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Lateral Flow Tests in Healthcare Settings

Volume 711: debated on Monday 28 March 2022

Motion made, and Question proposed, That this House do now adjourn.—(Rebecca Harris.)

I am delighted to have secured tonight’s Adjournment debate on an important topic for my constituents and people across the country. I feel driven to raise this point again because I do not believe that the Government are adequately considering the most vulnerable. Two weeks ago, I wrote to the Secretary of State on behalf of more than 50 hon. Members of this place and others. We were of all parties—this is not a party political issue but one of fairness and justice—and we were of one mind: that the charge for lateral flow tests would exclude many from a proper part of life in this country.

It is clear to everyone that the fight against covid-19 is not over. The rise of new variants and strains will continue. Researchers and healthcare professionals will develop and deploy new and more effective vaccinations and therapies. I think the Minister will agree that we have to learn to live with covid and that we will not eliminate it tomorrow, but living with it is a death sentence for many. Millions across the UK are clinically extremely vulnerable or have CEV relatives and friends in care homes and medical settings.

Protecting the most vulnerable has been a key aim of public health policy for two years, and that is right.

I congratulate the hon. Gentleman on bringing forward the debate. I agree with him entirely. Does he agree that it is essential for testing to remain widely accessible for those who are face to face with the most vulnerable in society: the carers, who have been at the forefront of protecting all of us across the United Kingdom of Great Britain and Northern Ireland over the last two years? Lateral flow tests are still worth the cost, and they must continue to be available free for all vulnerable people and their carers.

I thank the hon. Member for that important intervention. I am sure that the Minister took note of his concerns.

We all know that we are experiencing and facing an increasing cost of living crisis, and earlier this month the Foreign Secretary agreed that the escalating crisis in Ukraine will only drive inflation higher, so in the midst of the most serious cost of living crisis for a generation, with a national insurance tax rise and with covid remaining a global threat, it would be wrong to add a further burden on to families wanting to stay safe from covid and visit friends and families in care settings. The introduction of charges for lateral flow tests risks introducing a serious cost on many for visiting their closest family when those visits mean so much to visitor and host.

I am grateful to my hon. Friend for bringing forward the debate. In York, the case rate is now 977.7 per 100,000, 261 patients are in hospital poorly, five more deaths have just been announced and four people are in intensive care, so the virus is far from leaving us. In Labour-run Wales, an extension to the lateral flow test programme has been announced so that we can know where the virus is, manage it and protect our NHS. Should we not be doing that in England?

I thank my hon. Friend for that intervention. Again, the Minister has taken note. I am certain she will make that comparison and try to assist and to follow the best practices in other parts of the country.

Low-income and frontline workers will be hit the hardest by the introduction of charges, but regular testing is vital to minimise the spread of covid-19. The money saving expert Martin Lewis said last week that he was out of ideas. There is nothing left for families to do. Inflation is just too high. In my constituency, I have spoken to staff and volunteers at Ealing food bank who do amazing work to help those most in need. They are deeply concerned about the move to charge for lateral flow tests. Their service users will have to make the choice between paying to test and heating and eating.

In January, I raised this issue with the then Minister for the Cabinet Office, the right hon. Member for North East Cambridgeshire (Steve Barclay), who agreed that testing

“has played a key role in our response”.—[Official Report, 13 January 2022; Vol. 706, c. 629.]

But now we are cutting off that limb of the response. The Government are choosing to weaken their arsenal in the fight and to lessen the effect of two years of hard work and sacrifice.

Even before the newest wave of inflation struck, families in my constituency were struggling to feed themselves. Now it will get only worse, with a cost of £12 for just one pack of tests. At the end of February I asked the Secretary of State for Health and Social Care how much the packs cost his Department, but he could not give me the figures for commercial reasons.

But please, Madam Deputy Speaker, do not think it is just the cost that is the problem: no, it is the fairness too. Throughout the country, nearly 1.5 million people are eligible for treatments such as antivirals if they get covid-19, because the UK Government have identified them as being at the highest risk of severe illness. We know that those people are more at risk, less safe, and less protected by natural or acquired immunity. Around 500,000 of these people are immunocompromised, meaning it is less likely that they receive the same level of protection from covid-19 vaccines. The vaccines have been incredible and have reopened the world for many, but not for everyone. Infection is still a terrifying and uncertain prospect for many of the 500,000 immunocompromised.

