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Oral Answers to Questions

Volume 692: debated on Tuesday 13 April 2021

Health and Social Care

The Secretary of State was asked—

Health Service Capital Estate

In our election manifesto, we committed to building 40 new hospitals by 2030 and upgrading another 20 hospitals. We are delivering on that commitment and now have plans to build 48 new hospitals this decade. We will open a competition for the eight further new hospitals shortly.

I thank my right hon. Friend for the investment that we have seen in Scunthorpe General Hospital over the last year. Residents are seeing those changes and it will certainly help us in the medium term. Looking to the future, will he continue to work with me on the plans for a new hospital for Scunthorpe?

I thank everybody who is working at Scunthorpe General Hospital for their incredible effort over the last year. My hon. Friend has been an assiduous campaigner for Scunthorpe hospital and the upgrades that we have already been able to put money into, and now there are eight slots for further new hospitals. Forty have been announced and we will build eight more over this decade. We will shortly announce how we are going to make that decision. There will be an open process and I look forward to working with her, her colleagues and colleagues across the NHS in Lincolnshire to make sure that they can put together the best possible application.

I would like to take this opportunity to thank the Government for investing in mental health facilities at Heartlands Hospital and acute facilities at the Royal Stoke University Hospital. Together, this will see over £32 million being invested in our local NHS, so would my right hon. Friend agree that it is more important than ever, as our NHS starts to recover from the pandemic, that we provide the best possible health facilities?

Yes, I would. The NHS has clearly played such a critical part in the response to the pandemic in the last just over a year. I thank all those working in and around Stoke, including at the Royal Stoke, which is a great hospital. We have put £32 million into the local NHS, and we protected the NHS even through the worst challenges of this pandemic. Of course, I will be open to further investment to make sure that the NHS across Stoke gets the support that it needs so that we can build back better. Today, we are all able to see the improvements that are being made in the response to the covid pandemic, with the opening yesterday of step 2 —I am delighted, Mr Speaker, to see that you have had a haircut. So many of us have been looking forward to being able to get life back to normal, and thanks to the work of people across Stoke and across the nation, we are able to take these steps.

Congratulations to Mrs Hoyle on a job well done.

New investment is welcome, but it is no consolation to those patients missing out because the rest of the NHS estate is being starved of investment. We have seen a 23% increase in treatments being delayed or cancelled in the last year because of infrastructure failures, and the maintenance backlog went up by another 50% last year. We are not going to see those record waiting lists drop if operations are cancelled because basic repairs are not done, so will the Secretary of State tell us by what date we will see no more delays to treatment because of crumbling buildings?

We are putting a record amount of investment into the infrastructure of the NHS. That is evidenced by the questions that we have had already, with the improvements in Stoke, Scunthorpe and across the rest of the country. It is about not just the physical investment, but making sure that we support staff to be able to deliver and making sure that the NHS gets the support that it needs to tackle this backlog. We have a very significant backlog because of the pandemic and we are working incredibly hard to tackle it.

Covid-19 Vaccine Roll-out

What assessment he has made of the progress of covid-19 vaccine roll-out among the UK adult population. (914190)

First, I would like to pay tribute to our fantastic NHS and all the frontline vaccinators, our volunteers, armed forces and local authorities and all those working on the vaccine deployment programme. I am very grateful for their tireless efforts in vaccinating those most at risk across the country.

I am absolutely delighted, Mr Speaker—no haircut puns at all here—that another significant milestone has been reached, as we have met our target of offering a vaccine to those in cohorts 1 to 9 ahead of schedule. Over 32 million people have had their first dose and more than 7.6 million have had their second dose. We are making phenomenal progress, but we remain focused on ensuring that no one gets left behind.

Last week I became one of those people who had their first jab, at Boots the chemist in Nottingham. Will my hon. Friend join me in thanking all those in places such as Boots and all those involved in the roll-out of the Pfizer-BioNTech, Oxford-AstraZeneca and Moderna vaccines? Does he agree that the best way out of this situation is to get that jab, and that when the time comes and people get the call, they should take that opportunity as soon as they can?

I absolutely agree with my hon. Friend, and I thank Boots the chemist not only for its frontline capability but for its distribution arm, which has helped us to distribute Pfizer-BioNTech, Oxford-AstraZeneca and, now, Moderna. I agree that when people get the call, they should come forward and have their jab.

I welcome today’s news that the over-45s are being invited to receive their first dose of the vaccine, and I thank everyone in Carshalton and Wallington who is involved in the roll-out. I recently held a vaccine roundtable with NHS leaders in Carshalton and Wallington to encourage everyone, including ethnic minority groups, to come forward and get the vaccine when their time comes. Could my hon. Friend update the House on what steps the Government are taking to work with community leaders and others to ensure that every part of our community comes forward and gets the vaccine?

