Medicines and Medical Devices Bill

Baroness Winterton of Doncaster Excerpts

Consideration of Lords amendments & Ping Pong & Ping Pong: House of Commons
Wednesday 27th January 2021 Commons Chamber

Consideration of Lords amendments

[Madam Deputy Speaker (Dame Rosie Winterton)]

I must draw the House’s attention to the fact that financial privilege is engaged by Lords amendments 1 and 54. If any amendment engaging financial privilege is agreed to, I will cause the customary entry waiving Commons financial privilege to be entered into the Journal.

Before Clause 1

Establishment and core duties etc

[The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)]

I beg to move, That this House agrees with Lords amendment 1.

[Madam Deputy Speaker (Dame Rosie Winterton)]

With this it will be convenient to discuss the following:

Government motion to disagree with Lords amendment 2.

Government motion to disagree with Lords amendment 3.

Lords amendments 4 to 10.

Lords amendment 11, and Government amendments (a) to (d) thereto.

Government motion to disagree with Lords amendment 12.

Government motion to disagree with Lords amendment 13.

Government motion to disagree with Lords amendment 14.

Lords amendments 15 to 21.

Lords amendment 22, and Government amendments (a) to (c) thereto.

Government motion to disagree with Lords amendment 23.

Government motion to disagree with Lords amendment 24.

Government motion to disagree with Lords amendment 25.

Lords amendments 26 to 29.

Government motion to disagree with Lords amendments 30 and 31.

Lords amendment 32, and Government amendments (a) to (c) thereto.

Lords amendments 33 to 39.

Government motion to disagree with Lords amendment 40.

Lords amendments 41 to 47.

Government motion to disagree with Lords amendment 48.

Government motion to disagree with Lords amendment 49.

Government motion to disagree with Lords amendment 50.

Government amendments (a) to (c) in lieu of Lords amendments 2, 3, 12 to 14, 23 to 25, 30, 40 and 48 to 50.

Lords amendments 51 to 56.

[Jo Churchill]

I am extremely pleased to be back at the Dispatch Box to speak to this Bill. It is a changed Bill since we last looked at it but one that still has the patient at its heart. I am pleased that it comes back to us with the same spirit of consensus and collaboration that it left us with.

Since we had the Bill’s Third Reading, the pandemic’s evolution and the importance of the regulation of clinical trials, the roll-out and regulatory approval of a vaccine, and the ability of healthcare professionals to get medicines into patients has bought into sharp focus precisely how essential this Bill is. The Government made a number of amendments to the Bill through the other place in response to Committees of the House, the report of the independent medicines and medical devices review, led by Baroness Cumberlege, and, importantly, as a result of genuine, cross-party discussions on how to make this Bill better.

I am glad to say that the Bill still—and for those who know me, this is my passion—puts patients first: patients who will have the opportunity to trial new treatments; patients whose safety is paramount; patients who need to see quick and effective action from regulators in the event of an emergency. The Bill that left us on Report had a new change to it, anticipating Baroness Cumberlege’s report. The medical device information system, which will transform post-market surveillance of medical devices and improve the ability to track down patients and prevent harm, followed talks across this House and in the other place. I reiterate my thanks in particular to the hon. Members for Washington and Sunderland West (Mrs Hodgson) and for Central Ayrshire (Dr Whitford) for their contributions to that effort.

We said on Report that we awaited the conclusions of the Cumberlege review and that we would take steps when the review was published. I can tell the House now that we have, and Lords amendment 1 establishes a Patient Safety Commissioner—a champion for patients in relation to medicines and medical devices. I pay tribute to all those who have spoken here and in the other place of the impact of harm on patients and on women—those who have not been listened to whose stories are difficult and heart-wrenching. Much was said during the Bill’s passage in the other place about the whole system change to enshrine the voice of patients at the heart of the process and our commitment to it. The Patient Safety Commissioner will act within and outside the system. They will be an advocate for patients and ensure that the patient voice is primary. The commissioner will be able to seek information, make reports without fear or favour and expect responses, and, more importantly, get change.

Lords amendments 1, 41, 47, 54 and 56 together provide for both the appointment of a Patient Safety Commissioner and regulations to support this appointment. I congratulate Baroness Cumberlege and her team, and thank her and others who contributed to getting this into the Bill so quickly after her report.

Lords amendment 31 provides for a small but important change that was also recommended in that review: a power to put the devices expert advisory committee on to a legislative footing.

I am very conscious of the passion and commitment shown by the hon. Member for St Helens South and Whiston (Ms Rimmer) when we were last discussing the Bill. She has shown admirable determination. I am pleased to draw her attention to Lords amendment 8, which the Government were happy to support in the other place. That important amendment provides for provisions about the origin and treatment to be made in relation to the regulation of human medicines.

We have had two reports, one from the Delegated Powers and Regulatory Reform Committee and one from the House of Lords Constitution Committee.

Vaccine Roll-out

Baroness Winterton of Doncaster Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

Wherever possible is the answer. The truth is that the NHS has not in the past collected people’s mobile numbers routinely or their email addresses, hence why this roll-out is primarily being done through invitations by letter. I hope that, actually as part of this roll-out, one of the things we will be able to do is make sure that the NHS can put people’s email addresses and mobile numbers on their clinical record, where people consent to that of course, because we have seen in other countries such as Israel that where a very large proportion of people have given their mobile number and their email to the health system, we can get in contact with people much more quickly. Having said all of that, some people will never have a mobile phone and some people will never have email, and this is a universal service—of course it is—so letters and texts to those who have poor sight, and ultimately phone calls, including on landlines, or teams going round to people’s doors, are all important to make sure that everybody gets access to the vaccine and can receive the invitation.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. Before I call James Daly, I just want to say that I want to try to get everybody in, so we probably need to speed up a little bit.

[James Daly (Bury North) (Con) [V]]

Will my right hon. Friend join me in thanking Bury Council, our local CCG, NHS staff, medical practitioners and all those involved in the vaccine roll-out in Bury, Ramsbottom and Tottington? Approximately 19,000 vaccinations will have been given by the end of this week across the borough of Bury, and we are confident that all frontline workers and care home residents will be offered the vaccine by Sunday. It has been and continues to be a magnificent effort.

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[Matt Hancock]

We absolutely have plans to make sure that we can get the vaccine out, even with significant challenges. We do not take any supply from the Serum Institute of India; that supply is for the developing world. Wockhardt, the company that does fill and finish in Wrexham, has put out a statement around the serious rain and flooding that there has been in and around Wrexham over the last few days, and this is obviously a critical factor.

On the hon. Gentleman’s point about ensuring that we have the manufacturing capability, we are investing in that capability for the medium term. We can make so much of the Oxford-AstraZeneca vaccine in the UK right now because of the work that was done with the vaccine taskforce over the summer, getting in the capability and the manufacturing. Even when the vaccine was not the major topic of discussion, we were working incredibly hard to expand UK capabilities. We took the approach that we should buy from abroad and make it here at home. It is about getting vaccine into people’s arms, no matter where it comes from, so long as it is safe and effective and does the job. That is what is happening across the whole UK.

It is really good to finish with a question from a Welsh colleague, because it demonstrates that this is a programme that can, I hope, bring the whole country together. Everybody is on the same side trying to make it happen, and we will all keep working on it together. I thank everybody involved, and I thank all colleagues for their enthusiasm and support for the vaccine roll-out programme.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I thank the Secretary of State for responding to the urgent question. I am suspending the House for three minutes to enable the necessary arrangements for the next business to be made.

National Security and Investment Bill

Baroness Winterton of Doncaster Excerpts

Report stage & 3rd reading & 3rd reading: House of Commons & Report stage: House of Commons
Wednesday 20th January 2021 Commons Chamber

[Stewart Hosie (Dundee East) (SNP) [V]]

I beg to move, That the clause be read a Second time.

[Madam Deputy Speaker (Dame Rosie Winterton)]

With this it will be convenient to discuss the following:

New clause 2—Report on impact on Small to Medium Enterprises—

‘Not later than 18 months after the day on which this Act receives Royal Assent, the Secretary of State must lay before Parliament—

(a) a report setting out the impacts the Act has had on Small to Medium Enterprises and early-stage ventures, and

(b) guidance for Small to Medium Enterprises and early-stage ventures on complying with the provisions of this Act.’

This new clause would require the Government to produce a report setting out the impacts of this legislation on Small to Medium Enterprises and early-stage ventures, and to produce relevant guidance.

New clause 3—Grace period for Small and Medium Enterprises—

‘For the purposes of section 32, a person has a reasonable excuse if—

(a) the entity concerned is a Small to Medium Enterprise;

(b) this Act has been in force for less than six months.’

This new clause creates a grace period whereby – for alleged offences committed under Section 32 – Small to Medium Enterprises would have a ‘reasonable excuse’ if the alleged offence was committed within the first six months after the Bill’s passage.

