Covid-19: Booster Vaccines

Sajid Javid Excerpts

Wednesday 30th June 2021 Written Statements

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

Today the Joint Committee on Vaccination and Immunisation (JCVI) has published interim advice on options for a covid-19 booster vaccination programme for adults this Autumn.

It should be noted that this is interim advice and the JCVI will consider additional scientific data as it becomes available over the next few months ahead of developing its final advice. This includes, but is not limited to, further data on the durability of protection from vaccines beyond six months, and clinical trial data on immune responses following a third vaccination.

In summary, on the basis of current evidence and with the aim of reducing the occurrence of serious covid-19 disease, the JCVI advises the following as the likely shape of the autumn programme.

Any potential booster programme should begin in September 2021, in order to maximise protection in those who are most vulnerable to serious covid-19 ahead of the winter months. Influenza vaccines are also delivered in autumn, and the JCVI considers that, where possible, a synergistic approach to the delivery of covid-19 and influenza vaccination could support delivery and maximise uptake of both vaccines.

Any potential covid-19 booster programme should be offered in two stages.

Stage 1. The following persons should be offered a third dose covid-19 booster vaccine and the annual influenza vaccine, as soon as possible from September 2021:

adults aged 16 years and over who are immunosuppressed;

those living in residential care homes for older adults;

all adults aged 70 years or over;

adults aged 16 years and over who are considered clinically extremely vulnerable;

frontline health and social care workers.

Stage 2. The following persons should be offered a third dose covid-19 booster vaccine as soon as practicable after stage 1, with equal emphasis on deployment of the influenza vaccine where eligible:

all adults aged 50 years and over;

adults aged 16 to 49 years who are in an influenza or covid-19 at-risk group (please refer to the green book for details of at-risk groups);

adult household contacts of immunosuppressed individuals.

As most younger adults will only receive their second covid-19 vaccine dose in late summer, the benefits of booster vaccination in this group will be considered at a later time when more information is available. The initial objective for winter 2021-22 is for persons in booster stages 1 and 2 to receive their influenza and covid-19 vaccines in good time.

Apart from the current UK approved covid-19 vaccines, the UK has placed orders for a range of other covid-19 vaccines, some of which may become available for use in a booster programme.

The JCVI will review the use of these vaccines once they have received UK regulatory approval. Vaccines designed specifically against variants of concern will not be available in time for booster revaccination this autumn. The use of variant vaccines will be considered by the JCVI in due course.

Additional scientific data will become available over the next few months which will require further consideration by the JCVI ahead of any final advice. These include:

further data on the safety and effectiveness of covid-19 vaccines used in the UK and internationally;

clinical trial and real-world effectiveness data on the durability of protection beyond six months;

clinical trial data on immune responses following a third vaccination (booster revaccination);

clinical trial data on reactogenicity and immunogenicity following booster revaccination with the same or alternative covid-19 vaccines;

clinical trial data on other covid-19 vaccines in development;

the emergence of any new variants of concern in the UK or internationally;

data on the duration of immunity following a primary course;

a better understanding of the immune correlates of protection; and

data on the effects of on-going sars-cov-2 circulation in the population and its potential to confer long-term public health benefits.

JCVI note early evidence supports the delivery of both covid-19 and flu vaccines at the same time where appropriate.

Subject to the JCVI’s final advice, we are developing detailed plans for a booster programme. NHS England and NHS Improvement will be asking all local systems to develop detailed plans to ensure they are ready to deliver a booster programme from the start of September in line with this advice, working closely with partners including local authorities and voluntary organisations to ensure equal access and maximise uptake of both covid-19 and influenza vaccines.

All four parts of the UK welcome this interim advice, which will help us ensure we are ready in our preparations for autumn. We look forward to receiving the committee’s final advice in due course.

[HCWS135]

Covid-19 Update

Sajid Javid Excerpts

Monday 28th June 2021 Commons Chamber

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

I am honoured to have been asked to become Secretary of State for Health and Social Care. I understand the responsibility that comes with this job, especially at this critical moment. As someone who has sat on the Front Bench for many years, this past year has been a difficult one. I have been frustrated not to be able to play my part in helping to meet the greatest public health challenge that our country has ever faced, so I am especially proud to have been given this opportunity for public service.

Nothing embodies the spirit of public service more than our national health service and those who work in our social care. I have seen it in my own constituency; I saw it again just this morning at St Thomas’s Hospital, where I met doctors, nurses and volunteers who have moved mountains over this past year. Now, they are helping us vaccinate our way out of this pandemic. I pay tribute to them all, and I pledge to do everything I can to deliver for them and the people of this great country. I look forward to working with colleagues on both sides of the House on this vital mission.

We are making phenomenal progress with our vaccination programme. Vaccination is now open to every adult in the country, 84% of adults have got a jab and 61% of adults have had two doses. This progress has allowed us to safely take the first three steps out of the lockdown and towards the greater freedoms that we can enjoy today. We owe this strong position not only to the NHS, but to everyone who has played their part.

I want to take this opportunity to pay tribute to my predecessor, my right hon. Friend the Member for West Suffolk (Matt Hancock), who has worked hard throughout all these testing times. He achieved a great amount in the work that he did, and I know that he will have more to offer in public life. I wish him the very best.

There remains a big task ahead of us to restore our freedoms—freedoms that, save in the gravest of circumstances, no Government should ever wish to curtail. My task is to help to return the economic and cultural life that makes this country so great, while, of course, protecting life and our NHS. That task has been made all the more difficult by the delta variant, which we now know makes up some 95% of new cases in the UK. Not only does it spread more easily, but the evidence points to a higher risk of those who have not been vaccinated needing hospital treatment, compared with the previously dominant alpha variant.

This narrowing of the race between the virus and the vaccine led to this Government’s difficult decision to pause step 4 on our road map until 19 July. We are using this extra time to protect as many people as we can. When the Government took that decision on 14 June, more than 4.3 million over-40s had had a first dose but not a second. The figure is now down to 3.2 million people over 40. We can all be reassured by how many more people are getting the life-saving opportunity that a vaccine offers.

At this two-week review point, I want to update the House on our progress on our road map to freedom. Our aim is that around two thirds of all adults in this country will have had both doses by 19 July. We are bringing forward second doses, and bringing forward our target for first doses too, so we can meet that 19 July goal. Vaccine uptake remains sky-high. We have seen that age is no barrier to enthusiasm for getting the jab: as of this weekend, more than half of adults under 30 have taken up the chance to be vaccinated—including, in the past couple of weeks, all three of my own adult children.

Our vaccines are working, including against the delta variant. The latest modelling from Public Health England shows that they have saved more than 27,000 lives and have prevented more than 7 million people from getting covid-19. We know that, after a single dose of vaccine, the effectiveness is lower against the new delta variant, at around a 33% reduction in symptomatic disease, but two doses of the vaccine are just as effective against hospital admission with the delta variant as with the alpha variant.

The jabs are making a difference in our hospitals, too. In January, people over 65 who were vaccinated earlier in our programme made up the vast majority of hospital admissions; the latest data shows that that group now makes up less than a third. While cases now are ticking up, the number of deaths remains mercifully low, and we will continue to investigate how our vaccines are breaking that link between cases, hospitalisations and deaths. I am also encouraged by new data just today from Oxford University’s mix and match trial, which shows that a mixed schedule of jabs, such as getting the AstraZeneca jab first and the Pfizer second, could give our booster vaccination programme more flexibility and possibly even some better immune responses.

Finally, we continue to see a rise in hospitalisations. Although in line with the kinds of numbers we had anticipated at this point in our road map, the number of people needing hospital treatment for covid-19 has doubled since the start of May. Admissions are most clearly increasing in the north-east and south-west of England, so we have been boosting testing centres and vaccines in those areas and keeping a close watch on the numbers.

