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Oral Answers to Questions

Volume 689: debated on Tuesday 23 February 2021

Health and Social Care

The Secretary of State was asked—

Covid-19: Isolation Support

What recent discussions he has had with Cabinet colleagues on the adequacy of isolation support for people who have tested positive for covid-19. (912264)

What recent discussions he has had with Cabinet colleagues on the adequacy of isolation support for people who have tested positive for covid-19. (912272)

What recent discussions he has had with Cabinet colleagues on the adequacy of isolation support for people who have tested positive for covid-19. (912293)

The Government have put together a range of measures to support people through the current crisis. These include Test and Trace support payments for those on low incomes, support for renters, help with utilities, the £500 million local authority hardship grant, the £170 million covid winter grant scheme and a £7.4 billion package of additional welfare support in 2021. The Government keep all elements of their covid response under review, as is right, to support people.

I thank the Minister for providing that information, but the lack of financial support to those self-isolating has resulted in an extremely low adherence rate. Seventy per cent. of those who apply for financial support are rejected. Will the Government consider increasing funding to cash-strapped local authorities to ensure that people have the financial means to self-isolate to control the spread of the virus?

I thank the hon. Lady for her question. We are continuing to work across Departments and with local authorities to monitor the effectiveness of the self-isolation support provided to people who have tested positive, their close contacts and their families. She is right that we continually look at this to ensure that we have the correct information. Currently, with NHS Test and Trace, we are carrying out surveys of reported compliance with self-isolation for people who have tested positive. The results are not published yet, but we have a clear set of parameters and the funding has been allocated to councils to assist with discretionary grants. Those are local decisions, and I have often heard it said that decisions should be local, but I ask her to wait until my right hon. Friend the Chancellor reports during the Budget next week on what additional support we will be giving.

Last November, I wrote to the Health Secretary to raise a number of serious concerns that have been raised with me by many of my constituents who are unable to claim their self-isolation support payment because of failings with the privately run Test and Trace system. Three months later, I have still not had a response. We all know how keen the Health Secretary is to avoid scrutiny of the contracts that his Department have issued, but he cannot bury his head in the sand and pretend that these problems do not exist. Can I get an assurance from the Minister that I will get a response and that the problems that I have raised will be addressed?

The Health Secretary has assured me that he has seen the hon. Gentleman’s letter. It is important that people understand that they need to self-isolate and they are given the right assistance. This is why the discretionary payments have been made to councils, so that we can make those decisions locally to support people.

Let us head up to Bolton, to Yasmin Qureshi. [Interruption.] No, we cannot, so we will go first to shadow Minister Justin Madders.

The Government’s road map yesterday said:

“While self-isolation is critically important to halting the spread of the disease, it is never easy for those affected.”

We agree with that. We have been making that point for months, along with most of the expert advisers in the Government, which is why creating a scheme that only one in eight people qualify for was never going to work. Will the Minister tell us why, despite yesterday’s announcement, it is still the case that only one in eight people who test positive will actually qualify for a self-isolation payment?

I thank the hon. Gentleman for his question. It is important that we have targeted support and that we support the people who need assistance, so that they can self-isolate. It is, exactly as I outlined in my first answer, what we have been doing, and as my right hon. Friend the Prime Minister said yesterday, we will continue to look after people through the pandemic. Our undertaking is to make sure that we protect people, whether they are self-isolating or unable to work for other reasons, such as shielding, throughout the duration of the pandemic. The hon. Gentleman will be hearing much more about that from the Chancellor next week during the Budget.

Thank you, Mr Speaker. My constituent, a shop worker, has a daughter who was sent home from school to isolate. She will not get paid, will not get sick pay and is worried about losing her job. She needs money to put food on the table for her family. Will the Minister tell the Chancellor that we cannot keep the infection rate down if people are not given adequate financial support?

I thank the hon. Lady for her question. I would also like to point out that, in her area, 93% of cases are being tracked and people are being spoken to, which highlights the great work that is being done on the ground locally in that area. We are providing support, and I would urge her constituent to reach out to the council, because it is important that we give people the support they need in order to isolate. As I say, she will be hearing more on that subject from the Chancellor during the Budget next week.