New clause 4—Framework for understanding national security—

‘When assessing a risk to national security for the purposes of this Act, the Secretary of State must have regard to factors including, but not restricted to—

(a) the potential impact of the trigger event on the UK’s defence capabilities and interests;

(b) whether the trigger event risks enabling a hostile actor to—

(i) gain control or significant influence of a part of a critical supply chain, critical national infrastructure, or natural resource;

(ii) conduct espionage via or exert undue leverage over the target entity;

(iii) obtain access to sensitive sites or to corrupt processes or systems;

(c) the characteristics of the acquirer, including whether it is effectively directly or indirectly under the control, or subject to the direction, of a foreign government;

(d) whether the trigger event adversely impacts the UK’s capability and capacity to maintain security of supply or strategic capability in sectors critical to the UK’s economy or creates a situation of significant economic dependency;

(e) the potential impact of the trigger event on the transfer of sensitive data, technology or potentially sensitive intellectual property in strategically important sectors, outside of the UK;

(f) the potential impact of the trigger event on the UK’s international interests and obligations, including compliance with UK legislation on modern slavery and compliance with the UN Genocide Convention;

(g) the potential of the trigger event to involve or facilitate significant illicit or subversive activities, including terrorism, organised crime, money laundering and tax evasion; and

(h) whether the trigger event may adversely impact the safety and security of UK citizens or the UK.’

The new clause provides a non-exclusive framework of factors which the Secretary of State is obliged to have regard to when assessing a risk to national security.

New clause 5—National Security Definition—

‘When assessing a risk to national security for the purposes of this Act, the Secretary of State must have regard to factors including, but not restricted to—

(a) the potential impact of the trigger event on the UK’s defence capabilities and interests;

(b) whether the trigger event risks enabling a hostile actor to—

(i) gain control or significant influence of a critical supply chain, critical national infrastructure, or natural resource;

(ii) conduct espionage or exert undue leverage over the target entity;

(iii) obtain access to sensitive sites; or

(iv) to corrupt processes or systems.

(c) the characteristics of the acquirer, including whether it is effectively directly or indirectly under the control, or subject to the direction, of a foreign government;

(d) whether the trigger event adversely impacts the UK’s capability and capacity to maintain security of supply or strategic capability in sectors critical to the UK’s economy or creates a situation of significant economic dependency;

(e) the potential impact of the trigger event on the transfer of sensitive data, technology or potentially sensitive intellectual property in strategically important sectors, outside of the UK;

(f) the potential impact of the trigger event on the UK’s international interests and obligations, including compliance with UK legislation on modern slavery and compliance with the UN Genocide Convention;

(g) the potential of the trigger event to involve or facilitate significant illicit or subversive activities, including terrorism, organised crime, money laundering and tax evasion; and

(h) whether the trigger event may adversely impact the safety and security of UK citizens or the UK.’

This new clause establishes factors which the Secretary of State must have regard to when assessing a risk to national security.

New clause 6—Dedicated Small to Medium Enterprise support—

‘(1) Within 3 months of this Act receiving Royal Assent the Secretary of State must set up, a specific division focused on engagement with Small to Medium enterprises (SMEs) engaged in any provisions of this Act.

(2) The division must focus on four functions—

(a) providing updated, efficient and accessible guidance specific to SMEs on compliance with the terms of this Act;

(b) engaging with SMEs in advance of formal notification that can allow efficient notice and assessment periods, including through use of regulatory sandboxes where beneficial for innovation and national security;

(c) providing regular engagement with and assistance to SMEs throughout the assessment periods for SMEs;

(d) seeking to deliver prompt, proportionate resolution of complaints by SMEs relating to the provisions of this Bill;

(e) monitor the impact on access to investment for SMEs and report to the Secretary of State.’

This new clause would require the Secretary of State to set up a Small to Medium Enterprise (SME) engagement unit to assist and support SMEs through the national security screening process.

New clause 7—Reports to the Intelligence and Security Committee of Parliament—

‘(1) The Secretary of State must, in relation to each relevant period—

(a) prepare a report in accordance with this section, and

(b) provide a copy of it to the Intelligence and Security Committee of Parliament as soon as is practicable after the end of that period.

(2) Each report must provide, in respect of mandatory and voluntary notifications, call-in notices, and final orders made under this Act, details of—

(a) the jurisdiction of the acquirer and its incorporation;

(b) the number of state-owned entities and details of states of such entities;

(c) the nature of national security risks posed in transactions for which there were final orders;

(d) details of particular technological or sectoral expertise that were being targeted; and

(e) any other information the Secretary of State may deem instructive on the nature of national security threats uncovered through review undertaken under this Act.’

This new clause would require the Government to publish an ‘Annual Security Report’ to the Intelligence and Security Committee of Parliament.

Amendment 3, in clause 3, page 3, line 10, leave out subsection (4) and insert—

‘(4) The Secretary of State must review a statement published under this section within one year after the publication of the first such statement, and thereafter at least once every 5 years.’

This amendment would require the Secretary of State to review the statement about exercise of call-in power to be reviewed one year after they are made, and once every five years thereafter.

Amendment 1, in clause 6, page 5, line 3, at end insert—

‘(10) Notifiable acquisition regulations must be reviewed one year after they are made, and once every five years thereafter.’

This amendment would require notifiable acquisition regulations (including which sectors are covered) to be reviewed one year after they are made, and once every five years thereafter.

Amendment 6, page 5, line 3, at end insert—

‘(10) Notifiable acquisition regulations must bring broadcast, print and social media companies within the scope of the mandatory notification regime.’

Amendment 2, in clause 8, page 6, line 38, at end insert—

‘(8A) The fifth case is where a person becomes a major debt holder and therefore gains influence over the entity’s operation and policy decisions.

(8B) For the purposes of subsection (8A), a major debt holder is a person who holds at least 25% of the entity’s total debt.

(8C) The sixth case is where a person becomes a supplier to the entity of goods, services, infrastructure or resources to such an extent that the withholding of the supply would seriously undermine the entity’s ability to continue its operations.’

This amendment would mean that a person becoming a major debt holder or a major supplier would count as a person gaining control of a qualifying entity.

Amendment 4, in clause 30, page 20, line 3, after ‘period’ insert ‘or any calendar year’

This amendment would make it mandatory for the Government to inform Parliament if financial assistance given in any financial year, or in any calendar year, exceeds £100 million.

Amendment 5, in clause 54, page 33, line 42, at end insert—

‘(aa) whether the law of the country or territory to whose authority the disclosure would be made contains provisions and prohibit any use or disclosure of the information contrary to subsection (4),

(ab) whether the Secretary of State considers that disclosing the information to that authority would in itself pose a threat to national security, and’

This amendment would add to the list of factors the Secretary of State takes into consideration a sub-clause to ensure that a country or territory making a disclosure request has sufficient safeguarding in place to prevent any action that would be considered unlawful in the UK.

Amendment 7, in clause 61, page 36, line 20, at end insert—

‘(m) the average number of days taken to assess a trigger event called in under the Act;

(n) the average number of days taken for acceptance decisions in respect of mandatory and voluntary notices;

(o) the average staff resource allocated to the operation of reviews of notices made under sections 14 and 18 over the relevant period;

(p) the number and proportion of notices and call-in notices concerning the acquisition of a Small to Medium Enterprise; and

(q) in respect of the transactions stated subsection (p), the sectors of the economy in relation to which call-in notices were given.’

This amendment would require the Secretary of State to report on the time taken to process notices, the resource allocated to the new Unit and the extent to which Small to Medium Enterprises are being called-in under the new regime.

[Stewart Hosie]

The new clause is in my name and the names of my hon. Friends, as are new clauses 2 and 3 and amendments 1 to 6.

On Second Reading of this Bill, I described how it was designed to bring additional scrutiny of foreign investment that may have an impact on national security. I agreed that not only was there nothing wrong with having a national security eye on investments in critical areas, but it was in fact absolutely vital. During that debate, the House appeared to acknowledge the concern about the national security implication from investments that are shared globally and that a number of other countries had been tightening up their investment security regimes in response to changing national security-related threats to enabling technology, to intellectual property and so on. The debate also saw descriptions of the tightening of these regulations in Japan, Canada, Sweden, Germany and elsewhere. There was little disagreement on the Government’s proposals where, if the trigger and threshold were both met, an individual investment could be called in by the Secretary of State for approval, the powers could be retrospective, and an investment could be called in after it had occurred. There was some concern about the time to conduct the national security assessments—30 days with potentially an extra 45, which might actually be deemed a little short and it still prompts the question of whether 75 days was actually sufficient. There was, however, broad agreement about the mandatory notification process where investment interests in certain sectors and asset types must be pre-emptively or retrospectively declared. There were real concerns that this may lead to a very large number of notifications from businesses erring on the side of caution.

The Bill also introduced new powers to increase screening in respect of health and preventing hostile acquisition through strategic buying of health supplies, and I welcome that, with the warning that the scope of activities that may be caught is very wide. That is because the statement of policy intent, which describes the core areas as including such things as advanced technology, is perfectly reasonable, but it also contains a much wider definition of national infrastructure.

