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Oral Answers to Questions

Volume 684: debated on Tuesday 17 November 2020

Health and Social Care

The Secretary of State was asked—

Covid-19 Testing Capacity

We are processing coronavirus tests on an unprecedented scale and expanding capacity further, having already met our testing capacity target of 500,000 tests a day by the end of October. We now have five Lighthouse labs operating across the UK, with two more announced yesterday, and significant progress on next-generation testing technologies.

I congratulate my right hon. Friend on the tremendous progress he has made over recent months on increasing our testing capacity, including the delivery of a new site in my constituency. The recent announcement regarding care homes is welcome. How quickly does he think the trial process can be concluded, so that we can roll out a nationwide scheme to ensure that those in care homes can finally see their loved ones again?

We have discussed many times in this House the importance of the use of testing because of the terrible dilemma of wanting to keep people safe in care homes, yet also wanting to allow visiting. Testing can help to resolve that. The pilots are ongoing in some parts of the country, and I very much hope that we can get to a position where we can offer testing to enable visiting across the country before Christmas

I welcome the testing pilots that are happening, including in Southampton. How will the Government be able to support local authorities and public health teams with the logistics of mass testing, particularly in large rural areas such as Hampshire?

Increasingly, the test itself is only one part of getting a high-quality testing system. The logistics around it are also vital. We are already funding local authorities across the country to support them to roll out mass testing, but we will learn from the pilots, including in Hampshire, to see what extra might be needed.

Testing, backed up by tracing and isolation, is key to avoiding further lockdowns. At the Secretary of State’s press conference yesterday, we heard that tier 1 has had “very little effect” and that the tiers must be strengthened. Can he confirm that it is the Government’s intention to impose a tougher set of restrictions on tier 1 areas post this lockdown?

It is too early to do the analysis that the hon. Gentleman requests, but of course, we remain vigilant.

We will soon be asked to make a decision on the future of the lockdown, so the earlier we get that information, the better.

Testing for NHS staff is crucial for dealing with the backlog in NHS care. Last week, we learned that 139,000 people are waiting beyond 12 months for treatment. We now know that 252,000 people are waiting beyond 18 weeks for orthopaedic surgery, which is often hip and knee replacements, and 233,000 patients are waiting beyond 18 weeks for eye surgery—many could go blind. People are waiting longer for gynae surgery and heart valve surgery, and many are languishing on trolleys in dangerously overcrowded A&Es. As well as testing NHS staff, Ministers have promised to give the NHS whatever it takes. Can the Secretary of State guarantee that the spending review will deliver the resources, beds and capacity to bring waiting lists down?

The good news is that we are managing to continue to drive through the backlog that understandably built up in the first peak. Instead of attacking the NHS, the hon. Gentleman should be backing the NHS and thanking it for the incredible hard work that it is doing right now and will be doing this winter.

NHS Capacity for Winter 2020-21

The Prime Minister has announced £3 billion to support NHS capacity this winter. Among other things, that money funds our Nightingale hospitals, so that surge capacity is available, and the NHS’s ongoing access to additional independent sector capacity. It also supports the safe discharge of patients, helping to reduce pressure on beds. In addition, £450 million of capital funding has been announced to upgrade and expand A&Es across the country, to help prepare the NHS for winter, and that money is already being spent.

The £3 million announced to increase winter capacity in Dudley is hugely welcome, but will my hon. Friend also look at Dudley’s bids for capital funding for a hybrid theatre and reconfiguration of critical care? Will he join me on a visit to Russells Hall, so that he can see the transformative effect that those projects would have on care for patients in Dudley South?

I am delighted that my hon. Friend’s constituents will benefit from £3 million to increase capacity at Russells Hall Hospital in Dudley as part of the investment to upgrade A&Es ahead of winter. Future NHS capital spending will, of course, be determined at the upcoming spending review, but once our settlement has been confirmed with the Treasury, we will consider carefully how projects are prioritised within it. In the meantime, I encourage the Dudley Group NHS Foundation Trust to discuss its proposals with NHS England and NHS Improvement. I would be happy to meet my hon. Friend to discuss this, because I know how hard he campaigns on this issue, and I would be delighted to take him up on the offer of a visit when I am able to.

The NHS will only survive the winter if its workforce are valued and supported. The evidence from the British Medical Association to the Health and Social Care Committee this morning was stark. So does the Minister understand how demoralising it is for staff to hear reports that they may face yet another two-year pay freeze? I asked those on the Government Benches to rule this out last week. I got no answer, so I ask them again today: will they rule out a pay freeze for NHS staff?

I am grateful to the hon. Gentleman. He is quite right to highlight the amazing work that our NHS and social care workforce have done throughout this pandemic, as they do every year, and I pay tribute to them for that. As he will know, the NHS agrees with its staff multi-year pay deals set by independent recommendations, and we continue with that process.

