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Health and Social Care

Volume 677: debated on Tuesday 23 June 2020

The Secretary of State was asked—

Cancer Services

What steps he is taking to tackle regional variations in the restoration of cancer services after the covid-19 outbreak. (903679)

What steps his Department is taking to enable the resumption of cancer treatments delayed as a result of the covid-19 outbreak. (903723)

Essential and urgent cancer treatment has continued throughout the pandemic and cancer specialists, as always, are discussing the best treatment options with their patients. We are working to ensure that referrals, diagnostics and cancer treatment are back at pre-pandemic levels across the whole of England as soon as possible. Due to covid-19, the 21 cancer alliances in England have established hubs to ensure dedicated cancer care away from hospitals dealing with the virus. From the end of April, local systems and cancer alliances have continued to identify ring-fenced diagnostic and surgical capacity for cancer in line with issued guidance. Regional cancer senior responsible officers must now provide assurance that these arrangements are in place to help minimal regional variation.

I thank the Minister for that comprehensive reply, but she knows that people living with cancer are experiencing cancellation and delays to treatment all over the country, and that is causing anxiety and distress to many families. In getting people urgently back into treatment, will she look at the 12-point plan for restoration, recovery and transformation of cancer services outlined by Macmillan Cancer Support, Cancer Research UK and 23 other cancer charities, to ensure that cancer does not become the forgotten C during the coronavirus crisis?

I regularly engage with cancer charities and would be delighted to look at them to see where we are making good headway and where, perhaps, we could have discussions about other things that need to be targeted. While I have the hon. Gentleman on the screen, I would also like to highlight the fact that the Greater Manchester cancer alliance has led the way in its response to this pandemic. It was one of the first to establish a surgical hub model to ensure that cancer surgery was able to continue and that the local cancer system as a whole responded well. The alliance has also been looking to accelerate the rapid diagnostic centre to help promote diagnostics, so I thank everyone for that.

As the Minister knows, being diagnosed with cancer is devastating, and one of the most important things to get patients through this difficult time is for them to be able to focus on their treatment. What message does the Minister have to comfort those people who are worried and stressed because they still cannot access the treatment they need because of covid-19?

I would say that, as soon as people notice any signs that might worry them, they should seek help. We have worked at pace to ensure that services have been resumed and are able to deliver for patients. Ensuring both early diagnosis and that patients can access the treatment that they need swiftly is our key ambition. We know that, following the guidance that has been delivered, we are achieving that throughout the system. Covid-19 has upended all our lives, and some decisions have been made to ensure the safety of patients, but we are now firmly back on track and will ensure that patients get the care they need.

Yesterday, the One Cancer Voice network of 25 charities published plans for restoring vital cancer services. I wrote to the Minister on 17 April with my own suggestion. Ideas included advanced radiotherapy, new models of chemotherapy, better cancer pathways and renewed screening and communication plans. This is not just about rebuilding what we had, but about making services better. If the Government are slow to do that, we face a cancer bubble that risks thousands of lives. Will the Minister commit to working with those charities and with me and other interested parliamentarians to form a cancer recovery plan to head off this looming crisis?

I assure the hon. Gentleman that, just as we have seen from working closely on the Medicines and Medical Devices Bill that is going through Parliament, there are lessons to be learned. There have been improvements in certain areas of radiotherapy in which it has been determined that fewer treatments actually mean a quicker and—I would not use the word “gentler”—an easier path for the patient. I would be happy to continue working both with him and with the cancer charities to ensure that we can improve that pathway for patients.

Adult Day Centres: Reopening

What his timetable is for the reopening of adult day centres for people with learning difficulties after the covid-19 outbreak. (903680)

I know how difficult it has been for people with learning disabilities and their families during lockdown, particularly without the back-up of day centres. I want to see those important services reopening as soon as it is possible and safe to do so, but that decision will need to be made locally. We are talking to the Local Government Association and others about what guidance and support may be needed to get day services up and running again.

I thank the Minister for that answer, and I would like to wish her a happy birthday. Unlike schools, day centres such as Whitemoor in my Derbyshire constituency are normally open throughout the summer to provide desperately needed stimulation for many adults with special needs. What measures will she introduce to ensure that staff working at day centres are adequately supported to function as safely as possible, as soon as possible?

I thank my hon. Friend for her birthday greetings. She makes a really important point: as day centres reopen, they need to be safe for staff and users. Risk assessments will need to be carried out, and some may need to use personal protective equipment. Public Health England is developing guidance on the use of PPE in community settings. Local authority-run services should have PPE provided by the local authority, and services provided by other organisations that struggle to get PPE from wholesalers should be able to access emergency local supplies.

