Health and Social Care Leadership Review
Sajid Javid Excerpts(1 year, 10 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
With permission, Mr Speaker, I will make a statement on the independent leadership review of health and social care.
This is an important report that comes at a critical time. This Government are embarking on a huge programme of reform to tackle the covid backlogs, to improve people’s experience of the NHS and social care, and to place this system on a sustainable footing for the future. But we cannot seize this opportunity and deliver the change that is so urgently needed without the best possible health and care leadership in place, because great leaders create successful teams, and successful teams get better results. So a focus on strong and consistent leadership at all levels, not just on those who have the word “leader” in their job title, will help us in our mission to transform health and care and to level up disparities and patient experiences.
This review, which I have deposited in the Libraries of both Houses, was tasked with proposing how to deliver a radical improvement in health and social care leadership across England. It sets out a once in a generation shake-up of management, leadership and training, as well as how we can make sure that health and care is a welcoming environment for people from all backgrounds, free from bullying, harassment and discrimination.
The review was led by General Sir Gordon Messenger, former Vice-Chief of the Defence Staff, and Dame Linda Pollard, the chair of Leeds Teaching Hospitals NHS Trust. I thank them both for taking on this role and providing their varied experience of leadership, along with everyone in their review team who has contributed to this important review.
Before I turn to the recommendations of the review, I shall update the House on its findings. The review found that, although there are many examples of inspirational leadership within health and social care, from ward to board, these qualities are not universal. The report states that
“there has developed over time an institutional inadequacy in the way that leadership and management is trained, developed and valued.”
As a result, careers in management are not viewed with the same respect and prestige as clinical careers. The review also found
“too many reports to ignore”
of poor behaviour, and that the acceptance of bad behaviours like discrimination, bullying and responsibility avoidance has become “almost normalised” in certain parts of the system.
We must only accept the highest standards in health and care, where failures in culture and leadership can make the difference between life and death. So we must do everything in our power to share and promote brilliant, innovative management and to act firmly where standards fall short. This means culture change from the top of the system to the frontline. The review identifies a number of areas where improvement is needed, and it makes seven transformative recommendations. I will quickly update the House on each of them in turn.
First, the review recommends new measures to promote collaborative leadership and to set a unified set of values across health and care. This includes a new national entry-level induction for new joiners to health and care, and a new national mid-career programme for managers.
Secondly, the review recommends that we should agree and set uniform standards for equal opportunities and fairness, with more training to ensure that the very best leadership approaches become ingrained. The Care Quality Commission must support this work by measuring progress through regular assessments. This does not mean more people working in diversity but fewer. In my view, there are already too many of these roles and, at a time when our constituents are facing real pressures on the cost of living, we must spend every penny with care. Instead of farming out this important work to a specific group of managers, it must be seen as everyone’s responsibility, with everyone being accountable for extending fairness and equal opportunities at work.
Thirdly, the review recommends a single set of unified leadership and management standards for NHS managers. These standards will apply to everyone, including those who work part time and flexibly, with a curriculum of training and development to help people meet them. This modernisation is well overdue, and completing the training should be a prerequisite for advancing to more senior roles.
Fourthly, the review recommends a more simplified, standardised appraisal system for the NHS, moving away from variation in how performance and career aspirations are managed towards a more consistent system that takes into account how people have behaved, not just what they have achieved.
Fifthly, the review identifies a lack of structure around careers in NHS management. It proposes a new career and talent management function for managers at a regional level, to oversee and support careers in NHS management and to provide clear routes to promotion, along with training and development.
Sixthly, the review recommends that the recruitment and development of non-executive directors needs to be given greater priority due to their vital role in providing scrutiny and assurance. It proposes an expanded specialist appointments team in the NHS, tasked with encouraging a diverse pipeline of talent.
Finally, there is currently little or no incentive for leaders and managers to move into the most challenging roles, as the barriers are often seen as simply too high. I want leaders in the NHS to seek out those roles, not shy away from them. It is essential that we address that and get great leaders into areas that feel left behind. The review proposes an improved offer, with stronger support and incentives to recruit top talent into those positions.
We will be accepting these comprehensive, common-sense recommendations in full. The recommendations have been welcomed by groups representing people who work throughout the NHS, including by the NHS Confederation and NHS Providers. By taking the review forward, we can finally bring how we do health and care leadership into the 21st century, so that we have the kind of leadership that patients and staff deserve, right across the country, and so that we make sure that some of our country’s most cherished institutions can thrive in the years ahead.
I commend this statement to the House.
Wes Streeting (Ilford North) (Lab)
The Secretary of State has picked quite the week to talk about standards in leadership.
I give a huge thanks to NHS staff and leaders for the work they are doing against the most extraordinarily difficult backdrop. I also thank General Sir Gordon Messenger and Dame Linda Pollard for carrying out the review. Its seven recommendations are sensible, and I am pleased the Secretary of State has already committed to implementing them.
As this is a rare example of decisiveness from the Health Secretary, can he tell us when he intends to publish his implementation plan? All too often, the senior leadership of the NHS still does not represent the diversity of the population it serves. Instead of throwing red meat to his Back Benchers, for reasons that will probably be obvious to everyone, I would like to hear how, in particular, he intends to ensure that equality, diversity and inclusion will be improved, so that the best leaders are incentivised into the most challenging roles and are able to provide inclusive healthcare for the breadth of diversity in our great country. Can he explain why the review has not covered leadership in primary care or social care in any detail? Surely this is a missed opportunity. Let us face it: although he is trying to dress this up as the biggest shake-up in history, I am not sure that giving staff an induction on joining the NHS is a revolutionary development, and it hardly meets the scale of the challenge.
The NHS faces the biggest crisis in its history. NHS staff are in a system under pressure like never before, and there are simply not enough of them. There are currently 106,000 vacancies across the NHS, and staff are leaving in droves. In some specialties, such as midwifery, they are leaving faster than we can recruit them. I do not know how the Health Secretary expects NHS managers to demonstrate good leadership and deliver the best outcomes for patients when there are no staff to lead. For an organisation the size of the NHS, one of the biggest employers in the world, not to have a plan for its workforce is unbelievably negligent. What is the NHS meant to do until he eventually delivers his long-term workforce strategy, which he has been promising for some time? How are managers meant to lead effectively when instead of thinking about patient care as their primary driver, they have become buildings and facilities managers, because the ceilings are falling in? The only place where more than 40 new hospitals really exist is in the Prime Minister’s imagination.
The Health Secretary said that we should accept only the highest standards in NHS management, so let me ask him not about the generalities, but about the specifics. Last month, it was reported that North East Ambulance Service bosses oversaw cover-ups of negligence, leaving about 90 families not knowing how their loved ones died. He said yesterday that he is still considering whether to launch a review. Is he seriously considering protecting managers who cover up bad practice, instead of standing up for grieving families? Staff in that service were reportedly paid to sign gagging clauses, and I understand that attempts to get them to sign such clauses are still under way. In a written question, I asked how many non-disclosure agreements had been signed in the NHS since the Government said that they would be banned in 2014. He does not know and he is refusing to investigate the use of gaging clauses in the NHS. So how can he claim to be shaking up NHS culture and dealing with bullying when he has no interest in what is going on under his nose?
Of course the NHS needs good leaders, but when it comes to examples of poor leadership in the NHS, the Health Secretary did not need the Messenger review; he just needed to look in the mirror. This is the man who described the NHS as Blockbuster Video
“in the age of Netflix”,
as if it was the greatest revelation since Moses received the 10 commandments. Who has been in government for the past 12 years? On his watch, on this Government’s watch, we have the highest waiting times in the NHS’s history; the lowest patient satisfaction since 1997; longer waiting times for cancer in every year since 2010; heart attack and stroke victims left waiting for about an hour, on average, for ambulances; and patients at risk of serious injury because the hospital is crumbling around them. He kicked off his own Health Week expecting applause for the fact that, despite his best efforts, there are still 9,000 people waiting for more than two years for treatment. He knows, I know, NHS staff know and the public know that with this Government, NHS staff are lions led by donkeys, wanting and inadequate.
Sajid Javid
I am not surprised by the typical response from the hon. Gentleman: not really engaging with the real issues and showing once again that he is more interested in theatrics than in the real issues facing our NHS. He started his comments by trying to make some kind of joke about the leadership news this week, but we all know that he is only interested in one leadership review in a political party in this House, and it is not the Conservative party’s.
Let us look at the issues that the hon. Gentleman raised. He rightly talked about the importance of the workforce overall and how we need more doctors and nurses. He should know that we have more doctors and nurses than ever before and that we are recruiting at a faster rate than ever before, with 10,000 more nurses and over 4,000 more doctors in the past year, and more in training than ever before. However, he will know that dealing with the challenges of getting more workers and building those hospitals, all of which are on track, requires proper funding, yet he and his party voted against the funding that the NHS needed to achieve that.
The hon. Gentleman is right to talk about when things go wrong in the NHS. Of course they need to be properly investigated, as they were in Telford and Shropshire, when we learned about the terrible things that had been going on under successive Governments in that trust. When there is a need for other investigations to take place, including independent ones, such as the one I have just asked for in Nottingham, that will be done. But the hon. Gentleman should understand that the best thing, which is far better than doing a review when things go wrong, is not having things go wrong in the first place. That is why he should have welcomed this report.
Mrs Theresa May (Maidenhead) (Con)
This is an important review. There have been regular radical changes in the management of the NHS throughout my 25 years in this House, so may I suggest that my right hon. Friend proceeds with care? He rightly says that good leadership of the NHS is important, for example, to ensure that we can deal with the covid backlogs, and that includes consultants. Too many experienced consultants are leaving the NHS because of problems with their pensions, so will he now commit to an urgent review of this issue, including looking at the change in the abatement scheme?
Sajid Javid
I thank my right hon. Friend for her comments. I always listen carefully to what she has to say, given her important experience. On the pension issue, she will know that in the 2020 Budget, I believe it was, significant changes were made, especially to where the taper rate kicks in—it went from £110,000 to £200,000. That benefited the top 5% of earners in this country, but it was the right thing to do to encourage and incentivise doctors, in particular, to work more. She is right to talk about what more we can do. We are looking precisely at what further flexibilities we can offer on pension arrangements.
Barbara Keeley (Worsley and Eccles South) (Lab)
The Health and Social Care Secretary talks about strong leadership and culture change. I point out to him his Government’s and his Department’s dismal record in meeting the pledge to close the in-patient units that are being used to trap more than 2,000 autistic people and people with learning disabilities rather than support them in their own homes. We have just passed the 11-year anniversary of the scandal at Winterbourne View. Not only has his Government failed in their pledge to close down these units, which was the original promise made after that scandal, but 560 people in those in-patient units do not need to be there at all, a quarter of them are more than 50 km from their own home, people are spending longer in units now than they were seven years ago, and more people have been admitted to the units year on year from 2015-16. This is one of the biggest scandals and the worst failures of his Department and Government. When is he going to act on it?
Sajid Javid
The hon. Lady is right to highlight the importance of this issue and she will know that my predecessor had asked for a review on it. It was done and we have accepted its outcome, and it is being implemented. I hope she will understand that in implementing the outcome of that review it is important that we listen to clinical advice from within the NHS and make sure that we put the interests of each patient first.
Jeremy Hunt (South West Surrey) (Con)
I thank the Health Secretary for this excellent report and commend Sir Gordon Messenger and Dame Linda Pollard for all their work in putting it together. It has some very important recommendations. People who run hospitals are doing one of the most difficult jobs in Britain today, and anything we can do to give them better support in their careers will help all of us.
Does my right hon. Friend agree that the elephant in the room is that one thing that makes their job most difficult: we have more national targets in the NHS than any other health system anywhere in the world? That means not only that there is a risk of patients turning into numbers, but that we remove the autonomy from managers to show the leadership that Sir Gordon is advocating in this report. So as my right hon. Friend implements the recommendations, will he look at the role of national targets in the NHS and whether we need to simplify and reduce them?
Sajid Javid
I thank my right hon. Friend for his support of the report. Of course he speaks with incredible experience. He is right to raise the issue of the importance of targets, and sometimes targets can have unintended consequences. The report does talk a bit about the importance of that issue. I can assure him that as we make changes and work with our colleagues in the NHS to make reforms, we will certainly be taking that into account.
Derek Twigg (Halton) (Lab)
As the Secretary of State will have seen over his years as an MP and a Minister, there are managers and leaders who are excellent and outstanding and there are others who are not so good. Is not part of the problem, as the right hon. Member for Maidenhead (Mrs May) mentioned, the continual structural changes, which add to instability, the massive recruitment and retention problems and the record numbers of people using the hospitals? No matter what he does to improve leadership, it will not solve all those problems. Part of the problem is that we do not have enough people coming forward to take up leadership roles. At what point in the next five to 10 years does he expect to have solved the leadership crisis in the NHS?
Sajid Javid
The hon. Gentleman is right to talk about the importance of recruitment in the NHS—bringing in the right people in the first place and then retaining them—but I hope that he will also recognise that good leadership plays an important part in that. This morning, I went to Chelsea and Westminster Hospital, which is an outstanding and incredibly well run hospital, and heard from the leadership team about the important role that they play in attracting and retaining talent. I hope that he recognises that point as well.
Sir Desmond Swayne (New Forest West) (Con)
Why is the Secretary of State’s departmental leadership team advertising for a deputy director, delivery, for the Covid Pass programme? What is that about?
