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Oral Answers to Questions

Volume 679: debated on Tuesday 1 September 2020

Health and Social Care

The Secretary of State was asked—

NHS Test and Trace

NHS Test and Trace is consistently reaching tens of thousands of people who need to isolate each week. In the latest week’s data, 84.3% of contacts were reached and asked to self-isolate where contact details were provided. Since its launch, we have reached over 300,000 people who may have been unwittingly carrying the virus and transmitting it, to ensure that they keep themselves safe and keep their community safe.

Scientists in the Scientific Advisory Group for Emergencies have continually warned that, for the test and trace system to be successful, 80% of people in contact with those who have covid must be reached. We are well off that target, I am afraid to say. Will the Secretary of State consider seeking advice from our European partners who have had a functioning system since May, or is he going to continue to allow the private sector to do this, on which it has no proven track record, and protect the interests of particular companies that certain civil servants allegedly may have links with? Are we going to see a serious approach to this?

Unlike the question, we will have a serious approach to this. I will absolutely defend to all ends the teams who work on our NHS test and trace system, the private sector companies without which this would be impossible and the civil servants who are working day and night to make this happen. I will not have disparaging remarks about civil servants, who have done so much during this pandemic, made in this House by the hon. Gentleman. I do not think he was listening to my answer, because the latest week’s data show that 84.3% of contacts were reached and asked to self-isolate where contact details were provided.

Cheadle residents welcome the release of the intervention measures that will take place tomorrow and the more local approach to this. Effective test and trace has been a vital part of getting us to this position and keeping the rates low. To continue with that, will the Secretary of State consider devolving the testing of cases to local authorities such as Stockport, which has a 99% rate of success?

My hon. Friend has played a very important role, and I pay tribute to her and her community for playing a role in the success of the local action that we had to take in Stockport and other parts of Greater Manchester, which meant that we were able to release the measures last week. I am grateful for her work, the work of her council and other local leaders and, most importantly, the people of Stockport, who have worked hard and followed the rules, and the case rate is coming down. She is right that the integration of a national system that can move fast at scale and a local system, which can often reach more contacts because there are boots on the ground and people who know the communities inside out, is critical.

In my right hon. Friend’s assessment, how does our track and trace programme compare with those of other countries, and what lessons are we learning from countries such as Germany and South Korea, which seem to be having some success with their systems?

Of course we learn the lessons, and I talk to my international counterparts, including those in Germany and South Korea. Compared with international systems, with the figures that I just read out, we are absolutely in the top tranche, and we are constantly looking all around the world to see how we can improve the operation of test and trace.

Devon’s director of public health has confirmed that we in North Devon have had no statistically significant increase in cases as a result of the return of tourism. Can my right hon. Friend confirm that test and trace will ensure that that remains the case?

I pay tribute to my hon. Friend for everything she has done to stick up for North Devon at this difficult time. I am really pleased that there is no evident increase in covid in Devon as a result of tourism. So many people go to Devon, during the summer especially, because it is such a wonderful place. We must ensure that, through test and trace and through social distancing, which is the first line of defence against this virus, that remains the case.

Covid hit Croydon and the rest of London early and hard, but Croydon has done us proud, and the number of infections has been very low for a number of weeks, thanks to the hard work of the people in the borough. We welcome the move towards more local track and trace, where expertise and local knowledge make all the difference, but as my director of public health said to me, we have just finished the beginning of this thing and we are now starting the next chapter. One of the things that keeps her awake at night is the need for certainty about budgets for outbreak control plans beyond the end of the year. Can the Secretary of State provide some reassurance?

Absolutely. I am glad to hear what the hon. Lady says about the constantly improving integration between the national and local systems. We have worked hard to make that happen, and I am glad to hear that it is happening in Croydon, as it is in other parts of the country. The budgets in that respect are of course important, and we have been clear that financial provision will be made. I cannot make any more definitive statement than that at this stage, but it is of course an important consideration.

Since June, the Scottish public health-based tracing system has managed to trace 99.7% of positive cases and almost 99% of their contacts, yet in England the commercial Serco call centres have traced less than 60% of contacts. Will the Secretary of State clarify whether any targets are included in the £10 billion contact with Serco? If so, are they being met?

If I may correct the hon. Lady, there is no £10 billion contract with any private company. The private companies have been critical in the work to make sure that the whole testing system could be built at the scale that it has been. As I said, the improvements are continuing. We are seeing local engagement, which is critical, and we are seeing testing rolled out right across the UK. For instance, when there was a local outbreak in Aberdeen over the summer, we were able to use UK resources to get huge amounts of testing into Aberdeen, thanks to the collaborative work between the UK Government, who provided the UK testing, and the Scottish Government, who were responsible for the lockdown.