I am grateful to my hon. Friend, and I echo his comments about the incredible work that is happening across the London borough of Sutton. I thank him for his work in promoting the vaccine, and according to the latest NHS figures almost 90,000 individuals have had their first dose of covid-19 vaccine in Sutton. To this end we are working closely with faith and community leaders to help to spread information about vaccines through trusted, familiar voices and in a range of different languages and settings. That also means leveraging the influence of celebrity figures such as Sir Lenny Henry and the powerful and incredibly moving “call to action” letter and video to black and Afro-Caribbean communities. This is really important. We are also working to support the vaccine programme over important religious observances such as Ramadan, which begins today. We are working with the Muslim community and reiterating the verdict of Islamic scholars and key Muslim figures within the NHS that the vaccine does not break the fast and is permissible, so come and get your vaccine.

Covid-19: Cardiopulmonary Resuscitation

What assessment he has made of the use of do not attempt cardiopulmonary resuscitation orders during the covid-19 outbreak. (914192)

In October 2020, I commissioned the Care Quality Commission to review how do not attempt cardiopulmonary resuscitation decisions were taken throughout the covid-19 pandemic and whether they had been inappropriately applied. We welcome the CQC report, which was published on 18 March, and we are committed to driving forward delivery of the recommendations through a ministerial oversight group, which I will chair, to ultimately ensure that everyone experiences the compassionate care that they deserve.

I welcome the Minister’s comments. It is over a decade since I worked with clinicians on how to communicate end-of-life care, so I was shocked by some of the reports and by reading the CQC and Compassion in Dying reports. The lessons learned from coronavirus can and should be seen as a catalyst to having more open and honest conversations about this decision making and advanced care planning. Will the Minister commit to a public awareness campaign, including groups such as Compassion in Dying, Marie Curie and Hospice UK, to ensure that patients are fully aware and at the heart of these decisions?

I thank the hon. Lady for her question. That is exactly what we are trying to do at the moment. We have posted a public-facing message on the nhs.uk website, which informs the public about how DNACPR decisions should be taken and the process involved. There should be no blanket application of DNACPR notices. Every patient should be involved in the decision when a notice is applied, as well as the family, relatives and care workers, and where possible it should be signed by a clinician. This engagement with the NHS, the wider public and the voluntary and care sectors is ongoing, and we continue to monitor it.

Health and Social Care Integration

We want health and social care to be joined up effectively, with the different parts of our system working together to meet people’s needs. The health and care White Paper sets out our plans for integrated care systems, which will not only join up local NHS organisations but strengthen collaboration among the health service, local authorities and others involved in social care.

One thing that will really help the integration of health and social care is the better use of technology and innovation, but one of the barriers we face is the sharing of information among different clinicians, general practitioners, hospitals and social care settings, so will my hon. Friend confirm that as part of the plans for better integration we are looking at how data and information can be shared much more effectively?

My hon. Friend is absolutely right: interoperability is essential to harness the potential benefits of health and care data for individuals and to create a health and care system that is fit for the future. We are going to legislate to ensure more effective data sharing across the health and care system and will outline our plans in the upcoming data strategy for health and social care.

Despite the incredible challenges of the past year, neither the Government’s White Paper nor the Budget even mentioned social care. Health and care integration has been progressing in Scotland since 2014, and the Scottish Government have committed to developing a national care service and ensuring equity throughout Scotland; will the Minister make such a commitment for England?

Actually, I have to disagree with the hon. Member: the White Paper does mention social care and includes several steps on the path to the reform of social care. We will bring forward further information about social care reforms later this year.

Integration and service improvement cannot be delivered without sufficient social care staff. The Scottish Government already fund the real living wage for social care staff in Scotland, have included them in the £500 thank-you bonus, and plan to standardise pay and training. Does the Minister not recognise that the only way to attract people to build a career in social care is by valuing care staff?

I agree with the hon. Member that it is essential that we value social care staff. Just as we have valued NHS staff during the pandemic, so we have rightly recognised the vital contribution of the social care workforce. We must continue to value our social care workforce, for which we plan to bring forward proposals as part of our social care reforms.

Local Health Services: Consultation

What steps he is taking to ensure patients are consulted on the provision of their local health services. (914194)

The Government are committed to putting patients at the centre of our health service. Patients are consulted on their local health services in a wide variety of contexts, including through Healthwatch England, the independent national champion for patients. When a major or substantial reconfiguration or change to services is proposed, the local clinical commissioning group is legally required to hold a consultation with local people.