Lateral Flow Covid-19 Testing

If he will allocate additional funding to local authorities to support the roll-out of lateral flow covid-19 testing. (908866)

In addition to giving local directors of public health access to tests, NHS Test and Trace will provide access to training, clinical, operational and service design guidance, and communication and engagement support. In addition, all local authorities have funding available up to £8 per head of population to support the roll-out.

I welcome the allocation of lateral flow tests to both Kingston and Richmond in my constituency to allow for mass testing. Can the Secretary of State confirm whether, in addition to the support he has just outlined for the testing, there will be additional resources to support local tracing efforts and to support those who are found to need to isolate?

Absolutely, the funding to support people who need to isolate is in addition to the funding I just outlined, which supports both the roll-out of mass testing and local contact tracing, and we always keep these things under review.

Personal Protective Equipment Supplies

What steps his Department is taking to ensure adequate supplies of personal protective equipment for (a) health, (b) social care and (c) other frontline services during the covid-19 outbreak. (908867)

What steps his Department is taking to ensure adequate supplies of personal protective equipment for (a) health, (b) social care and (c) other frontline services during the covid-19 outbreak. (908915)

We have a four-month stockpile of all covid-critical PPE in place. Thanks must go to the tremendous contribution from UK manufacturers, including Honeywell in Motherwell in Scotland, which now meet 70% of our PPE needs. We have distributed 4.7 billion items, ensuring health and care providers and others have access to the critical protective equipment that they need to help keep everyone safe.

According to Treasury figures, the UK Government have spent £15 billion to date on PPE contracts, and the majority to date have been awarded without open tendering, often to those with connections to the governing party or to companies with no PPE experience at all. Does the Minister consider it is acceptable that, instead of that resource being used to protect frontline healthcare staff, so much of it has been squandered on millions of items that are absolutely unusable because they do not meet NHS standards, and how does she propose to restore this Government’s reputation for competence, probity and openness in the tendering process?

The global pandemic presented us with unprecedented challenges in securing the volumes of PPE required. We moved swiftly in order to make sure that we kept people safe. We procured goods and services, and worked with extreme urgency in accordance with procurement rules and Cabinet Office guidance. All offers were prioritised based on volume, price, clinical acceptability and lead time. I am happy to reiterate: we have four months’ supply.

The UK Government removed the zero VAT rating for PPE on 1 November, increasing costs by 20%. Social care and other frontline services are already having to pay higher prices and to buy larger quantities of materials, so why are this Government making it even more expensive to protect key workers during what is the second wave of covid?

I would like to thank the hon. Gentleman. In the main, many of our frontline operators are getting it free—social care, general practice, dentistry, optometry and so on. The relief was designed specifically to relieve the burden of VAT on sectors particularly affected by coronavirus while supply did not match demand. Now the Government are able to supply covid-related PPE across all sectors, the burden of VAT will still not fall on frontline providers for all covid-related PPE and demand will be met. Most businesses that make taxable supplies can recover the VAT that they incur on purchases of PPE as business expenses. They will therefore be able to reclaim all VAT after the 31st. But I reiterate: for the majority of frontline healthcare, it is free.

The price of an FFP2 mask bought by the Government increased by 1,400% in just six weeks to the end of May and gowns by 350%. I welcome all efforts by the Government to procure PPE, but I have concerns that we may not be getting a fair price. One company, PPE Medpro Ltd, was given Government contracts worth over £190 million. PPE Medpro Ltd had no previous experience and coincidentally was only set up on 12 May 2020. Reports have suggested that the company has substantial links to Conservative party donors, so can the Secretary of State or the Minister categorically assure the country that no Conservative party donors are profiteering from the pandemic?

Our plan on PPE has to be to stabilise the system and build resilience. That was outlined in the PPE strategy published on 28 September. [Interruption.] Children! Thank you.

I am sorry, Mr Speaker, but it is that old habit from being a mother of four.

We procure goods and services, as I have said, with extreme urgency in accordance with procurement rules and Cabinet Office guidance. We are confident of our supply, with four months’ worth of covid-critical PPE, over 70% of it now manufactured in the UK, providing UK businesses with jobs and ensuring that all health and care providers have access to critical protective equipment needed to keep patients and staff safe.

Building New Hospitals

On 2 October, £3.7 billion-worth of funding was confirmed for 40 new hospitals, with a further eight schemes invited to bid for future funding, to deliver a total of 48 hospitals by 2030. Four in the programme are already in construction, and three others have commenced early, enabling works on site. The hospital building programme is, of course, in addition to significant upgrades to 20 hospitals, which will be complete by March 2024, and is part of a wider programme of investment.

I am grateful to the Minister for those clarifications, and I obviously welcome this programme, but before he came into office, in March 2018, his Department allocated £312 million for a major capital programme at the Royal Shrewsbury Hospital and the Princess Royal Hospital in Telford. Now that an independent reconfiguration panel has confirmed that these decisions were properly made and should proceed, the trust is seeking approval from his Department for advance of funds for enabling work by architects, structural engineers and others. Can he confirm when this requested £6.3 million will be forthcoming?

