, trying to get a young constituent into CAMHS treatment is simply too hard. We are failing a big and growing part of our population by not addressing that, too, so in that sense the strategy has missed a really important opportunity.
I turn to public health. As I say, I am glad that these proposals have been brought forward. It has to be said, though, that they follow a decade of the Government’s cutting services that improve the public’s health. I know that it is a core strategy of the current Administration to act as a new Government and run as far away as possible from their record over the last 11 years—I would want to do that if I were them—but they cannot do so.
The public health grant, even with the recent uplift relating to covid, is nearly a quarter lower in real terms than it was five years ago. I had responsibility for the public health grant in Nottingham for three years prior to entering this place. My experience was that, with the growing pressures for demand-driven services such as drug and alcohol services and sexual health services, added to the consistent cuts to local authorities, there just was not anything left for longer-term services such as those that deal with healthy weight. That has meant a withering of nutrition guidance, shared cooking programmes and specialist support. That has absolutely weakened our approach to taking healthy weight issues head-on in this country. These proposals should have included a commitment to reversing those cuts and, frankly, some humility for having imposed them in the first place. That point needs addressing.
Of course—I will make this my final point—this is an issue about poverty in this country, too. If we eradicated much of the poverty, we would take a lot of the obesity with it. As I said, there is compelling evidence that obesity is much worse in poorer communities. Again, that makes it all the more mystifying that those massive and ongoing cuts to local authorities have been targeted at the poorest communities, especially in the big cities. That is an extraordinary public policy disconnect and, again, it is something that we ought to address in the strategy if we really want an all-services approach, at all levels of government, to taking on this national issue.
This is a very important issue and it is right that the Government are seeking to act. We will support them to move at pace to implement evidence-based, effective interventions, but we will push them, too, to close the gaps in the strategy so that it becomes genuinely transformative. The stakes here are lofty, so our ambitions must be lofty too.
We will go, via video link, to Andrew Selous. Andrew, I have some great news for you; we have a bit more wiggle room, so you have four minutes.
I want to start by echoing the sentiments of the Obesity Health Alliance; in this debate, weight stigma does not help people lose weight. The right support, evidence-based weight management, and fundamental changes to our obesogenic environment and food systems are all required to tackle this.
The health harms caused by obesity are well known, but I initially wish to mention one particular aspect that does not get the attention it deserves: liver disease. On average 40 people die of liver disease every day. The Foundation for Liver Research and the British Liver Trust have sent a helpful briefing, but in truth I had already committed to mentioning it in this debate. My husband, Joe, was diagnosed with stage 2 non-alcohol related fatty liver disease in 2019, after wandering around complaining of a wee pain under his ribs for five years. Since his diagnosis, he has made difficult but necessary changes to his lifestyle; he has lost 22 kg, taken up hillwalking, and has been carefully monitoring his weight, and I am very proud of him.
Some 90% of liver disease is preventable and, luckily for Joe, at stage 2 it can be reversed; however, as it can remain asymptomatic for up to 20 years, three quarters of people are diagnosed at a late stage when it is too late for lifestyle changes or interventions. Liver disease is the third leading cause of premature death in the UK, with deaths increasing by 400% over the past two generations; this is in stark contrast to other major diseases, such as heart disease and cancer, so I urge the UK Government, who have acknowledged liver disease in their obesity plan, to come up with actions, including doing all they can to spread information about this disease and the ways of preventing it.
The disproportionate harm caused by covid 19 to older people, minority ethnic groups, the people living in greatest deprivation, and those with obesity, diabetes and respiratory and cardiovascular disease has highlighted new vulnerabilities and underscored existing health inequalities. While much focus has been put on the direct health impacts of covid, the SNP recognises that we must also work to shift our focus towards reducing those inequalities and preventing ill health. We want everyone to eat well, be a healthy weight and have equal access to care.
The ambitious and wide-ranging actions to address this challenge are set out in the Scottish Government’s diet and healthy weight delivery plan. The plan, which has over 60 broad-ranging actions, has a strong focus on prevention, including population-level measures to make it easier for people to make healthier choices, as well as more targeted interventions. Alongside this, the SNP Scottish Government also published “A More Active Scotland: Scotland’s Physical Activity Delivery Plan”. This recognises the importance of physical activity in promoting and maintaining healthy weight. Progress towards the outcomes set out in this delivery plan is being monitored through a dedicated set of indicators linked to the active Scotland outcomes framework”. The SNP Scottish Government are continuing to provide £1.7 million in 2020-21 for improvements to weight management services for children and young people. Earlier this year, the SNP Scottish Government also published the refresh of their diabetes improvement plan, which strengthens the actions in the original plan to improve the prevention and treatment of diabetes and the care of all people in Scotland affected by it.