Public Health England

We are currently considering the best future arrangements for Public Health England’s important health improvement functions. We have been engaging with key stakeholders throughout the process and will be setting out further details of our approach in due course. We are excited about creating the national institute for health protection to ensure additional capacity so that we have future capability and a laser-like focus on areas of health inequality.

I very much welcome the plans to reform Public Health England’s health protection functions, and I note with interest the Secretary of State’s new powers of direction in some public areas, such as obesity. Blackpool has some of the most severe public health challenges in the country. Further discussions about the health promotion functions of Public Health England were promised when the NIHP was announced, so can the Minister say now how other areas of public health promotion that are not referred to in the White Paper will be addressed?

I thank my hon. Friend for his question, and I recognise the challenges that Blackpool faces. I read with interest the Blackpool town prospectus, which highlights the public health challenges, and I am looking forward to talking to the clinical commissioning group lead about them later this week. We remain convinced that place-based approaches will have the best results, where we can target interventions in the right way when they are needed. I think my hon. Friend is alluding to other areas such as work, housing and so on. Discussions are going on with other Departments, but those specific initiatives are for those Departments themselves. As the details of the national institute for health protection are outlined, these things will become clearer. I know my hon. Friend cares deeply about his constituents and their health, and I look forward to working with him and others in the future.

Mental Health Legislation

On 13 January, we published a White Paper on reforming the Mental Health Act 1983, setting out proposals to make the Act work better for people. We have launched a 14-week consultation, during which we are inviting views from the public, professionals, service users and carers to ensure that we get this once-in-a-generation opportunity right.

I am delighted that my hon. Friend is taking steps to bring mental health laws into the 21st century, not least because they are 40 years old. Can I take this opportunity to pay tribute to Sir Simon Wessely, who produced his independent review into the Mental Health Act in 2018? Can my hon. Friend confirm that the Government will be accepting many of his recommendations?

I wholeheartedly agree with my hon. Friend, and I would also like to pay tribute to Sir Simon and his co-chairs for their comprehensive work. The Secretary of State said in the House last year that

“the Wessely review is one of the finest pieces of work on the treatment of mental ill health that has been done anywhere in the world.”—[Official Report, 23 June 2020; Vol. 677, c. 1164.]

I know that the review was welcomed by hon. and right hon. Members across the House. We are taking forward the vast majority of Sir Simon’s 154 recommendations, either directly or by advancing the principles put forward by the review. The White Paper document contains the Government’s response to each of the recommendations.

The overhaul of the Mental Health Act has been long awaited. It is people who have to be at the heart of the legislation, and that includes staff. The promises that the Secretary of State has made rely on a workforce: our fantastic frontline mental health staff, of which there are simply too few at present. I asked him last month to outline when we would get the workforce settlement and what reassurance he could give on filling the training places. We are still waiting for an answer. Would the Minister like to answer now?

Work is under way; Health Education England is looking at proposals, particularly for the training of mental health workers. I wish to highlight one area where we can see that happening rapidly: in the mental health support teams that are going into schools. People are coming out of universities with their degree and going through a year’s training so that we can get them into schools faster to work with children and young people. The hon. Lady is right; the mental health workforce is at the heart of these reforms. I assure her that we have seen an increase in the number of people applying to be mental health nurses—and nurses across the healthcare estate—and that will have a knock-on effect on the number of people we have working on the wards with people who have severe mental illness.

Covid-19 Vaccination Programme

I am delighted that on 14 February we hit our target of vaccinating 15 million people across the UK and now more than 17.7 million people—one in three adults in the country—have been vaccinated. The NHS is delivering more than 250 vaccinations every minute, on average, and we are vaccinating at a greater weekly rate than anywhere else in Europe.

