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Oral Answers to Questions

Volume 707: debated on Tuesday 18 January 2022

Health and Social Care

The Secretary of State was asked—

Discharge from Hospital: Covid-19 Outbreak

1. What steps his Department is taking to support the effective discharge of patients from hospital during the covid-19 outbreak. (905075)

We are working closely with the NHS, social care and local authorities to significantly reduce delayed discharge and free up beds for those who need them most. We are making full use of non-acute beds, including those in hospices, other community beds and beds in the independent sector. To drive further progress and support regional and local systems, I also established a new national taskforce last month to help deliver best practice.

I thank my right hon. Friend for his answer. Many people would like to leave hospital when their treatment is completed, but they are not quite well enough to cope alone at home. That is obviously frustrating for them, because they want their independence, it creates problems for hospitals, which need the beds, and it costs the taxpayer unnecessary money. Does my right hon. Friend therefore agree that the development of a strategy to provide intermediate care to support discharge would help alleviate pressure on both the NHS and the social care sector?

I do agree with my hon. Friend. That is why, as part of our continued response to the covid-19 pandemic, on 2 December last year NHS England asked local systems to consider ways to increase patient flow out of acute hospital settings. That includes surge capacity in care homes, identifying unused hospice capacity and, in some cases, repurposing hotel accommodation where appropriate. NHS England is reporting to me on this regularly, and it is something that we will closely monitor progress on.

The Government’s own impact assessment of discharge to assess in the Health and Care Bill, which was published almost two months after the Bill was voted on, expects unpaid carers to have to give up working hours and bear the financial burdens of the discharge to assess policy. In the light of that assessment will the Government provide greater support to unpaid carers, or will they actually reconsider this policy?

Throughout the pandemic especially we have been providing more and more support, quite rightly, across the care sector, including for domiciliary care in care homes and unpaid carers. We have made £3.3 billion of extra funding and support available since March 2020.

Kettering General Hospital is a 500-bed medium general hospital, and I am afraid that too many, mainly elderly, people who have completed their medical treatment still await discharge back into the community in a safe way. Will the Secretary of State ensure that the national taskforce is sent to Northamptonshire to help us deal with this issue?

My hon. Friend is right to raise this issue. It is of increasing concern, especially as we have seen hospitalisations rise because of the omicron wave. I believe that the national taskforce is already looking at Northamptonshire. If it is not, I will certainly make sure it does.

Around 10,000 medically fit people are currently in hospital when they should be at home with their families or in a supported setting. That is a tragedy for them and a mark of shame on this Government. Short-term cash, taskforces or threatening legal action are not solutions. Social care support is a lifeline not a luxury, so will the Government now work with us cross-party in line with the joint Select Committee report of 2018 to bring forward immediate change and offer hope and respite to those receiving and giving social care?

First, may I welcome the hon. Lady to her new position and wish her all the very best? She will have heard in a previous answer that social care and those who provide social care, which is such a vital act and such a vital service throughout our country, are receiving record amounts of support—£3.3 billion of extra financing since March 2020. Of course I would be more than happy to work with her and her colleagues to see whether there is more that we can do together.

Covid-19: Hospital Admissions

We have developed a globally recognised programme that combines boosters, testing and antivirals to protect the vulnerable and to reduce hospital admissions. Our “Get Boosted Now” campaign led to a huge increase in vaccination rates and we have successfully procured the highest number of antivirals per head in Europe. We are also employing the use of remote monitoring technology to enable more patients to get the care that they need at home rather than having to be admitted into hospital.

Before omicron arrived there had been over 10 million positive cases in this country of covid-19, of which 14 in every 1,000 appeared to have been fatal. Since omicron arrived there have been a further 5 million cases, and it looks as though the fatality rate is about 10 times lower. Will the Secretary of State tell the House how important the “Get Boosted Now” programme has been in reducing hospitalisations and fatalities?

Yes, of course. The officials within my Department have carried out a wealth of analysis on case fatality rates in the vaccinated and unvaccinated populations. Recent data has shown that covid-19 case fatality rates for the over-80s are likely to be more than five times greater in the unvaccinated versus those who have had at least two doses.

My hon. Friend may be interested to know that, when I recently visited the intensive care unit dealing with covid patients in King’s College, the consultant in charge told me that he estimated that about 70% of his patients on that day were completely unvaccinated. It is clear, as we have seen especially in the past few weeks, that vaccinations save lives.

I have a 90-year-old constituent who has been prevented from going to see his 89-year-old wife of 65 years. It took my intervention after 20 days of his being prevented from seeing her for him to be able to get into the hospital. Neither of them have covid. Will my right hon. Friend please instruct health trusts that, as we reduce the incidence of covid in hospitals, family members must be allowed to go and see their family in hospital?

I am very sorry to hear about what happened to my hon. Friend’s constituent. It cannot be right that people are unable to visit their loved ones while they are in hospital. It should not require the intervention of a Member of Parliament to do so. Allowing such visits should be an absolute priority in every trust, and I have recently raised this issue with the chief executive of the NHS. She has assured me that this message will be sent loud and clear to all NHS trusts.

Too many women with endometriosis are being forced to go to A&E or seek hospital admissions for their treatment. This is partly because they wait on average seven and a half years for a diagnosis. What can the Secretary of State do to improve the knowledge and awareness of endometriosis right across all aspects of the NHS?

