House of Commons
Tuesday 18 January 2022
The House met at half-past Eleven o’clock
[Mr Speaker in the Chair]
Business before Questions
Committee of Selection
That Jessica Morden be discharged from the Committee of Selection and Lilian Greenwood be added.—(Stuart Andrew.)
Oral Answers to Questions
Health and Social Care
The Secretary of State was asked—
Discharge from Hospital: Covid-19 Outbreak
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?
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?
Covid-19 Testing Infrastructure
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
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.
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
At the present time, no decision has been made to increase the upper age exemption for free prescriptions.
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
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
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
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?
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.
Discharge from Hospital: Care Packages
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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.
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?
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.
Migrant Crossings: Role of the Military
To ask the Minister for the Armed Forces to make a statement on the migrant channel issues and the role of the military.
Unacceptable numbers of people continue to make these dangerous channel crossings, and last November’s tragic deaths serve as the strongest reminder of the need to stop them. The Government have been exploring every avenue to prevent further crossings, and have now appointed the Ministry of Defence to take operational primacy for cross-channel counter-migration operations. That will mean a much larger and more visible role for the Royal Navy in operational planning, asset co-ordination and operational delivery.
As the Home Secretary explained during Home Office questions yesterday, the Home Office and the Ministry of Defence have worked closely on countering the small boats challenge through the military aid to civilian authorities process. Throughout the last 12 months Defence has provided a range of support, including the provision of surveillance aircraft, additional accommodation and planning expertise, and has assisted in the delivery of trials for novel tactics to help Border Force and the Home Office to better interdict and deter migrant vessels.
Details of how Defence will deliver and maintain the primacy of cross-channel counter-migration operations are currently being worked through. The Government’s objective is that no one should arrive illegally in the United Kingdom on their own terms, and all vessels transporting illegal migrants across the channel must therefore be intercepted before, or as, they land. Defence is committed to delivering that step change. Details of how it will be achieved will be made known in due course, but the House can be reassured that the MOD is working hand in hand with the Home Secretary and her Department to achieve this goal while ensuring the safety of all individuals involved and protecting other Defence priority output.
I am grateful to the Minister for that clarification.
We are rightly proud of our armed forces, who watch our backs and defend our interests across the world, and who are equipped and trained to step forward and assist other Government Departments in times of emergency. However, the bigger picture is clear to see. Our world is becoming more dangerous and more complex, and demands on our military—not least the Royal Navy—are increasing. The integrated review maps out the importance to the UK economy of retaining the freedom of the seas, increasingly challenged by China, Russia and, indeed, Iran. The Defence Committee’s recent review of the Royal Navy concluded that it is now too small to meet its current commitments in the Atlantic, in the Mediterranean, in the Gulf, off east Africa, in the Caribbean and in the Arctic, and, of course, with the tilt to the Indo-Pacific. Yet here we are introducing another task: co-ordinating the migrant crossing response, which is normally the responsibility of the Home Office.
As the Minister said, the migrant channel issue is complex and is not likely to go away soon. It is not an acute emergency, so why is the Navy being drawn in, even in this limited capacity? I say “limited”; the Minister spoke of “operational primacy”, and he is now responsible for it. There is a real danger of mission creep, with further navel assets being sucked into this challenge. Please will the Minister explain who will pay for this mission, what success looks like, and how long the task will last?
This tactic may, on the face of it, look popular, with 28,000 migrants now crossing every year—“send in the Navy to sort it out”—but it is not the strategy that will solve the problem of the movement of migrants. We need first to break up the gangs who encourage migrants in the first place, and secondly to help restore governance and security in the very countries from which these people are fleeing—places such as Afghanistan, Iraq, Syria, Libya and Somalia. Ironically, those are parts of the world where we have used our own hard power to intervene but then departed before there was enduring stability, and now families are fleeing towards Europe.
Unless the fires are put out at source, we will never reduce the numbers. We need a broader strategy than simply tasking the Navy to the channel, which will not be the answer.
I thank my right hon. Friend for elaborating on his urgent question. I take issue with his point that the Navy has to make a binary choice between work at home and work overseas. Ships are deployed all over the world right now, and other ships are making ready to set to sea in response to whatever crises may unfold in the Euro-Atlantic over the coming weeks.
In addition, there is capacity to do as we do year round, which is to deploy naval resources into the channel for purposes such as fishery protection and, indeed, securing our border. That is an important point. The purpose of our nation’s armed forces is to secure the UK’s national security interests both at home and abroad, and I would argue that deploying our armed forces to ensure that our borders are robust is a perfectly appropriate use of them. Indeed, as I know my right hon. Friend is very aware, there are parts of Europe right now in which state-sponsored illegal migration is being used as a sub-threshold weapon of competition. I am not suggesting for a second that the migration across the channel is that right now but, in the absence of robust defence of our borders, it could be in the future, and the MOD therefore has a perfectly reasonable role to play in ensuring that our borders are robustly protected.