Referral-to-Treatment Waiting Lists

The most recent performance data published by NHS England for April 2020 shows an 8% reduction in the size of the waiting lists compared with April 2019, from 4,297,571 to 3,942,748. However, it is important to note that reduced referrals due to covid-19 are likely to be the cause of that, and there are a number of people waiting longer.

To address the inevitable increase in waiting times for non-covid treatments, back in March the Government contracted private health providers to supply some 8,000 bed spaces at a cost of millions of pounds to the NHS and taxpayers. It was reported that a significant proportion of that capacity has been paid for but underused. The Government are now considering further contracts with private sector hospitals. How can we be confident that money will not be wasted again and that those waiting will get the treatment they so badly need?

I gently say to the hon. Lady that I do not think that contracting to ensure sufficient capacity in our NHS at all times, so that it was never overwhelmed, which it has not been, was a waste of money. In response to her substantive point, we continue to work with the independent sector and the broader NHS to get elective surgery and other non-emergency procedures restarted at pace.

Covid-19: BAME Health

There was a passionate debate on this issue last Thursday. As I said then, there is no doubt that covid-19 has upended our lives. The virus cruelly discriminates by many factors, including age, gender and ethnicity. There are still gaps in our understanding of occupational risks and co-morbidity that need attention. My hon. Friend the Minister for Equalities will be taking forward important cross-Government work with the Equality Hub, Public Health England and others.

We now know the full extent to which covid and other health inequalities affect black and minority ethnic communities, and the extent to which that is reflected in regional inequalities, but does the Minister also understand how much such inequality prevails within boroughs? In my local authority, there is a 16-year life expectancy gap between the poorest communities and the wealthiest, which reflects the disparity with black and minority ethnic communities. Will she ensure that an equalities review tackles inequality within boroughs as well as between them, and will there be funding to support that?

We know that health inequalities are stubborn, persistent and difficult to change—we knew that before covid-19, but that is not a reason to accept them. We fully agree that more needs to be done to reduce the disparity in health outcomes within the BAME community and the broader community. That is why we will ensure that the work on health inequalities goes on at pace.

Test and Trace

NHS Test and Trace was introduced on 28 May, working with local authorities to prevent and contain the spread of covid-19. I am encouraged by the early results, which show that in the first two weeks of operation 87,000 people were contacted by NHS Test and Trace and agreed to self-isolate.

The Secretary of State will recall that I wrote to him a little while ago suggesting that an approach that was a bit more Shoreditch and a little less Whitehall might be effective. Given the lack of success of the app, maybe he could have taken that advice. I am pleased that Hackney Council is one of the five areas that is piloting this, working with GPs and other health professionals in public health and so on, but the critical thing is that we are not getting the data locally that we need to do the proper tracing of those who were close to someone who has tested positive. When will that data arrive? Without it, it is like working with one arm tied behind our back.

The amount of data flowing to local authorities has increased substantially over the past few weeks since the start of the operation at the end of last month, and there will be more coming very, very soon.

We all want to see lockdown eased, but that reopening will only be safe if the system to test, trace and isolate is working effectively. As more people return to work, start to travel on public transport, and perhaps even go to pubs, cafés and hairdressers—albeit keeping their distance—the ability to trace contact people we do not know will become much more important. The Secretary of State initially said that the app would be rolled out in mid-May; it is now the end of June. When are we actually going to see the app in action?

Obviously, as soon as possible. I agree very strongly with the hon. Lady about the importance of contact tracing—the Test and Trace programme is one of the largest of its kind—to ensure that, as we manage to lift national measures, which we can because the disease is clearly under control and the number of cases is coming down, we can then respond through local action.

NHS Test and Trace will play an important part in our continued fight against covid-19, but efficient co-ordination across Great Britain will be vital to its success. What steps has my right hon. Friend taken to ensure effective joint working between England, Wales and Scotland?

That is an incredibly important question. Of course, I would add Northern Ireland to that group. We have regular meetings. I have a weekly call with my counterparts in the devolved Governments. Of course, the devolved Governments have a huge role to play in this. I will give whatever support I can to help the Welsh Government to make sure that they can deliver contact tracing, and indeed the wider testing programme, as well as possible.

Will the Minister urgently set out a plan to support local authorities to implement local lockdowns if needed, along with providing them with all the resources they need to implement this?

NHS Test and Trace is currently tracing the contacts of about 700 people every day who have the virus, but the Office for National Statistics says that 2,500 new people are being infected every day, which means that since the programme started, up to a quarter of a million people have not been asked to isolate who should have been. It is a big achievement to get the programme going, but that is also a big gap. What are the Secretary of State’s plans to close it?

I am not sure I agree with my right hon. Friend’s figures in terms of the assumptions that underpin them. We have had this discussion and this exchange before. There are a whole number of asymptomatic cases. The critical thing about Test and Trace is to find as many of the asymptomatic cases, and as many of the positive test result cases, as possible. We need to do that over time by expanding the programme.