The hon. Lady is absolutely right to raise the importance of endometriosis. She will know, I hope, that in the women’s health strategy there will be an important focus on it. Within that strategy, we have set out how we can work together to do much more.

We know that the number of covid admissions has led to a number of people having their routine hospital treatment cancelled. Last week it was announced that that had reached a record-breaking 6 million people. When might the Government make a statement about hitting this figure and set out a plan to tackle it?

The hon. Lady will know that, sadly because of covid and the need for the NHS to prioritise it—rightly—we have sadly seen an increase in people waiting for elective procedures and scans. She will also know that the Government have already set out a plan to deal with that in terms of funding—the biggest catch-up fund in history, with an extra £8 billion of funding over the next three years. After tackling the most immediate need to deal with omicron, we will shortly set out in much more detail how we intend to tackle the elective backlog.

Covid-19 Vaccination Sites

To maximise uptake there are now more than 3,000 sites—more than ever—delivering covid-19 vaccines and boosters, including hundreds of walk-in sites. Opening times have been extended to seven days a week. GPs and community pharmacies have been asked to do more vaccinations, and 750 armed forces personnel and 41 military planners have been brought in to every region to help co-ordinate the national effort. The offer of a covid vaccine—a first or second dose, and a booster for those eligible—remains open to everyone.

In rural areas such as mine in South East Cornwall, it can mean travelling miles to get to the nearest available centre. What ambitions do the Government have to get vaccinations out to the smaller communities to assist those who have yet to be vaccinated to get their jab?

Well, 99% of the population in England live within 10 miles of a covid-19 vaccination site, and robust plans are in place to ensure that everyone has convenient access to a vaccine. In Cornwall and the Isles of Scilly, 85% of those eligible have received their booster or third dose. There are targeted vaccination programmes in Cornwall to support the homeless, Traveller and migrant workers communities and fishermen—a community that has a great champion in my hon. Friend.

For those in more rural Cornwall communities, a further 16 pop-up sessions are organised throughout January, and more are planned to ensure that everyone can get boosted more easily.

A number of residents in Bolsover have written to me to ask why there is not a specific vaccination centre in the town. Given that the booster roll-out has slowed locally and given our poor bus connections, could the Minister—as my former Whip, I know that she is incredibly persuasive—look into having a specific site in Bolsover?

There are now six vaccination sites in the Bolsover district. A regular pop-up clinic was also set up in Shirebrook to address and identify the shortfall in uptake, but that has been phased out as new community pharmacy and primary care network clinics came on board to support the local vaccination programme and increase the number of Bolsover sites at the end of 2021. I am sure that my hon. Friend will be delighted to hear that a new roving vaccination van is being deployed across Derbyshire. It will visit Bolsover and surrounding villages to provide extra capacity and ensure that everyone has another way to get their booster jab. It will also allow those not yet vaccinated to come forward for this life-saving protection.

Undoubtedly, additional vaccine sites in rural communities will increase vaccine uptake, which is vital. However, does the Minister agree that, for NHS staff, counselling and one-to-one conversations are right and far more effective than the Government’s current plan potentially to sack the 5% of hospital staff in the Morecambe Bay region and indeed across the country who have not been vaccinated? That would cause a serious capacity problem in the NHS.

I reassure the hon. Gentleman that we are talking about patient safety. He is quite right that it is important to have that dialogue, and I know that colleagues across the board in the NHS are having that. It is interesting to note that more than 94% of NHS staff have already had their vaccine, and I commend them for that. As the chief medical officer Chris Whitty rightly said, those looking after other people who are very vulnerable have a “professional responsibility” to get vaccinated.

Access to vaccinations in remote areas is incredibly important, but so is a general health strategy for clinically very vulnerable people. Young Lara in my constituency had the organ that she desperately needed for a double organ transplant, but unfortunately there was no bed in intensive care for her to have the operation. What strategy is the Department taking in general for our clinically vulnerable to provide access to operating theatres so that there is a focus not just on vaccination but on the multiple health conditions that so many of them suffer across the board?

The hon. Lady makes a really good point. I reassure her that procedures for urgent cases have not been cancelled. As the House knows, we are looking at the private sector to help deliver vital support for those patients.

Covid-19 Testing Infrastructure

4. What assessment he has made of the capacity of the UK’s covid-19 testing infrastructure in comparison to other countries. (905078)

The UK continues to provide one of the highest testing rates globally. We have increased capacity for PCR testing by over 200,000 tests per day since December. Home delivery capacity is now at 7 million lateral flow tests every day, with community pharmacies supplying an additional 9.5 million tests last week. In comparison to England, countries that have put in place more restrictions might have chosen a different balance between lateral flow devices and PCRs to meet their individual testing demands. Therefore, we cannot meaningfully compare our testing infrastructure to that of other countries.

I thank the Minister for that answer. Health and social care workers who care for some of the most clinically vulnerable members of our society were rightly prioritised for early vaccination. Does she agree that, similarly, they must be prioritised for testing? What is she doing to ensure that?

My hon. Friend makes a good point. The most vulnerable people are being prioritised. The UK Health Security Agency and NHS Test and Trace currently deliver an average of more than 70,000 PCR kits and 970,000 LFD kits a week to adult social care settings. In recent weeks, as demand has increased due to the omicron wave, Dudley, like other local authorities, has provided tests to key workers to enable them to keep working.

