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Health and Social Care

Volume 675: debated on Tuesday 5 May 2020

The Secretary of State was asked—

Covid-19: Hospices

We are providing up to £200 million to hospices over the next three months to support their work alongside the NHS as part of the national response—by, for instance, providing spare bed capacity in community care to take pressure off hospitals, supporting vulnerable patients, and, of course, supporting those in need of palliative care. I am sure that my hon. Friend will be pleased to know that Sue Ryder, which runs one of his local hospices, received £5.9 million in April.

I thank my right hon. Friend for that answer. It is indeed great news that the Government are providing £200 million for those nearing the end of their lives. When does he expects hospices such as Thorpe Hall to receive that funding? In recognition of just how vital palliative care is, might we look to reform the way in which we commission palliative care when this crisis is over?

There are lots of things that we will need to learn when this crisis is over. The hospice system has always had a mixed model of funding—a very strong history of philanthropic support, as well as support and financial funding for the services it provides that the NHS commissions. The funding has started to flow. If there is a specific problem locally, I would like to know about it, and then we can get to the bottom of it.

Covid-19: Tests for Key Workers

We expanded testing to all symptomatic essential workers and members of their households last month. As capacity continues to increase, we have been able to go further still, with all those who have symptoms and who have to leave home to go to work—and members of their households—now able to access a test. This is all part of the overall testing strategy, with the 100,000 tests that are now available.

Testing of staff and residents at care homes in my constituency is being delivered by referrals either through the Care Quality Commission or through the pilot partnership that has been set up between our hospitals trust and our clinical commissioning group. In relation to the CQC, will my right hon. Friend examine why test results are taking five to seven days to come back, rather than the estimated 72 hours? In relation to the pilot scheme, where tests are being delivered efficiently, why are care home managers given the names of residents who test positive but, for data protection reasons, not the names of staff who test positive? That is creating obvious uncertainty.

I am glad to see the roll-out of testing to care homes, and we are able to go further for both residents and staff. It is an incredibly important part of the response and one of the reasons why testing is so important. My hon. Friend raises two important issues of detail in the roll-out, and I will ensure that they are looked into.

We need to be doing all we can to protect our key workers, especially those in healthcare. I welcome and note what the Secretary of State said about testing, but has he considered the study from Imperial suggesting that weekly screening of healthcare workers—testing them every week whether symptomatic or not—reduces their contribution to transmission by around 25% to 33%? Will he look at testing all healthcare staff whether they have symptoms or not?

Yes. The shadow Secretary of State has asked questions in a responsible and reasonable way, and I welcome his support for the test, track and trace pilot on the Isle of Wight that we announced yesterday. His question is quite right; we have piloted the testing of asymptomatic NHS staff in 16 trusts across the country. Those pilots have been successful, and we will be rolling them out further.

Covid-19: Vaccine Development

The development of a coronavirus vaccine is in its early stages but progressing rapidly. The Government have backed two promising vaccine candidates from the University of Oxford and Imperial College, and we are making over £45 million available to those teams—alongside the hundreds of millions that we are making available to the global vaccine search.

I am grateful for the Secretary of State’s response. The World Health Organisation has undoubtedly made mistakes over covid-19 and needs deep reforms, but this global pandemic requires a global response. How is the UK liaising with the WHO so that we work together globally to beat this virus?

We do work globally, and we do work together. As the Prime Minister made clear yesterday, we have committed £744 million to the global response to coronavirus. We are significant funders of the WHO, and I am grateful for its work. We are also a significant funder of the Coalition for Epidemic Preparedness Innovations, which is leading the global search for a vaccine. In fact, we are making the largest contribution of any country in the world to the global search for a vaccine, and three of the top 10 vaccine candidates are being developed here in the UK.

Covid-19: Test, Track and Trace

We are developing a new test, track and trace programme to help to control the spread of covid-19, and to be able to trace the virus better as it passes from person to person. This will bring together technology through an app, an extensive web of phone-based contract tracing and, of course, the testing needed to underpin all that. The roll-out has already started on the Isle of Wight, and I pay tribute to and thank the Islanders for the enthusiasm with which they have taken up the pilot. I hope that we learn a lot from the roll-out, so that we can take those learnings and roll the programme out across the whole country.

I thank the Secretary of State for his answer. I welcome the plans to introduce the contact-tracing app, but for it to be effective it will need to be rolled out to a large proportion of the population. What plans does the Secretary of State have to achieve that, and how will he alleviate privacy concerns?