That debate did focus on the impact assessment for the Bill, which estimated that the new regime would result in somewhere between 1,000 and 1,800 transactions being notified each year—a very high number given that only 12 transactions were reviewed on national security grounds since the current regime was introduced 17 years ago. It does also remain the case that we still need to carefully assess the impact of the Bill—the impact that it will have on sectors and on infrastructure not just in the UK as a whole, but in the devolved nations and in the English regions. On Second Reading, I asked the Minister to take a little time to convince himself that there were no unintended consequences either for the UK or, indeed, for the Scottish Government’s inward investment plans when Government agencies of all sorts are actively seeking investment in some areas, which may be deemed to be critical national infrastructure. That is an issue that I do hope he will still address today. How do we ensure collectively that this Bill does not impede growth or investment in such areas.

The key concern I had was about implementation. The Bill is set to radically overhaul the UK’s approach to foreign investment at a time of significant economic uncertainty. On leaving the EU, the UK Government cannot afford to get their global Britain approach wrong and suffer what has been described as the potentially chilling effect on investment if the measures in the Bill appear to be heavy-handed. That is a concern across the board, given that even microbusinesses are in scope.

I take this brief opportunity to thank my hon. Friends the Members for Glenrothes (Peter Grant) and for Aberdeen South (Stephen Flynn), who served on the Bill Committee. They raised a large number of concerns, including the impact on academic research spin-offs, SMEs and early-stage ventures. They called for a grace period for SMEs falling foul of this new legislation, a review of exercisable call-ins and a review of the notifiable acquisition regulations. They suggested that broadcast, print and social media companies should be in scope. They suggested that major debt holders should be defined as a person gaining control of a qualifying asset and they suggested a requirement to report if financial compensation from Government exceeded £100 million in either a calendar or financial year.

All those amendments and contributions were made for very good reasons. The Scottish National party has long argued that it is right to have this legislation and for it to be made. In some ways it is long overdue, but that does not mean there are no concerns, which is why we have tabled new clauses 1 to 3 and amendments 1 to 6.

New clause 1 would require the Secretary of State to assess the impact of the Bill on academic research spin-off enterprises. New clause 2 would require the Government to produce a report setting out the impacts of the legislation on small and medium enterprises and on early-stage ventures and to produce relevant guidance. New clause 3 would create a grace period whereby for alleged offences committed under clause 32, SMEs would have a reasonable excuse if the alleged offence was committed within the first six months of the Bill being in operation.

I will turn briefly to the amendments. Amendment 1 would require notifiable acquisition regulations, including the sectors to be covered, to be reviewed one year after they are made and five years thereafter. Amendment 2 would mean that a person becoming a major debt holder or a major supplier would count as a person gaining control of a qualifying asset. Amendment 3 would require the Secretary of State to review statements about the exercise of call-in power one year after they are made, and once every five years thereafter. Amendment 4 would make it mandatory for the Government to inform Parliament if financial assistance given in any financial or calendar year exceeded £100 million. Amendment 5 would add to the list of factors the Secretary of State has to take into account. They would have to ensure that a country or territory making a disclosure request had sufficient safeguarding in place to prevent any action that would be considered unlawful in the UK. Amendment 6 would ensure that notifiable acquisition regulations bring broadcast, print and social media companies into the scope of the mandatory notification regime.

All those new clauses and amendments in essence are designed to ensure that the scope of the legislation is appropriate, but that the impact, particularly on investment, is proportionate. I have not determined yet whether to press any of them to a vote. What I would prefer is for the Minister to give a commitment, not simply to have infrequent if regular reviews of parts of this Bill, but to keep the Bill under permanent review to ensure that the scope remains valid—not too wide and not too narrow—and that the impact on investment and risk, particularly in small and medium-sized enterprises, academia and research, is proportionate. Through that, we can ensure that we quite rightly protect national security, but do not suffer from the investment chill that some fear could be the consequence if we get this wrong. With those brief remarks, I commend the new clauses and amendments to the House.

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We have seen reports about so-called elite capture by foreign powers, we have seen the Russia report, and we would like far more assiduous action to be taken. It is naive to think that we are not vulnerable to these influences—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. Could I interrupt the hon. Gentleman to say that we have quite a few more speakers? We do have a fair amount of time, but I am hoping that speakers will take about 10 minutes, and he has now taken 15, so I hope that he might be bringing his remarks to a close before too long.

[Stephen Kinnock]

With apologies, Madam Deputy Speaker, I am indeed finishing now.

Protecting our national security is just one element of protecting, nurturing and developing the sectors that are vital for the future. Technology sovereignty will be the defining issue of the coming decade. The economic dislocation we have seen from covid means that the case for action is stronger and more urgent than ever.

Long Covid

Baroness Winterton of Doncaster Excerpts

Thursday 14th January 2021 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

I am sure all colleagues will have noticed that we have a relatively short amount of time for two debates this afternoon. This one will run for approximately one hour and 20 minutes, to divide the time equally, and there is a three-minute limit on Back-Bench contributions. I am sorry about that, but time is very pressured.

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[Carol Monaghan (Glasgow North West) (SNP) [V]]

I congratulate the hon. Member for Oxford West and Abingdon (Layla Moran) on securing this afternoon’s debate. For the past three years, I have been involved with individuals living with myalgic encephalomyelitis, a post-viral condition triggered by a virus such as flu or, in some cases, severe acute respiratory syndrome. Knowledge of post-viral conditions, particularly with regards to activity management, is essential for the many people now living with long covid. As early as January last year, some people expressed concerns that this mysterious new coronavirus could produce similar post-viral effects. However, the sheer numbers affected by long covid is a serious health challenge.

In addition to listening to and—crucially—believing and supporting people with long covid, health professionals should be providing guidance on symptom management. I am pleased to see that the National Institute for Health and Care Excellence moved quickly to provide guidelines for long covid, and thankfully it has cautioned against the use of graded exercise therapy. It is surprising to find a guideline recommending exercise testing. Exercise testing in people who may have an undetected cardiac pathology clearly carries a risk. In addition, the NICE guideline contains no specific guidance on the management of any of the common symptoms of long covid. That is a serious omission that requires urgent attention.

Advice on symptom management cannot be left to charities and support groups. Instead, we should be looking at how that can be delivered in primary care, with the help of, for example, properly trained community physiotherapists. There is a need for health professionals, employers and wider society to recognise that recovery from a virus takes time. Employers must identify tasks that individuals can continue to carry out, and that might be in a different setting from what they are used to doing. The Government must ensure that there is proper financial support for those affected. It may be that these people take months or even years until they start seeing improvements in their health, and we must make sure that the support system can be just that during these times.

Today, we had a study by Public Health England that shows that those who have had covid will have immunity for about five months post-infection. Those who are living with post-viral conditions such as long covid or, indeed, ME, should therefore be considered vulnerable beyond the five months and prioritised for vaccine. Finally, it has taken decades of campaigning, largely due to the lack of belief—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I am afraid I have to thank the hon. Lady for her speech. We need to move on, because not everybody will be able to get into this debate.

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[Andrew Gwynne (Denton and Reddish) (Lab) [V]]

I begin by thanking the hon. Member for Oxford West and Abingdon (Layla Moran) for her superb opening to the debate and for her leadership of the all-party group.

My experience with covid began in early March, when I started to feel grotty and run down. I just wanted to rest, but as a precaution I phoned NHS 111, which suggested to me that it could not possibly be covid because no cases had been reported in M34, even though I explained to them that I worked in hotspot SW1. Eventually, typical covid symptoms developed, so I spent the next fortnight in self-isolation. The illness lasted for about 12 days, by the end of which the country was in lockdown 1, but the reality is that, although the coronavirus passed, the effects are still with me today.

Thankfully, research is now being carried out and the Government recognise long covid as being real. That has been a battle. I was lucky: my GP is brilliant, and from an early stage recognised my condition—long before it had the name “long covid”. My condition is not as severe as it was even just a few months ago. There have been real improvements, but it has been a hard slog to get here. For the first seven months or so, the exhaustion came back frequently and to the point where just doing simple tasks around the House brought me out in massive sweats as if I had run the London marathon. I had lots of dizzy spells; I have never had vertigo before this. And oh, the brain fog! In a job where we have to be razor sharp, my short-term memory is shot to pieces. I have had to learn to pace myself. Trying to push my limits would set me back. I still have to remind myself not to overdo it.

The lasting symptom is still the brain fog. When it is bad, taking in information and processing it is so difficult. It is physically and mentally tiring, often triggering headaches, dizziness and vertigo. I am fortunate in having been able to balance work with my disabilities. Virtual participation and proxy votes have helped. I talk about the difficulties of doing my job, but what about the mechanic, the builder, the emergency worker, the teacher, the nurse—people who do not have the luxury of virtual participation, aides-mémoire, and an efficient and brilliant office to hide deficiencies? They are left to struggle and make the most of it, or to lose their jobs. On that point, the Department for Work and Pensions has to do more to recognise the condition for work capability assessments and other interviews.

