Oral Answers to Questions

Sajid Javid Excerpts

Tuesday 13th July 2021 Commons Chamber

[Martin Vickers (Cleethorpes) (Con)]

What progress he is making on bringing forward plans to reform adult social care.

[The Secretary of State for Health and Social Care (Sajid Javid)]

I want people to be able to get the care they need when they need it and to have the choices they want. I want people to live their life in full and to live independently as part of a community for as long as possible without facing an astronomical care bill. We are committed to social care reform, and we will bring forward proposals this year.

[Mr Sharma [V]]

I thank the Secretary of State for responding to my initial question. Eleven years into this Tory Government, 10 years on from Dilnot and almost 700 days since the Prime Minister promised

“to fix social care, once and for all”,

looking at it and studying the options is not enough for the four out of five people who say, “We need a solution now.” Is this just another of the Prime Minister’s promises that will not quite materialise?

[Sajid Javid]

We have already seen substantial increases in adult social care funding, but the Government have said that we want a long-term, sustainable solution, so we will bring forward proposals on that. The hon. Gentleman will know that later today we are debating the Health and Care Bill, which is also about structural reform, so I look forward to seeing him in the Aye Lobby.

[Mr Harper]

May I just say to the Chancellor—the Secretary of State, rather—that when he brings forward the proposals, will he make sure that he addresses social care for working-age adults, which actually accounts for more than half of public spending? The debate is always focused on older people, and people of working age often get forgotten. The reason for my slip just now is that he will be aware, as a former Chancellor, that the tax burden was at a 50-year high before covid. When he brings forward the proposals, can we not just default to putting up taxes, however they are disguised, but look at overall Government spending, set some priorities and make some choices about what we think is important? Social care is important, but we need to make those choices about overall Government spending.

[Sajid Javid]

First, my right hon. Friend is right to bring to the House’s attention the way that the Government are also working on social care for working-age people. He is also right to point out—I was thinking about this the other day—that around 55% of total adult social care spending is for working-age adults, and it is important that we continue to provide that support. He will be pleased to know that I am working with the current Chancellor and other Cabinet colleagues on bringing forward a more sustainable long-term plan, and I hope he will support it when it comes forward.

[Martin Vickers [V]]

I welcome what my right hon. Friend has said so far and the moves he is making to deal with the social care issue. One thing that elderly people particularly are worried about when they are in care or in hospital are the recent reports of “Do not attempt cardiopulmonary resuscitation” orders. Will my right hon. Friend give an assurance that they will only be put in place with the authority of the patient or their next of kin? Is he making inquiries into recent reports of their widespread use?

[Sajid Javid]

My hon. Friend will be interested to know that the Department commissioned the Care Quality Commission to review the DNACPR decisions that were being made during the first wave of the pandemic. That review was published in March, and the Department then established a new ministerial oversight group that will be responsible for delivery and the required changes that were recommended in the review. We want to ensure adherence to the guidance throughout the system whenever DNACPR orders are used. The first meeting of this new group will take place on 8 June.

[Liz Kendall (Leicester West) (Lab)]

I welcome the Secretary of State to his new position. I wondered whether he might be able to clarify something for me. Five days ago, he told the Local Government Association conference that for social care reform,

“we may not be able to announce the whole plan…with all the details there”,

but that he hoped to

“set out…the general sense of direction”.

The general sense of direction! It is two years since the Prime Minister made a clear promise to fix the crisis in social care “once and for all”. Since then, more than 40,000 care home residents have died from covid-19 and 2 million elderly and disabled people have applied for care but had their request turned down. Millions more families and staff have been pushed to breaking point, so may I ask the Secretary of State: what is the plan? When will we see the plan? Will it provide the full details that he and the Minister for Care, the hon. Member for Faversham and Mid Kent (Helen Whately) have promised, or does keeping your word mean nothing to anyone in government anymore?

[Sajid Javid]

I think the hon. Lady may well have misunderstood what I said at the conference; I am not sure she listened to the whole session. It is worth repeating that the Government are absolutely committed to coming forward with a sustainable plan for adult social care and to bringing forward that plan to make sure that every person when they reach old age in our country can have the dignity they deserve. We will bring forward full proposals—a full plan—this year.

[Steven Bonnar (Coatbridge, Chryston and Bellshill) (SNP)]

What recent assessment he has made of the effectiveness of his Department’s response to the covid-19 outbreak.