While a proximity app would assist in identifying casual contacts, many people were concerned that a centralised model would harvest their data. In the trial, this one failed to detect 96% of contacts. So why did the Secretary of State persist so long with an app that simply did not work on the majority of phones?

I am afraid the hon. Lady is wrong. The trials in the Isle of Wight showed that the app worked on Android phones, but was blocked from working effectively on Apple phones; hence we are now working with Apple and Google, as we have been over the past few weeks, to find a system that can be effective. But I will not sign off on an app when we do not know and have not been told by some multinational company what it is recommending to people because, after all, the critical thing that matters in test and trace is that people isolate to break the chain of transmission.

I would gently suggest that iPhones are actually quite common, so it is important that it does work on iPhones. The boss of Serco has admitted that its contact tracing system will not be fully functioning until the autumn, and we find that actually local public health teams are carrying out the vast majority of contact tracing, so would Government money not be better spent reversing five years of budget cuts to public health?

It is very strange taking these questions from the SNP spokesman, given that I am working with the SNP Government on resolving exactly these problems in Scotland, and maybe the SNP would do better to focus there. In response to the second question, honestly, we have put £300 million of support into local directors of public health to tackle this pandemic, and I know that her colleagues in the Scottish Government are working hard with local authorities in Scotland as well in exactly the same way.

The Prime Minister promised that 100,000 people a day would be tested by the end of April, so since that date, on how many occasions have more than 100,000 people been tested on any single day?

I have not got those data exactly—[Interruption.] Perhaps the Opposition would care to engage on the substance, rather than not taking this seriously. Yesterday, we delivered the 8 millionth test in this country. We have delivered more than 100,000 tests on almost every day since the end of April, and at the end of last week we were delivering 230,000 tests a day. I think what we need from the Opposition is support for the testing programme, because that is what people care about.

Infant Mental Health Awareness

I understand that Infant Mental Health Awareness Week was a great success. There is much to be gained from seeing the world through a baby’s eyes.

I am grateful to the Secretary of State for that short answer. We have heard much about the impact of lockdown on school-age children away from school, but little on the impact on babies and new parents facing particular challenges to their emotional wellbeing. Has the Secretary of State or the Minister, if she has got her voice back, seen the research published during Infant Mental Health Awareness Week by the First 1001 Days Movement last week, suggesting that three quarters of parents with children under two are feeling the detrimental impact of the lockdown, particularly BAME parents? What are the Government doing to put this crucial cohort on the radar and provide support before they grow up and take the problems to school and beyond?

My hon. Friend is absolutely right on this. I applaud the work of the First 1001 Days Movement. It is incredibly important. I strongly support the work that it has done to highlight the importance of the early days of life and the time before the birth of children. I have seen that report. I have discussed it with the Minister and we are working very hard to put that into effect.

Social Care Sector

What steps his Department is taking to support the social care sector during the covid-19 outbreak. (903686)

Social care is at the frontline of this cruel global pandemic here in the UK and around the world. We have brought together support across Government, the NHS, Public Health England, local health protection teams, the Care Quality Commission and local authorities, and done our utmost to help care homes and home care services to look after those in their care. The majority of care providers have been covid-free. Our support includes access to testing, PPE, guidance based on evidence from around the world, improved oversight and funding.

I have received many emails from constituents who are desperate to see and visit their family members in care homes, after months of not seeing them. Will my hon. Friend assure me and care workers in Ashfield and Eastwood that the Government will do everything they can to ensure that care homes have the right support and guidance, so that they are prepared to deal with an influx of friends and family visitors as they begin to open their doors in a safe way?

My hon. Friend makes an important point. I know that the current restriction on visiting is hard for residents in care homes and their families, and has a real impact on health and wellbeing. We are updating our visitor guidance and intend to publish it soon.

I, too, wish the Minister a very happy birthday.

I am sure the Minister will agree that lessons must be learned from what has happened so far, because the virus is not over for social care. With 13,375 deaths from covid-19 in care homes, what does she think she should have done differently?

The hon. Lady is absolutely right that there will be a time when we will look back and learn lessons, and I wish that not so many people had died in social care, but right now we are looking ahead. We are making sure that we have in place the plans to support the social care sector through the months ahead, and we are also pressing ahead with work on social care reform.

Cancer Centres: Radiation Therapy

If he will publish the timetable for the NHS England plan to roll out stereotactic ablative radiotherapy to all cancer centres by April 2021. (903688)

I thank the hon. Gentleman and the other members of the all-party parliamentary group on radiotherapy for meeting me and officials recently. It is expected that each of the 50 NHS trusts that provide radiotherapy will be able to deliver stereotactic ablative radiotherapy no later than 31 March 2021. Increased external quality assurance capacity means that we could complete the roll-out process for all commissioned indications more quickly than that. I am sure the hon. Gentleman would agree that such a result would be fantastic.