I wrote to the Secretary of State for Health and Social Care about this issue a month ago. Last December, amid the pandemic, Birmingham and Solihull clinical commissioning group decided to close Goodrest Croft GP surgery—which has more than 6,000 patients—in my constituency. The CCG did not consult anyone because apparently it is not required to do so. Does the Minister find that acceptable?

Although I am not familiar with the detail of the specific local case the hon. Gentleman raises, I am happy to meet him to discuss it if that is helpful to him.

Breast Cancer Diagnosis Data

What proportion of NHS trusts are in compliance with the requirement to collect data on all new diagnoses of recurrent and metastatic breast cancer. (914195)

The National Cancer Registration and Analysis Service works closely with hospital trusts to determine sources of data that can be used to complete the cancer outcomes and services dataset. It also works with the software suppliers of cancer-management systems to ensure that data items can be recorded. Compliance with data standards is monitored by local CCGs, but I recognise that that is not enough, as data is incomplete after some eight years.

Currently, women with metastatic breast cancer are counted only when they die. That is despite the fact that, since 2013, it has been mandatory for trusts to collect data such as the number of women involved, how long they have survived and whether there are any health inequalities. It cannot be acceptable to count only the dead, not the living. Will the Minister commit to ensuring that the 2013 mandatory requirement to collect data on women with metastatic breast cancer is enforced?

Yes. As I explained in my earlier answer, one of the challenges is that there is not a consistent way of capturing the data. We need to sort that out: we need to make it simple; we need to make people understand what data we are collecting; and we need to make sure that, for both breast cancer patients and all metastatic cancer patients, we know where they are and that we are helping them with this disease as effectively as we can.

Covid-19: Bereavement Services

The Government recognise that the effects of covid-19 have increased the demand for bereavement services and highlighted the complexity of grief that these services support. In response, since March 2020, we have given more than £10.2 million to support mental health charities, including bereavement services, to support adults and children struggling with mental wellbeing due to the impact of covid-19.

Last year, along with the Co-operative party, I called for a proper plan for bereavement to ensure that everyone who has experienced loss during this difficult period has the support that they need. Awareness of the services available is vital if people are to get this help. The Good Grief Trust, with which I have been in contact, has said that too many people simply do not know where to turn. What steps is the Minister taking to help signpost families to bereavement charities and support and to increase awareness of the support available to families in need, which also includes support that can be signposted from hospitals when loved ones die?

I thank the hon. Lady for her important question. The mental health and wellbeing recovery action plan published on 27 March this year aims to respond to the impact of the pandemic on people’s mental health, specifically targeting groups that have been most impacted. She mentioned the Good Grief Trust, and I mentioned the £10.2 million of funding that we have allocated recently. That is on top of the £2.3 billion a year for general mental health, which includes bereavement counselling, and the £500 million additional spending that we received in the spending review. Some of that money did go to the Good Grief Trust, which has done a fantastic job. It has been signposting services by putting cards in doctors’ surgeries and in A&E departments in hospitals so that people have immediate access to a line, but there are 700 other charities across the UK that are providing bereavement and grief counselling services to many members of the public. We recognise that the demand is high, but the services are there and available.

With your permission, Mr Speaker, I will pay a tribute to my father, Mohammad Aslam Khan, who passed away a few days ago. Not only was he a keen cricketer and an amazing dancer, he was also a champion of equality. He was incredibly strong and brave until his very last breath and he shall be missed beyond measure. I extend a huge thank you to all the team at St George’s, especially the marvellous team on Dalby ward, also to Victor and the incredible staff and carers at Ronald Gibson House and to a wonderful nurse called Anne Wheeler. My brother and I saw at first hand that not all angels have wings.

Covid-19 has stripped the humanity out of grieving, with millions being unable to attend funerals, say final goodbyes, or be with loved ones following a death. Last year, the Government provided £10.2 million to mental health organisations to ensure that services could continue during the pandemic. Many people have been relying on the support of dedicated bereavement organisations to help them cope, yet the extra financial support ended on 1 April. Will the Minister please consider reviewing this vital funding immediately to ensure that no one has to go through bereavement alone?

I pay tribute to my hon. Friend and her brave words about her much missed father. Politics divides us, but grief, for many reasons, unites us across this House. I have personally declared to my hon. Friend that I am here should she need me. I pay tribute to her for her bravery, being here today so soon after the loss of her wonderful father. I hear her request; it is constantly under review. Bereavement services are incredibly important to me personally and to many of us. She mentioned the £10.2 million. There are 700 bereavement charities, including the Good Grief Trust. We monitor carefully how people access bereavement services. We know that there is an increased need at the moment and that is being watched very carefully. My hon. Friend is incredibly brave.

