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Oral Answers to Questions

Volume 681: debated on Tuesday 6 October 2020

Health and Social Care

The Secretary of State was asked—

Cancer Outcomes

The NHS’s recovery approach is restoring urgent cancer referrals and treatment to at least pre-pandemic levels and building capacity for the future. Latest data from July suggests that urgent two-week-wait GP referrals are back to over 80% of pre-pandemic levels.

I thank my right hon. Friend for that answer, but does he agree that if we are to deliver better outcomes in cancer and all areas of care, our clinicians need the best possible infrastructure? Is not that why it is so important that the Prime Minister confirmed last week that we will deliver our manifesto pledge of 40 new hospitals? Does my right hon. Friend share my delight at seeing on that list a new rebuild for West Suffolk Hospital, to deliver even better outcomes for our constituents?

Yes, I do. I share my hon. Friend and neighbour’s enthusiasm for the rebuild of the West Suffolk Hospital. For treating both patients with cancer and patients with all other conditions, the West Suffolk is a brilliant local hospital that is much loved in the community; however, its infrastructure is getting very old and it needs to be replaced. I am delighted, along with the Minister for primary care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), in whose constituency the hospital is and will be rebuilt, that we are able to make the funding commitment and get this project going.

I understand that we continue to requisition private hospitals. Given that there are patients who are nervous about attending hospitals, could those be used as covid-secure environments for cancer analysis and treatment?

Yes, absolutely. The private hospitals of this country have played a very important role in responding to covid, and we have a contract with them to be able to continue to deliver much needed services, including cancer services. Because by their nature they rarely have the pressures of emergency attendance, we can ensure that they are part of the green part of the health service—that they are as free as is feasibly possible from coronavirus—and therefore safe to carry out all sorts of cancer treatments. They are an important part of the recovery plan.

In my constituency of Stoke-on-Trent Central, patients being treated for cancer at the Royal Stoke University Hospital were relocated to Nuffield Health in Newcastle-under-Lyme. That is an example of practical measures that hospital trusts across the UK have taken to limit the spread of coronavirus since the outbreak in March. As we approach the winter pressures on the NHS, will my right hon. Friend outline the precautions the Government are taking to ensure that cancer patients’ treatments and appointments are not put to the back of the queue and do not suffer from undue delays?

My hon. Friend makes an important point. The Royal Stoke Hospital has performed brilliantly during coronavirus, and I thank everybody who works there for the efforts that they have gone to. It is critical for everybody to understand that the best way to keep cancer services running is to suppress the disease; the more the disease is under control, the more we can both recover and continue with cancer treatments. I believe that it behoves us all to make the case that controlling this virus not only reduces the number of deaths directly from coronavirus, but enables us as much as possible to recover the treatment that we need to for cancer and other killer diseases.

Following an online meeting with the manufacturer, I am excited to visit the Royal Surrey County Hospital on Friday to see up close the robotics that are used in many soft tissue cancer operations. Does my right hon. Friend agree that these clever robots, operated by talented surgeons, help to reduce the size of the incision site and therefore trauma, meaning a swift discharge and recovery for cancer patients, and that they are crucial to ongoing success in hospitals such as the Royal Surrey, which is a world leader in cancer treatments?

I know the Royal Surrey and I enjoyed visiting it, albeit in the rain, in December last year with my hon. Friend. The Royal Surrey is carrying out some of the most cutting-edge treatments for cancer. We have put extra funding in—a more than £200 million fund—for the use of advanced technology for treating diseases such as cancer, and she will have seen that I announced to the House yesterday that we are engaging with the best regulators around the world as we leave the European Union to ensure that we get cancer treatments to the frontline as fast as is safely possible.

York Hospital, like a lot of others, experienced a fall in cancer referrals at the height of the pandemic as a result of residents having stopped going to consult their GP. There is real concern among health professionals in York about the knock-on consequences of that and the rise in the backlog of cancer referrals locally. What steps can the Secretary of State bring forward to assist NHS trusts such as York’s to ensure that the backlog does not lead to late diagnosis of cases, worsening cancer outcomes?

My hon. Friend raises a very important point. As I mentioned in response to the first question, we now have referrals back up to over 80% of pre-pandemic levels, but we need to get that up further, because we all know that early diagnosis saves lives. I am also very glad to be able to report that in July, on the latest data, over 90% of patients saw a cancer specialist within two weeks of a referral from a GP, and 95% of patients receive treatment within 31 days of a decision to treat, so those referrals are leading to the action that is necessary. It is very important that the message goes out that the NHS is open, and anybody with a concern over cancer should come forward and they can get the treatment in a safe way that can help to save their lives.

In June’s departmental questions, I pressed Ministers on the cancer backlog that has grown so greatly under covid, so it was alarming that despite those ministerial assurances, between August and September, with infection rates being much lower than they are today, the waiting list to see a specialist grew by 16%. Things will only get harder now that infection rates are rising and with the NHS facing winter pressures, so will the Secretary of State give us a categorical assurance that he has a cancer recovery plan, and that it will drive down the waiting lists each month for the rest of the year?