I am pleased to confirm to my right hon. Friend, a distinguished predecessor of mine in this office, at this Dispatch Box that £6 million-worth of funding has been approved in principle, allowing Shrewsbury and Telford Hospital NHS Trust to develop its plans and produce a business case for this scheme. The Department will continue to work closely with the trust to understand how the right support can be provided centrally to develop an affordable case for the overall scheme and to maximise the impact of this funding, and I will be writing to my right hon. Friend with more detail later today.

The independent reconfiguration panel overwhelmingly backed the plans for the development at the Epsom and St Helier trust; does my hon. Friend agree that the Labour party should take away the threat of a judicial review and allow this investment to take place so that my constituents and the constituents of south-west London can benefit from greater access and better-quality healthcare?

I am delighted that my right hon. Friend the Secretary of State recently gave these plans the green light following independent advice from the IRP, and I am pleased that this will mean my hon. Friend’s constituents and, indeed, many others will benefit from a new state-of-the-art NHS hospital in Sutton. Patients and the public will now be engaged in shaping the detail of the new services; I encourage all local people to participate positively in that process and the council and others to get behind that scheme and that record investment by this Government in his area.

Covid-19: Economic Effect

What recent discussions he has had with the Chancellor of the Exchequer on reducing the economic effect of the covid-19 outbreak. (908870)

I have regular discussions with the Chancellor of the Exchequer and others. The best strategy for both health and the economy is to suppress the virus, supporting the NHS and the economy, until a vaccine can make us safe.

The economic effect of the lockdown on the hospitality sector in particular is severe. In large constituencies such as Thirsk and Malton, the infection rate can vary significantly across different districts. When my right hon. Friend moves us back to a tiered system on 3 December, will he look at allocating tiers by district rather than by county to keep the economy as open as possible?

Throughout the process of the tiered system, we have always looked at a level of granular detail, whether at district council level or, indeed, ward level in some cases, to make sure that we have the appropriate measures in the appropriate places. While it is too early to say exactly how we will proceed from 3 December, that is a commitment that I can make to my hon. Friend.

As I have highlighted previously, covid is spread not just by droplets but by airborne particles, so good ventilation is key to reducing the risk of spread indoors, such as in hospitality. On 20 October, the Secretary of State agreed to speak to the Chancellor about removing VAT from ventilation and air-purification systems to make them more affordable. Can the Secretary of State tell us what discussions he has had with the Chancellor and what the outcome was?

There has been work on promoting ventilation in government. The hon. Lady is absolutely right that ventilation is important and that the scientific evidence on the aerosol transmission of coronavirus has strengthened over recent months.

If that is the case, can the Secretary of State clarify whether we will hear an announcement from the Chancellor in the near future on supporting the installation of such systems? Even with the good news about potential vaccines, it will be a long time before most of the population are vaccinated, so what is the Secretary of State’s strategy to control covid over the coming year?

Our strategy is to suppress the virus and support the NHS and the economy until a vaccine can make us safe. Increased ventilation can help to reduce transmission, so it is an important consideration, among many others, for how we tackle this disease.

Covid-19: Dental Services and Mouth Cancer Diagnosis

What recent assessment he has made of the effect of the covid-19 outbreak on (a) access to routine dental services and (b) early diagnoses of mouth cancers. (908871)

This Mouth Cancer Action Month is a timely reminder that everybody should seek advice if they are worried. Early in the first wave, dental services were suspended, but rapidly, over 600 urgent dental centres were set up to deliver care. Since June, dentists have continued to prioritise urgent treatment and vulnerable groups and to provide routine care across the dental network. They have worked hard to restore dental activities, while keeping patients and staff safe, owing to some aerosol-generating procedures that mean we have to take particular care in the dental sector.

I recognise the Minister’s comments that people are trying to get back to work in dentistry, but the reality is that there is massively reduced dental capacity; routine dental work is not going ahead as easily as people might imagine. Dentistry also plays a vital role in identifying mouth cancers. Following on from a previous question, I wonder what help the Minister can give dental surgeries to improve their capacity. Currently, they have to have an hour’s gap between patients. I understand that ventilation systems are available, which can help, but unfortunately they are very expensive. What help can Ministers give to enable dentists’ surgeries to purchase that equipment? Can grants be made available? This is a really urgent question.

I recognise the hon. Lady’s concern in this area. I assure her that I am working closely with NHS Improvement and the chief dental officer. I have held several meetings over the past week alone, and tomorrow I am meeting the chair of the British Dental Association. Some areas of challenge that she articulates, such as fallow time and so on, are things that we are actively working on at pace, as well as looking at specific testing solutions for dentistry. We are also looking at the issue of ventilation. I am happy to report when further work has been achieved.

Covid-19 Vaccines

Yesterday, the House will know that we secured 5 million doses of the Moderna vaccine, so we have now secured access to 355 million vaccine doses through agreements with seven separate vaccine developers. We have secured them for the whole UK.

I thank my right hon. Friend for that answer. What assessment has he done of the logistics necessary to deliver a vaccine to more rural areas, such as Cornwall?

