Elective Treatment

Sajid Javid Excerpts

Tuesday 8th February 2022 Commons Chamber

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

With permission, Mr Speaker, I would like to make a statement on a new, ambitious elective recovery plan—the NHS’s delivery plan for tackling the covid-19 backlog of elective care.

The NHS has responded with distinction during the country’s fight against the virus, caring for over 700,000 people with covid-19 in hospital in the UK and delivering a vaccination programme that is helping this country to learn to live with the virus, while at the same time doing so much to keep non-covid care going. Nobody—no institution—felt the burden of the pandemic more than the NHS. There have been 17 million cases of covid-19 and the NHS has had to respond to the original variant, the alpha wave, the delta wave and, most recently, of course, the omicron wave. Despite these pressures, we had one of the fastest vaccination programmes in the world, including one of the fastest booster programmes in the world.

Sadly, as a result of focusing on urgent care, the NHS could not deal with non-urgent care as much as anyone would have liked. The British people have of course understood this. Despite those exceptional efforts, there is now a considerable covid backlog of elective care. About 1,600 people waited longer than a year for care before the pandemic. The latest data shows that this figure is now over 300,000. On top of this, the number of people waiting for elective care in England now stands at 6 million, up from 4.4 million before the pandemic. Sadly, that number will continue rising before it falls.

A lot of people understandably stayed away from the NHS during the heights of the pandemic, and the most up-to-date estimate from the NHS is that that number is around 10 million. But I want these people to know that the NHS is open and, as Health Secretary, I want them to come forward for the care they need. We do not know how many will now come forward—we do not know whether it will be 30% or 80%—because no country has faced a situation like this ever before. So in developing this plan, the NHS has had to make a number of assumptions. Even if half of these people come forward, this is going to place huge demand on the NHS, and we are pulling out all the stops so that the NHS is there for them when they do. We have already announced that we are backing the NHS with an extra £2 billion of funding for elective recovery this year and £8 billion on top of that over the next three years. In addition, we are putting almost an additional £6 billion towards capital investment for new beds, equipment and technology.

Today we are announcing the next steps, showing how we will help this country’s health and care system to recover from the disruption of the pandemic but also how we will make reforms that are so important for the long-term future. That will allow the NHS to perform at least 9 million extra tests, checks and procedures by 2025 and around 30% more elective activity each year in three years’ time than it was doing before the pandemic. This bold and radical vision has been developed with expert input from clinical leaders and patient groups. It will not just reset the NHS to where it was before covid but build on what we have learned over the past two years to transform elective services and make sure that they are fit for the future.

This plan focuses on four key areas. The first is how we will increase capacity. On top of enormous levels of investment, we are doing everything in our power to make sure that we have even more clinicians on the frontline. We now have more doctors and nurses working in the NHS than ever before. We have a record number of students at medical school and a record number of students applying to train as nurses. The plan sets out what more we will be doing, including more healthcare support workers and the recruitment and deployment of NHS reservists. We will also be making greater use of the independent sector, which formed an important part of our contingency plans for covid-19, so that we can help patients to access the services they need at this time of high demand.

Secondly, as we look at the backlog, we will not just strive to get numbers down but prioritise by clinical need and reduce the very longest waiting lists. Assuming that half the missing demand from the pandemic returns over the next three years, the NHS expects the waiting list to be reducing by March 2024. Addressing long waits is critical to the recovery of elective care, and we will be actively offering longer-waiting patients greater choice about their care to help to bring down these numbers.

The plan sets the ambition of eliminating waits of longer than a year for elective care by March 2025. Within this, no one will wait longer than two years by July 2022, and the NHS aims to eliminate waits of over 18 months by April 2023 and of over 65 weeks by March 2024, which equates to 99% of patients waiting less than a year.

I have heard the concerns that have rightly been raised, including by many hon. Members, about the pandemic’s impact on cancer care. On Friday, World Cancer Day, I launched a call for evidence that will drive a new 10-year cancer plan for England, a vision for how we can lead the world in cancer care. This elective recovery plan, too, places a big focus on restoring cancer services.

The NHS has done sterling work to prioritise cancer treatment throughout the pandemic, and we have consistently seen record levels of referrals since March 2021, but waiting times have gone up and fewer people came forward with cancer symptoms during the pandemic. The plan shows how we will intensify our campaigns to encourage more people to come forward, focusing on areas where referrals have been slowest to recover such as lung cancer and prostate cancer. It also sets out some stretching ambitions for how we will recover and improve performance in cancer care: returning the number of people waiting more than 62 days following an urgent referral to pre-pandemic levels by March 2023; and ensuring that 75% of patients who have been urgently referred by their GP for suspected cancer are diagnosed or have cancer ruled out within 28 days by March 2024.

I am determined that we tackle the disparities that exist in this backlog, just as I am determined to tackle disparities of any kind across this country. Analysis from the King’s Fund shows that, on average, a person is almost twice as likely to experience a wait of over a year if they live in a deprived area. As part of our recovery work, we are tasking the NHS with analysing its waiting list data according to factors such as age, deprivation and ethnicity to help to drive detailed plans to tackle these disparities.

Thirdly, this new chapter for the NHS provides an opportunity to radically rethink and redesign how services are delivered, to bust the backlog and to deliver more flexible, personalised care for patients. The pandemic has shown beyond doubt the importance of diagnostics. Although over 96% of people needing a diagnostic test received it within six weeks prior to the pandemic, the latest data shows that has fallen to 75%. Our aim is to get back to 95% by March 2025.

A major part of this will be expanding the use of community diagnostic centres, which have already had a huge impact. These one-stop shops for checks, scans and tests help people to get a quicker diagnosis and, therefore, the treatment they need much earlier. Sixty-nine community diagnostic centres are already up and running, and the plan shows our intention to have at least 100 in local communities and on high streets over the next three years.

We will also keep expanding the use of surgical hubs, which will be dedicated to planned, elective surgeries. They will allow us to do more surgeries in a single day than can be carried out in out-patient settings, so that we can fast-track operations and ensure that patients are more likely to go home on the same day. We have already been piloting these hubs, and we will now be rolling them out across the country.

Finally, we will improve the information and support for patients. I know the anxiety that patients feel when they are waiting for care, especially if they feel that they do not have certainty about where they sit in the queue, and I am determined to ensure that, as we enter this next phase, we will be open and transparent with patients. We will be launching a new online platform called My Planned Care, which will go live this month, offering patients and their carers tailored information ahead of their planned surgery. They will be able to see waiting times for their provider, so they can better understand their expected wait. A third of on-the-day cancellations are due to people not being clinically ready for treatment, and the new platform will also be able to link patients to the most appropriate personalised support before their surgery. This shows the approach that we will be taking in the years ahead, putting patients at the heart of their care and giving the support that they need to make informed decisions. We will also put in place a payment system that incentivises strong performance and delivers value for money for the public.

Just as we came together to fight this virus, now we must come together on a new national mission to fight what the virus has brought with it. That will mean waiting lists falling by March 2024, strong action to reduce long waiting times, and stretching targets for early diagnosis and for cancer care. This vital document shows how we will not just recover, but reform and make sure that the NHS is there for all of us, no matter what lies ahead. I commend my statement to the House.

[Wes Streeting (Ilford North) (Lab)]

I thank the Secretary of State for advance sight of his statement, but it falls seriously short of the scale of the challenge facing the NHS and the misery that is affecting millions of people stuck on record high NHS waiting lists. We have been waiting some time for his plan to tackle NHS waiting times. We were told that it would arrive before Christmas; we were told that it would arrive yesterday; and it is not clear from his statement today that the delay was worth the wait. There is no plan to tackle the workforce crisis, no plan to deal with delayed discharges, and no hope of eliminating waits of more than a year before the general election in 2024. I wonder whether the Conservatives will be putting that on their election leaflets. The only big new idea seems to be a website that tells people that they are waiting for a long time, as if they did not already know.

Perhaps the Secretary of State can tell us whether the plan itself contains two other measures that have been floated in the press: the cancellation of patients’ follow-up appointments, whether they need them or not, and an offer enabling people to seize the opportunity to travel hundreds of miles around the country, if they can find a hospital in England that does not already have a waiting list crisis of its own. What we did hear was a series of reannouncements, including some perfectly sensible proposals for community diagnostic and surgical hubs. We welcome those, but the Secretary of State cannot pretend that they meet the scale of the challenge.

The Secretary of State reaffirmed the Prime Minister’s commitments on cancer, announced only yesterday. He announced a new target that no one should wait more than two months for cancer diagnosis, but there is already a target for the vast majority of cancer patients to be treated within two months of referral. Can he tell us which target he is aiming to meet? Is it the target that has not been hit since 2015, or the target announced yesterday, which seems to lower standards for patients because the Government consistently fail to meet them? The Prime Minister has also announced that three out of four patients should receive a cancer diagnosis within 28 days, but that is an existing target which was introduced in April and has never been met, and nothing that the Secretary of State has announced today gives me any confidence that it will be met in the future. Given that half a million patients with suspected cancer are not being seen in time, it seems that the Secretary of State declared a war on cancer after more than a decade of disarming the NHS, and is now sending the NHS into battle empty-handed.

Indeed, it is hard to believe that this is the announcement that the Secretary of State wanted to make. One Government official briefed Robert Peston that the plan was being blocked by the Chancellor, who is, “reluctant to rescue the Prime Minister”. Putting to one side the appalling spectacle of the Tory leadership crisis impacting on life and death decision making in Government, it seems from the statement that the Chancellor has won the day. What other explanation can there be for a plan to recover the NHS and bring down waiting lists that does not contain a workforce plan? The single biggest challenge facing the NHS is the workforce challenge. There are 93,000 staffing vacancies in the NHS today. The NHS is understaffed, overworked and, if the Secretary of State is not careful, he will lose more people than he is able to recruit. This is not a new development, and it should not be news to him.

In April, the NHS called for a national workforce plan. Polling from the Health Foundation found that the public want more staff with fewer workload pressures. The Secretary of State himself told the Health and Social Care Committee in November that his plan would include a strategy for the workforce crisis. We know the NHS wants a workforce plan and the public want a workforce plan. He promised a workforce plan, so where is it? There is not even a budget for Health Education England let alone a serious plan to recruit and retain the workforce that we need. Instead, he is proposing new NHS reservists. Who are they? Where are they coming from? How many does he imagine there will be? How does he imagine that they will make a dent in the 93,000 vacancies? It seems more “Dad’s Army” than SAS.

Then there is the issue of wider NHS and social care pressures that impact directly on waiting lists and waiting times: the pressures on GP practices that see people ringing the surgery at the crack of dawn in the hope of getting through before the appointments have gone; the pressures on social care that lead to delayed discharges from hospital, as we saw in more than 400,000 cases in November alone; and the missed opportunities and the wasted money that comes from a failure to invest in community services that lead to people turning up at A&E at greater cost to patient health and at greater cost to the taxpayer.

This plan falls well short of the challenge facing our country. Six million people are waiting for care. Cancer care is in crisis, with half a million patients with suspected cancer not seen in time. Heart and stroke victims are waiting more than two hours for an ambulance when every minute matters. It is clear from what the Secretary of State said today, from what his colleague, the Minister for Health, the hon. Member for Charnwood (Edward Argar), said yesterday, and no doubt what will be heard repeated in the Tory scripts in the days and weeks to come, that the Conservatives are hoping to blame the state of NHS waiting lists on the pandemic—the “covid waiting lists”, they called them. But this is not a covid backlog; it is a Tory backlog. After a decade of Tory mismanagement, the NHS had: record waiting lists of 4.5 million before the pandemic; staff shortages of 100,000 before the pandemic; 17,000 fewer beds before the pandemic; and 112,000 vacancies in social care before the pandemic.

In conclusion, it is not just that the Government did not fix the roof while the sun was shining, they dismantled the roof and removed the floorboards. With the ceiling of their ambition that the Secretary of State outlined today being to go back to where we were before the pandemic, it is now clear that the longer that we give the Conservatives in office, the longer patients will wait.