I spent my first day as Health Secretary—just yesterday—looking at the data and testing it to the limit. While we decided not to bring forward step 4, we see no reason to go beyond 19 July because, in truth, no date we choose comes with zero risk for covid. We know we cannot simply eliminate it; we have to learn to live with it. We also know that people and businesses need certainty, so we want every step to be irreversible. Make no mistake: the restrictions on our freedoms must come to an end. We owe it to the British people, who have sacrificed so much, to restore their freedoms as quickly as we possibly can, and not to wait a moment longer than we need to.

With the numbers heading in the right direction, all while we protect more and more people each day, 19 July remains our target date. The Prime Minister has called it our terminus date. For me, 19 July is not only the end of the line, but the start of an exciting new journey for our country. At this crucial moment in our fight back against this pandemic, we must keep our resolve and keep on our road map to freedom so that together we can beat this pandemic and build back better. It is a task that I am deeply honoured to lead and one I know will succeed. I commend this statement to the House.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

Can I just say at the outset that, despite our fierce political differences, my dealings with the previous Secretary of State, the right hon. Member for West Suffolk (Matt Hancock), were always courteous, respectful and professional, and I wish him well in resolving his personal difficulties.

I welcome the right hon. Member for Bromsgrove (Sajid Javid) to his place and thank him for advance sight of his statement. He will find working with the NHS and social care staff both inspirational and rewarding, and I hope he will agree to make arrangements for them to receive a fair pay rise and not the real-terms pay cut that is currently pencilled in.

Today, the Secretary of State has let it be known that the 19 July reopening will effectively go ahead. He told the news this morning that there is “no going back” and that lifting restrictions will be “irreversible”. A word to the wise: I have responded to a lot of these statements these past 15 months, and I remember Ministers telling us there was “nothing in the data” to suggest that 21 June would not go ahead. I remember children returning to school for one day before the January lockdown. I remember, “It will all be over by Christmas”. I remember, “We will send it packing in 12 weeks”.

Well, we have seen around 84,000 cases in the past week—an increase of around 61%. Today, we have seen the highest case rate since January. If these trends continue, we could hit 35,000 to 45,000 cases a day by 19 July. That will mean more long covid—the Secretary of State did not mention more long covid—and it will mean more disruption to schooling. For some, it will mean hospitalisation, and we know that even after two doses, someone can catch and transmit the virus, so what is he going to do to push infections down? Vaccination will do it eventually, but not in the next four weeks.

I want to see an end to restrictions and our constituents want to see an end to restrictions, but I hope the Secretary of State’s confidence today about 19 July does not prove somewhat premature or even, dare I say it, hubristic. Can he confirm that by “irreversible” he is ruling out restrictions this winter? Has he abandoned the plan that the previous Secretary of State and officials were drawing up for restrictions this winter?

Increased infections will impact on the ability of the NHS to provide wider care. Today, the Secretary of State has promised to give the NHS everything it needs to get through the backlog, so will the hospital discharge and support funding be extended beyond this September, or will trusts have to make cuts instead? How does he define getting through the backlog? When will the NHS again guarantee that 95% of patients will start treatment within 18 weeks of referral? We know thousands are waiting too long for cancer care, so when will the NHS meet its cancer target that 96% of patients wait no longer than a month from diagnosis to first treatment? When will he give primary care the resources to meet the challenge of the hidden waiting list of over 7 million patient referrals that we would have expected since March 2020?

Given the pressures on primary care, is it still the Secretary of State’s plan to press ahead with the GP data transfer? To be frank, Mr Deputy Speaker, if the Department cannot keep its CCTV footage secure, how does he expect it to keep our personal data secure? Will we see a plan to fix social care, or is today’s Telegraph correct when it reports that he, the Secretary of State, is of the opinion that we are completely at the wrong stage of a Parliament to launch a new social care strategy? Is that really his view? Given the pressures across the whole of the healthcare service, will he abandon the ill-thought-through top-down reorganisation of the NHS that the previous Secretary of State was set to embark on?

Finally, given the recent questions of propriety around covid contracts, the Secretary of State will understandably want to present himself as a new broom. Can he confirm that he will not use a personal email account to carry out Government business? Can he explain why the social care Minister has been using a personal email account to carry out Government business? Why was the Minister for Innovation, the noble Lord Bethell, using his personal email account to discuss the awarding of Government contracts, and why did he have meetings with a firm that won a contract but not declare it? Can he tell us whether he maintains confidence in that Minister? Is it not time that that particular health Minister was relieved of their ministerial responsibilities as well?

[Sajid Javid]

First, I thank the right hon. Gentleman for his comments and for what he said about my predecessor.

On the right hon. Gentleman’s questions, he started by rightly pointing out the incredible work that our NHS staff across the country have been doing, even before the pandemic, but especially, I think we would all agree, throughout the pandemic. I heard about that myself this morning during my visit to St Thomas’s Hospital talking to staff—doctors, nurses, consultants—and hearing directly about the challenges they faced at that time but also the challenges they continue to face. I wanted to hear from them what more the Government can do, whether on recruitment or resources, and what more help can be provided. So it remains an absolute priority. Of course, it is absolutely essential that, when the pay settlement process is complete, that is a fair process. Of course, it absolutely will be and it will be a fair pay settlement.

Turning to the right hon. Gentleman’s next question about the timing of the move to step 4, I set out, I think clearly in my statement, the Government’s plan and the rationale for that plan. I point out that what is at the heart of this is the vaccination programme and the excellent work that has been done by many across the country: the volunteers, doctors, and nurses. I visited a vaccination centre today, as well as St Thomas’s Hospital. Excellent work has also been done by the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi). More people are getting vaccinated. We are seeing clear evidence that we are breaking the link—this is absolutely crucial—between the number of cases of people getting infected by covid-19 versus those who sadly end up in hospital or even, in some cases, lose their lives. The more evidence we see of that, the more confident it can make us that we will put this pandemic behind us. That is what gives me confidence about the date of 19 July. With all the data I saw yesterday—I sat down and discussed it with the experts and my colleagues—it is very clear that we are heading in the right direction, and I am very confident about that date of 19 July.

The hon. Gentleman rightly asked about the backlog. The focus, for all the right reasons, of the NHS and social care system on dealing with the pandemic has, sadly, seen a significant backlog of cases build up. The Government have already provided record amounts of funding to try to deal with some of that backlog. In total to deal with the pandemic, some £92 billion of extra funding has been put into the NHS and social care system, and much of that is targeted at the backlog. It will be an absolute priority—it was for my predecessor, and it certainly will be for me—to see how quickly we can deal with that and what the best and most efficient way is to do so. Just today, on my visit to St Thomas’ Hospital, I heard some excellent new ideas from people on the frontline. We will certainly be listening to them as we set out further plans.

The hon. Gentleman also asked about social care, and I should warn him not to believe everything he reads in the press—and I think he should know that. Social care remains an absolute priority for this Government, and for me. The Prime Minister himself has rightly made some very clear commitments on social care, and we absolutely intend to meet them. When it comes to reform, of course we are committed to the Bill on NHS and social care reform, which my predecessor has talked about at the Dispatch Box. If hon. Gentleman sits down with me, perhaps I can persuade him a little of the virtues of that Bill, and I am sure I can convince him that it is essential. If, like me, he believes that what matters most are the patients—we want the people who go into hospital feeling unwell to be seen quickly and efficiently and to get better—the people in our social care system, and having better integration, then he will believe in the virtues of that Bill. I hope, eventually, he can come to support the Bill and do the right thing.

Lastly, the hon. Gentleman asked me about my Ministers. I have such a fantastic ministerial team—all and every single one of them. It is not just a question of confidence; it is a group of Ministers who are incredibly talented and who have delivered both in this House and in the Lords. Having led five Departments previously, I have had some considerable experience of working with Ministers, and this is one of the best teams I have ever had.