[The Secretary of State for Health and Social Care (Sajid Javid)]

Since the start of the pandemic, we have acted swiftly to reduce the spread of the virus and to keep the public safe. As our vaccine programme progresses, links between cases and hospitalisations weaken, and that means that we are confident we can move forward with step 4, as I set out in the House yesterday.

[Steven Bonnar]

I thank the Health Secretary for that answer. After the planned changes next week, the Health Secretary is predicting that covid cases will reach 100,000 a day. Research is suggesting that that could result in 3,000 hospital admissions and again put our health services under pressure. What is his response to Dr Mike Ryan of the World Health Organisation, who described the proposals to remove all covid measures and simply let people get infected as “epidemiological stupidity”?

[Sajid Javid]

The hon. Gentleman talks, understandably, about pressure on the NHS, and he will know that the restrictions we have necessarily had in place during the course of this pandemic so far have also led to considerable pressure on the NHS, especially when it comes to non-covid health problems. He may be aware, perhaps for his own constituents, that mental health problems are up, there are many undiagnosed cancer cases, domestic violence is up and child abuse is up. I hope he will agree with me that one of the things we can look forward to as we gradually start removing restrictions is helping people with their many non-covid health problems too.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

I also welcome the Secretary of State to his new role. I hope he will soon see that the Department performs best when it follows the scientific advice. This morning, Professor Graham Medley, the chief modeller for the Scientific Advisory Group for Emergencies, said of mask wearing that

“if it’s not mandated it probably won’t do any good.”

That advice would explain why, last year, the Government moved from just guidance on mask wearing in May 2020 to making it compulsory on public transport in June and in shops in July. So if the advice is clear and the Government took that advice last year, why on earth are they moving away from it now?

[Sajid Javid]

The hon. Gentleman will know that the Government’s decisions are rightly informed by the best possible scientific advice there is and, as well as that, looking at the data and then taking all of that into account when reaching decisions. The hon. Gentleman asks about masks, and I have answered that question a number of times at the Dispatch Box. I am very happy to repeat that we are moving away from a system of regulation to guidance, but in that guidance, which was published yesterday, we have made it very clear that in certain situations masks will still make sense, and we believe that people will use their common sense and follow that guidance.

[Robbie Moore (Keighley) (Con)]

What steps he is taking to improve the infrastructure of the NHS estate.

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[James Sunderland (Bracknell) (Con)]

What evidence he plans to use to inform the Government’s decision on whether to proceed with step 4 of the covid-19 road map on 19 July 2021.

[The Secretary of State for Health and Social Care (Sajid Javid)]

The Government have committed to taking a cautious approach to easing restrictions, guided by the data and not by dates. As I set out in my statement to Parliament yesterday, the decision to lift the remaining measures on 19 July and proceed to step 4 is based on an assessment of the four tests that were set out in the road map.

[Karl MᶜCartney [V]]

I thank my right hon. Friend for his answer and welcome him to his new post.

For me and most of my constituents, 19 July cannot come early enough. It is refreshing to see the Secretary of State’s new approach to the wider issues of health provision, and the huge success of our vaccine roll-out has surely ensured that there should and will not be any more lockdowns or restrictions on our civil liberties. Will he assure me that no matter what vested interests have held sway in his Department and across Government in the past 18 months, he is clear that lockdowns and state intervention in the lives of our constituents have gone far enough and need to be curbed?

[Sajid Javid]

First, I am pleased that my hon. Friend agrees with the decision we have made to proceed with step 4. It sounds like he agrees with the central decision to move from a system of regulation to one of guidance. As he knows, the pandemic is not over, so we are rightly moving forward in a measured way. I am pleased that he agrees with the approach.

[James Sunderland]

I also welcome yesterday’s step 4 announcement. Does the Secretary of State agree that his Department should embrace a bit more risk by working with the Department for Transport to open up the international travel sector fully? Will he also ensure that GPs return to fully physical appointments and that we open up the full range of dental services?

[Sajid Javid]

I am pleased to tell my hon. Friend that, now that we have begun the process of opening up, more work is being done between my Department and the Department for Transport on international travel. The announcements made by my right hon. Friend the Transport Secretary last week will certainly help and be welcomed by the sector and travellers. On GP access, now that we have started to open up, working together with GPs we can see better direct access, and especially face-to-face access.

[Taiwo Owatemi (Coventry North West) (Lab)]

What steps he is taking to develop the role of pharmacies in primary care provision.

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[Ben Bradley (Mansfield) (Con)]

What steps his Department is taking to improve collaboration between health and social care.

