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Topical Questions

Volume 699: debated on Tuesday 13 July 2021

It is an honour to be here for my first oral questions as the Secretary of State for Health and Social Care, and I thank the Prime Minister for bringing me back from furlough. I accepted this role because I love my country and the NHS. I know that I join this Department at a pivotal time, and I have three pressing priorities for these critical few months. The first is getting us on the path out of this pandemic. The second is busting the backlog of non-covid services. The third is putting social care on a sustainable footing for the future. I want to draw on what I have learnt during this time of adversity and what we have all learnt together. I want to make this great nation a healthier and fairer place, and I am looking forward to working with all hon. Members in this House.

East Sussex Healthcare NHS Trust has the potential to get hundreds of millions in investment as part of the Government’s NHS estate infrastructure improvement plan. Will funding be allocated on a two to three-year basis, so that the NHS can better plan its funding and estates plans? Where funding has been indicated for a longer term, what plans are there to ensure that providers have sufficient resource in the shorter term to address immediate issues, or to support covid or recovery?

We have put more and more capital into the NHS. There are always representations from hon. Members, including you, Mr Speaker, for even more capital. My hon. Friend is right to raise the issue of the importance of local healthcare systems, which will need more capital funding as we progress. She will know that we set out our capital plans for this financial year, 2021-22, but she is right to say that multi-year funding will mean that trusts can plan better, and that is a priority; we want the spending review to have more sight and better planning for capital.

Let us consider these words about mental health services:

“prior to 2017, no government invested in or prioritised MH services.”

Those are not my words but the words of the Minister for Patient Safety, Suicide Prevention and Mental Health, the hon. Member for Mid Bedfordshire (Ms Dorries). Indeed, the new Secretary of State was the architect of these cuts, during his time as a Treasury Minister. The unparalleled devastation he left behind has been simply staggering, so does he agree with his Minister? Can he explain to us why 140,000 children were turned away from mental health services last year? Can he explain why a quarter of mental health beds have been cut since 2010? Is he ashamed of his track record?

The hon. Lady will know that the NHS long-term plan that has been set out by this Government is committed to a transformation in mental health services and mental health spending; some £2.3 billion extra is being invested by 2023-24. In addition, she will be aware of the mental healthcare White Paper and the mental health recovery action plan. I hope these are all initiatives she will support.

May I welcome the Secretary of State to his place? I am sure he will do an excellent job. As he thinks about a 24-hour A&E for Chorley, I hope he will also think about the urgent need for a cancer institute at the Royal Surrey County Hospital as only second on his list.

The Secretary of State will know that this morning the Health and Social Care Committee published a worrying report about the inhumane treatment given to 2,000 people with learning disabilities and autism in in-patient units, often because no community provision was available. When he brings forward his plans for social care, will he make sure that there is adequate funding for local authorities to give care to such people? Will he also make sure that care workers are always paid the minimum wage, including for the time taken to travel between appointments?

I welcome my right hon. Friend’s comments and the work that he and other Members do through the Select Committee to scrutinise the work of the Department. He just referred to some of that work, especially in his comments about learning disability and autism, which will remain a huge priority for the Government and certainly for my Department.

My right hon. Friend also rightly raised the issue of care workers and the minimum wage; it is worth pointing out that the Care Act 2014 requires local authorities, when they provide funding, not just to support the minimum wage but to take account of the costs that care workers might incur, such as travelling costs. I look forward to working with my right hon. Friend and the members of his Select Committee.

I congratulate the Secretary of State on his new role.There are 1.5 million older people, disabled people and carers with unmet needs who are desperately waiting for care reform. What is the Secretary of State’s estimated start date for the implementation of the care package that the Government claimed was ready in their manifesto more than 20 months ago? (902596)

As the Government have said, we want to make sure that every person in this country has the dignity that they deserve in old age. We have recognised that the current system needs substantial reform. The process of reform has already begun in, for example, the Health and Care Bill that will have its Second Reading tomorrow, but we do need a new, sustainable way to fund care and we will come forward with the plans later this year.