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

Mr Deputy Speaker, my apologies for missing the start of this statement. May I warmly welcome my right hon. Friend to his post? He will bring experience, ability and integrity to this role, and I have no doubt he will do it with great distinction. He will understand, of course, that in my role I have to scrutinise him, so I want to say to him now that he is welcome to as many seven-hour sessions of the Health and Social Care Committee as he is willing to attend, and we look forward to talking to him there. I do want to wish him well, and I also want to echo his comments about his predecessor. To be Health Secretary in a pandemic is the most difficult job imaginable. My right hon. Friend the Member for West Suffolk (Matt Hancock) brought enormous energy and determination to that role, and the country is in his debt.

As the Secretary of State deals with what we hope are the final stages of this pandemic, can I ask him whether he will also be giving thought to how to prepare the NHS and care system for future pandemics, and whether at the top of his list will be putting more resilience into the social care system—not just meeting our manifesto promises on a cap on social care, but making sure that local authorities have long-term stability in funding to ensure they can look after every older person with dignity and respect?

[Sajid Javid]

First, I thank my right hon. Friend for his remarks, and I welcome the scrutiny that he and his Committee will provide. I am not sure about the seven hours bit, but I very much welcome the scrutiny and the intention.

On his question about preparing for future pandemics, a huge amount of work is already going on. Just yesterday, I met the chief executive of the UK Health Security Agency, which will work on much of that. As I think my right hon. Friend knows, in the best part of a year that I have been away from the Front Bench, I spent time as a senior fellow at the Harvard Kennedy School where my project was looking at potential future pandemics. I will put that knowledge, and everything I learnt through the process in doing that preparation, to use.

My right hon. Friend is also right to raise the importance of social care reform and the work that needs to be done, including on sustainable funding. He will remember how in the past we often worked together as Ministers. In these different roles, I look forward to working with him on that same issue of how we provide a long-lasting, sustainable solution to the social care challenge that this country faces. As I said to the right hon. Member for Leicester South (Jonathan Ashworth), that remains a huge priority, and I look forward to talking to my right hon. Friend and learning from him, too.

[Dr Philippa Whitford (Central Ayrshire) (SNP) [V]]

In welcoming the new Secretary of State to his place and thanking him for advance sight of his statement, I would like to ask how he plans to review or modify current covid policy? The management of any epidemic is not rocket science but infectious diseases 101: avoiding the importation of dangerous variants through border control and quarantine; and stopping the virus spreading from one person to the next. Does he plan to revise the Government’s quarantine and traffic light system to avoid importing more variants, which, like the delta, would threaten the reopening of the domestic economy and society?

On Friday, the National Audit Office released a report on the NHS Test and Trace system, which did not quite get the media coverage one would have expected. One year on, Serco is still reaching only 83% of contacts, while Scotland reaches 98% and Wales 95%. Both of them have used public health and health protection teams from the start. As covid restrictions are eased, a well-functioning test, trace, isolation and support system will be critical to detect and control small clusters and avoid future surges. Therefore, instead of awarding Serco a new contract for more than £300 million, should the opportunity not be taken to reform the system?

It is only isolation that stops the onward spread of the virus, and while the £500 isolation payment is welcome, it is less than the minimum wage, and many are excluded by the eligibility criteria. With no results at all registered for almost 600 million issued lateral flow tests, will the Secretary of State shift some of that funding to provide more generous and accessible financial support for those who are asked to isolate? While vaccines are reducing the likelihood of hospitalisation, cases are rising exponentially. Does he recognise that allowing the current surge to go unchecked would put pressure on the NHS and run the risk of even more infectious or vaccine-resistant variants emerging?

[Sajid Javid]

The hon. Lady first talked about the importance of border control, and she was right to do so. That is why the Government have already put in place the so-called traffic light system, with this Department working across Government with the Home Office, Border Force, the Department for Transport and others. The system absolutely needs to be kept under review to ensure that it is doing its job in protecting the people of this country from viruses, and especially from any new variants of covid-19 that may emerge. I can give her reassurance on that.

The hon. Lady also raised Test and Trace. She should know that the NHS Test and Trace system is the largest diagnostic exercise of its kind in British history. We have carried out more than 200 million tests, identified more than 4 million positive cases and found more than 7 million of their contacts. Every time that happens, whether in England, Scotland or any part of the United Kingdom, that breaks the chain of transmission and saves lives.

[Lucy Allan (Telford) (Con)]

May I say how delighted I am to see my right hon. Friend back on the Front Bench? I congratulate him on his appointment to this crucial role, and I welcome his approach, as set out in his statement. He will be an excellent Health Secretary.

Can my right hon. Friend confirm that 19 July will mark the end of the road map out of lockdown, that “terminus” means the end of the line, not an interchange, and that it is his intention that all restrictions will be lifted on that date?

[Sajid Javid]

I thank my hon. Friend for her kind remarks. As she will have heard in my statement, it is absolutely our intention to have step 4 commence on 19 July and to remove restrictions and start returning to normal. She asked me specifically about all restrictions, or which restrictions. It is certainly our intention to remove restrictions, but as we follow the data in the coming days, we will set out more in due course.

[Munira Wilson (Twickenham) (LD)]

May I begin by welcoming the Secretary of State to his place? I look forward to engaging constructively with him on a range of issues.

The Secretary of State will be aware that during the course of the pandemic, well in excess of 40,000 people lost their lives to covid in care homes, and the “protective ring” that his predecessor talked about being in place at the start of the pandemic went in far too late. He will also be aware that two in three unpaid carers looking after loved ones—some 7 million people—have reported their mental health worsening as a result of the pandemic. Will he help his boss to make good on his promise of almost two years ago on social care reform and honour his manifesto pledge to work cross-party on this issue, and meet me and my right hon. Friend the Member for Kingston and Surbiton (Ed Davey) to urgently start work on it?

--- Later in debate ---

[Sajid Javid]

I thank the hon. Lady for her comments about working together. She is absolutely right to say that, especially on something as important as social care, which she is right to raise as a priority for the Government and for this House. She reminded the House that, sadly, so many people in care homes have lost their lives through this pandemic. She will be aware that, even before the pandemic, the Government had pumped billions more into the social care system, and during the pandemic there was a lot of support, but a lot more needs to be done, and I think that is what she rightly gets to. The Government have said that the best way to find a sustainable solution to the country’s social care challenge is for parties to work together and co-operate, and I would happily meet her.

[Alberto Costa (South Leicestershire) (Con) [V]]

I welcome my right hon. Friend back to the Government, and I look forward to working with him in the months and years ahead.

The Feilding Palmer Hospital in Lutterworth is the only hospital in my constituency. It was threatened with closure but is now being used as the principal covid vaccination centre in the southern part of my South Leicestershire constituency. Once the Secretary of State has settled into his important role, will he meet me to discuss the important future that I hope to see for that much-valued district hospital?

[Sajid Javid]

I thank my hon. Friend for raising that issue about his local hospital. As a constituency MP, I absolutely understand the importance of local hospitals and having that support in the local community. This hospital in particular has done a great job with vaccinations, and it continues to do a fantastic job. I think that is a very good sign of the contribution that it can potentially continue to make for the local community, and I would very happily meet him.

[Jim Shannon (Strangford) (DUP)]

I thank the Secretary of State for his statement and, as the Democratic Unionist party health spokesperson in this place, I wish him well, on behalf of my party, in his new role. I have absolutely no doubt that he will do an excellent job.

If we are aiming for progression and moving away from restrictions such as the wearing of masks, may I ask when people will be able to attend worship and sit in churches self-distanced, without wearing a mask, just as diners can sit in a restaurant self-distanced without a mask? If we are going to have parity, then I believe that churches should have parity with restaurants.

[Sajid Javid]

I thank the hon. Gentleman for his remarks. I agree with him that as we move towards removing restrictions and step 4, we should take seriously into account what he said about people attending churches and the restrictions that they currently face. That is certainly my intention.

[Dr Kieran Mullan (Crewe and Nantwich) (Con) [V]]

The Secretary of State will rightly focus on the immediate challenges of covid, but his Department is also about to make decisions related to integrated care systems, which have potentially enormous long-term implications for the provision of healthcare for my constituents and the constituents of fellow Cheshire MPs. The NHS wants to create a Cheshire-Merseyside ICS, which will not serve the best interests of our residents. Will the Secretary of State meet us urgently to discuss the proposal before it is quietly pushed through?

