HIV Action Plan: Monitoring and Evaluation Framework Report

Andrew Gwynne Excerpts

Friday 29th November 2024 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

This Government are committed to ending new HIV transmissions within England by 2030. On 28 November, the Prime Minister made a significant down payment on this as he announced that emergency department opt-out testing for HIV will be extended to both extremely high and high prevalence areas during 2025-26, backed by £27 million of funding from the Department’s budgets, further confirming our determination.

I am pleased to update the House on the publication of the third annual report, “HIV Action Plan monitoring and evaluation framework 2024 report”. This report provides an annual overview to Parliament of the Government’s progress towards no new HIV transmissions within England by 2030, as committed to in the 2021 HIV action plan.

We are making progress towards our shared goals, and we should be encouraged by some of the highlights from the report.

HIV testing in sexual health services increased by 8% from 2022 showing greater rises in some key population groups, such as gay, bisexual and men who have sex with men where a 36% increase can be observed. This is coupled by a substantial progress to reduce new HIV diagnoses first made in England between 2019 and 2023, particularly among the same population group.

Overall, new HIV diagnoses first made in England fell by 12% from 2,801 in 2019 to 2,451 in 2022. However, this figure rose by 15% to 2,810 in 2023.

The blood borne virus opt-out testing in emergency department programme has been a great success and has helped us identify a significant proportion of new HIV diagnoses in 2023.

England continues to be one of the few countries in the world officially meeting the 95-95-95 targets when using the global measurement methods. However, in response to stakeholders’ suggestions, UKHSA adjusted the UNAIDS 95-95-95 targets, for the first time, so that they also account for people diagnosed but not in active HIV care and people for whom information on viral suppression was not reported. This new approach shows UNAIDS 90-90-90 goals were met in England in 2023 and partially met for the UNAIDS 95-95-95 goals, with 96% of all those living with HIV being diagnosed, 94% of those diagnosed receiving treatment, and 92% of those treated being virally suppressed and thus unable to pass on the virus.

Due to success in HIV treatment, over half of people living with HIV are over the age of 50.

However, there is more work to be done to achieve our shared ambitions.

Inequalities are widening in access to HIV prevention interventions, treatment and ongoing care, quality of life and stigma across most demographic characteristics, in particular, age, ethnicity, gender identity and exposure. For example, among men exposed through sex with men, HIV diagnoses fell by 35% amongst white men between 2019 and 2023, whilst in men from ethnic minority backgrounds, there was an increase of diagnoses from 26% in 2019 to 33% in 2023.

Similarly, there has been a significant increase in identifying need for and initiation of HIV pre-exposure prophylaxis (or PrEP): highest in white GBMSM and lowest in people from ethnic minority groups such as black African and black Caribbean.

As we reach the later stages in ending transmission, it is likely that identifying everyone living with the virus and narrowing inequalities will become more challenging. Our approach relies therefore on concerted efforts across the whole system.

The Department of Health and Social Care, the UK Health Security Agency, NHS England and a broad range of system partners in consultation with people living with HIV, their friends and families and the voluntary and community sector, are considering evidence from this report and working together to develop a new HIV action plan that will address these challenges. We aim to publish the plan in summer 2025.

I will keep Parliament updated on our progress and trust you will continue to support our shared goal of becoming the first country in the world to end HIV transmission.

[HCWS270]

Epigenetics

Andrew Gwynne Excerpts

Wednesday 27th November 2024 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

My noble Friend the Under-Secretary of State for Patient Safety, Women’s Health and Mental Health (Baroness Merron) has made the following written statement:

Today I am announcing the launch of a new research collaboration between the Government, UK Biobank and Oxford Nanopore Technologies. The new generation of nanopore-based molecular sensing technology created by this leading UK-headquartered, life science company will be used to conduct detailed genetic sequencing of 50,000 samples in the UK Biobank, the UK’s primary biomedical database.

This represents a significant expansion of Oxford Nanopore’s collaboration with UK Biobank which started with a 5,000-genome pilot. This new collaboration will create the world’s first comprehensive dataset of epigenetic modifications in the human genome and demonstrate the UK’s continued leadership in the field of genetics. Further exploration of epigenetics—the emerging study of how DNA and its expression is affected by modifications that do not change the underlying DNA sequence—could unlock a deeper understanding of the causes of diseases such as cancer and neurological conditions. This could pave the way for new diagnostic and targeted treatments, improving patient care and giving hope to the millions of people who live with conditions like these.

This expansion of the epigenetics programme is an early example of collaboration between Oxford Nanopore and HMG, building on the plans to form a strategic partnership announced on 5 November. I will provide further updates to the House on this collaboration as it develops.