Sajid Javid
The reason why the Department keeps that under review is that, although the pass has stopped and there is absolutely no prospect that I can see of its ever coming back into place, it is right that, as we wind things down and work on the digital resources, all things are looked at appropriately.
Florence Eshalomi (Vauxhall) (Lab/Co-op)
On Thursday 19 May, I and a group of south London MPs met south London nurses from the Royal College of Nursing. They told us that they are tired. They told us that they are fed up. They told us that they are having to use food banks. They told us that they are seeing their salaries squeezed by the cost of living. They told us that they face bullying, intimidation and abuse at work. This was coming from staff members who work in our hospitals, including at St Thomas’s Hospital, in my constituency, which I know the Secretary of State has visited on many occasions.
There is a big gap—an omission—around this leadership issue in social care. We have big retention issues. There are more than 9,000 vacancies. Does the Secretary of State have a plan to address that big omission in health and social care, including retaining the people we need on the frontline?
Sajid Javid
The short answer is that, yes, the hon. Lady is right to talk about the importance of retaining and recruiting more nurses. When it comes to nurses’ pay, she will know that we gave a 3% rise last year when there was a freeze for the public sector workforce generally. This year, we will be listening carefully to what the independent recommendation is.
John Redwood (Wokingham) (Con)
How many directors and chief executives of health bodies are there in the NHS, and what performance requirements are built into their contracts? We want them to deliver high-quality care with falling waiting times.
Sajid Javid
I cannot give my right hon. Friend the exact number that he is asking for, but I can answer the latter part of his question. I agree that we want to see a massive improvement in appraisal and performance standards; I am sure that, when he gets to see the report in detail today, he will be pleased by what he reads.
Grahame Morris (Easington) (Lab)
The Secretary of State said that we must accept only the highest standards and act where standards fall short. My constituent, Paul Calvert, bravely exposed the management failures of the North East Ambulance Service and, indeed, the criminal negligence of cover-ups of patient deaths.
Mr Calvert, who gave me his permission to raise this case—I met him in person last week—is being bullied, harassed and blackmailed, but he still refuses to sign a non-disclosure agreement. He was offered £41,000 conditional on his silence and on destroying the evidence that he has of wrongdoing. Tomorrow, we anticipate his employment being terminated. Mr Calvert and grieving families want a public inquiry into the North East Ambulance Service. Does the Health and Social Care Secretary agree, and will he outline how the Messenger review will protect NHS whistleblowers such as my constituent, Mr Calvert?
Sajid Javid
I thank the hon. Gentleman for bringing Mr Calvert’s case to my attention. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), has listened to that carefully. She is meeting some of the families affected by that case very shortly, and Mr Calvert is someone to whom she can reach out directly.
Like the hon. Gentleman and, I am sure, the whole House, I am very concerned about what I have heard about this ambulance service. I am not satisfied with the review that has already been done. We need a much broader and more powerful review. I will have more to say on the matter very shortly.
Mary Robinson (Cheadle) (Con)
I welcome this review and thank my right hon. Friend for bringing his statement to the House. Good leadership is important because it drives the culture within an organisation. It was terrible to hear what the hon. Member for Easington (Grahame Morris) had to say just now. We can see that bullying and harassment in an organisation often come down to how the leadership and the processes are operating.
Whistleblowers need to know that they can rely on the processes within organisations, but who do they go to as well? The National Guardian’s Office would be one, as would the local guardians in the hospitals. I recently introduced a whistleblowing Bill to ensure that people are able to go to another body, because they cannot be constricted within their organisation. We need to be able to benefit from whistleblowers who speak out and expose wrongdoing so that we can close down these cultures that we have seen operating in our organisations.
Sajid Javid
My hon. Friend is right: it is important that, where people who are working within the NHS or social care see wrongdoing or things that concern them, they have a safe space to report that and to make sure that their concerns are properly addressed. She will know that the Health and Social Care Act 2022 contains new provisions, including one for the Health Services Safety Investigations Body, but I have listened carefully to what she has said and I will consider what more we can do.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
The Secretary of State might recall that, as a member of the all-party group for management, I have had a long interest in management and good management. I congratulate him on having this review, because the NHS is a complex organisation.
The Topol review that was carried out only two or three years ago showed a world of technology and change that is almost beyond belief for such a massive human organisation. I have not had the time to read the report yet, but is the Secretary of State sure that we have high-quality training for our managers? Many of the business schools and many of the people providing the training in our universities are not training for that kind of environment. We do need first-rate, high-quality management schools with a health bias.
Sajid Javid
I agree with the hon. Gentleman. I know that he has a long-standing, valuable interest in this issue. I appreciate that he has not had time to look at the report, but I think he will be pleased when he reads our recommendations around a modern training plan.
Mr Peter Bone (Wellingborough) (Con)
The most important thing that happened in Westminster this week was yesterday’s reception for Harry’s Pledge. Harry is a young boy who needs a lot of care. Harry’s Pledge campaigns for the needs of carers and those who are cared for. I am introducing a private Member’s Bill to give guidance for that. Will the Secretary of State look at that Bill to see whether the Government could support it? Leaders in care need to have the guidance to judge whether they are succeeding.
Sajid Javid
This is a very important issue for my hon. Friend. I would be happy to meet him to discuss it further.
Clive Efford (Eltham) (Lab)
NHS staff are exhausted and demoralised, and now we are asking them to deal with the growing waiting lists. We still have a huge vacancy problem within our NHS. Where is the plan to deal with that issue? If we are to improve our NHS going forward and have anything there for these managers to manage, we need to deal with that problem within the workforce.
Sajid Javid
That is exactly why I have commissioned a 15-year workforce strategy from the NHS.
Lucy Allan (Telford) (Con)
I thank the Secretary of State for his statement and congratulate him on the work he has been doing in this important area. Does he agree that for too long there has been a culture of a lack of accountability among NHS senior management, and too often a blame culture, where things go wrong but are not transparently acknowledged? Does he agree how awful that is for the patients concerned? Will he do everything possible to ensure that we tackle the blame culture and the lack of accountability to the public, who the NHS is there to serve?
Sajid Javid
I agree very much with my hon. Friend. She will know from her own NHS trust, particularly the maternity problems there and the terrible cases set out in the Donna Ockenden report, just where that kind of culture can lead. Of course there are fantastic examples day in, day out of great culture and great leadership in the NHS, but there are also poor outcomes. She is absolutely right that we need to tackle those. That is exactly what is in this report.
Alex Cunningham (Stockton North) (Lab)
I cannot really understand why yet another restructure of the NHS is the answer to the crisis we face. The last one diverted billions of pounds from patient care, and millions of people are suffering as a result. Instead of yet another costly restructure, why does the Secretary of State not just get on with building the new hospitals we need, such as the one at North Tees in Stockton, and tackling the health inequalities that blight our communities?
Sir David Evennett (Bexleyheath and Crayford) (Con)
I warmly welcome my right hon. Friend’s statement on the review and his strong support for inspirational leadership, which is key for our NHS. Does he agree that relevant training and career development are vital for all staff working in the NHS, to allow them to gain career advancement?
Mr Clive Betts (Sheffield South East) (Lab)
I hope the Secretary of State will agree that it is key that managers in the NHS and local authorities can work together effectively. I give great credit to the leaders in the clinical commissioning group, the hospital trust, the director of public health, the social care directors and the city council, who worked really well together in Sheffield during the pandemic to deliver a joined-up service and have kept us as MPs thoroughly involved.
As we move on to the slightly wider integrated care system and integrated care board, will he give a commitment that the place-based working that has been so effective in the past will be allowed to continue at local authority level?
Sajid Javid
The place-based working that the hon. Gentleman talks about is also at the heart of the integration White Paper that the Government presented recently.
Dr Andrew Murrison (South West Wiltshire) (Con)
I welcome Gordon Messenger’s review, but does the Secretary of State not agree that in the history of the national health service, reorganising senior management has often been a distraction? Will he prioritise the area that would make a real change to health and care—the interface between the two—and focus on career progression and development for care workers in particular, who hold the key to unblocking the awful problems that we have in both sectors?
Sajid Javid
I know my right hon. Friend speaks with experience, and I appreciate that he will not have had time to look at the report in detail yet, but I think when he does read it he will find that it is precisely what he has just asked for. This is not a reorganisation; it is all about strengthening management, and the report sets out in quite some detail how that can work.
Nick Smith (Blaenau Gwent) (Lab)
I agree with the right hon. Member for Maidenhead (Mrs May) on NHS reorganisations. I once met a very senior and very able NHS manager who said they had been through 14 restructures of the NHS and they quite liked number five. How will this review better integrate ambulance services with their local hospitals to improve performance standards for local patients?
Sajid Javid
When it comes to ambulance services, an important part of the NHS, this review is just as important. We all want to see good leadership in ambulance services, but if we get better leadership across the board we will see better collaboration and co-ordination—something heavily referred to in the report.
John Stevenson (Carlisle) (Con)
I welcome this statement; leadership is vital and it is something we do not talk enough about in this country, whether in the private or public sector. My right hon. Friend referred to recommendation 6 on non-executive directors. Does he agree that we need to attract a more diverse set of non-executive directors, with regard to their skillset as much as anything else?
Jim Shannon (Strangford) (DUP)
I thank the Secretary of State for his statement and for the commitment to quality leadership within the NHS. As he said himself, that is so important. The review findings and recommendations are a method to deliver that improvement. Retention of staff—the consultants, the GPs, the doctors and the nurses—is core to any improvement, so what is being done to retain staff and not lose them? Is it the Secretary of State’s intention to share the findings with regional Administrations, particularly the Northern Ireland Assembly, to provide betterment across all the United Kingdom of Great Britain and Northern Ireland?
Sajid Javid
The hon. Gentleman will know that the review specifically looked at the NHS and care in England, but there are important lessons here that can be drawn on by, for example, the health service in Northern Ireland. On the issue of retaining staff, the NHS is undertaking many initiatives to improve that, but I hope he will agree with me that one key way to retain staff is to ensure we have good leadership and good managers.
James Wild (North West Norfolk) (Con)
The review underlines how vital leadership is to driving change and improvements in care. I put on record my thanks to the chief executive and board of the Queen Elizabeth Hospital Kings Lynn NHS Foundation Trust, who have taken that hospital out of special measures, thanks to the hard work of the staff. As my right hon. Friend knows, to continue to improve care and to retain and recruit staff there is a pressing need for a new hospital for the QEH. I urge him to make an announcement on the new hospitals programme and to back QEH’s bid.
Sajid Javid
My hon. Friend rightly never misses an opportunity to make the case for his local hospital. I have heard him carefully and I am happy to meet him to discuss it.
Stephen Hammond (Wimbledon) (Con)
I thank my right hon. Friend for his statement and for the report. Recommendation 4 talks about a standardisation of appraisal. Does he agree that cutting out variation in performance is key, and will he therefore confirm that the recommendations from Tim Briggs’s “Getting It Right First Time” report will be embedded in that standardisation procedure?
Sajid Javid
I agree with my hon. Friend: that recommendation for a standard appraisal system, which, remarkably, does not exist at the moment, is of particular importance, like all of the recommendations. I agree with the emphasis he puts on that.
Richard Graham (Gloucester) (Con)
The focus that the Health Secretary is giving to leadership management training must be right. We all know that in a Care Quality Commission report on a hospital or an Ofsted report on a school, one of the key differences between adequate and outstanding is the quality of leadership. All credit to the report for focusing on that; I think we would all benefit from understanding that it is one of the key characteristics of hospitals whose internal staff surveys show strongly positive morale—often a key leading indicator.
Will the Secretary of State say a word or two about the point raised by the hon. Member for Easington (Grahame Morris)? The report and what has come out of the North East Ambulance Service are truly shocking and highlight what I think Sir Gordon Messenger called a need for a change of culture. How can we encourage all our NHS trusts to be open and transparent about what has gone wrong, so that we do not have future scandals like that?
Sajid Javid
My hon. Friend will see when he has had the opportunity to read the report in full that it does rightly talk about the importance of that particular issue: ensuring that people within the NHS and care feel comfortable coming forward when they see wrongdoing, so that we can act much more quickly. That is why we will be implementing all the recommendations. Regarding the North East Ambulance Service, I hope he heard what I said earlier about the need to look at that again very carefully.
Mr John Baron (Basildon and Billericay) (Con)
As a former chair of the all-party parliamentary group on cancer for 10 years, I welcome this review. However, I put it to my right hon. Friend that at least part of the problem with waiting times and lists is the fact that only around half of all NHS staff are clinically trained. There is an imbalance there. Following my amendment during the passage of the Health and Care Act 2022, which he accepted, I suggest that one thing that could really help would be to get the NHS to focus more on outcomes such as one-year cancer survival rates, as a means of encouraging earlier diagnosis, and less on processes, which are very management-heavy.
Anna Firth (Southend West) (Con)
I thank the Health Secretary for this vitally important report at this critical time. Is he aware of reports circulating in the media that some NHS health information pages appear to have been de-sexed in their language about conditions affecting women? Is he, like me, very concerned about this, and will he look into it?
Sajid Javid
My hon. Friend will not be surprised to learn, I hope, that as Health Secretary I think an individual’s biological sex is incredibly important when trying to meet their health needs. I have seen the reports. In fact, I do not think they are just reports. With regard to the NHS website on ovarian cancer, I think it is actually has been, as she puts it, de-sexed. That is not something that I agree with. Of course, issues of gender, rather than sex—I distinguish the two—should be approached with compassion and sensitivity, but it is right that when it comes to healthcare, where there are health issues that impact only people of a particular biological sex, such as ovarian cancer and prostate cancer, the health service recognises that.