[Sajid Javid]

First, I thank my hon. Friend for the work that he personally has done to support the NHS, especially through his work in A&E departments. I also thank others who have contributed in that way. On his particular question, no final decisions have been made on ICSs. I absolutely understand the importance of his point. I want to make sure that we get these things right and, although I understand that he has already met Ministers in the Department, I would happily meet him myself.

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

I welcome the Secretary of State for Health and Social Care to his new role. During the past 10 years, nearly £8 billion has been lost from budgets for adult social care. Too often during the covid pandemic, social care has been an afterthought for Ministers and officials. The results have been all too clear in the tragic levels of mortality in care homes. The social care sector is desperate for investment and reform, so will the new Secretary of State commit today to bringing forward proposals to invest in and reform social care as soon as possible, and at the latest by Christmas this year, as promised?

[Sajid Javid]

I agree with the hon. Lady on the importance of social care and that it should be a priority for reform, as it is for this Government. I do not agree with her characterisation that under this Government it has not been a priority or her suggestion that there has been under-investment. When in my previous role as the Secretary of State for Housing, Communities and Local Government, and certainly as Chancellor, we increased funding a number of times. I think we agree that we need a long-term, sustainable solution—we are not there yet—and that is something the Government are absolutely committed to.

[John Redwood (Wokingham) (Con) [V]]

I welcome my right hon. Friend to his new role, I wish him every success and I support his plan to unlock soon. Will he look at expediting trials of other drugs and treatments that may help covid-19 patients and have been looked at elsewhere? Will he also encourage work on air extraction and cleaning systems, to see what more can be done to stop transmission of the disease, as we are going to have to live with it to some extent?

[Sajid Javid]

I thank my right hon. Friend for his welcome. On his question, I simply say yes, I will.

[Mr Clive Betts (Sheffield South East) (Lab) [V]]

I welcome the Secretary of State to his new role. He could begin by launching cross-party work on social care reform by responding to the 2018 report by the Housing, Communities and Local Government Committee and the Health and Social Care Committee, because three years later we are still waiting for a Government response.

On test and trace specifically, the NAO report on the national system that was published the other day was hardly complimentary. The Secretary of State will be aware, from his previous role as Secretary of State for Housing, Communities and Local Government, of the great professionalism of directors of public health and the work that they do. As the NAO report says, in many cases they are still waiting for up-to-date data to deal with local covid outbreaks. Will the Secretary of State commit to rectifying that situation and ensuring that directors of public health are fully involved in the new model for testing and tracing that will be undertaken from July this year?

[Sajid Javid]

I think the hon. Gentleman agrees with me on the importance of social care, which we have discussed in the past and will no doubt discuss again going forward. He mentioned the NAO report; if he will allow me, I will take a closer look at that and write to him.

[Theresa Villiers (Chipping Barnet) (Con)]

I warmly congratulate the Secretary of State on his new role. Now that thousands of people are allowed to gather together at a football match to shout and cheer as much as they want, is it not time that we allowed congregations in church to sing hymns together?

[Sajid Javid]

I can tell my right hon. Friend that that is certainly what I would like to see and it is certainly my intention to allow that to happen as soon as possible. When it does, I hope we can sing a hymn together.

[Matt Western (Warwick and Leamington) (Lab)]

I, too, welcome the Secretary of State back to the Front Bench. One vector of the current surge in cases has been the rise in cases in schools. On 17 June, we had a quarter of a million pupils away from school. What steps does he think need to be taken to address the decline in the number of tests being carried out in schools? Does he think that the wearing of masks should become mandatory?

[Sajid Javid]

I am pleased that the hon. Gentleman has raised that issue, because it is very important. The point he is rightly making is that when we are asking children not to be in school for those reasons, to try to control infections, it is having a huge knock-on impact on their education, and none of us wants to see that. I have already asked for fresh advice from my Department on this issue and I intend to discuss it with my right hon. Friend the Education Secretary to see what more we can do.

[Rob Butler (Aylesbury) (Con)]

I wholeheartedly welcome my right hon. Friend to his new position. Given his extensive experience, both inside and outside Government, does he agree that the UK’s success post-pandemic will depend on the Department of Health and Social Care working closely with local councils, social care providers, businesses and community representatives to ensure that we protect both lives and livelihoods in the years ahead?

[Sajid Javid]

I agree wholeheartedly with my hon. Friend. As someone who has also been the Local Government Secretary and the Business Secretary, I agree with him even more, just directly from that experience.

[Richard Burgon (Leeds East) (Lab)]

The new Health Secretary has not been on the Front Bench for a year, but in that time he has been very busy—very busy indeed, lining his own pockets. He has been getting £1,500 per hour for his second job and £1,500 for his third job, all while NHS staff at Seacroft Hospital and St James’s University Hospital in my constituency have been working harder than ever, getting our communities through this covid crisis. Given that he has done very well out of the past year, bagging hundreds of thousands of pounds during a national crisis, would it not be the height of hypocrisy for the new Health Secretary to refuse our NHS staff the pay rise they so clearly deserve?

[Sajid Javid]

The hon. Gentleman is going to have to try a lot harder than that.

[Richard Drax (South Dorset) (Con) [V]]

I welcome my right hon. Friend to his place, as others have done. I also welcome his optimistic and confident statement, which is so refreshing and is music to millions of ears. I concur with him when he says that we must learn to live with this virus, which will continue to throw up variants in the years ahead. Many constituents are having trouble actually seeing their GPs. Will he help by persuading some in the profession to return to physical meetings?

[Sajid Javid]

My hon. Friend has raised an important issue. Even before I had this job, that issue came up again and again when I was a constituency MP just like him, and I absolutely understand it. It has especially been raised by older members of my constituency; people have brought this issue up where they are perhaps not as familiar with technology and they want that face-to-face meeting. I have already asked for advice on that and I will write to him on it, if I may.

[Catherine West (Hornsey and Wood Green) (Lab) [V]]

Many constituents have contacted me about GP provision too, particularly the letting of key practices to private US healthcare companies. Will the Secretary of State take this opportunity to reassure me and my constituents that he intends to keep our NHS public?

[Sajid Javid]

The hon. Lady will know that the NHS is one of our greatest public services. In fact, it is one of the greatest public services that any country has, and it is an example to the rest of the world. It is something that we will cherish and continue to support in every possible way.

[Theo Clarke (Stafford) (Con)]

I warmly welcome the return of my right hon. Friend to the Front Bench. Some services such as maternity were temporarily suspended at Stafford’s County Hospital so that those wards could be used to treat covid-19 patients at the height of the pandemic, but does he agree that it is vital that those services are now returned to the hospital as soon as possible?

[Sajid Javid]

That is an important issue for many hon. Members. Services, in this case maternity services, were understandably, I think it is fair to say, suspended to deal with the pandemic. As we return to normal, it is important that those services, on which local people rely, begin to return to normal as well. If it is helpful for my hon. Friend, I can certainly set up a meeting for her with my hon. Friend Minister for Health so that she can discuss that in more detail.

[Marion Fellows (Motherwell and Wishaw) (SNP)]

Now that the Health and Social Care Secretary is in post, will he break with his predecessor’s outright refusal to deliver the pay rise to NHS staff in England that they deserve? Will he, at a minimum, commit to matching NHS pay rates in Scotland, delivering a pay rise for staff in England, and to providing more money in consequentials to help devolved Governments support NHS staff in devolved nations?

[Sajid Javid]

The whole House would agree that the Government must absolutely make sure that there is a fair pay settlement for all NHS workers, and that is certainly what there will be.