[HCWS257]

World AIDS Day

Andrew Gwynne Excerpts

Wednesday 27th November 2024 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

It is a pleasure to serve under your chairmanship, Sir Mark. I am extremely honoured to have the opportunity to speak today at the first dedicated debate on HIV and AIDS in this Parliament. I am incredibly grateful to my hon. Friend the Member for Uxbridge and South Ruislip (Danny Beales) for securing the debate on a topic that is close not only to both of our hearts but to the heart of this Government.

We are a Government who are committed to ending new HIV transmissions in England by 2030. With World AIDS Day fast approaching on 1 December, the debate is a welcome opportunity to highlight the importance of our new HIV action plan, which we aim to publish in summer of next year. Achieving that goal demands collaboration and that is why dialogue and engagement with every part of the system will be crucial as we progress with the development of the new plan.

I am delighted to have the continuing support of colleagues from across the House, and like many speakers today I commend the engagement of fantastic charities and organisations such as the Terrence Higgins Trust, the National AIDS Trust and the Elton John AIDS Foundation, among many others. I also pay tribute to all Members who have contributed to the debate. I assure the hon. Member for Strangford (Jim Shannon) that, as the Minister responsible for public health in England, I will liaise closely with my counterparts in Northern Ireland, Scotland and Wales to ensure that we are all on track to end new cases of HIV in our respective jurisdictions.

My hon. Friend the Member for Gedling (Michael Payne) spoke powerfully, and the right hon. Member for Dumfriesshire, Clydesdale and Tweeddale (David Mundell) and my hon. Friend the Member for Exeter (Steve Race) both raised the issues of global inequality, stigma and the pervasive legislation that still exists in far too many parts of the world. I assure them and the whole House that this new Government will continue to be a major contributor to the Global Fund. Our obligations on the international stage are clear: we are not just about tackling HIV in this country, but around the globe. On human rights and anti-LGBTQ+ legislation, this Government and this country will always stand for equality, human rights and justice across the world, as well as at home.

My hon. Friend the Member for Clapham and Brixton Hill (Bell Ribeiro-Addy) spoke specifically about issues within black and minority ethnic communities. I would love to come and visit the new clinic she mentioned; consider it a date.

My hon. Friend the Member for Bournemouth East (Tom Hayes) made a lovely and loving contribution to the debate. On behalf of the British Government, I thank him for putting the name of John Eaddie on the record. John is no longer just a statistic; he is a human being who happened to die of AIDS. We pay tribute to John and to those who died after him, ahead of all the drugs, treatments and advances in technology that we now have. However, their death was not in vain, because we remember them and the sacrifices of their friends and families to support them in really difficult times so that we have a better world ahead of us today.

My hon. Friend the Member for Sherwood Forest (Michelle Welsh) and the hon. Member for North Shropshire (Helen Morgan), who spoke for the Liberal Democrats, also contributed to the debate. I assure the hon. Lady that this Government are committed to public health and prevention and although I cannot circumnavigate the Budget process, we will do all we can to restore the public health grant across this Parliament and into the future, because public health and prevention matter. They are a priority for us all.

On Monday, I had the pleasure of attending the launch of the voluntary and community sector report produced jointly by the Terrence Higgins Trust, the National AIDS Trust and the Elton John AIDS Foundation, where I offered my reflections on its valuable recommendations. I welcome the report and its recommendations, and I look forward to developing the HIV action plan alongside such a vital sector. We remain committed to hearing from those whose frontline expertise, grassroots connections and powerful voices will ensure that our plan is not only ambitious but grounded in the lived experiences of those it seeks to support.

Let me be clear: getting to zero new transmissions means smashing stigma. World AIDS Day is a stark reminder of how far we have come since the 1980s, but this year’s theme of tackling stigma starkly shows how far we have to go. It calls on all of us, not just as lawmakers but as members of our communities to reflect on the prejudice that people living with HIV have faced through not only a life-threatening illness but alienation, misinformation and discrimination. I have been thrilled to see the innovation and effectiveness of stigma-reduction strategies across the country. I am keen to build on that knowledge and work closely with the UK Health Security Agency as it continues to monitor stigma data through the “Positive Voices” survey report, to ensure that addressing stigma is a key priority for our new HIV action plan.

The experiences of the 1980s should remind all of us that stigma thrives in ignorance and silence. That is why we are determined to address it head-on, as part of honouring the legacy and work of so many others who went before. For the avoidance of doubt, we will not be satisfied until the number of transmissions reaches zero, yet there remain differences in the rate of diagnoses between demographics.

