If he will make a statement on his departmental responsibilities. (912559)

Yesterday, the Government published the road map that will put us cautiously but, we hope, irreversibly on the path towards reclaiming our freedoms once more. We are able to take these steps because of the resolve of people across the UK and the extraordinary success in vaccinating more than 17.7 million people—one in every three adults across the UK—and I would like to pay tribute to everyone who has played their part.

This coming Sunday is Rare Disease Day 2021. One in 17 people in the UK will be affected by a rare disease, and today people with PKU—phenylketonuria—are awaiting the outcome of a NICE appraisal of Kuvan, but 12 years waiting for Kuvan or other treatments is too long. Does the Secretary of State agree that our rare disease community deserves access to early diagnosis and treatment, and what will he do to make sure that this happens?

The hon. Lady is a long-standing and passionate campaigner for Kuvan, and I pay tribute to the work that she has done. The NICE methods review looks at the question she raises. It is important that we have a clinically led process for approval of medicines, and I know she agrees with that. The question is ensuring that the details live up to that principle. The methods review will make sure that we take advantage of advances in medical technology, which will, I hope, allow us to bring drugs and treatments to patients of rare diseases who need them more quickly than in the past.

Can I add my support to the previous question about the urgent need to sort out the issue of Kuvan, because I too have constituents suffering very badly from the long wait that they have had?

I wanted to talk to the Secretary of State about support for NHS frontline staff, who have done such a magnificent job this year but worry that, even now, we are not training enough doctors and nurses for the long-term needs of the NHS, and that is the crucial way that we will reduce the pressure on them. Will he be publishing a workforce plan this year, will that have independent projections of the number of doctors and nurses the NHS will need in every specialty over the next couple of decades, and will he commit to funding the number of training places that we need to make sure that we meet those needs of the future?

The good news is that, thanks in part to the work that my right hon. Friend did when he was in my shoes, we now have a record number of doctors in the NHS, and he will have been as pleased as I was to see the record number of applicants to nursing places as well, because we need both more doctors and more nurses. I am delighted that, during the pandemic, we have increased numbers very substantially. We are on track to meet our manifesto commitment to 50,000 more nurses, and we have seen a significant increase—just under 10,000—in the number of doctors too, so there is significant progress. Of course there is more to be done, and of course we will need to set out the route to that, as he suggests. The time is not quite right now, because there are still very urgent needs and pressures, thanks to the pandemic—I am sure that he and the Select Committee understand that—but this is undoubtedly a question that we will return to.

Everybody knows—apart from the Secretary of State, it seems, from this morning’s media—that there were PPE shortages. The National Audit Office reported on it, we saw nurses resorting to bin bags and curtains for makeshift PPE, hundreds of NHS staff died, and his response was to pay a pest control firm £59 million for 25 million masks that could not be used, to pay a hedge fund based in Mauritius £252 million, again for facemasks that were inadequate, and to pay a jeweller in Florida £70 million for gowns that could not be used. Will he take this opportunity to apologise, and will he commit to recovering every penny piece of taxpayers’ money from those companies that provided us with duff PPE?

Well, I am going to start by congratulating the hon. Gentleman—the right hon. Gentleman—on his appointment to the Privy Council. I appreciate the work that he has done in support of the Government and in support of the nation during this pandemic. Although occasionally he turns to rhetoric and narrow questions that he knows there are perfectly adequate answers to, he has generally during this pandemic, in the face of temptation—I mean this very genuinely—done the right thing and supported the right messages to people where they need to be made across party lines. So I congratulate him and thank him for that.

On the specifics of the question the right hon. Gentleman raised, of course, where a contract is not delivered against, we do not intend to pay taxpayers’ money, but of course, also, we wanted to make sure that we got as much PPE as we could into the country. While of course there were individual instances that we all know about and that highlight how important it was to buy PPE, there was, as the National Audit Office has confirmed, no shortage at the national level, and that was because of the incredible work of my team and the amount of effort they put into securing the PPE and doing the right thing.

I dare say the Secretary of State has just finished off my political career with that praise but, on the substance of the point, I think he confirmed that he will—[Interruption.] When did it start? [Laughter.] I think he was saying in that answer that he will not be trying to recover money that he has paid out for duff PPE, but can I ask him about a different issue, which again comes down to public scrutiny and accountability? In London, a week or a week and a half ago, GP services with 375,000 patients were taken over by the US health insurance corporation Centene. There was no patient consultation; there was no public scrutiny. This is arguably a stealth privatisation, with huge implications for patient care. Will he step in, halt the transfer, ensure it is fully scrutinised and prevent takeovers like this happening in the future?

On the right hon. Gentleman’s first point, such a reasonable and sensible man is, of course, always welcome on these Benches, and I might ask, since his wife is taking the Labour party to court: why doesn’t the whole Ashworth family come and join us on this side?

On the substantive point the right hon. Gentleman raises, of course what matters for patients is the quality of patient care. We have seen again and again, especially throughout the pandemic, that what matters to people is the quality of care. That is what we should look out for, and that is, I know, what doctors, nurses and other staff, in primary care and right across the board, are working so hard to deliver on.

My right hon. Friend will be aware that the Airedale hospital in my constituency is now over 50 years old and 83% of the building is constructed from aerated concrete, which is known for its structural deficiencies. It is great news that this Conservative Government will commit to funding eight new hospitals in addition to the 40, but may I make an urgent plea to my right hon. Friend that the Airedale hospital, given its high-risk profile, is considered as one of the final eight? (912560)

I think my hon. Friend has just made his heartfelt plea and it has certainly landed with me, but I am not surprised because he has made this case to me on behalf of his constituents over and over again and he is quite right to. We are in the process of considering which hospitals will be in the eight additional, on top of the 40 that we committed to in our manifesto. I am grateful for his representations and we will certainly consider Airedale and its full needs for the local community.