Jerome Mayhew (Broadland) (Con)
I am very concerned that the review found evidence of a blame culture and responsibility avoidance. We have to be clear that this culture is not just damaging but actually kills patients, because lessons are not learned from mistakes that are actively hidden. What can we learn from the airline industry, which adopted a no-blame culture and, through that, dramatically reduced airline-related deaths?
Sajid Javid
It was precisely because of that important point raised by my hon. Friend that when we had the recent Bill before Parliament—now the Health and Care Act 2022, thanks to the will of this House—we accepted the safe space amendment.
Duncan Baker (North Norfolk) (Con)
I recognise the importance of leadership and reform of the NHS. Can we now show some leadership and reform in the area of NHS dentistry? The Labour Government wrecked NHS dentistry when they brought in the contracts that have led to dentists leaving the profession in droves. When people up and down the country, including my constituents in North Norfolk, cannot see an NHS dentist, is it not about time that we reformed the rotten contracts that Labour brought in?
Sajid Javid
My hon. Friend is right. It is well known how the Labour Government came up with contracts with the British Dental Association that are leading to poor outcomes for millions of people across the country. We have already made some short-term changes, and we are in the process, right now, of making some longer- term strategic changes that will create all the right incentives.
Monkeypox
Sajid Javid Excerpts(1 year, 11 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
Following announcements made by the UK Health Security Agency on 7,14,18 and 20 May, I am writing to inform the House that—as of 12 pm on Monday 23 May 2022—a total of 56 monkeypox cases, in three unlinked incidents, have now been confirmed in the UK. Further cases have been identified worldwide, outside the endemic regions of west and central Africa.
Monkeypox virus in the UK is extremely rare and the detection of monkeypox in unlinked cases indicates community transmission. Prior to May 2022, there were three previous domestically acquired cases—two household transmissions related to an imported case and one healthcare worker related to a separate imported case.
In the coming days, I expect that further cases will be detected by the UK Health Security Agency’s expert diagnostic capabilities, working with NHS services to ensure heightened vigilance among healthcare professionals.
The UK was the first country in the world to identify and report this recent emergence of non-endemic cases to the World Health Organisation, which continues to receive reports of further cases in other countries across the globe.
The infection can be passed on through direct contact with monkeypox skin lesions or scabs; contact with clothing or linens—such as bedding or towels—used by an infected person; and potentially by close respiratory contact via coughing/sneezing by an individual with a monkeypox rash. Monkeypox has not previously been described as a sexually transmitted infection, though it can be passed on by direct contact during sex. A notable proportion of cases have been among gay, bisexual and other men who have sex with men.
The virus does not usually spread easily between people without close contact and the risk to the UK population remains low.
World-leading experts at the UK Health Security Agency, working in partnership with health protection agencies in Scotland, Wales, and Northern Ireland, are providing the latest scientific, clinical and public health advice. They are also providing testing capability at the Rare and Imported Pathogens Laboratory at UKHSA Porton Down and have stood up additional capacity at UKHSA Colindale. They continue to contact trace, rapidly investigate the source of these infections, and raise awareness among healthcare professionals. Any close contacts of the cases are being identified and provided with health information and advice.
UKHSA, and its partner public health agencies in the devolved Administrations, will continue to keep the scientific and clinical evidence under review to ensure that decisions are made on the best available evidence despite the fast-moving situation.
Individuals, especially gay, bisexual and other men who have sex with men, who develop an unusual rash or lesions—such as scabs—on any part of their body, but particularly their genitalia, should contact NHS 111 or a sexual health service. Individuals should notify clinics ahead of attendance and avoid close contact with others until they have been seen by a clinician. They can be assured that discussion will be treated sensitively and confidentially.
UKHSA has set up a dedicated helpline to support clinicians dealing with monkeypox cases.
Vaccination and treatment
The smallpox vaccine, Imvanex (MVA-Bavarian Nordic), although not specifically licensed for the prevention of monkeypox in Europe, has been used in the UK in response to previous incidents. This vaccine has a good safety record; it is made from a smallpox-related virus that cannot replicate and has been demonstrated to be highly effective at preventing infection—when given within four days of exposure—and reducing severe illness, if given between four and 14 days of exposure.
The vaccination of named close contacts of cases is under way, with vaccine eligibility being kept under close review. As of 10 am on 23 May 2022, over 1,000 doses of Imvanex have been issued or are in the process of being issued, to NHS trusts. There remain over 3,500 doses of Imvanex in the UK.
We are also exploring procurement options in case any specific antiviral treatment is shown to be effective against this virus; further details will be provided in due course.
I can confirm to the House that it will be kept abreast of updates as the situation evolves.
[HCWS49]
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Sajid Javid Excerpts(1 year, 11 months ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) affects the lives of children and adults across the country. It can be an incredibly disabling condition with fluctuating symptoms, making it difficult to take part in everyday activities, enjoy a family or social life, access services and engage in work or education, especially for the estimated 25% of people who have severe or very severe symptoms. Whilst there are currently no known cures or treatments for the condition, people with ME/CFS can be supported to manage their symptoms and maximise their quality of life.
Today, on World ME Day, I have two announcements to make to show that the Government are committed to better care and support for people living with ME/CFS and their families.
Firstly, I am pleased to welcome today the publication of the top 10 (plus) research priorities for ME/CFS, published by Action for ME and agreed by the James Lind Alliance Priority Setting Partnership on ME. This partnership included people with lived experience and clinicians working together to reach a consensus. I want to thank Action for ME and everyone who took part in this important work, recognising that for many this would have taken considerable effort.
To support these research priorities, I will co-chair a roundtable with my Department’s chief scientific adviser, Professor Lucy Chappell, to bring together experts on ME/CFS, including people with lived experience, to discuss what needs to happen next. The chief scientific adviser has asked the UK clinical research collaboration to convene a subgroup on ME/CFS to work with funders, researchers, charities, and people with ME/CFS to drive high-quality applications for research into ME/CFS and support the research community to build capacity and capability in this field. We are committed to funding research into this important area. Funding for high-quality research into ME is available through existing commitments of HM Government to research and development. The National Institute for Health and Care Research (NIHR) will work with the research community to respond to the priorities as set out in the Priority Setting Partnership, alongside other funding partners.
Secondly, I am announcing the Government intention to develop a cross-Government delivery plan on ME/CFS for England, aligning with other devolved nations as appropriate. In particular, we are engaging with the Scottish Government to explore areas of potential shared interest and learning, especially in terms of research into ME/CFS.
This will build on the recommendations of the priority setting partnership, the recently updated guideline for ME/CFS from the National Institute for Health and Care Excellence, and the comprehensive work of the All-Party Parliamentary Group on Myalgic Encephalomyelitis to date.
At the heart of the delivery plan will be two core principles: firstly, that we do not know enough about ME/CFS, which must change if we are to improve experiences and outcomes; secondly, we must trust and listen to those with lived experience of ME/CFS.
Following this announcement, officials will work with stakeholders ahead of publishing the delivery plan later this year.
[HCWS23]
Oral Answers to Questions
Sajid Javid Excerpts(2 years ago)
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Sir Charles Walker (Broxbourne) (Con)
The Secretary of State for Health and Social Care (Sajid Javid)
I know that my hon. Friend has long been a passionate advocate for a smoke-free England, and I read his recent Westminster Hall debate with interest. Some 64,000 deaths a year are attributed to smoking and it is one of the greatest drivers of health disparities in our country. I am personally determined that we should do everything we can to reach the Government’s ambition of a smoke-free 2030. That is why, in January, I asked Javed Khan to lead an independent review into tobacco control. Once that review is complete, the Government will set out their next steps.
Sir Charles Walker
To get to a smoke-free 2030, for every 100 people smoking today we need to reduce that figure by eight, because “smoke-free” actually means 5% or less of the adult population smoking. Can I ask the Secretary of State to ruthlessly target the barriers that stop people stubbing out their last cigarette? We need to get the numbers of smokers down; otherwise, 2030 will be an ambition that is not achieved.
Sajid Javid
My hon. Friend is absolutely right. The smoking rate is currently 13.5%, which is the lowest on record. However, smoking remains the largest driver of health disparities in our country. The new tobacco control plan, which will be informed by the new independent review, will be looking to do exactly what my hon. Friend says.
Mr Barry Sheerman (Huddersfield) (Lab/Co-op)
As one of the original campaigners for a ban on smoking in public places, I fully support what has just been suggested, but can I go further and beg the Secretary of State to come up very soon with a plan so that every child, every person and every family in this country can breathe clean, fresh air away from the pollution coming from diesel vehicles and other sources?
Sajid Javid
The hon. Gentleman has long been a campaigner on this issue and I commend him for that. He is right to continue pushing. I do not want to pre-empt the outcome of the independent review because it is just that, a review fully independent of Government. However, once it is complete—I hope to publish it in May—we can set out our plans.
Ben Bradley (Mansfield) (Con)
Andrew Lewer (Northampton South) (Con)
The Secretary of State for Health and Social Care (Sajid Javid)
The past few years have shown that we are strongest when we work together. Earlier this year we published the integration White Paper, drawing on our experience of the pandemic to develop a plan that will bring together the NHS and local government to deliver jointly for local communities. We have also created integrated care partnerships, such as the programmes in mid-Nottinghamshire and Northamptonshire, through which we are already showing how we can bring together health and local social care services.
Ben Bradley
As covid regulations come to an end, I understand that the discharge fund is also set to end. This could leave local government vulnerable where there are no formal procedures locally to pass funding from the NHS to local government services and local authorities. Particularly as we seek to reduce hospital backlogs, it is vital that we get people out of hospital and into appropriate care settings. Will my right hon. Friend assure me that, where local authorities seek to tackle such backlogs, they will have access to appropriate funding?
Sajid Javid
I can give my hon. Friend that assurance. Of course, we are already putting in record funding for local authorities and the NHS to deal with backlogs. I believe the plan we set out earlier this month for the integration of NHS and local authority care services will make a real difference.
Andrew Lewer
I thank the Secretary of State for referring to the work in Northamptonshire to integrate health and social care. Can he assure me that the central role of local government in ensuring that health and social care services work together to make the most efficient use of local resources will continue? And will he give me a clear guarantee that adult social care will not be taken over by the NHS?
Sajid Javid
I am pleased to give my hon. Friend the assurance he seeks. The integration White Paper signals our intention to go further and faster on health and care integration, building on the work already being done by the NHS, adult social care and local government to deliver services jointly. The plan will lead to better collaboration, and we want to make sure that overall responsibility is still shared between local authorities and the NHS.
Valerie Vaz (Walsall South) (Lab)
The Secretary of State will know that Walsall Manor has been merged with the Royal Wolverhampton—they share a chief executive and chairman—without consultation with local people. How on earth can integration take place when Walsall Manor does not have a full-time chief executive to ensure that it happens? Will the Secretary of State please ensure that Walsall Manor gets its own chief executive?
Sajid Javid
I understand the right hon. Lady’s point, but it is about what works on the ground. My understanding is that what is happening in her area is about a shared management team that shares best practice and tries to address challenges together, rather than any kind of formal merger.
Alex Norris (Nottingham North) (Lab/Co-op)
Across the country, tens of thousands of people sitting in hospital are medically fit to go home but cannot do so due to a lack of social care. The Health and Care Bill should have addressed that, but it does not. Rather than making us wait for more legislation, will the Secretary of State at least concede that local health leaders, be they in clinical commissioning groups or in integrated care systems in shadow form, should be driving this locally as a matter of urgency?
Sajid Javid
That is exactly what the new integrated care systems are all about. My understanding is that the hon. Gentleman sat on the Health and Care Public Bill Committee, which made it a reality.
Mr Speaker
I call the shadow Secretary of State, Jake Berry. [Laughter.] Sorry, Wes Streeting.
Wes Streeting (Ilford North) (Lab)
Thank you, Mr Speaker. You have clearly had a happy Easter.
The fact is that the Government’s failure to fix the social care crisis is causing huge pressures on the NHS. As of last week, more than 20,000 patients were fit to leave hospital but could not be discharged because the care was not available, which means that 22,000 patients each month are waiting more than 12 hours in A&E and that heart attack and stroke victims have to wait more than an hour for an ambulance. We are used to hearing about winter crises, but is it not the case that, after more than a decade of underinvestment in the NHS, a failure to fix social care and the absence of a plan even to address the staffing challenge in the NHS and social care, we have not just a winter crisis but a permanent crisis in the NHS?<
Sajid Javid
That is not the case at all. The hon. Gentleman knows, although he pretends not to, that the NHS and social care are facing unprecedented pressure because of the pandemic. He will know that as a result of the pandemic, both in NHS settings and in adult social care there has been a necessity for infection and protection controls. He will know that, sadly, staff absences are higher than they have been in normal times. But the NHS is stepping forward, with its colleagues in adult social care, to provide whatever support it can bring, especially with the record funding the Government are providing, both to the NHS and to adult social care.
Jake Berry (Rossendale and Darwen) (Con)
My hon. Friend the Member for Hyndburn (Sara Britcliffe) and I have been working with east Lancashire local authorities and our GP services to see whether we can increase the number of face-to-face GP appointments. Will the Secretary of State say what action he and the Government are taking to ensure that people in east Lancashire can see their general practitioner face to face?