As the numbers move towards zero, we must work together to reach those communities that have not been captured thus far. That means including and empowering those voices, not essentialising them. It means cultural competence, innovation and collaboration. That is why we are hosting engagement sessions and roundtables in parallel with external stakeholders, including people with lived experience, the voluntary and community sector, professional bodies, local partners and others. We are working alongside UKHSA, NHS England and a broad range of system partners to inform the development of the new action plan, which will build on the progress made on the existing plan and guarantee that it is robust, inclusive and evidence-based.

Central to that effort is the importance of testing. That is a message we cannot repeat enough. I apologise to the shadow Minister, but I am going to repeat it: test, test, test. Testing is the gateway to prevention, treatment and ultimately ending new HIV transmission. We know that HIV opt-out testing works well. Over the past 27 months, more than 2 million HIV tests have been conducted, reaching those who do not typically engage with sexual health services.

Tomorrow, UKHSA will publish its opt-out testing report, providing us with the latest data. That will inform the next steps for the expansion of opt-out testing. We will also use that as a foundation to explore how our action plan can build on those successes—successes such as the national HIV testing week, yet we know that lower levels of testing persist among black African and heterosexual groups. We have seen that trend intersect with women, too. That requires tailoring our approach to reach those people living with undiagnosed HIV, who have been overlooked.

PrEP plays a vital role in the combination approach. Breakthroughs in science and medicine mean that, with the right treatment, people living with HIV can now lead long, healthy lives. The PrEP road map was published by the HIV action plan implementation steering group in February this year, identifying barriers to access for under-represented groups. That road map will guide our efforts to improve access, uptake and the use of PrEP among those most at risk of HIV.

In closing, I want to say that we are determined to reach zero HIV transmissions. On World AIDS day, let us honour those we have lost by recommitting ourselves to a future free from fear, misinformation and discrimination. The “Don’t die of ignorance” slogan is sadly as relevant today as it was on release. Together with science, compassion and unity we can achieve a future of zero new HIV transmissions, with stigma consigned to history.

[Sir Mark Hendrick (in the Chair)]

Order. In the 20 seconds we have left, I leave it to Mr Beales to say a few words.

Draft Medical Devices (Post-market Surveillance Requirements) (Amendment) (Great Britain) Regulations 2024

Andrew Gwynne Excerpts

Tuesday 26th November 2024 General Committees

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I beg to move,

That the Committee has considered the draft Medical Devices (Post-market Surveillance Requirements) (Amendment) (Great Britain) Regulations 2024.

It is a pleasure to serve under your chairmanship, Mr Efford. I will begin by setting out the policy context for the regulations.

The 2020 independent medicines and medical devices safety review, led by Baroness Cumberlege, highlighted the consequences of inadequate post-market regulations for patients, especially women, who received pelvic mesh implants. The review found that the system often failed to listen to patients’ concerns and acted too slowly when issues were identified. Those women have suffered horrendously as a result. The review called for substantial changes to the Medicines and Healthcare products Regulatory Agency, the MHRA, to ensure patient safety, including improved regulation of medical devices to enhance the collection of adverse incident data to reduce patient safety risks and prevent a recurrence of harm.

This statutory instrument will deliver improved safety for patients. It will introduce clearer and more robust requirements on medical device post-market surveillance—PMS—so that manufacturers are required to collect and evaluate the safety and performance of medical devices in a thorough and consistent manner, once they are in real-world use.

What will this mean for patients in the UK? This instrument represents the first step in a series of amendments to reform the Medical Devices Regulations 2002. These changes are designed to enhance the safety of medical devices, to ensure availability and to support innovation.

This instrument will create a strong foundation for this medtech regulatory reform and deliver patient benefits in three key areas—first, by improving patient safety. This instrument will not only enable the MHRA, but the whole health system to better protect patients by more closely monitoring the safety and performance of medical devices. This includes medical devices within the NHS and in our local communities, thereby supporting the Government’s mission to shift focus from hospital to community. This will result in more rapid identification, investigation and resolution of safety issues, allowing the NHS to focus its resources more effectively. While doing so, these regulations will also strengthen the patient voice by requiring manufacturers to undertake patient and public engagement where appropriate during their post-market surveillance.

Secondly, this statutory instrument will provide stronger assurance that devices supplied to the market are safe and effective, supporting both the continuation of supply, and improved access for the NHS and patients to potentially transformative technologies. With stronger assurance of safety and efficacy, we are able to implement new routes to market. For example, this instrument will help support the introduction of an international reliance framework, taking into account, where it is safe to do so, decisions made by comparable regulators. We intend to lay that draft legislation in 2025 as part of future medical devices regulatory reform.