I very much welcome the Minister’s response and thank her personally for her excellent attention to this matter and the progress that she has helped to make possible. Of course, with a 60% drop in the number of cancer referrals and a 20% drop in the number of people starting cancer treatment, we have late diagnoses and a backlog that could, tragically, kill more people than covid. Will the Minister therefore go further and faster and deploy expanded radiotherapy treatment this summer to clear the backlog? Will she commit to appointing a radiotherapy tsar and to a rolling radiotherapy fund, so that we can stop more lives being unnecessarily lost?

The hon. Gentleman will know which parts of that are still open for discussion between us, but we are of course driving hard to make sure that patients get their radiotherapy and other treatment as quickly as they can. The NHS has a “Help Us Help You” campaign: it is open for business and people should make sure that they attend any appointment they are called to.

NHS Workers: Mental Health

What steps his Department is taking to support the mental health of NHS workers during the covid-19 outbreak. (903689)

What steps his Department is taking to support the mental health of NHS workers during the covid-19 outbreak. (903697)

What steps his Department is taking to support the mental health of NHS workers during the covid-19 outbreak. (903703)

Our NHS workers—from the doctors, nurses and allied health professionals to the healthcare assistants, porters and all those who work behind the scenes—are truly heroes. I wish to say a special thank you to students: thank you to the medical students and nursing students who courageously stepped up to work at the frontline in a global pandemic. I am determined to do all that we can for our NHS workers. We have set up a round-the-clock mental health support line, which includes a freephone helpline run by the Samaritans and an out-of-hours text support service provided by Shout.

I thank the Minister for her answer and wish her a very happy birthday.

Owing to physical challenges with geography in rural communities, such as much of my Truro and Falmouth constituency, there can be higher incidences of mental health issues, loneliness and isolation, and that has been intensified by the covid-19 pandemic. Will my hon. Friend provide an update on departmental plans for support for mental health issues in rural communities?

My hon. Friend is absolutely right: we anticipate an increase in demand for mental health support, including in rural communities, as a result of the pandemic. We are working with the NHS and a wide range of stakeholders to understand the need for mental health support all over the country and to make sure that that support is in place.

In my regular meetings with the Royal Wolverhampton NHS Trust, the issue of staff mental health has been repeatedly raised as a serious concern, especially among staff who are working with covid patients. Will the Minister join me in thanking those staff at New Cross Hospital and reassuring them that mental health support will be available for all staff who need it?

I would be delighted to join my hon. Friend in thanking the staff at New Cross Hospital for all that they have been doing in these incredibly difficult times. Mental health support absolutely should be, and is, there. There is the mental health support helpline and the text messaging service. It is also really important that NHS trusts take steps locally to ensure that their staff have the support that they need.

When we stood with our neighbours and clapped for the carers, we showed solidarity across the nation with them and recognised the strain, stress and anxiety under which many of them were working. Can the Minister assure me—and say what practical steps can be taken to ensure—that, as they work through the experiences they have had, they will get the care and support that are necessary for them, and that we care for our carers?

The clap for carers initiative was fantastic because it was a moment when we showed, as a nation, our support for our health and social care workers, but my right hon. and learned Friend is right to say that clapping is not enough. One thing that I want to do in the months ahead is bring forward the people plan—work that had to be paused because of covid—and to ensure that it includes all possible support for the NHS workforce, so that the NHS can be the best place to work in the world.

Even before the covid pandemic, our frontline NHS and care staff were already working in overstretched and under-resourced settings. It is heartbreaking to see how the virus has taken its toll on them. They have had to deal with redeployment, not enough PPE, a fear of losing patients and getting ill themselves. These are all factors leading to staff burnout and very poor mental health. After all their sacrifices, our frontline staff deserve to have their mental health taken seriously. Is the Minister satisfied with the Government’s current package of support for frontline NHS and care staff?

The hon. Member is absolutely right about how hard it has been for NHS staff stepping up, and we cannot say enough how grateful we are for what they have done. I also recognise the mental health burdens on the NHS workforce who have worked in these really stressful circumstances. It is important not only that the package of support is there now, but that it is there for some time to come, because we know that the trauma and effects of working in these environments may take a while to play through.

Cancer Targets

As my hon. Friend knows, one of our key commitments was to diagnose more cancers earlier. Through NHS England and NHS Improvement, the Government have committed over £1.3 billion to deliver this, including with an overhaul of screening programmes and new investment in state-of-the-art technology to transform the process of diagnosis and to boost research and innovation. I am sure that he will welcome the fact that 18 rapid diagnostic centres towards our target of 40 are already up and running, as well as the introduction of personalised care plans, which he and I both consider very important.