My right hon. Friend specifically asked about pay. Clearly this will be a multi-agency effort under Royal Navy command. Where agencies are already doing things in the channel, they will continue to be funded by the Departments that own them.
Success is that we do not allow anybody to land in the UK on their own terms. For how long? Until the deterrent effect is achieved and the cross-channel route for small boats collapses.
There is a limit to my right hon. Friend’s question, which is the role of the Royal Navy and the military within the channel—that is what I am here to answer today—but I completely agree that this is just one part of a wider system. Indeed, he is right to note that the MOD has plenty of equity in providing stability in countries such as Iraq and in the Sahel, where the majority of migrants are coming from, and we are engaged in that.
Nobody is pretending that the presence of a rear admiral and a few extra Royal Navy ships solves this issue. It is regrettable that only part of the Government’s solution should appear in the papers, and I will do my best to answer any questions my right hon. Friend asks.
This Government now really are desperate. They are desperate to distract attention from accusations about the Prime Minister lying and partying in Downing Street, and they are desperate to prop up a Home Secretary who has been utterly failing for two years as the number of cross-channel migrants has tripled. The military are there to protect the nation, not Tory Ministers.
The Minister has confirmed today that the armed forces will be involved in what he calls operational delivery. He says the details are still being worked through, so let me try again. What will the armed forces now do? Will naval vessels be deployed in the channel? Will the Navy be used to push back migrant boats? Will the Navy use sonic weapons, as No. 10 wants? Will it step up the use of drones for surveillance? Will it transport migrants from British beaches? What military accommodation will be used to house and process migrants? We are told by the media that Rear Admiral Utley has been put in charge. To whom will he report, the Home Secretary or the Defence Secretary?
This announcement is official confirmation that the Home Secretary is failing. Our armed forces are always the Government’s last resort. The military aid to the civil authorities code means such assistance is granted only when
“the civil authority lacks the necessary capability to fulfil the task”.
Who will pay the military’s bills for this work? What will be the arrangements for co-operation between the UK and French military? The Minister promised me last month that he would
“publish details of Military Aid to the Civil Authorities…tasks on a fortnightly basis beginning in January 2022. These updates will be placed in the Library of the House.”
When will he actually do this, and will he publish the detailed terms of this MACA agreement?
The Navy was used before, in 2019. Two patrol vessels were redeployed from defence tasks to the channel. They intercepted no boats, at a cost of £780,000 to the taxpayer. Will the Minister guarantee that this military deployment in the channel will not compromise our armed forces in any of their fundamental defence tasks? When will the Home Secretary step up to do her job to secure a proper security agreement with the French, break the smuggling gangs, and prevent more tragic deaths of migrants in the channel?
I thank the right hon. Gentleman for his questions. I do not share his view of the Home Secretary; we have worked closely with her on a number of issues, including Op Pitting over the summer, where she made a number of courageous decisions about how to accelerate border flow at the Baron Hotel, and indeed throughout the past year when the MOD has been trying to support the Border Force. The fact is that this is not a MACA request; it is something quite different. It is asking the Navy to take primacy, from a command-and-control perspective, to bring to bear all the Government’s maritime assets that set sail, across all agencies, in order to try to cohere a more robust response at sea. It is an evolution of what we have been doing rather than a replacement of something that had previously existed.
As the right hon. Gentleman knows, there may be a requirement for more naval assets—warships—to be in the channel, but they sit too high off the water to be a credible platform from which to cross-deck people from a dinghy, so the presence of naval assets is probably from a command-and-control perspective rather than from an interdiction or interception perspective. There are better platforms within the Government’s inventory, and things that we can lease from the open market, that will be much more effective for mid-channel cross-decking under RN command and control.
Neither the Royal Navy nor the Royal Marines will be engaged in pushback, but that tactic has been developed by Border Force, and if it is applicable it will be used. The Royal Navy will not use sonic weapons. The Royal Navy or the wider military may be involved in transportation of people when they reach the shore as they enter the processing system. There may be a use for military accommodation. As I said, this is a UQ responding to a partial revelation of the plan, and I make no apology for the wider plan being still in development.
Rear Admiral Utley continues to report to the fleet commander, who reports to the First Sea Lord, who reports to the Secretary of State. Costs will lie where they fall, other than for novel capabilities, in which case there will be a chat with the Treasury. The MOD and the Navy enjoy excellent relations with the French MOD and the French Navy. We are confident in our ability to manage the cross-channel relationships.
I apologise to the right hon. Gentleman if I promised him an update on MACAs; I forgot that I had done so and I will make sure that that is rectified.
