Health and Care Bill

Richard Fuller Excerpts

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Edward Argar]

My right hon. Friend is perspicacious in his prediction of where I was about to go. I was about to turn to amendment 10 tabled by my right hon. Friend the Member for South West Surrey and new clause 28 tabled by the shadow Minister, which go to the heart of what my right hon. Friend is talking about.

I hope the shadow Minister will agree that amendment 10 and new clause 28 are, essentially, broadly unified in their intention and therefore I hope that he will allow me to take them both together. They require the Government to publish independently verified assessments of current and future workforce numbers for the needs of the health, social care and public health services in England.

There has rightly been much discussion on workforce planning for the NHS and adult social care. That reflects the deep debt of gratitude that the country owes the staff and also, as I said, their absolute indispensability in delivering on all our aspirations for healthcare and social care in this country and for our constituents’ care.

As part of our commitment to improving workforce planning, my Department is already doing substantial work to ensure that we recover from the pandemic and support care. We have already committed to publishing, in the coming weeks, a plan for elective recovery and to introducing further reforms to improve recruitment and support for our social care workforce, with further detail set out in an upcoming social care White Paper. We are also developing a comprehensive national plan for supporting and enabling integration between health, social care and other services, which support people’s health and wellbeing.

Let me turn to that framework, to which my right hon. Friend the Member for Epsom and Ewell (Chris Grayling) was alluding, for a longer-term perspective. The Department has already commissioned Health Education England to work with partners to develop a robust, long-term 15-year strategic framework for the health and social care workforce, which, for the first time, will include regulated professionals in adult social care. That work was commissioned in July by my hon. Friend the Member for Faversham and Mid Kent (Helen Whately) when she was in post in the Department. That work will look at the key drivers of workforce demand and supply over the longer term and will set out how they impact on the required shape and numbers of the future workforce to help identify those main strategic choices, and we anticipate publication in spring of next year.

It is vital that the workforce planning is closely integrated to the wider planning across health and social care and, as such, Health Education England, which has established relationships with the health and care system at a local, regional and national level, is best placed to develop such a strategy. Crucially, following the announcement yesterday of HEE merging with NHS England in improvement, we will, for the first time, bring together those responsible for planning services, for delivering services on the ground, and for delivering on the workforce needs of those services so that we can have a more integrated approach to delivering on that framework.

[Richard Fuller (North East Bedfordshire) (Con)]

I am grateful to the Minister for giving way. There is much to commend in the amendment of my right hon. Friend the Member for South West Surrey (Jeremy Hunt) and in what the Minister is saying. One thing that is not obvious in either, though, is the focus on labour costs and productivity. For example, how is technology going to reduce labour costs in the delivery of the same quality or higher quality of service? What is the possibility of creating new care pathways, which require less qualified staff to deliver as good or better service? What is going on in terms of reducing the proportion of non-clinical staff by the adoption of technology and other means in healthcare? Perhaps the Minister could address that. I am sure that my right hon. Friend will be doing so later, too.

[Edward Argar]

My hon. Friend is absolutely right. We see huge opportunities, almost every day, from new technology and new ways of using that technology to deliver more efficient and shorter turnaround times—for tests and diagnostics, for example. He is also right to talk about the need constantly to examine care pathways, and, where opportunities exist, to use highly qualified healthcare professionals but to look carefully at the most appropriate level at which a treatment or test can be carried out; historically, we may have used healthcare professionals for particular tasks for which they were almost over-qualified. It is right that care pathways are informed by clinical and scientific expertise and judgment, but that we continue to review how new technology, new ways of working and new care pathways can improve the productivity of our amazing workforce.

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[Justin Madders]

My hon. Friend is correct; we could not have anticipated what has happened in the past 12 to 18 months, but we can see what it means moving forward. Regular reviews of demand are critical, and we know that training these highly qualified and skilled staff takes time, which is why a longer-term view and approach are required.

[Richard Fuller]

I want to pick up on the increasing demand for mental health services. Does the hon. Gentleman accept that in general, it is utterly impossible to meet the expectation of increasing demand for health services without vast improvements in the efficiency with which people working in the health and care sector deliver that service? Is it not a shortcoming of both the Government and the Opposition that there is not an intense focus on solving that problem of labour cost productivity? Without that, we will not be able to meet current needs and we certainly will not meet future needs.

[Justin Madders]

We are always looking at ways to improve productivity, but we know that on the current figures there are 100,000 staff vacancies in the NHS. No amount of productivity gains will cover for that.

Health and Care Bill

Richard Fuller Excerpts

Report stage
Monday 22nd November 2021 Commons Chamber

[Alex Norris]

Yes, I agree. I look with real sadness at the loss of exercise-on-prescription schemes that were part of the public health grant but have gone over the last decade. Similarly, on swimming, the decisions in the Budget relating to local authorities will lead to councils, which are setting their budgets as we speak, closing more leisure centres and swimming pools. We should mourn those losses, which come as a result of a weak bit of public policy.

In the Bill, the proposed watershed with regard to high fat, sugar and salt products is broadly a good thing. With that in mind, we do not oppose Government amendments 31 to 39, which are relatively modest tweaks, but we should not lose sight of the fact that we are talking about a significant proposal; I know that colleagues have interest in this. Beyond a watershed on traditional broadcast media, we will also see a complete online ban of high fat, sugar and salt advertising. This is a blunt tool in pursuit of an important goal.

New clause 14 in the name of the hon. Member for North East Bedfordshire would implement a more nuanced system, as proposed by the advertising industry itself. This is mirrored in amendments 106 to 109 in the name of the hon. Member for Buckingham. We probed this point in Committee. I was surprised then, and remain surprised, that there seems to be little interest from Ministers or the Department in even having that conversation and exploring creative alternatives. The desired benefits are non-negotiables. If there are other ways to achieve those benefits, they ought to be approached with an open mind.

[Richard Fuller (North East Bedfordshire) (Con)]

I am grateful to the hon. Gentleman for mentioning my new clause. We have a number of issues potentially to put to a vote later. Given what he has said and given that the Minister was a bit hazy about this issue in Committee, would he be minded to support my new clause if it were put to a vote and the Minister did not come forward with something more robust?

[Alex Norris]

The hon. Gentleman tempts me, but my problem is that I want to know that the conversations have taken place and that the proposal has been considered as an option. I would not say today that I think it is the best option, but I am surprised that that conversation has not taken place, which is why I have highlighted it. There is still time for the Minister to reconsider, and he should.