[Sajid Javid]

I am surprised with the argument and the tone of the hon. Gentleman. It is 2022, not 2024. We have all come to expect the scaremongering that we have just heard from the Labour Benches at election time—that has happened in every election campaign since the war—but what I did not expect is this scaremongering from the hon. Gentleman on the plans to recover in the wake of a deadly pandemic.

I am astonished and disappointed that the hon. Gentleman is willing to stand there and claim that there is no covid backlog. [Interruption.] That is what he just said. He just said that there is no covid backlog. He is well aware that this country has just gone through its biggest health challenge in history. He is also well aware that there has been a national mission across the NHS to deal with that challenge and to recover from it. I paid tribute to the hon. Gentleman just last week in this House—perhaps I was just a bit too early—when he rightly supported the nation’s vaccination programme, because he understood just how important it was. Perhaps some of his Back Benchers have now got to him, so instead of standing up for the British people, he is just thinking about his own leadership prospects in his party—perhaps that is what is actually going on.

Today, instead of doing the right thing and backing the NHS—backing the hundreds of thousands of doctors, nurses and everyone working heroically across the NHS—the hon. Gentleman decided to play party politics. A moment ago, he heard me talk about the 10 million people who the NHS estimates have stayed away from the NHS and who need reassurance from both sides of the House about what the NHS is doing. He should reconsider his approach and work together in the national interest.

[Lucy Allan (Telford) (Con)]

I welcome the statement and I am grateful to the Secretary of State for setting out a covid recovery plan to tackle the challenges that lie ahead. Every single Member of the House should support him in that endeavour. I ask him, however, how he will tackle the staffing crisis.

[Sajid Javid]

I thank my hon. Friend for her support. Over the past two years, the number of clinicians in the NHS has risen by about 40,000. In the past year, we have 10,000 more nurses, 5,000 more doctors and more people in medical school than ever before, so a huge amount of record investment is going into the workforce. Recently, I also asked the NHS to put together a long-term 10-year-plus workforce strategy and I look forward to receiving it.

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

The elective care backlog is not the only crisis facing the NHS. Covid has affected the care being delivered by mental health services, primary care, emergency care, community care and social care. In the Health and Social Care Committee’s recent report on tackling the NHS backlog, we recommended that a broader national health and care recovery plan be published to set out a clear vision for how patient care will be improved. Will the Secretary of State confirm that that will be published before April, as the Committee recommended?

[Sajid Javid]

I thank the hon. Lady for her work on the Committee. She is right to raise the importance of mental health. Although today’s plan is focused on elective surgical procedures and diagnostics, she is right to talk about other types of care, especially mental health care. I know that she supports the huge amount of record investment going into the NHS for mental health care. Under the NHS long-term plan, it is an additional £2 billion a year. She is also right to raise the importance of patient care. I believe that there is a lot in this plan on patient care that she will support.

[Paul Bristow (Peterborough) (Con)]

I welcome the statement and the national mission. I must say that for the Labour party to try to play party politics with it is a serious misjudgment. Surgical hubs have been successfully piloted in London by the Getting It Right First Time programme. As they are rolled out across the country, will the Secretary of State ensure that GIRFT continues to be properly resourced and is given a key role in leading the programme in future?

--- Later in debate ---

[Sajid Javid]

Absolutely; I agree wholeheartedly with my hon. Friend. There are already 44 surgical hubs up and running across the country, including in London. I went to see one at Moorfields, which is getting through cataract operations more quickly and seeing more people per day than ever before. He is right to talk about their importance and the funding is there in the plan to see many more of them across the nation.

[Chris Bryant (Rhondda) (Lab)]

The key issue seems to be the workforce. It is about trying to ensure that people do not leave the workforce now or do not leave it early. It is also about recruiting enough people, sometimes into specialties that are not necessarily the sexiest ones that people are pushed into at the beginning. For instance, there is no chance of getting diagnoses within the target set in 2018, which we now hope to meet in 2024, unless we train more pathologists every single year. This year, we will not train enough pathologists to meet the number who are leaving this year, so we are going backwards rather than forwards. How will the Secretary of State address that?

[Sajid Javid]

I agree with the hon. Gentleman about the importance of the workforce, especially in the context of specialisms, and pathology is a really good example. That is why we are putting record amounts of investment into the workforce and training. It is also one of the reasons why, to get a more joined-up plan in health, I have decided that Health Education England should be merged with the NHS. This will enable more joined-up thinking and much better planning for the future, especially in specialist areas.

[Dr Andrew Murrison (South West Wiltshire) (Con)]

I declare my interest as a doctor. Will the Secretary of State look again at how we structure doctors’ pay and remuneration? At the moment, we are training lots of doctors—more and more of them—which is a great thing, but typically they leave in their late 50s, so we are losing a whole decade of productive medical time. That cannot go on. Will he look again to see how we can disincentivise early retirement of medical professionals?

[Sajid Javid]

My hon. Friend speaks with great experience and raises a really important issue. The short answer is yes. We have fantastic doctors throughout the NHS and more in training in medical schools than ever before, but we should also focus on retaining talent throughout the NHS. I assure him that that work has already begun.

[Daisy Cooper (St Albans) (LD)]

I am shocked that some Government Members are trying to pat each other on the back, because right now my heart is breaking for all those constituents who have emailed me to tell me that they are in fear and in pain, and what they have just heard is that that may continue for years to come. The Secretary of States talks about new tech, new hubs and new scanners, but without people to operate them they may be of limited use. Where is the plan to fill the almost 100,000 NHS vacancies?

[Sajid Javid]

The hon. Lady, like other hon. Members, is absolutely right to raise the importance of workforce. To deliver on this plan, of course we need to do so much more to keep increasing the workforce and make sure all the skills we need are there. Just last week, I believe, the NHS published that it has more doctors, nurses and clinicians than ever before; 40,000 people have joined the NHS over the last two years, including many more doctors and nurses. Also, as I mentioned, I have asked the NHS, with HEE, which will become part of the NHS, to come up with a long-term plan. We look forward to that plan and will invest in it.

[Sir Edward Leigh (Gainsborough) (Con)]

People of a certain age, of whom, unfortunately, I am one, are terrified because they think that if something goes wrong, they might have to wait in pain for two years. We cannot wait until March 2024 to join the back of a slightly shorter queue. Then we see our friends who have private health insurance—I am not one of them; we cannot afford it—being seen within days. May I suggest a policy that would be wildly popular with many of our own supporters, which every Conservative Government until 1997 followed, which is to give tax relief to private health insurance? Why not look at every innovative solution that unleashes new money? Before the Secretary of State says that that is a matter for the Chancellor, will he at least put it at the back of his mind, so that when he next talks to the Chancellor they will at least discuss it?

[Sajid Javid]

I am always pleased to talk with my right hon. Friend about his ideas and suggestions, and I am happy to meet him to discuss this further, but I am sure he agrees with me on the importance of making sure that we invest in the NHS and the workforce so that they can deal with as many people as possible.

[Mick Whitley (Birkenhead) (Lab)]

Across the country, millions of people are waiting for potentially life-changing procedures, and it is absolutely right that every effort be made to bring this backlog down, but the Secretary of State should be aware of just how big an ask he is making of frontline staff. This will be a herculean effort, especially for all those who have spent the last two years on the frontline of the fight against covid-19. When he considers the enormous sacrifices that NHS workers have made over the course of this pandemic and everything that they will be asked to do in the very difficult months ahead, will the Secretary of State concede that last year's 3% pay rise was pitiful and commit to giving our healthcare heroes the substantial pay rise they truly deserve?

[Sajid Javid]

I agree with the hon. Gentleman that all those working in health, and social care for that matter, have been the heroes of this pandemic. Everything that they have delivered and gone through over the last two years is something that the whole nation will respect. He is right to also point out that the expectation over the next few years for delivering on the plan is very high, and the workforce of course deserve maximum support. When it comes to pay, it is right that the Government listen to the independent pay review bodies, which will take into account a number of factors, and that is exactly what we did last year.

[Mr Peter Bone (Wellingborough) (Con)]

I am grateful to the Secretary of State for coming to the House and making this announcement here first. Does he agree that, as other Members have said, particularly Opposition Members, we need to increase the workforce? How then can the mandatory vaccination of NHS health workers, which was going to lose us 80,000 people, possibly have been right? We knew the covid backlog was there, so how on earth was that ever a good policy? I know that Opposition Members supported it hugely, but Conservative Members had their doubts. Was it not a wrong decision?

[Sajid Javid]

I agree with my hon. Friend about the importance of the workforce, but I am afraid I do not agree with his comments about the plans for mandatory vaccination. I will not go through the details again; I did make a statement to the House on that last week, and in fact it was supported by the vast majority of Members of this House. The short answer to his question is that it is all about patient safety. The Government and the NHS are always absolutely right to put patient safety first, and although the Government have now, in the light of omicron, rightly changed their plans, it is still the professional responsibility of everyone working in healthcare to get vaccinated.

[Tim Farron (Westmorland and Lonsdale) (LD)]

I am grateful for what the Secretary of State said about diagnostic hubs. Will he investigate personally why the planned hub for Westmorland general hospital has been delayed until 2023? I am also grateful for what he said about cancer services more generally. He knows that there have been 60,000 missed cancer diagnoses over the last two years, and I am sure he knows that radiotherapy is a key factor in tackling the backlog. Is he aware that radiotherapy ought to be accessed by 53% of cancer patients in this country but is accessed by only 23%, and that, as a proportion of our cancer budget, funding for radiotherapy in this country is only a little more than half the average for similar developed countries? Will he therefore make it a priority to meet with the all-party parliamentary group for radiotherapy and look at our manifesto, so that we can work together to save tens of thousands of lives that would be needlessly lost otherwise?

[Sajid Javid]

The hon. Gentleman raises a series of very important points, especially in what he said about cancer and radiotherapy. I believe he already has a meeting in the diary with Health Ministers, and I will look out for the output of that meeting. I agree with what he said about radiotherapy and the importance of investment in that, and there is a lot more investment. I referred earlier to the £6 billion extra capital budget, and a large part of that will be used for new diagnostics. I hope he also agrees with me that, as well as radiotherapy, we need to invest in the very latest cutting-edge technology for cancer care, such as proton beam therapy, which I saw for myself last week in London.

[Mr Mark Harper (Forest of Dean) (Con)]

The Secretary of State will know that many on this side of the House were very reluctant, but did support the increase in resources for the NHS through the increase to national insurance and then the health and social care levy. When we are making that argument to our constituents, they will expect that money to deliver results, so may I make one observation and ask one question? The observation is that, while the plan is welcome, only getting to 99% of patients waiting less than a year by March 2024 is not ambitious enough, so will he perhaps be more ambitious? Will he also say a word about how the resources raised through national insurance will be removed from the NHS and flow into social care? From October 2023, we will have to fund social care with the same money. He did not talk about that, and social care is as important as the NHS, so will he say a word about that?

[Sajid Javid]

My right hon. Friend is absolutely right about the importance of making sure that every penny spent in the NHS, or social care for that matter, is spent wisely and in the very best interests of taxpayers. I absolutely agree with him on that, and that also has to translate into the ambition. My right hon. Friend, like other hon. Members, will not have had time yet to look at the plan. I am happy to discuss it with him afterwards if he wishes. I hope he agrees that it is full of ambition. Indeed, if the NHS can go much further than the targets I set out earlier, that is what we all want. As I said in my statement, it does depend on how many people come back to the NHS, and that is very hard to estimate, but I want as many people as possible to come back.

My right hon. Friend is right to raise the importance of social care and the need for much better integration between healthcare and social care. We will set out more detailed plans on just that very shortly.

[Rachael Maskell (York Central) (Lab/Co-op)]

As a clinician, I am astounded by what the Secretary of State has brought forward today. First, he talks about health inequality, then puts forward a solution that will exclude people who experience the greatest health inequality because they also experience digital inequality. Not only that, but people on waiting lists are in a lot of pain. They are put on waiting lists because of the advancement of their condition. They do not need a website; they need clinicians surrounding them to give them the physical and psychological support they need over the two or more years they will have to wait. What plans has the Secretary of State got to ensure that they get the physical and psychological support that they need over that time?