I welcome my hon. Friend’s statement. I do not see any problem with the Royal Navy getting involved with this issue. For weeks—for years—those on the Opposition Benches have been whingeing and whining that we are not doing enough. It is excellent that the military are taking control and that we are co-ordinating all the assets that we have. It makes perfect sense. When a ship intervenes somewhere in the middle of the channel, will it have the power to take the people back to France, where legally they should be, or do we have to take them into our country and then face all the problems of removing them if indeed they should not be here?
No. There is no power to enter another country’s sovereign waters to return people. This evolution in the capability of command and control means that there is a more robust response at sea so that nobody lands on their own terms and they enter a process in the United Kingdom that may take them to return or to some other outcome. The evidence in Australia and elsewhere is that that very quickly has a deterrent effect. I am answering questions on merely a part of the plan, and the House can sense my discomfort at being unable to illuminate it fully.
Let me start by underlining what a worrying development this is from the Government, both operationally and morally. The motivation to militarise this situation, in which desperate people make perilous crossings to reach safety and security, is immediately apparent, to say the least: this is the use of military camouflage to disguise a political crisis at the heart of the Government. We are talking about the Ministry of Defence, which is charged with the defence of the state and its people against external state or terrorist malign activity, threat or attack; not in any recent cogent assessment has the MOD or our armed forces been reconfigured to protect the state against civilians.
Will the Minister update the House on the admiralty’s critical analysis of whether to undertake significant maritime operations in respect of civilian subjects that are fraught with operational and reputational risk to the Royal Navy? Will he confirm that the Home Office request goes way beyond the realms of military aid to the civil authorities and instead represents an alarming politically expedient morphing of a civilian crisis into an entirely inappropriate military operation that is doomed to fail?
I take issue with the premise of the hon. Gentleman’s question, which was that people need to get into a small boat to find sanctuary. They are coming from France, which is a safe country. Those who continue their journey do so because they want to be in the United Kingdom, not because they are scared of where they are.
As for the idea that the MOD is not configured to protect against civilian threats, we have just been through two decades of counter-insurgency and reconfiguring to deal with the emergence of sub-threshold threats. Threat no longer wears a uniform or drives around in a painted military vehicle that flies a flag; it is increasingly likely that the threats posed to the United Kingdom come not from military sources. Of course the Ministry of Defence, which is charged with the defence of the homeland, has a role to play in ensuring that our borders are more robustly protected.
I welcome the announcement that the military are finally to be brought in to supersede Border Force—or, as some of my constituents refer to it, “taxi force”. We need to add credibility to this announcement, so, first, what operational name is the mission to be given; which armed forces units are likely to be involved; and thirdly, if they are not going to be involved in pushback or to deploy sonic weapons, what are they actually going to do?
Its name is Operation Red Meat!
My former boss on the Energy and Climate Change Committee, the hon. Member for Na h-Eileanan an Iar (Angus Brendan MacNeil), is sure that he knows the name of the operation, but I am afraid he is wrong: its name is Operation Isotrope. In all probability, the units involved initially will be some of the batch 1 offshore patrol vessels that are permanently committed to home waters, probably with some P2000s.
As I said earlier in response to the shadow Secretary of State, the right hon. Member for Wentworth and Dearne (John Healey), when he pointed out that military warships have not previously been applicable in mid-channel cross-deckings, their height off the water makes them an inappropriate platform to be hands-on in the process; their role will be one of command and control, if, indeed, anything at sea. The reality is that, as I think my right hon. Friend appreciates, the Government have a large inventory of maritime assets. We argue that if the full spectrum of those maritime assets were brought to bear on this problem and cohered under a military command structure, that would provide a step change in capability.
My right hon. Friend will be disappointed that the Royal Navy and the Royal Marines will not be using pushback tactics, sonic weapons or whatever else but, as I have said clearly in response to previous questions, Border Force has been trialling those tactics and they may have a purpose. That is all part of the ongoing military estimate. I would argue that the deterrent effect is achieved not just through an ability to push back mid-channel, with all the problems that come with that. If we can guarantee that nobody gets to land in the UK on their own terms and that the system beyond that delivers an effective outcome that acts as a deterrent for those deciding to put themselves in the people traffickers’ hands, this approach could and should work.
My right hon. Friend will be frustrated that I am unable to unveil the full scope of the plan. That is partly because I do not know it. I also think that the Prime Minister would like to do that himself later in the month.
The Minister said that the Royal Navy will not use sonic weapons, but long-range acoustic weapons are already fitted to Border Force vessels. As the Royal Navy has assumed operational control of Border Force, will he state that no Border Force sonic weapons will be used for migrant crossings? Will he also publish a rule of engagement for using sonic weapons against civilians? Even the leaking and spinning of that suggests a really dark force that we do not need in the debate.