That does not address the fact that the call-centre system run by Serco has managed to contact only 60% of people’s contacts. Regional Public Health England teams have been working flat out for the past seven months and are tracing more than 95% of the cases with which they deal. Does the Secretary of State really think that the middle of a pandemic is a good time to be threatening the job security of those teams with a huge reorganisation?

The answer to the first part of the hon. Lady’s question is that when we are trying to reach scale fast, we use the national system. That then engages with the local system—for instance, in Croydon, as we just heard—so that we can get the boots on the ground to find those contacts who cannot be contacted through the national system. It is the combination of the two that works best. As for making sure that our systems are in the best possible place to tackle coronavirus going forward, I absolutely think that it is right constantly to be seeking to make improvements to how things operate, which is why I announced the changes that I did.

In some areas, the private companies involved in test and trace have been reaching less than half the contacts they are supposed to reach, not the 80% that the Secretary of State has claimed. We do not need an algorithm to work out that those companies’ performance, compared with that of local public health teams, is where test and trace is failing. Why, then, are the Government rewarding private sector failure by extending the contracts?

As I have just explained, the test and trace system at the national level makes the immediate and rapid first attempt at contact. If no contact is made, the local teams can then go in. It is the combination of the two that works best. I really think that the Opposition —especially coming from the Front-Bench team—are making a mistake in trying to divide people between public and private. Actually, everybody is working very hard together to deliver the control of this virus.

NHS and Social Care Resources: Winter 2020-21

What discussions he has had with Cabinet colleagues on ensuring that the (a) NHS and (b) social care sector are adequately resourced during winter 2020-21. (905225)

We recognise that there will be increased pressures on the NHS and social care during winter, and substantial preparations have been and are being made. The NHS has already published its winter plan, and we will shortly publish the winter plan for social care.

That is exactly why there is a need for significant additional funding to prepare for a surge this winter, and that has to include a fully funded pay rise for health and care staff. At the height of the crisis, the Secretary of State was saying, “Now is not the time to consider a pay rise.” When will the time be? Is it now or some time in the future?

As I expect the hon. Gentleman knows, we have announced £3 billion of additional NHS funding for the winter and are continually looking at additional funding needs for social care.

There is a looming mental health crisis this winter, and as such it is vital to meet with experts. I know the Secretary of State believes that that is important, so I asked him several parliamentary questions wanting to know how many mental health trusts and organisations he had met during the first three months of lockdown. I was told that he “holds these meetings regularly”, but a freedom of information request revealed that he and the Mental Health Minister organised only two meetings with mental health trusts and organisations during that entire period. Can the Secretary of State confirm that he did not attend either of those two meetings? Does he think that is an acceptable track record?

The Secretary of State has regular meetings with stakeholders about the future of mental health.

Public Health Protection

On 18 August, I announced the establishment of a brand-new organisation to provide a world-leading approach to public health protection and resilience, the National Institute for Health Protection. It will bring together the health protection expertise of Public Health England, the Joint Biosecurity Centre and NHS Test and Trace under unified leadership and will start work immediately so as to boost the UK’s ability to deal with covid-19.

Everyone accepts that my right hon. Friend’s priority at the moment is fighting the invisible enemy, but with winter approaching many people will be worried about the threat of flu, so will he tell the House if there are any special arrangements for those people who want the vaccine? Does he have any further news about the reopening of all GP surgeries?

The flu vaccination programme this year will be the biggest in history. As I was going to say in my statement—I will say it now for my hon. Friend—we will be putting before the House proposals to expand the number of NHS qualified clinicians who can administer vaccinations, whether for the flu programme, which is coming, or for a covid vaccination programme, should a covid vaccine come out.

The NHS Confederation, the British Medical Association, the British Dental Association, NHS Providers, the Royal Society for Public Health and many health charities have expressed real doubts about the Secretary of State’s plans for Public Health England. It is evident that, come what may, he will have his own organisation for tackling disease and that, come what may, he will pick which of his pals he wants to lead it, but he seems to have ignored the fact that Public Health England also leads crucial work on tackling drug and alcohol misuse, reducing smoking, promoting sexual health and much more. Six weeks ago, obesity was the Prime Minister’s priority, and now the Health Secretary wants to cut the organisation that leads our fight against it. Will he end the confusion today by committing to the remaining functions of Public Health England continuing to be led by a dedicated national organisation?

The hon. Gentleman obviously did not read the announcement, because part of the purpose of having a dedicated national institute for health protection is also to ensure that the ill health prevention agenda—the health improvement agenda—is embedded in the health system, including the NHS. This is a good day to discuss this, because just this morning the NHS set out the next steps in its diabetes prevention and remission programme. Embedding the anti-obesity drive right across the health system, including the NHS, is a critical part of its future, and we are consulting widely on making sure we have the right and best organisational structure to deliver that.