[Sajid Javid]

The hon. Lady is of course right to talk about the importance of health inequalities. I hope that when she has had time to look at the plan she will see just how seriously the NHS and the Government take that. More broadly, I will have a lot more to say about tackling health inequalities shortly. Of course, the hon. Lady is right that there need to be alternatives to digital access for those who cannot easily access digital, be it through a web platform or the NHS app. There are alternatives in place, but I hope she agrees that for those who can use digital tools, we should make them part of the offering. The new “my planned care” service will be hugely important in providing more transparency than ever before, but also in helping people prepare for their surgical procedures. She may have heard me say earlier than one third of on-the-day cancellations of surgical procedures happen because people were not prepared.

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

I declare my interest as an NHS doctor and I echo much of what has been said by colleagues across the House about the workforce challenges.

As the Secretary of State said, covid has been a huge challenge to the NHS and it is a testament to NHS workers that cancer treatment was maintained at 94% of pre-pandemic levels throughout the pandemic and that 95% of people who needed cancer treatment started that within a month. However, I am sure the Secretary of State agrees that one month is a very long and frightening time to know that cancer is growing inside and that every day’s delay could be the day that costs your life. How does he intend to reduce that time and what will be his target from diagnosis to treatment?

[Sajid Javid]

I agree with my hon. Friend about the importance of the workforce. She is right to raise the importance of cancer care and to note that it has remained a huge priority for the NHS despite all the pressures of the pandemic. In the plan that we are publishing today, we have set out a number of cancer targets. They are all very ambitious with record amounts of investment. Once my hon. Friend has looked at the plan, I would be happy to discuss it further with her, either the cancer aspects or anything else.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for a progressive and positive statement on the way forward. With statistics showing that there were some 10 times more patients waiting six weeks or more for cancer diagnostic tests at the end of November 2021 than in November 2019 in England, and with similar UK-wide statistics, what specifically is the Secretary of State doing to address the massive backlog in those life-saving tests?

[Sajid Javid]

I welcome the hon. Gentleman’s comments. With respect to life-saving tests and scans, including for cancer, the plan sets out a huge amount of new investment in diagnostic capacity. One area of investment is the new community diagnostic centres, some 69 of which have already opened across England in convenient places such as shopping malls and car parks, which people can access much more easily and get their results from much more quickly.

[Dr Luke Evans (Bosworth) (Con)]

I welcome the plan. I am most intrigued by the “my planned care” website, because one of the biggest problems for clinicians is that they spend a lot of time chasing admin. It is a great opportunity for pre-operative checks and for people to know where their follow-ups are. Will the Secretary of State look at expanding it to out-patient settings? People over the age of 80 may well have four, five or six specialists, so trying to keep track of their letters, of where they should be and of their appointments is really difficult.

During covid, 29 million people downloaded the NHS app and we had the fantastic covid dashboard, so we have seen what we can do with technology to help our patients and clinicians. Will the Secretary of State encourage the NHS to build on the measures that he is bringing forward to help with the backlog?

[Sajid Javid]

Yes. My hon. Friend is absolutely right to talk about the importance of technology in delivering world-class care. He will know that I have already announced that the parts of our health system that contribute to the best use of technology, NHSX and NHS Digital, will become part of the wider NHS so that we have a more joined-up strategy. “My planned care” will start as an online platform, but will move to an app-based service as soon as possible. My hon. Friend is right to talk about the importance of having something similar for out-patient care; we are already on it.

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

Will my right hon. Friend work with our excellent GPs to increase access to primary care? Will he encourage them to open up more channels of communication such as email, text and chat apps to ensure that people feel able to raise their health concerns at the earliest possible stage rather than putting them off until they become more serious, when it is potentially too late?

[Sajid Javid]

Yes. I join my hon. Friend in thanking GPs up and down the country for all their phenomenal work throughout the pandemic amid the huge pressure that they have had to deal with. He is right about making sure that channels of communication with GPs are as varied as possible and are available to everyone in all age groups so that we can better support early diagnosis.

[Aaron Bell (Newcastle-under-Lyme) (Con)]

I thank my right hon. Friend for his statement and for his leadership as we recover from covid. I must say that I find the words of the hon. Member for Ilford North (Wes Streeting) a bit hollow when the Opposition voted against £36 billion recently.

May I raise the matter of recovery in our emergency care? The Secretary of State will know that too many people in Newcastle-under-Lyme have had to wait too long for ambulances recently. Will he or his Ministers help to bring together West Midlands ambulance service, Royal Stoke University Hospital and the clinical commissioning groups to find a solution so that we can get patients into hospital and back out again as quickly as possible?

[Sajid Javid]

I thank my hon. Friend for reminding the House that the Labour party voted against additional investment in the NHS. He is right to talk about the impact on urgent care, particularly for ambulance services and especially during the recent omicron wave. We invested an additional £55 million in ambulance services over the winter. A lot more needs to be done to support urgent care, but the plans that we will shortly set out for the integration of healthcare with social care will certainly help to relieve many of those pressures.

[Mr Philip Hollobone (Kettering) (Con)]

Kettering General Hospital performed heroically during the pandemic and is now gearing up with determination to increase its elective surgery capacity by 30%. Does the Secretary of State take on board the point that in addition to having to clear the covid backlogs, areas such as Kettering and north Northamptonshire are seeing a very steep rise in the local population, with tens of thousands of new houses being built, and are expecting a very sharp rise in the next five years in the number of people aged 80 or over? Will he ensure that Kettering General Hospital gets all the resources it needs?

[Sajid Javid]

I join my hon. Friend in thanking the staff at Kettering General Hospital for everything they have been doing, especially over the past two years. Of course, challenges remain. I understand that my hon. Friend the Minister for Health will visit Kettering General Hospital shortly; I look forward to hearing about it. I can assure my hon. Friend the Member for Kettering (Mr Hollobone) that when we look at funding and directional resources, we will certainly take account of not just the current population, but the forecast population.

Points of Order

Sajid Javid Excerpts

Tuesday 8th February 2022 Commons Chamber

[Mr Speaker]

I do not know if the Secretary of State wants to respond—

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

indicated dissent.

[Mr Speaker]

Then I will try to do the best I can. I thank the hon. Member for giving me notice that she would raise the point of order. The Chair is not responsible for the content of Ministers’ answers to parliamentary questions or for Departments’ responses to freedom of information requests. If the hon. Member believes that there is an inconsistency between the two in this case, there are always ways in which she can press the Department for further information to clarify the matter. Can I suggest that she takes it up with the Table Office for further advice? I hope that those on the Treasury Bench are well aware that this issue has been raised and are able to inform ministerial colleagues. I think we do need the answers: I do not want to keep dealing with the same points of order.

Health Disparities

Sajid Javid Excerpts

Friday 4th February 2022 Written Statements

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

The pandemic has shone a light on the unacceptable disparities in health outcomes that exist across the country. The Government are committed to reducing health disparities, addressing the gap in healthy life expectancy that exists between different communities and building on the positive action set out in the levelling up White Paper.

I am therefore pleased to announce that we will take bold action on health disparities through a health disparities White Paper, aiming to break the link between people’s background and their prospect for a healthy life.

We will publish our plans in spring 2022 and look forward to engaging with stakeholders and partners to address this critical agenda.

Linked to the health disparities White Paper, I would also like to announce two reviews with a focus on health disparities:

Independent review on tobacco control

Firstly, I have asked Javed Khan to lead an independent review into smoking in support of the Government’s bold ambition to be smoke free by 2030.

While the Government have made good long-term progress in reducing smoking rates, there are still nearly 6 million smokers in England, and an estimated 64,000 people died from smoking in 2019 alone. Smoking is one of the largest drivers of health disparities and causes a disproportionate burden to our most disadvantaged families and communities.

As a leading figure in the UK public and voluntary sectors, Javed Khan will bring a wealth of experience to help determine what more can be done to drive down smoking rates. The review will support the Government to identify the most impactful interventions to reduce the uptake of smoking, and support people to stop smoking, for good.

The independent, evidence-based findings will inform both the health disparities White Paper and the Government’s new tobacco control plan, which will be published later this year. Javed Khan will report back to the Government in April 2022.

Independent review into medical devices

Professor Dame Margaret Whitehead will lead an independent review of the health impact of potential ethnic bias in the design and use of medical devices.

Professor Dame Margaret Whitehead has vast experience in tackling health inequalities, and for many years has led the work of the World Health Organisation’s Collaborating Centre for Policy Research on the Determinants of Health Equity.

The review into the design and use of medical devices in the UK aims to:

Identify systematic inequalities in medical devices registered for use in the UK.

Make recommendations on how inequalities should be tackled.

Consider what systems need to be in place to ensure emerging technologies are developed without ethnic inequalities.

Improve global standards to better healthcare and tackle disparities.

I look forward to the outcome of both reviews so we can continue to level up across society and make sure everyone—no matter where they live or come from—can live a long, healthy life.

[HCWS591]

Covid-19 Vaccinations: Condition of Deployment

Sajid Javid Excerpts

Thursday 3rd February 2022 Written Statements

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

In December 2021, Parliament approved legislation requiring vaccination as a condition of deployment (VCOD) in health and wider social care. This was due to come into force from 1 April 2022.

On 31 January I announced the Government intention to revoke the regulations making vaccination a condition of deployment in all health and social care settings. This is subject to consultation and Parliamentary process.

I have listened to the best clinical and scientific advice and considered how we can achieve public health and safety with the minimum number of restrictions or requirements on people’s lives. The changes in the pandemic as a result of the omicron variant and the continued success of the vaccination programme mean it is right that we revisit the balance of risks and opportunities that guided our original decision last year.

Whilst vaccination remains our very best line of defence against covid-19, and all people working in health and social care settings have a professional duty to be vaccinated, the view of this Government is that it is no longer proportionate to require vaccination as a condition of deployment through statute.

Following this announcement, I am now providing further clarity on how this planned revocation impacts on the 3 February deadline for a first dose of covid-19 vaccination for those currently working in CQC-regulated health and wider social care settings. I am aware that, based on the guidance already issued, those who employ or engage staff working in health and wider social care settings may have begun to prepare for formal meetings with staff if they remain unvaccinated.

With the announcement of our intention to revoke this legislation, the Government’s clear advice is that those employers do not serve notice of termination to employees in connection with the VCOD regulations.

NHS England has written to healthcare employers requesting that employers do not serve notice of termination to employees affected by VCOD regulations. Furthermore, my Department has written to the adult social care sector and advised that employers in wider adult social care do not serve notice of termination to employees in connection with the VCOD regulations.

I want to acknowledge the incredible efforts of the health and social care sector over the past year to encourage staff to receive their covid-19 vaccinations. These have been very much appreciated. Since September there has been a net increase of over 127,000 people working in the NHS who have been vaccinated. During the same time, we have also seen a net increase of 32,000 people vaccinated in social care including 22,000 people in care homes and 10,000 people working in domiciliary care.

My Department will move quickly to publish a consultation as legally required, and will continue to keep all those affected updated.

[HCWS587]

Covid-19 Testing: Transparency

Sajid Javid Excerpts

Thursday 3rd February 2022 Written Statements

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

I am today laying in Parliament a set of documents in response to the Humble Address motion of the House of Commons passed on 17 November 2021.

The Department of Health and Social Care has followed a rigorous process to identify and quality assure all relevant-documents. Specialist document review software was used to identify references to “Randox” across 56 ministerial private office and special adviser email accounts. The Department also asked current and former ministers and special advisers who could have been involved in correspondence about the specified meeting and contracts to provide relevant records from their private systems. The Department reviewed approximately 11,000 records to identify the documents laid today.

We are committed to ensuring transparency in order that Parliament is able to scrutinise and hold the Executive to account. However, the Government also have a responsibility to consider whether it will be in the public interest to place information into the public domain. This necessitates balancing the need for openness against other important and long standing, and often competing, principles, such as the need to protect legal confidentiality and Cabinet papers for reasons of collective responsibility, and legislation, such as the Data Protection Act.