I take the hon. Gentleman’s point. If Border Force vessels are fitted with a capability that the Royal Navy commander feels is inappropriate for use, he will not direct that it is used. That is his judgment. The hon. Gentleman, as the proud MP of the Royal Navy in Devonport, probably appreciates that in the MOD we deal with operational mission command and the Royal Navy uses its judgment to bring to bear what it thinks is best. I trust Rear Admiral Utley entirely to make the right decisions in that regard.
I will be honest with the hon. Gentleman: I am not entirely clear about the custom for publishing rules of engagement. Perhaps he will let me write to him with that in due course.
Can my hon. Friend guarantee that no resource—be that manpower or asset—will be removed from another theatre to which an already overstretched Royal Navy is currently deployed, carrying out its primary role of protecting the UK and its interests, and those of our allies around the world?
Well, there we have it. Yesterday, No. 10 was briefing that this is the new tough approach to migrants, and today the Minister comes to the Dispatch Box and says that he has not got a clue what the plan is or what is proposed. He mentioned deployment of assets. We had nine offshore patrol vessels until 2019, when HMS Clyde was decommissioned; others are committed overseas, including in the Pacific, and in home waters for tasks such as fisher protection. So what assets are there? There are not any.
May I check two things? First, will the Navy abide by the UN conventions on people in distress at sea? Secondly, the Minister said that Rear Admiral Utley will answer to the Defence Secretary, so has the MOD taken over control of Border Force and its operation, with the Home Secretary having no role? If so, that is a huge kick in the teeth for the Home Secretary.
First, the OPV fleet is well deployed around the world. As the right hon. Gentleman knows, Trent is in Gibraltar having just got back from autumn in the gulf of Guinea; Medway is in the Caribbean; Forth is in the Falklands; and Tamar and Spey are in the south Pacific and far east. Further, three batch 1 OPVs continue and are routinely deployed in home waters. That is not just for fishery protection, as he sought to characterise; they routinely take on the role of fleet-ready escort and are used for whatever is required to protect the United Kingdom’s interests in her home waters, and this task clearly comes within that bracket.
I am disappointed that the right hon. Gentleman felt it necessary to ask whether the men and women of the Royal Navy would still feel bound by their compulsion under the safety of life at sea convention. Of course they would. The Chief of the Defence Staff is a sailor, and Rear Admiral Utley is obviously a sailor, and they have been clear throughout that military involvement is about delivering a robust plan, but they will not endanger life at sea.
The right hon. Gentleman asked about how this is all reflected in Government policy and ownership of policy. I reflect back to him that Rear Admiral Utley is a sailor working within the MOD for a part of our border protection that has been placed into the hands of the Royal Navy. He clearly reports through his chain of command to the Secretary of State for Defence, but that is not the totality of the Government’s migration policy nor the totality of the role of protecting our borders. Obviously, the Home Secretary owns the wider system and she is doing a good job in doing that.
The Minister will be aware that in 2019 two Navy patrol vessels were deployed in the channel to deal with channel crossings. Yet they intercepted no boats and it cost the taxpayer £780,000. What will be different this time?
Behind the criminal gangs often lie the root causes of disease, famine, poverty, poor governance, conflict and war. We have heard reference today to Syria, Iraq and Libya. My hon. Friend mentioned the Sahel. What discussions has he had with his defence counterpart in the French Government about President Macron’s decision to withdraw the 5,000 troops based in the Sahel, which of course will stretch UK armed forces further in that important region?
We speak to our French counterparts regularly, and the Sahel is a frequent topic of conversation. The French would argue that they are going through a transition from one operation to another—from Barkhane to Takuba—but that is clearly a decision for France. The UK’s commitment in the Sahel through the UN peacekeeping mission operation MINUSMA and our support to the French through Op Newcombe remains in place, but it will not surprise my right hon. Friend to know that the UK is looking for opportunities all the time to do more in western Africa. We recognise that the instability in the Sahel poses a direct threat to the UK’s interests. Indeed, were it not for the telegraphing of the intent of my right hon. Friend the Member for Bournemouth East (Mr Ellwood) to ask the urgent question, I would have been in Accra today having exactly those conversations. But it is a pleasure to be here answering these questions.
I welcome what the Minister says about not using sonic weapons—an idea that was described by a Home Office source in the press today as “f***ng bonkers”. When the Home Office is saying that your idea can be classified as that, you have to think you have taken a wrong turn in your planning somewhere. May I press the Minister on the relationship between the Royal Navy and the Marines, on the one hand, and UK Border Force? He tells the House—I welcome the assurance—that the Royal Navy will not be engaged in pushing back boats with refugees in them, but that leaves open the door that the UK Border Force might still do that. In that case, how can he possibly say that operational primacy sits with the Royal Navy?