I thank the Minister for her response. The Government have recently announced that self-isolation will be cut to five days, given a negative lateral flow test. Has the Minister come to an assessment on the impact that will have on demand for lateral flow tests, given the struggle many have faced trying to obtain a box of them in recent weeks?

As we look at policy and amend it like we did last week, it is right that we make sure that we can fill those requirements. I reassure the hon. Gentleman that we can, and we have increased the procurement of lateral flow devices. This month, we will get another 750 million lateral flow devices into the UK for January and February.[Official Report, 20 January 2022, Vol. 707, c. 6MC.]

I am sure the whole House will welcome the early signs of falling numbers of people in hospital with covid. Does the Minister have any comments on the news yesterday from the World Health Organisation that it thinks that the UK looks set to be one of the first countries out of the pandemic, and how much weight does she put on the vaccination and booster programme, and the colossal scale of our testing availability, in that achievement?

My right hon. Friend makes a really good point. We know that omicron numbers are still really high, and we still have more than 2,000 people hospitalised every day, so we do need to be cautious. But my hon. Friend is right, in that our vaccine and testing programmes have been vital in being able to tackle this deadly virus. I encourage everybody to get their booster and, if they have not come forward for their first or second jab, to get those too.

Covid-19 Tests: Supply

5. What plans his Department has to ensure that there is an adequate supply of covid-19 tests during the covid-19 outbreak. (905079)

19. What steps his Department is taking to increase the supply of lateral flow and PCR covid-19 tests. (905094)

We have significantly increased our testing and supply capacity since December, procuring over 700 million more lateral flow tests, ramping up our delivery capacity and expanding the UK’s daily PCR capacity. Around 1.7 billion lateral flow tests have been distributed across the UK since the start of the pandemic. Home delivery capacity is now at over 7 million lateral flow tests every day, and we have also recently increased capacity for PCR testing by more than 200,000 tests per day.

I asked the Prime Minister, but he did not know. I asked the Business Secretary and he did not seem to care. So today is third time lucky. Why were 30 million British-made lateral flow tests sitting in a warehouse waiting for approval while Chinese tests were given temporary approval, all while people could not get test kits from pharmacies or from Test and Trace? It took six months to give approval to SureScreen diagnostics: when will the Government support British test manufacturers and end the preference for imports from China?

I can give the hon. Gentleman an answer, and I am very happy to do so. He will know that whenever we try to procure tests, in this case lateral flow tests, we should always try to buy British first, and we do buy from SureScreen—it is a fantastic supplier. But he will also know that we can only, rightly, buy lateral flow tests once they have been approved by our independent medical regulator.

Does my right hon. Friend agree that access to the largest testing programme in Europe is just one example of the advantages to the people of Scotland when we adopt a UK-wide approach to shared challenges?

I absolutely agree with my hon. Friend about a unified approach to shared challenges such as covid-19, and that unified approach being the best way forward. Across the UK, we have built the largest diagnostic network in British history and our testing programme has been one of the most important lines of defence, alongside our UK-wide vaccination programme. Our procurement of tests, antivirals and vaccines has been another fantastic example of the strength of the Union.

“Always try and buy British first” was what the Secretary of State said a few moments ago, but a few weeks ago it was reported that plans to manufacture lateral flow tests here in the UK were shelved because the Government were scared that they might be accused of handing out dodgy deals to their mates. I know the Minister has form on this, but on this point they were misguided. Can he now say to the House that that was not the case and that he was not running scared of a transparent procurement policy, and that he will now do all he can to turbocharge British manufacturing and get British lateral flow tests in the system, so that we do not ever suffer again from those avoidable shortages we saw over Christmas?

First, I think the hon. Gentleman accused me of doing something inappropriate, and I think that that is not appropriate, unless he has something else to say or some evidence, but it is true to form for the Labour Front Bench, which just constantly makes things up to make false points. When it comes to testing, as he has just heard me say, we have purchased 1.7 billion lateral flow tests since the start of the pandemic. Wherever possible, whether it is PCR testing or lateral flow testing, whenever tests are approved by our independent regulator, we buy British.

Free Prescriptions: People aged 60 and Over

Such a policy change would hit a vulnerable age bracket who are more likely to have one or more long-term illnesses requiring medication. A constituent of mine has told me of his concern at the cost of paying for his wife’s Parkinson’s medication, should such a change be introduced. Given that the millions facing a new charge will also be hit by a rise in living costs, will the Secretary of State shelve such proposals and review the list of conditions that qualify for a medical exemption certificate?

Can I just reinforce the answer I have just given? There is no decision to increase the upper age exemption for free prescriptions, and the rumour circulating that the Government are removing free prescriptions for pensioners is completely false. The Government are absolutely committed to maintaining free prescriptions for pensioners.

I am very pleased to hear that no decision has been made on this important topic, and I hope the situation remains as it is. Will my hon. Friend take this opportunity to remind those who are paying for their prescriptions that a pre-payment certificate is available that can save a significant amount of money for those who regularly use their pharmacy?

My hon. Friend is absolutely right, and he does well to highlight the pre-payment certificate. If people go for a 12-month certificate, which is about £2 a week, for two items they can save £116.30 and for three items, £228.50, so it is well worth the investment.

Folic Acid in Flour

8. What recent steps the Government have taken to progress the introduction of mandatory folic acid supplementation in flour to prevent spinal conditions in babies. (905082)

Following consultation last September, we announced that we would legislate to fortify non-wholemeal wheat flour with folic acid. We are working at pace to move this policy forward, and we have already engaged with industry as part of a cross-Government review of bread and flour regulations. All four nations are now working closely together to develop the draft legislation and impact assessment for future consultation.