This has been a costly and time-consuming exercise. Initial searches identified 1.5 million pieces of information relating to Randox. This was narrowed to the approximately 11,000 documents which then needed individual review in order to determine whether they were relevant or in scope of the Humble Address. Those which have been identified as in scope have been published, subject to public interest considerations such as the application of data protection principles towards named staff. Had this been a Freedom of Information Act request or Parliamentary Question, this exercise would have passed the disproportionate cost thresholds.

As noted in the Government Response to the Public Administration and Constitutional Affairs Committee's Fifteenth Report: “Status of Resolutions of the House of Commons” in March 2019, “the Government therefore agrees with PACAC that this device should not be used irresponsibly or over-used. As the Committee notes, such powers lack statutory force and if they cease to be exercised responsibly, the Government will have to reflect carefully on what measures may be required in order to protect how it should respond in the public interest.”

As the public would expect, at the start of the pandemic the Government took every possible step to rapidly build the largest testing industry in UK history from scratch, this has played an important role in stopping the spread of covid-19 and saving lives, and the service Randox provided was integral to that response.

There are robust rules and processes in place to ensure that all contracts are awarded in line with procurement regulations and transparency guidelines and that any potential conflicts of interest with respect to commercial matters are appropriately managed. Ministers are not involved in the assessment and evaluation process for contracts.

Building the scale of testing needed at an unprecedented speed required extensive collaboration with businesses, universities and many others, to get the right skills, equipment and logistics in place as quickly as possible. We make no apology for working at an incredible pace to tackle the biggest public health emergency in living memory.

I want to take the opportunity to reiterate my thanks everyone who has worked tirelessly across Government, the private sector and beyond to help deliver one of the biggest testing programmes in Europe.

[HCWS586]

Vaccination: Condition of Deployment

Sajid Javid Excerpts

Monday 31st January 2022 Commons Chamber

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

With permission, Mr Deputy Speaker, I would like to update the House on vaccination as a condition of deployment.

Last Thursday, we woke up to a new phase of this pandemic as we returned to plan A. People are no longer advised to work from home. Face coverings are no longer mandatory. Organisations no longer have to require the NHS covid pass. And, from today, there is no limit on the number of visitors allowed in care homes.

Week by week, we are carefully moving our covid response from being one of rules and restrictions back to being one of personal responsibility. We are able to do this because of the defences that we have built throughout this pandemic—in vaccines and antivirals, in testing and surveillance.

We know, of course, that covid-19 is here to stay. While some countries remain stuck on a zero-covid strategy and others think about how they will safely open up, here we are showing the way forward and showing the world what successfully living with covid looks like. The principle we are applying is the same principle that has guided our actions throughout this pandemic, and that is to achieve the maximum protection of public health with the minimum intrusion in people’s everyday lives. To me, that is what learning to live with covid is all about.

Even with this progress, we must of course remain vigilant. While overall cases and hospitalisations continue to fall, we are seeing rises in cases in primary and secondary schoolchildren. Part of living with covid means living with new variants and subvariants. Our world-class health surveillance operations are currently keeping a close watch on a subvariant of omicron called BA.2, which the UK Health Security Agency has marked as a variant under investigation—one below a variant of concern. Some 1,072 genomically confirmed cases of BA.2 have been identified in England. While early data from Denmark suggests that BA.2 may be more transmissible, there is currently no evidence that it is any more severe. In addition, an initial analysis of vaccine effectiveness against BA.2 reveals a similar level of protection against symptomatic infection compared with BA.1—the original variant of omicron—which underlines, once again, the importance of being vaccinated against covid-19 and the imperative to get the booster if you are eligible.

Nowhere is vaccination more important than in our health and social care system. Throughout this pandemic, we have always put the safety of vulnerable people first, and we always will do. It has always been this Government’s expectation that everyone gets vaccinated against covid-19, especially those people working in health and social care settings, who have a professional duty to do so. When designing policy, there will always be a balance of opportunities and risks, and responsible policy making must take that balance into account.

When we consulted on vaccination as a condition of deployment in health and wider social care settings, the evidence showed that the vaccine effectiveness against infection from the dominant delta variant was between 65% and 80%, depending on which of the vaccines people had received. It was clear that vaccination was the very best way to keep vulnerable people safe from delta because, quite simply, if you are not infected, you cannot infect someone else. Balanced against this clear benefit was the risk that there would always be some people who would not do the responsible thing and would choose to remain unvaccinated—and, in doing so, choose to walk away from their jobs in health and care. Despite its being their choice to leave their jobs, we have to consider the impact on the workforce in NHS and social care settings, especially at a time when we already have a shortage of workers and near full employment across the economy.

In December, I argued—and this House overwhelmingly agreed—that the weight of clinical evidence in favour of vaccination as a condition of deployment outweighed the risks to the workforce. It was the right policy at the time, supported by the clinical evidence, and the Government make no apology for it. It has also proved to be the right policy in retrospect, given the severity of delta. Since we launched the consultation on vaccination as a condition of deployment in the NHS and wider social care settings in September, there has been a net increase of 127,000 people working across the NHS who have done the right thing and got jabbed, becoming part of the 19 out of 20 NHS workers who have done their professional duty. During the same time, we have also seen a net increase of 32,000 people getting jabbed in social care—22,000 people in care homes and 10,000 people working in domiciliary care.

I am grateful to the millions of health and care colleagues who have come forward to do the right thing, and the health and care leaders who have supported them. Together, they have played a vital part in raising our wall of protection even higher, and keeping thousands of vulnerable people out of hospital this winter.

When we laid the November regulations, the delta variant represented 99% of infections. A few short weeks later, we discovered omicron, which has now become the dominant variant in the UK, representing over 99% of infections. Incredibly, over a third of the UK’s total number of covid-19 cases have happened in just the last eight weeks. Given that delta has been replaced, it is only right that our policy on vaccination as a condition of deployment be reviewed. I therefore asked for fresh advice, including from the UK Health Security Agency and England’s chief medical officer.

In weighing up the risks and opportunity of this policy once again, there are two new factors. The first is that our population as a whole is now better protected against hospitalisation from covid-19. Omicron’s increased infectiousness means that at the peak of the recent winter spike one in 15 people had a covid-19 infection, according to the Office for National Statistics. Around 24% of England’s population has had at least one positive covid-19 test, and as of today in England 84% of people over 12 have had a primary course of vaccines and 64% have been boosted, including over 90% of over-50s. The second factor is that the dominant variant, omicron, is intrinsically less severe. When taken together with the first factor—greater population protection—the evidence shows that the risk of presentation to emergency care or hospital admission with omicron is approximately half of that for delta.

Given those dramatic changes, it is not only right but responsible to revisit the balance of risks and opportunities that guided our original decision last year. While vaccination remains our very best line of defence against covid-19, I believe that it is no longer proportionate to require vaccination as a condition of deployment through statute. So today I am announcing that we will launch a consultation on ending vaccination as a condition of deployment in health and all social care settings. Subject to the responses and the will of this House, the Government will revoke the regulations. I have always been clear that our rules must remain proportionate and balanced, and of course, should we see another dramatic change in the virus, it would be only responsible to review the policy again.

Some basic facts remain. Vaccines save lives, and everyone working in health and social care has a professional duty to be vaccinated against covid-19. So although we will seek to end vaccination as a condition of deployment in health and social care settings using statute, I am taking the following steps. First, I have written to professional regulators operating across health to ask them to urgently review current guidance to registrants on vaccinations including covid-19 to emphasise their professional responsibilities in this respect. Secondly, I have asked the NHS to review its policies on the hiring of new staff and deployment of existing staff, taking into account their vaccination status. Thirdly, I have asked my officials to consult on updating my Department’s code of practice, which applies to all Care Quality Commission-registered providers of healthcare and social care settings in England. They will consult on strengthening requirements in relation to covid-19, including reflecting the latest advice on infection protection control.

Finally, our vital work to promote vaccine uptake continues. I am sure that the whole House will join me in thanking NHS trusts and care providers for their relentless efforts in putting patient safety first. I also thank the shadow Health Secretary and the Opposition for their support of the Government’s approach to this policy area. One of the reasons that we have the highest vaccine uptake rates in the world is the confidence in our vaccines that comes from this place and from both sides of the House. We may not agree on everything, but when it comes to vaccination, together we have put the national interest first. It is now in our national interest to embark on this new phase of the pandemic, when we keep the British people safe while showing the world how we can successfully learn to live with covid-19.

I commend this statement to the House.

[Wes Streeting (Ilford North) (Lab)]

I thank the Secretary of State for advance sight of his statement, and also for his regular contact and briefings on this issue at both ministerial and official level. He is right to say that Labour worked with the Government to ensure maximum take-up of the vaccine across health and social care, and we do not regret that decision. Indeed, we welcome the decision that he has come to today.

Let me be clear from the start: vaccines are safe, effective, and the best defence that we have against the virus. Whether compulsory or not, it remains the professional duty of all NHS and care workers to get themselves vaccinated, just as it is the duty of all of us to protect ourselves, our loved ones, and our society from the greater spread of infections and hospitalisations, and from the need for harsh restrictions that impact on our lives, livelihoods and liberties. The debate over this policy is about whether the state should mandate the vaccine for health and care staff, or whether it should take a voluntary approach. It is not a discussion about the need to get vaccinated, the arguments for which are overwhelmingly one-sided. With five million people in the UK still to have their first jab, we cannot afford to take our foot off the pedal in getting the message out.

Labour Members supported the initial policy in early December. Since then we have seen a significant increase in vaccinations among NHS staff, with tens of thousands more staff now protected. I say an enormous thank you to the NHS trusts that worked tirelessly to persuade hesitant staff of the need to get vaccinated, and to those colleagues who have given up considerable time to have supportive conversations with their peers. I thank the health unions and royal colleges which, despite their misgivings about the mandatory nature of the policy, nonetheless did everything they could to encourage their members to get vaccinated.

Clearly, things have now moved on, in terms of both our overall levels of infections, and in our understanding of this latest variant. It has also become clear that to follow through with this policy could see tens of thousands of staff forced to leave their roles, at a time when our health service is already understaffed and overstretched—indeed, that has been a particular anxiety on these Benches and right across the House. However, efforts must continue to persuade those staff who are still hesitant.

What lessons have the Secretary of State and his Department learned from the Welsh Government, where 95% of staff were double jabbed by November without any mandate? What can we learn from the Welsh Government’s approach to persuasion, and how can we emulate their success? In light of today’s decision, it is all the more important that health and care workers are empowered to do the right thing and isolate when they need to, without the fear of being unable to feed their families. One in five care homes do not pay staff their full wages to isolate. If we are to learn to live well with covid, that must change. Labour’s plan for living well with covid includes making all workers eligible for proper levels of sick pay. Why have the Government still not sorted this? I appreciate that those are also Treasury issues, but that approach is penny-wise and pound-foolish when it comes to protecting public health.

The Labour party supported this measure in December, put the national interest before party politics, and made sure it had the votes needed to pass through the House. We understand the difficulties faced by the Government in coming to today’s decision, and we will continue to be as constructive and helpful as we can be in a national crisis, just as Labour has been throughout the past two years. I welcome very much what the Secretary of State said this afternoon about welcoming Labour support for this policy, and indeed about our wider support for the vaccination roll-out, but let me end on a point of criticism, which is not in any way levelled at the Secretary of State. Given the way that the Labour party has handled its approach to the pandemic response, and the constructive way that we sought to work with the Government, it is not unreasonable to expect the Prime Minister, and others in his party, to stop pretending that that has not been the case. Perhaps he might stop seeking to turn the pandemic—the greatest threat we have faced to our nation for more than 70 years—into a party political mud fight. Surely we can do better than that, and I would like to think that the Secretary of State and I have been leading by example.

[Sajid Javid]

Once again, I thank the hon. Gentleman for his approach to this policy area and to vaccinations in general. He is absolutely right in the comments he has made on that and the importance of working across the House and working together on such an important issue in the national interest, as he has done. I very much welcome that approach. Not all countries take such an approach to such an important issue, and they have sadly paid a price for that. I believe that one of the reasons we have such high vaccine uptake in this country is the cross-party approach that has been taken, and I thank him once again for that.