Yes, absolutely. I think we agree right across the House on the importance of this agenda. The first and most important part of it is to bear down on the long waits, because the longer that people wait, the more dangerous cancer can become. That is happening, and we also have to make sure we bring the referrals forward, because we do not want to have fewer people referred for the diagnostics. At the same time, we are expanding the diagnostics that are available, both in hospitals and increasingly in community hubs, which are safer from a covid point of view and, for the long term, will mean that diagnostic centres for things such as cancer can perhaps be on a high street or in the places where people live, so that they do not necessarily have to go to a big, acute hospital to get the diagnostics part of the pathway done.

Non-covid Treatments

What steps he is taking to ensure that patients with illnesses other than covid-19 can access the treatments and procedures that their diagnosis requires. (907100)

It is vital that non-covid treatments are restored as quickly and safely as possible. That is what the NHS is doing. It is working to have them restored, by October, to around 90% of last year’s levels.

Thankfully, children are relatively robust in the face of coronavirus. However, children’s services, like other hospital services, were understandably reduced during the pandemic. What is my hon. Friend doing to ensure that paediatric services are now 100% up and running and will not be affected by a future wave of the pandemic? What is he doing to support NHS trusts in dealing with the backlog of appointments delayed by the coronavirus?

I pay tribute to my hon. Friend for her service to her constituents both as their MP and as a paediatric clinician. She is right to raise this important issue. Restoration guidance has already been published by NHS England and NHS Improvement, setting out a framework to fully restore services in this area, which I agree is vital. I would be very happy to meet her to discuss this further.

Mental Health Support in Schools

What recent discussions he has had with the Secretary of State for Education on allocating additional resources for mental health support in schools. (907101)

We are working closely with the Department for Education to support children and young people’s mental health, and we remain committed to implementing the proposals in the children and young people’s mental health Green Paper putting mental health support teams in schools and colleges, otherwise known as trailblazer schemes.

Schoolchildren have had their education interrupted. They have been separated from their friends and face continual threats to their daily lives. The Government knew schools were to return. Why did they not put adequate measures to provide mental health provision in schools for students and teachers?

I am afraid I have to say that, actually, the opposite is the case. We have just completed the wellbeing for education return “train the trainer” scheme. The trainers have been trained by the Anna Freud Centre and are ready to go out into schools across the country. It was always the position that schools should be open and the best place for children to receive help and support, for exactly the reasons that the hon. Member described: separation from their routine and their friends, and school being a place of safety.

Train the trainer has now completed. The Under-Secretary of State for Education, my hon. Friend the Member for Chelmsford (Vicky Ford), and I worked hard on that over the summer to ensure that the £8 million was there and the training was in place, ready to provide mental health and wellbeing support to children when they return to school. I am pleased to say that the last “train the trainer” scheme happened last week, and those involved are now ready to move into schools across the country.

It has been six months of uncertainty for our country’s children and their parents, with schooling cancelled, the exam results fiasco and now students trapped in uncertainty in their university accommodation. Despite the Education Secretary recognising that there was a serious impact on young people’s mental health, yet again it seems that the Government have no plan. Children and young people are being failed. When will the Minister finally address the pending mental health crisis in our schools, colleges and universities?

I just do not recognise the picture that the hon. Lady has presented. We are investing at least £2.3 billion in mental health support and mental health provision. That investment translates to 345,000 children and young people who will be able to access mental health support via NHS-funded health services and school-based mental health support teams. Spending on children and young people’s mental health services is growing faster than the overall spend on mental health, which itself is growing faster than the overall NHS budget. Children and young people’s mental health is our priority, and we are showing that by investing in it. The picture that she paints is, I am afraid, completely not the case.

NHS Test and Trace

NHS Test and Trace launched in May. Four months later, more than 150,000 people who have tested positive for covid-19 have been contacted, and 450,000 of their contacts have been reached so that they can self-isolate. We have tested more than 7 million people at least once and many, such as care home workers, more than once. Rapid expansion brings with it challenges. Working with local authorities, we will continue to improve test and trace, as it is an important part of our armoury to defeat this virus.

As a co-chair of the all-party parliamentary group on adult social care, I meet weekly with a working group drawn from across the care sector. Providers on that group report that they are still experiencing delays in receiving weekly test results, still have no routine access to weekly testing for domiciliary care workers or staff working in supported living environments and urgently need regular testing for family members to alleviate the terrible isolation of care home residents from their loved ones. When will the care sector have all the access to testing that it needs on a reliable basis to stop the second wave of coronavirus delivering the utter tragedy and devastation of the first to the care sector?

I thank the hon. Member for her question and for the work that she does with the APPG, which I joined recently for a very valuable conversation. Supporting care homes through the pandemic and in the months ahead is absolutely our, and my, priority. One part of that is ensuring that they have the testing that they need. We are getting regular repeat testing to care homes. I acknowledge that the turnaround times have not been what we would have liked them to be, but those turnaround times are coming down and we are seeing a rapid improvement in performance.