I was less persuaded by amendments 3 to 5 in the name of the hon. Member for North East Bedfordshire, which seek to permit brand advertising as long as it does not refer to an HFSS product. In many cases, the brand and product are so inexorably intertwined that it might undermine the goals and aims of the whole intervention. I do, however, support amendments 6 to 8, which refer to the nutrient profiling model—the model that is used to determine what is and is not considered to be a high fat, sugar and salt product. It is important that there is certainty and that it does not move around more than the science would say that it ought to.

We talked about this issue at length in Committee. If we are asking the industry to reformulate and change, companies ought to be able to base product decisions on the certainty that the Government will not arbitrarily change the criteria. Such companies may have made significant time, financial or infrastructure investments in a certain product and then could see the criteria change overnight. In Committee, we extracted a commitment from the Minister to a Government amendment on this matter. That was reiterated in a letter on 13 November, when the Minister wrote to Committee members and committed to

“introducing a Government amendment at Commons Report Stage to include a duty to consult before changing the NPM technical guidance.”

I am surprised not to see that at this point. I hope that we will get clarity from the Minister, or indeed that he is minded to accept these amendments, because this is an important development. We also want the level playing field suggested by amendments 110 to 113, so we will be listening with great interest to his reply.

This is the wrong Bill at the wrong time. It does nothing to address the real causes of ill-health in this country today. In this part of the proceedings, colleagues have given the Minister a chance to change that and I hope he is minded to take it.

[Richard Fuller]

It is a great pleasure to follow the hon. Member for Nottingham North (Alex Norris). I will speak to new clause 14 and the other amendments in my name. I am grateful for the Opposition’s support for amendments 6, 7 and 8 and for an industry-led alternative—in spirit, if not necessarily in voting. I think the hon. Gentleman, as well as many of my hon. Friends, will be wanting to hear something from the Minister to show that he has been listening to concerns that have been raised across the House.

I was surprised and delighted to see on some of my amendments the name of the hon. Member for Central Ayrshire (Dr Whitford), but she advised me that that was an error, so I am sorry that the potential amity between me and those on the Scottish National party Benches will have to wait for another day.

[Dr Whitford]

I am grateful to the hon. Gentleman because that has saved me from having to put a disclaimer at the start of my speech, as I was rather shocked to find my name on his amendments. I just reiterate the point made by the hon. Member for Nottingham North (Alex Norris). It is a concern that the names of companies, as we saw in F1 racing and other things, simply promote certain types of food and drink and you cannot separate the brand from the product.

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[Richard Fuller]

I am grateful to the hon. Lady for making her point clear.

As the hon. Lady and other hon. Members know, my amendments relate to the ways in which the Government are seeking to restrict advertising for foods that are high in fat, sugar and salt as part of their obesity strategy. Those measures essentially ban such advertising on TV before the 9 pm watershed and ban all paid-for HFSS advertising online at any time of the day or night. My hon. Friend the Member for Buckingham (Greg Smith) has already done a very good job in drawing out some concerns about that.

What are the concerns about what the Government are doing? First, I should mention that I have a number of important food businesses based in my constituency, including Unilever and the cereal company Jordans Dorset Ryvita, and I think everyone would be surprised to hear that products such as porridge, muesli and granola are going to be subject to these bans. All these products have ingredients such as naturally occurring oils and sugars, as well as fibre, vitamins and minerals, and because of those natural ingredients they will be caught by the Government’s definition of “HFSS”.

It is also worth considering—I was not on the Committee and I do not know if it was considered at length—the impact on food services such as takeaways and home-delivered foods. Papa John’s, which is located near me in Milton Keynes, supports hundreds of entrepreneurs and small businesses through its franchise model, and it writes to warn me:

“These would restrict our ability to invest in our businesses and our people, at a time of significant economic uncertainty for the UK economy, and would also place our franchisees, many of whom are single owner small businesses, on an unsustainable financial footing.”

I think the Government have to do a few more hard yards in support of our small businesses, and this is not a very good way of showing any support for them.

[Jim Shannon]

The number of diabetics, both type 1 and type 2, across the United Kingdom and the number of children with obesity is rising. Does the hon. Gentleman feel that new clause 14 cannot address the issue of those rising numbers? If it cannot, what more needs to be done?

[Richard Fuller]

I absolutely do not agree. The reason why the Opposition Front-Bench team are probing on this is that we are not harnessing all the talents to come up with the solution. As the hon. Member for Nottingham North said, he does not have, or want, any objection to the objective—he just feels that there may be better ways to do it. That is what my amendments are trying to create. They would introduce a better way, working with established principles and with the industry—let us face it, it has the experts in this—rather than undermining issues to do with how the Advertising Standards Authority has managed how products are advertised and rather than bulldozing through the industry, which is the current process that the Government, or this Department anyway, are proposing.

Let us just remember that this pressure on our food and drink manufacturers is part of a wider effort of social responsibility that we are putting on them. The proposal does not sit alone, but with other things, in particular around environmental protection. The Food and Drink Federation has calculated that the cost of the UK Government’s proposed environmental health policies is at least £8 billion. That is equivalent to £160 a year on household food bills that we are asking the industry to take on.

It is estimated that the introduction of this policy will cost £833 million, but the Government’s own impact assessment estimates that the benefits are likely to be in the order of only £118 million. That is a real dead loss that we will be putting, let us face it, on food bills, primarily of those in lower income brackets. Members on all sides should take a moment to consider whether this is the right time and the right process for doing that. As the Government’s own assessment shows, the actual effect on diet for those who are targeted is estimated to be 1.7 calories a day, so it is a lot of effort and cost, but not very much impact.

New clause 14 proposes an alternative that would require the regulator to implement an alternative set of increased restrictions for online, but developed through the industry by the Committee of Advertising Practice. The new clause would legislate for a three-step filtering process drawn up by the industry to appropriately manage the targeting of online ad campaigns.

Another of my amendments would introduce brand exemptions. I take a different view from the hon. Member for Central Ayrshire, who said that brands are intrinsically tied to their product. The truth of the matter is that Coca Cola is made by Coke and Coke Zero is made by Coke. Coke Zero is advertised with the word “Coke” on it. This issue is not necessarily covered by the legislation, but Coke is not tied to one thing. Brands are extraordinarily flexible in how they can assist progress in achieving some social means. The Minister should consider looking again at this area.

Finally, on the nutritional profile, the issue is consultation. I can see that the Secretary of State has tabled some amendments on that, and perhaps the Minister can talk about that. They do not seem to make the changes I would like to see, but I would be interested to hear what he has to say.

It is worrying that the Government have undermined the Advertising Standards Authority with their approach. One of the other things is targeted advertising. I am sure it has struck hon. Members here as it has me that the tech revolution of the dotcom era was 20 years ago, and two decades of technical expertise in understanding how adverts are targeted is being swept away or ignored by the Department of Health and Social Care, which would much rather have “nanny knows what’s best”. The truth of the matter is that, by harnessing technology, the Government could get a better outcome than this official ban. As my hon. Friend the Member for Buckingham said, there are plenty of other ways to do it that would be hard for advertisers to get around.