NHS Capacity: Winter 2020-21

In July this year, my right hon. Friend the Prime Minister announced £3 billion of additional funding to help the NHS to address the challenges of winter. In addition, in August this year, we set out an £300 million for the enhancement of urgent and emergency care capacity and to provide infection control measures.

I thank the Minister and the Secretary of State for the forward-thinking measures to support winter capacity in our hospitals. We should not, however, forget the work of our hospices, which have no seasons and work compassionately all year round. Will my hon. Friend and the Secretary of State join me in visiting one of the jewels in the crown of my constituency—Mary Stevens hospice, which due to covid-19 has had to delay the official opening of its day services unit?

My hon. Friend is absolutely right to pay tribute to the amazing work of hospices. She is also right to highlight the work of Mary Stevens hospice in her constituency, of which she is a great champion. I very much look forward to taking up her offer to visit.

I thank the Secretary of State for the investment into Warrington A&E announced recently. An additional £4.3 million will create a treatment plaza and, most importantly, a new paediatric A&E unit for the hospital. This investment is very welcome for the short term, but will the Minister and the Secretary of State meet me to discuss the longer-term issues for our hospital—plans for a better healthcare facility in Warrington South, better parking, and, in the long term, a new hospital?

I am grateful to my hon. Friend. He is right to highlight the investment we are making in NHS infrastructure, as he did recently in his Warrington Guardian column. He is well known for his energetic campaigning, on behalf of his constituents, for a new hospital. Although such decisions are for the spending review, I would be very happy to meet him.

I welcome the extra £1.6 million the Government are investing in Ipswich Hospital’s A&E department ahead of the crucial winter period, but will the Minister build on this work by ensuring that the new plans for a £25 million A&E department at Ipswich Hospital are accelerated? If this were to happen, it would go some way towards alleviating my constituents’ concerns about the merger with Colchester Hospital.

I am grateful to my hon. Friend. When I visited him earlier this year, he made a powerful case for the longer term for a new A&E department at his hospital—a cause that he has been a driving force behind. I know that the trust is keen to progress this, and I would hope and expect that it is engaging with him. Although the spending review will see the Chancellor’s final decision on spending on this, my hon. Friend’s voice is being heard loud and clear.

The capacity of Barnet Hospital to cope with winter pressure is being assisted by a brand-new modular ward with 35 beds. Can the Minister assure me that there will be continued investment in expanding NHS services in Barnet so that it can cope with any covid pressures this winter and also help to clear the backlog of people who have been waiting for treatment for other conditions?

As my right hon. Friend highlights, the new modular 35-bed ward at Barnet Hospital will add to its capacity to cope with winter pressures. More broadly, we have invested £2.5 million in the Royal Free London NHS Foundation Trust, of which Barnet is part. She is of course right to make the case for continued investment in the longer term, with her typical effectiveness and commitment to her constituency, and I am always happy to discuss that further with her.

Covid-19 Testing

We have developed capacity to over 200,000 antigen tests per day across the testing programme. We are planning for the next phase of testing and are committed to rapid and accessible testing at scale for everyone who needs one. Localisation of testing in accessible places is absolutely critical.

I thank the Secretary of State for his answer. He may well be aware of the outbreak in my community of Newcastle-under-Lyme centred on Silverdale working men’s club. The outbreak appears to be under control. I praise his Department for its support, and also Staffordshire County Council. Close to 2,000 tests have been carried out, a number of those at the new local centre at Ryecroft. If I could make one suggestion based on our experience of this outbreak, it is that the online booking system needs to react more quickly to make spaces available. Spaces always have been available, but not always online. Will he comment on that?

I am very grateful to my hon. Friend for the work he has put in over the summer to make sure that the challenges we have seen in Newcastle-under-Lyme are dealt with as well as possible. Of course, when we put in extra testing and extra mobile testing units, making sure that that is tied in with the online booking system is critical. I am very happy to work with him to resolve the specific issues in Newcastle.

Alongside the need to increase capacity, there is a real need to make sure that what is already there is working properly. In Chesterfield, I have had many people contact me over the summer to say they have been waiting four or five days to get a test result back. I have also had people who have applied online and been told to go for testing 20 or 30 miles away, when there is a testing centre in Chesterfield. With Chris Hopson of the NHS Providers organisation saying that the current system is not even

“fit for purpose, much less world class”,

will the Secretary of State tell us what he can do to ensure that the system is ready when we approach the potential increase in cases in the autumn and winter?

Of course, we are constantly working to improve the system, but as the statistics that I read out at the start of this Question Time show, we have made very significant progress over the summer. NHS Test and Trace is just over three months old, and is now reaching 84% of contacts when contacts are given. On testing expansion, of course when a testing site is full, people will be directed to a nearby but not immediately close testing centre. That does sometimes happen when there is an increase in demand for testing, but we try to respond by putting in more testing where it is needed and in the highest-risk areas, of which, thankfully, Chesterfield is not one.