Sajid Javid
My right hon. Friend is absolutely right to raise this issue. We have heard time and time again in this Chamber about the pressures our constituents are facing in order to get that kind of face-to-face access to their GPs. We all know why the situation was particularly bad at the height of the pandemic, but we expect it to improve rapidly. The percentage of people being seen face to face is increasing substantially, in large part because of the measures the Government have taken, including the £250 million access fund that was announced a few months ago.
Martyn Day (Linlithgow and East Falkirk) (SNP)
Thank you, Mr Speaker.
Integration and service improvement cannot be delivered without sufficient staff, and the only way to attract people to a career in social care is by valuing them. In Scotland, they are already paid better than those in England and Wales, and through the national care service the Scottish Government will improve terms and conditions for care workers, through the introduction of national pay bargaining. Have the UK Government considered following the Scottish Government’s approach and commitments?
Sajid Javid
Integration between the NHS and social care requires the right level and quality of workforce, both in the NHS and in adult social care. In the NHS in England, we have more doctors and nurses—more people working than ever before. In adult social care, we are recruiting at high levels, not least because of the huge recruitment campaign we ran with the sector, and some of the other changes we made, including the £400 million- plus of retention funding over the winter period. In addition, the support for the workforce more generally is making a real difference.
Mr Peter Bone (Wellingborough) (Con)
In north Northamptonshire, integration is getting on very well, with Councillor Helen Harrison heading the adult social services. However, going back to what my hon. Friend the Member for Northampton South (Andrew Lewer) said, there is the worry that because the NHS is so big it will overwhelm local government. I have told the Secretary of State that they do not want to mess with Helen Harrison, but can he ensure that there is a mechanism for reviewing that?
Sajid Javid
I know that my hon. Friend knows Helen Harrison extremely well, but he is right to talk about the importance of the NHS and the adult social care sector and local authorities working together. We must make sure that it is a true partnership, where one does not overwhelm the other and they work together towards their shared interests.
Helen Morgan (North Shropshire) (LD)
One key cause of the urgent care crisis in Shropshire, in the Shrewsbury and Telford Hospital NHS Trust, is the inability to discharge patients who are medically fit to go home into social care in the community. Shropshire Council’s resource challenges in that area are well known. Will the Secretary of State commit to putting extra resource into social care in Shropshire so that the medically fit can be discharged into the community when they are ready?
Sajid Javid
The hon. Lady is absolutely right to raise this issue, and the whole House heard just before the recess the results of the independent work done by Donna Ockenden. The hon. Lady is right to talk about that and the pressure that has been faced locally. I understand that she has already reached out to my hon. Friend the Minister for Health and that he will be meeting her to discuss just that.
Tom Hunt (Ipswich) (Con)
Rushanara Ali (Bethnal Green and Bow) (Lab)
The Secretary of State for Health and Social Care (Sajid Javid)
I am determined to tackle unfair disparities in health outcomes. That is why I launched the Office for Health Improvement and Disparities. OHID’s regional directors of public health will work with local government and the wider health system to empower local partners with the tools they need to respond to disparities in their regional and local areas. We will also publish a health disparities White Paper later this year, with a strong focus on prevention, to improve health for the whole population.
Rushanara Ali
I thank the Secretary of State for his answer, but a decade of under-investment and mismanagement have left 4.5 million people on waiting lists and staff shortages of more than 100,000 people even before we entered the pandemic, which exacerbated health inequalities. I welcome the work his Department is doing, but the reality is that people who live in a constituency such as mine are twice as likely to end up on a waiting list for treatment for more than a year as those in better-off areas. While I welcome what he has announced today, may I ask that he puts in appropriate investment to go along with tackling those appalling health inequalities?
Sajid Javid
The hon. Lady is right to talk about the importance of tackling health inequalities; on that we absolutely agree, and I hope she will contribute to the health disparities White Paper that I mentioned a moment ago. However, it is wrong of her to suggest that some of the current challenges we face are because of under-investment or because of a smaller workforce than otherwise. We have the largest investment ever going into the NHS. Its budget this year is bigger than the GDP of Greece. It is the highest amount ever, rising by billions each year. We also have more going to social care than ever before, and the highest level of workforce that the NHS has ever seen in its history.
Dame Caroline Dinenage (Gosport) (Con)
Surely one of the cruellest health inequalities is in fertility treatment. Of the 106 CCGs in the country, only six limit the age at which women can have in vitro fertilisation treatment to 35, and two of those are in Hampshire. Will the Secretary of State meet me to discuss how we can end that most devastating of postcode lotteries?
Sajid Javid
My hon. Friend is right, and of course I will be happy to meet her and discuss this further, but I can also tell her that that is one of the key things we will be covering in our upcoming women’s health strategy.
Andrew Gwynne (Denton and Reddish) (Lab)
Warm words from the Secretary of State, but people in the most deprived parts of England are almost three times as likely to lose their lives from an avoidable cause as those in the least deprived areas. With the cost of living soaring and the Resolution Foundation estimating that 1.3 million people will be pushed into poverty as a result of the Chancellor’s spring statement, those inequalities will worsen. Why will the Secretary of State not just admit that his Government have failed the poorest communities, and start doing something about it?
Sajid Javid
The hon. Gentleman acts as though health inequalities are something that has just emerged under this Government. There have been long-running health inequalities in this country over decades under successive Governments, and this Government are putting in record investment and coming up with the ideas to deal with them. As ever, the Labour party has no idea how to deal with the challenges this country faces.
Jonathan Gullis (Stoke-on-Trent North) (Con)
Mental health is a serious challenge of our time. It is totally unacceptable that waiting times, average number of sessions and minimum number of sessions differ according to which part of the country someone lives in. Sadly, recent statistics show that in Stoke-on-Trent people are taking their own lives at double the national average. That is why I am proud to support the cross-party “No Time to Wait” campaign, led by James Starkie with the backing of The Daily Telegraph and the Royal College of Nursing, for the provision of mental health nurses in GP surgeries, which could make a real difference to those who bravely come forward asking for help. Will my right hon. Friend meet me, hon. Members of this House who are supportive, and James to discuss how we can make that possible?
Sajid Javid
Yes, of course; I would be delighted to meet my hon. Friend and others to discuss the campaign. He speaks with passion and I know this is something he has long campaigned on. I have had time to look at some of the content of the campaign, but I would certainly be happy to discuss it further.
Dr Alan Whitehead (Southampton, Test) (Lab)
David Simmonds (Ruislip, Northwood and Pinner) (Con)
The Secretary of State for Health and Social Care (Sajid Javid)
Personalised healthcare is a key priority in my reform agenda. I recently set out a new ambition: that as many as 4 million people benefit from personalised care by 2024, covering everything from social prescribing to personalised support plans. We are also on track to deliver 200,000 personal health budgets and integrated personal budgets by 2023-24.
David Simmonds
I welcome the Secretary of State’s answer. My constituents are still telling me that they are experiencing some delays beyond the NHS guidelines on diagnosis for special treatment. What plans does my right hon. Friend have to address the lack of capacity and need for capacity in specialty-trained doctors and specialist diagnostic equipment, to make personalised care a reality?
Sajid Javid
My hon. Friend is absolutely right to mention the importance of the workforce and medical equipment. He will be reassured to know that the NHS has more doctors and nurses working for it than ever before, with more in training than ever before. We are investing record amounts of capital for new medical equipment, including investment in some 160 new community diagnostic centres, which will all include the latest, state- of-the-art diagnostic equipment.
Ms Anum Qaisar (Airdrie and Shotts) (SNP)
Mr Laurence Robertson (Tewkesbury) (Con)
The Secretary of State for Health and Social Care (Sajid Javid)
Our healthcare system is standing at a crossroads, and sooner or later we will have to make a choice between endlessly going back to the taxpayer to ask for more money and reforming the way in which we do healthcare in our country. Last month, I unveiled an ambitious new programme of reform, setting out how we are going to prioritise prevention, offer more personalised care, deliver improvements in performance and back the people making the difference in the NHS. The objective of this agenda is simple: to bring about the biggest transfer of power and funding in decades from our ever-expanding state to individuals, their families and their communities.
Mr Robertson
In Gloucestershire Hospitals NHS Foundation Trust, 30% of patients do not medically need to be in hospital; they are waiting for discharge. That figure is twice the national average. Will one of the Ministers contact the relevant people in the health service in Gloucestershire to ask them for ways in which the Government could help them to reduce that figure, because as it stands lives are being put at risk?
Sajid Javid
My hon. Friend is right to raise this. We are already in contact with the acute trust in Gloucestershire and some of the other trusts that are finding delayed discharge a particular challenge. My hon. Friend will know that, because of the pandemic, what has been a long-term challenge has become much more acute, not least because of the lost beds due to infection protection control and staff absences both in healthcare and in social care. Our delayed discharge taskforce is making a difference—the numbers are coming down overall—but we will be working with Gloucestershire.
Wes Streeting (Ilford North) (Lab)
Why does the Health Secretary think he has any licence to lecture the British people on their moral duty to pay taxes when he spent so many years avoiding his own?
Mr Speaker
Order. I am not quite sure that is relevant in topical questions.
Sajid Javid
I am very happy to answer if you will allow me, Mr Speaker. The hon. Gentleman could have asked me a question on anything to do with health and care—anything he wanted—but instead he chooses to talk about my personal affairs before public life. That was his choice. He could have asked me about the covid backlogs that he pretends he cares so much about. He could perhaps have given me suggestions—
Mr Speaker
Order. Secretary of State, I have got it. These are questions about your responsibilities. Now we can have another try—Wes Streeting.
Sajid Javid
Mr Speaker, you have been very generous to the hon. Gentleman: you gave him another try, but that was another failure to ask a question. Again, the hon. Gentleman is not asking about the serious issues, which again shows that he will play petty party politics and that Labour has no plan for the challenges this country faces.
Mr Speaker
May I just reassure the Secretary of State for Health that I was not being generous? The shadow Secretary of State had two questions, so I have not been generous in any shape, way or form.
Mark Fletcher (Bolsover) (Con)
Sajid Javid
Like many across the House I have been deeply disturbed by the reports we have all seen from Shanghai and my thoughts are with the people affected. It shows what a dangerous fallacy this whole idea of zero covid was, and it also shows that we are the most open country in Europe and that we have got the big decisions right. We did not listen to the Opposition when they said we should not open up in the summer, and we did not listen to them when they again called for restrictions in the winter. We are showing the world how to live with covid.
Rachael Maskell (York Central) (Lab/Co-op)
Tony Lloyd (Rochdale) (Lab)
Sajid Javid
As the hon. Gentleman is aware, I know his constituency well; it is my birthplace. He might also know that just a couple of months ago I visited his constituency and met members of the local community at the Deeplish community centre to talk about exactly what he has rightly raised today: the importance of tackling inequalities in Rochdale and beyond. We will set out our plans in our upcoming health disparities White Paper.
James Sunderland (Bracknell) (Con)
Sajid Javid
I share my hon. Friend’s concerns, which is why the NHS commissioned this review from one of our top paediatricians. It is already clear to me from her interim findings and the other evidence I have seen that NHS services in this area are too narrow; they are overly affirmative and in fact are bordering on ideological. That is why in this emerging area, of course we need to be absolutely sensitive, but we also need to make sure that holistic care is provided, that there is not a one-way street and that all medical interventions are based on the best clinical evidence.
Bell Ribeiro-Addy (Streatham) (Lab)
Jeremy Hunt (South West Surrey) (Con)
The Secretary of State will have read the scandal exposed in The Sunday Times this weekend that six babies are born every month after being exposed to sodium valproate, which has been known for many years to cause disabilities. Last year the Government consulted on putting warning labels on valproate. Is it not time to go much further and ban the prescription of sodium valproate to epileptic pregnant mothers?
Sajid Javid
My right hon. Friend is right to raise this, and many of us will have seen the recent reports, especially from the families affected. It is right that we reconsider this and make sure that sodium valproate, and any other medicine, is given only in the clinically appropriate setting.
Mr Toby Perkins (Chesterfield) (Lab)
Mrs Sharon Hodgson (Washington and Sunderland West) (Lab)
Sajid Javid
I would be pleased to have the meeting that the hon. Lady has suggested. She should know that we just closed the consultation on the 10-year cancer plan. There has been a fantastic response. She may also have seen the announcement that we made today about lung cancer health checks. With improvements like that, we intend to do a lot more.
Ruth Edwards (Rushcliffe) (Con)
One of the best ways to maximise NHS capacity is to increase people’s access to GP appointments and treatments such as mental health services and physiotherapy in their own communities. Will the Minister join me in backing our bid for a new health centre in East Leake and in calling on Nottinghamshire’s clinical commissioning group to prioritise funds for this vital service?
Sir David Evennett (Bexleyheath and Crayford) (Con)
I welcome all that my right hon. Friend is doing to address health inequalities. However, could I ask him to look carefully at public health funding for my borough of Bexley, as we are seriously underfunded compared with similar boroughs in London?
Sajid Javid
I would be very pleased to meet my right hon. Friend to discuss that further. I am sure he will welcome the publication of the upcoming health disparities White Paper.
Kim Leadbeater (Batley and Spen) (Lab)
In a recent survey by Carers UK, almost half of unpaid carers said that they are currently unable to manage their monthly energy bills and expenses, and that any further increases would negatively affect their own physical and mental health, or that of the person they care for. What steps are being taken, along with the Secretary of State for Work and Pensions, to support those hard-working exhausted unpaid carers with the cost of living?