Long Covid

We are continuing to work with the NHS and the wider scientific community to understand better the long-lasting effects of covid-19 infection and the potential treatments. We are committed to supporting patients suffering from long covid. Specialist NHS assessment services have opened across England, and the “Your COVID Recovery” website contains support and provides a personalised programme for people recovering from covid-19, following a clinical consultation. More than £30 million of funding has already been committed to research projects and a further £20 million was made available on 25 March.

I pay tribute to all NHS and military staff who are administering vaccines across the UK, including to my mum and dad last week. The Minister knows of the debilitating and lasting effects of long covid. She has just outlined the funding elements that she proposes to put forward. Will she tell us whether she might set up a specific taskforce to look at more research into the damage that long covid causes and the effects that it has on so many people?

We are already taking strong action in this area; we have already worked hard and are taking long covid seriously. We are listening to patients, taking a patient-first approach, working with the NHS and the wider scientific community, and engaging with the Royal College of General Practitioners to better understand the disease, which is physiological and neurological. It is different for different people, and therefore treatments need to be different for different people. We are working on ensuring that we have the best post-covid assessment care and the best pathways.

Covid-19 Vaccine Roll-out: Scotland

The covid-19 vaccination programme has been the biggest in the history of the United Kingdom. The UK Government have ensured that the excellent work done by the vaccines taskforce to procure vaccines for the whole country has been rolled out to protect people across the UK. To support the roll-out in Scotland, I recently announced an additional £660 million of UK Government funding for Scotland. That is of course on top of the £3.6 billion that Scotland is already receiving over the next financial year through the Barnett formula.

I thank my right hon. Friend for his answer. Does he agree that this is proof of the irrefutable truth that we achieve much more together than we ever could apart and that we should be focusing on the vaccination roll-out and recovery—not a damaging and divisive second referendum on Scottish independence, which would be the case if the Scottish National party won the Scottish election on 6 May?

I entirely agree that the vaccination programme has clearly been a huge UK success story and that is because of the UK working together: the NHS across the whole UK; the military working in support across the UK; and, of course, the UK Government working with the devolved authorities and local councils. It is a big team effort. To split and separate out this team effort for no good reason would, in my view, be counterproductive to improving the lives of people across the whole country. We should be working together, not pursuing separation.

Online Junk Food Advertising

What steps he plans to take to ensure a level playing field between online and mainstream broadcasters in the implementation of the proposed advertisement ban on foods high in fat, sugar and salt before 9 pm. (914213)

We have made clear our intention to end the advertising of high fat, salt and sugar products on television before 9 pm. We recently held a short consultation on how to introduce advertising restrictions for online and we will publish our response soon. A level playing field, however, is important. I want to make it easy for everyone to be healthy.

Does the Minister agree that ending junk food marketing online is hardly an outrageous assault on our freedoms, would remove 12.5 billion calories a year from children’s diets, and would allow advertisers and food companies to make plenty of money from producing and marketing healthy food?

Indeed I do. We are not banning food. It is very important that we make the environment right to ensure that people can make the healthy choice as a default option and enjoy a healthy balanced diet where they have the full knowledge and understanding of what they are purchasing. I think this is actually a great opportunity for companies.

May I send my deepest condolences, thoughts and prayers to the hon. Member for Tooting (Dr Allin-Khan) and her family?

It is good to hear the Minister say that there will be a level playing field in this area, but it has been reported on national media over the past few weeks that the Government seem to be dropping plans to ban ads online for foods high in fat, sugar and salt. On that basis, surely she will agree that when half of 10-year-olds and 83% of 12 to 15-year-olds own a smartphone, with 86% of those children using video on demand, it would be absolute nonsense to ban advertising on mainstream broadcast TV where children watch very little.

I agree that making sure that there is a level playing field is the right thing to do. If we were currently doing so well, we would not have the number of children and young people overweight or living with obesity, so we must work on making sure that we do everything we can so that every child can be a healthy weight. But my hon. Friend will not get me to pre-empt the consultation that we will be reporting on shortly.

Social Care Sector: Pay and Conditions

What steps he is taking to increase pay and improve working conditions in the social care sector. (914200)

We recognise the extraordinary commitment and compassion of social care staff, especially during the pandemic. While the Government do not have direct responsibility for pay in adult social care in England, we want care providers to reward and support their staff appropriately for the vital work they do. During the pandemic we have asked care providers to pay staff full pay when they need to self-isolate and provided over £1.4 billion of extra funding to support the cost of this and other infection control measures.