In answer to the right hon. Gentleman’s suggestion that there may be some disagreement between Departments, I can only reflect that my great friends the Under-Secretaries of State for the Home Department, my hon. Friends the Members for Corby (Tom Pursglove) and for Torbay (Kevin Foster), work with me all the time, not just on this matter but on Op Pitting and all sorts of other issues where Home Office and MOD interests align. The right hon. Gentleman is right to note that I was clear that Border Force is developing a tactic. It may well be that the commander is comfortable with that tactic being employed, and there is a difference between the reason why the Royal Navy and the Royal Marines will not deploy that tactic and the reason why Border Force may. Border Force has the appropriate vessels, potentially, to do so safely; the Royal Navy and the Royal Marines do not.
The Minister calls it Operation Isotrope—not Isotope—which means having properties that apply in all directions. That pretty much sums it up. The honest truth is that it is Operation Red Meat, and it has no beef in it whatever. Nothing has changed. There is no plan—he admits that himself. The Government have completely failed to tackle the real issue, which many of our constituents worry about, and the people who bear the brunt of all this danger are those who are being illegally trafficked, many of them in miserable situations. The Government need to sort out the relationship with France and make sure we have a proper deal with the whole of the European Union so people can go back to the country where they originally landed. The Minister has used one phrase repeatedly today—that they will stop people landing “on their own terms”. What on earth does that mean?
First, there are a lot of questions coming from the Opposition about the incompleteness of a plan. I would just reflect that Labour is routinely and continually silent on what it would do to ensure that our borders are protected and illegal migration is stopped. As for the UK-French relationship, no one has pretended that the part of the plan that I am answering questions on today is, in and of itself, the answer to that challenge. Before it, there is a responsibility to have relationships with France and the EU within which that can be discussed; there is a requirement to attack the criminal networks that do the trafficking; and there is a requirement to deal with migration flows in the first place.
What “land on their own terms” means is that nobody gets to set foot on United Kingdom soil without having been intercepted and brought ashore by the Royal Navy or other agencies. They are then put into a system that I have every confidence will act as a deterrent to make the cross-channel route collapse thereafter.
I declare an interest as a serving naval reservist. I appreciate that the Minister is being bounced into this, but he must have a plan. Can he say when that plan will be available, and on what date command and control of the operation will swap from the Home Office to the Ministry of Defence?
I do not know whether my right hon. Friend is asking me to better articulate the MOD’s plan, which I have been trying to do and am happy to elaborate on further, or to elaborate on the wider plan which, regretfully, I am not able to do. The MOD’s plan is to bring all of the Government’s maritime inventory under the command of Commander UK Strike Force. We believe that if all assets were better cohered, it would be possible to have a more robust interception capability in the channel. That then feeds into a wider requirement that other Departments are engaged in delivering to make sure that what happens next, combined with that certainty about our ability to intercept at sea, provides the deterrent that we have been seeking for the last year. The plan is that that primacy is in place by the end of the month.
The Minister seems to forget the desperation of the people making these crossings. If there were alternative safe and legal routes, does he not think that people would take them rather than risking their lives in such a way? Is he aware that Human Rights Watch has condemned the regular and persistent degrading treatment of adults and children in Calais by the French authorities? It is hardly a safe country for them.
France is, in my view, an entirely safe country. Migrants do not need to put themselves into the hands of people traffickers to be smuggled across the channel. I hope that they will soon see that there is no point in doing so because they will not get to enter the UK on their own terms if they do.
In the absence of Ministers having the political will to use pushback, what is the point in appointing a royal naval admiral to help Border Force to be a more efficient taxi service so that the migrants will know, “Now we’ve got the Royal Navy to pick us up—we’ll be taken safely to the UK, we'll be put in a hotel and we'll never, ever be sent home”? This is just an embarrassment. Will the Minister now co-ordinate with his colleagues to do what we have been suggesting for months and get rid of the pull factors—namely, ensure that we reform any piece of legislation necessary, including the Human Rights Act, and that people who do the illegal crossing are arrested, put in a prison and deported?
On a point of clarification, the reason why there are lots of questions from the Opposition is that this is an urgent question—that is what we are doing here.
I would like to ask the Minister whether the Government have seriously been considering using sonic boom weaponry against people seeking to come to this country in already hazardous conditions in the channel. Can he please explain to the House what impact that weaponry has when used on individuals? May I also say that Operation Red Meat or Operation Save Big Dog—whatever you want to call it—is not in my name?
The hon. Gentleman’s last point is self-evident. The use of sonic weapons is something that people have been exploring around Government. The Royal Navy is clear that they will not be used by the Royal Navy. As the operation will be under Royal Navy command, it will be down to the Royal Navy commander whether he wishes other agencies to use them.