This week, the president of the Association of Directors of Public Health said that the funding is just not there for local authorities to effectively run local contact tracing. Where it has been done, at a cost to the local authority, evidence shows that local teams were more likely to be successful in contacting people compared with the national tiers 2 and 3. Can the Minister tell me why the Government keep insisting that the current track and trace system is working when public health professionals are telling them the opposite?

I thank the hon. Member for her question. I am sure she will know that local authorities received £400 million to support them with local outbreak management. It is really important to have this coming together of the national system and the local system, where local authorities are indeed playing an important part, using their local knowledge to follow up with contact tracing, particularly for some of the contacts that are proving harder to reach.

Schools in my constituency are having to close, disrupting children’s education and the work of their parents. Serco’s test and trace has been an unmitigated disaster. It is more than an extraordinary waste of public money; it is a public health crisis. To make matters worse, Ministers signed off on a wholly inappropriate Excel spreadsheet, blowing billions and leaving thousands of contacts untraced. When I asked the Secretary of State last week when he was going to take personal responsibility, he simply boasted that the system was working brilliantly. When does the Minister think her boss, the Secretary of State, will begin to take personal responsibility for this fiasco?

There was quite a lot in that question. One thing I will say on schools is that enabling our children to continue to go to school is very much part of the whole strategy that we are using to tackle and suppress coronavirus, because education is so important. On the specific test and trace system to which the hon. Member refers, the Secretary of State spent an hour and a half in the Chamber yesterday answering colleagues’ questions about the performance of that system.

In the light of the fact that infection levels in York have risen from 63.1 cases per 100,000 to 143.9 cases per 100,000 in just the past seven days, the local public health team is working with the university and local labs, and together they have put together a programme where they can test, process the testing and do contact tracing. This is a testing service that works for York, with test results the next day and tracers who understand local population flows. Will the Minister put the necessary resources in place to enable them to do their work and allow this to happen, because this is surely the game changer we need to beat this virus?

Well, it is very good to hear of the set-up in York that the hon. Member describes, and what I can do is take away from here and follow up to ensure that there is joint working, which we know is a really effective way to bring together national resources with the local resources, expertise and knowledge that are so important in tackling this virus.

With covid, speed is of the essence, but people are struggling to get a test due to limited capacity at the Lighthouse labs. New labs were due to open in Newport in August and in Loughborough last month, but both are delayed. As NHS labs are having to take on more testing, can the Minister say what additional funding will be provided specifically to increase NHS lab capacity?

The context is the huge increase in the testing capacity of our system that we have already seen, going from in the order of 2,000 tests a day back in March to well over 200,000 tests a day now and building up to 500,000 tests by the end of this month. I recognise also that there is both the Lighthouse labs—what is known as pillar 2 testing system—and the important part that NHS testing facilities play in the pandemic. And of course the hon. Member will know that a huge amount of money has been and is going into the NHS to support its response to covid.

Scotland’s public health-based tracing service has reached over 95% of contacts, yet four months on, the Serco system in England has still only reached 61%. As finding contacts and getting them to isolate is critical to reducing covid spread, should not tracing in England now be based more on local public health teams?

It may be helpful to say that, since the NHS Test and Trace system started, it has contacted 78.5% of those who have tested positive, and then 77% of their contacts have been reached. There is an important part of the system where the national contact tracers are handing over to local authority contact tracers who are able to access the same system and are supported in contact tracing but, critically, are also using their local knowledge of the local area to increase the success rate. It is really important that people are reached wherever possible and advised to self-isolate.

May I also say how much I appreciate and thank all those who are doing the right thing by self-isolating, both those with symptoms and those who have been contacted by contact tracers?

I am not going to ask about the current problems with test and trace, because it is clear from what we have heard already that the Government have no answers on that. Instead, I will ask about the so-called moonshot tests and Dido Harding’s comments that some people will have to pay for them. When the Prime Minister was given a chance in the Chamber, a fortnight ago, to deny that was on the table, he did not take it. We have real concerns about creating a two-tier system for tests where some people have to pay. It undermines a fundamental principle of the NHS and will do nothing to stop the spread of the virus. Will the Minister give us a definitive answer today? Are some people going to have to pay to access the moonshot tests, yes or no?

I do not recognise the hon. Gentleman’s suggestion that there could be a two-tier system. What we have in place is a universal system where everybody who has symptoms is able to access a test. As he well knows, where we know there are particular risks, such as for those in care home settings, there are also tests for those who do not have symptoms so that we can pick up outbreaks early. A huge amount of resource and investment is going into developing new technologies for testing—easier testing, quicker tests and tests that can be done at greater scale—because this is all part of building up our testing capacity, so we can suppress this horrid virus.

Education, Health and Care Plans

What discussions he has had with the Secretary of State for Education on ensuring that education, health and care plans are linked effectively with the healthcare system. (907104)

Education, health and care plans identify the support needs of children and young people across those three areas. Local authorities and health bodies are required to jointly commission the services. The Government are currently undertaking a review of the special educational needs and disability system, and I am working on this with my ministerial counterpart in the Department for Education.