Covid-19: Support to Scottish Government

The UK Government are supporting the covid-19 response right across the country. We have established the Joint Biosecurity Centre, ensuring decision makers in Scotland and across the UK have the best possible information when responding to outbreaks. The UK-wide test and trace programme has significantly enhanced the ability to respond to covid-19 in Scotland, notably through the six Department-funded testing sites and 18 mobile testing units, with additional ones deployed such as the one to Aberdeen during the recent outbreak there.

I thank my right hon. Friend for that answer. One of the things that has been welcomed in Scotland has been seeing both of Scotland’s Governments working together to fight this pandemic—for example, the British Army working with the Scottish Ambulance Service and local NHS boards to increase our testing capacity. Can he confirm that this one nation approach to tackling covid will continue in the future?

There is absolutely no doubt about the combination of the UK Government putting in place the capacity that we can get only because we are one united nation, working in concert with the Scottish Government and local councils, which have people on the ground who are in the communities. That combination is the strongest possible approach to responding to an emergency such as covid-19.

Cancer: Alternative Therapy Regulation

What plans he has to introduce additional regulations for practitioners of alternative therapies for cancer treatment. (905231)

The Government are clear that we will do everything we can to protect the most vulnerable. We will not tolerate the false advertising of alternative cancer treatments. It is dangerous, but it is also cruel, and we will ensure penalties are handed out for any breaches of the law. While there are no plans to bring complementary therapies into regulation at present, many are registered on voluntary registers accredited by the Professional Standards Authority for Health and Social Care, ensuring patients can access safe care.

My constituent Linda died of untreated breast cancer after she had been seduced, we believe, by advertising on the internet offering alternative therapies such as scans and pastes that were actually caustic to her body. She died alone in my constituency some months ago. Will the Minister consider bringing in tough restrictions on advertising on the internet, particularly as people are accessing internet therapies more now, and also tough restrictions on the people who practise these bogus therapies?

I thank the hon. Gentleman. I was really saddened to hear of the death of his constituent, and fully agree that we must protect people who are often so desperate to find something that will help them and give them hope of recovery. Under the Cancer Act 1939, all advertising of cancer services and treatments is prohibited wherever advertised—online or in the paper—including complementary or alternative services and treatments that purport to be able to cure cancer. We know the role that the internet can play in spreading harmful messages about alternative treatments. It is dangerous, and I have discussed the issue in its broadest sense with my Digital, Culture, Media and Sport colleagues. I give him an assurance that we are committed, across government, to taking any further action needed. He knows that my door is always open, and I would be happy to continue this conversation at any point.

Social Care: Covid-19

What steps his Department is taking to support the social care sector during the covid-19 outbreak. (905232)

What steps his Department is taking to support the social care sector during the covid-19 outbreak. (905237)

We know that those who receive social care are among the most vulnerable in our society. The Department of Health and Social Care has strived to support the sector throughout this pandemic, providing it with a sense of guidance, extra funding, emergency supplies of personal protective equipment and prioritising access to testing.

May I express my very sincere thanks for all the help that social care services have provided throughout this ongoing crisis, but can the Minister assure me that we have learned all the lessons from the shielding programme and that the social care sector is adequately prepared for the coming winter months?

I join my hon. Friend in thanking all those who work in social care for their commitment and compassion since the start of the pandemic. We have indeed carried out work to understand the impact of shielding on people’s health and we will shortly be publishing our winter plan for adult social care, setting out our preparations for the winter and in the event of a second wave.

Can my hon. Friend confirm that every care home in England has either received a coronavirus test or is about to receive one?

Yes, I can confirm that. Every Care Quality Commission-registered care home in England has been offered testing. Care homes for those who are over 65 and with dementia have been offered repeat testing. We have now opened up repeat testing to care homes for working age adults.

Following on from that question, Ministers initially promised weekly testing for care home staff by 6 July. They then abandoned that pledge and said that routine tests would not happen until 7 September. With more than 15,000 deaths from covid-19 in care homes so far and with winter and the flu season fast approaching, regular weekly testing of care home staff is critical. Will the Minister now guarantee that every care home will have weekly testing for their staff by Monday to help all of our loved ones in residential care keep safe?

We are indeed determined to support social care, particularly care homes, with repeat, regular testing. As the hon. Member knows, because we have spoken about it, there has been a delay with our repeat testing of care homes because of a particular issue with some of the test kits. That was communicated to her and to the sector. As I said in my previous answer, we have now been able to offer repeat testing to all care homes for older people, to open up the portal to those care homes with working-age adults as residents and to initiate our second round of repeat testing for the older sector.