Ockenden Report
Sajid Javid Excerpts(2 years, 1 month ago)
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The Secretary of State for Health and Social Care (Sajid Javid)
With permission, Mr Speaker, I would like to make a statement on the Ockenden report. The independent review was set up in 2017 in response to concerns from bereaved families about maternity care at Shrewsbury and Telford Hospital NHS Trust. Its original scope was to cover the cases of 23 families, but since it began, sadly, many more families have reported concerns. Due to this tragically high number of cases and the importance of this work to patient safety, early conclusions were published in an initial report in December 2020. We accepted all the recommendations of the first report, and the NHS is now taking them forward.
Today, the second and final report has been published. This is the one of the largest inquiries relating to a single service in the history of the NHS. It looks at the experiences of almost 1,500 families from 2000 to 2019. I would like to update the House on the findings of the report, and will then turn to the actions that we are taking as a result of it.
The report paints a tragic and harrowing picture of repeated failures in care over two decades, which led to unimaginable trauma for so many people. For these families, their experience of maternity care, rather than being of moments of joy and happiness, was one of tragedy and distress. The effects of these failures were felt across families, communities and generations. The cases in the report are stark and deeply upsetting. In 12 cases where a mother died, the report concludes that in three quarters of them, the care could have been “significantly improved”. It also examined 44 cases of HIE—hypoxic ischaemic encephalopathy—a brain injury caused by oxygen deprivation. Two thirds of the cases featured “significant and major concerns” about the care provided to the mother. The reports also states that of almost 500 cases of stillbirth, one in four was found to give rise to major concerns about maternity care that, if managed appropriately, “might or would” have resulted in a different outcome.
When I met Donna Ockenden last week, she told me about basic oversights at every level of patient care, including in one case where important clinical information was kept on Post-it notes, which were swept into the bin by cleaners, with tragic consequences for a newborn baby and her family. In addition, there were repeated cases where the trust failed to undertake serious incident investigations; and where investigations did take place, they did not follow the standards that would have been expected.
Those persistent failings continued until as late as 2019, and multiple opportunities to address them were ignored, including by the trust board accountable for these services. Reviews from external bodies failed to identify the substandard care that was taking place, and some of the findings gave false reassurances about maternity services at the trust. The Care Quality Commission rated maternity services inadequate for safety only in 2018, which is unacceptable given the huge deficiencies in care that are outlined in the report.
The report also highlights serious issues with the culture in the trust. For instance, two thirds of staff who were surveyed reported that they had witnessed cases of bullying, and some staff members withdrew their co-operation on the report within weeks of publication. The first report has already concluded that
“there was a culture within the Trust to keep Caesarean rates low because this was perceived as the essence of good maternity care”.
Today’s report adds:
“many women thought any deviation from normality meant a Caesarean section was needed and this was then denied to them by the Trust”.
It is right that both the Royal College of Obstetricians and Gynaecologists and the Royal College of Midwives have said recently that they regret their campaign for so-called normal births. It is vital, across maternity services, that we focus on safe and personalised care, in which the voice of the mother is heard throughout.
The report shows a systemic failure to listen to the families affected, many of whom had been doggedly and persistently raising issues over several years. One mother said that she felt like a
“lone voice in the wind”.
Bereaved families told the report that they were treated in a way that lacked sensitivity and empathy. Appallingly, in some cases, the trust blamed the mothers for the trauma that they had been through. In the words of Donna Ockenden, the trust
“failed to investigate, failed to learn and failed to improve”.
We entrust the NHS with our care, often when we are at our most vulnerable. In return, we expect the highest standards. I have seen in my family the brilliant care that NHS maternity services can offer, but when those standards are not met, we must act firmly, and the failures of care and compassion set out in the report have absolutely no place in the NHS.
To all the families who have suffered so greatly: I am sorry. The report clearly shows that you were failed by a service that was there to help you and your loved ones to bring life into this world. We will make the changes that the report says are needed, at both a local and national level.
I know that hon. Members and the families who have suffered would want reassurances that the individuals who are responsible for these serious and repeated failures will be held to account. I am sure that the House will understand that it is not appropriate for me to name individuals at this stage. However, I reassure hon. Members that a number of people who were working at the trust at the time of the incidents have been suspended or struck off from their professional register, and members of senior management have been removed from their posts. There is also an active police investigation, Operation Lincoln, which is looking at around 600 cases. Given that this is a live investigation, I am sure that hon. Members will recognise that I am not able to comment further on that.
Today’s report recognises that since the initial report was published in 2020, we have taken important steps to improve maternity care. That includes providing £95 million for maternity services across England to boost the maternity workforce and to fund programmes for training, development and leadership. The second report makes a series of further recommendations. It contains 66 for the local trust, 15 for the wider NHS and three for me as Secretary of State. The local trust, NHS England and the Department of Health and Social Care will accept all 84 recommendations.
Earlier today, I spoke to the chief executive of the trust, who was not in post during the period examined in the report. I made it clear how seriously I take this report and the failures that were uncovered, and I reinforced the message that the recommendations must be acted on promptly, but as the report identifies, there are also wider lessons that must be learned, and it sets out a series of actions that should be considered by all trusts that provide maternity services. I have asked NHS England to write to all of those trusts, instructing them to assess themselves against these actions, and NHS England will set out a renewed delivery plan that reflects those recommendations.
I am also taking forward the specific recommendations that Donna Ockenden has asked me to. The first is on the need to further expand the maternity workforce. Just a few days ago, the NHS announced a £127 million funding boost for maternity services across England. That will bolster the maternity workforce even further, and fund programmes to strengthen leadership, retention and capital for neonatal maternity care.
Secondly, we will take forward the recommendation to create a working group, independent of the maternity transformation programme, with joint leadership from the Royal College of Midwives and the Royal College of Obstetricians and Gynaecologists.
Finally, Donna Ockenden said that she endorses the proposals that I announced in January to create a special health authority to continue the maternity investigation programme that is run by the Healthcare Safety Investigation Branch. Again, we will take her proposals forward, and the SHA will start its work from April next year.
I thank Donna Ockenden and her whole team for the forensic and compassionate approach that she has taken throughout this distressing inquiry. The report has given a voice at last to those families who were ignored and so grievously wronged, and it provides a valuable blueprint for safe maternity care in this country for years to come.
Finally, I pay tribute to the families whose tireless advocacy was instrumental to the review being set up in the first place. I cannot imagine how difficult it must have been for them to come forward and tell their stories, and the report is a testament to the courage and fortitude that they have shown in the most harrowing of circumstances.
This report is a devastating account of bedrooms that are empty, families that are bereft and loved ones taken before their time. We will act swiftly, so that no families have to go through the same pain in the future. I commend this statement to the House.
Mr Speaker
The Secretary of State is quite right that this is a very important statement, so I will offer the shadow Minister, Feryal Clark, six minutes.
Sajid Javid
I thank the hon. Lady for her remarks. It is not often that we get to say this in this Chamber, but I agree wholeheartedly with what she has just shared with the House. She is absolutely right to talk about this as a fight for justice and to say that if these brave families had not been so persistent in coming forward with what was done to them and what went wrong, the inquiry might never have happened. She is also right to talk about institutional failure at the trust, which the first report set out in some detail and which we are seeing in much more detail today.
The hon. Lady talked, rightly, about patient safety. She will know that the Government have already set out plans to appoint a patient safety commissioner; that appointment will be made soon, but we need to do much, much more. That is why it was right to accept all the interim report’s recommendations, including seven immediate and essential actions and 27 local actions. I can tell the House that the trust has implemented all the actions set out in the interim report; that was backed at the time by £95 million in extra funding. As I said a moment ago, the final report quite rightly makes many more recommendations, which have all been accepted and which are backed by funding of at least £127 million, much of which will go to workforce.
The hon. Lady is right about the need to increase the size of the workforce, especially with respect to midwives. Last year’s acceptance figures for student nurses and midwives were, I think, the highest that the country had seen in decades, but clearly there is much more to do.
Mr Speaker
We now come to the Chair of the Health and Social Care Committee.
Sajid Javid
I very much agree. I want to acknowledge that the report ultimately took place because of my right hon. Friend’s decision to ask Donna Ockenden to do the independent review, but he is absolutely right that he, in turn, did so because of the bravery of Rhiannon Davies and Richard Stanton, of Kayleigh and Colin Griffiths and of the many other families who came to see him.
My right hon. Friend asked about the immediate and essential actions. The interim report sets out seven such actions; the trust has implemented them all, and across the NHS they are either fully or partially implemented. The final report also recommends such actions; their implementation has already begun. Of course, we have just received the report, but I have asked for a timetable of when it will all be done. I want to see it done as quickly as possible.
My right hon. Friend’s point about workforce is very important. I hope he welcomes the fact that, for the first time, the NHS has been asked to set out a 15-year workforce plan.
Helen Morgan (North Shropshire) (LD)
I join colleagues across the House in thanking all the families who have bravely come forward to share their experiences, particularly Kayleigh, Colin, Rhiannon and Richard, whose persistence has led to the review. I hope that women and babies in Shropshire, Telford and the Wrekin and across the UK will be safer in future as a result of their bravery.
I thank Donna Ockenden and her team for their thoroughness in reviewing so many tragic cases. I am sure that the Secretary of State agrees that this can never be allowed to happen again and that the deaths of these 201 babies must not be in vain. This must be a turning point for maternity services in England.
Donna Ockenden has endorsed the findings of the Health and Social Care Committee and recommended that an immediate investment of £200 million to £350 million per annum is required to keep women safe. I welcome the Secretary of State’s guarantees that the immediate and essential actions will be implemented, but may I ask whether he can commit the additional resources recommended by Donna Ockenden today?
Sajid Javid
I thank the hon. Lady for her comments. I assure her that constituents throughout Shropshire, Telford and the Wrekin, and indeed families across England, will be safer as a result of those brave families coming forward and this report.
On resources, the hon. Lady will have heard me talk about the £95 million given at the time of the interim report, plus the £127 million given for maternity services in the past few days. We will keep that under review.
Lucy Allan (Telford) (Con)
I thank the Secretary of State for his very welcome statement and the Under-Secretary of State, my hon. Friend the Member for Lewes (Maria Caulfield), for her excellent work. I pay tribute to my right hon. Friend the Member for South West Surrey (Jeremy Hunt) for everything that he has done for patient safety; he has led the way, and I am so grateful.
Does the Secretary of State believe that what we have seen at Shrewsbury and Telford Hospital NHS Trust is indicative of a culture in which senior management were unaccountable, no one felt responsible, failings were minimised, poor care was normalised and women’s voices were not heard? Will he do everything he can to increase the accountability of senior management across the NHS so that that institutional blindness can never again cause such harm to those who put their trust in the NHS?
Sajid Javid
Let me first thank my hon. Friend for her approach and her role in helping to make the report happen, and for the way in which she has worked with me, and with Ministers in my Department, on this most important of issues. She is right to talk about the importance of culture, especially given that, as the report makes clear, the voices of women were not heard time and again. I want to reassure her that we will implement all the report’s recommendations, but, more broadly, that women’s voices will be at the heart of the upcoming women’s health strategy.
Barbara Keeley (Worsley and Eccles South) (Lab)
Today is an important day for maternity safety, and we rightly pay tribute to the families directly affected, so many of whom have given evidence to the Ockenden review.
James Titcombe, who lost his baby son Joshua during the Morecambe Bay maternity scandal, has said that one of the most harmful experiences for the Morecambe Bay families was
“seeing influential people in the maternity world diminish… the…findings”
of the investigation report. I join James Titcombe in saying that we must not allow that to happen with this report. I urge the Secretary of State to ensure that the bereaved families are allowed a process of truth, reconciliation and healing, rather than any denial of the truth of what took place.
Sajid Javid
I agree with the hon. Lady, and she is right to raise the importance of the Morecambe Bay investigation. That report, which I believe was completed in 2015, contained 44 recommendations. Eighteen recommendations that were specifically for the trust have been implemented, and the 26 for the wider NHS are in the course of being implemented.
Philip Dunne (Ludlow) (Con)
I thank my right hon. Friend for both the tone and the substance of his response to this devastating report. Let me also add my voice to the consensus throughout the House that the way in which this is handled is vital, and that we must ensure that the NHS takes Donna Ockenden’s recommendations on board. She and her team of more than 90 experienced clinicians are properly being thanked for the work that they have done. They have painstakingly reviewed these cases going back some 20 years, which must have been harrowing for them, as of course it has been for all the families so tragically affected who have had to relive their tragedy.
In particular, I want to praise the courage and tenacity of Rhiannon Davies and Richard Stanton, who were my constituents when they lost their baby Kate in truly awful, and tragically avoidable, circumstances. It was they who kept pressing for answers from Shrewsbury and Telford Hospital NHS Trust. That led me to take them to see the then Health Secretary, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who agreed to launch this review five years ago. They are no longer my constituents, and I understand that they are now understandably keen to focus their attention on their family, having been living with this trauma since 2009.
I have some questions for my right hon. Friend the Secretary of State. Does he recognise that the Ockenden review has raised fundamental questions for maternity services across the NHS over the culture of so-called normal birth, and that a focus on targets, under successive Governments, rather than on patient outcomes, can distort clinical best practice and, tragically, patient safety? Following his discussion with the trust’s current chief executive, which he has mentioned, is he satisfied that the current management and clinical teams have accepted the “local actions for learning” recommendations in the initial Ockenden report, and are committed to studying and rapidly implementing all further recommendations specific to the trust? Finally, what reassurance can he give the thousands of expectant mothers in Shropshire, Telford and Wrekin that the maternity services there are safe, and that patient safety is paramount?