I thank the Secretary of State and Ministers for their focus on Dorset County Hospital in the recent investment announcements, but in my West Dorset constituency, I have totally unacceptable waiting times of up to two years for EHCPs for children and their parents. That is totally unacceptable. They face the most difficult of situations and, I am afraid, are losing hope. Will the Minister help me in supporting these desperate children and parents who need to get their EHCPs done?

My hon. Friend makes an important point about how we need to see children and young people getting in place, as soon as possible, the support that can help them and about how there are waiting times for these plans. There are two things I can say in response. First, in the context of covid, NHS England has made it clear to NHS organisations that they must restart and restore services that support children and young people with EHC plans and in the assessments for those plans. Secondly, in the review of the SEND system, we are indeed looking at how we can address some of the problems in the system and achieve better integration across health, care and education.

Breast Screening

Women at greatest risk of breast cancer continue to be prioritised for screening. The NHS has worked hard and has significantly reduced the backlog of delayed breast screening appointments from over 468,000 in June to under 52,000 in September. All services have now been restarted and, in Breast Cancer Awareness Month, the message is clear: when you get a screening invite, please attend; if you are worried about anything, contact your general practitioner.

Breast screening appointments were paused during the height of the pandemic. Breast Cancer Now has estimated that 986,000 women across the UK missed their mammograms, and it estimates that, as a result, there could be 8,600 women living with undetected breast cancer. With this being Breast Cancer Awareness Month, what steps is the Secretary of State taking to address the gaps in specialist breast cancer nurses recently highlighted by Macmillan Cancer Support?

I thank the hon. Lady for her question. Cancer nurse specialists are a particular interest of mine, and the long-term plan identifies that everybody deserves to have personalised care from a cancer nurse specialist. We did see the rate decline from 91% in 2018 to about 89% in 2019, and we are focused on making sure that everybody has a cancer nurse specialist. We promised it in the long-term plan and it is our ambition to deliver that personalised care to every woman. As I have outlined, the backlog of breast cancer screening has gone down but, again, I urge women who are called for screening to come forward. It is safe and, as with me, it could make all the difference.

Local Restrictions: Reducing Covid-19 Transmission

What assessment he has made of the effectiveness of local restrictions on reducing the rate of transmission of covid-19. (907107)

What assessment he has made of the effectiveness of lockdown restrictions on limiting the second wave of covid-19. (907108)

What assessment he has made of the effectiveness of local restrictions on reducing the transmission of covid-19. (907115)

I chair the Government’s local action gold committee, which considers the latest data and advice from experts, including epidemiologists and the chief medical officer, and the Joint Biosecurity Centre. Through this process, we consult local leaders and directors of public health. We have seen local actions in some parts of the country bring the case rate right down and we need to make sure that we are constantly vigilant to what needs to happen to suppress this virus.

Yesterday, the Health Secretary told me:

“we have been putting the extra money into…councils”—[Official Report, 5 October 2020; Vol. 681, c. 637.]

What money is that? He announced £7 million, split between nine councils, as compared with £12 billion for Serco. That is not putting the extra money into councils, is it? So may I ask him to show respect for Members of this House and, more importantly, for our constituents, and answer the question: when is he going to stop relying on the outsourcing giants and to support local public health teams with the funds they need, because that is how he and this country are going to fix test, trace and isolate?

We are, as the hon. Gentleman said in his question, putting money into local councils in areas where local action needs to be taken. We have an open dialogue with councils and local mayors about what needs to be done. But I urge him, on behalf of all of his constituents in Sefton, that it is better to support the whole effort to control this virus, not just part of it.

The Mayor of London has warned that the virus is now spreading widely again across London, although vital knowledge is being hampered by the problems with test and trace. Are the Government now looking at introducing wider restrictions across London? As a matter of interest for this House, will the Cabinet Secretary, as a part of that, commit to reintroducing a hybrid Parliament in such a situation?

I discuss these matters with the Cabinet Secretary and other colleagues across government all the time, and I also speak regularly to the Mayor of London. We maintain vigilance over the transmission of the virus right across the country.

Can the Secretary of State answer a very simple question: what rate of infection means that a local authority needs to go into local restrictions and what rate means that it can leave them? Of course I accept that there will sometimes be very specific circumstances, such as workplace outbreaks, that would need to be considered, but surely it is not beyond his level of competence to do both, because my constituents deserve to know when they can see their families.

Of course the hon. Member’s constituents and all those who are under local action restrictions yearn to see their families. We all yearn to be able to get back to the normal socialising that makes life worth living, but I am afraid that the answer to her question is in the question: because of specific local circumstances, such as outbreaks in a workplace or a halls of residence, it is not possible to put a specific number on the point at which a judgment is made to put in place local restrictions, which we do in consultation with the council, or to take an area out of them.

Student Lockdown: Access to Care

What steps he is taking with the Secretary of State for Education to ensure that university students with (a) cystic fibrosis and (b) other long-term health conditions who are required to self-isolate on campus as a result of the covid-19 outbreak have access to essential (i) medication, (ii) dietary provision and (iii) medical care. (907109)

Universities have a duty of care to support students who are required to self-isolate. The Department for Education is working with universities to make sure that where an outbreak occurs, support is in place. That includes ensuring that students with cystic fibrosis and other long-term health conditions who are self-isolating have access to the food, medicine and medical care they may need.