The hon. Gentleman is also right to point to the safety and effectiveness of the vaccines, as independently set out by our world-class regulator, the Medicines and Healthcare products Regulatory Agency, and other reputable regulators across the world. No one should doubt the safety and effectiveness of the vaccines. It is because of the success of this country’s vaccination programme that we are able to open up again in the way that we have and to start returning to normal life.

Very importantly for the people we are talking about today—the fantastic people working in the NHS and across social care—one of the key reasons we have been able to keep down the pressure on the NHS in particular is that so many people have come forward and got vaccinated. That is why it remains troubling that some people, in particular in the NHS, still refuse to get vaccinated, even when they know it is safe and effective, and do not do the responsible thing and act in a professional way.

We will keep going to work with those people in a positive way to try to persuade them about the benefits of vaccination and to provide them with the information they need. We will continue with the work of one-to-one meetings with clinicians if necessary and encouraging them to make that positive choice, but it will be about encouragement and helping them to come to the right decision. We will learn and look at what other parts of the UK have done in making sure that we have the very best practice and have learned from each other.

Finally, on the point that the hon. Gentleman raised about sick pay, I understand what he is saying. I just point to the fact that we have kept rules in place to allow sick pay to be claimed from day one, and a hardship fund is in place to give extra support where needed.

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

My right hon. Friend knows that my instinct is to support him in the very difficult decisions he has to take in a pandemic, and I think he is doing an excellent job, but I have some concerns about today’s announcement. I think they may not be shared widely in the House, so I hope colleagues will indulge me if I explain why. Frontline workers have done an extraordinary job in this pandemic, but I have yet to meet a single one who believes that anyone in contact with patients has a right to put them at increased risk by not having a vaccine, unless there is a medical exemption. My concern is that having marched the NHS to the top of the hill and having won a very important patient safety argument, we are now doing a U-turn. What will happen the next time the Secretary of State wants to introduce an important vaccine, for example for flu, and make it mandatory? Is not the real reason that we have made this decision that we have a staffing crisis that the Government have still not brought forward their plans to address? When will those plans be brought forward?

[Sajid Javid]

My right hon. Friend speaks with great experience, and I have the utmost respect for him, especially given the many years he spent successfully running this Department. I understand what he says, and I hope he will understand, having listened carefully to the statement, that when the facts change, it is right for the Government to review the policy and determine whether it is still proportionate. Many things have changed in the past couple of months with respect to covid, but the one big thing that has changed is that since this policy was originally implemented, we have moved from 99% of covid infections being delta to 99% being omicron. That is why we have had to change approach.

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

I am grateful to the Secretary of State for his statement and for advance sight of it. I welcome the intention to U-turn on vaccination as a condition of employment. I have never supported mandatory vaccination for workers—a policy that, I am pleased to say, Scotland has avoided going down. Adding a further 70,000 or more vacancies to the existing 100,000 in NHS England would be a serious act of self-sabotage.

Vaccines remain one of the best defences against covid-19, as they reduce the likelihood of infection and therefore break the chain of transmission, and are something we should all continue to encourage. The Scottish Government have pursued an “educate and encourage” strategy in their vaccine roll-out, which has resulted in a higher vaccine take-up to date through entirely voluntary means. The five most vaccinated areas in the UK are all in Scotland.

Why are the UK Government taking so long to drop their damaging policy and adopt the Scottish practice? When will the consultation conclude and a decision finally be made? The UK Government’s vaccination mandate may have alienated many NHS staff, so what will be done to repair relations and encourage continued voluntary vaccine take-up?

[Sajid Javid]

The hon. Gentleman is right to draw the House’s attention to the importance of vaccination, as other Members have done. As was reflected in his remarks, it is the UK’s first line of defence against covid. Thankfully, the UK has put in place many other defences, such as the antivirals that are used across the UK and our testing and surveillance regime, but vaccines are the first line of defence. He is right to talk about encouraging as many people as we possibly can to take up the vaccine if they have so far not done so, whether they work in health and social care or otherwise. He is right that the best general approach is to educate and inform, and that is what we will continue to do.

[Esther McVey (Tatton) (Con)]

What a disappointment this statement is. Having read the newspapers, I was hoping to be able to come here and congratulate the Secretary of State on the Government’s recent conversion to common sense in halting the mandatory vaccination of NHS workers. Instead, he is making a half-and-half decision today, knowing that the sword of Damocles hangs over those 100,000 NHS workers, because they have to have their first vaccination on Thursday. He will then be sending them on a pathway to unemployment, along with the thousands of care workers who have already lost their jobs. What I want to know is what he is now going to do to help those thousands of people get a job, and what compensation he will pay them.

[Sajid Javid]

I am happy to clarify the point raised by my right hon. Friend. The Government have made a decision on this matter, which I hope I was very clear about in my statement, but for statutory reasons there needs to be a consultation. There will be a two-week consultation and then a statutory instrument will be presented to the House and will be subject to the will of the House.

The Government have made their decision on this, and the Department will write today to all NHS trusts and contact care home providers and wider social care settings, such as domiciliary care, to make it clear that the deadline my right hon. Friend referred to is no longer applicable. I am very happy to make that clear. She has raised an important point. While the decision is subject to this House, there will be no further enforcement of the regulations, for the reasons I have set out today.

[Rachael Maskell (York Central) (Lab/Co-op)]

The Health Secretary has not only bullied and threatened NHS staff at a time when they are so fragile, but ignored the royal colleges and all the trade unions when they said that the initial statutory instruments should not have been made. In fact, he has not made it clear today that both will be withdrawn, so I ask him to make that clear. I also ask him to say whether or not all those staff who have lost their employment to date will be reinstated with continuity of employment, including their pensions and other conditions?

[Sajid Javid]

I am happy to answer those questions. First, the Government’s decision is to revoke both statutory instruments; I am happy to confirm that. On those who, following the statutory instrument on care home settings, chose not to get vaccinated and preferred to leave their job than do the professional thing and get vaccinated, that was their choice, and that does not change. That policy was right at the time—I have set out the reasons why—because the dominant variant was delta. Should those people choose to apply for a job in a care home once the restrictions have been lifted, that is a decision for them. However, I continue to encourage them to make the right positive decision and get vaccinated.

[Sir Charles Walker (Broxbourne) (Con)]

I promised my wife that I would stop being angry, but I just cannot. Long before vaccines existed, these people who we cast as pariahs were day in, day out, coming into hospitals and care homes and holding the hands of the dying because their children and grandchildren could not. They were doing that while most people in this House were sitting on their backsides safely at home. Now, by all means, let us encourage people to get vaccines, but the language used, suggesting that these people who, for whatever reason—they may have needle phobia, like me—have chosen not to get vaccinated are somehow deserving of our bile is a disgrace. It does not reflect badly on them; it reflects badly on us.

[Sajid Javid]

What I hear from my hon. Friend, and I very much agree, is that vaccines are safe and effective. They remain our most important weapon in fighting the pandemic and, as more people come forward and choose to get vaccinated, that is not only good for them but right for the rest of society, their loved ones and everyone else around them. That is especially so if the people around them—they might be in a care setting or a hospital—are more vulnerable than most of the population. The best way forward is therefore to encourage everyone now to continue to think of the vaccine in that positive, sensible way and to come forward.

[Daisy Cooper (St Albans) (LD)]

I welcome this change of tack because I, like many others, opposed the compulsory vaccination policy. However, I fear that, in the care sector, the damage has been done—there are reports that about 40,000 people have already left—and it is damaging patient safety. With the change of tack, will the Secretary of State tell us his plans to get more carers quickly into the sector? With regard to the shortage occupation list, how many carers does he hope to recruit, and by when?

[Sajid Javid]

I thank the hon. Lady for that good question. She referenced 40,000 people having left care homes as a result of vaccine as a condition of deployment, and I can give her more information on that. While there is no exact data because care homes are independent and the people who work in them are not employed directly by the state, the Department’s best estimate, which is from the industry, is that the change in workforce during the final half of last year was a fall of 19,300. We do not believe that the 40,000 number is representative—the best proxy number is 19,300. Having said that, no one would want to see anyone leaving the care home sector when, as she rightly identified, we need more people coming forward. That is why we put in place a £162.5 million retention fund before omicron, and we have added to that fund by more than £300 million during omicron. We are also supporting the sector in having the largest recruitment campaign that it has ever run.

[John Redwood (Wokingham) (Con)]

I welcome the change of policy. In order to reassure both patients and staff about safety, what progress can the Secretary of State report to the House on better air extraction, air cleaning and ultraviolet filtration? I think that we need to control the virus without telling people exactly what they have to do in their own health treatments.

[Sajid Javid]

As always, my right hon. Friend has asked a very good question. He will know that infection protection control measures have been in place during the pandemic; they change along with the pandemic over time, depending on the risk profile, and that applies to care settings. The Government have supported care homes with hundreds of millions of pounds to make adaptations and changes and to implement these measures, and I know that many care settings have taken advantage of those funds to provide, for instance, air filtration and ventilation. That is the kind of support that the Government will continue to give.

[Hilary Benn (Leeds Central) (Lab)]

This has always been a difficult issue, because it involves balancing two different sets of rights, and I think that the Secretary of State has made a sensible choice. He talked about changing circumstances, but the one thing that has not changed is the fact that a considerable number of NHS staff remain unvaccinated. In reaching this decision, what representations did he receive from NHS leaders about the impact that those staff having to leave—which they will not now have to do—would have on the ability of the NHS to cope, and was that a factor in the reaching of the decision? I think most of us sitting here today know that it probably was.

[Sajid Javid]

I hoped that my statement had been clear enough to answer a question such as that asked by the right hon. Gentleman, but I am happy to emphasise what I said earlier. As I said, when coming to any decision, but certainly this decision, we must bear in mind that there are benefits and there are costs. The costs to which I referred related to the fact that obviously some people would no longer be employed in the NHS or in care settings, and that balance remains important. Because of the change in the variant and real change in the benefit part of the equation, the scales tilted, and that is why I no longer think that the policy as set out is proportionate.

[Miriam Cates (Penistone and Stocksbridge) (Con)]

I welcome my right hon. Friend’s statement, and thank him for listening to those of us on both sides of the House who have raised concerns about this policy. Of course it is right to change policy in the light of new evidence—particularly, in this case, the evidence that omicron is less severe and that vaccines are no longer as effective in reducing transmission. However, as reducing transmission was the only reason for pushing ahead with the vaccination of children, will the Secretary of State now commit himself to a review of that policy, given that children are at almost no risk from covid but there are small but potentially significant risks, both known and unknown—particularly to boys—from covid vaccinations?

[Sajid Javid]

I thank my hon. Friend for her introductory remarks. As for her question about children and vaccines, she will know that when it comes to vaccination in general, we take advice from the expert committee of the Joint Committee on Vaccination and Immunisation, which, as she would rightly expect, keeps vaccination decisions under review at all times.

[Jeremy Corbyn (Islington North) (Ind)]

I hope that the Secretary of State can recognise the very important message given by the unions and the royal colleges only seven weeks ago about the short-sightedness of a compulsion policy, which would drive people—vital workers—out of the care sector and the NHS. I hope that we will never go down the road of compulsory vaccination. I support vaccination, but persuasion is much more powerful than compulsion. Persuasion, when people understand it, is a far more powerful message to get across.

Will the Secretary of State tell us what is the cost of each vaccine to each resident of this country, what is the cost of its manufacture, and whether he has any plans for the patent to be moved into public ownership so that the massive profiteering from these vaccinations can end and the public can get the benefit of it?

--- Later in debate ---

[Sajid Javid]

Where I agree with the right hon. Gentleman is on the importance of persuasion in vaccination. Where I am afraid I disagree with him is on the idea that public ownership of patents connected with vaccinations or drug development in general would help. In fact, I think it would be a backward step and we would not see the innovation that has saved lives.

[Dr Julian Lewis (New Forest East) (Con)]

Many patients in hospital will presumably be protected by having undertaken their own vaccination process, but some will be clinically extremely vulnerable because of compromised immune systems. Is the Secretary of State saying that these people are at no greater risk of being made seriously ill or dying as a result of coming into contact with unvaccinated frontline staff? If they are at greater risk, is there something else that can be done to lessen that risk, such as a testing regime, before that contact takes place?