I am so grateful to some of the representatives from long covid support groups for meeting me earlier this week. They want the Government to acknowledge that children can also get long covid. Of course children often present with symptoms different from adults’, so an awareness campaign is required, but children should also have access to treatment in long covid clinics and throughout the NHS.

The problem of long covid is not going away; it is growing as the number of people catching covid grows. I would like to hear from the Minister about a holistic approach, with research, treatment and support in the health sense, but also in the wellbeing sense, the workplace sense and the family sense too. Let us support people and their families—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I thank the hon. Gentleman for his speech.

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[Barbara Keeley (Worsley and Eccles South) (Lab) [V]]

I thank my hon. Friend the Member for Denton and Reddish (Andrew Gwynne) and the hon. Members for Oxford West and Abingdon (Layla Moran) and for Central Suffolk and North Ipswich (Dr Poulter) for securing the debate and the Backbench Business Committee for scheduling it in the Chamber so that all MPs can take part.

The debate is important and timely as we pass the grim milestone of 100,000 covid-19 deaths and well over 3 million confirmed cases. We should remember each of those 100,000 deaths as the human tragedy it is as well as a sign of the failure to control the virus.

Together with colleagues who are taking part in the debate, I have heard evidence of the impact of long covid from witnesses to the all-party parliamentary group on coronavirus. The impact on their lives is profound, and their numbers are growing rapidly.

It is important to recognise that covid-19 is not binary, with people either dying or recovering fully. We still have little idea about how covid-19 affects those who survive it in the longer term. Even people who start with mild covid symptoms may end up suffering noticeable effects and developing new or worse symptoms for months.

Among the many issues that witnesses with long covid raised at the APPG, an important factor is where they contracted the disease. Our witnesses this week all worked in the NHS, and we heard that the doctors’ long covid group is expanding rapidly. It is right to ask whether the conditions on the frontline might mean that long covid is more prevalent among those who acquire it at work.

Given the devastating impact of long covid, we need to establish whether it is an occupationally acquired disease. If it is, it should be reported on, monitored and protected against, as any other workplace-acquired disease would be. Will the Minister therefore set out what the Government are doing to require employers, including the NHS, to monitor long covid among their staff, and what steps will be taken to support frontline staff with long covid?

As I said, covid is not a binary disease. It is simply not the case that people either die from it or recover fully. We must remember every covid death as the tragedy that it is, but we must also fully acknowledge and deal with the long-term impacts that the disease can have. People are living with the effects of the virus for months, and perhaps even years. They need our support. They need a health system that can identify long covid and research so that we can begin to treat it effectively. They need financial support if they cannot work.

We need a covid strategy that goes beyond preventing deaths. We need to drive cases down, even when the most vulnerable are vaccinated, so that we do not create a new generation of people living with long-term health conditions. We particularly need to establish covid-19 as an occupational disease and support the frontline staff with long covid who cannot work because of their symptoms. They must not be forgotten.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I am afraid we must now move to our last Back-Bench speaker.

[Janet Daby (Lewisham East) (Lab) [V]]

I thank the hon. Member for Oxford West and Abingdon (Layla Moran) for arranging this important debate, which I hope will raise awareness of the issue, and cause the Government to reassess the rate of sickness benefit and to invest in research.

Long covid can affect anyone who has caught the virus. It is another one of those invisible illnesses that people cannot see, and many still do not know it exists. Constituents, friends and family have reached out to tell me of their physical and mental struggles with long covid. Persistent breathing problems and coughing, fatigue, dizziness, chest pains and insomnia are some of the things that have been mentioned to me. Even getting a diagnosis has been challenging, with people having to go through all manner of scans and tests. The lack of explanations and solutions has led to support groups being created online, where people with long covid can connect with one another and share their difficulties. But not everyone has online access and not everyone is able to communicate their experiences. Low public awareness of long covid leaves sufferers feeling even more isolated. I would be grateful to hear from the Government how they will raise the profile of this illness.

The NHS is desperate to help these patients, but it needs help from the Government to do this. The Government need to ring-fence funding for research into the illnesses and find treatments. People with long covid also often find their ability to work seriously affected. The economy suffers from this section of the workforce being incapacitated. Sick pay is £95.85 per week. My constituent’s rent in a shared home is £900, with bills, each month they are short of more than £500, and their situation is not dissimilar to that of others, which means that the sickness pay rate is inadequate.

Another constituent asks me:

“How much longer is our society going to keep treating people with illness as a burden? How long are people going to face such hard decisions just to keep living?”.

Although I cannot give my constituent all the answers they need, I, along with colleagues today, call on the Government to recognise this illness, commit to reassessing the sick pay rate, and fund research treatments to cure and help sufferers with long covid.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I realise that a number of colleagues have not been able to get into this debate. As I have said, we had a very short time for it. The Front Benchers have agreed to speak for less time than they normally would, and I now call the Scottish National party spokesperson, Neale Hanvey.

--- Later in debate ---

[Layla Moran [V]]

I thank all Members who have contributed to this debate, but also all those who were unable to contribute. When we put in for it, we thought that it would be well subscribed, given that, I would wager, most Members in this House will have been contacted by a constituent, or more than one constituent, who now has long covid. For all those with long covid who are watching today, I hope they have the assurance that this House will continue to listen and encourage the Government to take action as our understanding of this disease improves.

We certainly heard some powerful stories today. There is obviously not time to go through all of them. I was struck, as we always are, by the contribution from the hon. Member for Denton and Reddish (Andrew Gwynne), who brings the subject to life with his own experience but also rightly asks: what about those who do not have the flexible working that is afforded to us as MPs?

Several Members mentioned that there are learnings that we must take from other conditions. In particular, ME was mentioned by the hon. Member for Glasgow North West (Carol Monaghan), among others. I thank her for her work and leadership on the all-party parliamentary group on ME. There is a lot that we can learn from that.

The hon. Member for Central Suffolk and North Ipswich (Dr Poulter) rightly raised mental health, and the trauma that people face as a result of being hospitalised with covid. I think that almost all Members mentioned financial support, and many highlighted the failure of the welfare system to cope with this changing landscape. That is an area that we continue to need to push on. My right hon. Friend the Member for Orkney and Shetland (Mr Carmichael) put it very well when he said that the Government need to take a humble approach to the changing picture.

I thank the Front Bench spokespeople, and particularly the Minister for her response and for listening so diligently to the debate. I thank her for the update on the research and the NHS response. It is clear that we are finally getting going, but I hope that she also recognises that we need to continue to finesse and change as our understanding evolves. I hope she will take a personal interest in that. Finally, it would be wonderful if she would consider a meeting with me and others in the all-party group, to talk about the areas that she did not cover, in particular publishing the register, if that is possible, and a recognition by employers that long covid could be an occupational disease, and the support that would be needed by those who suffer from it.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I thank the hon. Lady for winding up the debate, but we now need to move on because we have another full debate.

Question put and agreed to.

Resolved,

That this House has considered long covid.

[Madam Deputy Speaker]

We will now have a two-minute suspension to allow preparation for the next debate.

Public Health

Baroness Winterton of Doncaster Excerpts

Wednesday 6th January 2021 Commons Chamber

[Jonathan Ashworth]

I think that as a rule in politics it is always better to under-promise and over-deliver. Maybe the Whip on the Treasury Bench could send that advice to the Prime Minister, because the Prime Minister tends to have the opposite approach to some of these matters, I would say.

Our big target should be to vaccinate more, particularly among NHS staff. Many NHS staff on the frontline, in the face of danger, are scared. They are exhausted. Many have said to me that they feel they were sent out in the initial weeks of the first wave without the protection of personal protective equipment, and now they are exposed again without the protection of inoculation. Will Ministers move heaven and earth to get all frontline NHS staff vaccinated urgently, and can we have a clear date by which NHS staff on the frontline will receive the vaccine? If manufacturers can increase supply, what more can be done to improve distribution? In addition to GPs, our community pharmacists have tremendous links with hard-to-reach communities. We need to make full use of them.

Vaccination not only saves lives, and is not only the route out of restrictions; it is also urgent, because we are now in a race against time. The B117 strain is fast becoming dominant, and it has done so in just a matter of weeks. The more virus there is circulating, the more opportunities there are for further mutations that could give the virus greater advantage—possibly a variant on which vaccines no longer work, risking another devastating covid wave in winter 2021. Vaccination, both at home and across the globe, is now fiercely urgent, and the race to vaccinate is therefore literally a race against evolution.

We will also support this lockdown tonight because we know we have to reduce transmission. That is why we are asking people to stay at home. But not everyone can work from home on their laptops. There are 10 million key workers in the United Kingdom, of whom only 14% can work from home—key workers, many of whom are low paid and often use public transport to travel to work in jobs that, by necessity, involve greater social mixing, who are more exposed to risk. Often, because of their home circumstances, they end up exposing others to risk as well. We witnessed that in Leicester, where it is suspected that a spike back in the summer was the result of a spillover of infections into the community from those sweatshops that did not adhere to proper health and safety rules.