There is more. The national health service has worked tirelessly to keep us safe and to save lives. I again pay tribute to the incredible staff of Hillingdon Hospital who did so much for me when I had my own covid infection. They saved my life, and I am eternally grateful to them. What payment to them for two years of danger and worry is it that they will have no certainty that their patients are covid free?

I recall the fuss from Members on the Government Benches when they were asked to wear masks to help to prevent the spread of covid-19. There were ludicrous comments from some. One compared wearing a mask to abuse, agreeing with the statement that masks were

“germ or bacteria ridden cloths”.

Well, those in the NHS still have to wear masks for their own safety. Perhaps more testing, and allowing people to take responsibility without having to pay for tests, would allow a few more people in hospitals and GP surgeries to take their masks off.

My hon. Friend is making an excellent speech, I must say, but could I mention care homes as well? People have made huge sacrifices over the last two years in not seeing their loved ones in care homes, and not being able to afford a test will put another barrier in their way. Does my hon. Friend agree that in the care home setting it is vital that relatives have access to tests?

I thank my hon. Friend very much, and I was going to talk next about care homes, but her intervention has certainly confirmed my argument and point of view that this is the most important area the Government need to look at very seriously if we want to control the effects of covid-19 on our society.

We could also speak about dentists, whose industry is struggling with the pandemic, while they are driven by targets in NHS contracts that they cannot meet. There is no help from the Government to meet the massive costs of making their practices safer, but now patients are being robbed of the opportunity to test before going to the dentist’s. We cannot erase risk, but we can try to minimise it for everyone working in healthcare and in healthcare settings.

We have all gone through so much to combat covid-19, suffered so much and sacrificed so much. I do not argue for lockdowns and closing the economy or closing the country off from the world, but now is the wrong time to cut this specific key lifeline for millions. It is the wrong time to take away peace of mind, and the ability to do the right thing in checking whether we have covid-19 and acting responsibly. I urge the Minister to work with the Chancellor of the Exchequer to find a way to pay for lateral flow tests, and to protect this tool in the fight to ensure that the worst-off in society are not cut off from their loved ones and that the most vulnerable feel more secure leaving their homes.

First, I thank the hon. Member for Ealing, Southall (Mr Sharma) for bringing forward this debate about lateral flow tests in healthcare settings. He speaks so passionately about health issues more broadly, and I am grateful for his speech on this important topic today. He has spoken previously about access to covid-19 testing, particularly in specific settings, and I want to put on record my thanks for his contributions on these matters.

As the hon. Member highlighted, the pandemic has provided this country with a monumental challenge. When coronavirus first emerged, we knew very little about it, other than reports that people were becoming seriously ill and, very sadly, passing away. The Government moved quickly with unprecedented measures that affected every single person on these isles, building and scaling up our testing capability to levels not seen before, sponsoring the development of groundbreaking vaccine technology and being the first country in the world to approve a vaccine.

Our huge thanks go to all those who supported the vaccine roll-out and mass testing. From our NHS staff on the frontline, primary care workers and individuals in the community to the military providing expertise in logistics and planning, colleagues from the private sector and civil servants deployed from their normal roles, we recognise the immense effort and long, exhausting hours they have put in working to keep the nation safe.

I am proud of how the Government responded at pace to the challenges that health and social care staff faced. Since April 2021, we have dispatched over 5.8 million rapid lateral flow tests to NHS workers in England—directly to NHS trusts, care settings and the homes of individual staff members—with over 60,000 of those going directly to the hon. Member’s local NHS trust in Ealing.

Testing has been a crucial countermeasure throughout the pandemic. The world-beating scaling up of our PCR testing capability proved invaluable, enabling us to diagnose symptomatic individuals when facing a growing but relatively unknown threat from a new virus.

We introduced lateral flow devices in November 2020 as a tool in addition to the highly sensitive PCR tests. LFTs were a significant step change in our battle against covid-19, enabling us to open up greater levels of asymptomatic testing and tackling asymptomatic transmission when the vaccine roll-out was in its infancy yet still ahead of the rest of the world.

Since April 2021, 13,500 positive but asymptomatic NHS-linked individuals have been identified by LFTs. Through their tireless dedication to regular testing, staff in the NHS and in care drove that most pressing fight to protect those most at risk—their colleagues at work, their friends, their families and, most importantly, their patients. All were protected because we were able to break the chains of infection using LFTs. I want to put on the record my immense thanks to each and every NHS and care worker for their valiant and unwavering efforts.