I do welcome that; I have visited many of the centres. Before the pandemic, we were battling to meet the cancer targets that I helped to set and that my hon. Friend now looks after so ably. Would she confirm that we have not lost sight of the 75% ambition in the long-term plan, and say whether there will be a revision to the cancer section of the long-term plan in the light of the backlog of the stuff that we know? Of course, there is also plenty of stuff that we do not yet know that we know, as a result of presentations not coming forward through primary care.

There are lessons to be learned; that is the essence of my hon. Friend’s question. I have met both Cally Palmer and Professor Peter Johnson throughout the crisis, and our focus on cancer has remained. Ensuring that we deliver on the long-term plan is a key objective, and I am sure that my hon. Friend will work with me on that.

Health and Social Care Workers

What steps his Department is taking to support the health and social care workforce during the covid-19 outbreak. (903691)

Our health and social care workforce are at the frontline in fighting this cruel disease. I would particularly like to talk about social care workers, who in the past have not had the same recognition as NHS workers. Let this pandemic be the moment when that changed and when we, as a society, recognised the skills, compassion and commitment of our entire care workforce. We have sought to put in place the same support for social care workers as there is for NHS workers and funding to local authorities to pass on to care providers, so that they can pay social care staff full wages for isolating because of covid-19.

I wish the Minister a happy birthday. The coronavirus pandemic has highlighted how vital social care workers are to our nation, and we as a House should thank them for the job that they do. Unpaid carers in particular have borne a huge weight throughout this pandemic, so will my hon. Friend tell the House what steps she has taken to support unpaid carers during this period?

Unpaid carers are vital in our society. Being an unpaid carer is hard at the best of times, but even harder during this pandemic, and my hon. Friend is right to draw attention to that. During the pandemic, we have published guidance specifically for carers. We provided funding to extend the Carers UK helpline, we made unpaid carers a priority group for testing, and we are working with local government to support the reopening of day care services as soon as it is safe to do so.

Covid-19: Continuing Healthcare

What plans he has in place for the provision of continuing healthcare for people recovering out of hospital from covid-19. (903692)

We know that people who have been very ill with covid will take some time to recover and may need ongoing help after they have left hospital. At the moment, as part of the covid emergency measures, continuing healthcare assessments are not required, which means that people can be properly discharged when they are well enough and have access to the ongoing healthcare they need.

Happy birthday to the Minister. Our wonderful NHS staff have helped so many people recover from this terrible disease and leave hospital, and many of them will have been ventilated for a long time. Is the Minister planning to set up a specialist service that helps with those very difficult cases where a lot of rehabilitation will be needed?

My hon. Friend raises an important point. We are still learning about the impact of this horrible disease, but we know it may take people some time to recover and they may need extra help after they have been discharged from hospital. We are indeed doing work to ensure that the right support is there for them.

Covid-19: Next Phase

What plans he has to ensure that the NHS has the capacity to tackle the next phase of the covid-19 outbreak. (903693)

What progress his Department has made on ensuring the provision of adequate critical care capacity in hospitals during the covid-19 outbreak. (903700)

What progress his Department has made on ensuring the provision of adequate critical care capacity in hospitals during the covid-19 outbreak. (903701)

What plans he has to ensure that the NHS has the capacity to tackle the next phase of the covid-19 outbreak. (903705)

Thanks to unprecedented action, we have protected the NHS. It was not overwhelmed during the peak of this crisis, and all covid-19 patients admitted to hospital were able to receive urgent treatment that they needed. We remain vigilant.

I thank the Minister for his answer, but after the end of the Brexit transition period, all four health services in the UK and Northern Ireland will face increased bureaucracy and increased costs to import drugs from Europe. On top of that, it has been estimated that a trade deal with the United States of America could increase the drugs bill from £18 billion to £45 billion. How will the Secretary of State prevent these extra costs from hampering NHS capacity?

First, there is no reason at all why the exit from the transition period should have the impact that the hon. and learned Lady describes. We have put in place a huge amount of work to ensure that Brexit works positively for our life sciences industry and indeed, as we do now, that we can buy pharmaceutical products from around the world, not just from within the European Union. As for the idea that somehow a trade deal will increase prices of drugs, that is flatly wrong.

With the need for additional infection control measures, how can the Secretary of State ensure that there are sufficient staff to support parents to spend time with their babies in special care baby units, when covid-19 is creating additional barriers to parents, being with their baby as much as they want and need to be? Moreover, will he look at an emergency form of neonatal leave and pay, or a subsistence fund similar to Scotland’s, to allow parents affected by covid-19 to have the time they need with their baby?