[The Secretary of State for Health and Social Care (Sajid Javid)]

We can no longer just think of a health system; we have to think about the health and social care system. We want people’s experiences of care to be seamless, which is why we have introduced the Health and Care Bill and will debate its Second Reading today.

[Ben Bradley]

In order to better integrate and support local services in Nottinghamshire, we would benefit greatly from working with a single integrated care footprint for a simpler and fairer service. A boundary congruous with our county boundary would allow us to offer more equitable care across the whole area. I understand that the decision on the integrated care system boundaries is imminent, so will my right hon. Friend meet me to discuss the potential benefits?

[Sajid Javid]

I am aware that several factors are helpful in fostering stronger partnerships between the NHS and local authorities, including alignment of boundaries. My hon. Friend will know that the former Secretary of State, my right hon. Friend the Member for West Suffolk (Matt Hancock), asked NHS England to conduct a boundary review for integrated care systems. That review, which is just being completed, will certainly look at and give advice on the best ICS footprint for alignment. No final decision has yet been made, but it is a priority for me. I would be happy to arrange a meeting for my hon. Friend with Ministers to discuss the matter further.

[Afzal Khan (Manchester, Gorton) (Lab)]

What steps he plans to take in response to the findings of the Royal College of Paediatrics and Child Health on the effect of covid-19 on child health services, published on 14 June 2021.

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[Sally-Ann Hart (Hastings and Rye) (Con)]

  If he will make a statement on his departmental responsibilities.

[The Secretary of State for Health and Social Care (Sajid Javid)]

It is an honour to be here for my first oral questions as the Secretary of State for Health and Social Care, and I thank the Prime Minister for bringing me back from furlough. I accepted this role because I love my country and the NHS. I know that I join this Department at a pivotal time, and I have three pressing priorities for these critical few months. The first is getting us on the path out of this pandemic. The second is busting the backlog of non-covid services. The third is putting social care on a sustainable footing for the future. I want to draw on what I have learnt during this time of adversity and what we have all learnt together. I want to make this great nation a healthier and fairer place, and I am looking forward to working with all hon. Members in this House.

[Mr Speaker]

You missed the fourth: a 24-hour accident and emergency unit for Chorley.

[Sally-Ann Hart]

East Sussex Healthcare NHS Trust has the potential to get hundreds of millions in investment as part of the Government’s NHS estate infrastructure improvement plan. Will funding be allocated on a two to three-year basis, so that the NHS can better plan its funding and estates plans? Where funding has been indicated for a longer term, what plans are there to ensure that providers have sufficient resource in the shorter term to address immediate issues, or to support covid or recovery?

[Sajid Javid]

We have put more and more capital into the NHS. There are always representations from hon. Members, including you, Mr Speaker, for even more capital. My hon. Friend is right to raise the issue of the importance of local healthcare systems, which will need more capital funding as we progress. She will know that we set out our capital plans for this financial year, 2021-22, but she is right to say that multi-year funding will mean that trusts can plan better, and that is a priority; we want the spending review to have more sight and better planning for capital.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Let us consider these words about mental health services:

“prior to 2017, no government invested in or prioritised MH services.”

Those are not my words but the words of the Minister for Patient Safety, Suicide Prevention and Mental Health, the hon. Member for Mid Bedfordshire (Ms Dorries). Indeed, the new Secretary of State was the architect of these cuts, during his time as a Treasury Minister. The unparalleled devastation he left behind has been simply staggering, so does he agree with his Minister? Can he explain to us why 140,000 children were turned away from mental health services last year? Can he explain why a quarter of mental health beds have been cut since 2010? Is he ashamed of his track record?

[Sajid Javid]

The hon. Lady will know that the NHS long-term plan that has been set out by this Government is committed to a transformation in mental health services and mental health spending; some £2.3 billion extra is being invested by 2023-24. In addition, she will be aware of the mental healthcare White Paper and the mental health recovery action plan. I hope these are all initiatives she will support.

[Jeremy Hunt (South West Surrey) (Con)]

May I welcome the Secretary of State to his place? I am sure he will do an excellent job. As he thinks about a 24-hour A&E for Chorley, I hope he will also think about the urgent need for a cancer institute at the Royal Surrey County Hospital as only second on his list.

The Secretary of State will know that this morning the Health and Social Care Committee published a worrying report about the inhumane treatment given to 2,000 people with learning disabilities and autism in in-patient units, often because no community provision was available. When he brings forward his plans for social care, will he make sure that there is adequate funding for local authorities to give care to such people? Will he also make sure that care workers are always paid the minimum wage, including for the time taken to travel between appointments?