Since the early months, we have learned a lot more about covid-19, including what makes someone more at risk of contracting the virus and how best to mitigate the risk of transmission. That applies in all settings, although especially in healthcare and social care ones, where the close nature of the care provided creates greater opportunity for transmission. In these places, LFT testing has helped to ensure that staff can continue to safely carry out essential care for those most at risk.

By relying on the expert advice of our medical and scientific advisers, many of whom have become household names because of their immense contributions, we have been able to take steps to mitigate the rate of transmission of covid-19. We are now in a much better position, where the link between infection and severity of disease is substantially weaker than in earlier phases of the pandemic. We have severely weakened the link between infection and severe disease. As the hon. Member for York Central (Rachael Maskell) said, cases are rising again. However, we are on the front foot thanks to vaccines and community covid-19 treatments.

The UK’s investment in groundbreaking vaccine technology and our world-beating vaccination programme has put us one step ahead of the virus. Vaccination is now the UK’s first line of defence. Thanks to the actions taken by the people of the United Kingdom, as of 24 March 2022 more than 85% of those over 12 have had two doses. Now we are also inviting those aged 75 and over, residents in care homes for older adults, and individuals of 12 years and over who have a weakened immune system to take up the offer of a spring booster jab.

Importantly, we now have widespread availability of targeted community covid-19 treatments. For people who are eligible, those can significantly minimise the chance of developing severe disease. I hope that the spring booster and the community covid-19 treatment programme reassure the hon. Member for Ealing, Southall that we take very seriously the situation of the immuno-suppressed.

My concern is that in York, where about 90% of people are vaccinated, the rate of people getting very poorly with covid is going up. The antiviral treatments are not effective, because there is an increase in mortality as well. Putting the additional line of defence—testing to prevent transmission—in the system is one way to save lives. I cannot understand why the Government will not move the issue on for three months; we could then review the situation again.

I thank the hon. Lady for that intervention; I know she is passionate about this issue, which she has spoken about many times. It is important that we should recognise that we have moved on. We have broken the chain of transmission with the vaccination programme, which is our first line of defence along with antivirals and therapeutics within NHS settings.

Core to continuing to stay ahead of the virus and learning to live with covid is a move to everyone embodying safer behaviours in their day-to-day lives. The Government recommend continued vaccination, which ensures that everyone is as protected as possible and reduces the chance of their becoming infected and transmitting it to others and of developing severe disease. We have the spring booster programme, and there is an evergreen offer to those who have not yet come forward for their first dose—there are a few of them every day—or who have delayed their second dose or booster. They are welcome to book their vaccines at any time.

We recommend ventilation to ensure that harmful particles are blown away, and the wearing of face coverings in crowded and enclosed spaces to minimise transmission, particularly where prevalence is higher. People should stay at home if they are unwell, to ensure that they do not spread the virus to their friends and family, as well as washing hands regularly and following NHS advice to “catch it, bin it, kill it.” In addition to that advice, NHS England for NHS staff, and the Department of Health and Social Care and the UK Health Security Agency for social care staff, provide expert infection prevention and control guidelines to ensure that healthcare staff, their families and their patients are kept as safe as possible.

Over the past two years we have worked relentlessly to ensure that the people of the United Kingdom have been protected from the virus, reacting to learnings and putting them into practice, as well as using them to implement pragmatic long-term plans. The approach to managing covid-19 in NHS and social care services has evolved over time, giving us the opportunity to learn what works best to keep people safe. We have the opportunity to put that learning into practice, while continuing to focus on providing care for those who need it and supporting those at risk from covid-19.

As we know, the pandemic is by no means over. The UK Health Security Agency continues to monitor the virus and has recommended a package of contingency capabilities that form a reasonable insurance scenario to enable us to respond to resurgences or new variants of concern. I reassure the House that in line with recommendations, the Government have secured a supply of lateral flow devices to use if necessary. Limited ongoing free testing will be available for a small number of high-risk groups within the settings we have discussed, plans of which will soon be set out in further detail by the Government. Once again I thank the hon. Member for Ealing, Southall for securing this debate on such an important issue and expressing his remarks so well.

Question put and agreed to.

House adjourned.