We have done a huge amount of work. The deployment of the vaccine is, of course, being led by the NHS, which reaches into all parts of the UK. Our principled approach is that we will deploy the vaccine according to clinical need in every single part of the UK at the same time. That, of course, includes rural areas. A significant amount of work has gone into how best to deploy to rural areas, especially as some of the people who clinically will need to get the vaccine first are also those who might find it most difficult to travel. It is a very important question on which a huge amount of work is being done.

I thank my right hon. Friend and fellow one nation Conservative for his hard work and that of his Department in impossible circumstances this year. Kate Bingham and the vaccine taskforce have done an amazing job in securing so many doses of vaccines, as and when they become available, which will be centrally procured by the UK Government and equally available across all parts of our United Kingdom. Does my right hon. Friend agree that that shows the power of all parts of the UK speaking with one voice and working together for the good of our entire Union?

I feel very strongly about this, and I agree very strongly with my hon. Friend. We should take forward this vaccine and ensure it is available fairly and equally across all parts of our United Kingdom. Of course, it will be deployed in each of the devolved nations through the devolved NHS. I have been working closely with my counterparts, and the four NHS organisations have been working together. Ultimately, let us hope that should a vaccine become available—we still do not yet have one authorised—it will be a moment at which the whole country can come together in support of making sure that those who are clinically most vulnerable will get support first wherever they live.

Anti-vaccination Disinformation Online

What recent discussions he has had with the Secretary of State for Digital, Culture, Media and Sport on tackling anti-vaccination disinformation online; and if he will make a statement. (908873)

The Culture Secretary and I discuss regularly with social media platforms the action that is needed to tackle vaccination disinformation online. I am encouraged by the fact that social media companies who have attended meetings with us have agreed to commit to the principle that no user or company should directly profit from covid-19 vaccine disinformation and to ensure a timely response when we flag such content to them.

It is obviously tremendous news that a vaccine will be available and that the people in the UK may be among some of the first in the world to receive it, but it is important that there is public confidence in the vaccine. The anti-vaccine movement is damaging: it is a threat to public health. Does my right hon. Friend agree that social media companies should not just be taking down anti-vaccine material when they are notified of it, but proactively looking for it on the internet and removing it themselves?

Yes, absolutely. A critical part of tackling disinformation is providing accurate, fair and objective positive information, and my hon. Friend is absolutely right about this point. The social media companies are working—and we are providing content for them—to ensure that proper, accurate information that the public can trust from the NHS about the effectiveness of vaccines can be promoted, as well as taking action to remove information that is not accurate and not correct.

Covid-19: Care Home Visits

What steps his Department is taking to help ensure that family members can safely visit relatives in care homes during the covid-19 outbreak. (908874)

Visits from loved ones are what makes life worth living for many care home residents, yet, sadly, these have been too few over the last few months. Unlike the first lockdown, during this period of national restrictions, we want visits to be able to continue. That is why we published new guidance on 5 November advising care homes of the steps that they can take to allow safe visiting while there are high rates of covid in the community. Yesterday, we launched our visitor testing trial and plan to offer visitor testing to care homes across the country by Christmas.

There are almost 2,000 people living with dementia in Lewisham and for those in residential care, a lack of social interaction through visits can cause their condition to deteriorate. Testing for family and friends is the way forward, but the Government’s pilot for this was launched only this week and just 20 care homes are included. With the festive period rapidly approaching, why was this not done months ago, and is it not just another example of the Government delivering too little, too late?

We have been testing and have prioritised testing in care homes going back as far as May, and we have been carrying out whole care home testing. We are now testing over 500,000 staff and residents in care homes every week. Now, as testing capacity increases, we are launching the visitor testing trial with 20 care homes across Hampshire, Devon and Cornwall. We will use the lessons from that trial to roll out testing more widely across the country as fast as we possibly can.

I am afraid the Government’s pilot scheme simply fails to understand the scale or urgency of the task. The average time someone spends in a care home before they pass away is two years, so after eight months of not being able to visit, families do not have a moment to lose. If the Government believe that weekly tests make it safe for care home staff to go to work, why not just do the same for families? Will the Minister now agree that a proportion of the 157,000 tests that are currently spare capacity every day will be ring-fenced for family visits so that we can safely bring all families back together in time for Christmas?

I absolutely want to enable relatives to go and visit their loved ones in care homes, but we have to remember that we are against a backdrop where covid is incredibly cruel to those living in care homes. We have seen outbreaks that have gone from one resident across to almost all residents within a few days, with staff also affected, so we have to get the balance right. We have to make sure that we do this in a way that is safe to residents and staff. That is why we are carrying out the trial to learn the lessons, so that we do it right and so we can then safely roll out testing and more visiting across the whole country.

Covid-19 Testing Pilot in Liverpool

What assessment his Department has made of the effectiveness of the whole city covid-19 testing pilot in Liverpool. (908875)

The Liverpool pilot will help to inform a blueprint of how mass testing can be achieved and how rapid testing can be delivered at scale. We are now making mass testing available right across the country.