[Sajid Javid]

That is another good question from my right hon. Friend. I will say two things. First, this is not about zero risk; it is about less risk. What I am saying is that, based on the advice that I have received and for the reasons that I set out in my statement, whether or not someone is immunosuppressed, omicron, in general, represents less risk. It is also right to ask whether other measures could be taken to provide additional support. Yes, they can, which is why I have asked the NHS to review its own policies on the deployment of staff in certain settings, and that would include interaction with the most vulnerable patients.

[Clive Lewis (Norwich South) (Lab)]

I thank the Secretary of State for today’s U-turn. I know that many of my constituents, both NHS staff and patients, will be deeply grateful for it. We all wanted to see as many NHS staff as possible take up the vaccine, but no one wanted to see people being forced to take the vaccine, especially after all that they have done for us. Can the Secretary of State promise the House that, if there are future outbreaks, he will listen to the overwhelming body of public health evidence, which says that carrot, not stick, persuasion, not enforcement, has better results when it comes to vaccine take-up?

[Sajid Javid]

This Government will always listen to the evidence and be guided by it, as they have been today.

[Huw Merriman (Bexhill and Battle) (Con)]

Unlike a number of my colleagues here, I did actually vote in favour of these measures back in December. I did so because I felt that it was important that those going into hospital had the reassurance that those caring for them were fully protected. I understand the Secretary of State’s point that the matter has now changed, but I regret that that is so, because I still feel that my vote was the correct one. May I ask my right hon. Friend this specific question just to assist me to get to the right place with him? He mentions that he asked for fresh advice from the health regulators, and no doubt they advised that this was no longer proportionate in these changed circumstances. Did that precipitate a change in the legal position—that being one of the limbs for judicial review—which means that there is a legal requirement for our having to change course as well?

--- Later in debate ---

[Sajid Javid]

I understand my hon. Friend’s question. When the evidence changes—or, in this case, the change in the variant from delta to omicron—Ministers receive different advice. That advice always comes with up-to-date legal analysis as well, and that legal analysis is certainly taken into account when making a decision.

[Paula Barker (Liverpool, Wavertree) (Lab)]

Like the hon. Member for Broxbourne (Sir Charles Walker), I too am angry. I am angry because, in December last year, I twice asked the Secretary of State to pause and let us do this via consensus, rather than by making it mandatory. The language we use in this place is extremely important, and the Secretary of State has spoken this evening about care workers and their “choice” to be sacked. What I say is that they did not choose to be sacked. This Government chose not to give them appropriate personal protective equipment at the height of the pandemic. This Government chose to discharge elderly patients into care homes at the height of the pandemic. That is the real choice that this Government have made. Will the Secretary of State re-evaluate? Will he go back and apologise to those care workers, some of the lowest paid in our labour market, and ensure that they have continuity of service and of pension contributions?

[Sajid Javid]

Where the hon. Lady and I will absolutely agree is on the service that we have seen as a country from care home workers and domiciliary care workers over the pandemic. It has been the test of a lifetime for anyone working in that sector and each and every one of those people has risen to that challenge and provided the best care that they could in the most difficult circumstances. As the hon. Lady will know, there is an inquiry into the pandemic, where I am sure that many of the issues will be looked at, such as whether better support could have been provided under the circumstances. Looking ahead, however, it is important that we continue to do everything we can to continue to support that vital sector.

[Ben Bradley (Mansfield) (Con)]

I welcome the Secretary of State’s decision, which is important for the continuity and delivery of our local services. We were faced with losing more than 3,000 health and care staff in Nottinghamshire alone in a few weeks’ time, so this will massively take the pressure off come March and April. I urge him to go further if possible: I do not think it is fair to present the decision that care home workers made in November as leaving by choice. The truth is that we need those staff and more if we are to implement the reforms that the Government are asking the care sector to deliver on at a local level in the coming months, rather than having to focus all our energy on everyday firefighting. Will he change the view that he has stated so far, reach out to those staff and try to help them back into the sector?

[Sajid Javid]

Yes, I agree with my hon. Friend. As I said, we need more people in care and in the NHS. We have a waiting list in both sectors. There are many people out there who will have experience and will want to do that. He asked whether we can work with the sector to reach out and to support and help people to re-enter it where they wish to do so. Of course we can. At the same time, we can continue to give any information that may be helpful and necessary to help to persuade those who remain unvaccinated to make that positive choice and get vaccinated.

[Andy Slaughter (Hammersmith) (Lab)]

My hospital trust, Imperial College, has done its best to care for staff in the past two years. Like other trusts, it has found it difficult to implement what was, until a few moments ago, Government policy, but it did so because it was good clinical practice to protect its patients and it gave confidence to the general public, who might say, “Why should I get vaccinated if my doctor won’t?” What advice does the Secretary of State have for the hospitals and care homes, and their staff and ex-staff, who may now feel betrayed?

[Sajid Javid]

I will say two things to anyone involved in NHS trusts, especially those who were leading the campaign to encourage their colleagues to get vaccinated. First, I say a huge thanks for what they have done and what they have achieved so far. I mentioned earlier that, since we consulted on the original regulations, 127,000 more people across the NHS have been vaccinated, which represents in total some 19 out of every 20 employees in the NHS. That is a phenomenal achievement. My thanks go to all those working in the NHS who have helped to make that happen and are still helping to make that happen.

Secondly, I say to those people that their work, with our support—the support of the Government and my Department—continues. Despite the changes today, for the reasons that I have set out, it is still hugely important to get vaccinated. We must keep reaching out positively to those who have not yet, for whatever reason, chosen to do so by helping them to make the right decision.

[Chris Green (Bolton West) (Con)]

I welcome my right hon. Friend’s statement. He made several references to conditions of employment and he finished by asking regulators, “to urgently review current guidance to registrants on vaccinations”.

What will he do to ensure that that does not become a compulsion for vaccinations by other means?

[Sajid Javid]

The regulators I referred to are independent, so all I can do is ask them to review their regulations. My hon. Friend might be aware that some regulators, such as the General Medical Council, already have requirements for vaccinations in certain settings, which is a decision for them. As he will know, however, the independent regulators usually set out guidance and allow some flexibility in how it is interpreted in certain settings.

[Bob Seely (Isle of Wight) (Con)]

I thank the Secretary of State for this decision. I opposed the policy in December for reasons that have been eloquently laid out by Members such as my hon. Friend the Member for Broxbourne (Sir Charles Walker), although I was respectful of the Government’s position. Overall, persuasion is better than coercion, and honesty is better than the manipulative games that we now hear the nudge unit was playing and that were entirely counterproductive. Will the Secretary of State reassure me that, now we have some breathing space, we can do a bit of forward thinking and prepare a plan for this winter that protects the vulnerable and enables the NHS to continue to treat people but does so without resorting to lockdowns? The idea that lockdown is a cost-free, risk-free option is absolutely untrue, as we have now seen from the 100,000 children who have come off school rolls and disappeared. Lockdown carries an extraordinarily heavy price, and frankly a lot of the modelling and forecasting behind it have been extremely flawed.

[Sajid Javid]

If we look at the experience from the omicron wave, we can see that we had the fewest restrictions on people’s freedom of any large country in Europe, yet we have been the first country to come out of the omicron wave and hit the peak. I believe the main reason for that is that we rightly focused on pharmaceutical defences: vaccines in particular, of course, as well as antivirals and testing. There is a lot to be learned from that.

[Mr Steve Baker (Wycombe) (Con)]

Though we may have arrived here by different routes, I am grateful that today my right hon. Friend and I agree on this policy area. We also agree that vaccination is the better choice for everybody for whom it is safe if they do not have a pre-existing condition. Can I just pick up the issue of language? He has used a range of tones when talking about people. He has used some quite soft language about persuasion, and we have heard a range of perspectives on that, but he has also used some very strident language, which my hon. Friend the Member for Broxbourne (Sir Charles Walker) criticised—rightly, I think. Can I ask my right hon. Friend to set out for the House what his attitude is to the issue of bodily autonomy and using the law to compromise it? If he does respect people’s bodily autonomy, can I ask him please to select language that is respectful of that choice?

[Sajid Javid]

I am pleased that my hon. Friend and I agree on what has been set out today, but he is right to raise what he has said in the way that he has. Language is vitally important, especially on issues of this great significance, when we are asking people to be injected with something, to put a needle to themselves and to get vaccinated, for all the right reasons. Of course some people will be more resistant than others to doing that, for whatever reason, and will have some kind of hesitancy. It is our duty to work with them. I am sure my hon. Friend will agree that when we reach for a statute in relation to vaccination, there needs to be a very, very high bar. He has heard me say at this Dispatch Box more than once that I would never support universal vaccination or any kind of statute. This policy I have talked about today required a very high bar to be reached. At the time we introduced the policy, I believed that the bar was reached, for the reasons I have set out about protecting vulnerable people. Now I believe it would be disproportionate, and that is why I have set this change out today. What has not changed is the importance of vaccination, and for those people who can get vaccinated and who are not medically exempt from it for some reason, we should continue to work together across this House to encourage them to do so and work with them in the most positive way possible, because they would be better off and we would all be better off.

[Madam Deputy Speaker (Dame Rosie Winterton)]

I thank the Secretary of State for his statement.

Covid-19: Adult Social Care

Sajid Javid Excerpts

Thursday 27th January 2022 Written Statements

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

Thanks to the success of the vaccination booster roll out, and the reducing level of both infection and hospitalisations across the country, the Government have been able to announce the end of plan B. This means we are now able to take steps towards getting care homes back to normal, easing some of the difficult restrictions that both staff and residents have had in place, which I know have been incredibly challenging for all, while still protecting residents from the continued risk of covid-19.

From 31 January, there will no longer be nationally set direct restrictions on visiting in care homes and there will be no limit on the number of visitors a resident can receive. Residents should be supported to undertake visits out of the care home without the need to isolate on their return, but should continue to take reasonable precautions and undertake testing arrangements for high-risk visits.

As well as removing those additional precautions we put in place in response to the omicron variant, we are now able to reduce isolation periods for residents in care homes so that they are the same as for the general public in most cases.

Residents who need to isolate will now only need to do so for a maximum of 10 days. The 10-day maximum period will apply to those residents who test positive, are identified as a close contact or have had an unplanned stay in hospital. For some residents, the isolation period could be as short as five days subject to the testing regime that will be outlined in guidance.

Today I am also announcing changes to regular testing for staff. For all adult social care staff, we are moving to lateral flow testing every day before work and removing weekly PCR testing. Recent clinical advice is that following the pre-shift testing regime provides better protection than the current regular testing regime of weekly PCR with three lateral flow tests a week in high-risk settings.

As restrictions are relaxed for care home residents and for the general population, testing continues to be essential for providing the protections needed to support this relaxation of restrictions. The introduction of pre-shift rapid lateral flow tests should help identify and isolate positive cases quicker rather than waiting for PCR results to return from the lab.

This change applies only to regular asymptomatic testing for staff meaning PCR tests will remain available for symptomatic staff and residents. Outbreak testing and monthly resident testing will also remain unchanged.

By maintaining a robust regime of testing in adult social care, continuing to press ahead with our vaccination programme and maintaining high standards of infection prevention and control, we are able to support residents of care homes and recipients of care to gradually return to enjoying life as it was before the pandemic.

[HCWS566]

Special Health Authority for Independent Maternity Investigations

Sajid Javid Excerpts

Wednesday 26th January 2022 Written Statements

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

I wish to inform the House of the Government’s plans to establish a special health authority under secondary legislation to continue the maternity investigation programme, which is currently a function of the Healthcare Safety Investigation Branch.

Plans to establish the Health Services Safety Investigations Body as a non-departmental public body are contained in the Health and Care Bill 2021. The Health Services Safety Investigations Body will take forward the work of the current Healthcare Safety Investigation Branch’s national programme once fully operational—expected to be 1 April 2023. The scope of the Health Services Safety Investigations Body’s investigations in the Bill does not include the current Healthcare Safety Investigation Branch’s maternity investigations programme. This is because conducting investigations under “safe space” is a key element of the new Health Services Safety Investigations Body. The maternity investigation programme investigations do not follow “safe space” principles.