Northern Lincolnshire and Goole NHS Foundation Trust

What assessment he has made of the adequacy of funding for hospitals in the Northern Lincolnshire and Goole NHS Foundation Trust. (905233)

I thank my hon. Friend for his question. He and I have had the opportunity in the past to discuss his hospital trust and I pay tribute to its work. I am conscious that his trust has faced financial challenges, running a £57 million deficit a year ago. That has now been halved, meeting the financial control total. I also understand that income levels at his trust increased by 22% from 2015-16 to last year.

I thank the Minister for replying and also for meeting me and my hon. Friend the Member for Great Grimsby (Lia Nici) before the recess. May I emphasise the importance of the Diana, Princess of Wales Hospital in Grimsby that serves my constituency as well? It needs £150 million to £200 million of major infrastructure work to avoid infrastructure failure. I urge him to consider that and bear in mind the pressures on the trust as he considers the additional resources?

My hon. Friend quite rightly raises the Diana, Princess of Wales Hospital in Grimsby. He has raised it with me before, and I give him that commitment.

Obesity Reduction

The Prime Minister is clear that we must care for the health of our population. In July, we published the ambitious strategy to empower adults and children to live healthier lives, taking forward actions from the previous three chapters of the childhood obesity plan and laying out a series of initiatives. It sets out an overarching campaign to reduce obesity and has measures to get the nation fitter—to protect, importantly, against covid-19, to protect the NHS, but most importantly, to improve individuals’ health and wellbeing and quality of life.

There is strong support for the Government’s ambition to reduce obesity among children and young people, in particular. There are many calls for advertising bans for broadcasters for high salt and sugar content, for example, but those are not as straightforward as is suggested, because there is the risk of driving advertising online, which is far more targeted and, as some believe, might be much more effective in communicating the message to attract people to buy those products. Does the Minister recognise that this is a complex picture that needs lots of analysis before clear policies are decided upon?

I thank my right hon. Friend for that question. I know that as a keen marathon runner, he has a keen interest in us all keeping fit. I could not agree with him more: our children’s online watching is considerably greater than their watching of terrestrial television, and that is precisely why we have included a consultation in the online space to ensure that we have fully considered all the impacts that he just mentioned before we move forward and any changes to advertising restrictions before they are introduced.

Nurse Recruitment

We will deliver 50,000 more nurses for our NHS. We are increasing the number of student nursing places on degree courses and improving the experience of working in the NHS so fewer nurses leave, and we will also add to our home-grown nurses through international recruitment. I am happy to report that we now have 13,840 more nurses in the NHS than a year ago.

I thank my hon. Friend for her answer. Does she agree that the changes made by Project 2000 in 1986 led to a large group of caring people being excluded from training to be nurses? If we are to recruit many more nurses, this approach should be rethought, with recruits once again being able to learn on the job, as they did prior to 1986. This would bring nurses’ education much more in line with the Government’s recognition that university is not for all children and fulfil our objective to have apprenticeships in all walks of life.

My hon. Friend makes an extremely good point. We want all those with the capability and aspiration to become nurses to be able to do so. That is why we are supporting multiple routes to becoming a nurse. While the majority of new nurses take the university route, another option is the degree apprenticeship, which enables students to earn while they learn. Last month, we announced a £172 million funding package to double the number of nursing apprenticeships.

I am delighted to hear that we are successfully recruiting into the nursing profession. Does my hon. Friend agree that it is not just school leavers, but dedicated and caring people of all ages and diverse working backgrounds who have the transferable skills needed to start nursing qualifications? Will she outline what steps her Department is taking to engage with these individuals and encourage them to consider nursing as a vocation?

I completely agree that nursing should be open to all men and women from diverse backgrounds. Our £5,000 grant to all nursing degree students, starting this autumn, will help students with the cost of that degree course. In addition to the apprenticeships route that I just mentioned, in January we are launching an online blended nursing degree to give another route into nursing.

Diabetes Screening: Covid-19

What recent assessment he has made of the effect of the covid-19 outbreak on diabetes screening. (905240)

Diabetic eye screening has continued throughout the pandemic for those at the highest risk. NHS England and NHS Improvement are working closely with service providers to ensure that where services took the decision to reschedule screening appointments during the pandemic, those services are restored as soon as it is safely possible to do so, to minimise any risk to individual patients and with appointments based on clinical need.

It is nice to see you in your place again, Mr Speaker. I thank the Minister for her response, which is, as always, comprehensive. In relation to diabetes, I wish to ask about both screening and weight loss. What funding has been set aside for those who are morbidly obese and need gastric procedures urgently to set them on the path to better health, in line with the Prime Minister’s statement and reaction to the massively increased risk of death from covid-19 for those who are obese? It is important that we address all the issues.