I say to the Minister that I am trying to be helpful, as always, and, to be serious, as are the Opposition. The Government have made a slight misstep by adopting a top-down, state-driven model. I say to the Minister that the path of good intentions is littered with unintended consequences. The essence of conservatism is not to use the state to bully or, as perhaps the advisers in the various Departments say in modern parlance, to nudge. It amounts to one and the same thing. The Department’s attempt to censor products such as these is profoundly un-Conservative. Our party believes in individual responsibility and that families are the foundation of society where choices and power in society most naturally lie. Nowhere is that more important than in health matters, yet these proposals extend the role of the state and undermine parental responsibilities.

The measures make the Department of Health and Social Care look like a new outpost of cancel culture that denies free speech and has a predisposition that individuals should conform to what the state determines, rather than enabling informed free choice. It is desperately sad to see them being pushed through by a Conservative Administration. I say to my colleagues on the Back Benches: when will we wake up and realise that we need a Government who support free enterprise and individual responsibility, and who understand that the way to create growth in the economy is through enabling people to make free choices, rather than expecting the state to be the answer to every problem? With that question, I will wait to listen to what the Minister has to say.

[Dr Whitford]

I thank the hon. Member for North East Bedfordshire (Richard Fuller) for clarifying that I had not voluntarily added my name to his amendment.

Whenever we talk about such subjects, we hear a lot about the nanny state. As a surgeon working in A&E in general surgery, however, the difference when seatbelts, airbags and speed limits came in was night and day in how much time I spent dealing with people in operating theatres who had been involved in car crashes. Sometimes the state has to take action to protect people’s health and wellbeing.

The Bill focuses largely on reversing some of the most egregious aspects of the Health and Social Care Act 2012, which I welcome, but these measures focus on improving public health. There is no question that obesity, type 2 diabetes and other diseases associated with obesity pose not just a real threat to individual health but a threat that will overwhelm national health services in future. When I looked at the original Bill, however, I was surprised that, apart from the measures around obesity, there was little in the way of public health policy to improve and promote health, and there is also little enough about care.

It is not the national health service that delivers health. I have often said that it would be more appropriate to call it the national illness service, but who would want to work somewhere called that? The NHS spends most of its time catching people when they fall. Health comes from a decent start in life, a warm dry home, enough to eat and a decent education. Those are the things that deliver health, but there is nothing like them in the Bill.

Particularly, and surprisingly, there is nothing in the Bill on reducing harm from tobacco products and alcohol, which is why I rise to speak in support of new clauses 2 to 4, which seek to strengthen the health warnings on all tobacco products; new clauses 7 to 10, which seek to allow regulation of tobacco pricing; and particularly new clause 6, because the use of sweet flavourings to entice children and young people to take up smoking is indefensible.

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[Edward Argar]

I wondered what I was about to have bowled at me there, but my hon. Friend is absolutely right. I entirely agree that a huge amount of progress has been made; we believe that we need to go further with our proposals, but he is right to highlight that progress. He is also right to highlight the relevance of the central role of personal responsibility and the decisions that we and our families all take.

To meet the ambition of halving childhood obesity by 2030, it is imperative that we reduce children’s exposure to less healthy food and drink product advertising on TV and online. We want to ensure that the media our children engage with the most promote a healthy diet. The Bill therefore contains provisions to restrict the advertising of less healthy food and drink products on TV, in on-demand programme services and online.

[Richard Fuller]

The Minister has just mentioned seatbelts, and earlier he talked about alcohol and cigarette smoking, but this is about porridge and muesli. There is a sense that there is no end to what the Department of Health and Social Care feels is its responsibility to legislate on for what people should be able to do for themselves and their family. My point is that this is overreach by the state, as well as perhaps being the incorrect process for achieving the Government’s aims.

[Edward Argar]

I know my hon. Friend well and entirely understand the perspective that he brings, but I would argue as a counterpoint that the Bill strikes a proportionate balance, in the same vein as with seatbelts and other issues. Alongside personal choice and giving people the information to make choices, I believe that it is a proportionate and balanced approach—not the thin end of the wedge, as he might suggest, although perhaps I am characterising his words unfairly.

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[Edward Argar]

I am grateful for my hon. Friend’s confirmation that he does not intend to press his amendments to a Division, and I will ensure that his point will be heard not only in the Department of Health and Social Care but in DCMS as well.

I am grateful to my hon. Friend the Member for Carlisle (John Stevenson) for his amendments 111 to 113 and for bringing this debate before the House. I would like to reassure him that small and medium-sized enterprises—businesses with 249 employees or fewer—that pay to advertise less healthy food and drink products that they manufacture and/or sell will be exempt from the less healthy food and drink restrictions and can continue to advertise. The definition of SMEs will be provided in secondary legislation and not on the face of the Bill, which will enable Ministers to act promptly in future years if new or emerging evidence suggests that amendments are needed. We will conduct a short consultation as soon as possible on the SME definition to be included in the draft regulations. The Government want to ensure consistency with other definitions for size of business that have been used for other obesity policies, such as the out-of-home calorie labelling policy, to create a level playing field. Our preferred definition, therefore, is a standard definition used by Government across other policies.

[Richard Fuller]

On the point about an industry-led alternative, on which the Minister has kindly made some comments today, I think that this discussion will continue, particularly when the Bill is considered in the other place, so would he be prepared to meet me so that I can continue to make representations about certain improvements that could be made?

[Edward Argar]

I am certainly happy to commit that either I, as the Bill Minister, or the relevant policy Minister will meet my hon. Friend to discuss his views in this space.

Amendment 110 would ensure that advertisements placed on distributor or retailer websites are out of scope of the less healthy food and drink advertising restrictions. Again, I am grateful to my hon. Friend the Member for Carlisle for tabling the amendment, and I would seek to reassure him that the Government’s intention is to ensure that restrictions are proportionate to the scale of the problem. It is not our intention to prohibit the sale of less healthy food and drink products on the internet. Our aim is to reduce children’s exposure to advertisements of less healthy food and drink products, which is why the restrictions are being applied only to paid-for advertising online—namely, where an advertiser pays by monetary or other reciprocal means for the placement of adverts online.

We appreciate that there will be consumers who seek less healthy food and drink products, which is why this restriction applies only to paid-for advertising, and companies will be able to continue to use owned media in the same way as they do now. The restrictions will not apply to spaces online where full editorial control and ownership apply, such as a brand’s own blog, website or social media page. This means that retailers are able to continue promoting their own products on their own website, as this would not be covered by the restrictions.