The SNP has consistently pressed the UK Government to ban junk food advertising on television and online before the 9 pm watershed, and we welcome that this is finally coming to fruition. Online adverts on social media are an area the UK Government must tackle strongly, as other Members have mentioned, because they are pervasive. In our recent manifesto, the SNP renewed its commitment to halve childhood obesity by 2030 and to significantly reduce diet-related health inequalities by pledging to provide free school breakfasts and lunches to every primary school pupil in Scotland, all year round, and to all children in state-funded special schools in Scotland; and to pilot the provision of free nutritious school breakfasts in secondary schools and explore the feasibility of universal breakfast provision in secondary schools.
We also want to make Active Schools programmes free for all children by the end of the Parliament, continue to improve nutritional standards of food and drink in schools, and bring forward legislation over the next Parliament to restrict the use of promotions on food and drink that is high in fat, sugar and salt. We will also aim to enshrine the fundamental right to food in law, as the cornerstone of being a good food nation. That will form part of the commitment to incorporate UN human rights charters into Scots law.
Scotland has one of the world’s best natural larders, but we know that so many people do not eat well and that obesity remains a significant problem. Evidence shows that in less well-off communities it is more difficult to obtain good-quality, fresh food at a price people can afford. Community larder projects, such as the Govanhill People’s Pantry in my constituency, have been springing up all over the place and working hard to try to redress the balance, in this case by working with FareShare to provide access to food in the community.
The overriding issue of poverty is, of course, key to tackling a lot of the issues; access to sufficient healthy food and the means to cook it is not there for everyone, not least because of policies such as the two-child limit, the upcoming removal of the £20 uplift to universal credit and tax credits, the UK Government’s neglect of people on legacy benefits, and the pretendy living wage. They all contribute to a situation where people cannot afford to eat healthily. If the UK Government want to tackle obesity, they cannot continue to ignore this reality.
Investment in regenerating neighbourhoods, increasing access to walking and cycling, and improving parks is also significant in getting people out and about and moving. Just last night, alongside local councillors, I met mums and grans from the Calton Community Association, who are desperate to access the newly announced Scottish Government fund for parks so that their kids can benefit from outdoor play. An obesogenic environment, coupled with a culture that allows the insidious influence of food giants and their ultra-processed foods to be advertised not just to us but to our children, has proven to be a recipe for disaster. I am looking forward to watching the latest programme by campaigner Dr Chris van Tulleken, “What Are We Feeding Our Kids?” and urge the UK Government to tune in tonight. The supermarket aisles are heaving with unnecessary infant snack foods, and the new report by the First Steps Nutrition Trust should be essential reading for the Minister.
One significant point of difference in the UK and Scottish strategies concerns our youngest citizens. Scotland’s healthy weight strategy specifically mentions the significance of breastfeeding, which can of course have a positive effect on maternal weight, as well as that of babies. The UK Government are committed to consulting
“on our proposals to help parents of young children to make healthier choices through more honest marketing and labelling of infant foods.”
Ministers could start by doing more to protect babies and pregnant mothers from the rapacious global formula industry, and, in this the 40th year of the World Health Organisation’s international code of marketing of breast milk substitutes, fully adopt the code. That used to be something the UK Government would blame the EU for their inability to do, but they have lost that excuse and must now act. The code sets out to protect all babies, however they are fed. As the chair of the all-party group on infant feeding and inequalities, I do not set this up as any kind of false pro-breastfeeding/anti-formula battle, because I know that for many formula is essential. Many mums want to breastfeed, but are failed by a UK Government who do not see breastfeeding as a priority and do not invest in support. Some years ago, Norway changed its approach and it now has one of the highest rates in the world. Norwegian mums do not have different breasts from us, but they do have a Government who made their needs a priority.
The Minister said that if adverts did not influence people, they would not be used, and she is correct. Formula companies spend astronomical figures on marketing, a cost that gets passed on to consumers at the tills and makes it challenging for many families to afford formula, and on the promotion of follow-on and specialist formulas, which are not necessary, but exist largely as a means of cross-promotion. I hope the UK Government will also act on that, as they claim they intend to look at honest marketing and labelling. As an example of that marketing, I share the concerns raised by the UK’s Baby Feeding Law Group that the National Trust has formed a partnership with HiPP Organic, a company with many documented violations of the code over the years. We should be under no illusions: these kinds of partnerships exist to benefit the company and boost their brand, and I urge the National Trust to reconsider.
I wish to touch briefly on the issue of calories on menus, on which I have received many emails, as I am sure other Members have. I can see what the UK Government intend, and I appreciate that for some people having calories listed on menus may be useful—I have certainly eaten fewer Danish pastries since coffee shops started to put calories on the display—but the policy is not about anecdotes and headlines and must be based on evidence. For those with a history of disordered eating, this is a deeply serious issue and such triggers can be very harmful indeed, so I urge Ministers to be cautious in what they are doing and to listen to and learn from the evidence from expert organisations such as Beat and from those affected.