[Dr Liam Fox (North Somerset) (Con)]

I am absolutely delighted to see my right hon. Friend back in his rightful place on the Front Bench. There can be no clearer example of the Government’s commitment to recycling. I hope that he will bring his customary consistency in approach to the covid crisis, and tell us whether we are following dates or data. As for the data we get, it is not just about the number of infections—it is about who is infected, what age they are, whether they have pre-existing conditions, and whether they have been offered a vaccine, but have refused. It is not just about hospitalisations and how many people are in hospital. How long have they been hospitalised compared with the figures for previous parts of the pandemic? How many of them require extra care and how many are in intensive care units? We need to understand much better how the Government are reaching their decisions. The British people are not stupid, and Parliament needs to be taken into the Government’s confidence much more. I trust, given the previous examples of how he has conducted himself, that my right hon. Friend can do that.

[Sajid Javid]

I should first tell my right hon. Friend that I am happy to be recycled. Recycling is something that we are all in favour of. On his important point about data, I saw the data in the Department for the first time yesterday. I saw the detail that it provides and how granular it is. I was impressed with that data, so I can give my right hon. Friend reassurance that the Government are looking at the data, and are absolutely taking it into account. I would also like to find a way to make sure that we can share as much of that data as possible so that others can benefit from it, and I will certainly look at ways in which we can do just that.

[Navendu Mishra (Stockport) (Lab)]

Despite the best efforts of our hard-working NHS staff, covid-19 has created a backlog in cancer care. Macmillan estimates that the backlog of people receiving their first cancer treatment stands at 37,000 people across England. One of the key ways in which the Secretary of State can help with the Government’s goal of recovering from the pandemic is ensuring that we have enough well-trained and motivated NHS staff now and in future, so will he commit to addressing the cancer backlog and investing in the NHS workforce to build back better for the future now that he is in post? Will he meet me and Macmillan Cancer Support to discuss this urgent matter?

[Sajid Javid]

Cancer diagnosis and treatment has remained a top priority, and rightly so, throughout the entire pandemic. Some 2.47 million urgent referrals have been made and over 618,000 people have been treated between March 2020 and April 2021. The hon. Gentleman may also be interested to know that following the “Help Us, Help You” symptom awareness campaign, many of the so-called missing patients are starting to come forward and urgent referrals are rising. That is what we all want to see.

[Greg Clark (Tunbridge Wells) (Con)]

I warmly welcome my right hon. Friend to his post and place on record my thanks to his predecessor, my right hon. Friend the Member for West Suffolk (Matt Hancock), who was always assiduous in attending the Science and Technology Committee and, indeed, in coming to the Dispatch Box.

Is the Secretary of State aware that Professor Sir Andrew Pollard, one of the heroes of the Oxford vaccine, recently told my Committee that we need to be aware that new variants are likely to infect even the vaccinated, but:

“If…high protection against hospitalisation continues despite spread”

of cases

“in the community, the public health crisis is over”?

What will my right hon. Friend do to inform the public, and perhaps some officials, that we must move from being concerned about the number of cases of covid to focusing squarely on hospitalisation?

[Sajid Javid]

I absolutely agree with my right hon. Friend. This is a such a crucial point and it is one that I referred to earlier. Of course, cases are not unimportant, but because we now have the vaccine, thankfully, and in this country in particular so many people are getting vaccinated—of course, we want to see more and more people coming forward, but the take-up is excellent, especially compared with other countries—it is the vaccine that is going to break the link between case numbers and hospitalisation. As I said, we are absolutely starting to see that. The indications are very, very positive on this, and I hope that is the kind of news that my right hon. Friend will welcome.

[Paul Blomfield (Sheffield Central) (Lab) [V]]

The Home Office recently updated its visa guidance to say that new international students and those returning to the UK must be here by 27 September or lose their post- study work rights. Around one fifth of our international students are from red list countries. Their arrival risks a surge in demand that will overwhelm the hotel quarantine system. Universities UK, the Confederation of British Industry and others have written to Ministers urging flexibility on visa rules to enable blended learning to continue with phased entry to the UK, so will the Secretary of State urgently meet his successor as Home Secretary to seek this change?

[Sajid Javid]

I was not aware of this issue. I am glad that the hon. Gentleman has brought it to my attention, and I will certainly raise it with my right hon. Friend the Home Secretary.

[Jason McCartney (Colne Valley) (Con) [V]]

I welcome my right hon. Friend to his challenging new role. One of the big challenges in my area is parents, grandparents and guardians having to deal with children and students from local schools and colleges who have to isolate for sometimes a third or fourth time in the past couple of months as a result of having been a close contact of a positive case. This is having a huge impact on education, mental health and wellbeing, so what extra PCR testing, and what new approach to isolating, can be introduced to help to support local families and children?

[Sajid Javid]

This is another very important issue. My hon. Friend is right to highlight the impact of the isolation that is demanded of children—understandably so, but it is having an impact on their education, their mental health and in so many other detrimental ways. That is exactly why I have asked for fresh advice on this. I want to see if there is anything more that we can do—any more flexibilities. I am aware that there is a pilot programme in place at the moment that certain local authorities are using whereby tests can be used in lieu of isolation, but I want to see if we can go further, and I will be happy to discuss that further with my hon. Friend.

[Sir David Evennett (Bexleyheath and Crayford) (Con) [V]]

I congratulate my right hon. Friend on his appointment as Secretary of State and wish him well.

In Bexley borough we have some of the highest-performing vaccination teams in the country, and we are all grateful to those involved for their tremendous work. However, will my right hon. Friend confirm that the vaccine roll-out remains his top priority, so that my constituents can be confident that we will defeat this pandemic, ease restrictions and see life return to normality after 19 July?

[Sajid Javid]

I can certainly confirm that to my right hon. Friend. As he suggests, the vaccine is the best way out of this pandemic. Let me share with him that four fifths of adults have had their first jab and three fifths have had both jabs—that is almost 77 million jabs across the country, with millions more to come. This is going to be our way out of this crisis, I am grateful for the huge amount of work that NHS staff and volunteers are doing in his constituency and throughout the country to achieve that and to get more and more people vaccinated.

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

In Newcastle, infection rates are doubling every week and are now at over 400 per 100,000. The Secretary of State may think that that is not important because, thankfully, hospitalisations and deaths are not rising at the same pace, but more and more people are being asked to self-isolate. My constituents want to do the right thing, and the vast majority do, but support is woeful. Does he recognise that that is one reason for higher rates in areas with higher levels of low-paid and insecure work? As a former Chancellor, will he fight for more support, including extending eligibility to anyone without access to workplace sick pay?

[Sajid Javid]

I could not hear the question entirely, but I think I got the gist of it. Areas that are seeing rising case rates—as I mentioned, some parts of England are seeing particularly high increases—are, as the hon. Lady knows, being given extra support through testing, tracing and other means, including extra financial support. We will absolutely keep under review how much further support can be provided to help with the issues she mentioned.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

I congratulate my right hon. Friend on his appointment and warmly welcome his return to the Front Bench. Does he share my concerns regarding this winter, when we predict that an increase in covid hospitalisations may be superimposed on normal NHS winter pressures? Can he confirm that plans and preparations are being put in place now to support our NHS in what may be a very difficult winter indeed?

[Sajid Javid]

My hon. Friend is right to raise this issue. I can absolutely confirm that plans are being put in place. A huge amount of work was done by my predecessor and, of course, I will continue that work—just yesterday, I had meetings on winter plans. I can give my hon. Friend the absolute assurance, not just on vaccinations but on dealing with the backlog, that there are plans in place, and in due course I will come to the House and set them out.

[Clive Efford (Eltham) (Lab)]

In answer to my right hon. Friend the Member for Leicester South (Jonathan Ashworth) earlier, the Secretary of State said that he is working on a plan for social care and that we are not there yet but that we are getting there. However, the Prime Minister told us that he had a ready-made plan back in July 2019. What has changed? Does that plan exist, or has it been changed?

[Sajid Javid]

The Prime Minister has a plan, and we are working on the detail of that plan.