First, I imagine the whole House will join me in mourning the 364 care workers who have died in public service since covid began. Many care workers have told me that they feel undervalued by the fact that their average salary is only £17,200. I am sure there are very few Ministers who could live on that kind of salary. They particularly feel devalued when they discover that the Government are paying nine times that salary equivalent to Test and Trace consultants. It is an outrage. Will the Minister now say how she will show that these people are valued by doing three things: first, end privatisation; secondly, insist on a proper salary rise; and thirdly, ensure that a professional career structure is instituted which recognises and rewards the professionalism, talent and commitment of these essential workers?

I share the hon. Gentleman’s sorrow for the lives that have been lost among the health and social care workforce during the pandemic. I am determined that we will support and continue to support our health and social care workforce through these difficult times. One of the things that I want to achieve for our social care workforce, for whom I am truly ambitious, is that rather than doing something one-off for the pandemic, we should come up with a workforce strategy that will improve the opportunities for those working in social care to develop their careers, with a real career progression in working in that sector. That will be part of our social care reform proposals.

Despite repeated promises, the truth is that someone would be better off stacking shelves at Morrisons than caring for older or disabled people, and that is simply not good enough for our country. Can the Minister confirm that the Government’s covid infection control fund had to be used to improve pay so that staff did not have to work for more than one care home and could actually afford to self-isolate? If that is the case, will she commit to permanently enshrining these improvements across the sector to keep all care users and all care workers safe?

In response to the hon. Lady’s question about the use of the infection control fund, it was available to providers to use in a range of ways to keep their residents safe from covid, including, for instance, reducing the movement of staff between one care home and another, which is often part of the service model of how care is provided, and also, as I mentioned earlier, funding full sick pay for staff who needed to self-isolate because of covid. I am determined that as part of our social care reforms that we will be bringing forward, we will look at how best we can support the workforce.

Independent Medicines and Medical Devices Safety Review

What progress he has made on implementing the recommendations of the independent medicines and medical devices safety review. (914201)

A written ministerial statement was published on 11 January 2021, updating Parliament on the Government’s current progress on each of the nine recommendations. The Government will respond in full to the report later this year. It took more than two years to produce the report and we therefore consider it vital, for the sake of patients and especially those who have suffered greatly, to give this independent report the full consideration it deserves.

Baroness Cumberlege’s respected report makes it clear that those harmed by sodium valproate have suffered great and irreparable harm for many decades and that redress is needed. The patient reference group adds more delay for people who have waited long enough already. Will my hon. Friend commit to doing the right thing today and take up this issue of redress and give those harmed the support they have waited so long for?

I would like first to convey my most sincere sympathies to anyone who has suffered as a consequence of taking sodium valproate during pregnancy. It remains still the only drug that some women who suffer from epilepsy can take to control their epilepsy. As set out in the recent written ministerial statement, the Government will carefully consider the recommendations and make a full response to the whole report later this year.

Recruitment of NHS Nurses

NHS nurses have gone above and beyond throughout the pandemic. We are committed to increasing the number of nurses in the NHS by 50,000 over this Parliament through improving retention and increasing domestic supply and international recruitment, and we are on track to do that. The number of nurses in the NHS is at an all-time high of 301,491 full-time equivalent nurses employed in NHS trusts and CCGs.

We all know how hard our NHS nurses have had to work in the past year, many without a break and, for those with international origins, without seeing their families either. As public focus inevitably turns towards the NHS backlog, can Ministers assure me that they will work with NHS England to protect staff holidays and enable and encourage NHS staff to get the rest and recuperation they need?

I completely agree with my hon. Friend that staff must be allowed and supported to recover from the pandemic. We have advised NHS Employers to make sure that staff can carry over annual leave. We are determined that the pace of NHS recovery must also allow staff the rest and recuperation they need.

Health-Related Manufacturers

What steps he is taking to encourage health-related manufacturers to base themselves in the UK. (914204)

The UK is one of the best places in the world to locate a life sciences business. We are making vaccines in Livingston, Wrexham, Oxford and Hartlepool. We are making cell and gene therapies in Stevenage, surgical robots in Cambridge, cancer medicines in Macclesfield, hip replacements in Leeds and care products in Hull. Last week, we announced another £20 million fund to incentivise companies to put medicines and diagnostics manufacturing investments here in the UK.

Some people have very short memories, I must say. The UK was found desperately wanting when this horrid covid-19 pandemic swept through the cities, towns and villages of this country. The nation’s silverware was sold off and the stock cupboards laid bare. There was a deliberate policy of under-investment in the NHS, with a view to buying everything on the cheap from elsewhere. This was an ideological crime. What steps are the Government taking to ensure that we are never again left without the capacity to produce essential health and safety equipment, and how might a real industrial strategy aid the need to produce personal protective equipment, to bring good, well-paid jobs to long held back communities like Wansbeck here in the north-east?