Sajid Javid
I thank my right hon. Friend for the way in which he has worked with the Department and with my predecessor in representing his constituents throughout this investigation. He referred to “so-called normal birth” in his question, and he was right to do so: the only normal birth is a safe birth, which is what the NHS should be working towards, but that did not happen in this trust. The report has made that absolutely clear. Just as important are its recommendations, including some for my right hon. Friend’s local NHS trust. I can reassure him—partly as a result of my conversation earlier today with the current chief executive—that all the recommendations in the interim report have been implemented by his local trust, and all those in this report have been accepted.
Taiwo Owatemi (Coventry North West) (Lab)
Let me start by paying tribute to all the families affected, and thanking Donna Ockenden and her team for their recommendations.
More midwives are leaving the profession than are joining it. We cannot run equally safe services in all NHS trusts without appropriate staffing levels. I therefore hope that the Secretary of State will be able to give further details of what the Government are doing to ensure that there are safe staffing levels in all trusts to provide care for pregnant women.
Sajid Javid
The hon. Lady is right to talk about the importance of having the right workforce, and certainly more midwives. I can tell her than last year there were 30,185 acceptances for nursing and midwifery courses, the highest number in a decade. Recruitment is being supported by some of the extra funding that I have talked about today. The Government have established grants enabling students to take courses, and, where appropriate, are also focusing on international recruitment.
Laura Trott (Sevenoaks) (Con)
This courageous report makes clear that keeping caesarean section rates artificially low contributed to babies dying. I am pleased that, following a recommendation from the cross-party Health and Social Care Committee, NHS trusts are no longer being assessed on performance for their caesarean rates, but will the Secretary of State go further? Will he ensure that we look at where caesarean section rates remain artificially low in trusts, so that this dangerous “normal births” ideology is eradicated from the NHS once and for all?
Debbie Abrahams (Oldham East and Saddleworth) (Lab)
I, too, pay tribute to the families named in what is a truly shocking report.
I am sorry, but I have not read all the recommendations, so may I ask the Secretary of State whether, as well as identifying issues relating to the culture in this particular trust, the report includes recommendations concerning governance for boards? Boards have a key role in holding their executives to account. Will he be writing to them to make them aware of their responsibilities in that regard? May I also ask him what the implications are for the national clinical audit of the confidential inquiries into maternal and infant deaths?
Sajid Javid
If I may, I will write to the hon. Lady about the national clinical audit. As for her important point about boards, the report refers to their importance and the importance of ensuring that the people on them are vetted, understand their responsibilities, and have the information that they need in order to fulfil those responsibilities. In, I think, 2014 or thereabouts, the Care Quality Commission changed the rules relating to NHS trust board members, requiring them to meet a new “fit and proper” test.
Siobhan Baillie (Stroud) (Con)
It is impossible to think about these lost babies, lost lives, and damaged families without becoming very upset and then very, very angry. However, I know from the work I have been doing with midwives and families, mums and dads, in the last six months or so that this does not involve just one trust. We have thousands of midwives marching on the streets. During the pandemic, mums were taking to social media, feeling that they were being marginalised and their voices were not being heard. Midwives tell me that they did not want to speak out before because they did not want to frighten the mums and dads in their charge, and that is why they often feel that they are not heard themselves. So we have to help them. How will the NHS and the Government reassure pregnant women and help the midwives to reassure them, given that all this is in the news at the moment, and how can we prevent other maternity services from failing?
Sajid Javid
My hon. Friend has raised a very important point. Hundreds of thousands of births are delivered through the NHS each year, and the vast majority are completely safe, as I myself have found and as many other Members have found, including my hon. Friend. What we have heard about today is what happens when it goes wrong, and goes tragically wrong, but especially when that was avoidable.
My hon. Friend was right to talk about the importance of considering other trusts. This report focuses on one trust, but we know that there was a problem in Morecambe Bay and that an independent investigation is taking place in East Kent. There is action to be taken by all trusts. That is why I think it is so important for the NHS to act on the recommendations for the wider NHS, and for me to act on the recommendations for my Department. We will certainly be taking action and so will the NHS.
Carla Lockhart (Upper Bann) (DUP)
I thank the Secretary of State for his statement. Not one person could help but be moved by that account or by his sincerity in dealing with this horrific situation. I also want to commend all those involved in the Ockenden report for their work on this issue. Our hearts break for the little babies, the mums and dads and the family units who have been impacted by these horrendous practices, and today we remember and commend the bravery of the families who had the courage to speak out. Given the findings and the negative cloud that will hang over all those who work in maternity services, will the Secretary of State take this opportunity to thank the maternity teams throughout this United Kingdom who, day in and day out, bring new life into this world in a compassionate and professional manner? I am thinking of the wonderful services at Craigavon Area Hospital in my own constituency. I know that those who work there will be saddened today by what they are hearing in the report, so I trust that the Secretary of State can commend them for the work that they do.
Sajid Javid
I join the hon. Lady in warmly thanking and commending the work of maternity teams throughout the United Kingdom for what they do, day in and day out, especially over the last two years of the pandemic, which has probably made it even harder than normal. I know that they will all welcome this report because they will want to see the very changes that are set out in it.
Jill Mortimer (Hartlepool) (Con)
I would also like to thank the families for shining a spotlight on this. One of my children suffered from oxygen deprivation at birth, through what I now know were failings in my care. I was lucky, though, in my third pregnancy. By sheer fluke, the GP practice I was registered with had a wonderful community midwife. She was with me through my pregnancy and through the birth of my daughter and she took care of me afterwards. I was listened to, I was supported and I felt safe. I thank my right hon. Friend for taking on board these recommendations, but would he agree that every woman deserves that continuity of care? It can make a profound difference in outcomes for families, because they will have somebody by their side who understands them and they will not have to go through their medical history over and over again, often missing out vital pieces. We should have loftier ambitions. Will my right hon. Friend try to make sure that every woman has the opportunity to have their own midwife with them all the way?
Sajid Javid
Yes, I agree very much with my hon. Friend and I thank her for sharing with the House her own valuable experiences. She is right to talk about the importance of continuity of care, and that is part of our maternity transformation plan.
Paul Girvan (South Antrim) (DUP)
I thank the Secretary of State for the report, although it is sad that we have to have a report such as this in front of the House. I want to highlight a point and check whether we can do something about it. There are many good people working in our NHS, and the majority of people are probably there for the right reasons, but, unfortunately, due to the culture of institutional blindness that has been mentioned, or to bullying, they cannot whistleblow, and whistleblowers are not being protected. As a consequence, more and more of these types of reports are going to be required, not only on maternity services, because whistleblowers are being targeted and put down. I would ask that whistleblowers be protected and given the opportunity to have their concerns understood and heard.
Sajid Javid
The hon. Gentleman is absolutely right. One of the reasons we are creating the special health authority that I referred to earlier is to provide that independence, and also more protection for members of staff to come forward. For example, members of staff will be able for the first time to report things they are concerned about directly to the SHA, and it will have the right to investigate.
Fay Jones (Brecon and Radnorshire) (Con)
Many members from across the House have mentioned the incredible bravery of all the parents who fought for their babies, particularly Rhiannon Davies. Rhiannon is originally from mid-Wales, although she now lives in a constituency across the border. There are many women who live in mid-Wales who need to access the Shrewsbury and Telford Hospital NHS Trust, and I am concerned that they will hear about today’s report and be worried about the care that they will be receiving over the next few days. So, as well as implementing the Ockenden review in full, will the Secretary of State please give his reassurance to those women in Wales who need to travel across the border for maternity services?
Sajid Javid
Yes, I can give my hon. Friend that reassurance. I can add that Donna Ockenden, in doing her work, looked at cases from Wales as well. The issue that my hon. Friend has raised has also been raised by my hon. Friend the Member for Montgomeryshire (Craig Williams), and I can give them both that assurance.
Jim Shannon (Strangford) (DUP)
I thank the Secretary of State for his statement, for the obvious compassion that he has for all those involved, and for his support of the Ockenden report. I want to place on record my sympathy with all those parents who still grieve their loss, and for whom no report will never, ever soothe the pain. Will the Secretary of State confirm that the report into this dreadful spate of deaths will be made available to all hospital trusts across the United Kingdom, including Northern Ireland, to ensure that lessons are learned and that the 84 recommendations of the Ockenden report and any mechanisms of prevention can be understood and put in place UK-wide?
Sajid Javid
Yes, I can give the hon. Gentleman that assurance. We are more than happy to reach out to the Northern Ireland health service and to work proactively with it on improving maternity services in Northern Ireland.
Simon Baynes (Clwyd South) (Con)
I thank my right hon. Friend for his statement, and all the many Members present who have contributed to the process that has led to this report. Following the remarks by my hon. Friend the Member for Brecon and Radnorshire (Fay Jones), I have been working with my hon. Friend the Member for Montgomeryshire (Craig Williams), who sadly cannot be here today as he has important constituent business, to look at the cross-border nature of this inquiry in relation to his constituency, my constituency of Clwyd South, my hon. Friend’s constituency of Brecon and Radnorshire and others on the Welsh borders. Will my right hon. Friend reflect on the fact that there will be many concerned residents in Wales, alongside the victims outlined in this report, who need representation on this important issue?
Sajid Javid
Yes, I can give my hon. Friend, and my hon. Friend the Member for Montgomeryshire, who cannot be with us today, the reassurance that they seek.
Mrs Flick Drummond (Meon Valley) (Con)
My right hon. Friend said in his statement that the Care Quality Commission rated these maternity services inadequate for safety only in 2018, which is unacceptable. Can he assure the House that the CQC inspections are now rigorous enough that failings are picked up much earlier to prevent this type of thing from happening again?
Sajid Javid
I can assure my hon. Friend that there have already been a number of changes in the CQC’s approach, but I cannot give an assurance that it has changed enough, because this report has only just been published and it is important to me to follow through and ensure that, where relevant, the independent regulators are also making the changes set out in the report. To respond to an earlier question from the hon. Member for Enfield North (Feryal Clark), she was right to suggest that there should be an update from Ministers on progress following this report, and I will ensure that that happens. That picks up on this question about the CQC as well.
Alicia Kearns (Rutland and Melton) (Con)
This House is united in our heartache over the lives lost and the lives destroyed, and over the women who were silenced and told that birthing had happened for centuries so they should shut up, or that it should happen as though in some sort of movie. I am afraid that, as an MP, I have concluded that NHS bureaucracy has a systemic problem of sexism, and I ask the Secretary of State to keep an eye on this nationally. I remember, after 36 hours of labour, being rushed to the operating theatre and being denied a C-section, then being rushed back an hour later and having a C-section, but only because my husband had noticed that my son’s heart rate had plummeted to almost non-existent. We must also prevent the unforgivable and unscientific locking out of loved ones across all health services. It compromises care and it is still happening in hospitals around the country across different types of care.
Sajid Javid
I thank my hon. Friend for saying what she has said in the way that she did, and also for talking about her own experience. She is absolutely right to emphasise the point that the NHS is there to care for anyone regardless of their gender, but when it comes to women in particular, I hope she agrees that this is precisely why the Government are right to want to set out—as we will do shortly and for the first time ever—a detailed women’s health strategy.
Covid-19 Testing: Future Approach in England
Sajid Javid Excerpts(2 years, 1 month ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Sajid Javid)
On 21 February 2022, the Government published, “Covid-19 Response: Living with Covid-19” which set out the Government’s plan for living with covid-19. This included removing remaining legal domestic restrictions while continuing to protect people most at risk of serious illness from covid-19 and maintaining resilience.
The Government’s objective in the next phase of the covid-19 response is to enable the country to manage covid-19 like other respiratory illnesses, while minimising mortality and retaining the ability to respond if a new variant emerges with more dangerous properties than the omicron variant. As a result, the Government now assess that it is time to transition their response towards guidance and encouraging responsible behaviours, while targeting protection towards those individuals most at risk from the virus. I have today set out the future approach in England to testing beyond April.
The “Living with Covid-19” strategy is already being implemented. Individuals are no longer legally required to self-isolate, and instead are advised to stay at home and avoid contact with other people if they test positive. This advice will be updated further as set out below. The Government have removed their advice for staff and students in most education and childcare settings to undertake routine twice weekly asymptomatic testing. The Government have started the process of reducing their testing and tracing infrastructure, in preparation for the end of free universal testing from 1 April. We are now reconfiguring our services to target Government testing provision to enable treatment and protect our most vulnerable settings.
Symptomatic Testing
The Government will continue to provide free symptomatic testing for:
Patients in hospital, for whom a test is required for clinical management or to support treatment pathways.
People who are eligible for covid-19 treatments, because they are at higher risk of getting seriously ill from covid-19. People in this group will be contacted directly and sent lateral flow tests to keep at home for use if they have symptoms as well as being told how to reorder tests.
Individuals who live or work in high-risk closed settings, for example in some NHS, social care and prison—and other places of detention—settings where infection needs to be identified quickly to minimise outbreaks.
NHS England will be writing to those eligible people to inform them of the new process.
DHSC will continue to fund some asymptomatic testing in NHS services, during periods of higher prevalence, including for staff and patients.
For ASC services and hospices, DHSC will also continue to fund some regular asymptomatic testing for staff in periods of high prevalence. Asymptomatic testing of care home and hospice residents will be provided on admission and during an outbreak, not routinely.