We need to make sure that our workplaces are covid-secure; otherwise, we will not get on top of transmission. What support are the Government offering to install ventilation systems in workplaces? Will the Government introduce a safety threshold for ventilation of indoor workplaces without outside air? Given that the B117 strain is so much more transmissible, are the Government considering reintroducing the 2-metre rule? Given that fewer than 20% of those who should isolate do so fully, will the Government finally accept that sick workers need proper sick pay and support? Otherwise, those workers will be forced to work, spreading this illness.

The British public have done so much over the last year and have made great sacrifices. We are a great country, and our people can and will rise to the occasion. All anyone asks is that the Government do the right thing at the right time: make all workplaces covid-secure; vaccinate health workers as soon as possible; introduce decent sick pay and support to isolate, and roll out a mass vaccination plan like we have never seen before. This is a race against time—a race against evolution—and we will support this lockdown tonight.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I will now introduce the three-minute limit. I remind hon. and right hon. Members that when a speaking limit is in effect for Back Benchers, a countdown clock will be visible on the screens of hon. and right hon. Members participating virtually and on the screens in the Chamber. For hon. and right hon. Members participating physically in the Chamber, the usual clock in the Chamber will operate.

Public Health

Baroness Winterton of Doncaster Excerpts

Wednesday 30th December 2020 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

The Business of the House motion just agreed to by the House provides for the motions on the five statutory instruments on today’s Order Paper, each relating to public health, to be debated together for up to three hours. Those are SI Nos. 1518, 1533, 1572, 1611 and 1646. At the end of the debate, I will put the Question on each motion separately. A large number of Members want to contribute to the debate, so we will start with a five-minute time limit.

[The Minister for Care (Helen Whately)]

I beg to move,

That the Health Protection (Coronavirus, Restrictions) (Self-Isolation and Linked Households) (England) Regulations 2020 (S.I., 2020, No. 1518), dated 11 December 2020, a copy of which was laid before this House on 11 December, be approved.

[Madam Deputy Speaker]

With this we shall debate the following motions:

That the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) Regulations 2020 (S.I., 2020, No. 1533), dated 14 December 2020, a copy of which was laid before this House on 14 December, be approved.

That the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 2) Regulations 2020 (S.I., 2020, No. 1572), dated 17 December 2020, a copy of which was laid before this House on 17 December, be approved.

That the Health Protection (Coronavirus, Restrictions) (All Tiers and Obligations of Undertakings) (England) (Amendment) Regulations 2020 (S.I., 2020, No. 1611), dated 20 December 2020, a copy of which were laid before this House on 21 December, be approved.

That the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 3) Regulations 2020 (S.I., 2020, No. 1646), dated 24 December 2020, a copy of which were laid before this House on 29 December, be approved.

[Helen Whately]

Before I say anything else, I want to say thank you to all our health and social care workers who have been working day and night through Christmas, Boxing day and the bank holiday. I know that every single one of them is feeling the strain and that they are not just tired but exhausted, having gone not just the extra mile but miles and miles of extra miles. I would also like to thank everyone across the country who has forgone the joy of sharing Christmas with family or friends. We have all missed those precious moments, and I know that this has been particularly painful for those facing what may be the last chance to spend Christmas with a loved one nearing the end of their life. That is why I say thank you to them from the bottom of my heart for what they have done, not so much for their own sake but to protect others.

I would like to take a moment to celebrate the good news of the authorisation of the Oxford-AstraZeneca vaccine for use. Although the development of vaccines is an international collaboration, we should recognise the contribution of the British life sciences sector, which offers the UK a way out of this disease and will make a huge impact on the global response.

--- Later in debate ---

[Helen Whately]

One thing that I will do when I have finished speaking is see whether I can look up the specific data for the hon. Member’s constituency. In general, however, the announcements made today, just as with previous announcements, are based on the data that we are seeing, which includes rapidly rising rates of infection in certain areas, the level of new infections, the trajectory and hospital pressures.

The tier 4 regulations require all non-essential retail, indoor entertainment, hairdressers and other personal care services to close. International travel is also restricted to business trips only. However, we have listened to hon. Members and the public about what is most important to people in their daily lives so, unlike in the November restrictions, communal worship and a wider range of outdoor recreation are still permitted. We also recognise the restrictions’ impact on businesses and continue to provide them with ongoing support to help get through the crisis.

We know that these measures are hard. We know that they keep families and friends apart, yet we also know that they are necessary for us to get through this situation and to prevent the loss of lives as we do so. This virus thrives on the things that make life worth living, such as social contact, but that means we can all play our part in stopping the spread—as I said, if not for ourselves, then for others. The end is in sight, but for now it is our duty here in Parliament to put in place these restrictions—onerous though they are—to control this virus. I commend the regulations to the House.

[Madam Deputy Speaker (Dame Rosie Winterton)]

As I said, we will start with a five-minute time limit on Back-Bench Members. I remind hon. Members that, when a speaking limit is in effect for Back Benchers, a countdown clock will be visible on the screens of right hon. and hon. Members participating virtually and on the screens in the Chamber. For right hon. and hon. Members participating physically, the usual clock will operate.

Covid-19

Baroness Winterton of Doncaster Excerpts

Monday 14th December 2020 Commons Chamber

[Craig Mackinlay (South Thanet) (Con)]

It is good to have the floor for more than the 180 seconds that was allowed in the debate before the last lockdown, which only gave us time to say our name and serial number.

I pay a very great tribute to the Government for what they have achieved. I think one of the crowning glories of what has been achieved in some of the testing data is the granularity of borough-by-borough data, which I will refer to that a little later. We have rolled out polymerase chain reaction—PCR—testing to a higher percentage of our population than anywhere else in the world. I had some doubt that we would ever reach 100,000 a day, let alone half a million, so this has been a real triumph in flexibility that our country has been able to achieve. We are now seeing the roll-out of lateral flow testing. Thanet schools will have the mobile testing units landing very shortly, as will other parts of Kent.

We have had a level of financial support that is almost unparalleled anywhere in the world. Of course, some businesses have not got what they thought they deserved, but we have to accept that this was new ground; we did not know what was around the corner and different support schemes had to be rolled out very quickly.

Then, of course, our own MRHA, the council that approves medicines, has rolled out at high speed but with absolute safety the first of the vaccines for licence around the world—the Pfizer/BioNTech vaccine—and there are others coming round the corner. The one that we all hope for is the home-grown Oxford/AstraZeneca vaccine—a rather more traditional vaccine, which is easier to store and administer. What is coming out of the billions that have been spent around the world in a very short time is this new messenger RNA-style of vaccine. Once we are out of covid, there could be—maybe, doubtless, possibly—a similar type of pandemic in years to come, and we will be better armed to respond rapidly to it, so hopefully our planet will not be in this situation once more.

We look at the vaccines as the way out of this, but we have to tell some truths. Some are being rolled out as we speak: my father of 86 is getting his vaccine No. 1 this Friday, and tomorrow vaccinations are being rolled out locally from GP surgeries in my Thanet constituency. That is all great news, but there are 66 million people in this country, and we need two vaccinations. We have limitations on the delivery of the vaccines and there is global demand for exactly the same product, so we need honesty about how we will scale it up and deliver it. It is not just about the numbers; it is also about the availability of staff and those who are able to vaccinate. It is a major undertaking.

We must pay real tribute to the NHS staff who have stepped up to the plate, shown massive flexibility and kept the show on the road. We all have fantastic communities that have been looking after the old people in their streets, church groups that have done their bit, and food banks and similar organisations that have risen to the challenge. The Minister, who is looking at me intently, can be quite sure that that is the end of my unalloyed congratulations for where we have got to thus far. I still have a number of fundamental concerns about the moving science that we are living under, and I aired some of them in the previous debate.

We had the ridiculous situation that, as we approached lockdown version 2, we pretty much banned everything. We banned swimming, gyms, golf courses and non-essential shops. We had what I then called the Wilkinson conundrum: the big shops could open, but the small shops selling some of what the big shops were selling were not allowed to open at all. We could not have group worship. Thankfully, under tier 3 and tier 2—obviously, 99% of the country is now under tiers 2 and 3, and the whole of Kent is under tier 3—some common sense has prevailed. All those shops can open, and we can indulge in group worship and do quite a number of the things that we could not before. That indicates that there has been some granularity of thought about these things—funnily enough, exactly what I was saying some months earlier—and it determined that those things were not so dangerous after all.