I am grateful to my hon. Friend for that question. She is right to say that the more people download the app, the more people will protect themselves, their families and their communities. The cross-party support for this test, track and trace programme is important, and right across this country people need to know that the app has privacy in its design. The data it holds is held on people’s phones and it does not go to the Government, until of course someone needs to get a test, in which case of course they have to get in contact with the NHS. So privacy is there by design, there is cross-party support and, according to a very early poll, 80% of people on the Isle of Wight want to download it. These are good early signs and we will have a big communications campaign to explain to people the benefits of the test, track and trace programme as we roll it out across the country.

In welcoming Dr Rosena Allin-Khan, may I say thank you for what you and all the staff do in the NHS, saving lives? It is appreciated.

Thank you very much, Mr Speaker. If I may, I would like to start by saying a huge thank you, on behalf of us all in the Chamber today and all those watching, to our NHS and care staff, who are working so hard on the frontline.

Frontline workers like me have had to watch families break into pieces as we deliver the very worst of news to them: that those they love most in this world have died. The testing strategy has been non-existent. Community testing was scrapped, mass testing was slow to roll out and testing figures are now being manipulated. Does the Secretary of State commit to a minimum of 100,000 tests each day going forward? Does he acknowledge that many frontline workers feel that the Government’s lack of testing has cost lives and is responsible for many families being unnecessarily torn apart in grief?

No, I do not. I welcome the hon. Lady to her post as part of the shadow Health team, and I think she might do well to take a leaf out of the shadow Secretary of State’s book on tone. I am afraid that what she said is not true; there has been a rapid acceleration in testing in the past few months in this country, including getting to 100,000 tests a day. We have been entirely transparent on the way that has been measured throughout, and I have confidence that the rate will continue to rise. Currently, capacity is 108,000 a day, and we are working to build that higher.

Of course, we have been working very hard to make the testing capacity grow as fast as possible, and as more tests are available, so we are able to make them available to more people and test people right across the NHS. I pay tribute, too, to the work of NHS and social care staff on the frontline; nothing should take away from the team spirit with which we approach this.

Test, track and trace is possible only with a mass testing programme, so I offer many congratulations to the Health Secretary on achieving such a challenging expansion in our testing capacity. He has always said that he follows the science in the decisions he takes, but does he appreciate that, Zoom or no Zoom, it is very difficult for us as MPs to scrutinise such decisions if he does not also publish the advice of the Scientific Advisory Group for Emergencies that he receives at the same time as he makes those decisions?

We are making public the membership of SAGE and a lot of the science. I know that my right hon. Friend is also able to scrutinise the scientists before the Select Committee on Health and Social Care, as he and his team did again this morning. The overall approach of transparency, which has been a lodestar of the Government’s response to this crisis, is important. Of course, different scientists have different views, and they make those plain, but, as he said, we are guided by the science in the decisions that we take, and that has been an important part of the response.

Covid-19: Community Hospitals

If he will allocate urgent additional funding to community hospitals as a result of the covid-19 outbreak. (902189)

Public safety remains the Government’s top priority, and we have been clear that the NHS will get whatever funding it needs to respond to the coronavirus pandemic. As such, as a country, we have established a £14.5 billion coronavirus emergency response fund, with £6.6 billion going directly to the NHS. I know that my hon. and gallant Friend is a strong champion of community hospitals in his county. They are vital to our response to coronavirus and currently are managing well. I am not aware of any specific requests from his county; however, if additional urgent funding is required, we will of course consider that.

I am most grateful to the Minister for his answer. May I thank him and his team for the wonderful job they are doing? The main reason I asked the question is that beds at Portland Community Hospital had to move to Weymouth because of a shortage of trained staff. Can my hon. Friend assure my constituents that we will fill the thousands of nurse vacancies, thereby allowing community hospitals such as Portland to fulfil their proper function?

Let me start by putting on the record my thanks to our amazing NHS and social care workforce at this time. As my hon. and gallant Friend is aware, the Government are committed to growing and supporting the NHS workforce to ensure that it continues to provide world-class health and care. We have set out our pledge that we will deliver 50,000 more nurses in our NHS by 2025 through multiple workstreams, including retention and recruitment. Many of those nurses will operate in community hospitals, enabling them to continue providing that world-class care and support.

Covid-19: EU Procurement Schemes

The UK has confirmed that we will participate in the current joint EU procurement scheme on therapeutics for covid-19 that is soon to launch. Owing to an initial communication problem, the UK did not receive an invitation in time to join the previous four EU joint procurements. However, participating in those four initial joint procurement schemes would not have allowed us to do anything that we have not already been able to do for ourselves. We will consider participating in all other future schemes on a case-by-case basis and on the basis of public health requirements and needs.