There might be a meeting of minds between the hon. Gentleman and me. Over the last year, we have developed the capacity to produce 70% of the country’s PPE needs here in the UK. We set that target last summer. We met it at Christmas for all different types of PPE, with the exception of gloves, but we keep working on bringing glove manufacturing onshore. As I said in my response, we have built a huge amount of pharmaceutical manufacturing capacity here in the UK, and there is a lot more to come.

Brain Tumours: NIHR Research Grants

What discussions he has had with the National Institute for Health Research on increasing the number of research grants for the treatment of brain tumours. (914207)

It is essential that we increase the amount of research to treat brain tumours, which is why in 2018, through the NIHR, the Government announced £40 million over five years for brain tumour research as part of the Tessa Jowell Brain Cancer Mission to increase the number of applications and grants allocated. The NIHR released a highlight notice that encourages collaborative applications to build on recent initiatives and investment already made in this area, as well as working with the Tessa Jowell Brain Cancer Mission to fund workshops for previously unsuccessful researchers in order to support them in submitting higher-quality applications.

Like many across the country, my constituent Greg has a family member with a brain tumour; in his case, it is his young nephew. The £40 million of funding is certainly welcome, but only £6 million of it has been delivered, and there are still difficulties for those trying to get grants for this urgently needed research. Will the Minister commit to taking a more proactive approach to this—for example, by ensuring that brain tumour experts sit on the grant panels for research bids?

I thank the hon. Lady and would like to extend my good wishes to Greg for this treatment. There has been £8.8 million committed so far based on the NIHR programme and academy spend. The important thing is the quality of the applications. Brain tumours are invidious, and we need to do more and we need to go faster. I will look at her suggestion, but I am aware that there are already experts sitting on the panel.

Obesity

Helping people to achieve and maintain a healthy weight is one of the most important things we can do to improve our nation’s health. That is why we published our healthy weight strategy last summer. We are taking forward actions from previous chapters of the childhood obesity plan, as well as further measures to get the nation fit and healthy, protect against covid-19 and protect the NHS. Question 25 on the call list is grouped with Question 26.

Yes, but unfortunately Jonathan Gullis is not here. You managed to jump in before James Daly could speak. Not to worry. We will go to James Daly.

Thank you, Mr Speaker. Encouraging an active lifestyle is a crucial part of tackling the obesity challenge that our country faces. Does my hon. Friend agree that local authorities, working with partner agencies, should invest in iconic community venues such as Gigg Lane in my constituency to house a wide range of public health services and provide inspirational settings for young people to take part in sport, no matter what their background or personal circumstances?

I agree wholeheartedly that we should encourage all children to make sure that they can take part in sports and enjoy the outdoors. Regular physical exercise is important for the health and wellbeing of young people, and the local community has an important role to play in developing facilities. That is why the Government launched a £150 million community ownership fund, to ensure that communities across the UK can benefit from the local facilities and amenities that are most important to them. That includes community-owned sports clubs and sporting and leisure facilities that are at risk of being lost without community intervention, and I urge my hon. Friend to work with his community to ensure that he has those facilities locally.

Cancer Workforce: Nurses

What plans the Government have to ensure an adequate number of nurses in the cancer workforce to deliver the targets for cancer set out in the NHS long-term plan. (914209)

Cancer diagnosis and treatment is a priority for this Government. I am working with the Minister for prevention and public health—the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill)—to ensure that we have the necessary workforce to deliver improved cancer care. Overall, we are increasing the number of nurses in the NHS, with over 10,000 more nurses in the NHS this January than a year ago. We are training 250 more cancer nurses and 100 more specialist chemotherapy nurses.

I thank the Minister for that encouraging response, but will she outline what steps have been taken to ensure that Northern Ireland students educated in UK mainland nursing schemes can easily transition to fill the needs in our cancer wards both in the UK mainland and in Northern Ireland?

I thank the hon. Gentleman for his question, and if he will allow me, I will look into that and write to him.

Prior to the pandemic, cancer services were understaffed and not meeting their targets. During the pandemic, our staff have made incredible efforts, but a cancer backlog has built up. The Government are now asking the same understaffed cohort to run their normal services and to deal with the backlog at the same time. This is unfair, will lead to burn out and will not work. Will the Government commit today to extra resources specifically targeted at cancer to give those staff a fighting chance?

I thank the hon. Member for his question. The Government have already committed significant additional resources to support the NHS in recovering from the impact of the pandemic, and that will include cancer services as well as other areas of treatment.