I thank the Minister for her answer. As she knows, the Scientific Advisory Committee on Nutrition has recommended mandatory folic acid fortification of flour. The UK Government launched a public consultation that closed in 2019. In September last year, the UK Government announced that folic acid will be added to non-wholemeal wheat flour across the UK to help to prevent life-threatening spinal conditions in babies. Therefore, can the Minister update the House on the UK Government’s timeline to implement the decision in a wee bit more detail, please?

I thank the hon. Gentleman for raising this important issue, because fortifying non-wholemeal wheat flour with folic acid will help to prevent hundreds of neural tube defects in foetuses every year. I regret that I cannot commit to a specific timetable, but we need to consult on the draft legislation and will look to give industry appropriate notice. All four nations are working together on the timetable and hope to deliver this important policy as soon as possible.

NHS Capacity and Resilience: Covid-19

9. What steps his Department is taking to help (a) maximise NHS capacity and (b) increase the NHS’s resilience during the covid-19 outbreak. (905083)

Alongside measures to reduce demand and admissions, such as the vaccine roll-out and new therapeutics for covid, the NHS is creating the maximum possible capacity and investing in improved discharge arrangements, the use of independent sector beds, virtual wards and Nightingales to provide surge capacity, alongside our investment in delivering more than 20,000 more clinical staff this year compared with August 2020.

I thank the Minister for that answer. As he knows, one of the main challenges facing hospitals is delays in the transfer of patients back to care homes due to historic restrictions, particularly where there has been an outbreak, although there may have been only one case. As we move to treating covid as more of an endemic condition, what steps can be taken to stop restricting admissions to these care homes, which would undoubtedly relieve pressure on hospitals?

There is local flexibility to allow residents to be safely admitted to a care home during outbreak restrictions, following a risk-based approach that takes into account the size of outbreaks, who is affected, care home size and layout, rates of booster vaccination and current Care Quality Commission rating. The CQC supports risk-based decisions made on admissions to support the discharge of people with a negative covid test result, but, of course, we must continue to ensure the safety of those in care homes.

The workforce are absolutely central to growing NHS capacity. The advice in a Migration Advisory Committee report was to amend migration policies, make

“Care Workers and Home Carers…immediately eligible for the Health and Care Worker Visa and place the occupation on the Shortage Occupation List.”

When will the UK Government start listening to their advisers and change migration policies to alleviate the pressures facing our NHS?

I am grateful to the hon. Gentleman for his question and for the tone of his question. He is absolutely right to highlight the importance of the workforce. The workforce are the golden thread that runs through the heart of everything we do in our NHS, which is why we have already taken a number of steps to increase our workforce. We are well on target to meet our target of 50,000 more nurses. As I mentioned in my initial answer, in August last year we had over 20,000 more clinically qualified staff compared with August 2020, so we continue to grow the workforce.

Delivering new community hospitals is a key part of upgrading and expanding NHS capacity. The Department is currently examining a bid to rebuild and expand services at Thornbury Hospital, which is desperately needed due to the expansion of the town. Will my hon. Friend meet me to discuss the next steps in delivering this vital infrastructure improvement in south Gloucestershire?

I am grateful to my hon. Friend. He is absolutely right that, in looking to meet the demand challenges imposed on our NHS, it is not just about district, general or acute hospitals, but about all our hospital facilities, including community hospitals. He has raised this subject with me on a number of occasions. He is a doughty champion for Thornbury and, of course, I am always happy to meet him.

On the issue of capacity, the argument has always been floating around that bed numbers can be cut on the basis of medical and technological advances. That was always deeply suspect, but in the context of covid-19 and its aftermath, can the Minister assure the House that there will be no cuts in bed numbers in any future hospital reconfiguration?

Decisions on hospital reconfigurations and changes to local hospital systems are a matter for the local NHS, following full consultation and consideration of the needs of local communities. The hon. Gentleman is right to highlight the importance of bed capacity in the NHS. The NHS as a whole will continue to look at what bed capacity is needed to meet future need.

My constituent David Hulbert contacted me to ask that I pay tribute in the Chamber to the phenomenal NHS teams from both Mount Vernon Hospital and Watford General Hospital for the care he has received, following his admission for cancer. Will the Minister join me in thanking the NHS for its tireless, backlog-clearing work, and for continuing with lifesaving non-covid operations, alongside its ongoing heroic actions leading our covid fight and vaccine roll-out?

I am always happy to take the opportunity, as I know the Opposition Front-Bench team and my colleagues are, to thank the amazing NHS workforce for the work they have done. I pay tribute to the work of the teams at Mount Vernon and Watford General and, in the context of the pandemic, I pay tribute to my hon. Friend the Member for Watford (Dean Russell), who volunteered to help out at the hospital.

The Minister highlighted the use of independent care providers. Last week, the Department announced that 150 hospitals would be on standby for three months to provide additional resource. Can the Minister tell the House when he or his Secretary of State asked NHS England to investigate standing up the 150 hospitals, which will receive a minimum income guarantee of £75 million to £90 million a month?

I think I heard the hon. Lady correctly and she asked when those discussions began. That was last year, prior to the peak of this wave. We believe that the use of the independent sector to assist our NHS and provide additional capacity is absolutely the right thing to do. Thus far, during the course of the pandemic, it has provided, I believe, over 5 million procedures to patients. Therefore, we think this is a valuable and important addition to our capacity, and it is right that we have this surge capacity insurance policy in place to help to meet further demand.