The Government’s vaccine programme, procurement and roll-out has been described as “world-beating”. Those are not my words, but those of the Public Accounts Committee, which has Scottish National party, Labour and Lib Dem Members on it. Will the Secretary of State just clarify the link between the vaccine programme and the road map, because it is the return to normality, as far as is possible, that we want to see as soon as possible?

My hon. Friend is absolutely right to make this link, because not only are the vaccines important to keep each individual safe—we saw wonderful data yesterday about how effective they are at reducing hospitalisations and deaths—but the vaccination programme is crucial to the road map out of this pandemic. It is only because of the success of the vaccine programme that we are able to set out the road map in this way. The vaccine is good for the individual, but it is also good for all of us, because by taking a vaccine people are helping to protect themselves and helping all of us to get out of this pandemic situation.

The provision of insufficient doses for care home staff to be vaccinated at the same time as elderly residents may have contributed to the fact that only two thirds have been immunised. As well as the convenience, the solidarity of being vaccinated with colleagues has helped to encourage uptake of 94% in Scotland. Will the Secretary of State ensure that staff can get vaccinated when second doses are delivered to care homes?

Yes, when the vaccination programme goes to a care home, vaccines are offered both to residents and to staff, of course. We want to support the ability of more and more people to access the vaccine, and that includes care home staff. People who work in a care home can now go on to the national vaccination site and book themselves an appointment. Alternatively, when we go to give the second dose to residents, any staff who have not yet taken up the opportunity of a vaccine will have the offer of getting going on the programme. I hope that care home staff and NHS staff across the board will listen to the words of the chief medical officer, who said that it is the “professional responsibility” of people who work in care settings to get vaccinated. It is the right thing to do.

More vaccine-resistant strains, such as the South African variant, could risk undermining the UK’s vaccine programme. As they could come via any country, does the Secretary of State not agree that all travellers should undergo strict quarantine?

Yes, I do. All those who arrive in this country as passengers need to undergo quarantine, and we have both the hotel quarantine and home quarantine; all need to be tested; and all the positive test results are sent for sequencing so that we can spot any new variants. This is a critical part of our national defences. The good news is that we can see from the data that the number of new variants in the country is falling and is much lower than it was last month. We obviously keep a very close eye on that, because making sure that we do not have a new variant that cannot be beaten by the vaccine is a critical part of the road map, as set out by the Prime Minister yesterday.

The Prime Minister promised that all staff in elderly care homes would be vaccinated by the end of January. Will the Secretary of State confirm that more than 30% of those staff in England have not been vaccinated, and that the proportion rises to almost half of all staff in elderly care homes in London? Will he urgently set out precisely how the Government will increase uptake and tackle lies and misinformation about the vaccine among this vital group of workers, as we have been urging the Minister for Care to do since before Christmas?

Yes. We are absolutely all on the same side on this issue. To be totally clear for the hon. Lady, and all those listening, the Prime Minister set out that we would offer the vaccine to all residents of care homes by the end of January and to all staff by 15 February, and we achieved that. The challenge is uptake. Rather than having a political ding-dong about it, what we all need to do is get out the positive messages about the vaccination programme. I am delighted that the Minister for Care and the Minister for Covid Vaccine Deployment have both been working incredibly hard on this issue, and we published an uptake plan last weekend. I am sure the hon. Lady will want to join the efforts to try to encourage everybody to get the jab.

Covid-19: Dental Services

We are committed to supporting all NHS dental services through the pandemic. NHS practices receive full funding for the first three quarters of the year, minus agreed deductions in England, and NHS dental contractors will continue to be supported while they meet reduced activity targets. NHS England and Public Health England continue to communicate regular updates, enabling practitioners to prioritise urgent care and reduce waiting times in what are challenging circumstances.

The British Dental Association has raised concerns that punitive financial penalties for not meeting the Government’s unrealistic activity targets are pushing NHS dentists in England to prioritise quick check-ups rather than catching up on the backlog of more time-consuming symptomatic cases. Will the Minister consider a more realistic approach to service recovery and commit to reforming the dental contract in England so as to promote preventive dental care in future?