The people who come here genuinely seeking sanctuary and who fear persecution deserve our compassionate care. The people traffickers and those rights lawyers who encourage, facilitate and give succour to people who know that they are not seeking asylum—who are economic migrants—deserve our condemnation. The Minister has made it clear that this proposal can be only part of the solution. Will he arrange for a Minister—possibly the Home Secretary—to come to the House to reassure us that offshore processing, the deportation of illegal immigrants and secure accommodation for those awaiting deportation form part of the policy? May I say in addition that, as my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) has just said, we must bring forward the reform of the Human Rights Act and other legislation as a matter of urgency?
My right hon. Friend will be pleased to know that he can expect to hear exactly what he hopes for very soon. It is unfortunate that today I have been required to come and expose part of the plan early, but that is my duty to you, Mr Speaker, and to the House. There will be a wider exposition of the plan in due course, I am certain.
The Royal Navy website says:
“Whether disasters are human-made or natural…Responding to these life-threatening scenarios is central to our ethos”.
Given that the Government have decreed that, contrary to what the right hon. Member for South Holland and The Deepings (Sir John Hayes) just said, almost two thirds of people crossing the channel in these small boats are so-called genuine asylum seekers, does the Minister agree that any genuinely responsible politician would refuse to be involved in further endangering the lives of these desperately vulnerable people? Before he accuses me of reading from Hansard, as he did so rudely with the right hon. Member for Hackney North and Stoke Newington (Ms Abbott), he said today that the Navy will not be involved in the pushback of people, but we all know that that could change tomorrow. Will he put on record his agreement that involving our Navy in pushing people back into dangerous waters would directly contradict that noble ethos?
I have somewhat more confidence in the Royal Navy than the hon. Lady does. I am absolutely certain that it can operate in the channel robustly, in the nation’s interest, but compassionately. As Royal Navy mariners, with all the fine traditions of that service, they are clear about their job and they will not threaten the life of innocent people.
On her point about vessels operated by the Royal Marines being involved in pushback, I have been very clear from the Dispatch Box that that will not happen. It cannot happen: the vessels are inappropriate for the practice.
We on this side of the House are determined to smash the gangs that charge desperate people thousands of pounds to take a perilous journey. It would be better if they did not undertake that journey in the first place, so what discussions has my hon. Friend had with the French military on intercepting boats before they set off and returning them to France, where they should belong?
This is fast becoming as ludicrous as it is disturbing. Yesterday, the Home Secretary was unable to explain what the military could do that Border Force could not, and the Minister has failed again today. Everybody knows that this announcement coming at this time is part of the campaign to save the Prime Minister’s job. How does the Minister think the armed forces feel about being used for that purpose?
The Chief of the Defence Staff has been involved in all the conversations. As I have made clear, we should not be dismissive of the importance of securing our borders, not only from an immigration perspective but from a national security perspective. Migration is being used as a subthreshold weapon of competition elsewhere in Europe, and it cannot endure that our border is not properly secured.
The hon. Gentleman asks what the mindset is of the military. I can tell him that from the nation’s most senior serviceperson downwards, they take great pride in making sure that they play their part in the plan to deliver what the democratically elected Government set as priorities.
This is not Operation Red Meat; it is Operation Dog’s Dinner. If the mission statement were to reduce illegal people trafficking across the channel, I would support it, but, as far as I understand it, the mission statement is to lower the number of people landing on their own terms on UK beaches.
With the deployment of royal naval vessels, the Minister has effectively announced that asylum seekers need get only halfway across the channel before being intercepted by the Royal Navy, under royal naval command. This will incentivise people traffickers. They will see the Royal Navy ship on the horizon and say, “Point your dinghy in that direction. You only need to get halfway,” and the Royal Navy will pick them up. The only way this will work is if the Royal Navy intercepts asylum seekers and returns them to France. Without the second bit, this simply will not work.
My hon. Friend knows that the last bit would be impossible without French permission, and French permission has not been given. I do not accept his characterisation of what is being spoken about today. The Ministry of Defence mission is to make sure that nobody arrives in the UK on their own terms. [Interruption.] That means that nobody arrives in the UK without having been intercepted at sea or as they land. What happens next is that we will just have to wait a short while, and I am sure all will become clear.
I am glad to see my old colleague from the Energy and Climate Change Committee doing so well in government. He will be aware of course that there is a vacancy coming up at the top quite soon, and I have high hopes for him that he will indeed go further.
I welcome that this has not been thought through very much—it is just like the rest of Operation Red Meat, to be honest—and I am glad that the Minister has indicated that the Navy will not intercept the small boats, unless, I would hope, there is a risk to life and there are people in distress, because around the world small boats have to be avoided for the terrorist risk. It will not take a terrorist with a PhD to see the opportunity of some of this, and I hope that the Government are thinking seriously about that. What assessment has been made of the terrorist risk both to the Navy and to the poor migrants, who are often escaping terrorists in the first place—as well as the efforts, of course, of international arms sellers—to find themselves in the channel?