I know that many of my constituents will be pleased to hear that from 16 August we will end the requirement for people to self-isolate after possible exposure to the virus if they are fully vaccinated. I am sure we all agree that it is right to change the rules as the information changes; however, will my right hon. Friend explain to the House the rationale for making this change on 16 August rather than next Monday? (902600)

I agree with my hon. Friend that it is good news that we can move away from restrictions and towards guidance. On the rationale for the decision he referred to, it is about vaccine effectiveness: we know that for those with both doses, vaccination is estimated to be 78% to 80% effective against symptomatic covid-19. The introduction on 16 August of the changes to which my hon. Friend referred will mean that more people will have been vaccinated and will help to reduce severe illness.

Macmillan Cancer Support calculates that since March 2020, 37,000 fewer people than expected have started their first cancer treatment, including an estimated 66 people in my constituency of Jarrow who have not started their first treatment. Given that Macmillan estimates that the cancer system will need to work at 110% of capacity for the next 14 months to address the backlog, will the Secretary of State confirm whether the NHS is on schedule to tackle the backlog of cancer diagnosis, care and treatment by the current March 2022 deadline? (902597)

I want to reassure the hon. Lady—because this is such an important question for so many people across the country—that cancer remains a huge priority for this Government. She is right to refer to the work that Macmillan has done on this issue because, sadly, during the restrictions thousands of people have not come forward in the usual way and their cancer sadly remains undiagnosed. We urge anyone who feels that this is an issue for them: please, go to your GP—please come forward. That is one reason why we have launched the “Help Us, Help You” campaign. We have also provided additional funding for rapid diagnostic centres.

Good afternoon from West Dorset, Mr Speaker. Constituents of mine have been in touch to say that they are struggling to get GP appointments either because there are not any, or because they are struggling with online booking and telephone consultations. That is resulting in people going to A&E, putting more pressures on their hospitals. What is my right hon. Friend doing to ensure that constituents, especially older constituents, can access a GP face to face if they need to? (902601)

I think we would all agree in this House that GP practices have done a magnificent job in responding to the pandemic, and I want to take this opportunity to thank all GPs and their staff for the work that they have done and that they continue to do. My hon. Friend is right to raise the issue of face-to-face access. We can all understand why it changed during the pandemic, but as we open up, we can start to provide more of this, particularly for older people. Over the coming weeks and months, that will be a priority for my Department.

Cancer Research UK estimates that, compared with pre-pandemic levels, nearly 45,000 fewer patients started cancer treatment in the UK in April 2020 to March 2021. It believes that this stems from there being less diagnosis during the pandemic. In England alone, 10,500 of those missing cases were breast cancer cases. What steps are the Government taking to reach out to those at risk of cancer who have not been diagnosed due to limited NHS access over the past 18 months? (902598)

As I said in response to an earlier question, this is a huge priority for the Government and, again, I am pleased that the hon. Lady has raised the issue. It is an issue for her constituents and for constituents throughout the country. She referred to the research by Cancer Research UK. I am afraid that it is right: there are thousands of people who did not come forward. We can understand why, so let me say this again as it is so important: for anyone concerned, please do come forward. We have provided additional funding—more than £1 billion—for more diagnostics and we will continue to provide additional support.

In vitro fertilisation treatment is a lifeline for many people desperate to conceive. My constituent Sarah Barker dreams of being a mother, but sadly suffers from an infertility problem. Sarah is being refused IVF treatment on the grounds that her partner already has a daughter from a previous relationship. Her petition to stop denying women fertility treatment for this reason has already reached almost 13,000 signatures. Does my hon. Friend agree that treatment for infertility should be available based on the medical needs of the women involved, and not affected by the partner that she has fallen in love with having a child from a previous relationship? (902602)

I thank my hon. Friend for raising this question and the situation of her constituent. What I can say is that we expect clinical commissioning groups to commission fertility services in line with National Institute for Health and Care Excellence guidelines, so that there is equitable access across England. We are aware of some variations in access, and we are looking at how we can address that. Very specifically, CCGs should not be using criteria outside that NICE fertility guidance.