Topical Questions

I am delighted to be able to tell the House that, across the UK, we have met our target to offer a vaccine to everyone in the top nine priority groups ahead of the deadline on 15 April. We have now delivered a first dose to more than 32 million people, and are on track to offer a vaccine to all adults by the end of July. This weekend, we also saw a record number of second doses. Overall, as of midnight last night, we have now delivered more than 40 million doses of vaccines right across the UK. It is a remarkable achievement.

Today, the Joint Committee on Vaccination and Immunisation has published its final advice on an age-based prioritisation, which we accept in full. So I can announce formally that, from today, we have opened up invitations to get a vaccine to all aged over 45, and then we will proceed to everyone aged over 40, in line with supplies.

Finally, following a successful start last week in Wales, the Moderna vaccine will be rolled out in England from today. I am very grateful to everybody involved in this vaccination programme, which allows us to lift restrictions across the country, and already has saved over 10,000 lives, with more to come.

With your permission, Mr Speaker, may I wish all Sikhs, Hindus, Muslims and other communities celebrating their religious and cultural events in the coming days and weeks a happy, peaceful and prosperous time?

The Secretary of State is clear about the importance of vaccination, but how is his Department working to ensure that all adults without English language knowledge, with very low levels of health literacy and in pockets traditionally untouched by health campaigns, choose to be vaccinated, rather than being coerced—not just regarding covid-19 vaccines but other vaccines?

I wholeheartedly agree with the hon. Gentleman. I am very proud of how, across this House, people have united to support the vaccination effort and to get those messages out there as he says so clearly. It is very important that we have trusted confidants working in and with communities to explain the benefits of vaccination to those who may be hesitant. For instance, in Leicester we have ensured that within the Somali community, Somali clinicians are administering the vaccine. Having a vaccination centre that is staffed by the Somali community near where they live, even though there is another vaccination centre round the corner, has proved successful in driving up vaccination rates in that community. I pick on that as one excellent example of the national and local systems working together, listening to the data, and working with local communities. and I very much look forward to working with the hon. Gentleman to make that happen.

At the Liaison Committee three weeks ago, the Prime Minister confirmed that there would be a 10-year plan for the social care sector, like that of the NHS, to fix the crisis in social care. Will the Secretary of State tell the House what he thinks that 10-year plan needs to contain, and whether external organisations such as Age UK, the Alzheimer’s Society, Care England, and the Health and Social Care Committee, will be able to contribute to the Government’s thinking on that plan? Will they be able to do so before the plan is published later this year?

I warmly welcome my right hon. Friend’s enthusiasm and support for that project, which the Prime Minister set out at a high level to the Liaison Committee. We are working hard, including with stakeholders, and the Minister for Care has held a number of roundtables on the subject. We want this to be an open and broad programme, to ensure that we get the right answers to these long-standing questions.

Will the Secretary of State explain why, following a private drink he had with Lex Greensill and David Cameron, Greensill was handed an NHS payroll financing contract that sought to convert income from NHS staff pay packets into bonds to sell internationally, and effectively to make money on the back of NHS staff in a pandemic? Why was that contract given without tender? Why was that meeting not declared? What pressure did the Secretary of State put on officials to hand that contract to Greensill?

Ministers were not involved in the decision by NHS Shared Business Services to facilitate the provision of salary advances in pilot schemes. I attended a social meeting organised by the former Prime Minister, and given that departmental business came up, I reported to officials in the normal way.

This is part of a wider pattern of behaviour. We see PPE contracts going to Tory donors, and a pub landlord WhatsApping the Secretary of State and receiving a testing contract. We see a US insurance firm taking over GP contracts, and one of its bosses gets a job in Downing Street. It is cronyism and it stinks. If the Secretary of State thinks he has done nothing wrong and has nothing to hide, will he publish all the minutes, emails, correspondence and directions that he gave to civil servants, and all his text messages with David Cameron, so that we can see exactly what went on with the awarding of this contract?

Yesterday the Government announced a review into this matter, and I will of course participate in that in full. It is important that Governments engage with external stakeholders and businesses and, as was raised in the previous question, it is important that that happens, and happens in an appropriate way within the rules, which is what happened in this case.

The covid-19 vaccine roll-out has shown the value of comparable statistics not only in this country, but worldwide. However, directly comparable data are often lacking for healthcare performance and outcomes between England, Wales, Scotland and Northern Ireland. Does my right hon. Friend agree that UK-wide data in the NHS, along with aligned inspection mechanisms and audit procedures, would increase transparency and ultimately improve service delivery? (914165)

Yes. I think that through the pandemic we have seen an improvement in our ability to see what is happening in the NHS right across the UK, and that helps us all work together better to deliver for patients. One example of that is the vaccine programme. That is a UK-wide programme with UK-wide metrics but it is delivered, of course, by the local NHS wherever people are in the UK. There are lessons we can learn from that.