Finally, this instrument will support innovation and economic growth by providing regulatory certainty for manufacturers considering placing their medical devices on our market. The collection of real-world data can result in more user-friendly and more effective innovations by highlighting opportunities for improvement, ultimately achieving better outcomes for patients.

I will now take a moment to summarise the key provisions of this instrument. Once in force, this statutory instrument will ensure that any medical device placed on the Great Britain market is subject to rigorous post-market scrutiny. This will enhance patient safety across the board, thereby promoting a consistent approach to PMS throughout the UK, where of course Northern Ireland has its own arrangements. This statutory instrument will set out in greater detail what must be included as part of a PMS system and a PMS plan. Manufacturers will need to ensure that their PMS system includes analysis of relevant data throughout the medical device's lifetime.

This comprehensive approach allows for a more accurate assessment of device performance, ultimately leading to faster identification and resolution of safety issues. This statutory instrument will provide greater detail on when and how to report serious incidents. The timelines for notifying the MHRA will be standardised throughout the UK, benefiting manufacturers that supply medical devices to both Northern Ireland and Great Britain and ensuring that safety issues are identified and investigated promptly.

The introduction of new requirements to share summary reports at regular intervals means that medical devices will be continually monitored to ensure their performance, with higher-risk devices facing even more scrutiny. These measures encourage manufacturers to monitor both serious and non-serious incidents over time, which will aid recognition of adverse safety trends and signals, supporting the containment of potential safety issues before they escalate.

I commend these measures to the Committee.

--- Later in debate ---

[Andrew Gwynne]

I thank the hon. Lady for her valuable contribution. These regulations introduce clearer, more robust requirements for post-market surveillance of medical devices, to improve patient safety and to signal a crucial shift in the way in which we manage medical devices in Great Britain.

The hon. Lady raised some important points. First, on the MHRA and whether it is appropriately resourced to cope with the likely increase in incident reporting as a result of this regulatory change, let me reassure her that the measures introduced in this instrument should not have a significant impact on MHRA capacity. Its systems and processes to provide regulatory oversight for vigilance reporting are already in place. The measures within this statutory instrument are expected to increase the volume of safety data reported to the MHRA. However, the accompanying improvements to data quality will support automation and reduce burdens associated with data analysis. To ensure that the MHRA’s systems for vigilance reporting are fully equipped to handle the new reporting requirements for manufacturers, we will verify system-readiness through comprehensive testing and validation ahead of the date of application of these regulations.

As the regulator for the whole United Kingdom, the MHRA is committed to protecting patient safety while enabling a regulatory environment in which the life sciences sector is able to innovate and to launch new medical products in the interests of public health across the UK. Contrary to the hon. Lady’s assertion that the regulatory burden will be increased and will therefore squash innovation, the opposite is the intention of this Government. The intention is to ensure that there is a clear regulatory framework throughout the United Kingdom—without having the disparities that we have at the moment—and to ensure that better, smarter use of the data will be available. The closer scrutiny of the efficacy of these medical devices will encourage innovation in medtech and in life sciences.

[Dr Caroline Johnson]

The Minister is saying that more regulation will encourage innovation. I am not sure I agree with that premise, but does he accept that these new regulations will lead to a higher regulatory burden on people wanting to set up medtech companies in the UK than in the EU or elsewhere?

[Andrew Gwynne]

We could get into a theological debate about the benefits or otherwise of regulations, but this statutory instrument will provide certainty and clarity across all four nations of the United Kingdom. It will provide a known framework for medtech and life science companies operating, or wishing to operate, in the UK. I see this as a good piece of secondary legislation to bring about the certainty that we want to give companies wishing to operate, or which are operating, in the United Kingdom, and to set up a common framework across our four nations. I see that as good. Regulatory divergence with another part of the United Kingdom is not, in my mind, good for business—particularly where a company wants to operate on both sides of the Irish sea.

On patient confidentiality and the cost estimates for the NHS, I hope the hon. Lady will forgive my having to write to the Committee on that point because the tablets of stone have not yet reached me from Mount Sinai.

On the hon. Lady’s question on innovation being reversed and whether people have long enough to prepare, we believe that the measures in the statutory instrument do give people long enough to prepare—not least because many of those companies are already operating in the parts of the United Kingdom that the instrument will bring our regulation in line with. Therefore the extra capacity that is needed in the system will not be to the detriment of the measures in this statutory instrument.

[Dr Johnson]

Parts of the UK are working to EU regulations, but does the Minister recognise that the statutory instrument he is bringing forward will introduce into the whole of the UK market, regulations that are not currently present in either the UK or EU markets?