The hon. Gentleman notes that the Royal Navy will not be directly involved in the interception of ships, and as I have explained, that is to do with the suitability of the vessel. However, I would not want him to think that that means we are not intending to intercept all dinghies. We are; it is just that there are better platforms to use for that under Royal Navy command and control.
The hon. Gentleman is absolutely right to identify—this is the point I have been seeking to illustrate—the justification for using the armed forces as part of this mission. Our adversaries, whether they are state or non-state, are very good at spotting where vulnerabilities are in countries. I would argue that the flow of migrants has reached a point where it is a threat to our national security, so it is entirely appropriate that the Royal Navy should play a role in the co-ordination of the response.
Any of my constituents watching these exchanges will note the comments of Opposition Members who are trying to pour cold water on a plan that my constituents actually want. They want to see an end to this cross-channel illegal immigration, and they will also be disappointed to hear from the Minister that plans are not yet finalised, because hints and announcements have been made about the use of the Navy for many months—years, probably—and our military are adept at putting together plans quickly to respond to emergency situations. Can the Minister at least give my constituents some hint of when a robust policy will be in place and the Navy will be involved?
In all the awful answers the Minister has given, he has not shown one iota of empathy for desperate people putting their own lives at risk to try to get to a place of safety, many of them coming from war zones around the world that Britain has been involved in. Can he not show some humanity and sympathy to these people and come to a European-wide agreement on support for asylum seekers and refugees? Can he not also look at the sources and at why people come, as well as the awful conditions that many face when they arrive in this country? These are human beings trying to survive in a very difficult world, and history will judge very harshly those Governments who use military means to repel refugees at the time of a refugee crisis around the world. Let us have some humanity, not just reach out to the military all the time.
I know that it was very much the right hon. Gentleman’s policy as Leader of the Opposition not to use the military at all, and probably to defund it as a consequence. I reject, however, the suggestion that we are not guided by a deep sense of compassion. The right hon. Gentleman is correct in observing that these people are desperate—so desperate, in fact, that they are putting themselves in the hands of exploitative criminal gangs that put them to sea in dinghies, increasingly in sea states that those dinghies are woefully ill-equipped to deal with. The responsible, compassionate response to this threat is to provide a robust deterrent so that people no longer put themselves in the hands of the criminal gangs, and that is exactly what we are doing.
If you will indulge me on a final point, Mr Speaker, the idea that conflicts in which I proudly served, as did hundreds of thousands of other British service personnel, are somehow the cause of why people are coming here now is utterly for the birds. Our nation’s armed forces are engaged around the world trying to provide stabilisation and security in some of the countries that need it most precisely so that people do not feel they need to take on the perilous journey across continents to the United Kingdom.
I congratulate the Chair of the Defence Committee on securing this urgent question. He is absolutely right to say that this plan is not a long-term solution. As deputy Chair of the Joint Committee on Human Rights, I have been pushing for the Home Office to consider our recommendation that claims to the UK asylum system should be able to be made from France, because the reason that people are desperate is that there is a dearth of safe legal routes to the United Kingdom. Can the Minister tell us what discussions he has had with the Home Office about that possibility as a long-term solution to the problem that would free up the Royal Navy for more appropriate duties?
The Under-Secretary of State for the Home Department, my hon. Friend the Member for Corby (Tom Pursglove), is sitting beside me. As the hon. and learned Lady was asking her question, I was told that the French Minister of the Interior has said in the French Parliament that the hon. and learned Lady’s proposal would be completely unacceptable to France.
Red dog, dead dog, red meat—I don’t know what this is, but it is a total embarrassment. Pope Francis has denounced the
“narrow self-interest and nationalism”
in how European countries treat migrants and in how they
“persist in treating the problem as a matter that does not concern them”.
Is it not time, as the Pontiff says, to treat our brothers and sisters seeking sanctuary with compassion? Is it not time to attack the root causes, not the people who pay the consequences?
I would argue that that is exactly what our policy does. We are engaged around the world through our aid and military efforts to provide security and stabilisation in the countries from which most people are fleeing. I think that the work of our armed forces and of the brilliant people in the Foreign, Commonwealth and Development Office who do international development is succeeding to an extent, but there is much more to be done. Criminal gangs are exploiting the most vulnerable, and it is right that we and our partners around the world get after those gangs to stop their work, because it is deeply insidious and malign.
It is also our responsibility to the people of this country to ensure that our borders are secure, for two reasons. First, it acts as a deterrent for those who are in France and are considering making an illegal crossing that will cost them their life savings and risk putting them to sea in a boat that is woefully ill-equipped for the sea state. Secondly, the people of the United Kingdom want control over their borders and over migration, and this Government are committed to delivering it.