The Healthcare Safety Investigation Branch became responsible for conducting independent investigations relating to intrapartum stillbirth, early neonatal death, or severe brain injury diagnosed in the first seven days of life and also maternal deaths—approximately 1,000 every year—on 1 April 2018. In 2020-21, the maternity investigation programme completed 1,024 reports and made more than 1,500 safety recommendations to individual NHS trusts addressing a wide array of issues.

The Government consider that independent, standardised, family-centred investigations should continue beyond April 2023 once the new Health Services Safety Investigations Body is established. The new special health authority will:

provide independent, standardised, and family-focused investigations of maternity cases that provide families with answers to their questions about why their loved ones died or were seriously injured;

provide learning to the health system at local, regional and national level via reports for the purpose of improving clinical and safety practices in trusts to prevent similar incidents and deaths occurring;

analyse the incoming data from investigations to identify key trends and provide system-wide learning in these areas including identifying where improvements are being made or there is lack of improvement;

be a system expert in standards for maternity investigations and support trusts to improve local investigations; and

collaborate with system partners to escalate safety concerns and share intelligence.

The special health authority will be established for up to five years from 2022-23 to enable maximum learning to be achieved and to equip NHS trusts with the expertise, resources, and capacity to take on maternity safety incident investigations in the future.

Learning from these investigations is key for meeting the Government’s commitment to “make the NHS the best place in the world to give birth through personalised, high-quality support”; and our national maternity safety ambition to halve the 2010 rates of stillbirths, neonatal and maternal deaths and brain injuries in babies occurring during or soon after birth by 2025.

[HCWS560]

Covid-19 Update

Sajid Javid Excerpts

Monday 24th January 2022 Written Statements

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

As part of our commitment to reducing the cases of hospitalisation and serious illness due to covid-19, the Government accepted the JCVI’s recommendation on the 29 November that all young people aged 12 to 15 years old should be offered a second dose of covid-19 vaccination a minimum of 12 weeks after their first.

To ensure that 12 to 15 year olds were able to demonstrate their covid status for international travel prior to the Christmas holidays, on 13 December, the Government launched the NHS covid pass letter service for children who are double vaccinated.

From 3 February, the Government will ensure that all children aged 12 and over will also be able to get a digital NHS covid pass for international travel to support our efforts to open up travel. The digital NHS covid pass will provide a record of covid-19 vaccinations received and will show evidence of having recovered from covid-19 up to 180 days following a positive NHS PCR test. The steps that the Government have taken ensure that families are not prohibited from travelling where countries require children over the age of 12 to be able to digitally demonstrate their vaccination status or proof of prior infection.

The covid pass will be available via the NHS.UK website for those aged 12 and over and via the NHS app for those aged 13 and over. To request an NHS covid pass, the child will first need to register for an NHS login, which will require them to verify their identity using their passport.

The Government have also sought to ensure that this solution can be used by children in both Wales and the Isle of Man. In Wales, 12 to 15 year olds will be able to generate a digital pass via NHS.UK. In the Isle of Man, they will be able to use both NHS.UK and the NHS app. Further information will be available shortly from the Department of Health for citizens in Northern Ireland. Paper youth passes are already available for citizens in Scotland and further information on the digital solution will follow in due course.

[HCWS556]

Oral Answers to Questions

Sajid Javid Excerpts

Tuesday 18th January 2022 Commons Chamber

[Rob Butler (Aylesbury) (Con)]

1. What steps his Department is taking to support the effective discharge of patients from hospital during the covid-19 outbreak.

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

We are working closely with the NHS, social care and local authorities to significantly reduce delayed discharge and free up beds for those who need them most. We are making full use of non-acute beds, including those in hospices, other community beds and beds in the independent sector. To drive further progress and support regional and local systems, I also established a new national taskforce last month to help deliver best practice.

[Rob Butler]

I thank my right hon. Friend for his answer. Many people would like to leave hospital when their treatment is completed, but they are not quite well enough to cope alone at home. That is obviously frustrating for them, because they want their independence, it creates problems for hospitals, which need the beds, and it costs the taxpayer unnecessary money. Does my right hon. Friend therefore agree that the development of a strategy to provide intermediate care to support discharge would help alleviate pressure on both the NHS and the social care sector?

[Sajid Javid]

I do agree with my hon. Friend. That is why, as part of our continued response to the covid-19 pandemic, on 2 December last year NHS England asked local systems to consider ways to increase patient flow out of acute hospital settings. That includes surge capacity in care homes, identifying unused hospice capacity and, in some cases, repurposing hotel accommodation where appropriate. NHS England is reporting to me on this regularly, and it is something that we will closely monitor progress on.

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

The Government’s own impact assessment of discharge to assess in the Health and Care Bill, which was published almost two months after the Bill was voted on, expects unpaid carers to have to give up working hours and bear the financial burdens of the discharge to assess policy. In the light of that assessment will the Government provide greater support to unpaid carers, or will they actually reconsider this policy?

[Sajid Javid]

Throughout the pandemic especially we have been providing more and more support, quite rightly, across the care sector, including for domiciliary care in care homes and unpaid carers. We have made £3.3 billion of extra funding and support available since March 2020.

[Mr Philip Hollobone (Kettering) (Con)]

Kettering General Hospital is a 500-bed medium general hospital, and I am afraid that too many, mainly elderly, people who have completed their medical treatment still await discharge back into the community in a safe way. Will the Secretary of State ensure that the national taskforce is sent to Northamptonshire to help us deal with this issue?

[Sajid Javid]

My hon. Friend is right to raise this issue. It is of increasing concern, especially as we have seen hospitalisations rise because of the omicron wave. I believe that the national taskforce is already looking at Northamptonshire. If it is not, I will certainly make sure it does.

[Mr Speaker]

I welcome the shadow Minister, Karin Smyth.

[Karin Smyth (Bristol South) (Lab)]

Around 10,000 medically fit people are currently in hospital when they should be at home with their families or in a supported setting. That is a tragedy for them and a mark of shame on this Government. Short-term cash, taskforces or threatening legal action are not solutions. Social care support is a lifeline not a luxury, so will the Government now work with us cross-party in line with the joint Select Committee report of 2018 to bring forward immediate change and offer hope and respite to those receiving and giving social care?

[Sajid Javid]

First, may I welcome the hon. Lady to her new position and wish her all the very best? She will have heard in a previous answer that social care and those who provide social care, which is such a vital act and such a vital service throughout our country, are receiving record amounts of support—£3.3 billion of extra financing since March 2020. Of course I would be more than happy to work with her and her colleagues to see whether there is more that we can do together.

[Harriett Baldwin (West Worcestershire) (Con)]

2. What steps his Department is taking to reduce the number of covid-19 hospital admissions.

[Lia Nici (Great Grimsby) (Con)]

15. What steps his Department is taking to reduce the number of covid-19 hospital admissions.

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

We have developed a globally recognised programme that combines boosters, testing and antivirals to protect the vulnerable and to reduce hospital admissions. Our “Get Boosted Now” campaign led to a huge increase in vaccination rates and we have successfully procured the highest number of antivirals per head in Europe. We are also employing the use of remote monitoring technology to enable more patients to get the care that they need at home rather than having to be admitted into hospital.

[Harriett Baldwin]

Before omicron arrived there had been over 10 million positive cases in this country of covid-19, of which 14 in every 1,000 appeared to have been fatal. Since omicron arrived there have been a further 5 million cases, and it looks as though the fatality rate is about 10 times lower. Will the Secretary of State tell the House how important the “Get Boosted Now” programme has been in reducing hospitalisations and fatalities?

[Sajid Javid]

Yes, of course. The officials within my Department have carried out a wealth of analysis on case fatality rates in the vaccinated and unvaccinated populations. Recent data has shown that covid-19 case fatality rates for the over-80s are likely to be more than five times greater in the unvaccinated versus those who have had at least two doses.

My hon. Friend may be interested to know that, when I recently visited the intensive care unit dealing with covid patients in King’s College, the consultant in charge told me that he estimated that about 70% of his patients on that day were completely unvaccinated. It is clear, as we have seen especially in the past few weeks, that vaccinations save lives.

[Lia Nici]

I have a 90-year-old constituent who has been prevented from going to see his 89-year-old wife of 65 years. It took my intervention after 20 days of his being prevented from seeing her for him to be able to get into the hospital. Neither of them have covid. Will my right hon. Friend please instruct health trusts that, as we reduce the incidence of covid in hospitals, family members must be allowed to go and see their family in hospital?

[Sajid Javid]

I am very sorry to hear about what happened to my hon. Friend’s constituent. It cannot be right that people are unable to visit their loved ones while they are in hospital. It should not require the intervention of a Member of Parliament to do so. Allowing such visits should be an absolute priority in every trust, and I have recently raised this issue with the chief executive of the NHS. She has assured me that this message will be sent loud and clear to all NHS trusts.

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

Too many women with endometriosis are being forced to go to A&E or seek hospital admissions for their treatment. This is partly because they wait on average seven and a half years for a diagnosis. What can the Secretary of State do to improve the knowledge and awareness of endometriosis right across all aspects of the NHS?

[Sajid Javid]

The hon. Lady is absolutely right to raise the importance of endometriosis. She will know, I hope, that in the women’s health strategy there will be an important focus on it. Within that strategy, we have set out how we can work together to do much more.

[Daisy Cooper (St Albans) (LD)]

We know that the number of covid admissions has led to a number of people having their routine hospital treatment cancelled. Last week it was announced that that had reached a record-breaking 6 million people. When might the Government make a statement about hitting this figure and set out a plan to tackle it?

[Sajid Javid]

The hon. Lady will know that, sadly because of covid and the need for the NHS to prioritise it—rightly—we have sadly seen an increase in people waiting for elective procedures and scans. She will also know that the Government have already set out a plan to deal with that in terms of funding—the biggest catch-up fund in history, with an extra £8 billion of funding over the next three years. After tackling the most immediate need to deal with omicron, we will shortly set out in much more detail how we intend to tackle the elective backlog.

[Mrs Sheryll Murray (South East Cornwall) (Con)]

3. What steps his Department is taking to provide additional covid-19 vaccination sites.

--- Later in debate ---

[David Duguid (Banff and Buchan) (Con)]

19. What steps his Department is taking to increase the supply of lateral flow and PCR covid-19 tests.

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

We have significantly increased our testing and supply capacity since December, procuring over 700 million more lateral flow tests, ramping up our delivery capacity and expanding the UK’s daily PCR capacity. Around 1.7 billion lateral flow tests have been distributed across the UK since the start of the pandemic. Home delivery capacity is now at over 7 million lateral flow tests every day, and we have also recently increased capacity for PCR testing by more than 200,000 tests per day.

[Bill Esterson]

I asked the Prime Minister, but he did not know. I asked the Business Secretary and he did not seem to care. So today is third time lucky. Why were 30 million British-made lateral flow tests sitting in a warehouse waiting for approval while Chinese tests were given temporary approval, all while people could not get test kits from pharmacies or from Test and Trace? It took six months to give approval to SureScreen diagnostics: when will the Government support British test manufacturers and end the preference for imports from China?

[Sajid Javid]

I can give the hon. Gentleman an answer, and I am very happy to do so. He will know that whenever we try to procure tests, in this case lateral flow tests, we should always try to buy British first, and we do buy from SureScreen—it is a fantastic supplier. But he will also know that we can only, rightly, buy lateral flow tests once they have been approved by our independent medical regulator.

[David Duguid]

Does my right hon. Friend agree that access to the largest testing programme in Europe is just one example of the advantages to the people of Scotland when we adopt a UK-wide approach to shared challenges?

[Sajid Javid]

I absolutely agree with my hon. Friend about a unified approach to shared challenges such as covid-19, and that unified approach being the best way forward. Across the UK, we have built the largest diagnostic network in British history and our testing programme has been one of the most important lines of defence, alongside our UK-wide vaccination programme. Our procurement of tests, antivirals and vaccines has been another fantastic example of the strength of the Union.