As well as our world-leading obesity strategy, we have today announced a targeted dietary approach to diabetes. From next week, thousands of people will be able to access a rigorous weight-loss programme to help tackle type 2 diabetes. The diet and lifestyle plans have been shown to put diabetes into remission for many people who have been recently diagnosed. This will provide 5,000 more patients with the first stage in an NHS drive to increase access to the NHS diabetes prevention programme and builds on the commitment to get another 200,000 people into the life-changing programme. We know that diabetes increases the risks of other health challenges and coronavirus, so it is vital that we take immediate action to help people.

NHS Expenditure and EU Negotiations

What recent assessment he has made of the potential effect on NHS expenditure of negotiations on the future relationship with the EU. (905242)

As the hon. Lady knows, the negotiations with the EU on our future relationship with it following the end of the transition period are ongoing. This Government are delivering on their pledge to respect democracy and the referendum result, with the UK engaging continuously and constructively in the negotiations. We must await the outcome of those negotiations, in which health-related aspects are very important, rather than prejudging what will emerge from them.

In just four months’ time, new customs bureaucracy will lead to increased drug costs for the NHS, including for insulin, which the UK does not produce. Pharmaceutical and medical supply firms report that they are struggling to rebuild last year’s stockpiles because of global shortages due to covid. How does the Minister plan to ensure that patients will not face shortages next year?

The Department is putting in place a multi-layered approach to help to ensure continuity of supply of medicines and medical products in any case that might fall out of the negotiations and the end of the transition period. We are confident that we will maintain continuity of supply.

Covid-19 Testing for GPs

What recent assessment he has made of the availability of covid-19 testing for GPs required to attend care homes. (905244)

GPs with symptoms can be tested through the self-referral portal. In addition, we are launching pilots in Northamptonshire, Peterborough and Cambridgeshire to provide regular covid-19 testing for professionals who visit care homes regularly and provide services within 1 metre of residents.

That is all in the future, of course. I was talking to GPs in Cambridge last week, and they told me about the difficulty they have with getting tested before going into care homes. Indeed, one of them told me she had to pretend to be a care worker to get a test. That cannot be right after all this time, can it?

As I said, the pilots are now being launched in Peterborough and Cambridgeshire to provide regular covid-19 testing for professionals, and I think that problem has probably been resolved.

Medicine and Medical Device Safety

What steps he is taking to implement the recommendations in the July 2020 Independent Medicines and Medical Devices Safety Review report. (905247)

The Minister is aware that the Cumberlege review has clearly set out Government failure, with Primodos not being withdrawn and thousands of babies being born with severe deformities. Does she think it is acceptable to cite legal action, which has no bearing on the report’s findings, to continue to delay justice for the families? Will she meet me and the all-party parliamentary group to discuss a road map to implement the recommendations for all the three causes without further delay?

We welcomed the Cumberlege report and we are looking into the recommendations made, but the hon. Lady knows that, as a result of live litigation, I am not able to comment further.

Face Coverings

What recent assessment he has made of the adequacy of Government guidance for people unable to wear face coverings due to medical or other reasons. (905250)

Guidance to explain the Government’s policy on face coverings continues to be updated and fully takes into account groups with protected characteristics. This guidance makes it clear that there are exemptions for people who are unable, for a variety of reasons, to wear face coverings. We have also run a proactive communications campaign to ensure that people are aware that some people are unable to wear a face covering in certain circumstances.

Georgina Fallows is a rape survivor who suffers from post-traumatic stress disorder when her mouth is covered. Georgina and others like her have been challenged for not wearing a mask in shops and on public transport, and this causes further stress and anxiety. Does the Minister support Georgina’s campaign for a badge to identify people who legitimately cannot wear a mask, and will she consider raising awareness of this issue via a public information campaign?

I was incredibly sorry to hear what Georgina has been through and fully understand that she and others who have undergone traumatic experiences cannot wear a face covering without distress. That is why our guidance and public messaging have been very clear that there may be people who should be exempt from wearing a covering for a variety of reasons. It is also clear that people do not need to prove it when challenged. We are actively engaging with stakeholders and charities to ensure that these messages sensitively get across, and we will continue to do so, but I would welcome a fuller discussion with the hon. Member about anything we can do further to help individuals such as Georgina.

Topical Questions

As well as our work to fight coronavirus, we are continuing our historic levels of investment in the NHS. Good progress is being made in the projects for 40 new hospitals. The number of NHS nurses in England has increased by more than 13,000 compared with this time last year, and the number of doctors is up by over 9,000. This landmark investment is bearing fruit.

Thank you very much for that welcome, Mr Speaker. I am one of those who most certainly owes an awful lot to the care and dedication of NHS staff. May I ask the Secretary of State a very simple question? One waiting list that is going up is the amount of time that overseas doctors offered jobs in the UK have to wait for a visa. Will he have a quiet word with Home Office Ministers to ensure that we have a joined-up Government and that these doctors, who are part of the solution, can get their visas?