Covid-19 Hospitalisations: Vaccination Programme

10. What assessment he has made of the effectiveness of the covid-19 vaccination programme in reducing hospitalisations. (905084)

Vaccination continues to offer our best line of defence against hospitalisation due to covid-19. The latest data shows vaccine effectiveness against hospitalisation with the omicron variant was 58% after one dose and 64% up to 24 weeks after two doses. Vaccine effectiveness against hospitalisation was 92% in the first two to four weeks after a third dose or booster and 83% after 10 or more weeks. Those who are unvaccinated are eight times more likely to be hospitalised. That is why it is so important that everybody takes up the offer to get boosted.

I thank the Minister for that reply. The facts are that the vaccination programme has been massively successful in reducing hospitalisation, particularly admission to intensive therapy units. So will the Minister confirm that, on 26 January, particularly given what we now know about the nature of the covid variant that we are currently struggling with, those regulations will lapse? Will she further confirm that she will amend advice on working from home? Most importantly, will she ensure that we reverse the counterproductive compulsory vaccination of NHS staff that the Government’s own figures suggest—

Although evidence shows that the omicron variant causes less severe disease than previous variants, yesterday in England we still had over 16,000 covid patients in hospital and over 84,000 reported cases. Plan B measures are currently in place in England, and will be reviewed before the regulations expire on 26 January. The best thing everyone can do to help to keep the virus under control is to keep coming forward for booster jabs to help to stop the spread of infection and manage the immediate pressures on the NHS.

I am seriously concerned about the rapidly depleting efficacy of the vaccine—at 10 weeks, between 40% and 50% protection—and therefore my question to the Minister is: what happens next? Already we are talking about a mandatory programme of vaccine for NHS staff which will see depletion after 10 weeks, but also public health measures may be removed: what next after the booster?

I would like to reassure the hon. Lady that the Joint Committee on Vaccination and Immunisation is monitoring this all the time, and we take advice from the JCVI.

Face-to-face GP Appointments

In October last year, the Government announced a plan to improve general practice capacity, backed up by £250 million of winter access funds to help GPs and their practices. That can be used to fund more sessions from existing staff, or indeed increase the physical premises at a practice. For my hon. Friend’s area, the Black Country and West Birmingham clinical commissioning group expects an award of £6.5 million from the winter access fund.

My constituents in West Bromwich East have been raising concerns with me about their ability to access face-to-face GP appointments at local surgeries. Given the significant £250 million winter funding package for general practice announced towards the end of last year, what assessment has the Minister made of whether that support is making a real difference on the ground?

I thank my hon. Friend, who is pushing me constantly to improve access for her constituents, but can I reassure her that the announcement, the funds and the support are making a difference? In November last year, there were on average 1.39 million general practice appointments per working day, compared with 1.31 million in November 2019, but crucially, 62.7% of those appointments were face to face, so this is really making a difference for patients.

A nurse wrote this week about working on covid wards during the height of the pandemic:

“There were no vaccines or treatments then and we worked for hours in full PPE to protect ourselves and try not to bring the virus home to our families. There were no after work drinks for us…It is clear that there was a culture inside Number 10 where even if rules were not technically broken, the spirit of the rules were, and this is completely unacceptable.”

The nurse is the Minister. Surely she must agree that the Prime Minister should now resign.

I am very disappointed by the hon. Lady’s question. Serious issues are facing the NHS and patients, and instead of playing party politics at the Dispatch Box, perhaps she needs to ask her own leader what he was doing in May last year.

Discharge from Hospital: Care Packages

13. What steps he is taking to help expedite the process of arranging care packages for people waiting to be discharged from hospital; and if he will make a statement. (905088)

People should be discharged from hospital safely and with the appropriate care and support they need. As the Secretary of State outlined, we have provided £3.3 billion via the NHS to facilitate timely hospital discharges over the pandemic, including £478 million just for this winter. We recognise that providers and local authorities have experienced significant challenges in recruiting and retaining social care workers. That is why we have provided £462.5 million over winter, for this period, to support care providers to improve existing care support.

I thank the Minister for that response, but even given all that help, almost 30% of available acute beds in Gloucestershire are occupied by patients who are medically fit for discharge. About half of those are awaiting care packages and the other half are looking for beds in community hospitals or care homes, or awaiting home discharge. What more can the Government do to relieve the pressure on the acute hospitals in Gloucestershire and on all the medical staff?

I assure my hon. Friend that this is something we take very seriously and we meet every day to discuss this issue. We are conscious of the pressures caused by omicron, and of the herculean challenges faced by health and social care providers to discharge people in a safe and timely way, particularly with outbreaks and having to manage infection prevention and control. That includes the Gloucestershire Hospitals NHS Foundation Trust, which declared a national incident on 28 December at its Gloucestershire site. But it responded brilliantly and stood down the incident nine days later. As the Secretary of State said, we have also established a national discharge taskforce, which is driving progress to bring a renewed focus on reducing discharge delays, including in Gloucestershire, and working with local government and the NHS.

Cancer Outcomes

Based on the latest available data—I am sure the hon. Gentleman will welcome this—one-year survival rates for all cancers combined are at a record high, with an increase from 63.6% to 73.9%, and the five-year survival rate for all cancers combined has increased from 45.7% to 54.6%.