Whatever mistakes were made or opportunities missed in the past, on the day that the UK has overtaken Italy as the country with the worst death toll in Europe, what reassurance can the Minister give the public that decisions taken now and in the future will be driven entirely by the public interest and not distorted by anti-European dogma?

I gently say to the right hon. Gentleman that there is no suggestion of any decision having been influenced in the way that he suggests. Indeed, the permanent under-secretary at the Foreign Office made it clear in his clarification to the Foreign Affairs Committee that this was not a political decision. I reiterate that we are open to participating in future schemes on the basis of public health requirements and on a case-by-case basis.

Operation Cygnus in October 2016 showed that the UK would struggle in a pandemic due to a lack of both ventilators and personal protective equipment for staff. Why did the Secretary of State not act on it?

The Government did act in looking at all previous modelling and all previous exercises. That is why the UK was well prepared. Let me take the example of ventilators, which she mentioned. The UK has massively increased the number of ventilators available to our NHS, meaning that at no point thus far in this pandemic has there been a shortage of ventilators. I reiterate, returning to the original question, that participating in those four initial joint procurement schemes with the EU would not have allowed us to do anything we have not already been able to do for ourselves.

Social Care: Personal Protective Equipment

What recent assessment he has made of the adequacy of personal protective equipment for the social care workforce. (902190)

What steps his Department is taking to ensure the adequate supply of personal protective equipment to (a) the NHS and (b) social care facilities. (902200)

What steps his Department is taking to ensure the adequate supply of personal protective equipment to (a) the NHS and (b) social care facilities. (902204)

I would first like to place on record my thanks to everyone on the frontline, be they in a hospital or in social care, as well as those in less obvious places such as my community nurses, pharmacists and others who are working ceaselessly on the frontline. We are working round the clock to ensure that everyone across the NHS and care sector has the personal protective equipment that they need. To date, we have delivered more than 1.11 billion items of PPE. We are ensuring that PPE is delivered as quickly as possible to those on the frontline. We have delivered to over 58,000 health and care organisations, and we are working closely with industry, social care providers, the NHS, NHS Supply Chain and the Army to ensure that all our NHS and care staff can get the protection they need.

I thank the Minister for that answer, but given how care homes have become a tragic focus in this pandemic, with so many staff and residents losing their lives, when will she be able to guarantee that every care home will have all the PPE they need? And why is the Clipper system, which is meant to supply PPE to the care sector, now one month late?

Every NHS and social care worker must have the protective equipment that they need. Clipper has been rolled out, and it is important that it is able to deliver the products that are ordered online. This is now being rolled out to more than 1,500 general practices and care home providers, and as it is piloted and stood up to more and more individual organisations, that will help that stream of work to ensure that people have the personal protective equipment they need. That is on top of the national supply disruption response—NSDR—line that people can ring in case of emergency, and this is also backed up by the wholesale distributors, where only last week 52 million more items were placed on that line as well.

Across Redcar and Cleveland, we have fantastic businesses such as Pendraken Miniatures and BC-FX, which have switched their manufacturing lines to making visors, the Materials Processing Institute, which has switched to making hundreds of bottles of hand sanitiser for Marie Curie nurses every week, and 15-year-old Daniel Sillett, who is using his 3D printer to make PPE for local care facilities such as Marske Hall. Will the Minister join me in commending those businesses and individuals as part of our national effort in overcoming this crisis?

I would indeed like to join my hon. Friend in congratulating them, and I congratulate him on the way he has just explained that this is the most enormous national effort, from large-scale businesses down to individuals such as Daniel, to whom we must give our special thanks. This national effort—the way in which individuals and businesses have stepped forward, and the many offers from all the different suppliers—has been extraordinary. We are working with industry partners across the piece to make PPE. We are working with Ineos and Diageo to produce hand and hygiene products and to ensure that we get these to the frontline, using services such as Clipper. Thanks to the work we have already seen, we have seen novel products arrive on the frontline. Seven companies have now been contracted in the UK to make over 25 million items of PPE and to send some 6 million square metres of fabric to NHS Supply Chain.

Like my hon. Friend the Member for Redcar (Jacob Young), I have local initiatives—including Scrubs for Stoke and the Heywood Academy—that have produced amazing amounts of PPE for our local health care sector. Can the Minister inform us what steps she is taking to ensure that staff in care homes—[Inaudible.]and to enable people to make optimal use of PPE and minimise the transfer of infection from one client to the next?