I thank my right hon. Friend for his reply. May I ask him to agree to extend the pilot for rapid testing to the whole of Derbyshire and Derby to give the pilot real work to compare our semi-rural area with the urban area of Liverpool?

We are now issuing test kits to 84 directors of public health across the country. I am very happy to work with Derbyshire and Derby to make sure that my hon. Friend’s request is taken up and we can make this happen.

Covid-19 Vaccines: Distribution

On top of the positive news this week of two vaccines, a covid vaccine will be deployed only once it has met robust standards on safety, effectiveness and quality through clinical trials and been approved for use by the Medicines and Healthcare Products Regulatory Agency or an appropriate regulatory body. The Government have asked the NHS to be ready to deploy any safe, effective vaccine as soon as it is available. Distribution arrangements must be flexible and include the make-up of the workforce needed to rapidly deliver a vaccination programme, training requirements, consumables and any supporting infrastructure. The key point, though, is that the Government have been clear they will do everything they need to do to roll out a successful vaccine.

Does the Minister agree that it is going to be a mammoth logistical effort, not only to do a vaccination-style thing as we do every year with flu, but to include everybody? Also, it looks as though, in order for the vaccine to be effective, people might have to have two injections rather than one, which doubles the number. Can she give any view at this stage, given the logistical efforts that are going in, of how long it will take us to safely vaccinate everybody in the country?

First, I would like to place on record my enormous thanks to Liverpool and its local leadership for how it has helped us with repatriating from Wuhan and with the mass testing. I am sure that Liverpool will once again step to the fore with any help we might need with deploying the vaccine. We will deploy it as fast as possible, but there is a process. We have to know that it is safe, through the regulatory framework. We then have to know that as it arrives from the manufacturers, we can distribute it at pace. We are aiming to do that, and every sinew is being strained to ensure that we can deliver as swiftly as possible. The entire population wants to get on with living a normal, or more normal, life.

Covid-19: Care Home Residents

Sadly, covid is cruel to care home residents, and outbreaks are hard to prevent and control, especially when covid rates are high in the surrounding community. As we set out in our winter plan for adult social care, we have a regime of regular testing for staff and residents, we are supplying personal protective equipment to care homes, we have been offering training in infection prevention and control, backed up by Care Quality Commission inspections, and we are providing £1.1 billion to social care specifically to go towards the cost of infection prevention and control.

I know that my hon. Friend has already touched on this subject, but she will be aware that since April, many people have not been able to visit relatives and loved ones in care homes, so will she please tell the House again what is being done to improve testing and to roll out the flu vaccine to ensure that these visits can resume safely after the latest lockdown?

My hon. Friend is a great advocate for the care sector—for those who receive care and for the workforce—in Southend West. Yesterday we launched a trial of visitor testing, and we plan to offer this to care homes across the country during December. On his question about flu vaccinations, this year we are carrying out the biggest ever flu vaccination programme. So far, the majority of care home residents have been vaccinated, but there is further to go for care staff, and I urge any careworker who has yet to have their flu jab to ensure that they get it over the next few weeks.

Covid-19: Adult Social Care

What steps his Department is taking to support the adult social care sector during the covid-19 outbreak. (908885)

Our winter plan sets out what we are doing to support adult social care during the second wave of the pandemic, including supplying free PPE to meet social care’s covid needs across domiciliary care, day care services and personal assistance as well as in care homes, and includes a further £546 million of funding for the infection control fund, bringing the total we have provided to social care for infection control to £1.1 billion.

The new megalabs will open in 2021, one of which will be just down the road in Leamington Spa. This is very welcome news for the care sector in Stourbridge, which needs fast access to testing to carry out its amazing work, and let us not forget that these megalabs will bring thousands of jobs to the midlands. The UK is already No. 1 in Europe for testing capacity. With these new labs on stream, that capacity will double. Will my hon. Friend commit to prioritising the social care sector in this new capacity?

The answer to my hon. Friend’s question is yes. Adult social care has already been at the front of the queue for testing. Care homes in Stourbridge and across the country have had whole care home testing since May. We have now sent out more than 13 million test kits to care homes. Every week we are testing more than half a million staff and residents, with nearly 90% of results back within 72 hours. I will continue to make sure that social care is a priority, going beyond care homes to include domiciliary care and supported living as we increase testing capacity.

Covid-19 Autumn 2020 Lockdown: Newborn Babies

What steps his Department is taking to support the healthcare needs of newborn babies and their families during the autumn 2020 covid-19 lockdown. (908880)

What steps he is taking to support the healthcare needs of babies and families during the covid-19 outbreak. (908886)

The indirect impact of covid-19 has been significant for pregnant women and their young families. Support for families is a priority, and it means short-term and long-term harms can be prevented. Health visiting teams have continued to support and prioritise high-need families. We have also gone to great lengths to ensure that informal support networks that have been there in the past to support mothers and younger babies can remain and provide the support they were unable to give during the first wave.