As anybody will know, I have been heavily engaged with the dental profession over recent months, because I agree that a preventive approach to dentistry is certainly one that we need to be moving towards. The activity target is expected to increase availability for patients, who are the important part of the equation. It is important that we support the profession but enable patients to have access and reduce waiting times and backlogs. The target is based on careful modelling—on data—and takes into account guidance on infection prevention and control and social distancing measures. We recognise that there may be exceptional circumstances, which is why there are exceptions to the target level. NHS commissioners have the discretion to deal with exceptions and support dental practices. I have a meeting with everyone again on Thursday.

Health Infrastructure Plan: District Hospitals

What steps he is taking to ensure that improvement work on district hospitals is taken forward under the health infrastructure plan. (912269)

Alongside our investment in 40 new hospitals, our health infrastructure plan more broadly will deliver a long-term rolling programme of investment in health infrastructure, including our vital district hospitals—I know that my hon. Friend’s constituents are well served by the Hospital of St Cross. Hospitals have benefited from more than £600 million of critical infrastructure risk funding, including for district hospitals, and will shortly receive their capital allocations for the forthcoming financial year.

I am grateful to the Minister for his reply. As he says, it is entirely right to be investing in the new hospitals—the 40 new hospitals for our NHS. He referred to our brilliant local district hospital, St Cross. The past year has reminded us of the importance of a well-resourced local health service. How can we ensure that existing district hospitals doing great work, such as St Cross, continue to receive the investment they need?

I am grateful to my hon. Friend for his question. May I join him in paying tribute to his local Hospital of St. Cross and the team who have done an amazing job in very challenging circumstances over the past year? I know that he is a strong champion of it and of his local NHS—I think I can recall him volunteering at the Locke House vaccine centre recently in support of his NHS. Of that critical infrastructure funding to which I referred, £2.2 million was allocated to his trust and local hospital. As I mentioned in my initial answer, we will be making further capital allocations shortly, which will benefit district hospitals, including his own.

Long Covid

The Government are working hard to set up patient-focused, evidence-based and effective support for people with long covid. In October, NHS England and NHS Improvement announced a five-part package of measures, including the establishment of 69 multi-disciplinary assessment services. Last week, almost £20 million of research funding was committed to helping identify the causes of long covid and the effective therapies to treat people who suffer from some of the chronic symptoms.

My constituent Emma Samms, the actress, has pulled together a reunion of the cast of “Dynasty” to add some glamour to fundraise for research into long covid. In Gloucestershire, we are also setting up a clinic. We clearly need to learn an awful lot more about the symptoms. Will my hon. Friend join me in praising those initiatives and continue to reassure us that we will provide full support to GPs, hospitals and patients for this awful disease?

I thank my hon. Friend for her question. I am delighted to join her in congratulating Emma, who I know is using her experience of having had covid to launch such an innovative fundraising idea. I already have a Dallas-style hairdo, because I have not been to the hairdressers for some months. I just need some shoulder pads. I thank her and all volunteers and fundraisers for their marvellous job in coming up with some really great ideas to support research.

Care Homes: Family Visits

Throughout the pandemic, we have had to strike a balance between protecting people from this cruel virus and social contact. Nowhere has this been harder than in care homes. That is why I am so pleased that, from 8 March, we will be enabling care homes to open up carefully to more visiting. Our guidance will set out how residents can have a named person for repeat visits, with testing and PPE so that those visits can be indoors. We look forward to enabling more visiting as soon as it is safe to do so.

I welcome the new guidance on care home visits, but I am concerned about this phrase:

“With the agreement of the care home.”

Does the Minister share my concern that that may allow some care homes to disagree with the guidance, therefore decide that the risk is too high and prevent the physical contact that residents in care homes are so desperate to have with their loved ones?

The hon. Member makes an important point. We have been clear that we want to see care homes enabling visiting. We recognise that care homes are having to strike a balance between giving residents access to visitors and making sure that those residents are safe. Our guidance will provide further support to care homes on how they can make sure that those visits happen.