I would like to pay tribute to businesses in my hon. Friend’s area. I think the crux of his question was about making sure that people are receiving the appropriate infection control training in order to utilise PPE effectively. We publish guidance—including videos, which are easier to watch and immediately understand—on the appropriate PPE for health and careworkers, based on clinical expertise. The guidance has been written and reviewed by all four UK public health bodies and informed by NHS infection prevention and control experts. It is consistent with World Health Organisation—

Thank you, Mr Speaker.

I have listened carefully to the Minister’s answers, but on the ground there are still serious problems. Maria, who is a careworker in the north-east, told me on Friday that she has only just received face masks and has to wear the same ones throughout the day. Kenzie in Leeds told me exactly the same thing: one mask, all day, even though one of the elderly ladies she cares for has coronavirus and cannot help coughing and spitting on her mask. With almost 8,000 deaths in care homes so far, what changes will the Minister make and what will she do differently to get a grip of this problem, which is still increasing, to help bring this terrible death rate down?

As I said, there are the three strands of guidance on making sure that the appropriate equipment is used in the appropriate place. We have also used the local resilience forums in order to ensure that individual care organisations can have a back-up of personal protective equipment so that people can use it in line with clinical guidance. I will contact the hon. Lady after this session, because I would like to ensure that the young lady she spoke about has seen that guidance, and the videos that accompany it, in order to make sure that she feels properly protected, which is the aim that we are all working for.

Covid-19: Dental Practices

NHS England and NHS Improvement have published detailed guidance setting out the support for NHS dentistry during the pandemic. To minimise the spread of infection, routine dentistry is currently suspended. NHS practices are providing telephone advice and triage at urgent dental centres to patients with urgent needs. NHS dentists will receive their usual remuneration in full, or in part if they do part-NHS, part-private work. Dentists can also seek help via all the Treasury means for lost income.

My constituents in Elmet and Rothwell have reported difficulties in obtaining emergency dental care in Leeds. Will the Minister detail what actions her Department is taking when this specific issue comes up in, say, Leeds so that patients can access emergency care during the lockdown?

Of course. As of the week ending 30 April, there were two urgent dental care centres in the Leeds area to provide urgent dental treatment and care for patients on referral either from the patient’s own dentist or from NHS 111. As with all urgent dental care centres, there is also a triage service that will give people advice, antibiotics or painkillers and then refer them through if clinical work is required. There are 308 urgent dental centres open across the country. I regularly talk to the chief dental officer and to the British Dental Association about the needs and requirements in the profession so that we can care for patients in the best way.

Covid-19: Health Inequalities

What assessment he has made of the effect of health inequalities on the prevalence of covid-19 in the general population. (902209)

It is vital that we find out what groups are most at risk so that we can help protect them. That is why we have asked Public Health England to conduct a rapid review of the different factors that might influence how someone is affected by the virus. Among other things, it will explore age, ethnicity and gender. As our deputy chief medical officer outlined yesterday, this is important but complex work.

I am sure the Minister would want to join me in paying tribute to the staff at Croydon University Hospital and those in our local community for the resilience, bravery and good grace they have shown during this crisis. Over 250 people have died in Croydon, and we are all thinking of their families and their loved ones who will be suffering so much. High levels of deaths in Croydon appear to be down to the underlying health of the population. Although of course it is early days in terms of analysing the data, it is clear that in Croydon covid has disproportionately affected people from black, Asian and minority ethnic backgrounds. Does the Minister agree that on early sight it looks like poorer people, often from BAME backgrounds, are being hardest hit by covid, and that we need to tackle the longer-term underlying health issues that have got us to this place of gross inequality?

It is so important that we do the research before we draw conclusions. Every death is a tragedy. Everybody who has died during this pandemic is somebody’s mum, dad, brother, sister and therefore we owe it to them to give Public Health England and all those researching this area all the support we can, so that we do not rush to conclusions, but draw conclusions that will truly help us to address the pandemic and those who are most affected by it in the right way.

I am sorry that we did not get more questions in, but maybe we can speed up the teams next time and we will get through more.

We come to the urgent question to the Secretary of State for Health and Social Care. I will follow the practice for substantive questions whereby I will call the Secretary of State to answer the question first. Before doing so, I have a short statement to make, which is relevant to this urgent question.

It has been widely reported that the Government will make a major announcement about the review of lockdown this Sunday. I consider this a matter of regret. It is important that the press is kept informed, but it is the duty of this House to hold the Government to account, not the media. Major Government announcements should be made first in the House, and that is more important than ever during this time of crisis.