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

May I also congratulate the Secretary of State and welcome him to his position? Does his optimism on the end of domestic restrictions extend to those who want to take up international travel again or who work in the industry? Is he also confident that the three fifths he mentioned who have been double-jabbed will be able to go to amber list countries without quarantine? Would he be willing to meet me and other colleagues who share a concern that we need to do more to try to help our industry?

[Sajid Javid]

First, my hon. Friend will know that, in terms of 19 July and the restrictions that will be removed, we are focusing on domestic restrictions. He knows that, separately, we also take very seriously the border controls, the border restrictions and the so-called traffic light system. In terms of making any further decision on that, he will know that it is kept under constant review on a very regular basis, and it is something that I intend to sit down and discuss with my right hon. Friend the Transport Secretary as soon as I can.

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

I very much welcome my right hon. Friend’s return to the Front Bench. I know from my experience of dealing with him in Government that he is a man of real integrity, which is an essential quality in a Health Secretary at a time like this, so I welcome his appointment.

I welcome my right hon. Friend’s tone and his intent to get us back to normal, but let me pick up on his earlier answer to our hon. Friend the Member for Runnymede and Weybridge (Dr Spencer). There are those in government, from documents that I have seen, who are preparing the ground for the return of restrictions in the autumn and the winter. Will he rule out the use of lockdowns and restrictions in the winter as a mechanism for managing covid, and look at alternatives to ensure that the NHS is able to deal with us getting back to normal?

[Sajid Javid (Bromsgrove) (Con)]

I thank my right hon. Friend for his kind and warm remarks. I know that he has taken great interest throughout the pandemic in the restrictions in particular, and I absolutely understand why it has been so important to him and others. I am very happy to meet with him to discuss the issues in more detail and listen to his views. He should know that it is my intention, and the Government’s intention, as I have said from day one on this job, to remove all restrictions as quickly as possible.

[Steve Brine (Winchester) (Con)]

I give a warm welcome to my right hon. Friend. I wish him very well. I am looking for a change in policy as much as a change in tone. I return him to the subject of education. Estimates suggest that a quarter of a million children are missing school today due to precautionary isolations, the vast majority of them sequential due to the bubbles that they are caught in. Under the current rules, 10 days of isolation is then unavoidable, even with a negative PCR test. Have our young people not suffered enough? Are we really going to continue to do this to ourselves? Is this not an area, given the availability and reliability of testing now, where I might find the change of policy that I am looking for?

[Sajid Javid]

Other hon. Members have rightly raised this very important issue, and my hon. Friend is right to draw attention to it once again. It is something that I have focused on from day one on the job. That is why I have asked for fresh advice on it. As he knows, that decision was made with the data that was available at the time. Clearly, data is changing all the time, and we must ensure that we keep that under review for exactly the reasons that he has just set out. As I say, I have asked for advice on that and will hopefully be able to say more on it as soon as possible.

[Mr Deputy Speaker (Mr Nigel Evans)]

I thank the Secretary of State for Health for his statement. In his first outing in the new role, he has responded to 31 questions in one hour, so thank you very much.

Health and Social Care Bill

Sajid Javid Excerpts

Tuesday 13th March 2012 Commons Chamber

[Andy Burnham]

No, I will not.

We have arrived at a dangerous moment, not only for the NHS but for our democracy. To recap, this is a Bill for which nobody voted at the general election and which does not have a mandate, a Bill ruled out by the coalition agreement, and a Bill that has been so heavily amended in another place that in effect the unelected Chamber has written a new legal structure for the national health service that we are being asked to rubber-stamp. Yet despite all that, it could be rammed through this House in just seven days’ time, in defiance of an outstanding legal ruling from the Information Tribunal and in the teeth of overwhelming professional and public opposition.

This is an intolerable situation, and it is no way to treat our country’s most valued institution. Far-ranging changes to the NHS of the kind proposed by the Secretary of State can be made only by public consent and professional consensus, and it is plain for all to see that the Government have achieved neither of those things.

[Sajid Javid (Bromsgrove) (Con)]

Will the right hon. Gentleman give way?

[Andy Burnham]

No, I will not.

To proceed as planned risks profound damage to the relationships of trust that underpin a successful health service and risks a further erosion of trust in our democratic process that this House can ill afford.

Today there is one final chance for this House to ask the Government to step back from this dangerous course and reflect the feeling that there is in every single constituency in England. In introducing this debate, I have a bigger responsibility than speaking for Labour Members. The call to drop the Bill is not a narrow Labour campaign, as was claimed just now and in Gateshead at the weekend—it is a new coalition for the NHS that has brought together patients, professionals and people of all political views, including, I dare say, some of those in the Secretary of State’s own party. People who have signed the petition will be watching our proceedings closely. They will be hoping against hope that somehow we will put the NHS first, put aside the customary clash of party politics, and find common ground that can help the NHS.

--- Later in debate ---

[Andy Burnham]

I am aware of the concerns expressed by Diabetes UK and, indeed, by many other organisations representing people with long-term conditions, who have not been given the clarity that they need in order to give their support to these changes. [Interruption.] The Secretary of State says “Rubbish”, but I am afraid that those questions have not been answered, and that is not good enough.

[Sajid Javid]

rose—

[Andy Burnham]

I will not give way.

As I said, we need to see whether we can find common ground and put the NHS before party politics. That is the test that I set for the debate, and it is the spirit in which I wish to frame it. Today is not just an Opposition day but Merseyside derby day. Usually both occasions put me in a highly partisan mood, yet despite having double reason to be in tribal mode, I am going to take the unusual step of urging Labour Members not to vote for our motion but to consider the amendment tabled by the hon. Member for St Ives (Andrew George) and his Liberal Democrat colleagues. We will listen with interest to what he has to say. The amendment sets out a sensible way forward that we can all unite around. It sends out the simple message that the importance of the NHS to us all and to our constituents should trump any tribal loyalty. It is important to say that, because I fear that sheer gut loyalty, political pride and the need to save face are the only forces driving a deeply defective Bill towards the statute book.

--- Later in debate ---

[Andy Burnham]

I am afraid that I cannot read all the intricate smoke signals of a Lib Dem conference, but to my simple mind, removing permission from the motion for peers to endorse the Bill is a pretty clear signal that that permission has been withheld.

Before I deal with the amendment that the hon. Member for St Ives has tabled, I want to tackle directly the charge of scaremongering that has been levelled at Labour Members, and draw the House’s attention to evidence already emerging that supports our central concerns about the effect of the reorganisation. We have consistently said that it is the wrong time to reorganise the NHS—indeed, it is the worst time imaginable. The Government are asking the NHS to do too much. It is facing its toughest ever financial challenge. Combining that with the biggest ever reorganisation was a catastrophic misjudgment. The Government dismantled the existing structures of the NHS before the new ones were in place, leading to a loss of grip and focus at local level just when that was most needed.

We have now had two lost years in the NHS. When the system should have been getting to grips with the financial challenge, it has been distracted and destabilised by reorganisation. Information is now emerging that bears that out. The Nicholson challenge is a huge task for the NHS, but after only six months, we hear that it is already falling behind. New information provided from the Department to the Health Service Journal in response to a freedom of information request reveals how two out of three—68%—non-foundation trust acute trusts missed their savings targets for the first six months of the Nicholson challenge. At least five have made less than 20% of their planned savings for the year 2011-12. Overall, at the half-year point, the non-FT acute sector had a net deficit of £135 million. That is a real warning sign, which suggests that the Government are storing up huge problems for the future.

That is not conjecture. There is evidence that a destabilised NHS is losing its grip on finances and operational standards. For the tenth week in a row, the NHS last week missed the Secretary of State’s lowered standard for accident and emergency, with fewer than 95% of people seen within four hours. That is the main barometer of pressure on NHS hospitals. The figures clearly tell us that hospitals are not coping with the pressure that they are under, and that job losses and staff shortages are having a real impact.

[Sajid Javid]

Will the right hon. Gentleman give way?

[Andy Burnham]

I will not.