I know that my hon. Friend is well aware of the desire of new families to return to face-to-face services as soon as is possible, but does she agree that the amazing work of so many in the early years sector to deliver online and digital services at this incredibly difficult time must not be lost? When we return to face-to-face services, we also therefore need to capture all the amazing learning on digital and make sure we can amplify support for new families in that way.

I absolutely agree with my right hon. Friend on that. First, may I pay tribute to her for the work she has undertaken throughout her career with families, parents and young babies, and on early years, particularly the first years of a child’s life? I am sure Members on both sides of the House are hugely anticipating and excited about receiving her review on early years and young families. She is right to say that using digital technologies has enhanced so many areas during the first lockdown and throughout our time with covid, not only in mental health, but with young families and children. In a way, it has been a catalyst whereby we have embraced technology in all areas across health service delivery. We are making sure that we continue to do that and we do not lose the moment.

Many low-income families have struggled to make ends meet during lockdown. Families with babies under one are entitled to Healthy Start vouchers of only £6.20 a week, which is not enough to buy any infant formula that I can find on the market. By contrast, Scotland’s equivalent provides £8.50 a week for Best Start foods. The all-party group on infant feeding and inequalities, which I chair, produced a report on the cost of infant formula in 2018. It recommended the uprating of Healthy Start vouchers, because the cost involved in buying formula means that families are watering down formula or feeding their babies unsafe alternatives. Will the Minister urgently consider uprating Healthy Start vouchers, to ensure that low-income families can claim their entitlement, because many do not?

Non-covid-19 Healthcare Treatment

What steps his Department is taking to support the provision of non-covid-19 healthcare treatment. (908881)

What steps his Department is taking to support the provision of non-covid-19 healthcare treatment. (908889)

The Government are supporting the NHS’s ambition to continue to restore elective services for non-covid patients, while of course recognising the pressure on services from covid-19 infection control, with September statistics showing services already restored to about 80% of last year’s levels. Some £2.9 billion of additional funding has been made available from 1 October to manage ongoing covid-19 pressures, alongside recovering non-covid activity levels.

I thank my hon. Friend for his response. Given the difficulties faced by the NHS because of covid-19, what considerations are being given to additional initiatives or the management of existing resources to address patient demand and break the backlog of non-covid-related treatments, such as diagnostic interventions for cancer?

The NHS is working hard to maintain elective activity as far as possible during the second wave with extra funding, as has been set out. As shown in published September data, hospitals are carrying out more than 1 million routine appointments and operations per week, with around three times the levels of elective patients admitted to hospitals than in April, with many hospitals innovating to get through their lists. For example, Buckinghamshire, Oxfordshire and West Berkshire sustainability and transformation partnership has set up additional bespoke cataract units to deliver services. In addition, we have been making use of independent sector sites to assist the NHS with almost 1 million NHS patient appointments taking place within those facilities.

One adverse consequence of the first lockdown was that many people failed to seek treatment because they were afraid of the virus, but due to good planning and hard work, the staff of the Norfolk and Norwich University Hospital are able to treat covid patients while still undertaking the normal work of the hospital. Does my hon. Friend agree that the people of Broadland should continue to seek medical assistance when they need it, confident in the knowledge that it will be provided in a covid-safe and effective manner?

I share my hon. Friend’s fulsome praise of the staff at Norfolk and Norwich University Hospital and the work that they are doing. They have a strong champion in him. Indeed, I pay tribute to all the health and social care staff who have worked so magnificently throughout the pandemic. I can wholeheartedly agree with everything he says. My right hon. Friend the Secretary of State has been clear throughout this pandemic that anyone who needs medical help should continue to seek it in the knowledge that they will be treated in a safe and effective manner appropriate to their needs. To put it bluntly, it is a case of help us to help you.

For cancer care, we are still dealing with the backlog from the first wave, but we are now hearing of treatments being cancelled during the second wave. Extremely vulnerable immuno-compromised cancer patients need covid-free wards and staff need regular testing. Similar backlogs to the first wave could be the difference between life and death. I ask this at every Health questions but am yet to receive a persuasive answer. What will the Government do differently in order to restore cancer services?

I am grateful to the shadow Minister, who always asks measured and sensible questions. He is right to ask that particular question, but I am very happy for him to raise with me any specific incidents of where urgent cancer care is being cancelled in the current situation. We have worked extremely hard, as has the NHS, to ensure that treatments such as that and emergency and urgent treatment can continue. He asked what we are doing differently. We have learned a huge amount, as has the whole country, over the past six to nine months. We have increased capacity in our hospitals, which is why, with the measures that we have taken, we can continue far more surgery and far more treatments, particularly cancer treatments, than we could in the first wave.

Unfortunately, we do finish at quarter past 12, so I will start topical questions, slightly late, with Steve McCabe.

Topical Questions

We are seeing major scientific advances that will help to get things back to normal. We are expanding mass testing with the two mega labs that will add another 600,000 to our daily testing capacity and, on vaccines, we have secured an initial agreement for 5 million doses of the very promising Moderna vaccine and begun clinical trials of the Janssen vaccine.