We are putting in a huge amount of support for maternity services and other services across the NHS in England. Of course, when it comes to the hon. Gentleman’s constituents in Glasgow, he will have to ask the SNP Government.

Local construction firms are working around the clock to build the NHS Nightingale hospital in Exeter, based in my constituency of East Devon. I am sure the Secretary of State will agree that we all hope it will never have to be used. Can he assure my constituents that the Nightingale will help the Royal Devon and Exeter Hospital, our community hospitals and our health and wellbeing hub to continue to focus efforts on delivering the superb services that they are well known for across East Devon?

Absolutely. My hon. Friend is a great advocate for Devon, and for East Devon in particular. The Nightingale Hospital in Exeter will have more flexible uses than the previous Nightingales, so, for instance, it will be usable should there be extra winter pressures. This is all part of protecting our NHS. It was at the heart of our response to this dreadful disease that we protected the NHS, making sure it was always there for everyone. That has been down to, and is a testament to, the work of so many people, who delivered on that requirement.

Yesterday, our local NHS trust, the United Lincolnshire Hospitals NHS Trust, temporarily downgraded and closed emergency admissions at Grantham and District Hospital, in response to covid-19. After many years of uncertainty, there is understandable scepticism about this latest move by the trust. Will the Secretary of State join me in calling on the trust to ensure that these changes are indeed temporary and that covid is not used as cover to make them permanent?

Thanks to my hon. Friend’s assiduous work on behalf of his constituents in Grantham, and at his suggestion, I discussed this issue directly with NHS officials. Grantham’s unit will be open, 24/7, as an urgent treatment centre; this is part of plans to ensure that covid and non-covid services are kept as separate as possible. In addition, thanks to his intervention, we will ensure that that position will be reviewed quarterly.

The NHS in England had more than 40,000 nursing vacancies at the start of the covid pandemic, but student nurses stepped forward to contribute to the response. So why are many of their contracts now being terminated, given that they may well be needed this autumn? Would a better approach not be to increase nursing bursaries to £10,000, as they are in Scotland, where nursing vacancies are half those of England?

We have increased by about 10,000 the number of nurses in the NHS in the past year, and during the crisis that number increased further. We also set out at the start how we are paying student nurses, as they stepped up to the mark, as the hon. Gentleman rightly said. I am delighted that so many of them did, and we are sticking to the agreements that we set out with the student nurses at the start of the crisis.

Covid-19: Testing Kits for Care Homes

We are doing all we can to help care homes to control and prevent covid outbreaks, and the majority of care homes have not had outbreaks. Testing is an important part of that. On 11 May, we launched a programme of testing all staff and residents in care homes, starting with older people and those with dementia, based on public health guidance. We met our target of offering tests to all these care homes by 6 June, which involved sending more than 1 million test kits to 9,000 care homes. We are now getting tests out to all the other Care Quality Commission-registered care homes for adults that ordered them on the testing portal.

Further to what my hon. Friend has said, will she confirm that there is a rolling programme to test for covid-19 in our care homes? Recently, a care home in my constituency had a whole-home test and found that someone was positive. When it then asked for another test for everyone, it was told by NHS England that it was not eligible, and that cannot be right.

I will say two things on that. First, when a care home has a new outbreak, either for the first time or having recovered from a previous outbreak, it should contact its local health protection team to arrange for initial testing of symptomatic residents, in order to confirm the outbreak. The local health protection team or the director of public health can then refer the care home to the national testing team so that it can be prioritised for whole-home testing.

Mesh Treatment

What recent assessment he has made of the effectiveness of NHS services for the treatment of mesh complications. (903698)

Departmental officials have been working with NHS England and NHS Improvement to establish means of specialist support for those women requiring it. NHS England is in the process of commissioning a number of mesh removal centres, which it hopes will be operational later this year. We urge anyone who has concerns about their treatment to speak to a clinician.

I thank my hon. Friend for her answer, but I understand from constituents that many women have to travel miles for their operations in great discomfort, and that when they get there, they are told they are not eligible. As the Minister said, the mesh recovery centres have not yet been opened. I have met women who are going through utter pain and torment as a result of surgical mesh surgery. There are concerns that English and Welsh patients do not get the same monetary help as their Scottish counterparts. What is the Minister doing to address these issues?

On access to services, NHS England advises that it is aware of the negative impact that covid-19 is having on patients during what is a very challenging period. As a result of my hon. Friend’s question, I will ask officials to look into why women may or may not be eligible for services during this time. As healthcare is devolved, the Scottish element of his question is a matter for the Scottish Government. I would advise anyone who intends to make a claim for compensation, or is having difficulty seeking services, to seek independent advice or see a clinician. It is important to reiterate that NHS England is currently in the process of commissioning those specialist services for mesh removal, which it hopes will be operational later this year.