May I join you, Mr Speaker, in welcoming the hon. Member back to the screens—and hopefully, one day soon, back to the House in person? The question that he raises is an important one. I am working with the Home Office to introduce the NHS visa, which will mean not only that the numbers are uncapped, but that the administration around visas is much reduced. It is not just about Home Office administration; it is also about reducing the burden of bureaucracy from the General Medical Council and others. The GMC is working incredibly hard to reduce the bureaucratic requirement while still ensuring that any doctors who come to practise in this country are fully qualified and can speak English to a high enough standard, as the people of Rochdale and the whole country would expect.

The ongoing problems in maternity units in Shrewsbury, Telford and east Kent hospitals have shown that independent, blame-free investigations into baby deaths have never been more important. Will the Secretary of State confirm that it is still the Government’s intention to put the healthcare safety investigations branch on to a statutory footing and that those plans will remain in the Queen’s Speech later this year?

Nobody has done more for the cause of patient safety in this country than my right hon. Friend. We are seeking to put the health service investigatory branch into law at the earliest legislative opportunity. He will know that, as a Minister, I could not possibly pre-empt what Her Majesty might say in a few months’ time in the other place, but I will say that, in the same way that we introduced the Health Service Safety Investigations Bill just before the election, it is our full intention to legislate for it at the earliest chance.

I listened carefully to the Secretary of State’s response to the hon. Member for Southend West (Sir David Amess). Can he guarantee that he has currently sourced enough flu vaccine to vaccinate all 50 to 64-year-olds by Christmas?

We have the biggest flu vaccination programme in history, and we set out very clearly when we announced the plans our proposals, which are that we will vaccinate those who are clinically most vulnerable—that starts with the over-65s and those with another health condition that causes them to be particularly vulnerable to flu—and then move to vaccinate the 50 to 64-year-olds. We set that out several weeks ago. It is exactly as clinically recommended, to make sure not only that we have the biggest flu vaccination in history but that we get it to the people who really need it first.

I think the Secretary of State was saying there that he cannot guarantee vaccinations for all 50 to 64-year-olds. We are heading into a difficult winter. He knows that; the whole House will know that. One area of the health service that is particularly under pressure is rehab services and community mental health services, because they often now treat people who have had covid and have long-term conditions associated with having covid, yet many local areas are currently putting local community and public health contracts out to competitive tender. That could mean staff being made redundant. It could open the door to Virgin Cares coming in. At the very least, it is distracting and wasteful. Will the Secretary of State halt all competitive tendering of community and public health contracts until the end of the pandemic?

What I will do is ensure that we put in the best possible resources to improve the public health of the nation. That is our goal; that is our policy. It of course follows on from the policy that was put in place by the Government of which the hon. Gentleman was a behind-the-scenes part. He knows very well that I admire the work that he did when he was trying to expand the provision of health services. No matter where those health services come from, what matters is the quality of the service that people get on the frontline, and that is what we on the Government Benches will be focused on.

Tomorrow, the people of Burnley will have the additional restrictions that have been in place for the last month removed. That is possible only because of the efforts and sacrifice of people across Burnley, so I want to start by putting on the record my wholehearted thanks to people in Burnley, Padiham and all our villages. These have been difficult measures, but they have been effective at driving down the virus. Can the Secretary of State reassure me, though, that as an area of enhanced support, we will still get access to Government support to ensure that we continue to make progress? (905287)

My hon. Friend has been a tireless advocate for Burnley. He is quite right to praise the people of Burnley, who have had local restrictions put in place. Because of the actions they have taken—because they have followed their duty and followed those tougher rules—and the sacrifices they have made, the case rate has come down in Burnley, and I pay tribute to my hon. Friend and to every single resident of Burnley who has played their part. Absolutely, the enhanced support will continue in Burnley, as it does across those parts of Greater Manchester, East Lancashire and West Yorkshire that we have been able to take out of the most restrictive measures, and we continue to watch with vigilance.

The Secretary of State will know that on Friday, the Royal College of Nursing launched a campaign for a 12.5% pay increase, which would do only a little more than restore real pay to the value it had in 2010 when the Conservatives were elected. There is huge public support for all who work in our health and care system, so, ahead of the Budget, will the Secretary of State commit to pressing the Chancellor for the funds necessary to pay all our health and care staff properly? (905285)

Of course we have put in over the last two and a half years some very significant pay rises for nurses, and the whole House commends the work that the nursing profession as a whole, and each individual nurse, has done during this pandemic. Of course we are putting unprecedented sums into the NHS, and we work to make sure that everybody has the best possible working conditions, both now and in the future.