Self-isolating students throughout the country, and their understandably worried parents, are reporting problems with accessing food, drinks, exercise and other support. That is completely unacceptable for any student, but for those with cystic fibrosis, who often need high calorie requirements to stay well, access to regular food supplies is absolutely essential for their health. What is the Minister doing to ensure that students with CF who are required to self-isolate at university and have previously shielded are able to access priority supermarket delivery slots? Many will have relied on their parents’ accounts when they were at home. What other action is she taking, in partnership with universities and the Department for Education, to ensure that every student with CF who finds themselves in lockdown is supported on their healthcare needs?

The hon. Lady asks a really important question. Clearly, it is a difficult time for students starting university now, but particularly for those with long-term health conditions such as cystic fibrosis. Overall, as she knows, the context is that we are prioritising education. We do not want students to put their life on hold, but we do want them to be supported by their university, particularly if it is harder for them to self-isolate because of health conditions. I am in regular contact with the Minister for Universities and will take up with her the specific questions about support for students with cystic fibrosis and access to supermarket deliveries. If the hon. Lady would like to raise any specific case with me, she should let me know and I will take that up with the Minister for Universities to address the specific issues.

Covid-19 Laboratory Testing Capacity

As part of the drive towards the capacity target of 500,000 tests a day by the end of October, we have announced additional Lighthouse labs as part of the national lab network, and work is ongoing to expand the UK’s lab capacity inside the NHS.

The Lighthouse labs do not appear to be delivering sufficient test results. Schools and care homes in my constituency are still having to wait an unacceptably long time for covid-19 test results, and the delays are making it difficult for them to operate properly. What is my right hon. Friend doing to make better use of the many life science companies in Kent, including those at Discovery Park in Sandwich and at the Kent Science Park in my constituency of Sittingbourne and Sheppey? Those companies have laboratories in which some of the tests taken in Kent could be analysed.

We are increasingly contracting with labs like the ones my hon. Friend mentions—as well as the Lighthouse labs, which have huge capacity—to make sure that we can both increase capacity and reduce the turnaround time. I am glad to say that the latest figures for the past week showed that the turnaround time is coming down, which is important in Kent and right throughout the country.

Mental Health Service Provision

What steps he is taking to equalise the provision of resources allocated to mental health services for (a) children and (b) young adults. (907112)

As I said in an answer to the hon. Member for Tooting (Dr Allin-Khan), we are committed to spending on children and young people’s mental health services, which is growing faster than the overall spend on mental health, and the overall spending itself is growing faster than the NHS budget.

See, Hear, Respond, a new service managed by Barnardo’s in response to covid-19, to provide early intervention support for families and children in crisis, has received more than 11,000 referrals since June. The majority of children and young people referred need support for their mental health and wellbeing. What early intervention measures have been introduced? Are they enough? Does the Minister agree that early intervention measures are key to tackling the increase in children and young people’s mental health and wellbeing needs?

I could not agree with the hon. Gentleman more. The Government’s £8 million Wellbeing for Education Return programme, which is to support staff to respond to the emotional, mental health and wellbeing pressures that some children have experienced during the pandemic, is in place. As I have said, the last train the trainer session took place last week and those trainers are ready to go into primary schools to assist both teachers and parents to recognise when children display early signs of emotional distress or mental health issues as a result of the pandemic. I have been working closely with the Under-Secretary of State for Education, my hon. Friend the Member for Chelmsford (Vicky Ford), to ensure that this programme is in place to address exactly the needs that he has highlighted.

Long Covid

I am sure that the right hon. Gentleman would welcome yesterday’s announcement that the National Institute for Health and Care Excellence and the Scottish Intercollegiate Guidelines Network will work with the Royal College of General Practitioners to develop guidelines to support patients and practitioners in the treatment of and recovery from the disease. This follows on from the NHS launch in July of the Your COVID Recovery service, which provides personalised support for individuals. In addition, we are funding research into covid-19, including a study of 10,000 patients who were admitted to hospital with covid, building our understanding of the long-term effects and helping direct those improved treatments that are needed.

I thank the Minister for that helpful and comprehensive answer. If she has not already read it, may I commend to her the most recent edition of The Doctor, the British Medical Association magazine, which outlines several compelling case studies of GPs who are still suffering, some up to six months, after they first contracted covid? There is a growing body of evidence that a number of people continue to suffer with this months after it has been contracted, in a quite debilitating way. Will she build on the work that she is already doing and make the case to the Treasury and the Department for Work and Pensions in particular to ensure that all those who suffer from long covid get the support that is necessary for them?

I thank the right hon. Gentleman for that statement and I will read the document that he mentions with interest. It is a new disease on which we are still gathering evidence and data, so that we know how we can best support the individual in their recovery and, arguably, in their new covid-tinged life. I assure him that that is precisely what I shall be doing—looking at the evidence base and making sure we work with the colleges and general practitioners to ensure that we get the right answers.