I shall turn briefly to Government amendments 32, 35 and 37, tabled in the name of the Secretary of State for Health and Social Care. Amendments 32 and 35 will amend the definition of an advertisement placed on television and on-demand programme services to ensure that sponsorship credits around programmes and sponsorship announcements respectively are included for the purpose of this Bill. Members will be aware that sponsorship announcements and sponsorship credits are required so that viewers know which product is sponsoring any particular programme. Although these are not routinely considered to be advertisements in other contexts, the Government’s view is that they could reasonably be considered to be advertising less healthy food and drink products for the purposes of the Bill’s restrictions.

Amendments 32 and 35 will therefore clarify the status of those announcements, in effect to prohibit identifiable less healthy food and drink products from sponsoring programmes before the watershed, in line with the Government’s original policy aims. Amendment 37, meanwhile, will make it clear that UK businesses producing online advertisements intended to be accessed principally by audiences outside the UK fall in scope of the exemption and will not be in breach of the less healthy food and drink advertising restrictions set out in the Bill. This amendment is needed to ensure that the legislation aligns with the Government’s policy intention to exempt advertisements made to be viewed outside the UK. We are confident that the likely frontline regulator already has a clear remit and tests in place that should allow it to apply this exemption effectively.

Health Incentives Scheme

Richard Fuller Excerpts

Friday 22nd October 2021 Commons Chamber

[Maggie Throup]

My hon. Friend makes a very good point. We cannot do this with one action alone. To me, it is very much cross-departmental. Whether it is through planning legislation or encouraging people to be more active, there are lots of different ways we can tackle obesity and the health disparities it brings with it.

[Richard Fuller (North East Bedfordshire) (Con)]

I am sorry to strike a discordant note, but with regard to the Minister’s justification for this measure may I remind her that it is not the role of life to support the NHS; it is the role of the NHS to support life? Many despair of an obsessive cult within the Department of Health and Social Care for nudging. Can the Minister advise me on how this proposal is different from a social credit system that is adopted in other countries?

[Maggie Throup]

We want to have a whole range of measures to tackle obesity. The important thing is that we know how much obesity costs the NHS—£6 billion is a huge amount. That money could provide for a lot of more operations. There are a lot of other ways to stop people becoming obese, or to help them to lose weight and become more active. That is better for the NHS and saves money for the NHS, but it also helps people’s lives as well.

Coronavirus Act 2020 (Review of Temporary Provisions) (No. 3)

Richard Fuller Excerpts

Tuesday 19th October 2021 Commons Chamber

[Sajid Javid]

What I can tell my right hon. Friend is that there are provisions that we hope to keep in the Act, subject to the House’s will today, which are still necessary. For example, there are provisions that protect NHS capacity with respect to temporary registration of nurses and other healthcare professionals. There are similar provisions for the care sector; there are also provisions that provide support packages for those whose jobs may have been hit or who have to take time off work to meet the self-isolation requirements. There are provisions in the Act that I think are still necessary; I will speak about some of them in just a moment.

[Richard Fuller (North East Bedfordshire) (Con)]

Does my right hon. Friend recognise that by leaving the Act intact, albeit with certain restrictions, he is leaving the opportunity for extreme measures to be taken relatively simply and with limited reference to this House, as the hon. Member for Brent Central (Dawn Butler) mentioned? A lot relates to pressures on the NHS; those could come because every winter the NHS is under pressure or because catching up on services puts it under pressure. I am interested to know how on earth my right hon. Friend will work through the next few months to understand what is an undue amount of pressure on the NHS that might require him to take the actions in plan A or plan B, or potentially even further actions.

[Sajid Javid]

In our response to the pandemic, we have set out clearly our plan for the autumn and winter; I have certainly done so in the House. We certainly expect more pressure as we head into winter. We have been very open about that; it is why the covid vaccination booster programme and the flu vaccination programme both remain important. However, there are provisions in the Act that I believe are still necessary and proportionate to help with the pressure that my hon. Friend refers to, such as the registration of healthcare and social care workers and the power to discontinue healthcare assessments for people being discharged from the NHS. I think that it is wise—especially as we head into the winter, when we do not know just how significant the pressures will be—to have that flexibility.

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[Jonathan Ashworth]

The right hon. Gentleman is better than that, with respect. He is very experienced, and he knows full well that right hon. and hon. Members have various responsibilities as Members of Parliament. Come on! That was akin to those ridiculous tweets that we sometimes see going around, saying that an important issue is being debated in Parliament and asking why the Benches are empty and so on, when it is an evening Adjournment debate.

[Richard Fuller]

I have a great deal of sympathy with what the right hon. Gentleman has just said, but there is an underlying point. On many occasions since March 2020, the Opposition have absented themselves from providing effective voting opposition to measures that the Government have proposed, often affecting the rights and liberties of individuals. If the right hon. Gentleman is saying that he is balancing all the issues involved in the restrictions that result from the continuation of the Act with the single purpose of continuing statutory sick pay for three days, and that because he is not prepared to test the willingness on the Government Benches to support him in any measure he would turn down this whole measure, I think that what he is handing us is giving him a little bit short of what he might expect.

[Jonathan Ashworth]

The hon. Gentleman knows full well that if the Government wanted to bring forward a separate Bill to pay statutory sick pay from day one—and to increase the level of statutory sick pay, which is not currently at a satisfactory level—that would of course have our support. However, that would have to come from the Executive. It is unlikely to come from Back Benchers, although I am confident that, should such an opportunity present itself, the hon. Gentleman would find himself in the same Lobby as me on the question of paying enhanced statutory sick pay.

A number of provisions have been taken out of the Act that restricted liberties and freedoms. We raised concerns about those provisions six months ago and 12 months ago, and we are pleased that they have been lifted from the Act, particularly those sections that gave the power to detain potentially infectious persons, which have been used for a number of prosecutions, every one of which was found to be unlawful by the Crown Prosecution Service. Hon. Members from both sides of the House made that point in the six-month debate and in the original debate 12 months ago, so we are pleased that the Government have listened to those Members and to the Joint Committee on Human Rights, which said that those powers ought to be repealed. They have now been removed from the Act.

There are some sections whose removal from the Act we would question. A lot of my local government colleagues have asked why the powers that enable local authorities to meet remotely have been removed from the Act. Would it not be better to allow local authorities to come to their own decisions on whether they want to continue to hold online meetings in the next few months? I am not quite sure why we need to remove that provision from the Act.

Of course we would not want to lose statutory sick pay from day one, but the Secretary of State also referred to the emergency legislation covering healthcare workers. This is important because it means that we can get recently retired workers back on their licences and back onto the frontline. We would not want to lose that from the Act. The Act continues to allow remote participation in court proceedings to take place, which we believe is needed in the current circumstances.