I am hearing increasingly difficult stories from constituents across my constituency whose children are suffering severe mental health problems and are regularly having to wait up to a year for a first appointment. In that year, their condition gets progressively worse, so by the time their appointment comes around, they already need a much greater level of treatment than they would have needed had they been seen earlier. That also has a disruptive impact on their education, on top of the disruption that they have all experienced over the last year. The situation is getting worse; we are seeing more and more young people needing mental health care in my constituency. What is the Secretary of State doing to increase resources in this very important area of child and adolescent mental health? (914160)

We are putting record resources in. Of the increase in the NHS budget, the fastest increase in the long-term plan settlement is for mental health services, and within that, for children’s mental health services. We have also increased support through the pandemic. There is an awful lot that we continue to need to do, and there is a very significant plan, as part of the long-term plan, for improving access to these vital services.

Last week we had the fantastic news that the Moderna vaccine had arrived in the United Kingdom. Can the Secretary of State tell the House how many vaccine doses, across all three vaccines currently being rolled out, have been allocated to Scotland so far? (914168)

Scotland gets her fair share of vaccines allocated, and then we publish the amount of vaccines that are delivered. That is slightly lower in Scotland as a proportion of the population compared with the UK as a whole, but we are working very closely with the NHS across Scotland, with the armed services and, of course, with the Scottish Government to try to make sure that they can catch up.

Yesterday, many hospitality venues remained closed. Those that could open erected large marquees and were able to recover some of the losses that they have suffered. Others were completely dismayed that there is clearly no difference at all between some of those marquees and well ventilated, covid-secure indoor hospitality. Will the Secretary of State explain what he perceives the difference to be? (914161)

The definition of “outdoors” used in these regulations is the one set out by the Labour Government in the ban on indoor smoking.

The foul gases and odour coming from Walley’s Quarry landfill in my constituency are no longer just an environmental catastrophe; they are also a major public health concern. A local GP surgery in Silverdale reports exacerbation of asthma, hay fever-like symptoms, nausea, insomnia and depression. The Environment Agency figures that have been passed to Public Health England show that World Health Organisation guidelines for hydrogen sulphide have been exceeded on the 24-hour public health limits. What is going on is not fair on my constituents. What assessment has the Secretary of State made of the public health implications, both physical and mental, of the major environmental incident going on in my constituency, and will he meet me and the Environment Secretary to discuss the matter? (914169)

I am very happy to meet my hon. Friend. I am grateful to him for raising this vital question of local public health in the House, and I am absolutely determined that the authorities—both the local authority, with its responsibilities, and the national authorities, including Public Health England—play their role in tackling this problem.

Nottingham University Hospitals NHS Trust is giving all its staff an extra day’s leave this year to thank them for their sacrifices during the pandemic. I am sure that is a welcome gesture, but staff in Nottingham and across England deserve so much more. Real-terms pay in the NHS is already below 2010 levels, and we went into the pandemic facing serious staff shortages, with 40,000 nurse vacancies and 7,000 doctor vacancies. What will the Government’s proposed real-terms pay cut do to vacancy rates? (914162)

I am very glad to say that the numbers that the hon. Lady uses are out of date. We have seen a very significant increase in the number of nurses and other staff in the NHS. In fact, we have a record number of nurses in the NHS. For the very first time, we have more than 300,000 nurses in the NHS. We have seen over 10,000 more nurses over the last year alone. Of course, the mission to work caring for others and looking after the health of the nation in the NHS has never been more important, and I am delighted that so many people are rising to that, because we have record numbers of people in training too.

While the NHS acted heroically when the pandemic first hit, what lessons have been learned about translating the learnings of junior doctors and experienced nurses into policy more quickly? For example, junior doctors knew that loss of taste and smell was a symptom, and that proning helped patients, quite some time before those became policy. (914175)

There is a huge amount that we can learn from the early response to the pandemic, and it is very important that we adopt the scientific understanding and learnings as quickly as is rigorously possible. We need the time for the rigour, but we need to adopt the policies. We have seen in the vaccine roll-out a huge amount of these lessons adopted, and the speed at which the scientific advice takes into account what we are learning on the ground in the vaccine roll-out is impressive. So we should keep going down this route—always open-minded, always asking the scientific questions and always then asking how quickly we can rigorously put those understandings into practice.

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

Sitting suspended.