Adult Care: Covid-19

What steps his Department is taking to support the adult care sector during the covid-19 outbreak. (907119)

What steps his Department is taking to support the adult care sector during the covid-19 outbreak. (907120)

What steps his Department is taking to support the adult care sector during the covid-19 outbreak. (907127)

We have sweated blood and tears to support the sector through this pandemic. Last month, we launched the adult social care winter plan, with regular testing for care home staff and residents, free personal protective equipment and mandatory infection prevention and control measures for care providers, supported by £546 million of Government funding. I am enormously grateful to all those on the frontline in social care. I recognise the challenges that they have faced and how many feel daunted by the winter ahead. I say to care workers: “I cannot thank you enough for what you do and I am with you every step of the way.”

I have been contacted by Ann Penrose, who is 91, in good health and in a care home in Ashbourne, Derbyshire Dales. She asked her family to contact Boris, but sadly she got me. Does the Minister agree that the time has come to look very carefully at what is happening in care homes to review the existing measures, routines and guidelines, bearing in mind that we are testing so much now? We need to have a bit more humanity. We are in danger of throwing the baby out with the bathwater. These people need their families, yes, in a safe environment, but they do need to have access to families and, at times, to their pets.

My hon. Friend makes an important point about the importance of visiting both to the individuals living in care homes, and to their family and friends. Achieving the balance between protecting care home residents from the risk that covid might be brought into the care home, where it is so hard to control, and giving them access to visitors, has been one of the hardest areas to get right over the past few months. That is why in the summer we issued guidance on safe visiting and gave more freedom on the decisions about visiting to local authorities, with directors of public health working with care homes. I want us to continue to support and enable safe visiting for care homes.

Order. We have to get through this grouped set of questions, and it is going to take us well into topicals time; the Minister really does need to speed up on the answers.

I thank the Minister for the social care winter plan announced two weeks ago. Can she tell me when this half a billion pound infection control fund will be released to councils covering constituencies such as mine in Congleton, in order to help protect residents and staff over the winter?

The infection control fund is being distributed in two equal instalments, the first of which has already been paid to local authorities. My hon. Friend’s local authority, Cheshire East Council, will be receiving £4.7 million in total, so it should already have received £2.35 million to go towards the extra costs for care providers and others in infection prevention and control.

As always, I commend the Department and the Secretary of State on their work during the pandemic. Although not every part of the response has been perfect—and we never expected that it would be—I am convinced that the Department has done its utmost to protect the public. I do have some concerns, however, about the transmission between care homes. What measures has the Department taken to prevent cross-contamination of covid between care homes, particularly from staff who work in multiple locations?

I thank my hon. Friend for his comments, but most of the credit should go to those working in social care, who have been looking after some of the most vulnerable people in our society in such difficult circumstances. He is right that it is really important that we ensure that there is no transmission between one care home and another, which is why we are requiring care homes to make sure that their staff work in only one setting and are providing additional funding to enable them to do this.

Care homes are rightly the focus of our attention at the current time, but I know that the Minister is reviewing the future of social care. Does she agree that our focus in that regard should be on more community-based services, not solely on residential provision? Will she also set my mind at ease by ruling out the creation of a new national care service run from Whitehall?

First, may I congratulate my hon. Friend on his recent report on levelling up our communities? As he said, care homes have indeed been the focus of our social care response to the pandemic, but I would not want anyone to think that that was the limit of our support for social care during the pandemic; the winter plan also includes support for domiciliary care, supported living and others. I agree with him that as we look to the future, we should support the aspiration that most people have to live independently, with their own front door, well into their old age. There are no plans to create a national care service run from Whitehall.

Families with loved ones in care homes are desperate to start visiting again, but are banned from doing so in swathes of the country with extra restrictions. The Government’s own carers advisory group says that visits are essential for residents’ health, and that, to make them safe, relatives should be treated like key workers—with regular testing. Will the Minister now please put that testing in place and lift the blanket ban on care home visits in lockdown areas, so that we can help to bring all families back together again?

The hon. Member makes an important point, as did my hon. Friend the Member for Derbyshire Dales (Miss Dines) a moment ago, about the importance of visiting for those in care homes, and for their relatives and loved ones. We are striking the difficult balance between protecting those in care homes and ensuring that they have visits wherever possible, but these visits must be done safely. I have heard from the sector about the aspiration for some family members to be treated as care workers—for instance, if they visit the care home regularly. As we expand testing, I very much intend that we should test some visitors—and am making the case for doing so—but it is all part of how we expand and use our testing resources.

Topical Questions

On Friday we confirmed the 40 hospitals we will build by 2030 as part of a package worth £3.7 billion, with a further eight new schemes also invited to bid, all to ensure that we protect the NHS long into the future.

All I want from the Secretary of State today is a simple yes or no answer. It has come to light that the Northern Ireland authorities have taken unprecedented action and committed to pay for private prescriptions for medical cannabis for severely ill children. Will he do the right thing and follow the example set in Northern Ireland in supporting other children with intractable epilepsy by paying for their private prescriptions—yes or no?