The Act was not the legislation that brought in the lockdowns, including the local lockdowns for my home city of Leicester and areas such as Burnley, Bolton and Calderdale, which, sadly, were put into localised lockdown in the past year or so. None of us wants to see those lockdowns ever again. Nobody wants to see a national lockdown, and nobody wants to see local lockdowns. I understand that the Government have quite rightly ruled out further lockdowns, but the public health crisis is not over. That is why we still need some of the provisions in the Act. Covid has not gone away. We can learn to live with the virus, but that is not the same as pretending the virus no longer exists. Yesterday, we recorded close to 50,000 infections, more than 7,000 people were in hospital—with nearly 800 in ICU—and every day on average 100 of our fellow citizens sadly die from this disease. A decision on vaccination in schools by the appropriate committee was delayed, but record numbers of children are now infected. In the past three weeks, we have seen an average of 10,000 new covid infections every day in schools and thousands are missing school as a consequence.

The ongoing pandemic is making existing inequalities worse and worse, so we need some of these provisions to stay on the statute book. However, we need to go further as well. As I have said, I never want to see another lockdown again, either locally in my home city of Leicester or nationally. There are a couple of things that I hope the Government will consider in order to avoid further lockdowns and to avoid needing some of the most draconian measures in the Act to return.

First, we need to fund public health properly in the spending review. The virus thrives on health inequalities. The Secretary of State rightly referred to health disparities and stalling life expectancy in Blackpool, but his Government have presided over public health cuts of £43 per person per year across Blackpool, which are some of the largest in the country. Secondly, we need substantial investment in ventilation support for businesses, public spaces and schools. Better ventilation has been proven, time and again, to reduce the transmission of covid. In addition, it brings other health benefits.

We know that vaccination is waning and that parts of the programme are stalling. The wall of defence is crumbling, so we need to encourage those retired clinicians who helped with the initial vaccination programme to help again. We also need to encourage those retired clinicians who did not help out last time to consider playing their part. That is why the clauses in the Act on the emergency registration of healthcare workers need to remain on the statute book.

We also need to fix the booster programme. As of Friday, only half of eligible over-80s had received their booster jab. Charities including Blood Cancer UK and Kidney Care UK are warning that the third-dose programme for the immunosuppressed has been a “chaotic failure”, with between 55% and 60% yet to be invited to get a third dose, as of Friday. What are the Government going to do to scale up third jabs and boosters? Will the Government consider pop-up clinics, for example? They were successful in the previous round of vaccinations.

Our case rates are concentrated among the young, but only around 30% of children have been vaccinated. One problem in getting vaccinations out to children is that there are not enough staff, which is another reason why we need the emergency registration provisions to stay on the statute book to try to encourage more retired clinicians to join the children’s vaccination programme.

The Secretary of State is now allowing children to book a vaccination in a walk-in centre for half-term, but it is half-term this week in some parts of the country, including in Leicester, so can that part of the programme start today rather than waiting for next week?

There are still parts of the country, including Leicester and many London boroughs such as Brent, Lambeth and Tower Hamlets, as well as parts of the country that were in lockdown last time such as Blackburn and Pendle, where second-dose rates are still below the national average. What will we do to drive up vaccination rates in those parts of the country that were in lockdown last time and where vaccination rates are still too low? Will the Secretary of State consider guaranteeing mandated paid time off for vaccination and mandated sick pay for people who need to take a couple of days off due to side effects or due to feeling unwell, as people sometimes do following a vaccination?

We will support the Government in renewing this Act, although we want them to find a better way of scrutinising its provisions. We are concerned about the infection rates we are seeing. The embers are burning bright again and, because we were world leading on vaccination, we could be world leading again on the waning of vaccination. We need a plan to drive up boosters, to drive up third doses and to drive up second doses for those who have not had them. This disease remains lethal, especially to the frail, to those with underlying health conditions and, obviously, to those who are unvaccinated.

Let us strengthen the vaccination programme, let us pay proper sick pay, let us ensure fresh, clean air in public buildings and let us properly fund public health. Remember that the Select Committee reported last week that the Government’s handling was one of the worst public health failures in British history. This is no time for complacency, and I hope Ministers act now.

Covid-19 Vaccinations: 12 to 15-year-olds

Richard Fuller Excerpts

Monday 13th September 2021 Commons Chamber

[Nadhim Zahawi]

I remind the hon. Gentleman of the answers I gave earlier on consent. Parental consent will be sought, and the school-age vaccination programme is very well equipped to do that. The consent process is being handled by each school in its usual way and will provide sufficient time for parents to provide their consent. Children aged 12 to 15 will also be provided with information, usually in the form of a leaflet, for their own use and to share and discuss with their parents. The consent of the parent, guardian or carer will be sought by the school. In the rare circumstances in which a parent withholds consent but the child wants to be vaccinated, the child has to be deemed competent by the clinicians after consultation between the child and the parent. If that consultation is unsuccessful, the child has to be deemed to be Gillick competent. That has been the law of the land for other vaccination programmes, and in those circumstances the vaccination would proceed.

[Richard Fuller (North East Bedfordshire) (Con)]

My hon. Friend has again cited Gillick competence as a reason why parental consent can be overridden, but many people will think that this situation is very different from the fundamental basis of the Gillick competence. This is a widespread programme with all the issues of pressure and peer pressure that may arise from it, and we have had only a few months to understand the implications of this vaccine for people’s health. Also, the Minister himself has said that there is not much evidence on the long-term implications. Can he advise the House what legal assessment he has undertaken to support the Gillick competence in this case?

[Nadhim Zahawi]

The Government have taken copious legal advice on this issue. I remind the House that on the rare occasions when there is a difference of opinion and a parent withholds consent when their child wants to be vaccinated, the clinician will bring together in consultation the child and the parents to try to reach consensus before they move on to the question of Gillick competence.

Covid Vaccine Passports

Richard Fuller Excerpts

Wednesday 8th September 2021 Commons Chamber

[Nadhim Zahawi]

I said this at the Dispatch Box before recess. Actually, the Secretary of State took to the World Health Organisation a plea to the rest of the world that people in trials should be considered fully vaccinated, whether they have had the placebo or otherwise, in order to encourage them to come forward for vaccine trials. I repeated that today. It will not be an issue for nightclub bouncers.

[Richard Fuller (North East Bedfordshire) (Con)]

The measures presented by the Minister today are unsupportable because they are bereft of any rationale. I ask him to think carefully about whether this Government wish to take powers that were deemed to be emergency powers and make them the normal powers of a Government in a free society. I, for one, think that that is extremely unwise and that there is no case for this.