LGBT so-called conversion therapy is an abhorrent and fraudulent practice, so please will my right hon. Friend confirm to me and all my Conservative colleagues across the House who care deeply about this issue that he will do all he can to end this abusive practice at the very earliest opportunity? (905289)

Yes, I will. I agree wholeheartedly with my hon. Friend that so-called conversion therapy is abhorrent. I praise her for the campaign she is running on this. I agree with the Prime Minister who, from this Dispatch Box, committed to ensuring that that practice is stamped out. We have a review under way. I will make sure that I work very closely with my hon. Friend, who has done so much to make the case.

Care homes in my constituency and right across the country are currently waiting several weeks to access coronavirus tests and those in supported living still cannot access regular testing. I wrote to the Care Minister last month about this issue, but I have yet to receive a reply. So will the Secretary of State please confirm today when regular and swift testing will be available in care homes and supported living, or will he finally admit that the so-called protective ring for social care simply does not exist? (905288)

Yes, we have been rolling out the asymptomatic testing for residents and staff in care homes. As the hon. Member will know from the statement I gave to the House in July, we had a problem with the supply of tests from one particular company, which caused some difficulties. We have spent the summer catching up on that programme.

Will my right hon. Friend join me in welcoming the appointment of Jo Whitehead as the new chief executive of the Betsi Cadwaladr University Health Board in north Wales, and wish her every success with resolving specific issues, such as the cramped doctors’ surgery premises in my constituency of Clwyd South and Hanmer, and more generally in reducing the stubbornly high waiting lists in north Wales? (905291)

Yes. The direct provision of healthcare is of course devolved, but as the UK Health Secretary, I take an interest in ensuring we have high-quality healthcare right across the country. I am very happy to work with my colleagues in the Welsh Government on improving the delivery of services in the Betsi Cadwaladr health service. I wish the new chief executive all the very best. I am sure she will take the service, improve it and work with her colleagues in this House to make sure that the people of north Wales get the very best health services that they deserve.

Having used the coronavirus testing kit produced by Randox, which was awarded a £133 million contract by the Government, care homes in Blackburn were told that the kits were unsafe and re-tests should be carried out. As the Secretary of State knows, people in Blackburn have worked extremely hard to get the virus rates down. However, when care homes asked for replacement kits, they were informed that they had already received their quota and that no kits would be available until September. On the one hand the Government are saying, “Don’t use the kits,” and on the other hand they are saying, “We have no kits to replace them with.” When will the Government reassure care homes in Blackburn that they will receive test kits regularly and, more importantly at this stage, the rapid results of those tests? (905290)

In response to the last point, the turnaround time for test results is now the next day for almost every one. However, there has been a challenge, referred to just now and in a previous question, with the Randox kits. The test results from the Randox kits that were withdrawn were accurate. The challenge was that the Randox kits did not pass our very high and stringent standards; essentially they were not as clean as we would have wanted. I am informed by the clinicians that there is no evidence of any health threat from that, but of course we have to make sure that we protect people as much as possible. Hence, we had to withdraw the kits. As I said, we have a catch-up programme that is under way.

During the pandemic, I have been volunteering at my local hospital and have seen first-hand the outstanding dedication, enthusiasm and care given by all who work at North Tees Hospital. This fantastic, award-winning workforce deserve to work in a modern, fit-for-purpose building. Will my right hon. Friend join me in visiting this ageing building to see how we can make it fit for the future? (905292)

Yes, I would love to come up to Stockton and have a look round. I have enjoyed my many visits, especially the one in December, which went particularly well, just before the House reconvened after the general election.

Yesterday, a dear friend of mine died of stage 4 pancreatic cancer. It has the lowest survival rate of all common cancers, yet it receives less than 2% of funding for cancer research. Half of all the diagnoses come about only after emergency admissions to hospital, because patients commonly visit their GPs three or four times with symptoms before being referred to a consultant. What will the Secretary of State do to improve early diagnosis of this disease, because it is killing 10,300 people a year, which is 28 people a day? (905296)

My heart goes out to the hon. Member and to the family and friends of his friend, about whom he spoke so movingly just now. He is absolutely right to raise this. The early diagnosis of cancer is a critical part of improving cancer survival rates in this country. We have talked an awful lot in this House over the last six months about the testing and diagnosis of covid, but frankly this country needs to increase its testing and diagnosis of all diseases, including cancer. For a generation, we have not had enough testing. He is quite right to raise this issue, because it is not just about people coming forward; it is also about the problems being spotted earlier. We are investing £2 million in more rapid diagnostic centres, and we are trying to get diagnostics not just in the major hospitals but out into the community so that they are closer to primary care. There is also a major piece of work under way to recover the backlog that was necessarily built up during covid—that is under way and the backlog is down by about half—and also to go further and never give up on trying to have earlier diagnosis of cancer.

In order to allow the safe exit of hon. Members who have participated 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.