I am not here to be part of the difficult squad. I know I am in the Covid Recovery Group. I am attempting to be a serious critical friend of the Government, but we still have our hospitality industry, which many right hon. and hon. Members have mentioned this evening, and I suspect that more following me will do so. I feel that, because we are getting somewhat desperate to get out of this mess, we are losing sight of what works and what does not work. I find it hard to believe that we will all be going Christmas shopping. I am sure the density in our supermarkets will be that much higher over the next 10 to 12 days, as we scramble around for the cranberry sauce and the turkey. That is allowed. The nail bars and the hairdressers, thankfully, are allowed. [Laughter.] Well, my nails are not looking too bad. But we are not allowed to go to a well-managed location of hospitality, and I just cannot see the sense of that.

I still have my concerns about the economics of tier 3 and lockdowns. I think London will suffer greatly over the next couple of weeks. We still have not really seen the analysis of what other deaths may be caused because people are too fearful of going to health locations. Macmillan Cancer Support said just this morning that lockdown version one is likely to have led to 50,000 people not seeking the help for an early diagnosis that they might have sought. That means that once they are diagnosed, their cancer may have advanced to a higher level and treatment will be more invasive, more expensive and more unpleasant—and there will be deaths.

I am not sure we are considering the effect on mental health sufficiently. I know that has been mentioned on the Floor of the House many times. There is not just one example, but I think very much of the multi-generational family business of some standing, with a bit of a status in the community, that goes bankrupt through no fault of its own. I worry about the likelihood of suicide in such instances.

Her Majesty’s Treasury is very capable of modelling almost anything—it certainly tried to model Brexit over many years—yet it seems incapable of properly modelling the economic impact of these ongoing lockdowns. We had the spending review and the Office for Budget Responsibility report just a couple of weeks ago, which suggested that, at the mid-way point—a sort of tier 2 point—there is a permanent 3% scarring of our economy. Obviously, tier 3 has to be a little worse, if not a lot worse. As we have discussed on the Floor of the House over many years, there are reports from diverse organisations that say that long-term poverty, and the scarring of our economy that this will cause, will lead to worse life opportunities, fewer life chances and shorter lives. None of that has been factored in at all.

Let me turn to a couple of points that I hope the Minister will take away. I mentioned how useful the granularity of borough data has been. I think we all watch that avidly. Strangely, Thanet, part of which is in my South Thanet constituency, was at the very highest level of infection rates per 100,000 a few weeks ago, despite having been in the very lowest league at the end of the summer. I cannot explain that; I do not know why. We have our backs to the sea, and we do not have a community that mixes like a big city may. Thankfully, though, it is the only borough in the whole of Kent where the figures are now just on the way down. We are at 425 per 100,000 today, whereas we were at over 500 just a couple of weeks ago. That compares with a national average of 181.

My concern as we go forward is that we have seen that the tiers only get stricter. We have these five bases on which we are trying to interpret whether an area should go up or down. We have the pure numbers—that rate per 100,000, which we have all become very familiar with. I do not know what the threshold is between tier 1 and tier 2; it seems to be around 200, but I am really not sure. The shape of the graph is important: is it going up exponentially, or is it plateauing and going down? There are also the bases of the rate of infection among the over-60s, the most at-risk group for obvious reasons, and the positivity rate and whether that is going up or down. I have no idea about positivity rates—whether a rate of 2% is good or 10% is bad. Then, of course, there is the pressure on the NHS.

Concentrating on the pure numbers, however, I think that could be one of the tools by which we keep a lid on this—squash the sombrero and bide our time until we get to the vaccine. I do not know about any other Members in this House, but those numbers have really worked on me. At the end of the summer, when Thanet numbers were low, we had a spring in our step; we were not quite so worried—we were quite happy to walk down the high street to go shopping, and if we saw somebody without a mask on it did not really worry us too much. However, as those numbers have got to very high levels, I know that my behaviour has changed. If I see someone in the supermarket without a mask on —thankfully, it is a pretty rare event these days—I give them a very wide berth, of not just 2 metres but perhaps 3. I think we just do more careful things, too: we carry our hand sanitisers with us on a daily basis when our local numbers are high. I have the feeling that those numbers could be the most powerful tool in affecting behaviour.

Of course, the last of the five bases that we have to consider is pressure on the NHS, and I have a number of concerns about that. The community can affect the other bases—people can do something for themselves—but they can do very little, I am afraid, about what is happening in our hospitals.

I am very concerned. Last week a number of hospitals were reporting the percentage of their in-patients who had acquired covid within the hospital location. If our hospitals are under pressure, that creates more pressure for them. I find it hard to believe that this—the so-called nosocomial infection rate—cannot be solved. It was reported last week in The Daily Telegraph that 10,000 patients could have been affected, and we are all hearing about this. I am afraid I am hearing about it far too often; I hear about when patients go in for a routine treatment and are placed in a hot ward—in a mixed ward with others who are covid-positive. Last week, I watched ITV—national ITV—report on a situation at Medway Maritime Hospital. Few things really shock me these days, but this really did. A chap called Paul Tucker, aged 57, went into hospital with a serious condition that was nothing to do with covid and he died because he was in a mixed ward with covid-positive patients.

I can give another example, about someone I know: an old gentleman who broke his leg and went in for treatment. He came out solved, but he had had a covid test the day before discharge and no test result came forward. He went home for five days, and in those five days he had up to five carers attending to him every day—he is a gentleman on his own with no family living nearby—and on day five the hospital rang and said, “Ah, really sorry, but the test was a bit late: you’re positive.” Five carers every day had been attending a man they thought was covid-negative, and those same carers would be going out to possibly 10 different clients on a daily basis. The declared hospital-acquired infection figures that we are hearing do not count infections that have been created by such new spider’s webs because of a failure in a hospital. If there is a takeaway from tonight, Minister, it is that I beg you to get infection control under control in our hospitals.

I think I will leave it there, Madam Deputy Speaker, but these are serious times. We are not going to be out of this immediately or any time soon. Rolling out 66 million vaccines, times two, will take time. We need to live with the virus in a sensible way, and going in and out of lockdown, with the damage to health, the economy and mental health, must form part of the balance sheet of how a nation deals with this infection.

I give the Government great credit for their achievements. They are world class. Very few nations in the world can say that they did it as well and as rapidly as we have tried to do it. It is all very well being the specialist after the event, saying what might have been or what we could have done that might have been better, but the world is not like that. I give top marks to the Government, but there are some takeaways that could make it even better before we are fully out of the woods.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. There is not that much pressure on time, but we have to be slightly conscious that everyone will want an equal go.

Ockenden Review

Baroness Winterton of Doncaster Excerpts

Thursday 10th December 2020 Commons Chamber

[Madam Deputy Speaker (Dame Rosie Winterton)]

As questions 14 and 15 have been withdrawn, the final one is from Kerry McCarthy.

[Kerry McCarthy (Bristol East) (Lab)]

In that case, I thank the Minister for what is clearly a very genuine response to the concerns expressed today. What has been said about the culture within the NHS, revealed in this review, has echoes of the Bristol heart babies scandal, and it is tragic that parents must still fight to have their voices heard now. One of the things mentioned by families contributing to the Ockenden review is the desperate need for longer-term support following experience of baby loss. I know from my constituents that the NHS has struggled to provide that during the current pandemic. What more can we do to ensure not just that parents are listened to at the time of losing their baby, but that they are supported from then onwards, too?

[Ms Dorries]

I thank the hon. Lady for her comments, sincerely, and for her important question. Baby loss is something that we discuss in this House—rightly so—and we are discussing what happened at Shrewsbury and Telford, because many parents there lost their babies. The report makes a recommendation that the care and support that parents are given following a bereavement are strengthened, and that measures are put in place to ensure that the right package is there. Many charities work in this area across the UK—I will just mention Baby Lifeline, Sands and others—and have themselves put in place both practical and emotional measures to help parents at such a time. It is the worst time, in anyone’s life, to lose a child. We say that so many times in here, and it is our responsibility, both in the Department and in society as a whole, to hold those parents and to help them through those awful times. I thank the hon. Lady for her question—this is something we take very seriously in the DHSC.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I thank the Minister for her statement and her full responses to all the issues that were raised by right hon. and hon. Members. We will now have a three-minute suspension for the safe entry and exit of right hon. and hon. Members.

Coronavirus Vaccine

Baroness Winterton of Doncaster Excerpts

Wednesday 2nd December 2020 Commons Chamber

[Matt Hancock]

Oh yes—mass testing is rolling out as we speak. My team have been working with Kirklees Council to make sure that the council’s enthusiasm for mass testing is matched by the resources that come its way in terms of the tests themselves, the financial support—£14 per test, as the hon. Lady says—and the logistical support from the armed forces. Kirklees’s plans are very advanced, I pay tribute to its local leadership and look forward to working with them to make it happen.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. I want to get everybody in but we are getting a little behind schedule, so I ask for succinct questions.

[Mr Gagan Mohindra (South West Hertfordshire) (Con)]

I congratulate the Secretary of State and our Government on their brilliant work to make sure that we were the first country in the world to have a vaccine approved.