To ensure the best cancer outcomes, patients need to start treatment as soon as they can. But in the latest data the Minister addresses, the number of those who waited for more than two weeks to see a specialist set a new record high for the third month running, soaring to more than 55,000 people in November, prior to the peak of this wave. Macmillan Cancer Supports states that more than 31,000 people in England are still waiting for their first cancer treatment, which will not do. When will the Government publish a properly resourced, properly staffed national recovery plan for cancer care?

I reassure the hon. Gentleman that cancer has been an absolute priority throughout this pandemic, and treatment and services have continued. I thank all those working in cancer care for making sure that has happened. Ninety-five per cent. of people started treatment within a month of diagnosis throughout the pandemic, and there have been more than 4 million urgent referrals and 960,000 people receiving cancer treatment during that time.

Geoff Cosgrave was admitted to hospital in mid-November with kidney cancer that had spread through his lymph nodes and lungs. Last week, his wife Glynis contacted me in desperation because he was unable to access treatment to clear the blockage in his lungs as the thoracic ward at the nearby hospital had closed because of staffing shortages. After frantic and desperate chasing by his family and NHS staff, he was finally admitted to Bristol Royal Infirmary last week, but unfortunately his condition had deteriorated so he could not receive treatment. Geoff died on Friday and I am sure the whole House will want to send their deepest condolences to Geoff’s family. [Hon. Members: “Hear, hear.”] Glynis wants me to place on record her family’s enormous thanks to the NHS staff who cared for Geoff, and to ask the Minister what the Government are doing to address the serious understaffing in the NHS, and the covid pressures that are having an impact on cancer care, so that no family has to suffer what the Cosgrave family are experiencing right now.

I thank the hon. Gentleman for his question. I put on record—I am sure this is shared by the whole House—our sympathy for Geoff and his family. There is no doubt that despite cancer being a priority throughout the pandemic, there have been pressures on the system. I again thank the staff, as Geoff’s family have, for carrying on throughout. I want to reassure the hon. Gentleman that the NHS is focusing on recovering cancer services to pre-pandemic levels; an additional £2 billion of funding was made available to the NHS and there were 44,000 more staff from October 2020. We are absolutely committed to getting back on track for pre-pandemic levels. Cancer has always been a priority. That is no comfort to Geoff and his family, but hopefully they can be assured that we are doing all we can.

Topical Questions

Eight weeks ago, when this House last met for Health and Social Care questions, the world had not even heard of the omicron variant; but a third of the total number of UK covid-19 cases have been recorded since then. The action the Government have taken in response to omicron, and the collective efforts of the British people, have seen us become the most boosted and tested country in Europe, and the country with the most antivirals per head in Europe. That is why we are the most open country in Europe. I have always said that the restrictions should not stay in place a day longer than is absolutely necessary. Due to those pharmaceutical defences and the likelihood of our having already reached the peak of case numbers and hospitalisations, I am cautiously optimistic that we will be able to substantially reduce measures next week. The best thing we can all do to continue that progress is get boosted now.

May I put on record my gratitude to the Secretary of State for all the help he provided to my constituents before Christmas? He went beyond the call of duty, and I am very grateful to him.

The aftershock is often worse than the earthquake. My anxiety about covid is that it was the earthquake, but we still have the aftershock to come—that is, all the problems in cancer care, and the lack of doctors in emergency medicine, as well as in so many other disciplines. How will we make sure that the 6 million people on waiting lists get the care that they really need, and that the number does not grow over the next few months?

The hon. Gentleman is absolutely right to raise this issue, and I thank him for his comments at the start. We all know, as we have just heard from the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), that the NHS in particular and social care have been under huge pressure; I think it has been the most challenging time in their history. Everyone has performed in a way that we can all be proud of. Despite that, we have seen a huge rise in electives, and I think that the number will go higher before it goes lower, because so many people stayed away when they were asked to. I want them to come forward. I want them to know that the NHS is open for them. We will support it with a bigger workforce and more investment, including the £36 billion of extra investment from the new NHS and social care levy.

T4. Delays in cancer diagnosis and treatment have had tragic consequences for some of my constituents. What is my right hon. Friend doing to improve cancer survival rates? (905068)

My hon. Friend raises an issue that is very close to my heart, and the hon. Member for Rhondda (Chris Bryant) rightly raised it a moment ago, too. The pandemic has exposed huge health disparities in this country. It is clear to me that we need to go much further on cancer, not only to catch up on cancer referrals, diagnosis and treatment and radical innovation, but to improve the persistently poor outcomes that patients in this country have long experienced compared to those in other countries. It is time we launched a war on cancer. I am working on a new vision to radically improve the outcome for cancer patients across the United Kingdom, and I will have more to say on that in due course.

Keeping the Secretary of State on the subject of cancer, half of all patients with suspected breast cancer are not seen within the recommended two weeks. In two months, the number of patients who were not able to see a specialist in the target period has gone from 5,000 to 23,000—a far steeper increase than for all other forms of cancer—so I ask the Secretary of State: has breast cancer care been deprioritised?

Of course it has not been deprioritised. No cancer has been deprioritised. As the House has heard again today, we have seen an impact on healthcare across the country because of this terrible pandemic, including, sadly, on cancer care. Whether we are talking about breast cancer or other forms of cancer, they all remain a priority, including during the omicron wave; the NHS has made it absolutely clear that cancer remains a priority. As I said—I hope the hon. Gentleman agrees—we need to do more on cancer. I know that he cares deeply about this; he is right to have raised it twice in the past hour, and I hope that he will work with the Government on it.