Rather than just reel off statistics about elective waiting times, I ask the Secretary of State today to address A and E performance. Why does he think the NHS is missing his relaxed target and what steps is he taking to address that?

Another of our central concerns—

[Sajid Javid]

Will the right hon. Gentleman give way?

[Andy Burnham]

Just one second. I have said that I want to give hon. Members a chance to comment in the debate, and that is what I am going to do.

NHS Risk Register

Sajid Javid Excerpts

Wednesday 22nd February 2012 Commons Chamber

[Alan Johnson]

I see that the Whips’ brief dragged up something I did in a previous life. [Interruption.] The risk register is, with respect, a second-order issue. I cannot understand why the Health Secretary does not publish it. He is in enough trouble already, and the Government are in enough trouble already without adding an issue of transparency that simply makes the situation worse.

[Sajid Javid (Bromsgrove) (Con)]

rose—

[Richard Graham (Gloucester) (Con)]

rose—

--- Later in debate ---

[Dame Joan Ruddock (Lewisham, Deptford) (Lab)]

I should like to tell the hon. Member for Finchley and Golders Green (Mike Freer) that it is hard to take seriously all the points that he made, as the strategic health authority in London has published a risk register. I want to devote my contribution to that issue.

That risk register lists 18 areas of risk. It describes the risks to the improvement programmes agreed by the strategic health authority, including London’s contribution to the Government’s £20 billion efficiency savings, and to the public health transition programme, in which some mitigating actions would be beyond the direct control of NHS London. It goes on to list the risks involved in the transition to the reorganisation that the Government plan for the NHS. It makes devastating reading. I shall highlight a few of the 18 risk areas. On the risk to the efficiency savings and improvement plans, it says that they

“may not be realised in full or are delayed, thereby undermining significant improvements in the health of Londoners.”

On the public health transition, which involves NHS public health staff dispersing into local government, it says:

“The consequence of this risk would be a negative impact on the leadership and structure of the public health workforce, and thereby delivery of public health services.”

On the abolition of primary care trusts next year, it says that the result

“may be poor, both in securing the best health outcomes for London’s population and in maximising value for money.”

In all cases, I am quoting directly from the reports.

[Sajid Javid]

We have heard from two former Labour Health Secretaries, both of whom refused to release the risk register. Does the right hon. Lady think that they made the right decision?

[Dame Joan Ruddock]

The decision that was made was about strategic health risks, and reference was made to things such as nuclear war, climate change and pandemics. We are talking about the transition, and we want to see a risk register on that. As my right hon. Friend the Member for Leigh (Andy Burnham) said, the London risk register goes on to describe risks to the safeguarding of children and maternity services as creating possible harm to patients. On patient safety and clinical quality, it concludes that the risks are such that the consequence

“could be poor or unsafe care for patients and loss of public confidence in healthcare in London.”

I understand the argument made by Members from all parts of the House that the point of a risk register is to enable mitigation measures to be applied to those risks. That is exactly what the London document does, but in half the risk areas the original red risk is still red after the mitigation measures are proposed. In all areas, the risks after mitigation are still amber. That is an extraordinarily serious matter of which we have to take account when we look at how the planned reorganisation will affect the health of Londoners and of my constituents.

How is it possible, I ask the Secretary of State, for staff already under pressure to deliver more with less, to carry on doing their job against the change programme that their strategic managers believe poses such risks? With so many issues raised by the London risk register, is it any wonder that the British Medical Association, the Chartered Society of Physiotherapy, the Royal College of Midwives and the Royal College of Nursing have all called on the Government to publish their risk register, which, as my right hon. Friend the Member for Leigh pointed out, relates specifically to the transition required by the Health and Social Care Bill and, presumably, the very changes already under way that are forcing people to wait longer and most definitely undermining confidence in the service?

In Lewisham alone, nearly £21,000 has been spent reorganising the PCT, and now the number of those patients waiting more than 18 weeks has gone up by 73%. How can that be the improvement of which the Secretary of State speaks? Even more worrying for my constituents are the difficulties faced at Guy’s and St Thomas’ foundation trust, where the latest available figures showed that over 20% of patients urgently referred by their GPs and subsequently treated for cancer in those hospitals waited more than two months for hospital admission. I tell the Secretary of State that if I had a diagnosis of cancer, I would be terrified of waiting more than two months to begin my treatment.

I do not blame the Guy’s and St Thomas’ foundation trust, where I myself have had excellent treatment in both hospitals, but I do blame this Government. I blame them for this top-down reorganisation that is already under way at a time of straitened financial circumstances.

I could not end without paying tribute to two of my constituents—Jos Bell and Dr Brian Fisher—who have mounted a superb local campaign, with thousands and thousands of people signing their petition. In 2010, the NHS was shown by the World Health Organisation to be the most efficient health service, and one of the best health services in the world. Patient satisfaction in that year was at its highest ever rating. We now face rising waiting lists; a fragmented service; a focus on finance, profit and private patients; and poorer health outcomes for those of us who cannot pay or who refuse to pay for private health insurance. The Secretary of State, I suggest, faces two challenges: he should either publish that risk register and let us make our own decisions or, frankly, he should just drop the Bill.

Oral Answers to Questions

Sajid Javid Excerpts

Tuesday 22nd November 2011 Commons Chamber

[Mr Lansley]

Of course I, or one of my colleagues, will be glad to meet the hon. Lady to discuss that. I might also say that it was important to have announced, as I did last week, the expansion of ECMO—extracorporeal membrane oxygenation—facilities across England. Those facilities present a life-saving opportunity for people with the severest respiratory disease.

[Sajid Javid (Bromsgrove) (Con)]

T3. My apologies, Mr Speaker, for having missed my question on the Order Paper earlier.Every five minutes someone in the UK suffers from a stroke, and over 1 million people are living with the effects of stroke. That is why I welcome the establishment of the first “life after stroke” centre—a £2 million investment in my constituency. Will my right hon. Friend join me in welcoming this excellent initiative by the Stroke Association?

[Mr Lansley]

Yes, of course I will join my hon. Friend in paying tribute to all the work that I know personally that the Stroke Association has done over a number of years in raising public awareness of the importance of developing stroke services, which has had an impact inside the NHS. We have improving figures in terms of reducing stroke mortality, and I now want to go further in ensuring that we enable people not only to survive stroke but to recover as many as possible of their abilities afterwards.

NHS Future Forum

Sajid Javid Excerpts

Tuesday 14th June 2011 Commons Chamber

[Sajid Javid (Bromsgrove) (Con)]

Can the Secretary of State confirm that the Government have no plans to decrease the budget for the NHS—unlike the plans of the Labour party to slash it by £30 billion?

[Mr Lansley]

Yes, my hon. Friend makes an important point. If we had listened to the Labour party last year, we would have cut the NHS and would not have increased the resources going into it. The £20 billion efficiency savings required to respond to demand and cost would have been £30 billion, which would have put an unsupportable degree of pressure on the NHS. As it is, we are giving the NHS not only resources but the opportunity to deliver improving care.

Future of the NHS

Sajid Javid Excerpts

Monday 9th May 2011 Commons Chamber

[John Healey (Wentworth and Dearne) (Lab)]

I beg to move,

That this House notes the growing concerns over the Government’s handling of the NHS and the effect its policies are having on hospitals and patient care; and calls on the Government to uphold the Coalition Agreement promise to stop the top-down reorganisations of the NHS which have got in the way of patient care, to use the present pause in the progress of the Health and Social Care Bill to make fundamental changes, including dropping the damaging and unjustified market-based approach, and to concentrate efforts instead on achieving sound efficiencies, better clinical quality and improved integration of services.

We have called this debate after the Prime Minister was forced to order an unprecedented pause in his health legislation last month. He was forced to do so because of the growing criticism, confusion and crisis of confidence over the Government’s NHS reorganisation. It was unprecedented because he told his Health Secretary to stop what he was doing while 45 others on the NHS Future Forum work out what he should be doing. It looks as though the Prime Minister is listening to anybody and everybody on the NHS except the Health Secretary.