[Andrew Gwynne]

I recognise that we are not only bringing Great Britain in line with Northern Ireland but adding other patient safety measures. If the hon. Lady is saying—I hope she is not—that the result of the Cumberlege review is that we do nothing in this area to improve the issues highlighted by it, she is within her powers to oppose these measures. However, we think not only that ensuring regulatory consistency throughout the United Kingdom is the right thing to do, but that this statutory instrument gives us the opportunity to start to put right some of the shocking, appalling things that we know have happened, as highlighted by the Cumberlege review. That is what these measures seek to do.

This Government are committed to the delivery of a framework for medical device regulation that prioritises patient safety—that is the crucial thing that we are seeking to do—and that gives patients access to the medical devices they need, and ensures that the United Kingdom remains an attractive market for medical technology innovators. We have an obligation to patients and the public to maintain the highest standards of safety and efficacy for the medical devices they rely on. These regulations are an important first step to deliver this framework, and they place patient safety at the forefront. They will enable not only the MHRA but the whole health system to better protect patients.

I am grateful to the hon. Lady for her contribution, and to Members across the Committee for considering these regulations today. I hope they will join me in supporting these regulations, so that we have consistency across the UK and put patient safety at the heart of medtech and life sciences.

Question put and agreed to.

Tobacco and Vapes Bill

Andrew Gwynne Excerpts

2nd reading
Tuesday 26th November 2024 Commons Chamber

[Jim Allister (North Antrim) (TUV)]

I will vote for this Bill. I admit that I am sceptical about the enforceability of the age escalator, but fundamentally the legislation addresses a huge problem in our society. There can be no doubt that smoking is a killer, so it is our responsibility to seek to diminish the death toll. Vaping is a totally unregulated sector, and I fear that it is a gateway to smoking for many young people. Therefore, it is right that it, too, comes within the ambit of the Bill.

The Secretary of State said this afternoon that this is a “four-nations Bill”. I welcome that, and I trust that it is right. That is the point I want to test in my contribution, and I will seek reassurance from the Minister about it. The reason I want to test it is that Northern Ireland, and Northern Ireland alone, is still subject to the EU’s tobacco directive. We are subject to the EU’s tobacco directive because it is one of the 289 EU laws listed in annex 2 of the protocol—or the Windsor framework, as it is now called—that remain in force in a part of this United Kingdom. Article 24 of the tobacco directive says:

“Member States may not…prohibit or restrict the placing on the market of tobacco or related products”.

Does this Bill, by its necessary steps, restrict the placing on the market of tobacco? If it does, it will fall foul of the tobacco directive and will therefore be unenforceable in Northern Ireland, because of our ridiculous subjection to foreign laws that we do not make and cannot change.

We have an illustration of what might happen, because in 2022 Denmark sought to introduce almost identical legislation. It had to withdraw it, and in withdrawing it, the Health Minister told the Danish Parliament on 6 April 2022:

“The ministry…therefore considers that a ban on the sale of tobacco and nicotine products to people born in 2010 or later would require an amendment to the European Tobacco Products Directive”.

On that basis, they withdrew it. Earlier this year, the Irish Republic was minded to introduce legislation like this, but it did not proceed for the same reason.

If we are in a situation where a part of this United Kingdom quite absurdly cannot be governed by laws that this Parliament wishes to make, we are in a very sad situation indeed. It is my fear that, like in Denmark, the imprimatur would not be forthcoming from the tobacco directive and we could therefore have a situation where laws that we want to make and apply throughout the United Kingdom cannot be applied because of our subservience to foreign jurisdiction. If that is so, it will be an appalling situation. The House will have an opportunity to do something about this when my private Member’s Bill comes before it on 6 December, and I trust that Members will take that opportunity to liberate Northern Ireland from the bind of foreign jurisdiction and foreign law.

There are vested interests who will try to challenge the Bill’s applicability in Northern Ireland because of the tobacco directive, and I am fearful of the line that the courts might take, because we have had some examples. This House passed—for better or for worse—the Northern Ireland Troubles (Legacy and Reconciliation) Act 2023. It also passed the Safety of Rwanda (Asylum and Immigration) Act 2024. I am not commenting on their merits; I am making it clear that when they went to the High Court in Belfast, both were declared inoperable in Northern Ireland. Why? Because of the supremacy of EU law.

If that were to happen with this Bill, it would be an absolute scandal. We would not be able to afford the people of Northern Ireland the same health protections that the Bill will afford to everyone else in the United Kingdom. And why not? Because we are subject to a foreign jurisdiction. It is the lifting of that jurisdiction that will bring us liberty to be governed as this House would wish us to be governed, and I trust that the Minister will be able to assure us that those fears are unfounded, that the Danes were wrong to withdraw their Act, and that our courts will—

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I am grateful to the hon. and learned Gentleman for giving way. I fully understand his concern. That is why this Government need to give credit to the previous Government, who worked so hard to make this a four-nation approach. I want to give him and the House the assurance that it is the responsibility of the UK Government to ensure the compatibility of the Bill with the Windsor framework. The Government have taken into account all domestic and international obligations in bringing forward this Bill today.