Covid-19: Vaccine

Vaccine development is progressing well, with human clinical trials being undertaken by both the University of Oxford and Imperial College London. We are also exploring how other vaccines, both from the UK and internationally, can be deployed here should they show promise.

Can my right hon. Friend reassure me, the House and my Welsh constituents in Montgomeryshire that if and when a vaccine for covid-19 is developed, it will be rolled out in a UK-wide partnership? Will he work with the devolved healthcare systems but ensure that the vaccine is UK-accessed?

Yes, of course. That is an incredibly important question for anybody living in Scotland, Wales or Northern Ireland, like my hon. Friend’s constituents. The vaccine programme is being taken forward on a UK-wide basis. Of course people living in the devolved nations should have access to vaccines according to a prioritisation that is clinical and not based on where people live. We will absolutely work with the devolved authorities on the delivery and deployment of that vaccine. Of course, we want the whole country to get the vaccines, if they become available, according to clinical priority.

Topical Questions

Yesterday, clinicians set out our advice for those who are shielding because they are clinically extremely vulnerable. The whole House will want to pay tribute to the enormous sacrifice of that group, who are among the most vulnerable to covid-19. Very shortly, the Prime Minister will set out to the House the next steps to get the country back on her feet.

There is no doubt that lockdown has taken its toll on the mental health and wellbeing of many children of all ages, whether by way of social isolation, physical inactivity or a sense of loss. I know that my right hon. Friend is very exercised by that, so, as we understand more about the impact, will he look again at the long-term NHS plan to establish whether it is really able to meet what will be a more acute challenge in the future?

That is a very important question on supporting children’s mental health. We absolutely reiterate the long-term plan ambitions for service transformation and expansion. Indeed, one of the things we have learned during coronavirus is that when it comes to paediatric mental health, telemedicine can actually have a better and more effective impact than face to face. That is a good thing to have learned and will help the roll-out further.

On the app, the Secretary of State told us it was crucial and would be ready by mid-May. Experts warned him it would not work. He spent three months, wasted £12 million and has got nothing to show for it. It is a good job he is a tech-savvy expert on apps; otherwise, this would be a right shambles now, wouldn’t it?

On the contrary, ensuring that we use technology to its best possible effects is incredibly important. I would have thought that the shadow Secretary of State would want to side with and support the efforts of all those, including in the NHS, who are doing the work to ensure that we can get this up and running as quickly as possible.

In the past few days, I have been listening to the Secretary of State’s excuses. He is the Eric Morecambe of the Commons: he has been playing all the right notes, just not necessarily in the right order. On test and trace, local areas such as Leicester, which has had a spike, still do not have local data; GPs still cannot refer people for testing; and NHS staff are still not tested regularly. He has spent £100 million on a Serco and Sitel call centre where the tracers are saying they have nothing to do. This is not a “world-beating” system; it is more like a wing and a prayer. When are we going to get a functional test, trace and isolate strategy?

The shadow Secretary of State is far better when he supports the Government than when he pretends to oppose them. We have all seen him explaining why the steps that the Government are taking are the sensible ones, why it is important to move from a national lockdown as much as is safely possible to local outbreak control, and why test and trace is important. When he gets on to saying that the money we have spent to protect the NHS and put in place the actions needed to get us out of the lockdown is wasted, I think that that is opposition for opposition’s sake.

Maintaining safe and healthy food standards is essential for public health. As we leave the European Union and sign trade deals around the world, what are Ministers doing to ensure that the system maintains public confidence? (903653)

As we sign trade deals around the world, we will have enhanced animal and food standards in this country, and of course the Food Standards Agency plays a vital role in ensuring that those standards are upheld.

On 21 May, the Prime Minister bowed to pressure and agreed to abolish the immigration health surcharge for NHS workers. However, NHS workers applying to renew their visas are being told by the Home Office that this policy is still being applied and is still in place. Why is this immoral and mean-spirited policy still being applied, in light of the Prime Minister’s clear promise? (903650)

We are putting this policy into action and it will be retrospective to the date of the announcement by the Prime Minister.

Yesterday’s announcement on easing restrictions for those like me who are among the 2.2 million people who have been shielding for months is very welcome. What reassurance can my right hon. Friend give on the scientific evidence that supported the decision to ease restrictions for shielders from 6 July and to finish them on 31 July? (903654)

I am absolutely delighted that my right hon. Friend will be able to follow guidance and take more steps out after 6 July. The decisions on shielding were all based on the best clinical advice. Dr Jenny Harries, the deputy chief medical officer, has led the medical advice on this programme with great élan and wisdom. The reason we are able to make these changes and recommend these steps to my right hon. Friend and the 2.2 million others in his situation is that we have protected the NHS and got the virus right under control.