It would be worth the Secretary of State’s repeating the criteria and pecking order for the 800,000 doses. A colleague of mine, Councillor Bentley, always says that people need to hear something at least eight times before they embed it, so will the Secretary of State take this opportunity to repeat it?

--- Later in debate ---

[Matt Hancock]

My hon. Friend is right. The candle of hope is burning brighter today. On the mass testing she is so enthusiastic about, I can tell her that this morning when I asked my officials to ensure that the community testing programme that is being developed for Hyndburn is advanced as quickly as possible, they told me that they had been told of the need for it by so many people and that so many people had been lobbied by her, that it was already in hand. I suppose that that goes to show just how vociferous my hon. Friend is in fighting for the people of Hyndburn.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. We will have a three-minute suspension.

Virtual participation in proceedings concluded (Order, 4 June).

Covid-19

Baroness Winterton of Doncaster Excerpts

Wednesday 18th November 2020 Commons Chamber

[Peter Gibson (Darlington) (Con)]

The people of Darlington have followed the rules, but this invisible virus has continued to infect them. Sadly, the infection rate remains high, with 337 cases per 100,000 last week. The local hospital trust, which includes Darlington Memorial Hospital, has more covid-positive patients than at the peak earlier in the year, so we welcome the additional 10,000 tests that have been made available to us.

As we entered the national lockdown, negotiations were under way to move the borough of Darlington, along with the other four Tees valley local authorities, into tier 3. It is my sincere hope that the efforts and impact of the lockdown will be such that, as we emerge from the current restrictions, we can remain in tier 2. My right hon. Friend the Paymaster General is aware that I and other colleagues from the Tees valley were opposed to an early move from tier 1 to tier 2, not because we wanted the virus to continue to spread but because we were concerned about the impact on the mental health of our constituents and the economic wellbeing of our communities. Part of that concern was alleviated by my right hon. Friend the Chancellor’s additional support for those businesses able to remain open in tier 2 but adversely impacted. I welcome Darlington Borough Council’s efforts to distribute the grants as quickly as possible.

Darlington hospitality is legendary. We are proud to fly a purple flag, celebrating our town centre night-time economy. While hospitality businesses across Darlington are presently closed, I am confident that the support that has been forthcoming to Darlington will help us bounce back. We have had 9,000 jobs protected through furlough; 2,000 self-employed people supported, over £50 million of bounce back loans, millions in grants, rate exemptions and reductions. There is also the continued delivery of our levelling up agenda, with tangible investments, including £100 million in our expanded mainline train station and over £23 million through the towns fund, setting our plans on track for the development of the rail heritage quarter. Those investments will truly level up and help us bounce back.

I and many colleagues were elected not only to get Brexit done but to breathe new life into towns that stagnated under Labour control for decades. I am proud that, despite the wholly unprecedented challenge that this year has brought, we are continuing to deliver on those manifesto commitments. Recent figures reveal that in September the economy of the north-east bounced back at a faster rate than any other region of the country: a really positive sign.

We have the energy, drive and ambition of our Tees Valley Mayor, Ben Houchen, who has been at the forefront of much support through these times. With a saved airport, investment in hydrogen buses, trains and cars, carbon capture and storage and massive investment in offshore wind, new jobs in emerging technologies are putting the Tees valley at the heart of the green revolution. They make me confident that, certainly in the Tees valley and specifically in Darlington, levelling up is having a tangible and visible impact on the community I serve.

We all want to see the back of this virus. It has destroyed lives, changed everyone’s way of life and wreaked financial havoc on many businesses. I have been a champion for all the Government have done to support businesses, but on behalf of the people of Darlington, caught between the desire for liberty and their commitment to protecting the most vulnerable, I urge Ministers to continue their support for our local businesses and charities, and in particular—I declare my interest—to provide more support for our hospices not only in Darlington but across the country.

Finally, I pay tribute to the team at Darlington Memorial Hospital. They have adapted at pace, doubling their capacity in A&E and in ICU and working around the clock. They are doing all they can in the fight against this disease and delivering their other services too.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I can see that we still have a fair number of speakers, so after the next speaker I will reduce the time limit to five minutes. It may have to go down a little bit more after that.

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[Sir Christopher Chope (Christchurch) (Con)]

It is a pleasure to follow the hon. Member for Liverpool, Wavertree (Paula Barker), although I do not agree with her obsession with trying to restrict free speech and information for the general public. Surely it should be for the general public to discuss and determine these things themselves.

The Minister referred to evidence, data and scientific advice as being the watchwords of the Government. Those words ring rather hollow with my constituents, because they regard that as spin rather than substance. Earlier today, I suggested to the Prime Minister at Prime Minister’s questions that the million-plus people who had tested positive for covid-19 and had recovered should be exempt from the regulations because their T cells would give them immunity for at least six months. That is the evidence provided by and published in The BMJ, and yet the Prime Minister seemed to cast doubt on it, despite the fact that that evidence was produced in collaboration with Public Health England and has won plaudits from the Medical Research Council.

One of the advantages of providing such an exemption is that it would deal with the people who are suffering from long covid, to whom the Minister also referred. In Sweden, they apply such an exemption. I know that any references to Sweden are anathema to the Government. Last time I mentioned Sweden, the Minister tried to pour cold water on my statistics. She was wrong, and I questioned her and have not had an answer. Again, I make no apology for referring to the comparable statistics.

In the past week, ending 17 November, there have been 85 deaths from covid-19 in Sweden. In the similar period in the United Kingdom, there have been 2,975 deaths. Taking into account the population difference, there are six times as many deaths per capita in this country as in Sweden, and that takes no account of all the collateral damage that we are causing to our people who cannot get access to healthcare, including 5,000 excess deaths from heart disease alone.

The Minister was saying that we talk about evidence. In answer to parliamentary question 111413, asking about the public health justification for refusing to allow the giving and receiving of the sacrament in places of worship, this is the answer I received:

“Public Health England had not been requested to research and publish detailed specific data on the numbers of COVID-19 cases related to place of worship and allied settings on outbreak investigation. This is now being performed.”

That answer came in 10 days after it should have done, but why was that work not done before? Why are we refusing to allow people to receive the sacrament in places of worship without any evidence in justification? Similarly, I asked about the difference between two people playing golf on a public golf course and two people walking a dog on a public footpath. There was no satisfactory response from the Government.

On another issue, while the Government say that people are at great risk if they go to play golf together, the greatest risk, it seems, is to have the misfortune to go to hospital and then contract covid-19. In answer to a question yesterday, I have been told by the Minister that in October alone there were 3,934 cases of people who went to hospital without covid but got covid while they were there, as a result of hospital transmission of infection. In October, in Poole hospital, which serves many of my constituents, 120 people were in hospital, and some 73 of them contracted covid as a result of infection within the hospital.

The question I ask of the Minister, therefore, is: when we get the vaccination, will someone getting a vaccination automatically be exempt from the lockdown rules? If not, why not? Also, when we get into discussing criteria for moving out of the lockdown, what will we do about false positive tests? If there are 500,000 tests a day and 5% are false positives, we will have 25,000 false positives. That is number enough to justify a continuation of lockdown—based on false tests. Surely that cannot be sensible policy for the Government.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. It will be obvious from the Order Paper that I have to reduce the time limit. I will do so to four minutes, but after the next speaker.

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[Nickie Aiken (Cities of London and Westminster) (Con)]

It is a pleasure to follow the hon. Member for Richmond Park (Sarah Olney).

I pay tribute to all the amazing key workers who have worked tirelessly this year in the care system, the NHS and local government, which I think is quite often forgotten, as well as the police and our teachers. However, I also pay tribute to the local people of my constituency of the Cities of London and Westminster. Many people think that central London is an unfriendly place, but I can tell them that it is a place that is full of community spirit. I have seen that at first hand in the City, on the Golden Lane estate, in the Barbican and on Mansell Street. I have seen it at the Square Mile food bank, which has done brilliant work. It is manned by volunteers, and I pay tribute to them. I have seen it in Westminster, among the residents of Pimlico, Marylebone, Covent Garden, Belgravia and Paddington, who are really working together to help the more vulnerable in our society. I saw it when Westminster City Council launched its Westminster Connects volunteer scheme, which I took part in myself, helping to prepare food for the rough sleepers we have brought in. Some 90% of rough sleepers were brought in under the Government’s Everyone In scheme, which was outstanding. So I pay tribute to everyone today.

I pay tribute to the Government. Let us not forget how far we have come in 10 months. Yes, there have been difficulties, but we now have amazing laboratories doing the testing, we have the PPE, and we have the NHS working so well. I pay tribute to the Government for doing that, and I look forward to the vaccine coming on board and to us being able, hopefully, to get back to some normality at some point next year. It is also important to pay tribute to the businesses. Central London is usually first out of the traps when it comes to facing up to an economic depression or recession. Sadly, this time, I think we will be one of the last to get back to normal. We used to see 1 million people come into my constituency to work every day, but they have disappeared and the retail and hospitality sectors have paid the price, as have other service industries such as beauty therapists, cobblers and dry cleaners. Those small businesses rely on workers and visitors coming in every day of the week, but they have disappeared. I also pay tribute to the brilliant financial schemes that the Government have brought in. I held a roundtable for representatives of the theatre industry in my constituency last week, and every single one of them paid tribute to the furlough system.