In addition, in some closed or semi-closed settings, for example: parts of the prison estate, places of detention, and some refuges and shelters, where individuals are at high risk of severe disease outcome and infection can spread rapidly, asymptomatic testing will continue to mitigate risk during higher prevalence periods.
Most visitors to adult social care settings, and visitors in the NHS, prisons or places of detention will no longer be required to take a test.
Contingency
UKHSA will maintain critical surveillance capabilities to provide insight into emerging threats and retain contingency capabilities to enable a rapid response . This includes genomic sequencing to identify a variant of concern and the ability to scale up a national response, should that be warranted. It will retain the ability to enable a rapid testing response should it be needed, such as because of a new variant of concern. UKHSA will also retain critical lab and contingency infrastructure, delivery channels, mobile testing units, and accompanying digital infrastructure. Altogether, this will ensure we retain critical resilience—giving rapid, reactive capability to respond to a future health threat, while a more comprehensive response can be scaled.
Guidance
Guidance will be published on 1 April that sets out the actions that those with symptoms of covid-19 or respiratory illness should take to reduce risk of infection to others.
Devolved Governments
UKHSA is committed to working with devolved Governments to take forward the testing programme in each nation in 2022-23.
Funding
The Government have provided significant additional funding, through additional borrowing, to respond to the pandemic, the cost of living with covid-19 will be met within existing funding streams, including the additional funding allocated at SR21. The Government will reallocate resources as necessary to pay for the maintenance of our pharmaceutical defences against covid-19 and preserve hard-won freedoms.
Free parking in hospital car parks for NHS staff introduced during the pandemic will also come to an end on 31 March. However, over 93% of NHS trusts that charge for car parking have implemented free parking for those in greatest need, including NHS staff working overnight.
Conclusion
Finally, on behalf of the Government, I would like to record my thanks to everyone who has worked tirelessly to keep people safe over the last two years and whose efforts have enabled us to move to the next stage of the covid-19 response.
The Government will continue to work together with our partners to keep all these measures under review.
[HCWS740]
Healthcare Reform
Sajid Javid Excerpts(2 years, 1 month ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Sajid Javid)
I wish to update the House on my vision on health reform, “Our Health System: the Government’s reform agenda”. In today’s address, I outlined our intention to take bold action on healthcare reform, setting out our agenda for transforming the healthcare system. This agenda addresses the enduring issues facing the system, and recognises the challenges and opportunities arising from the pandemic—building on our recent elective recovery plan and the publication of the integration White Paper.
The NHS has many strengths and is rightly regarded as a national treasure. However, it faces long-term challenges, including an ageing population and people increasingly living with multiple long-term conditions. All of these have been exacerbated by the covid-19 pandemic, which has added extra pressure on the system, highlighted existing issues, and created new challenges.
At this critical moment, we must now seize the opportunity to put our healthcare system on a more sustainable path for the future while meeting the immediate recovery challenge we face as we emerge from the pandemic.
The Health and Care Bill will, subject to Parliament, create the structures for the future, but we need to consider how we will work within those structures. I recognise waiting time recovery is a significant challenge. However, this is not a reason to back away from those changes, but to double down and ensure we deliver the full benefits.
In the face of growing demand, we will focus on taking a more prevention-centred approach to healthcare, where the emphasis is on preventing needs from arising in the first place—prevention; putting people in control of their own care—personalisation; and driving up the quality of care by working smarter—performance.
As we do this, we must build on existing progress and work with the brilliant individuals and teams in our healthcare system who are already making change happen on a daily basis—which will include continuing to invest in the workforce.
We will build on the announcements made during my speech and set out wider Government policy in this area in due course.
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Health and Social Care
Sajid Javid Excerpts(2 years, 2 months ago)
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Jessica Morden (Newport East) (Lab)
Sajid Javid
First, I wish a happy St David’s day to the hon. Member and all those celebrating. I would be happy to meet her on this issue. The Government greatly value the role of physician associates. She knows that they bring new talent to the NHS and act in an enabling role, where they can help healthcare teams with their workload. Physician associates will be regulated by the General Medical Council, and the Department has consulted on draft legislation on just how to do that.
[Official Report, 1 March 2022, Vol. 709, c. 900.]
Letter of correction from the Secretary of State for Health and Social Care, the right hon. Member for Bromsgrove (Sajid Javid).
An error has been identified in my response to the hon. Member for Newport East (Jessica Morden).
The correct response should have been:
Sajid Javid
First, I wish a happy St David’s day to the hon. Member and all those celebrating. I would be happy to meet her on this issue. The Government greatly value the role of physician associates. She knows that they bring new talent to the NHS and act in an enabling role, where they can help healthcare teams with their workload. Physician associates will be regulated by the General Medical Council, and the Department plans to consult on draft legislation later this year on just how to do that.
Oral Answers to Questions
Sajid Javid Excerpts(2 years, 2 months ago)
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Kate Green (Stretford and Urmston) (Lab)
The Secretary of State for Health and Social Care (Sajid Javid)
We are committed to ensuring that everyone with mental health needs has timely access to support and treatment. We remain committed to the expansion in mental health services in the NHS long-term plan, which should see 345,000 more children accessing services by 2023-24. To accelerate that expansion, we have provided an additional £79 million this year in recognition of the impacts of the pandemic.
Kate Green
The NHS long-term plan promises a
“new approach to…mental health services for people aged 18-25”.
Could the Secretary of State set out in detail how university mental health and wellbeing services will work seamlessly with NHS mental health services so that students in need of support do not fall through the cracks?
Sajid Javid
The hon. Lady raises a very important point, especially as this week is Eating Disorders Awareness Week. Sadly, as she and many other hon. Members will know, eating disorders have increased significantly over the past couple of years.
Last year, during the pandemic, we published a mental health recovery action plan with an additional £500 million of funding, a minimum of £13 million of which was dedicated to young people between the ages of 18 and 25, particularly to help with the transition from children’s to adult mental health services. My hon. Friend the Minister for Care and Mental Health has been in talks with the Department for Education and has a meeting soon to discuss what more action we can take collectively.
Andrew Bridgen (North West Leicestershire) (Con)
Has my right hon. Friend made any specific assessment of the effect of the covid-19 lockdown restrictions on children’s mental health and general wellbeing?
Sajid Javid
I can tell my hon. Friend that we have and that that assessment continues. Sadly, as he will know, we have seen a significant increase in mental health referrals, especially for young people, over the past two years. The extra support that we have provided through the action plan and the £500 million of funding is helping, but I am afraid that there will be some long-term challenges created by the pandemic. We are very much looking at what more we can do.
Dr Rosena Allin-Khan (Tooting) (Lab)
I echo the words of solidarity with Ukraine that many colleagues have shared in recent days.
There are stark inequalities in children’s mental health services, from the postcode lottery of whether a child is ever seen after a referral to the luck-of-the-draw results of eating disorder treatment. Children from black and mixed-race backgrounds make up 11% of the population, but account for a staggering 36% of those detained in the highest-level mental health units. However, just 5% of those who access routine children’s mental health services are black. That is unacceptable—something clearly is not working.
Labour will put a mental health support hub in every community and a specialist mental health staff member in every school. What are the Government going to do?
Sajid Javid
I think we all agree, across the House, about the importance of mental health services, especially for younger people. As for what the Government are doing, before the pandemic there was already a commitment to increase funding for mental health services in the NHS’s long-term plan by an additional £2.3 billion a year. On top of that, there has been the response during the pandemic, with the mental health recovery action plan and the additional £500 million that I referred to a moment ago. When it comes to children’s mental health services, there is £79 million included, which will pay for an extra 22,500 referrals.
Sir David Evennett (Bexleyheath and Crayford) (Con)
The Secretary of State for Health and Social Care (Sajid Javid)
We have worked with the NHS to expand virtual wards and establish a new national discharge taskforce to safely maximise patient discharge and free up beds. We have also announced a delivery plan for tackling the covid-19 backlog of elective care, which sets out our clear vision for how an additional £8 billion will be spent over the next three years to help the NHS to recover and expand elective services.
Sir David Evennett
I thank my right hon. Friend for that information. As we look beyond the pandemic, our priority must be tackling the NHS waiting list. Does my right hon. Friend agree that the record number of doctors and nurses working in our NHS shows that the Government are putting the NHS on the best possible footing to meet the challenges ahead?
Sajid Javid
I absolutely agree with my right hon. Friend. Let me take this opportunity once again to thank everyone who has been working in the NHS, especially for all that they have done during the pandemic. We are continuing to invest in the workforce through our 50,000-person expansion in the nurse programme, and we already have 44,000 more full-time employees in healthcare settings than we had this time last year, including 4,600 more doctors and 11,100 more nurses.
Helen Morgan (North Shropshire) (LD)
The lack of capacity in accident and emergency departments and other healthcare services is a major contributor to the ongoing ambulance waiting time crisis in my constituency. Will the Secretary of State meet me and representatives of the West Midlands ambulance service—as I have repeatedly asked him to do—to help to resolve the crisis?
Sajid Javid
The hon. Lady is right to raise this matter. As she will know, owing to the pressures of the pandemic we have seen significant challenges for ambulance services throughout the country. Just a few days ago I met the head of the West Midlands ambulance service to discuss some of the issues, and also how the extra funding that we provided over the winter—some £55 million of support for ambulance services—is helping.
Mr Mark Harper (Forest of Dean) (Con)
May I press the Secretary of State on how the increases in NHS capacity will be maintained over the medium term? His own Department has forecast that waiting lists may hit 9 million or 10 million in the next couple of years. The Government also have a plan to take the extra funding coming from the increase in national insurance and the health and social care levy out of the NHS to fund our long-term social care plans. How are the two to be reconciled?
Sajid Javid
As my right hon. Friend will know, when I presented the NHS’s elective recovery plan for the covid-19 backlog in the House a couple of weeks ago, I made it clear that we expect waiting lists to rise before they fall. That is because some 10 million people stayed away during the pandemic, and we want as many as possible of those who want and are able to come forward to do so. At the same time, the NHS will be massively increasing its activity, in new ways and with new funding. It is essential for there to be much greater integration between the NHS and social care, and we set our plans in detail in the White Paper published last week.
Karin Smyth (Bristol South) (Lab)
The Government seem to think that there is some kind of magic staffing tree, but there is no increase in capacity, no elective recovery and no fixing of social care without an immediate and ambitious workforce plan. We have legislation in this place, and we have seen a tsunami of White Papers, but none of that includes a credible workforce plan. Given the estimated 93,000 NHS vacancies and more than 110,000 vacancies in social care, when will we have that plan?
Sajid Javid
The hon. Lady has just stood up and said that there is no increase in capacity. I am afraid she was probably not listening a few minutes ago when I said that in the last year the number of people working in the health service had increased by 44,000, and that we had 11,000 more nurses and nearly 5,000 more doctors. As for a plan, the hon. Lady may know that I have already asked the NHS to work on a long-term plan—a 15-year workforce plan. If she really wanted a new workforce plan, she should have thought about how we could fund it, and should not have voted against the increase in spending that the Government proposed.
James Daly (Bury North) (Con)
On the subject of NHS capacity, data released by NHS Digital shows that NHS Bury clinical commissioning group had the lowest number and also the lowest percentage of face-to-face GP appointments in England in January 2022. Only 37% of Bury appointments are face-to-face, which is clearly unacceptable and unfair to my constituents. Will my right hon. Friend agree to meet me to find solutions to this serious problem?
Sajid Javid
It is a serious issue, and I will of course meet my hon. Friend to discuss it further. He may be interested to know that over the winter the Government provided an additional £250 million in a winter access fund for primary care services throughout the country. That has certainly helped to increase the number of face-to-face appointments, although the omicron wave made the process more challenging. As my hon. Friend suggests, it should ultimately be for patients to choose how they want to be seen.
Valerie Vaz (Walsall South) (Lab)
The Secretary of State for Health and Social Care (Sajid Javid)
Addressing the disparities discussed in that report is one of my key priorities. We are already making progress in crucial areas such as increasing covid-19 vaccine take-up among ethnic minority groups. To go further, we also plan to publish a health disparities White Paper later this year that will set out impactful measures designed to address disparities and their causes, including those linked to ethnicity.
Valerie Vaz
I thank the Secretary of State for his response. I hope he will ensure that he implements all the conclusions of that report. He is aware of the McLean review into the senior leadership of the Royal Wolverhampton NHS Trust, who have now annexed the Walsall Manor Hospital. Can he say what he will do to ensure that all those working in the NHS and using the NHS are treated with equality and transparency, starting with the Manor?
Sajid Javid
The right hon. Lady is absolutely right to raise this issue. This is one of the most important issues and one of the biggest longer-term challenges to face the NHS. I welcome the report and I will be taking it very seriously. She will know that I have commenced action on ethnic disparities in healthcare. For example, I have asked for an investigation, headed by Dame Margaret Whitehead, into potential bias in medical devices. The right hon. Lady is also right to raise the importance of inequality of treatment, and I will shortly have more to say on that.
Feryal Clark (Enfield North) (Lab)
This report is damning. The evidence shows that, over a decade of Conservative Government, we have not seen any significant change. Ethnic minority patients continue to receive poorer care because of their race at every stage of their life. The Tories have had 12 years to act. Why have they failed to do so?
Sajid Javid
The reason this report exists is that the Government want to see this kind of work being done by an independent organisation so that we can address these types of disparities and issues. There have been ethnic disparities in our health service for decades, sadly, under successive Governments, and it is this Government who are doing something about it. I have already referred to the medical devices review. Earlier this week, the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), set out the maternity disparities taskforce, and we will have a lot more to say on this when we publish our forthcoming White Paper.