We have called this debate after the Deputy Prime Minister’s flagship policy was sunk in the AV referendum last week. He is now trying to find a replacement, and claims that changes to the Health and Social Care Bill are his new No. 1 priority. The Deputy Prime Minister and his party are up to their necks in the Tory NHS plans. He and the Prime Minister co-signed the foreword to the White Paper last summer, and he signed off the NHS legislation in Cabinet before Christmas. He and his Lib Dem MPs have backed the Bill at every stage in Parliament. In Committee, his Lib Dem Health Minister led the rejection of Labour’s amendments—the amendments that he now says he wants to make.

Now that the Lib Dems are making many of the arguments that Labour has been making since early autumn, people may ask what the Deputy Prime Minister has been doing for the past year, when he changed his mind and why. People may suspect that the deal he is stitching together has more to do with saving his party than safeguarding the NHS.

[Sajid Javid (Bromsgrove) (Con)]

Will the right hon. Gentleman tell the House whether he still believes that the Government’s plans are “consistent, coherent and comprehensive”? If not, when did he change his mind?

[John Healey]

Indeed, they are comprehensive, consistent and coherent, and they are wrong.

NHS Reform

Sajid Javid Excerpts

Monday 4th April 2011 Commons Chamber

[Mr Lansley]

I am afraid the hon. Lady is completely wrong about that. We have continuously listened. After the publication of the White Paper, we had a full 12-week consultation with more than 6,000 responses, and in December’s Command Paper we set out a whole series of changes that were consequent on that, including to the structure of commissioning and the timetable for the transfer of NHS trusts into foundation trusts. In Committee, we have introduced further amendments, not least to make it clear that competition in the NHS will be on the basis of quality not price, which is very important because that is a concern that people raised.

[Sajid Javid (Bromsgrove) (Con)]

I warmly welcome my right hon. Friend’s efforts in modernising the NHS. The concept of GP commissioning has been widely supported by politicians from all parties for many years. May I urge my right hon. Friend to keep putting patients first by increasing GP involvement in the NHS?

[Mr Lansley]

I am grateful to my hon. Friend for his remarks. We have now—earlier than any of us had imagined—arrived at the point where most of the country has pathfinder consortia in place. It is absolutely the right moment to engage with them to discuss how we can ensure that the concerns that have been properly raised, about transparency and accountability in governance and the avoidance of conflicts of interest, will be dealt with in the legislation. We want the legislation to work for them and the people we serve.

NHS Reorganisation

Sajid Javid Excerpts

Wednesday 16th March 2011 Commons Chamber

[John Healey]

My hon. Friend is right: this reorganisation and legislation leave no part of the NHS untouched. One big concern is that when GPs are making both rationing and referral decisions at the same time, patients will start to ask whether their GP is making a judgment about their treatment in their best interests or in the best interests of his or her budget and consortia business. That can hit at the trust at the heart of the patient-doctor relationship.

[Sajid Javid (Bromsgrove) (Con)]

I thank the right hon. Gentleman for giving way so generously. He has mentioned the Labour manifesto twice, and I just happen to have a copy of it. It says that Labour will support a

“role for the independent sector”,

encourage any willing provider, make all hospitals foundation trusts and give them the

“freedom to…increase their private services”.

On that basis, will he explain why he and the leader of the Labour party, who I believe to have been the author of that manifesto, are reneging on that position?

[John Healey]

We were doing what the manifesto said before the election. [Interruption.] We were doing it where the private sector and competition could add capacity to clear waiting lists, or do something new that the NHS was not doing. We did it in circumstances that were carefully planned, properly managed and always publicly accountable. If the hon. Gentleman is going to swallow the guff from those on his Front Bench that this is somehow an evolution of Labour’s policy, he will have to ask the Health Secretary why he needs legislation that is more than three times longer than the Act that set up the NHS in the first place.

Why do we say what we do in the motion before the House? In truth, this is a Tory reorganisation, and the legislation has been mis-sold. It is not just about getting GPs to lead commissioning or looking to cut layers of management; it is setting up the NHS as a full-scale market driven by the power of the competition regulator and the force of competition law. The reorganisation and legislation is designed to break up the NHS, open up all areas of the NHS to private health companies, remove requirements for proper openness, scrutiny and accountability to the public and to Parliament, and make the NHS subject to both UK and European competition law. The Tories are driving the free market political ideology through the heart of the NHS.

Hospital Services (Worcestershire)

Sajid Javid Excerpts

Wednesday 2nd March 2011 Westminster Hall

[Karen Lumley (Redditch) (Con)]

It is a pleasure to speak under your chairmanship, Mr Hood. I am delighted to secure the debate on hospital care in Worcestershire. To put hospital care in Worcestershire in context, I should explain that we have two acute hospitals and a treatment centre. The acute hospitals are based in Worcester and my constituency of Redditch, and the treatment centre is in Kidderminster. In other parts of the county, we have community hospitals, which play a great role in delivering the highest level of care to our constituents.

The emphasis today is of course on the new cancer care facility, but all areas of the NHS trust are working hard and playing important roles. Worcestershire Acute Hospitals NHS Trust has recently appointed a new chairman, who is determined that the mission of the trust will be to make all care patient-orientated. To do that, the care offered, the facilities available and the attitude of all staff must put patients and their well-being first.

I shall begin by sharing with hon. Members some of the successes within the trust. The national target of ensuring that 80% of patients brought to accident and emergency by ambulance staff are seen within 30 minutes has been surpassed by our trust. The benefits of receiving treatment quickly are self-explanatory. Obviously, the more quickly a person is seen, the less likely they are to deteriorate, and the ambulance staff can get back to doing what they do best.

I spent some time in A and E at the Alexandra hospital and was incredibly impressed by what I saw. The staff do an amazing job, sometimes in very challenging circumstances. Guided by Mr Christopher Hetherington, a consultant in the department, I saw at first hand how staff dealt efficiently with arriving patients. I was struck by their professionalism and commitment to their patients.

Despite the added challenge of the snow and bad weather in December and January in Worcestershire, the trust’s ambulance staff achieved a performance rating of more than 90%—the result of focus and dedication. I look forward to seeing them later this month when I do a night shift with an ambulance crew in Redditch.

Successes have also been shown in the results of patient surveys. The national maternity survey from 2010 showed that mothers in Worcestershire were impressed by the maternity care that they received. Those who completed the survey were pleased with all aspects of care, including care at home after leaving hospital. The trust now ranks in the top fifth for offering mothers choice. Choice should be at the forefront of the reorganisation that our NHS trusts face. If we are to create an NHS that is centred on patient care, offering patients choice about and influence over their treatment is essential.

[Sajid Javid (Bromsgrove) (Con)]

I echo my hon. Friend’s comments about Alexandra hospital. It is a hospital that people in her constituency and in my constituency share, and I know that constituents from far and wide respect the services that they receive, the quality of care and the dedication of the employees and the health care professionals. Does she agree that, along with Alexandra hospital and the other acute hospital that we have in our county, the community hospitals, such as the Princess of Wales community hospital in Bromsgrove, complement the health services on which our constituents rely in Worcestershire?

[Karen Lumley]

I thank my hon. Friend for his intervention. I totally agree with him. Many of my constituents in Redditch also use the Princess of Wales hospital. I have been there on many occasions and know what a fantastic job the staff do.

Effective hospitals rely on good facilities. Kidderminster hospital has recently acquired a state-of-the-art MRI scanner. It offers patients the best diagnostic procedures available. New services can now be offered, including breast scans and whole-body imaging. Some 9,400 scans a year can be performed with the machine. One-stop-shop access to out-patient clinics cuts waiting times and means that patients are in the clinics for as little time as possible. Developments such as those are lessening the postcode lottery effect in the NHS.

Worcestershire is awaiting a decision about whether a radiotherapy unit will be built at the Alexandra hospital in Redditch or the Worcestershire Royal hospital. I, of course, hope very much that it will be built at the Alexandra hospital in Redditch.