[Nadhim Zahawi]

I agree with my hon. Friend that the times that we are enduring are not normal. This is a measure that we are having to take. As he will hear from our chief medical officers in England, Scotland, Wales and Northern Ireland, this is a mitigation to allow us to continue to transition this pandemic over the winter months and not have to reverse our policies. I say, with a heavy heart, that I would much rather stand here and take from colleagues arrows in the back—or in the front—than come back to this House and have to close down nightclubs because the virus has caused a super-spreader event. I do not want to have to explain that to the whole industry, because it would be much more detrimental to businesses to have to open and shut them, and open and shut them again.

Obesity Strategy 2020

Richard Fuller Excerpts

Thursday 27th May 2021 Commons Chamber

[Jo Churchill]

I am going to push on just a bit, and then I will of course come back to my right hon. Friend.

We are also taking action to stop the promotion of less healthy products by volume and prominent locations online and in store. We want to support shoppers to purchase healthier options and shift the balance of promotions that way by maximising the availability of healthier products. We still need to eat, and we are not banning anything, but we are trying to educate, encourage and make people aware, so that they have the option of a healthier choice by default.

Last December, we confirmed that we will legislate on the promotion of foods high in fat, salt and sugar in stores and online. This will apply to medium-sized and large businesses—those with more than 50 employees—in England, and it will come into force next year. I would like to congratulate and thank those large retailers that are already taking these steps, because the argument is often put forward that it is unaffordable for a business to do this, yet many of the large retailers are doing it.

[Richard Fuller (North East Bedfordshire) (Con)]

I am grateful to my hon. Friend for outlining some of the measures she is asking businesses to undertake. She will appreciate that the last year has been very difficult for all businesses. As a Health Minister, she perhaps has not been able to have as much engagement with business, so would she take up the opportunity, ahead of the implementation in June, to come and visit Jordans & Ryvita, a cereal manufacturer in my constituency—she may have some familiarity with it—so that she can listen to its points of concern about the proposals she is making?

[Jo Churchill]

My hon. Friend and I have spoken about Jordans. Indeed, my first job was selling Jordans Crunchy bars at county shows when I was—oh—several decades younger. I will of course be happy to talk to him after this, but I would also gently point out that I have British Sugar, which is also in this food group, in my constituency. I not only meet its representatives on a regular basis, but I also met as lately as yesterday representatives from the British Retail Consortium and the Food and Drink Federation.

[Jo Churchill]

I am very glad that my right hon. Friend is joining me in the ambition of wanting to get the weight of the nation down. I would gently push back, and say that I do not recognise those calorie figures. I am sure we can have a longer discussion over where that evidence base is drawn from, and about the fact that there is actually a much greater impact. As I have pointed out on two or three occasions, this is about the building blocks of all these different measures coming together, and they will be monitored and assessed as we go through.

Another element of the environment is advertising. Currently, we are failing to protect children from over-exposure to high-fat, salt and sugar products via advertisements on both television and online platforms. I would gently say that if adverts did not influence people, they would not be used. Therefore, to help tackle the current situation, let us just see more advertising of healthy food. It always strikes me as quite interesting when watching a diet programme on the television that each ad break is often interspersed with adverts for high-fat, salt and sugar products. This does not affect the advertising industry’s revenue, because there is still a need to advertise and people still need to eat, but the foods advertised often do not reflect the balance that we need to enjoy a healthy life.

[Richard Fuller]

Will the Minister give way?

[Jo Churchill]

I am going to push on, I am afraid.

The Queen’s Speech on 11 May confirmed our intention to take that measure forward through the health and care Bill, and the Government aim to publish the consultation response as soon as is practicable. Many people objected to the sugar drinks industry levy, saying that it would mean a decline in sales. Five years on, we have seen a decline of around 44% in sugar in soft drinks. Revenue raised has often been diverted into sports activities in schools and so on, and sales have risen to over 105% of what they were in the beginning.

Information helps the consumer; it also helps manufacturers and retailers to look at diversifying their products, and much of the customer research, including the McKinsey report—I think it was put out by the Food and Drink Federation, but it might have been the British Retail Consortium—shows that this is the direction in which customers want retailers and manufacturers to go.

We want to take this measure into alcohol labelling, as well. As we know, each year around 3.4 million adults consume an additional day’s worth of calories each week from alcohol, which is the equivalent of an additional two months’ worth of food a year. Despite that, the UK drinks industry is not required to provide any information on how many calories each drink contains, and up to 80% of adults have no knowledge at all.

Action to ensure that people can make an informed, educated choice is what we want, and we will be publishing a consultation shortly on the introduction of mandatory calorie labelling on pre-packed alcohol and on alcohol sold in the on-trade sector. Once again, it is interesting to note that this labelling happens to a large degree with most low-alcohol content drinks and in many own brands, so the measure is merely about ensuring that customers can feel fully informed.

Turning to weight management services, on 4 March, we announced £100 million of extra funding for healthy weight programmes to support children, adults and families to achieve and maintain a healthier weight. More than £70 million of that will be invested into weight management services made available through the NHS and local authorities, enabling some 700,000 adults to access the support that can help them lose weight. It includes digital apps, weight management groups, individual coaches and specialist clinical support.

There has been a fantastic response from local authorities to the planned roll-out of these services. It shows the widespread need and support for helping people achieve a healthier weight and is an example of the importance of partnership in action. The remaining £30 million will go to: funding initiatives to help people maintain that weight, because we know that weight lost can often be quickly regained; giving access to the free NHS 12-week weight loss plan app; continuing the Better Health marketing campaign to motivate people to make healthier choices; improving services and tools to support healthy growth in early years and childhood; and helping up to 6,000 families and their children to grow, develop and have a healthier lifestyle and weight. In addition, we will invest in helping people access the weight management services and support they need through a range of referral routes across the health system.

We are also looking at incentives and incentivising healthier behaviours. We have committed £6 million to developing a new approach to health incentives. The aim is to support people towards adopting healthier behaviours. That work will be supported by Sir Keith Mills, who pioneered reward programmes such as air miles and Nectar points. It will look at the best innovation to motivate people drawn from not only the public sector, but the private sector.

Since it is critical that a child has the best start in life, we are also working to improve infant food and the information around it. We will consult shortly on proposals to address the marketing and labelling of commercial food and drink products for infants and young children—to reiterate what Dame Sally Davies has said, there is the halo effect, where we think what we are purchasing for our children is healthy, but potentially it is not—so that parents and carers can have clear and honest information that aligns with advice on the products that they feed their children and babies, giving every child the best start in life.