I commend the Government for taking action on a range of issues to do with obesity but urge them to look more widely at the factors that cause obesity and to follow the Scottish Government’s approach with a healthy weight strategy.
I am grateful to the right hon. Gentleman for clarifying the matter. I knew that is what he meant, but I thank him.
The health survey for England refers to 1,000 people aged over 16, 277 of whom were obese and 31 were morbidly obese. In Northern Ireland, the figures are replicated; in fact, they are the same everywhere. Childhood obesity is a crucial issue on which much more needs to be done to make youths feel less self-conscious about the issue but at the same time able to do something about it. Obesity affects one in every five children in Northern Ireland. The figures there unfortunately show that there are outstanding problems to be addressed. Obesity exaggerates high blood pressure, diabetes and liver disease. Obesity is one of the three main causes of liver disease, in particular. Obesity also affects many other things, as the Minister said. It is very important to put that on record.
I have met constituents of mine over the years who had a medical condition that meant that they were not obese by choice but because of the circumstances of their own individual bodies. The people I am referring to had to go for bariatric surgery. I know some people who did that and I know it changed their lives. Perhaps the Minister could comment on how such procedures can be looked after within the NHS, because to do it privately costs over £10,000.
This is a serious health problem and it affects thousands of people. I want people to live their lives healthily and happily. I believe children should be taught that support is all around them and that their size is nothing to be ashamed of. There are ways to go about detecting obesity. However, I feel that one of the most important factors in tackling this issue is to reassure people that they will not be judged. Judgment often leads to resentment and failure, and there is no doubt that it is a sensitive issue for those who struggle with weight loss. I therefore urge the Minister to take that into consideration. I also urge others to be kind when it comes to such a topic. I believe that help and support is there for all those who are obese and seek help. I sincerely hope that in the coming years we can work together to bring forward a strategy that will encourage people and not do them down.
Wind ups begin at 4.44 pm. There are six speakers left. Hopefully, we will get you all in at four minutes. We will see.
No, I am terribly sorry, I have only two minutes left, but I am more than happy to talk to my right hon. Friend at considerably more length. He asked me for a bit of evidence on the sugary drinks tax. There is the fact that that, over three years, it has reduced the calories consumed on every occasion that somebody drank a soft drink by 35.2%. The figures on out-of-home calorie labelling show that £5.6 billion will be saved for the economy over 25 years, and that is before we even get to the associated benefits to people’s health.
I am sorry that I am probably not going to answer every point, but we want to achieve the full potential of all people. It is about a joint effort. My hon. Friend the Member for South West Bedfordshire (Andrew Selous) has been a doughty campaigner. I have met members of Bite Back 2030 with him, and those are young people asking us to do something. I am working with colleagues in the Department for Education and the Department for Environment, Food and Rural Affairs to make sure that we are doing that. Indeed, the Under-Secretary of State for Environment, Food and Rural Affairs, my hon. Friend the Member for Banbury (Victoria Prentis), who is on the Front Bench next to me, and I have the food strategy. Part 1 is already out and we are expecting part 2 in short order—that will very much go towards responding to what my hon. Friends the Members for Keighley (Robbie Moore) and for Stoke-on-Trent Central said. That Minister and I have worked together, with the Under-Secretary of State for Education, my hon. Friend the Member for Chelmsford (Vicky Ford), to look at how we can promote healthy eating for children and work across Government to drive these objectives.
I agree with my right hon. Friend the Member for Forest of Dean (Mr Harper), who said that this was about education, changing behaviour, changing the environment and not demonising individual foods. I want everyone to get to where he has, so I can see a future career as a healthy weight consultant, if nothing else. I congratulate Lucozade on what it has done. We will be continually monitoring the situation to make sure that we achieve our ambition on this. Partnership is key, and we are working with local authorities and working to build healthy weight management services. Promoting good health is central to this Government’s health agenda, and we will do that through the new Office for Health Promotion and proactively take the burden of preventable ill health and empower everyone to make the right choice. We would like to see immediate results, but the situation is complex, and we know it will take time. We all have a lot to gain by helping people achieve and maintain a healthy weight, and I look forward to the support of the whole House in doing that.
Question put and agreed to.
Resolved,
That this House has considered implementing the 2020 Obesity Strategy.
I ask Members to leave the Chamber in a covid-friendly way. The Minister for the Adjournment will not touch the Dispatch Box cover, because I am going to ask the Serjeant at Arms to sanitise it while we hear the opening speech.