[Jim Allister]

It gives me no assurance if the Government’s commitment is to ensure compliance with the Windsor framework, because it is the Windsor framework that imposes EU law on Northern Ireland. Because the tobacco directive is one of the laws listed in annex 2 that continue to apply to Northern Ireland, it could trump this Bill. There is no point in the Government saying to this House, or to my constituents, that they will abide by the Windsor framework, because the Windsor framework binds us to EU law. It is only by setting it aside that we can have liberty.

[Andrew Gwynne]

I am sorry to detain the House, but I make it clear that this is a United Kingdom law. It covers all four nations of the United Kingdom, and we are assured that it complies with the requirements of the Windsor framework. This law will stand.

[Jim Allister]

The previous Government told this House—and Government lawyers probably said the same—that the Rwanda Act would apply to Northern Ireland and that the legacy Act was unchallengeable, yet it turned out that both fell under the supremacy of EU law. On the face of it, the tobacco directive suppresses this Bill and still has legal force in Northern Ireland. If that is how it turns out, I would like to hear a commitment from the Minister that the Government will override any suppression of this law in Northern Ireland and stand up for UK sovereignty in my part of the United Kingdom.

--- Later in debate ---

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

It is a pleasure to close this debate on behalf of the Government. I commend my hon. Friends the Members for City of Durham (Mary Kelly Foy), for Newcastle upon Tyne East and Wallsend (Mary Glindon), for Chatham and Aylesford (Tristan Osborne), for Suffolk Coastal (Jenny Riddell-Carpenter), for Worthing West (Dr Cooper), for Southampton Itchen (Darren Paffey), for Mid Cheshire (Andrew Cooper), for Cardiff West (Mr Barros-Curtis), for Dartford (Jim Dickson), for Bolton North East (Kirith Entwistle), for Hartlepool (Mr Brash) and for Bolton West (Phil Brickell) and, on the Opposition Benches, the hon. Members for North Dorset (Simon Hoare), for Harrow East (Bob Blackman), for Lewes (James MacCleary), for Aberdeenshire North and Moray East (Seamus Logan), for Bath (Wera Hobhouse) and for South Antrim (Robin Swann), the hon. and learned Member for North Antrim (Jim Allister) and the hon. Member for Newbury (Mr Dillon), for a series of outstanding contributions this afternoon. Many of us on the Labour Benches remember the last Labour Government’s proud history of public health measures—indeed, some of us were in this place at the time. From the indoor smoking ban to putting an end to cigarette advertising, we took the bold action to drive down smoking prevalence, and the country is still feeling the benefits of those policies today. However, after 14 years of public health neglect, we have seen much of our hard work squandered. Health inequalities have grown worse, and life expectancy is stalling. Most appallingly, life expectancy is going into reverse in some communities.

[Afzal Khan (Manchester Rusholme) (Lab)]

I welcome this Bill. Some 6,000 children in Greater Manchester take up smoking each year, allowing tobacco and vape companies to profit from increasing health inequalities. If we eradicate smoking, Greater Manchester’s economy will gain over £2.5 billion each year, funds that could be allocated to our health and social care sector. Does the Minister agree that if we follow the recommendations of the smoking review by Professor Javed Khan OBE, who did an excellent job on that review, we have the unique opportunity to both save lives and reduce poverty, creating a healthier and more equal society?

[Andrew Gwynne]

I thank my hon. Friend for that contribution, not least because it allows me to place on record this Government’s thanks to Javed Khan for the work he did in his review of smoking. My hon. Friend has hit the nail on the head, because in the parts of Greater Manchester that he and I represent, health inequalities are stark and visible. We are going to turn them around. Our health mission pledged to tackle the social inequalities that influence health, and to ensure that children have the very best start possible, in which they are given the building blocks for a healthy life. That will be an immense challenge, but every member of this Government is up for the battle.

Colleagues have made a number of points, and I will try to answer as many as I can in the time we have left. First, I pay tribute to the hon. Member for Harrow East for the work he has done on this issue over a number of years. I assure him that all tobacco products are covered by this Bill, including the chewing tobacco product that he referred to. My hon. Friend the Member for City of Durham, who has also been a passionate spokesperson for tackling smoking harm, is absolutely right to raise the issue of article 5.3. The new Labour Government take very seriously their obligations as a party to the World Health Organisation’s framework convention on tobacco control, and we remain fully committed to that convention, including the important commitment, under article 5.3, to protecting public health policies on tobacco control from

“commercial and other vested interests of the tobacco industry”.

The shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), referred to the powers to bring in smokefree places. We will consult on extending smokefree places to include areas outside schools, children’s playgrounds and hospitals in England. We believe that strikes the right balance between protecting the most vulnerable and recognising the pressures facing the hospitality sector. I want to make the shadow Secretary of State aware, though, that the Bill was designed in full consultation with, and to meet the needs of, the devolved Governments across the whole of the United Kingdom. It is a UK Bill, with powers that meet the requirements of each of the component parts of our country, and I reiterate that as far as England is concerned, this Government will seek to consult on schools, children’s playgrounds and hospitals only.

A number of Members, including the hon. Member for Harrow East, raised the topic of stop smoking services. We are putting an extra £70 million into local stop smoking services, which could help with up to 200,000 successful quits a year. We are still rolling out a smokefree pregnancy incentive scheme, which will support pregnant women in quitting and ensure that more babies do not suffer a hit to their life chances before they are even born.

[Jamie Stone (Caithness, Sutherland and Easter Ross) (LD)]

I am very sorry that I was not in the Chamber for the beginning of the debate. I have very strong views on this matter, because my father died of cancer—I quit 20 years ago, thank God. It occurs to me that we have heard from other people who have quit, and that we who have quit could be mobilised to help others quit. Why do the Government not use us? We could do a lot of good and provide a lot of help.

[Andrew Gwynne]

I think the hon. Gentleman has just talked himself into a job. He is absolutely right that the best people to advocate for stopping smoking are former smokers.

We will still encourage adult smokers to switch to vaping through Swap to Stop in England, and I am delighted that localities have asked for over half a million starter kits so far. On advertising regulations, of course the consultation will take place after Royal Assent, but I hope that I can assure the hon. Member for Harrow East that we will take away his point about ensuring that the NHS can still advertise Swap to Stop under those regulations. On a tobacco industry levy, fiscal matters are for the Treasury, but I am sure that his views and those of others have been communicated to Treasury Ministers.

The hon. Member for Lewes mentioned the rise of the black market. This is a line that has been parroted by the tobacco industry for years, so we need to spell out the facts. Whenever Governments of any guise have introduced targeted tobacco control measures, the black market actually has not prospered. Consumption of illegal tobacco has gone from 15 billion cigarettes nearly 25 years ago to just one 10th of that amount last year, and when the last Labour Government raised the age of sale from 16 to 18, the number of illicit cigarettes fell by a quarter. However, this requires better enforcement, and we will use every second of the generously long buffer period to support businesses in preparing for and implementing the changes, including through information campaigns. We are providing £10 million to trading standards to increase their capacity and capabilities next year, and there is £100 million for Border Force and His Majesty’s Revenue and Customs over the next five years to tackle illicit and under-age sales. The Bill also allows trading standards to issue on-the-spot fines of £200, and to reinvest the proceeds of those fines, and indeed the licensing regime, back into further enforcement.

[Bob Blackman]

Will the Minister consider ensuring that the fines are raised by at least inflation each year? Fines could be increased on a scale, to make sure that they keep progress with changes.

[Andrew Gwynne]

We have already doubled the fine proposed in the previous Government’s Bill, which is a step. I listened very carefully to the hon. Gentleman’s argument, and he might wish to pursue it in Committee, should he be fortunate enough to be a Committee member. I look forward to the debates we might have.

A number of questions about the licensing regime were posed by the shadow Secretary of State, as well as by the hon. Member for North Shropshire (Helen Morgan), the hon. Member for North Dorset (Simon Hoare) and others. I reassure the House that across the sector, there is broad consensus among retailers about a licensing scheme; more than four fifths of them have expressed their support. Unlike alcohol, there is no licensing requirement for tobacco. A lot of people outside this House would find that hard to understand. They assume that convenience stores, supermarkets and other places that sell alcohol are licensed in a similar way to sell tobacco products, but that is not the case. We will bring in a licensing scheme, because we know that will have a huge public health impact, as other licensing regimes do.

[Tristan Osborne]

When I was on a council, I had a portfolio managing licensing. Councils already manage significant licensing functions, so it would be very convenient to simply add this function to those. That would not necessarily be a significant bureaucratic hurdle, as has been said.