Care homes for older folk and disabled people are a basic human right. Given that care home residents—either in the care homes themselves or perhaps in hospital—account for a third of all deaths from covid, should the Government not be trying just a bit harder to provide the staffing that is often required for those extra visits? When will the Government lay out their plan to address social care, which is so clearly lacking and has been promised for about 10 years now?

The hon. Member is right to say that visiting at the moment involves extra staffing—for instance, staff to supervise visits and to support the testing that we will be bringing in with the new visiting guidance. We have already provided funding to the social care sector that can be used to support the cost of visiting, and there is additional funding for extra workforce costs.

Covid-19 Vaccine Supply

The Government have secured early access to 457 million vaccine doses through agreements with eight separate vaccine developers. I assure the House that the Government are in constant contact with the vaccine manufacturers, and remain confident that we are on track to offer a vaccine to all priority cohorts by mid-April.

People like my constituent, Ken, in Dudley South have seen the European Commission threatening to ban vaccine exports to the UK, and are worried about whether they will be able to get their second dose. What assurances can my hon. Friend give to Ken and others like him that they will be able to get a second dose of the same vaccine within the specified time schedule?

The vaccine taskforce—I pay tribute to Kate Bingham and Clive Dix, and to the brilliant civil servants who do the heavy lifting—has conducted a supply chain risk assessment and continues to monitor requirements across the supply chain, from supplier through to patient. We are in constant contact with the suppliers. The NHS is already reserving second doses. Last week, we began informing the frontline—primary care networks and others—of the second dose schedule. I can reassure my hon. Friend’s constituents that if they have had a Pfizer first dose, they will get a Pfizer second dose within the 12 weeks; and if they have had an Oxford first dose, they will get an Oxford second dose within the 12 weeks.

Will my hon. Friend confirm that Wales has been provided with enough supplies of vaccines to hit the targets set by the UK Government, particularly the 31 July target? Does he agree that, had we joined the EU’s vaccine procurement programme, immunisations in Wales would be much further behind right now?

We are working very closely with the Welsh Government and the other devolved Administrations to ensure that vaccines are allocated as per the Barnett formula. The Secretary of State has quite rightly reassured all the devolved Administrations that they will receive the vaccines to be able to deliver on the targets that we have set. It is great to see that over 860,000 people have received their first dose in Wales. The pace of our vaccination programme means that we have administered more vaccines than any other European country.

Adult Social Care Funding

During the pandemic, the Government have provided over £1.1 billion for infection control, £149 million for rapid testing costs and £120 million to boost the workforce in adult social care, and that is in addition to £4.6 billion to local authorities. For 2021-22, we are meeting our commitment to an annual uplift of £1 billion for social care and will provide councils with access to an additional £1 billion.

Does my hon. Friend agree that the best long-term funding solution for adult social care is a German-style social care premium?

I agree that we need a sustainably funded social care system. I know that my hon. Friend is very well informed of the options. We are committed to taking forward social care reform, and will be publishing proposals later this year.

Health Service Capital Estate

A total of £600 million has been allocated to tackle almost 1,800 urgent maintenance projects across 178 trusts, all due for completion by March 2012, while £450 million has been invested to upgrade A&E facilities, with funding awarded to over 120 trusts, and improve over 190 urgent treatment sites this winter. In addition, of course, the Prime Minister has confirmed that 40 new hospitals will be built by 2030, with an additional eight further schemes to be identified. Six of these are already under construction. With your permission, Mr Speaker, may I group this question with Question 21?

NHS staff at Royal Stoke University Hospital in my constituency have been using the old Stoke Royal Infirmary site, which stopped delivering clinical services in 2012, for car parking. However, with the demolition of buildings on the site in readiness for the creation of many new houses, hospital staff really need the University Hospitals of North Midlands NHS Trust’s proposed plans for a multi-storey car park to come to fruition. Will the Minister ensure that the necessary investment is forthcoming for additional staff car parking facilities at Royal Stoke University Hospital to support our wonderful NHS staff and unlock this vital regeneration project for the people of Stoke-on-Trent?