[Sajid Javid]

I welcome my right hon. Friend’s comments and the work that he and other Members do through the Select Committee to scrutinise the work of the Department. He just referred to some of that work, especially in his comments about learning disability and autism, which will remain a huge priority for the Government and certainly for my Department.

My right hon. Friend also rightly raised the issue of care workers and the minimum wage; it is worth pointing out that the Care Act 2014 requires local authorities, when they provide funding, not just to support the minimum wage but to take account of the costs that care workers might incur, such as travelling costs. I look forward to working with my right hon. Friend and the members of his Select Committee.

[Neil Coyle (Bermondsey and Old Southwark) (Lab) [V]]

I congratulate the Secretary of State on his new role.There are 1.5 million older people, disabled people and carers with unmet needs who are desperately waiting for care reform. What is the Secretary of State’s estimated start date for the implementation of the care package that the Government claimed was ready in their manifesto more than 20 months ago?

[Sajid Javid]

As the Government have said, we want to make sure that every person in this country has the dignity that they deserve in old age. We have recognised that the current system needs substantial reform. The process of reform has already begun in, for example, the Health and Care Bill that will have its Second Reading tomorrow, but we do need a new, sustainable way to fund care and we will come forward with the plans later this year.

[Stephen Metcalfe (South Basildon and East Thurrock) (Con)]

  I know that many of my constituents will be pleased to hear that from 16 August we will end the requirement for people to self-isolate after possible exposure to the virus if they are fully vaccinated. I am sure we all agree that it is right to change the rules as the information changes; however, will my right hon. Friend explain to the House the rationale for making this change on 16 August rather than next Monday?

[Sajid Javid]

I agree with my hon. Friend that it is good news that we can move away from restrictions and towards guidance. On the rationale for the decision he referred to, it is about vaccine effectiveness: we know that for those with both doses, vaccination is estimated to be 78% to 80% effective against symptomatic covid-19. The introduction on 16 August of the changes to which my hon. Friend referred will mean that more people will have been vaccinated and will help to reduce severe illness.

[Kate Osborne (Jarrow) (Lab) [V]]

Macmillan Cancer Support calculates that since March 2020, 37,000 fewer people than expected have started their first cancer treatment, including an estimated 66 people in my constituency of Jarrow who have not started their first treatment. Given that Macmillan estimates that the cancer system will need to work at 110% of capacity for the next 14 months to address the backlog, will the Secretary of State confirm whether the NHS is on schedule to tackle the backlog of cancer diagnosis, care and treatment by the current March 2022 deadline?

[Sajid Javid]

I want to reassure the hon. Lady—because this is such an important question for so many people across the country—that cancer remains a huge priority for this Government. She is right to refer to the work that Macmillan has done on this issue because, sadly, during the restrictions thousands of people have not come forward in the usual way and their cancer sadly remains undiagnosed. We urge anyone who feels that this is an issue for them: please, go to your GP—please come forward. That is one reason why we have launched the “Help Us, Help You” campaign. We have also provided additional funding for rapid diagnostic centres.

[Chris Loder (West Dorset) (Con) [V]]

Good afternoon from West Dorset, Mr Speaker. Constituents of mine have been in touch to say that they are struggling to get GP appointments either because there are not any, or because they are struggling with online booking and telephone consultations. That is resulting in people going to A&E, putting more pressures on their hospitals. What is my right hon. Friend doing to ensure that constituents, especially older constituents, can access a GP face to face if they need to?

[Sajid Javid]

I think we would all agree in this House that GP practices have done a magnificent job in responding to the pandemic, and I want to take this opportunity to thank all GPs and their staff for the work that they have done and that they continue to do. My hon. Friend is right to raise the issue of face-to-face access. We can all understand why it changed during the pandemic, but as we open up, we can start to provide more of this, particularly for older people. Over the coming weeks and months, that will be a priority for my Department.

[Taiwo Owatemi (Coventry North West) (Lab)]

Cancer Research UK estimates that, compared with pre-pandemic levels, nearly 45,000 fewer patients started cancer treatment in the UK in April 2020 to March 2021. It believes that this stems from there being less diagnosis during the pandemic. In England alone, 10,500 of those missing cases were breast cancer cases. What steps are the Government taking to reach out to those at risk of cancer who have not been diagnosed due to limited NHS access over the past 18 months?