We are not alone in working to address the challenges of obesity; it is pretty much a global problem. The effect of collaboration internationally is critical for us all to learn. The UK has established effective working partnerships with, for example, Mexico, Chile and Canada, as well as international organisations such as the World Health Organisation. I have had discussions with some of my counterparts across the world, including those leading on measures such as health incentives. Through partnerships we share best practice and ensure our interventions are based on experience and the evidence.

Tackling obesity and helping people to maintain a healthy weight is, as I have said, an extremely complex issue, and that is reflected by the wide range of action we are taking. Of course, we would like to move more quickly and have a magic solution, and there is more that we want to do, but I recognise the scale of the policy we are bringing forward. It is a far-reaching and radical plan to reduce obesity in our society; I do not want us to carry on being second in a league table in which we should not be proud of being second.

The high prevalence of obesity in adults and children has been decades in the making. It is going to take time to see results from our interventions, and we may want to go back and change some of them. There is no single fix and no single point of responsibility. We all have a part to play and it is vital for us all—Government, Parliament, industry, employers, the health service, the wider public sector and all of us as individuals—to work together. I am really looking forward to what I anticipate will be a very varied set of contributions this afternoon.

--- Later in debate ---

[Alex Norris (Nottingham North) (Lab/Co-op)]

It is a pleasure to open this important debate on behalf of the Opposition.

Obesity is a significant public health challenge in this country. It is a growing problem that compounds down the years in missed potential and accelerated poor health. I am glad the obesity strategy recognises that, as well as being a matter for individuals in their personal choices, there is a significant impact from our environment. As such, we have a responsibility in this place to do what we can to help people to maintain a healthy weight.

Almost two thirds of adults are overweight or living with obesity—I am one of them—and we have heard that a staggering number of our children leave primary school overweight. This is an unequally distributed problem, with hospital admissions due to obesity nearly three times greater in poorer communities than they are in the best-off communities. At a population level, it is clear that excess weight brings with it increased risk of diseases such as diabetes, cancer, heart disease, liver disease and, of course, associated mental health conditions. In 2019-20—this is such as staggering figure—there were over 1 million hospital admissions for which obesity was either the primary or secondary cause. That was up 17% on the year before, and represents a 600% increase on the previous decade. That is an extraordinary changing picture and one that should kick us all into action. We have also seen in the last year that living with excess weight makes us more vulnerable when fighting the effects of covid. As the Minister says, it is one of the risk factors we can actually make a direct and swift impact on. It is clear that we need to act.

I have said before when we have debated this topic that where the Government bring forward sensible proposals, we shall work with them to implement them in the national interest. Happily, the 2020 strategy contains many such proposals that we are very keen indeed to see implemented. The 9 pm watershed on unhealthy food adverts is prudent. Efforts to curb the promotions and prominent placements of things that we know are bad for us is a good idea, too. Sometimes, even when we are trying to make healthy choices it feels like we cannot escape reminders of those other options. An expansion of NHS weight management services is well overdue, and I hope we will empower such services to use all effective treatments and resource them to be able to do so, too. Traffic lighting is a valued and effective tool in understanding what our food comprises of. We will support proposals that strengthen and develop that system, and I hope we hear a little bit more about that later. A national-level publicity campaign is valuable and we will support its introduction. There is so much to agree with and I have consistently said so to the Minister. Indeed, the only addition I will contribute here is that we need to get on with it and that we do not have time to waste. There are elements, however, that I want to probe and seek reassurance on from the Minister.

On the total online advertising ban, I do not think it is a secret that the Government do not do online policy very well. I think the ever-running saga of the online harms Bill shows that. Online advertising is complex and sophisticated and is changing all the time. I am conscious of concerted efforts by those in the advertising industry to seek to offer the Government a way of delivering on this goal that reflects their expertise in this area. I hope to get an assurance from the Minister that officials are at least talking to them about that and taking it seriously.

On the restrictions on retailers, I hope that we will get a proper chance to understand and debate the qualifiers on square footage and staffing levels. I do not think we would want to be in a situation where this ends up affecting relatively few organisations, creating an unlevel playing field or promoting perverse outcomes, such as having fewer staff. I would be interested to hear from the Minister in that regard.

Crucially, we heard from the hon. Member for Bath (Wera Hobhouse) about calories on menus. I know that that has public support, and support from many campaigners, but if we effect that, it really must be done correctly and properly. I strongly do not believe that before they sought to publicise that and press on the Government have given enough consideration to those with eating disorders who will be negatively impacted.

[Richard Fuller]

I am grateful to the hon. Gentleman for cantering through his support for the Government. I just want to take him up on his first principles and the rationale, from his philosophical point of view, for why he believes the Government have a right and a responsibility to manage what people eat and how they look. Does he put obesity on the same level as the tobacco industry of the past? Obviously, health measures were taken because of the harmful effect that tobacco could have on people. If he does not put it on that level, what level does he put it on? Does he put it on the same level as alcohol, which causes a lot of poor health? If not, does he believe that we ought to be doing more on alcohol?

--- Later in debate ---

[Richard Fuller (North East Bedfordshire) (Con)]

I congratulate my hon. Friend the Member for South West Bedfordshire (Andrew Selous) on securing this debate, and I welcome my hon. Friend the Minister to her place. It is clear with the breathless endorsements from the Opposition that the Government, if they wish, can fully get their way with these proposals, but I worry.

I worry that an opportunity for a determined and modern policy based on empowering individuals has instead been replaced with a rather tired, top-down, bureaucratic approach. I worry that the Department of Health and Social Care algorithm has resulted not in an intelligent group of products, but a confusing and ill-targeted group of products, as my hon. Friend the Member for Buckingham (Greg Smith) said.

I worry that the policy is literally treating adults like children, particularly with its full-scale transfer of the nutrient profile model. Worse, I worry that the policy targets those who are poor, ethnic minorities and the elderly, who are most likely to be obese or overweight, and it connotes with it a rather condescending attitude that the Government know best for those particular groups of people.

I worry that the evidentiary base is flimsy. The Minister mentioned the sugar tax, and the sugar tax may have been successful, but that is not what is in this policy. In fact, the policy being proposed is very different from the sugar tax. I worry that success is not defined or measured. Essentially, the policy remains a matter of hope, as my right hon. Friend the Member for Forest of Dean (Mr Harper) pointed out.

I worry about the haste of implementation, adding new efforts and responsibilities on businesses just as they are recovering from the impact of lockdowns. In particular, I worry about the impact on Jordans in my constituency and the farmers who are supporting that business. I worry that the Department has chosen to silence the power of businesses and the power of their brands, rather than enhance them in the efforts they wish to undertake.