My constituent Jonathan e-mailed me to say:“Today for the first time my partner will see our baby and hear their tiny heartbeat. However, I’m writing to you from the car outside as she attends our 12 week scan. I’m banned from attending due to government guidelines.”Jonathan says he is being robbed of enjoying these special moments with Emma, yet they can shop together, travel on public transport and even visit the beach. What does the Secretary of State have to say to expectant fathers like him? (903651)

Of course it has been necessary to have tight controls over visitors in hospitals during this crisis, because people picking up nosocomial infections in hospital has been one part of the epidemic that we need to get under control. My heart goes out to those many people who have made sacrifices, including the hon. Member’s constituent, and of course we always keep this under review.

As we return to normality, we inevitably run a risk of a second wave of the virus. What infection threshold would my right hon. Friend consider sufficient to warrant further lockdown, and what criteria would be applied to determine the geographical ambit of any future lockdown? (903655)

My hon. Friend makes an important point. She may have seen this morning that in Germany, North Rhine-Westphalia has been put back into lockdown because of a local outbreak. So far, the local outbreaks we have seen have essentially been clusters in very small areas, and we have been able to bust those clusters and tackle them. We do, of course, hold the powers to have wider local lockdowns. Those will be based on judgments based on the epidemiological advice and the adviced of the joint biosecurity centre, working with all the relevant agencies.

The Secretary of State rightly says that black lives matter. The time for action is now, yet the latest figures show that black African and black Caribbean people are four times more likely to be detained under the Mental Health Act. When will he bring forward the White Paper on the mental health Bill? Will he please ensure that that legislation enshrines the four principles laid out in the Wessely review, including treating the patient as an individual, so that we can start to tackle racial disparities in mental health treatment? (903652)

We will bring forward that White Paper. The work has been ongoing even while we have been dealing with coronavirus. As far as I am concerned, the Wessely review is one of the finest pieces of work on the treatment of mental ill health that have been done anywhere in the world.

We have just marked Loneliness Awareness Week. Does the Secretary of State agree that combating loneliness is vital to ensuring the health and wellbeing of elderly people? I have seen excellent work at the Rainbow Centre in Penley in my constituency and by the charity I helped to set up, the Concertina Charitable Trust, which provides live music in care homes and day centres. (903657)

Absolutely. When we set up the loneliness strategy in 2018, when I was the Culture Secretary, I had no idea that covid-19 would make it so vital. I very much hope that, in England at least, the measures the Prime Minister is due to set out very shortly might help in that regard. Covid has underlined the importance of loneliness as an issue that we must directly and actively tackle.

At the start of the crisis, as a former emergency planner for the NHS, I thought the Government would trust the local well-established emergency planning systems that were in place, and they had my support. However, they have wasted time and money. My hon. Friend the Member for Leicester South (Jonathan Ashworth) is quite right to criticise the Government, because that has led to excess deaths and time lost. It is welcome that we are now supporting the local, but will the Secretary of State tell me why, when his friends at Deloitte have been set up to do the testing at Bristol airport, the complaints process is run through an NHS trust? (903659)

Because this is a big team effort by a combination of public and private sector partners. I pay tribute to Deloitte, without which the testing programme would not be possible. I pay tribute to all the pharmaceutical companies and I pay tribute to Amazon, which has delivered the home testing with remarkable success. Instead of trying to divide, we should unite and bring people together.

Dr David Rosser and his team at the University Hospitals Birmingham NHS Foundation Trust have done amazing work during the pandemic to make sure that people in Birmingham are safe and cared for. Will the Secretary of State give them all the flexibility and support they need to ensure that services at hospitals like Queen Elizabeth can go back to normal as quickly and as safely as possible? (903662)

Yes. David Rosser is a great leader of a very, very impressive trust. I was speaking to him only last week. There is an important lesson from covid, which is that many of the NHS central rules and much of the bureaucracy were lifted to allow local systems to respond as a health system. That has worked well. We need to learn from that. We need to not only make that permanent, but see where we can go further in that sort of system working.

My borough of Enfield has been allocated the equivalent of £4.58 per head to support the NHS test and trace programme. That is a third of what other London boroughs have received, despite the fact that it has the 12th highest number of covid-19 cases in London. That exacerbates the unfair share of public health grant received by Enfield and fails to take account of its health inequalities. Will the Secretary of State meet me to discuss the allocation of funding for Enfield’s needs? (903660)

We were scrupulously fair in the allocation of funding to local authorities, ensuring, for instance, that the support for social care went according to the number of beds. We have taken a great deal of care to make sure we get this right.

To allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next, I am now suspending the House for three minutes.

Sitting suspended.