[Sajid Javid]

As I said in response to an earlier question, this is a huge priority for the Government and, again, I am pleased that the hon. Lady has raised the issue. It is an issue for her constituents and for constituents throughout the country. She referred to the research by Cancer Research UK. I am afraid that it is right: there are thousands of people who did not come forward. We can understand why, so let me say this again as it is so important: for anyone concerned, please do come forward. We have provided additional funding—more than £1 billion—for more diagnostics and we will continue to provide additional support.

[Dr Caroline Johnson (Sleaford and North Hykeham) (Con) [V]]

  In vitro fertilisation treatment is a lifeline for many people desperate to conceive. My constituent Sarah Barker dreams of being a mother, but sadly suffers from an infertility problem. Sarah is being refused IVF treatment on the grounds that her partner already has a daughter from a previous relationship. Her petition to stop denying women fertility treatment for this reason has already reached almost 13,000 signatures. Does my hon. Friend agree that treatment for infertility should be available based on the medical needs of the women involved, and not affected by the partner that she has fallen in love with having a child from a previous relationship?

[Helen Hayes (Dulwich and West Norwood) (Lab)]

  Many of my constituents who are extremely clinically vulnerable due to conditions such as blood cancer are terrified that, from 19 July, the Government are effectively abdicating responsibility for keeping them safe in public. There is evidence that more than two thirds of people do not understand that vaccines are not always effective for people who are immuno-compromised or the importance of wearing a mask to protect others and to alleviate anxiety. Can the Secretary of State not see why it would send a much clearer message to keep masks on public transport mandatory, rather than leaving the safety of clinically vulnerable residents to chance?

[Sajid Javid]

The hon. Lady is right to raise this issue. As she has rightly explained, there will be a number of people who, understandably, will be concerned about the move away from regulations to guidance. None the less, there must come a point when we start to remove the restrictions slowly, in a measured way, as we are doing—not least because we want to be able to start dealing much more with all the non-covid health problems that have been created as well. We have provided very clear guidance on masks and it was published yesterday. I hope that the hon. Lady can share that with people who are concerned.

[Paul Holmes (Eastleigh) (Con) [V]]

We know that there have been hidden costs to the restrictions that are in place to protect us, including worsening mental health and the risk of domestic violence. Will my right hon. Friend confirm that the need to balance those risks with the reduced threat posed by the virus is a key part of the Government’s decision to lift restrictions?

[Sajid Javid]

Yes, I can confirm that. Removing restrictions is not without risk—I accept that—but keeping restrictions is not without cost. As my hon. Friend points out, the restrictions have led to increased domestic violence, child abuse, mental health issues and undiagnosed cancer, which we have heard about today, to name but a few. As we start lifting restrictions, that means that we can better deal with all these major non-covid health problems.

[Mr Speaker]

Wendy Chamberlain is not here, so I call Jason McCartney.

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[Wendy Chamberlain (North East Fife) (LD) [V]]

Thank you very much, Mr Speaker. When I return to my constituency of North East Fife, I will cross into Scotland, where the mandating of face masks is likely to continue. Is it the Government’s expectation that passengers will wear a mask only when they cross into Scotland—or, indeed, Wales? What consultation has happened with the Home Office in relation to guidance to the British Transport police? Do the Government accept that a lack of a four-nations approach to such measures is not helpful?

[Sajid Javid]

Throughout the pandemic, my predecessor and other Ministers have rightly been working with the devolved Administrations, and of course that work continues; it will remain a priority. I myself have already started weekly meetings with all my counterparts in the devolved Administrations. We discuss a number of issues and keep each other informed, but we also respect that in certain areas, in dealing with this pandemic, we may take a different course.

[Rushanara Ali (Bethnal Green and Bow) (Lab) [V]]

I congratulate the Secretary of State on his appointment. Cases of covid rose by 30% last week compared with the previous week, and on 10 July we saw over 35,000 new cases, the highest since 22 January. By mid-August we could see 1,000 people a day being hospitalised, and up to 200 people a day could die, despite the excellent vaccination programmes. Given that the Secretary of State now considers it irresponsible not to wear masks, is it not equally irresponsible for the Government not to require people to continue to wear masks rather than leaving it as an option?

[Sajid Javid]

The hon. Lady understandably talks about the link between case numbers and hospitalisation. She will know that the last time we saw cases at 30,000 and above on a daily basis, we saw a lot more hospitalisations. The reason for the difference now is the vaccine wall of defence. Masks do have an important role to play, but we think that that role can be played by moving from regulation to guidance.

[Mr Speaker]

I am suspending the House for three minutes to enable the necessary arrangements to be made for the next business.