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

“Always try and buy British first” was what the Secretary of State said a few moments ago, but a few weeks ago it was reported that plans to manufacture lateral flow tests here in the UK were shelved because the Government were scared that they might be accused of handing out dodgy deals to their mates. I know the Minister has form on this, but on this point they were misguided. Can he now say to the House that that was not the case and that he was not running scared of a transparent procurement policy, and that he will now do all he can to turbocharge British manufacturing and get British lateral flow tests in the system, so that we do not ever suffer again from those avoidable shortages we saw over Christmas?

[Sajid Javid]

First, I think the hon. Gentleman accused me of doing something inappropriate, and I think that that is not appropriate, unless he has something else to say or some evidence, but it is true to form for the Labour Front Bench, which just constantly makes things up to make false points. When it comes to testing, as he has just heard me say, we have purchased 1.7 billion lateral flow tests since the start of the pandemic. Wherever possible, whether it is PCR testing or lateral flow testing, whenever tests are approved by our independent regulator, we buy British.

[Sarah Green (Chesham and Amersham) (LD)]

6. If he will make it his policy that prescriptions will remain free for people aged 60 and over.

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[Chris Bryant (Rhondda) (Lab)]

T1. If he will make a statement on his departmental responsibilities.

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

Eight weeks ago, when this House last met for Health and Social Care questions, the world had not even heard of the omicron variant; but a third of the total number of UK covid-19 cases have been recorded since then. The action the Government have taken in response to omicron, and the collective efforts of the British people, have seen us become the most boosted and tested country in Europe, and the country with the most antivirals per head in Europe. That is why we are the most open country in Europe. I have always said that the restrictions should not stay in place a day longer than is absolutely necessary. Due to those pharmaceutical defences and the likelihood of our having already reached the peak of case numbers and hospitalisations, I am cautiously optimistic that we will be able to substantially reduce measures next week. The best thing we can all do to continue that progress is get boosted now.

[Chris Bryant]

May I put on record my gratitude to the Secretary of State for all the help he provided to my constituents before Christmas? He went beyond the call of duty, and I am very grateful to him.

The aftershock is often worse than the earthquake. My anxiety about covid is that it was the earthquake, but we still have the aftershock to come—that is, all the problems in cancer care, and the lack of doctors in emergency medicine, as well as in so many other disciplines. How will we make sure that the 6 million people on waiting lists get the care that they really need, and that the number does not grow over the next few months?

[Sajid Javid]

The hon. Gentleman is absolutely right to raise this issue, and I thank him for his comments at the start. We all know, as we have just heard from the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), that the NHS in particular and social care have been under huge pressure; I think it has been the most challenging time in their history. Everyone has performed in a way that we can all be proud of. Despite that, we have seen a huge rise in electives, and I think that the number will go higher before it goes lower, because so many people stayed away when they were asked to. I want them to come forward. I want them to know that the NHS is open for them. We will support it with a bigger workforce and more investment, including the £36 billion of extra investment from the new NHS and social care levy.

[Lucy Allan (Telford) (Con)]

T4. Delays in cancer diagnosis and treatment have had tragic consequences for some of my constituents. What is my right hon. Friend doing to improve cancer survival rates?

[Sajid Javid]

My hon. Friend raises an issue that is very close to my heart, and the hon. Member for Rhondda (Chris Bryant) rightly raised it a moment ago, too. The pandemic has exposed huge health disparities in this country. It is clear to me that we need to go much further on cancer, not only to catch up on cancer referrals, diagnosis and treatment and radical innovation, but to improve the persistently poor outcomes that patients in this country have long experienced compared to those in other countries. It is time we launched a war on cancer. I am working on a new vision to radically improve the outcome for cancer patients across the United Kingdom, and I will have more to say on that in due course.

[Wes Streeting (Ilford North) (Lab)]

Keeping the Secretary of State on the subject of cancer, half of all patients with suspected breast cancer are not seen within the recommended two weeks. In two months, the number of patients who were not able to see a specialist in the target period has gone from 5,000 to 23,000—a far steeper increase than for all other forms of cancer—so I ask the Secretary of State: has breast cancer care been deprioritised?

[Sajid Javid]

Of course it has not been deprioritised. No cancer has been deprioritised. As the House has heard again today, we have seen an impact on healthcare across the country because of this terrible pandemic, including, sadly, on cancer care. Whether we are talking about breast cancer or other forms of cancer, they all remain a priority, including during the omicron wave; the NHS has made it absolutely clear that cancer remains a priority. As I said—I hope the hon. Gentleman agrees—we need to do more on cancer. I know that he cares deeply about this; he is right to have raised it twice in the past hour, and I hope that he will work with the Government on it.

[Wes Streeting]

I am going to raise it a third time, because it is very clear that breast cancer care is worse than care for other forms of cancer. The Secretary of State needs to account for that and tell us what he will do about it. On cancer more broadly, it is not good enough to return to the situation pre-pandemic, because as much as he wants to blame covid pressures for delays in cancer treatment, we went into the pandemic with waiting lists at 4.5 million, and with staff shortages of 100,000 in the NHS and of 112,000 in social care, which impacted on broader NHS performance. Where is the plan to fix the workforce challenge in the NHS? That is the biggest single challenge that will impact on his mission—the mission we all share—to improve cancer outcomes for everyone in the country.

[Sajid Javid]

The hon. Gentleman will know that survival rates from cancer were increasing before the pandemic, but as I think the whole House understands, the pandemic has had an impact on all other types of healthcare, including cancer. This is a challenge throughout the United Kingdom. He talks about waits for breast cancer treatment; those are longer in Wales, so this is an issue throughout the UK. It is right that we continue to focus on the workforce. We have 44,000 more health workers than we did in October 2020, and we will continue to build on that.

[Derek Thomas (St Ives) (Con)]

T5. Vast numbers of children and adults right across Cornwall cannot get access to an NHS dentist. That is not about funding, covid or even a lack of dentists; it is just that the contract under which they work is no longer fit for purpose. Next year, the responsibility for dentistry comes to Cornwall. Could we perhaps have a statement from the Minister about how we can reform that contract, which no longer works and keeps dentistry away from people who need it?

[Martyn Day (Linlithgow and East Falkirk) (SNP)]

We will not globally defeat covid if large proportions of the global population do not have access to vaccinations. The UK is one of a small number of countries blocking the TRIPS— trade-related aspects of intellectual property rights—waiver. Will the UK Government stop blocking the vaccine intellectual property waiver, and allow nations to manufacture the vaccines themselves?

[Sajid Javid]

The hon. Gentleman is right about the importance of helping the whole world to acquire these life-saving vaccines. That is why the UK can be proud of the more than 30 million vaccines that it has delivered to developing countries already. We will meet our commitment to increase that to 100 million by June, but we do not agree with the suggestion about the TRIPS waiver, because it will make future access to life-saving vaccines much more difficult.

[John Lamont (Berwickshire, Roxburgh and Selkirk) (Con)]

T6. I was delighted by the recent announcement of £50 million for motor neurone disease research, which my constituent Doddie Weir campaigned for tirelessly. Will the Secretary of State update the House on the steps being taken to allocate those funds, and to ensure that is done as quickly as possible, as time is of the essence for MND sufferers?

[Sajid Javid]

My hon. Friend is right to raise that point, and I commend him on the fantastic work that he has done in leading this campaign. We were delighted to announce £50 million of funding for MND research. That will support a new MND research unit, which has already started work to co-ordinate research applications, and a new MND partnership, which will be formed to pool expertise across the research community.

[Sarah Green (Chesham and Amersham) (LD)]

T2. Last week, the Royal College of Physicians reported that one in five doctors felt “overwhelmed almost every day”. One doctor in my constituency told me that every single member of staff at their surgery was either receiving counselling, on antidepressants or signed off work with stress, compounded by what they perceived as GP-bashing in the media. With that in mind, may I ask the Secretary of State what steps his Department is taking to protect the mental health of GPs and NHS workers?

[Sajid Javid]

The hon. Lady is right to raise that issue. Healthcare workers have been under significant pressure, especially over the past two years, and of course that applies to GPs. The support we have provided through the winter access fund—the £250 million—is there to help GPs’ surgeries across the country, including with their workforce.

[Caroline Ansell (Eastbourne) (Con)]

T7. My hospital trust is looking to redesign ophthalmology and cardiology services across its two hospitals, Eastbourne District General Hospital and Conquest Hospital in Hastings. The trust puts forward an important clinical case for the change, but given the realities—the road, the distance and the public transport options, which mean that it can be a journey of two hours via two buses for the one in four households in Eastbourne that do not have a car—any change can present a real problem and create issues for local people. Ahead of his visit to Eastbourne, will my hon. Friend the Minister meet me here to discuss this vital question of access to hospital services?

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[Chi Onwurah (Newcastle upon Tyne Central) (Lab)]

T10.   I hope you are watching “Geordie Hospital”, Mr Speaker—the Channel 4 series that follows the talented, highly skilled, dedicated and wonderfully witty staff of Newcastle upon Tyne Hospitals NHS Foundation Trust. As we enter our third pandemic year, after a decade of under-investment and low pay, and with staff shortages, absences and NHS waiting lists all rising, I hope that the Secretary of State recognises that what NHS staff need, as well as a great sense of humour, is a long-term workforce plan. Will he bring one forward?

[Sajid Javid]

First, I commend everyone working in the Newcastle hospitals trust and across the NHS for everything they are doing. The hon. Lady is right to talk about the importance of the workforce—that is why we have asked Health Education England to come up with a 15-year workforce framework—but she knows that the resources that the NHS has make a big difference, and it would have helped if she had supported the Government’s record investment of £36 billion over the next three years in the NHS and social care.

[Damien Moore (Southport) (Con)]

T9. Can my right hon. Friend tell the House how he is making it easier for transport workers, who are disproportionately under-vaccinated, to get their jabs and get this country moving?

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

This morning, the Health Secretary is reported in The Times as saying that the NHS can learn from the way in which academy chains are regulated, but he will know that the education system has no national targets, while the NHS uses more national targets than any healthcare system anywhere in the world. Will he look at the role of targets and the risk that they focus managers on bureaucratic numbers, sometimes at the expense of quality of care for patients?

[Sajid Javid]

I very much agree with my right hon. Friend; as the whole House knows, he speaks with considerable experience. We need to do things differently, especially as a result of the pandemic and the challenges that it has created. That requires reform, and we will set out further reforms in due course. He is absolutely right about targets: they can play an important role, but they can also lead to poor outcomes for patients, and all targets need to be properly reviewed.

[Dan Jarvis (Barnsley Central) (Lab)]

Sheffield’s Weston Park Cancer Centre is one of just four specialist cancer facilities in the country, but it desperately needs a £50 million upgrade, as the Secretary of State will know because I raised the matter with his predecessor and wrote to the Secretary of State in October and again just last week. Will he urgently respond to the proposal, which is vital for cancer outcomes in South Yorkshire?

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[Rachel Hopkins (Luton South) (Lab)]

Just last month, Luton lost an outstanding champion in the other place with the sad passing of Lord Bill McKenzie of Luton. Just 21 months previously, he had been diagnosed with pulmonary fibrosis.

Last week I met the chair of the Pulmonary Fibrosis Trust, one of my constituents in Luton South, who told me that there is no current cure for the disease and that for most people there is no known cause. Will the Secretary of State outline what steps his Department is taking to support research into a cure and to improve diagnosis, support and care for people living with pulmonary fibrosis?

[Sajid Javid]

I thank the hon. Lady for raising the matter in the House. Pulmonary fibrosis is a very serious condition. Far too many people suffer from it, and there needs to be more research globally—not just here in the UK, but working with our international partners. I will bring the matter to the attention of my officials and see what more we can do.

[Sir Robert Goodwill (Scarborough and Whitby) (Con)]

Sadly, the situation in Scarborough and Whitby for patients seeking a new NHS dentist is no better than that in St Ives, with thousands of UDAs going unused. Dentists tell me that it would help to have a date for the end of the UDA system so that they could start recruiting staff and, in some cases, building new premises to deliver NHS dentistry to local people.