The hon. Lady has long been a campaigner on this subject. We have made significant progress in terms of expanding access where it is clinically safe to do so. On this, as on so many things, I will make sure that I constantly follow the clinical evidence.

My right hon. Friend knows that for every person who tragically dies from coronavirus, at least one other person has long-term symptoms lasting more than three months, meaning that they have breathlessness and chronic fatigue and often cannot go back to work normally. In his letter to me of 14 September, he said that clinics were going to be set up so that they could get mental health support, face-to-face counselling and rehabilitation. Have those clinics been commissioned, and when will those long covid sufferers be able to access them throughout the country?

My right hon. Friend makes an incredibly important point. I know very well the impact of long covid; it is something that I understand deeply. We are in the process of setting up those clinics and there will be further information on this very shortly.

Given that the Office for National Statistics has said today that deaths have increased three weeks in a row, and given the rising prevalence of the virus, can the Secretary of State understand the upset and the anger over the Excel spreadsheet blunder? Can he tell us today what he could not tell us yesterday: how many of the 48,000 contacts—not the index cases, the contacts—have been traced and how many are now isolating?

We have obviously been continuing to contact both the index cases and the contacts. The total number of contacts depends on how many contacts each index case has. That information will of course be made available in the normal way when it has been completed. However, we cannot know in advance how many contacts there are because the interviews with the index cases have to be done first.

So essentially thousands of people who have been exposed to the virus could be wandering around not knowing they have been exposed and infecting people, and the Secretary of State cannot even tell us if they have been traced.

Let me move on to something else. I listened carefully to what the Secretary of State said about a vaccine yesterday in light of the news that the Government are aiming to vaccinate about 30 million people—just under 50% of the population. There has been an expectation that the whole of the population would be vaccinated, not least because he said at the Downing Street press conference that he “would hope, given the scale of the crisis, we would have the vaccine and everyone would be given the vaccine.” Those are his words. We accept the clinical guidance. However, can he tell us how long it will take, for the 50% of people who will not be vaccinated, for life to return to normal for them?

As the hon. Gentleman well knows, decisions on the distribution of any vaccine have not been taken. The Joint Committee on Vaccination and Immunisation is the body that advises the Government on the appropriate clinical prioritisation of vaccines. It has published an interim guide, which he well knows about and we have discussed. That sets out the order of priority as an interim measure, but we await the data from the clinical trials of the vaccine before we will come to a clinically validated full roll-out plan. We are putting in place the logistical plans now, but on the decisions as to the clinical order of priority, we will take the evidence from the Joint Committee.

Can I just say to those on both Front Benches that these are meant to be short and punchy topical questions, not full debates?

With many GPs surgeries adapting to coronavirus guidelines by holding surgeries outside, often in car parks, one of my constituents was left feeling embarrassed and upset by having to discuss a sensitive and personal health issue within earshot of other patients waiting in line. Does my right hon. Friend agree that in times when alternative methods are replacing the usual privacy of face-to-face appointments behind closed doors, GPs surgeries must be sensitive to the whereabouts and comfort of their patients to ensure that others do not have the same experience as my constituent? (907160)

Yes, I wholeheartedly agree with my hon. Friend, who speaks well for her constituent. I am very sorry that her constituent had that experience, and of course GPs should be sensitive, as the large majority are.

The implications of coronavirus include rising levels of loneliness, which can impact on mental health and physical wellbeing while increasing pressure on the NHS. Last Friday, I visited Henley Green community centre in my constituency of Coventry North East and saw the work it is doing with health services to combat loneliness and deliver positive health and wellbeing outcomes. What resources can the Government provide to accelerate the spread of such social prescribing schemes so that community groups can deliver tailored local support to tackle this growing problem? (907161)

I pay tribute to the group that the hon. Lady mentions. I have put a huge amount of effort into supporting social prescribing, including with funding, and I encourage her CCG to engage with such bodies to make sure that we can get funding to support them on the frontline.

At the start of this pandemic, in the first lockdown, abortion services were relaxed to allow women to enable them to access the service from home, but I am particularly worried about the effect that has had on those women who are particularly vulnerable, subject to abuse or in coercive relationships. Now that we know that the risk to women of childbearing age from attending a face-to-face appointment is extremely low, what assessment has my right hon. Friend made of the ongoing need to continue in this way? (907167)

The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill) has committed to consult on the subject to make sure we get to the right outcome.

This Government have repeatedly refused to meet the group representing covid-19 bereaved families. I met the group last week, and they confirmed that they are not in litigation with the Government and never have been. They simply want to put across the concerns of thousands of people who have lost loved ones to coronavirus, so will the Minister now commit to meeting the group and hearing their concerns at first hand? (907162)

Of course I have met and continue to meet the families of those bereaved through coronavirus. With this particular group, I am afraid that when I last looked into it, they were in legal action—in pre-action protocol—with the Government, so I am advised that I should not therefore meet them.