I wonder whether the Health Secretary would agree with me that coronavirus has not only changed many of the ways that we have to do our lives, but it is fundamentally going to have to change the whole structure of the NHS for the future. That means we are going to have to recruit more pathologists in this country for ourselves; we are going to have to have far more intensive care unit capacity; we are going to have to have UK manufacture not only of PPE but of vaccines if we are to be able to be self-reliant; we are going to have to have much better long-term rehabilitation for people with brain injuries; and we are going to have to have a complete review of our care homes, aren’t we? (912562)

We will need to draw many lessons from the pandemic. For instance, my brilliant team who have done all this procurement of PPE have also built an onshore PPE manufacturing capability. With regard to almost all items of PPE, 70% of it is now made onshore in the UK, up from about 2% before the pandemic. Likewise for vaccines—we did not have large-scale vaccine manufacture and we now do—and for a host of other areas, including some of those that the hon. Gentleman mentioned.

With regard to the recent court ruling on the issuing of PPE contracts, will my right hon. Friend confirm that, as a result of the action taken by Health Department officials, NHS trusts did receive vital PPE, despite there being a global shortage? (912561)

My hon. Friend is absolutely right. The court ruling in question found that we were on average 17 days late with the paperwork, but it did not find against any of the individual contracts. My team worked so hard to deliver the PPE that was needed and so, as the National Audit Office has confirmed and as my hon. Friend set out, there was never a point at which there was a national shortage. There were, of course, localised challenges and we were in the situation of a huge increase in global demand, but I think that we should all thank the civil servants who did such a good job.

The Prime Minister’s first test for easing restrictions is that the vaccine deployment continues successfully, yet GPs and pharmacists have been telling me for weeks and weeks and weeks in St Albans that they cannot get the vaccine supply that they desperately need. They could be vaccinating 14,000 people a week, but they are only getting the supplies for 1,000. Why is that and when will it be fixed? (912568)

As we have repeatedly explained, supply is the rate-limiting factor. The hon. Member will no doubt have seen that there have been international discussions on the rate of supply, and countries around the world are finding supply the rate-limiting factor. Thankfully, thanks to the decisions that this Government took early, we have some of the best access to the supply of vaccine in the world. That is why we have one of the best vaccine delivery programmes in the world.

I congratulate my right hon. Friend again on the progress of the vaccination process. He should be proud of what he has achieved. The documents published yesterday about the road map did not appear to contain any assessment of the infection risk in individual settings, which could have demonstrated that there had been carefully informed decisions about the reasons for each individual restriction. Has that work been carried out? If so, will my right hon. Friend commit to publishing those assessments immediately? (912563)

Of course we assess this, but it is challenging to get to a statistical answer to the question that my right hon. Friend raises. When we have taken action to restrict access to areas where there is evidence of significant transmission, such as the hospitality industry, that confounds the statistical analysis because people cannot go into that environment and therefore the passing on of infection there is reduced. This is a matter of evidence and judgment. It is a significant challenge, but the road map is based on our best assessment of the situation, which is based on clinical advice, including the focus on the fact that we know that outdoors is safer than indoors. Hence the early steps, after schools, are focused on opening things up outdoors.

Opening up by date and not data, as described by the Prime Minister yesterday, will allow prevalence in the general population to continue, unfortunately increasing the number of people affected by long covid. What discussions has the Secretary of State had with the Secretary of State for Work and Pensions to ensure that proper financial support is available for those afflicted by long covid, including a continued £20 a week uplift of universal credit? (912572)

Of course long covid is an incredibly serious condition for some and is part of our considerations and deliberations, but I want to correct something the hon. Member said. The road map sets out indicative dates before which we will not move, but we will be guided by the data, hence the five-week gaps between each step to make sure we have four weeks to see the impact of the step and one week of advance notice for the go/no-go decision. That is based on clinical advice, which I know is shared across the UK.

I am delighted that many carers are in priority group 6, given the enormous and vital role they are playing during the pandemic. Recently, I led an initiative to help my local county council identify carers—and unpaid carers—around Norfolk as many are not on official registers. Will my right hon. Friend tell me how he is working with Norfolk County Council and all local authorities to ensure that those difficult-to-find carers are not missed in the call to be vaccinated? (912564)

I pay tribute to my hon. Friend’s work in making sure that all carers, who are properly in priority group 6, get the opportunity to be vaccinated, including those who may be unregistered, but nevertheless are carers. It is very important and I pay tribute to the work of Norfolk County Council. I know that my hon. Friend the Care Minister will be happy to meet my hon. Friend and the county council to discuss what further can be done.

Let us head to Dr Rupa Huq for our final question. I am sorry about this, but we have taken a long time to get to this stage.

It is pleasing that anti-vax propagandising has been clamped down on, but long predating covid, on a daily basis, women seeking to access abortion clinics have faced anti-choicers. When they are on a 40-day running Lent protest. Will the Secretary of State work with Ministers across Government to ensure that no woman ever feels harassed or intimidated when obtaining medical care that she is legally entitled to? (912573)

I am very happy to take up that proposal. Nobody should be harassed when accessing any medical treatment. There are agreed rules around abortion and people should be able to access abortion properly, according to those rules.

I am suspending the House to enable the necessary arrangements to be made for the next business.