Many of my constituents who are extremely clinically vulnerable due to conditions such as blood cancer are terrified that, from 19 July, the Government are effectively abdicating responsibility for keeping them safe in public. There is evidence that more than two thirds of people do not understand that vaccines are not always effective for people who are immuno-compromised or the importance of wearing a mask to protect others and to alleviate anxiety. Can the Secretary of State not see why it would send a much clearer message to keep masks on public transport mandatory, rather than leaving the safety of clinically vulnerable residents to chance? (902599)

The hon. Lady is right to raise this issue. As she has rightly explained, there will be a number of people who, understandably, will be concerned about the move away from regulations to guidance. None the less, there must come a point when we start to remove the restrictions slowly, in a measured way, as we are doing—not least because we want to be able to start dealing much more with all the non-covid health problems that have been created as well. We have provided very clear guidance on masks and it was published yesterday. I hope that the hon. Lady can share that with people who are concerned.

We know that there have been hidden costs to the restrictions that are in place to protect us, including worsening mental health and the risk of domestic violence. Will my right hon. Friend confirm that the need to balance those risks with the reduced threat posed by the virus is a key part of the Government’s decision to lift restrictions? (902603)

Yes, I can confirm that. Removing restrictions is not without risk—I accept that—but keeping restrictions is not without cost. As my hon. Friend points out, the restrictions have led to increased domestic violence, child abuse, mental health issues and undiagnosed cancer, which we have heard about today, to name but a few. As we start lifting restrictions, that means that we can better deal with all these major non-covid health problems.

I have been contacted by a number of my Colne Valley constituents who have had operations and medical procedures cancelled or postponed at short notice. With coronavirus cases still on the rise, what is the strategy to tackle the backlog in operations and medical procedures? (902606)

My hon. Friend rightly raises an issue that I know will be a concern for constituents of all Members of this House. The backlog of treatment—the waiting list—is over 5 million. However, we are making rapid progress with that, and so is the NHS. We are looking at a variety of ways to do that—not just providing the funding needed to do it, but through innovation, accelerator hubs and diagnostic hubs, all designed to get the waiting list down and to get people the treatment they need when they need it. I would be very happy to discuss the specifics of my hon. Friend’s local situation with him outside this place.

Thank you very much, Mr Speaker. When I return to my constituency of North East Fife, I will cross into Scotland, where the mandating of face masks is likely to continue. Is it the Government’s expectation that passengers will wear a mask only when they cross into Scotland—or, indeed, Wales? What consultation has happened with the Home Office in relation to guidance to the British Transport police? Do the Government accept that a lack of a four-nations approach to such measures is not helpful? (902604)

Throughout the pandemic, my predecessor and other Ministers have rightly been working with the devolved Administrations, and of course that work continues; it will remain a priority. I myself have already started weekly meetings with all my counterparts in the devolved Administrations. We discuss a number of issues and keep each other informed, but we also respect that in certain areas, in dealing with this pandemic, we may take a different course.

I congratulate the Secretary of State on his appointment. Cases of covid rose by 30% last week compared with the previous week, and on 10 July we saw over 35,000 new cases, the highest since 22 January. By mid-August we could see 1,000 people a day being hospitalised, and up to 200 people a day could die, despite the excellent vaccination programmes. Given that the Secretary of State now considers it irresponsible not to wear masks, is it not equally irresponsible for the Government not to require people to continue to wear masks rather than leaving it as an option? (902605)

The hon. Lady understandably talks about the link between case numbers and hospitalisation. She will know that the last time we saw cases at 30,000 and above on a daily basis, we saw a lot more hospitalisations. The reason for the difference now is the vaccine wall of defence. Masks do have an important role to play, but we think that that role can be played by moving from regulation to guidance.

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

Sitting suspended.