It is important that communities, such as mine in Middlesbrough, can see a way out of the tighter local restrictions that have now been imposed. Notwithstanding my right hon. Friend’s earlier, very reasonable answer to the hon. Member for Bradford South (Judith Cummins) about the impossibility of setting hard metrics for the release from lockdown, can he set out what would constitute a path out? Does it include, for example, a sustained fall in transmission rates? (907169)

The level of cases matters, but so too does the direction of travel, and when the number of cases is falling—especially if it is falling rapidly—that is the sort of indicator that we will look at. One example is the action we took in Leicester a few months ago now, where we removed some of the most restrictive measures when the numbers were coming down sharply.

Please, please, Secretary of State, my constituents need extra support. Despite the outstanding efforts of the staff at Northumberland County Council, covid-19 is running rife through our towns and villages. Since stricter local lockdown measures were introduced, we have seen a huge increase in transmission levels. Parts of Ashington, Bedlington, Morpeth and Newbiggin have seen rates of almost 500 per 100,000. Secretary of State, please help us. (907163)

I am very worried about the rates of transmission in the north-east, as I am about parts of the north-west of England. I look forward to working with the hon. Gentleman and colleagues from across the regions affected to take the action necessary to suppress this virus and to support the economy, education and the NHS right across this land.

I have first-hand experience of how effective the app has been, as it has kept my father covid-free before he goes into hospital tomorrow. Could my right hon. Friend update the House on the success of the app and advise me of what more Members can do to ensure that the covid-19 app continues to keep us all safe, including my father? (907168)

The covid-19 app has now been successfully downloaded by around 15 million people, including my hon. Friend’s father. Every extra person who downloads it helps to keep themselves safe and keep others safe. I urge everybody in this House to download it—I hope you have, Mr Speaker. It is one of the tools in the armoury, and everybody can play their part in keeping this virus under control by downloading the app.

As you can imagine, Mr Speaker, I was astounded to be told that people living in Devon were being advised to go to Inverness for a covid test. Can the Secretary of State reassure me that a truly collaborative effort is being made by Her Majesty’s Government and the Scottish Government to beat this virus? (907164)

Yes, absolutely. The testing facilities are one example of that. Testing facilities across the UK work very closely with the Scottish NHS, to ensure that people can get a test as close to them as possible. I think we have reduced the problem of people being sent to Inverness, but we continue to work to increase the capacity in Inverness and right across the country.

Partly in response to large queues and hours-long waits for tests in Canada, Health Canada has followed the US Food and Drug Administration in approving rapid testing, such as the ID NOW test, which can give a result in 15 minutes. Can the Secretary of State update us on where we are with the roll-out of rapid testing? (907171)

We are making good progress in validating the tests and in doing what needs to be done to be able to use them effectively. I have seen some of these reports from around the world, and I talk regularly to my opposite numbers about how we can get this sort of next-generation testing going.

With Spina Bifida Awareness Week coming up, can the Secretary of State say when the Government will respond to the consultation on putting folic acid into flour? It is a move that could help to reduce the number of babies born with defects of the spine, and it is important to hear when that might happen. (907165)

I am a strong supporter of the work we have done to look at that approach. The hon. Lady is right to raise it, and I will write to her with a timetable for that response.

Positive outcomes are more likely when cancer is detected early through breast screening, and evidence suggests that take-up of screening is generally higher when mobile units are used, yet women in Heald Green have missed out on local screening and been directed out of Cheadle to Macclesfield. It is the second time that their three-yearly checks have been disrupted, potentially affecting uptake and risking cancers going undetected. Will the Secretary of State agree to meet me to discuss ways to address the situation in Stockport and give women in my constituency access to the local mobile screening units they need? (907173)

Yes, of course I would. I would underline some news announced by the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), which is that the breast screening backlog from the first peak, which was 450,000, is now down to just over 50,000. I pay tribute to the NHS and all those involved in screening who have done so much work to bring that backlog down, and I am very happy to meet my hon. Friend to discuss this subject.

The pharmaceutical industry has highlighted supply difficulties due to covid-19 as a challenge to recreating stockpiles before the end of the transition period in December. How will the Secretary of State ensure that there are no drug shortages, particularly of medicines such as insulin, which is not produced in the UK? (907172)

A huge amount of work is under way to ensure that we are fully prepared for all eventualities this winter. It is an important piece of work across the Department.

I would like to thank the Secretary of State for his commitment to Northumberland hospital investment, with the Northgate Hospital investment announced last week. Does he agree that rural hospitals such as Berwick Infirmary—one of the most rural English hospitals—are places to develop the technology to enable us to reach many more patients, without them having to travel long distances to get to hospital? (907174)

We have ended where we started this questions session: with my delight at a new hospital that has been funded and announced by the Prime Minister on Friday—Newgate in Northumberland. That is a very important development. My right hon. Friend makes a wider point about the importance of community hospitals, which are local to where people live. With modern advances in technology, we can deliver more services closer to people’s homes and in people’s homes, and then in community hospitals, while of course needing to build those superb hubs of science and care that our great hospitals are.

In order to allow the safe exit of Members participating in this item of business and the safe arrival of those participating in the next, I am suspending the House for a few minutes.

Sitting suspended.