I am going to raise it a third time, because it is very clear that breast cancer care is worse than care for other forms of cancer. The Secretary of State needs to account for that and tell us what he will do about it. On cancer more broadly, it is not good enough to return to the situation pre-pandemic, because as much as he wants to blame covid pressures for delays in cancer treatment, we went into the pandemic with waiting lists at 4.5 million, and with staff shortages of 100,000 in the NHS and of 112,000 in social care, which impacted on broader NHS performance. Where is the plan to fix the workforce challenge in the NHS? That is the biggest single challenge that will impact on his mission—the mission we all share—to improve cancer outcomes for everyone in the country.

The hon. Gentleman will know that survival rates from cancer were increasing before the pandemic, but as I think the whole House understands, the pandemic has had an impact on all other types of healthcare, including cancer. This is a challenge throughout the United Kingdom. He talks about waits for breast cancer treatment; those are longer in Wales, so this is an issue throughout the UK. It is right that we continue to focus on the workforce. We have 44,000 more health workers than we did in October 2020, and we will continue to build on that.

T5. Vast numbers of children and adults right across Cornwall cannot get access to an NHS dentist. That is not about funding, covid or even a lack of dentists; it is just that the contract under which they work is no longer fit for purpose. Next year, the responsibility for dentistry comes to Cornwall. Could we perhaps have a statement from the Minister about how we can reform that contract, which no longer works and keeps dentistry away from people who need it? (905069)

My hon. Friend gets to the nub of the problem. The 2006 contract, which was introduced under the last Labour Government and is dependent on UDAs—units of dental activity—creates perverse disincentives for dentists to take on NHS work. We are already starting work on reforming that.

We will not globally defeat covid if large proportions of the global population do not have access to vaccinations. The UK is one of a small number of countries blocking the TRIPS— trade-related aspects of intellectual property rights—waiver. Will the UK Government stop blocking the vaccine intellectual property waiver, and allow nations to manufacture the vaccines themselves?

The hon. Gentleman is right about the importance of helping the whole world to acquire these life-saving vaccines. That is why the UK can be proud of the more than 30 million vaccines that it has delivered to developing countries already. We will meet our commitment to increase that to 100 million by June, but we do not agree with the suggestion about the TRIPS waiver, because it will make future access to life-saving vaccines much more difficult.

T6. I was delighted by the recent announcement of £50 million for motor neurone disease research, which my constituent Doddie Weir campaigned for tirelessly. Will the Secretary of State update the House on the steps being taken to allocate those funds, and to ensure that is done as quickly as possible, as time is of the essence for MND sufferers? (905070)

My hon. Friend is right to raise that point, and I commend him on the fantastic work that he has done in leading this campaign. We were delighted to announce £50 million of funding for MND research. That will support a new MND research unit, which has already started work to co-ordinate research applications, and a new MND partnership, which will be formed to pool expertise across the research community.

T2. Last week, the Royal College of Physicians reported that one in five doctors felt “overwhelmed almost every day”. One doctor in my constituency told me that every single member of staff at their surgery was either receiving counselling, on antidepressants or signed off work with stress, compounded by what they perceived as GP-bashing in the media. With that in mind, may I ask the Secretary of State what steps his Department is taking to protect the mental health of GPs and NHS workers? (905066)

The hon. Lady is right to raise that issue. Healthcare workers have been under significant pressure, especially over the past two years, and of course that applies to GPs. The support we have provided through the winter access fund—the £250 million—is there to help GPs’ surgeries across the country, including with their workforce.

T7. My hospital trust is looking to redesign ophthalmology and cardiology services across its two hospitals, Eastbourne District General Hospital and Conquest Hospital in Hastings. The trust puts forward an important clinical case for the change, but given the realities—the road, the distance and the public transport options, which mean that it can be a journey of two hours via two buses for the one in four households in Eastbourne that do not have a car—any change can present a real problem and create issues for local people. Ahead of his visit to Eastbourne, will my hon. Friend the Minister meet me here to discuss this vital question of access to hospital services? (905071)

I am grateful to my hon. Friend. Public consultation on the reconfiguration in East Sussex was launched on 6 December last year and will close on 11 March. She is right to highlight access and transport links as a key factor in such decisions, and I would of course be delighted to meet her.

T3. Only 9% of people in low-income countries have received one vaccine dose. The UK Government have delivered less than one third of their pledged contributions to COVAX. Given that no one is safe until everyone is safe, what assessment has the Secretary of State made of the risk to public health from emerging variants from the unvaccinated worldwide, and will he ensure that all doses pledged will be delivered to COVAX by the end of June? (905067)

From the start of the pandemic, the UK has worked to support equitable access to covid-19 vaccines. It helped to establish the international joint procurement initiative COVAX, which supports higher and lower-income countries in securing the vaccines they need. As my right hon. Friend the Secretary of State has indicated, we are committed to delivering 100 million doses by mid-June; we had delivered more than 30 million by the end of 2021. The UK leads the way on variants through the UK Health Security Agency, and we are willing to progress that technology throughout the world.