It is now 41 days since I asked the Secretary of State whether he would stop the clock so that no one seeking access to fertility treatment loses out because of delays due to the pandemic. When does he hope that his Department will get around to answering?

The provision of fertility services is happening in the normal way in as many places as possible across England, but it is not happening everywhere because of the huge pressures on the NHS from the second wave of covid. As my hon. Friend the Minister of State was saying a moment ago, there are pressures on the NHS. There are now 15,000 people in hospital with covid across the UK, but the NHS is doing far more normal services that it was not able to do in the first wave.

This morning, the Select Committee has been hearing about workforce burnout. Witness after witness said that the one thing that would make a big difference to NHS staff is knowing that we are training enough doctors and nurses for the future even if we do not have enough now. Nearly two years on from the NHS 10-year plan, we still do not have the workforce projections published—I know that the Secretary of State is keen to get them published. Can he assure the House that, when they are published, they will be the independent projections and not what the Treasury has negotiated with his Department as part of the spending review?

I am grateful to my right hon. Friend for that question. I can give him a couple of projections and a couple of facts. Over the past year, we have 13,500 more nurses in the NHS than we did a year ago, and thousands more doctors. Let me give him this projection, which I am sure that he and everybody on the Government Benches will buy into: we are going to have 50,000 more nurses in the NHS by the end of this Parliament.

Many of my constituents have taken part in the Liverpool mass testing pilots, but they need to know that the tests being used are accurate. Reports in The Times that suggest very high levels of both false positives and false negatives are deeply worrying, so can the Secretary of State tell us what steps he is taking to ensure that the tests being used in the mass testing are indeed accurate? (908926)

Yes; the lateral flow tests that are being used in Liverpool are accurate. They measure whether somebody is infectious and have a very high specificity. We publish all these statistics, having had them assessed at Porton Down in one of the best medical science units across the whole world, so I assure the hon. Gentleman—and, through him, his constituents —that the lateral flow tests have a quick turnaround and a high degree of accuracy regarding whether someone is infectious. I have not seen the reports to which he refers, but I assure him that the best thing that people can do if they are offered a test is to get one.

I was delighted when the Secretary of State came to visit the Yeatman Hospital in Sherborne at the end of last year, but my constituents in West Dorset are becoming increasingly concerned that the Yeatman Hospital’s minor injuries unit has been closed for too long. Will the Secretary of State confirm that the MIU will not be permanently closed, and that it will reopen at the first possible opportunity? (908925)

I am very happy to meet my hon. Friend and to discuss with him how we can strengthen the services that are available across Dorset, especially as the population is not as dense as in some other parts of the country. We need to ensure that we get services out into the community, rather than just in the big cities.

Our home care workers have gone above and beyond during the pandemic. Tragically, they are some of the lowest paid workers in the entire labour market. Does the Secretary of State agree that there is a role for local government, as the commissioners of home care services, in strengthening enforcement of national minimum wage legislation to ensure that no home care worker, anywhere, is not properly paid for travel time between visits? (908929)

As a proud supporter of the Conservative Government’s introduction of the national living wage, I am a big fan of the pay increases that we have seen for some of the lowest paid people in the country, such as some of those working in social care including the home care sector, about which the hon. Member speaks. National living wage legislation is not a “nice to have”; it is mandatory, and all employers must follow it.

I thank my right hon. Friend for his incredible hard work over recent months. I am delighted that Scunthorpe General Hospital has received significant funding, which will help with the short to medium-term pressures, but he knows that it is in need of a much more significant upgrade. When he is able to, will he meet me to discuss a way forward? (908927)

Yes; my hon. Friend has been a champion for Scunthorpe and for supporting Scunthorpe General Hospital. I am glad that we have been able to make an investment in that hospital, and I am happy to meet her to talk about what more we can do.

NHS Blood and Transplant has recently reported a dramatic reduction in some transplant operations. For example, living kidney donations are down three quarters on last year. What steps is the Department taking to ensure that patients who require an organ receive the life-saving operation that they so desperately need? (908930)

The hon. Gentleman and I share a passion for ensuring that organ donation is possible and is supported wherever it is needed. That is very close to my heart through personal experience—not mine, but that of a friend. The hon. Gentleman has raised this issue and driven a change in the law, and I am glad that the change in the law to an opt-out system has happened. However, during the first lockdown there was clearly a slowdown in the number of donations, and we do not want to see that. There are more services available in the second peak of this coronavirus crisis. I look forward to working with him and others to make sure that organ donation is as high as it possibly can be.

Royal Stoke University Hospital in my constituency has warned that the rising level of obesity is becoming an increasingly serious problem. With nearly one in seven adults considered obese in Stoke-on-Trent Central, does my right hon. Friend agree that tackling rising levels of obesity has never been more important for our public health and should remain a priority for our Government? (908928)

Yes, I do, and so does the Prime Minister. We feel very strongly about this. It is so important that we have the work across the country to tackle obesity; this has only been made more urgent because we know of the link between obesity and the risk of dying from covid. I look forward to working with my hon. Friend and others to make this happen.