Diolch, Mr Speaker. It is disappointing that the Minister has not ruled out pushback in his answers today, because it poses an obvious danger to life. In response to the announcement this week, navy sources have said that they deem pushback to be unethical. If Border Force implemented that policy and a small boat capsized, what would be the policy for Border Force staff?
I have been clear that the Royal Navy and the Royal Marines will not use the tactic, principally because they simply do not have the platforms that are appropriate for doing so. Arguably, the Border Force does; it has been doing trials with it, so it remains an option. But let us be clear: there are parts of the channel in which it definitely cannot be done, and there is a small part of the channel in which it might possibly be done. That is for the Navy commander to consider in due course.
Having a robust response that starts with the guarantee that we will intercept all boats either at sea or as they land, and then bringing people into a system that itself acts as a deterrent, is the right way to go. The people want the Government to get control of our borders—it is one of the Prime Minister’s top priorities. The MOD has a part of that plan, which we are confident in our ability to deliver; the rest of the plan will be unveiled in due course.
Since 2014, more than £200 million—about half a million pounds a week of taxpayers’ money—has been given to France, yet crossings are increasing. The latest announcement will do absolutely nothing to halt those dangerous crossings. The Minister and the Government need to be smashing the criminal gangs. That is the reality; this is just red meat headlines, but more of the same failed policy.
The Government are introducing life sentences for people smugglers. We agree vigorously with the hon. Gentleman that the absolute key is to get upstream of the problem, prevent the migration flows in the first place ideally, and get straight after the organised crime gangs to attack the network. That is very much part of the plan, although not necessarily a part of the plan the MOD owns. As he would expect, that sits much more neatly in the Home Office and the National Crime Agency, and in the Foreign Office when it comes to diplomacy. As I have been clear throughout, it is suboptimal that I am able to unveil only our part of the plan in response to an urgent question today, but in due course the full system will be made clear.
Nearly five years on the Defence Committee has demonstrated to me that the woeful legacy of a decade of cuts to non-frontline services mean there is probably little option. The Defence Sub-Committee on contracted services to the MOD has also shown the pernicious effect of outsourcing services, such as those, for example, at HM Naval Base, Clyde, which affected so many of my constituents. Will the Minister give his word to the House today that there will be no private sector involvement in Operation Isotrope? If there is one thing we and the poor souls in the channel do not need, it is for Serco and Capita to get their tentacles into a very lucrative Government contract.
About 45 minutes ago, I was clear that there would be leased platforms that are far more appropriate for use in the channel. The hon. Gentleman suggests that this might be a contract with a single provider. That is not the case. What I am talking about is contracting platforms to come fully under command. I cannot say who they are owned by, but the names of the big conglomerates he just mentioned have not been mentioned.
Bringing in the military seems to be the Government’s solution to everything these days, to the extent that I was surprised it was not part of the Culture Secretary’s plan yesterday for the future of the BBC. Given the conflation of responsibilities, in particular around issues of aid and security, can the Minister confirm that there will be no creative accounting in any attempt to hive off the costs to the overseas development assistance budget, or, for that matter, the NATO 2% target?
I am not sure that the military is brought in for everything, as the hon. Gentleman says. Our country has just been through an extraordinary period. We are drawing on the mass, expertise and commitment of our armed forces to support the NHS and civilian authorities through the pandemic. I think that that is a sign of the extraordinary service and professionalism of the men and women in our armed forces. Actually, I think it is good that the Government have been willing and able to draw on that capability throughout. As to his wider point, there is a requirement for a robust response. The Navy is able to bring that robustness not necessarily through the ships it can set to sea, but through its command and control, and through bringing all the Government’s maritime assets—there are many of them—to bear in a co-ordinated way. If we can do that, we can do things differently from how they have been done over the past few years.
We must remember that we are talking about 25,000 people who came to the UK in this dangerous way last year, a threefold increase that proves the Government’s plans are simply not working. The only thing we do know is that creating safe routes takes away trade from criminal gangs. Why are the Government making the situation worse without having clear objectives, rather than addressing the real problem?
There are many safe routes to the UK. I have been very clear that the part of the plan I have been able to answer questions on in the House today is not the full breadth of what needs to be done. The hon. Lady is right that the most decisive things we can do on migration are upstream of the channel. If she can wait just a few weeks, I am sure she will be illuminated fully.
I thank the Minister for his answers to questions. Recent figures show that in 2021 some 28,000 migrants crossed the channel in small boats. That number is rising. The UK has a long-established asylum system, but the use of military vessels sends an unfortunate message. There are many civilian companies every bit as efficient, so can the Minister confirm co-ordination between our Border Force, other vessels in the channel, and civilian companies that have the capability, expertise and the talent to do the job? That, Minister, could be a much better solution.