I am very grateful to my hon. Friend, who is a strong champion and a strong voice for Stoke and for her local hospital. The Government are committed to increasing hospital car parking capacity and supporting trusts to invest in their car parks. We will continue working with NHS England, as well as trusts such as her own, to understand the specific requirements. I understand that an emergency funding application by the Royal Stoke in this respect has been received and is currently being considered. However, I am always happy to discuss with her the specifics of the case she raises.

Harrogate District Hospital, which is an excellent hospital, will be reducing its carbon footprint by a quarter and making energy cost savings thanks to a £40 million Government grant, but the healthcare estate is much more than hospitals: it is also doctors’ surgeries, specialised units and so on. What steps is my hon. Friend taking to ensure that the whole estate, whether large or small, is included in the decarbonisation investment programme?

How could I have failed to remember to group my hon. Friend’s question? I apologise to him. He is right to pay tribute to his local hospital in Harrogate. Zero carbon and environmental sustainability are key design criteria in our 40 hospitals programme, but it is also right, as he says, for that to flow throughout the NHS estate. The NHS’s net zero report provides a detailed plan for decarbonising the whole NHS estate and services. In that context, there is already a range of action under way, including the £50 million NHS energy efficiency fund, which, as a small example, is upgrading lighting across all NHS buildings, big and small, to improve environmental sustainability.

Covid-19: Health and Social Care Workforce

What steps his Department is taking to support the health and social care workforce during the covid-19 outbreak. (912277)

Our health and social care workers have been simply extraordinary during the pandemic, caring for people in the most challenging circumstances. We have done our utmost to support them every step of the way and we will continue to do so. We are recruiting extra staff and we are on track to have 50,000 more nurses in the NHS. We are funding things that help when working long hours, we are funding social care providers to provide full pay for staff who are isolating, and we have put in place a package of mental support for health and social care staff.

I thank the Minister for that detailed answer. Ensuring that we take care of our NHS is critical, as I know here in Lincoln. Therefore, we must be at the forefront of fighting all aspects of this disease. At what stage did the Secretary of State and his officials become aware that vitamin D helped to fight covid symptoms for certain sections of our society, for how long was this information suppressed or ignored, what steps have subsequently been taken to take appropriate action, and what other drugs have also not been fully utilised so far, such as hydroxychloroquine?

I thank my hon. Friend for his question. I can tell him that the National Institute for Health and Care Excellence published a guideline on vitamin D for covid in December. Its expert panel supported current Government advice to take vitamin D supplements through the autumn and winter. However, there is insufficient evidence that taking vitamin D mitigates effects of covid-19. I can also say that hydroxychloroquine is not recommended or authorised for the treatment of covid outside of trials.

Covid-19: Cancer Care and Treatment

What recent assessment he has made of the effect of the covid-19 outbreak on cancer care and treatment. (912286)

The tremendous efforts of our NHS cancer workforce are helping to ensure that those who need treatment can continue to access it without delay. The NHS has been clear, as have Ministers, since the beginning of the pandemic that continuation of urgent cancer care must be a priority. The NHS has established covid-secure cancer hubs, consolidated surgery, centralised triage to prioritise patients based on clinical need, and utilised the independent sector for capacity.

Staff at North Middlesex University Hospital have done an incredible job under difficult circumstances, delivering cancer care and treatment, but despite that the Government have acknowledged that more than 30,000 people are missing a diagnosis of cancer compared with 2019. With the cancer recovery plan due to expire at the end of March, can the Minister please set out her commitments to beat the backlog after March? How will a renewed cancer recovery plan help meet the ambitions for cancer care set out in the NHS long-term plan?

I am concerned, like the hon. Gentleman, about those who have not come forward and those who are not currently accessing treatment. I reassure him that once people do come forward, there is a speedy path to treatment. The numbers of those who are entering treatment, both on two weeks and on 31 days, is ahead of what it was at this time last year, and we are seeing enormous efforts from the cancer workforce. I am meeting this afternoon with the all-party parliamentary groups on radiotherapy and on cancer, and we will be discussing the recovery plan, which he is right goes to March. However, every single trust has been given a target to produce a plan for ongoing assessment of how it is addressing the backlog going forward.