I worry that the policy is blunt where it could be smart. For example, it prefers an outright ban to using technologies in advertising online that would help achieve the Government’s goals. I worry about the unintended consequences for people with eating disorders. I worry about timing. Many people are already anxious about their health post covid, and these measures will do nothing to avert those anxieties.

I worry about the social credit system of points that Sir Keith Mills may come up with in his review, with all of its potential ramifications. I worry where all this may lead—potentially we will have an NHS app. As we walk down the street and pass a restaurant or a bar, it will beep to tell us, “Please input what you have eaten.” Perhaps we will reach there one day. In fact, we are already there. Those apps are already under trial by the NHS.

NHS Staff Pay

Richard Fuller Excerpts

Monday 8th March 2021 Commons Chamber

[Helen Whately]

I disagree with the hon. Member about what he just said—as I said, we are committed to giving NHS staff a pay rise—but he actually made a really important point when he talked about Catherine and other frontline staff, who have been through incredibly difficult times. I speak to nurses and other healthcare workers all the time, and one of the things I have heard many times in recent weeks and months is how badly staff need time off, and many staff have not been able to take holiday because they have been putting in extra hours to help with the pandemic response. It is absolutely vital in the weeks and months ahead that staff get the annual leave they need to rest and recuperate, and I am working with the NHS to make sure that happens.

[Richard Fuller (North East Bedfordshire) (Con)]

Hundreds of thousands of people have lost their jobs during this pandemic and will be looking to the Government to support them so they can start earning again for their families. Millions of people in this country are on furlough and are living with pay cuts of 10% or 20% and will be looking to the Government to continue to support their businesses through extension of the furlough programme. Thousands and thousands of small businesses have seen the value of their businesses evaporate over the last 12 months and will be looking to the Government to support the economy to rebuild their businesses. So will my hon. Friend remind us that it is the Government’s job to balance all of those calls on the taxpayer, and it is the job of the pay review body to come back with a recommendation?

[Helen Whately]

My hon. Friend is absolutely right. So many businesses have been so hard hit by the pandemic, and it is vital that we support not only the livelihoods of individuals who work in the businesses that have been hit, but those businesses themselves, because they are what will help us come through this and recover from the economic pain of the pandemic. He is right that the Government are having to balance these enormous demands on the public finances, and we also need to take steps ourselves to recover those finances so that we have a strong economy for the future.

Covid-19

Richard Fuller Excerpts

Monday 22nd February 2021 Commons Chamber

[Richard Fuller (North East Bedfordshire) (Con)]

The most telling aspect of today’s debate is the focus on specifics rather than on principle, on trends in data and details of subsidy rather than the eager pursuit of freedom, on continuing comfort with the state making choices for us rather than a clamour by us for the freedom to be responsible for ourselves. As Oxford University ranks the stringency of the UK’s response the fourth most restrictive in the world after Cuba, Eritrea and Ireland, this absence is telling. One year ago, few of us would have suggested that the state could ban people from leaving their home, from leaving the country, from getting married, or from touching a loved one in their final moment, or that it could stop a child receiving education or keep an elderly person living alone from the comfort of a neighbourly chat over a cup of tea. Do we fully appreciate the scale of what we have done?

This has been a year of ambiguous choices, when each of us in Parliament has had to wrestle with our conscience to render judgments with many unknowns, yet each of us, rightly or wrongly, has allowed essential freedoms to lapse and thus been party to the creation of a new illiberal precedent that may imperil the meaning of liberty for decades to come.

We should each reflect on our judgments to determine how we can repair our common heritage of freedom. The House should reflect on whether it has provided effective legislative scrutiny and whether casting Members away gave too much allowance for Executive decree. We should reflect on whether the experiment of remote technology has substituted a pretence for the substance of scrutiny, parading a Potemkin Parliament as the real thing.

Ministers should reflect on whether speed of response became an excuse, rather than a genuine requirement for presumptive Executive action and whether the drift towards lawmaking without the sharing of adequate data and without questioning or accountability with Parliament became a lazy path routinely chosen for convenience, rather than need.

The Opposition should consider why their response to the greatest power grab by the state has been to demand more state, more restriction and more control. They made a series of cynical, tactical moves designed to wrongfoot Government mid-crisis, at best setting out a vision of even greater repression and control while heightening public fears and worry.

I and my colleagues on the Government Back Benches should reflect on whether a more vigorous defence of our liberties was called for, and if so, why we did not heed that call. For our citizens, we should ask to what purpose we removed those liberties a year ago and for what purpose we are withholding those liberties yet further today.

The decision has not been so much one of medical necessity, but rather of a presumed political necessity. We should reflect candidly and fearlessly on whether the accumulated costs in diminished livelihoods, debts, school closures, misdiagnoses, loneliness and lives lost as a result of these measures have been worth the reduction in covid deaths and the avoidance of an annual rate of death for our population that was commonplace and went unremarked barely two decades ago. Whatever the conclusions of our reflections, we must now resolve together to lead the recovery of these liberties with every moment and every strength we have.

Vaccine Roll-out

Richard Fuller Excerpts

Thursday 21st January 2021 Commons Chamber

[Matt Hancock]

We are very much open to the vaccination of teachers, and school staff more broadly, whom the hon. Gentleman mentioned, once we have got through those who are clinically most vulnerable. The vaccine programme has to be used to save lives, first and foremost; I think everybody agrees with that. Of course we look at all available data and information in forming that view.

[Richard Fuller (North East Bedfordshire) (Con) [V]]

I welcome the opening today of the Weatherley Centre in Biggleswade, which fills a gap in delivery across Bedfordshire, but I wish to raise with the Minister another question that has arisen in Biggleswade and get some policy advice from him. Penrose Court, a residential care home in Biggleswade, has recorded positive cases among residents. The home was advised that there would therefore be a delay in the vaccinations. Today, I understand from the clinical commissioning group that those vaccinations are back on track, but can the Minister advise the House what the policy is on vaccination of residents in care homes where a recent positive case has been recorded?

[Matt Hancock]

That is a really important question. For the most part, even when there is an outbreak, a care home can offer vaccinations with its local primary care network to those residents who do not have covid. Of course, when this is done, very scrupulous infection control needs to be in place. For instance, many care homes have vaccinated in a garden hub to make sure that the vaccination is outside, which is, of course, so much safer if there is an ongoing outbreak. Sometimes, an outbreak in a care home is so significant that it has to wait, and that has happened in a couple of cases, but all these decisions should be based on the local clinical advice of the GPs who are in the lead on the roll-out of the vaccination to care homes. I am really glad that this situation has been resolved in Biggleswade, and, of course, I am delighted at the new pharmacy-led vaccination centre in Biggleswade, which, as my hon. Friend said, is plugging a gap. He will have heard colleagues across the House praising the roll-out of the vaccinations in Bedfordshire.