However, there are still things we could do. I would like to see an extension to the business rate holiday. I would also like to see an extension to the VAT cut, maybe to other industries such as the beauty industry and hairdressers, who have been hit particularly during the second lockdown. As we move towards the lifting of restrictions, hopefully in a couple of weeks’ time, we need to plan ahead. Businesses need to know what tier they will go into. We also need to look at the 10 pm curfew, which to me is counterintuitive. I would rather see the ability to stagger the times at which people leave restaurants and bars, because I think that would be safer. I would also like to thank the business organisations that I have been working with, such as UKHospitality, who have made their arguments. I have enjoyed working with those people, because they care about their sectors and about recovering the economy when it is safe to do so.

[Madam Deputy Speaker (Dame Rosie Winterton)]

In order to try to accommodate everybody, I will reduce the time limit to three minutes after the next speaker.

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[Claudia Webbe (Leicester East) (Ind)]

Amid a deadly second wave and record-breaking numbers of covid-19 infections, it is important to act for change. The virus is continuing to rise. The measures put in place are not working. Time is running out. My constituency of Leicester East knows this only too well as our city has been under enhanced restrictions and/or lockdown longer than any other area in the UK, yet our numbers are continuing to rise.

People in Leicester East and across the country cannot afford to live below the minimum wage. Even before this crisis, more than half of the 40 million people in poverty in the UK were part of the working poor—suffering in-work poverty. Child poverty is off the scale due to a decade of austerity, extortionate rents and declining living standards. The Conservatives have overseen an unacceptable breakdown in our social contract in which a job no longer provides a route out of destitution. Yet now, during an unprecedented crisis, the Government are handing out poverty payslips and driving our residents into hardship. Will the Government today commit to ensure that no one receives less than a living wage throughout the remainder of this crisis? We are only as safe as the most vulnerable in our society, so, yes, local and regional authorities need funding to use their discretion to fully support undocumented workers and those on no recourse to public funds. Will this Government relax the barriers and grant status now to all undocumented workers, so that they can access much-needed social security benefit and not be destitute or desperate?

What makes this lack of support even more disgraceful is the billions that the Government have been willing to pay to private companies to oversee the disastrous test, track and trace system. The recent National Audit Office investigation into Government procurement has highlighted cronyism at the heart of Government. That has had a devastating impact on the spread of the virus in Leicester. In one week this month, the success rate of Leicester’s privatised contact system was just 55.5% and this has decreased by more than 5% on the previous month. That means that, in one week alone, nearly 700 Leicester residents who may have been exposed to the virus were not informed and therefore did not self-isolate. This is a Government who are frivolous when it comes to handing out public money to Tory donors or private companies, but penny-pinching when it comes to bailing out communities and the 3 million excluded, including the self-employed across the country.

As the representative of one of the most diverse areas of the UK, I am also especially concerned about the disproportionate impact of coronavirus on African, Asian and minority ethnic communities. Recently published research by the universities of Leicester and Nottingham found that black people were twice as likely, and Asian people 1.5 times more likely, to be infected with covid-19 compared with white—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order.

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[Claudia Webbe]

Does the hon. Member not agree that the intensive care beds are filled today with covid-19 patients from African, Asian and minority ethnic backgrounds—back at levels seen during the first peak, despite earlier pledges from the Government to learn lessons and protect the vulnerable? What we need is change now.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I really do urge people not to make interventions, because it is going to prevent other people from speaking.

[Paul Bristow]

I thank the hon. Member for Leicester East (Claudia Webbe) for her comments, but if she listens further to my speech, she might fully appreciate the points that I am trying to make.

The conclusion that the NHS is somehow structurally racist can come only from the new logic of our age. The standard form of this new logic is this: if 10% of people are characteristic x, then 10% of workers should be x, 10% of every company should be x, 10% of every role should be x and 10% of all chief execs should be x, and where that is not true, it is offered as evidence of discrimination—differences are inequalities, and the logic assumes that what is unequal must be wrong. We have seen this logic applied to sex, gender, education or geographical background, disabilities and race, and now it is being applied to a virus: if 10% of NHS staff get covid, 10% of NHS staff with characteristic x should get covid, and because that does not hold for BAME staff, it is viewed as evidence of racism. I am staggered by how many intelligent people seem to have bought into this argument.

Characteristics cannot be taken in isolation; we have to control for variables. Moreover, no free society will ever see equal distributions for anything, even if individuals started from the same place. And, Madam Deputy Speaker, we do not—we do not in character; we do not socially; we do not genetically; we do not economically; we do not in terms of upbringing, geographical opportunity or education; we do not in health and diet; we do not in career paths; and we do not in our preferences. These may be inequalities, but they are not evidence of discrimination. That does not change when characteristics are used to define groups. As any scientist should know, correlation is not causation. As scientists also know, getting particular diseases and viruses is not uniform, particularly across ethnic groups. No organisation could escape from this mad progressive logic: if it was not damned for one thing, it would be damned for another, no matter how woke its values—just look at The Guardian.

I want to be very clear: obviously there are incidents of racism within our NHS. There is still racism within our society. The NHS is far more diverse than most organisations, but it employs human beings, and it gets its fair share of bad ones. This needs to be detected and it needs firm action. Likewise, the NHS can be unwieldly and inefficient, so problems are not always dealt with as they should be. But this pandemic has shown our NHS at its best and its staff at their best. We ought to be proud of them. If—

[Madam Deputy Speaker (Dame Rosie Winterton)]

Order. The hon. Gentleman has had longer than three minutes.

[Fleur Anderson (Putney) (Lab)]

I echo the sentiments of many Members in thanking our NHS workers for the work they have done throughout this crisis and will be expected to do through the winter ahead. I want to focus on an issue that affects them very keenly: the national scrubs crisis, which leaves NHS workers without the equipment they need to do their job in fighting covid on the frontline.

In answer to a written question I asked, the Government assured me in August that

“NHS Supply Chain, the main provider of consumables and equipment into the National Health Service, report that its suppliers have sufficient supplies of scrubs for NHS customers to order.”

That is not the case on the ground, as I am told by so many NHS staff and by those who are sewing scrubs on a voluntary basis across the country. The Government are lying, in denial or blissfully unaware of the reality on the ground. I would like the Minister to take the time following the debate to look into the scrubs crisis, to meet the leader of the Putney scrub hub, who is a very inspiring woman, and to find out what is going on at NHS Supply Chain in order to sort this out.

It is essential that our NHS workers have enough scrubs and the right scrubs in the right size. Scrubs must be lightweight enough to be worn under other PPE, and they must not take three months to order from abroad, as they currently do, if an order can even be got in. There has been a massive increase in the need for scrubs in hospitals, clinics, care homes, prisons and now vaccination clinics. The demand for scrubs will increase at a time when we cannot even provide enough scrubs to our NHS workers. Staff are being told to go home. There is one hospital that has 500 staff and 300 scrubs, so 200 staff are being sent home because they do not have the equipment they need. Newly qualified medical staff are being told to find their own scrubs, and they cannot get hold of them.

The Putney scrub hub in my constituency, which has a highly-skilled leader, is making 15,000 scrub sets, all from a squash court in Roehampton. Those volunteers are still making those scrubs, and they want to go home. That is why I implore the Minister to look into this. The most recent orders they have had are from a psychiatric unit in West Middlesex University Hospital, from King’s College Hospital, Central Middlesex Hospital, the West London Kidney Patients’ Association—I could go on, but this demonstrates that a lot of NHS providers do not have enough scrubs.

There seems to be no central co-ordination of scrubs procurement and no national plan to deal with obvious supply issues. In July, I said that the Government needed to put this at the top of their to-do list to sort out in the summer. It has still not been sorted out, but there is time. Can the Minister address this and enable Putney scrub hub volunteers to put down their scissors and get back to their normal lives?

[Madam Deputy Speaker (Dame Rosie Winterton)]

We will start the winding-up speeches at 6.44 pm. There are three speakers left, so if colleagues take two minutes instead of three, we can get everybody in. I call Tom Hunt.

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[Penny Mordaunt]

I will happily respond. I am sorry that I did not have a lot of time at the Dispatch Box. However, during the course of the debate I arranged for the covid-19 taskforce—who, through the Cabinet Office and my office, will co-ordinate this—to have a meeting with the hon. Lady and any other people, whether colleagues in this place or the local resilience forum. The notes that she has given us today on further logistical support are incredibly important, and we will act on them. I will see her after this debate to confirm all that.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Thank you. I should just say that both Front Benchers agreed to keep their contributions shorter than they ordinarily would have done in order to accommodate as many Back Benchers as possible.