Peter Grant (Glenrothes) (SNP)
Jason McCartney (Colne Valley) (Con)
The Secretary of State for Health and Social Care (Sajid Javid)
I share the horror and disgust of almost everyone in this House, this country and the whole world at the unprovoked, unjust and unjustifiable invasion of Ukraine by President Putin last week. That appalling act has created a humanitarian emergency and we are looking at every opportunity to give the people of Ukraine the support that they so urgently need.
On Sunday night we sent almost 50,000 items of medical supplies to Poland via air for onward transport to Ukraine. I can inform the House that another plane departed at 7 o’clock this morning with more supplies, including medical equipment and personal protective equipment. We have all been in awe of the bravery and heroism shown by the Ukrainian people. Rest assured, we all stand with them shoulder to shoulder in their hour of need.
Jason McCartney
On behalf of my constituents with blood cancer, will the Secretary of State please consider providing free asymptomatic testing for the close contacts of immunocompromised people?
Sajid Javid
We will keep under review the testing offer that we will provide over the coming weeks and months. We continue to consider whether any changes are necessary, but as we learn to live with covid we will target our free asymptomatic testing offer on vulnerable people. That includes, of course, those who are immunocompromised. Such individuals will also be eligible for antiviral treatments through a free priority PCR test service.
Wes Streeting (Ilford North) (Lab)
I associate myself and everyone on the Opposition Benches with the Secretary of State’s remarks and warmly welcome the support that the Government are providing to the people of Ukraine and the Ukrainian army. We all stand with the people of Ukraine in their fight for freedom and democracy.
Turning to matters closer to home, the Secretary of State asked the Chancellor for £5 billion to cover essential covid costs—ongoing covid costs—and he came away with nothing, so where will the cuts now fall in the NHS budget?
Sajid Javid
We must all learn to live with covid. The Government have been very clear about that, and we set out a very detailed plan. As infections fall, cases fall and rates of hospitalisation for covid fall, which means we can now have this type of plan. It is a properly funded plan that focuses on vaccines, treatments and targeted testing, and that builds in resilience should there be future variants of concern. It is right that this plan is funded by the Department because it is our No. 1 health priority.
Wes Streeting
Hang on a minute. So one minute the Secretary of State is asking for £5 billion from the Treasury, and the next minute he has found the money within the Department. Either he was trying to pull a fast one on the Treasury, because he had the money he needed, or he has not got the money he wanted and therefore the cuts are going to fall within existing budgets. Members do not need to take my word for it; it was reported in The Times that the Health Secretary threatened that, if he did not get the funding, it would mean delaying investment in social care, fewer elective surgeries and cuts to the hospital building programme. Having, I think, not tried to pull a fast one on the Chancellor, is he now pulling a fast one on patients, and is it not really the patients who are going to pay the price for his failed negotiations?
Sajid Javid
First, the hon. Gentleman should not believe everything he reads in the press. We would think he knew that by now. As I said, when it comes to funding our plan for living with covid, it is right that it continues to be the No. 1 priority of my Department to keep this virus at bay and that it is funded by the Department. When it comes to funding, this is the hon. Gentleman who, with all his colleagues, voted against extra funding when he was given the opportunity.
Henry Smith (Crawley) (Con)
Sajid Javid
My hon. Friend is absolutely right to raise this. NHS England has already given clear guidance to all GP practices that they must provide face-to-face appointments alongside remote consultations. Patients’ input into the type of consultation they want should be sought by all practices and their preferences should be respected.
Martyn Day (Linlithgow and East Falkirk) (SNP)
The Scottish Government have now confirmed their initial aid for humanitarian support to Ukraine of £4 million, as well as medical supplies. They are keen to work with aid agencies and other UK nations to get support to where it is most needed as soon as possible. What discussions has the Secretary of State had with his Cabinet colleagues on boosting urgent medical equipment provision to Ukraine from the UK and on guaranteeing access for doctors to the country?
Sajid Javid
The hon. Gentleman raises a very important point, and he will be pleased to know that the UK was one of the first countries in the world to provide medical aid. As I mentioned a moment ago, one flight left on Sunday night and one left this morning, and there will be many more, I hope. I welcome the work of the Scottish Government and their offer, and we will certainly work together in making sure that aid reaches the people who need it.
Selaine Saxby (North Devon) (Con)
Jessica Morden (Newport East) (Lab)
Sajid Javid
First, I wish a happy St David’s day to the hon. Member and all those celebrating. I would be happy to meet her on this issue. The Government greatly value the role of physician associates. She knows that they bring new talent to the NHS and act in an enabling role, where they can help healthcare teams with their workload. Physician associates will be regulated by the General Medical Council, and the Department has consulted on draft legislation on just how to do that.
Damien Moore (Southport) (Con)
Laura Trott (Sevenoaks) (Con)
Sajid Javid
First, I pay tribute to my hon. Friend and to my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) for all the work they have done on this most important of issues. Over the past few months, we have all heard in this House some horrific examples of botched, non-cosmetic procedures scarring people for life. No longer will that be allowed. We will be introducing a licensing regime for such procedures. The details of the regime will be set out in regulations, meaning that it will be flexible, agile and change in response to changes in the cosmetics industry.
Mr Toby Perkins (Chesterfield) (Lab)
Jeremy Hunt (South West Surrey) (Con)
Today is the first day of Brain Tumour Awareness Month. The Secretary of State kindly wrote to me in January when my mother died from a brain tumour, and Baroness Tessa Jowell, who was much loved on all sides of the House, also died from a brain tumour. Given that it is the biggest cause of cancer death for the under-40s, and we still do not really know what causes them, does he agree that this should be a priority for research, so that we understand as much about brain tumours as about other cancers?
Sajid Javid
I once again express my condolences to my right hon. Friend for his loss. He is absolutely right to raise this issue and the need for more research. That is one of the reasons why, back in 2018, we announced £40 million of extra research funding over the next five years. I can tell him that some £9 million of that has already been committed to 10 projects. In addition, the Tessa Jowell Brain Matrix is an exciting new trials platform that will give people with brain cancer access to trials of treatments that are best suited for their individual tumours.
Kirsten Oswald (East Renfrewshire) (SNP)
Dame Diana Johnson (Kingston upon Hull North) (Lab)
Will the Secretary of State meet me as chair of the all-party parliamentary group on sexual and reproductive health in the UK? Can I bring along the Royal College of Obstetricians and Gynaecologists, the Royal College of Midwives, the Royal College of General Practitioners, the Royal Pharmaceutical Society and the Faculty of Sexual and Reproductive Healthcare to explain why the decision to remove telemedicine is wrong for women in this country?
Jane Hunt (Loughborough) (Con)
A dental practice in Shepshed has informed me that its NHS contract has changed little since 2006. Can the contracts and value of units of dental activity for treatment be increased to focus on prevention, rather than treatment alone?
Jim Shannon (Strangford) (DUP)
I thank all the Ministers for their responses. What steps have been taken to work with the Education Secretary to provide a higher number of places for medical students containing a golden handshake that allows for no student loan repayment or fees on condition that they stay in the NHS for a set time?
Sajid Javid
It is an important question on the workforce. The hon. Gentleman will know that over the last two years we have removed the cap on medical places and we have the highest number of doctors and dentists in training ever. It is right to think about what more we can do, however, and we are having active discussions with the Secretary of State for Education to see what can be done.
Kim Leadbeater (Batley and Spen) (Lab)
On the issue of children’s mental health, does the Minister agree that children with ADHD and autism have found the last two years even more stressful than usual? A cross-departmental approach is long overdue to ensure that their needs are adequately met.
Ronnie Cowan (Inverclyde) (SNP)
The Secretary of State is on record saying:
“Making medicinal cannabis available on prescription will benefit the lives of ill patients currently suffering in silence. There is nothing harder than seeing your loved ones in pain”.
Since he said that, there have been three prescriptions for medical cannabis on the NHS. They are important, because they set a legal and medical precedent that it can happen, and it can happen now. Currently, however, if I can afford it, I can buy it, but if I cannot, I cannot. When will he address that anomaly?
Sajid Javid
The hon. Gentleman will know that for medicines to be generally available on the NHS, they have to be deemed safe and effective by the independent medical regulator. That requires trials to take place and that is where the focus should be. Those who want those medicines to be more easily available should encourage the companies that produce them to have trials and the NHS will support them in doing so.
Mrs Emma Lewell-Buck (South Shields) (Lab)
Chloe Rutherford and Liam Curry from South Shields were tragically murdered in the Manchester Arena terror attack. Their parents’ pain is unimaginable and constant. After sitting through hours of the inquiry, they have been told that, in just two days’ time, the registration of their precious children’s deaths will be done not by them, but by a stranger. Apparently that is standard practice for mass casualty events. These grieving parents are being denied this final act for their children. Please can the Secretary of State explain why, and urgently intervene?
Sajid Javid
Of course I would be very happy to meet the hon. Lady. It is a very important issue that she has raised. I also send my condolences to the parents of Chloe and Liam.
Carla Lockhart (Upper Bann) (DUP)
The right decision was taken by this Government last week in confirming that the temporary telemedicine at-home abortion pill should cease. I commend the Government for that decision. Given that more than 10,000 women have ended up in hospital in the year 2020 after taking a first abortion pill, can my hon. Friend confirm that the Government will follow through on that decision?
Daisy Cooper (St Albans) (LD)
Since the NHS was created, it has been governed by the principle that services are free at the point of use, and, of course, the Secretary of State has a duty to protect that. Many of my constituents want to know whether the Government’s decision to start charging for covid tests marks a departure from that founding principle.
Sajid Javid
Clearly, that is one of the most important principles of the NHS and it will not change. It is right, though, that when we look at living with covid, we target testing on those who are most vulnerable or who are in vulnerable settings. That is the right, proportionate and balanced approach.
Covid-19: Vaccination as a Condition of Deployment
Sajid Javid Excerpts(2 years, 2 months ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Secretary of State for Health and Social Care (Sajid Javid)
Covid-19 vaccination as a condition of deployment—revocation consultation response
On 31 January I announced this Government’s intention to revoke the regulations making covid-19 vaccination a condition of deployment in all health and social care settings, subject to consultation and parliamentary procedure.
My statement before the House on 31 January made clear that vaccination as a condition of deployment was the right policy when the original decision was taken, but that it is no longer proportionate in the light of the most recent clinical evidence regarding the current omicron variant of covid-19, which is intrinsically less severe than Delta, and the high rate of vaccination across the population.
On 9 February Government published a consultation document, “Revoking vaccination as a condition of deployment across all health and social care”. The consultation outlined the latest clinical evidence and the proposed way forward, and sought views from all interested parties on whether the regulations should be revoked, as well as what further steps could be taken to increase vaccine uptake.
The consultation received over 90,000 responses from across the health and social care sector, as well as from members of the public. My Department also conducted engagement sessions with sector representatives. I am grateful to all those who have taken the time to respond to the consultation.
My Department’s officials have carefully analysed the consultation responses. The vast majority of the feedback received supported revocation, with 90% of respondents agreeing that the requirement for covid-19 vaccination as a condition of deployment in health and social care settings should be revoked.
I have considered this strong preference for revocation, the relevant equalities assessment, and the scientific evidence. I have concluded that it is right and proportionate to proceed with revocation of covid-19 vaccination as a condition of deployment in all health and social care settings, and have today published the Government’s full response to the consultation on www.gov.uk. I am also laying the regulations to revoke vaccination as a condition of deployment today. These regulations will come into force on 15 March, and will remove the requirements already in place in care homes, as well as those due to come into force in health and wider social care settings on 1 April 2022.
Irrespective of this step, and while we have a number of defences and mitigations in place, such as antivirals and personal protective equipment, vaccination continues to be our most important weapon in the fight against covid-19. I have made it clear that I consider it a professional responsibility for health and care staff, and others who work in the health and social care sectors, to be vaccinated, and I am glad to note that the professional regulators, the Royal Colleges, the chief medical officer, the chief nursing officer, and the chief midwifery officer among others, agree with this. It is encouraging that 92% of the NHS workforce and 95% of care home staff are now vaccinated with two doses, while 89% of home—domiciliary—care staff have so far received at least one dose of the vaccine.
This Government are committed to working with the health and social care sectors to engage with those who are yet to make the positive choice to be vaccinated. In adult social care, the vaccine boosters taskforce has published a paper to support good practice for driving booster vaccination in England. In addition, Government have committed to consulting on updating the code of practice on the prevention and control of infections, which applies to all Care Quality Commission registered providers of all healthcare and social care in England, to strengthen requirements in relation to covid-19, including reflecting the latest advice on infection prevention control.
While we commit to these actions, we also have measures in place to ensure that those most vulnerable to covid-19 remain protected in health and social care settings, as well as across the country. While the shielding programme ended on 15 September 2021, we have made new antibody and antiviral treatments available to people who are at highest risk of becoming seriously ill who test positive for covid-19, to help reduce the development of severe covid-19. On 21 February 2022, Government launched their living with covid-19 plan. The plan confirms that both NHS and adult social care will continue to provide access to free PPE to the end of March 2023, or until the IPC guidance on PPE usage for covid-19 is amended or superseded. Revocation of these regulations plays an important and proportionate role within Government’s approach in ensuring that our entire society, including the health and social care sectors, can learn to safely live with covid-19.
The Government’s response to the consultation is published on www.gov.uk.
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