T8. Building the women’s and children’s hospital at the Royal Cornwall Hospital was a key promise of this Government, and the Secretary of State’s predecessor was very supportive of it. Will my hon. Friend reaffirm the Department’s commitment to the building and agree to meet me to ensure that everything is done to get this vital project delivered on time? (905072)

We remain fully committed to the delivery of the important new women’s and children’s hospital in Truro for the Royal Cornwall Hospitals NHS Trust as part of our new hospital programme. My right hon. Friend the Secretary of State remains committed to it, and of course I would be delighted to meet my hon. Friend.

T10.   I hope you are watching “Geordie Hospital”, Mr Speaker—the Channel 4 series that follows the talented, highly skilled, dedicated and wonderfully witty staff of Newcastle upon Tyne Hospitals NHS Foundation Trust. As we enter our third pandemic year, after a decade of under-investment and low pay, and with staff shortages, absences and NHS waiting lists all rising, I hope that the Secretary of State recognises that what NHS staff need, as well as a great sense of humour, is a long-term workforce plan. Will he bring one forward? (905074)

First, I commend everyone working in the Newcastle hospitals trust and across the NHS for everything they are doing. The hon. Lady is right to talk about the importance of the workforce—that is why we have asked Health Education England to come up with a 15-year workforce framework—but she knows that the resources that the NHS has make a big difference, and it would have helped if she had supported the Government’s record investment of £36 billion over the next three years in the NHS and social care.

T9. Can my right hon. Friend tell the House how he is making it easier for transport workers, who are disproportionately under-vaccinated, to get their jabs and get this country moving? (905073)

We are intent on making vaccines as accessible as possible, so there are now more vaccination sites than at any point in the programme. They operate 12 hours a day, seven days a week where possible, including at hundreds of walk-in and pop-up sites. In every community, there should be slots available at least 16 hours a day; in some places, that is extended to 24 hours a day to support workers such as those in the transport sector, who often work unsociable hours.

The Secretary of State has introduced guidance for essential care givers so that family members can visit loved ones in care homes. Is he considering going further to guarantee the right to visit residents in care homes and patients in hospitals?

The hon. Member makes a very good point. It is important that people get the right to visit their loved ones in care homes. That is why we have introduced guidance that says that essential care givers should get access to care homes at all points, even during outbreaks. There is a process, which the Care Quality Commission manages, for reporting those that do not comply, but if there are specific examples, I am very happy for him to write to me with details and I will follow it up.

This morning, the Health Secretary is reported in The Times as saying that the NHS can learn from the way in which academy chains are regulated, but he will know that the education system has no national targets, while the NHS uses more national targets than any healthcare system anywhere in the world. Will he look at the role of targets and the risk that they focus managers on bureaucratic numbers, sometimes at the expense of quality of care for patients?

I very much agree with my right hon. Friend; as the whole House knows, he speaks with considerable experience. We need to do things differently, especially as a result of the pandemic and the challenges that it has created. That requires reform, and we will set out further reforms in due course. He is absolutely right about targets: they can play an important role, but they can also lead to poor outcomes for patients, and all targets need to be properly reviewed.

Sheffield’s Weston Park Cancer Centre is one of just four specialist cancer facilities in the country, but it desperately needs a £50 million upgrade, as the Secretary of State will know because I raised the matter with his predecessor and wrote to the Secretary of State in October and again just last week. Will he urgently respond to the proposal, which is vital for cancer outcomes in South Yorkshire?

We will endeavour to respond swiftly, but if the hon. Gentleman would like to meet me about capital funding for those sorts of projects, I am always happy to meet him.

Now then: the Health Secretary will be aware that King’s Mill Hospital in Ashfield was built under a disastrous private finance initiative deal under the last Labour Government. It now costs us about £1 million a week to service the debt—money that could be spent on social care in Ashfield. Will he meet me to discuss how we can rid my trust of this crippling debt of £1 million a week and spend it on social care?

My hon. Friend is absolutely right to highlight the impact of yet another of Labour’s disastrous PFIs on the funding available to our NHS, and indeed to social care. We continue to work hard to deliver our manifesto commitment to improve on those disastrous PFI schemes. I am very happy to meet him to discuss the matter.

Just last month, Luton lost an outstanding champion in the other place with the sad passing of Lord Bill McKenzie of Luton. Just 21 months previously, he had been diagnosed with pulmonary fibrosis.

Last week I met the chair of the Pulmonary Fibrosis Trust, one of my constituents in Luton South, who told me that there is no current cure for the disease and that for most people there is no known cause. Will the Secretary of State outline what steps his Department is taking to support research into a cure and to improve diagnosis, support and care for people living with pulmonary fibrosis?

I thank the hon. Lady for raising the matter in the House. Pulmonary fibrosis is a very serious condition. Far too many people suffer from it, and there needs to be more research globally—not just here in the UK, but working with our international partners. I will bring the matter to the attention of my officials and see what more we can do.

Sadly, the situation in Scarborough and Whitby for patients seeking a new NHS dentist is no better than that in St Ives, with thousands of UDAs going unused. Dentists tell me that it would help to have a date for the end of the UDA system so that they could start recruiting staff and, in some cases, building new premises to deliver NHS dentistry to local people.

My right hon. Friend is correct. As I said earlier, the disastrous contract of 2006 is causing disincentives for NHS dentists to take on NHS work. I assure my right hon. Friend, however, that dental services in Scarborough are currently being commissioned by NHS England following the handing back of dental regional accountability. Procurement processes are in place, and a new practice is set to be in place by the summer.