York’s contact tracing work has proved to be incredibly effective, not just in its reach but in persuading people to isolate. However, it is not getting data through until around day five, when people are having a test, and it could be so much more effective if it had that data on day one. Will the Secretary of State look at York being a pilot for having immediate access to the data and the resources necessary to get on top of this virus and lock it down? (908934)

I am happy to work with the hon. Lady and the director of public health in York, and obviously with NHS Test and Trace, to make sure that the link-up is as effective as possible.

My right hon. Friend will be aware that nosocomial spread is high in the NHS and that transmission is sometimes via staff. In order to help the amazing teams at Royal Stoke University Hospital and the Hayward walk-in centre, will he give guidance that stops substantive staff working bank, agency and locum shifts in other hospitals, to help reduce transmissions? (908931)

I am very happy to look into that idea, while making sure, of course, that we also have the availability of staff, which is critical. We have just had two questions from Stoke-on-Trent. Let me say how much I appreciate the work of everybody at the Royal Stoke, who I know are doing so much. There are difficult circumstances there because of the second wave, which is quite significant in Stoke. I thank everybody at the Royal Stoke for all the work they are doing.

I was very pleased by the Secretary of State’s answer to me last week that the vaccine would be rolled out on a needs basis. As the House knows, I represent a vast and very remote constituency. What worries me is the thought of elderly and vulnerable constituents having to travel long distances to get the vaccine. Health is devolved in Scotland, of course, but what proposals does he have for England and Wales to take the vaccine to those people who are elderly and vulnerable, and will he share that methodology with the Scottish Government? (908940)

Yes, I would be happy to do that. We are proposing roving teams who can get out into rural communities across England. I know that there are ongoing discussions between those in the NHS in England and in Scotland who are responsible for the deployment of the vaccine. However, it is a critical principle that it should be deployed according to clinical need, not according to where people live across the United Kingdom.

Although covid has highlighted the value of our care workers, care remains generally low-paid, high-turnover employment. A route into nursing would give care workers more opportunity to progress and build a career. Would the Government consider fast-tracking a specialised training course for care workers seeking to go into nursing, which reflects the many transferable skills that they have? (908932)

I welcome the news that the Secretary of State has secured 5 million doses of the Moderna vaccine, totalling 355 million dosages for the UK. Does he agree that it is key to putting this virus back in its box, and that it is down to the willingness of the great British public to step forward and to voluntarily have this vaccine so that we can all move on? (908933)

Yes, that is right. A vaccine will be approved only if it is both effective and safe, so when your ticket comes up, if you are asked to take the vaccine, then I and the whole serious clinical establishment—all of those who understand the vaccines and the value of them —will be urging people right across the country to get it, because it is good for you, it protects your loved ones and it protects your community. It is the primary route, alongside other things like testing, by which we will get out of this and get life back more closely to normal.

I welcome the Government’s substantial investment in hospital services in my area. The Secretary of State knows that I remain disappointed that Epsom, was not the NHS’s choice of location— rather than Sutton—but will he assure me that as the NHS reviews the impact of the pandemic and looks at future capacity needs, he will keep an open mind if that decision needs to be changed, because in the end Epsom represents better value for the health service? (908935)

I appreciate my right hon. Friend’s tenacity and doggedness in making the case for Epsom. I am a big supporter of the decision that has been made, and I am afraid, from his point of view, that the final decision on the location of the new hospital—in Sutton—has now been made. However, I am always open-minded to what further health services can be deployed in Epsom itself, and I suggest that my right hon. Friend and I work together on that.

Rising infection rates in Dudley are extremely worrying. The launch of the third covid vaccine trial in the UK this week is excellent news and I pay tribute to the volunteers and researchers involved in the trials, but does my right hon. Friend agree that it is still early days, so it is vital that all of us continue to play our part in doing everything possible to bring down that infection rate, particularly in areas, like Dudley, where it continues to rise? (908936)

Yes. Vaccines could not be approved if there were not volunteers who were willing to take them and play their part. I want to end this session, if I may, with a tribute to my PPS, my hon. Friend the Member for St Austell and Newquay (Steve Double), who, along with some other Members of the House, is taking part in a vaccine trial, and therefore doing his bit to make vaccines available to help everybody across this country.

The Health Secretary will remember—his hon. Friend the Member for St Austell and Newquay (Steve Double) was there as well—that we had a really good meeting on 2 October about the link between covid and vitamin D. Since then the PM even said, two weeks ago, that good news is on the way. Will the Secretary of State update us on what is happening? The Government are meant to be getting rid of dither and delay. We could be like New Zealand; they have only had 16 deaths in care homes in the whole of this pandemic. What can he do?

Yes, we are making progress on that and working on the clinical protocols. I look forward to updating the hon. Lady with more information when a final decision has been made.

In order to aid the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the next, I suspend the House for three minutes.

Sitting suspended.