Macmillan Cancer Support estimates that more than 40,000 people are missing a cancer diagnosis across England, including around 60 people in my constituency of Birkenhead. Behind each statistic is a family member and loved one whose prognosis and survival chances are being severely affected by the disruption caused by the pandemic. Can the Minister tell me what additional funding will be made available to ensure that missed cancer diagnoses are caught as soon as possible?

I thank the hon. Gentleman for his question. The latest official data for December, as I say, suggests that two-week wait GP urgent referrals were 7% higher than for the same month last year, 62-day GP urgent referrals were 6.7% higher, and urgent referrals for cancer were 151% higher than in April, showing the month we were most impacted. As I say, we are straining every sinew to make sure that cancer services not only recover but go on and are better to deliver more care for patients.

Going into this pandemic, staff shortages were already causing increased waiting times for cancer treatment. Despite being short-handed, our wonderful NHS cancer staff have done a heroic job maintaining services while fighting this virus, but given the size of the backlog, cancer services will need to go above and beyond pre-pandemic levels for a significant period of time—straining every sinew, as the Minister says. They need extra resources to be able to do so. Next week’s Budget must contain these resources. Has the Minister asked for them?

Cancer has been prioritised with funding throughout the pandemic. It is, as I say, a key priority. Not only have we invested in radiotherapy equipment to the tune of some £325 million but there is a £160 million initiative to provide covid-friendly cancer treatments that are safer for people. We still have the same objective in the long-term plan to diagnose more cancers early, and appropriate funding, such as the billion pounds targeted at the NHS to drive down cancer backlogs and to ensure that people can access care, is part of that strategy.

Covid-19 Vaccination: Vulnerable Groups

What estimate he has made of the level of covid-19 vaccination among (a) black and (b) white people in the most vulnerable groups. (912279)

Overall, we are encouraged by the vaccine uptake in the most vulnerable groups, with more than 17.7 million people in the UK having now received their first vaccination. To date, black people, who account for around 3% of the population, make up 1.7% of those vaccinated, while white people, who account for 86% of the population, make up 82% of all those vaccinated in England. We appreciate that there is still work to do, and our vaccine uptake plan addresses that.

Will the Minister speak to Public Health England and ensure that local directors of public health make this information and other information in relation to specific cohorts available at a borough level to local MPs? He will be aware that the danger is that we could be hitting our vaccination targets overall, but certain groups are left behind. Many local MPs want to have some transparency about what is happening locally.

I am grateful for the right hon. Lady’s question. She and I visited the Hatzola first responders, who did an incredible job that Saturday night of vaccinating 364 people from not only the Haredi Hasidic Jewish community but the Muslim community as well. Our uptake plan has four key enablers: working in partnership with local government and directors of public health; removing barriers to access—in other words, access being available at the time and place that people need it; data and information, which we share with directors of public health, and we want to share it in more granular ways; and, of course, engagement, engagement, engagement.

Liver Disease Treatment Pathways

The NHS is working to improve care for patients with all types of liver disease. Development and improvement of clinical care is supported via NHS England’s hepatobiliary clinical reference group. This clinical reference group has started work on the development of liver networks in England to enable quicker access to specialised liver services, as well as providing clinical advice on disease prevention and referral practice.

Liver disease has become one of the major causes of premature mortality in the UK, and covid has highlighted the susceptibility of people with liver disease to more serious cases of the virus. With that in mind, what plans does the Minister have to include improvements to liver care in the NHS recovery plan?

Last autumn’s spending review included £1 billion of funding to address backlogs, tackle long waiting lists and support up to 1 million extra checks, scans and additional operations in the NHS. As the NHS recovers, for liver care, as for other areas of treatment, we will look to not only recover backlogs but continue to improve the care provided and help people to live healthier lives to prevent illness in the first place.

Topical Questions

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Sitting suspended.