[Andrew Gwynne]

Local government will take the lead on this matter, and we will consult widely on how we bring forward the licensing regime, and on how we implement it through secondary legislation, following that consultation. An impact assessment will be prepared before the secondary legislation is introduced, but I want to work with local government across England—I am sure that ministerial counterparts in other parts of the United Kingdom seeking to bring in a licensing regime will do the same—to ensure that we get this right for local government. That includes ensuring that the cost of running a licensing regime is met by the regime itself.

[Mr Brash]

We have mentioned the fact that local government is responsible for public health. I have had our director of public health email me just today to say how supportive they are of this Bill. Local government wants this opportunity to try to improve the health of local people. The fears that local government would be under pressure are simply wrong, are they not?

[Andrew Gwynne]

My hon. Friend is absolutely right. From the engagement that I have had with members across all parties in local government—elected members, officers and directors of public health—I know that they want these measures. They are up for introducing them, and for helping us to get them right.

The hon. Member for North Shropshire raised the issue of ID checks, as did a number of others. I gently say to those who expressed a degree of scepticism that most retailers already follow recommended practice and regularly ask customers for ID. We are stopping people from ever starting smoking, and 83% of smokers start before the age of 20. That means that someone who has never previously smoked is highly unlikely to want to take up smoking later in life. Our published modelling shows that smoking rates in England for 14 to 30-year-olds could be close to 0% as early as 2050 with the measures in this Bill.

[Amanda Martin (Portsmouth North) (Lab)]

As a former teacher, I hope that the Government are working across Departments. Will we work with the Department for Education to ensure that these conversations are had in our schools, right from the beginning, at primary level, and all the way through?

[Andrew Gwynne]

That is absolutely crucial. With this legislation, we have to make sure that we do not take our foot off the pedal when it comes to education and informing the next generation of children of the harms of smoking and vaping through our public health initiative.

[Johanna Baxter (Paisley and Renfrewshire South) (Lab)]

My constituents in Paisley and Renfrewshire South need a health service that moves from sickness to prevention, so can my hon. Friend confirm that this UK-wide Bill will impact my constituents? Has he had discussions with the Scottish Government about ensuring its implementation north of the border?

[Andrew Gwynne]

That is an important point, and it allows me to place on record my thanks to the Health Ministers in Scotland, Wales and Northern Ireland for how they have approached our desire to bring all parts of the United Kingdom together to make a smokefree United Kingdom, not just a smokefree England, through this legislation. I hope that I can reassure my hon. Friend that I have had incredibly fruitful conversations with the Health Minister in the SNP Scottish Government. She is as wedded and committed to this Bill and its measures as we are in this House today. I am reassured that across the whole United Kingdom, we will be walking in step to ensure that the next generation of children never takes up smoking.

[Several hon. Members rose—]

[Andrew Gwynne]

I will not give way now, as I have to end my speech. I know that you are keeping a careful eye on the clock, Madam Deputy Speaker.

If I had had more time, I would have talked about the huge public health benefits of the Bill that will do so much to prevent death, dementia and disability in old age. I could have gone into further detail about the economic benefits of the Bill, such as getting people back into work and saving untold sums of money for our NHS, but, from my perspective, the single most important thing that the Bill will do is tackle those stark inequalities across our country, because this fight is personal to me.

I have seen the harmful effects of tobacco on the people around me my entire life. As a schoolboy, I was educated about the harms of smoking, but it did nothing to stop a number of my peers from getting addicted to cigarettes. As an MP, I have seen at first hand how tobacco has devastated deprived communities across our country, not least in Greater Manchester. As the Minister for public health, I am determined to end the cycle of poverty and ill health, the blight of addition, disease and despair caused by smoking. No longer will it sap the strength of our cities—Stoke, Sunderland, Salford and so many others. This is the will of His Majesty’s Government, this is the promise of the Bill, and I urge colleagues across the House to vote with us to protect their constituents and do the right thing.

Question put, That the Bill be now read a Second time.

Pandemic Accord Negotiations and International Health Regulations

Andrew Gwynne Excerpts

Monday 25th November 2024 Written Statements

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I would like to update the House on the most recent round of negotiations on the legally binding international agreement on pandemic prevention, preparedness and response—the pandemic accord—at the World Health Organisation (WHO), as well as the outcome of negotiations to agree targeted amendments to the International Health Regulations (IHR). The most recent round of pandemic accord negotiations took place between 4 and 15 November.

Pandemic accord negotiations:

As outlined in my statement of 9 September 2024, infectious diseases do not respect borders. The risk of another pandemic is very real—a question of “when” rather than “if.” All countries would benefit from strengthening our collective ability to prevent, prepare for and respond to the next pandemic threat. The pandemic accord is an important opportunity to establish a framework for a comprehensive new global approach to pandemic prevention, preparedness and response.

Co-operation with countries around the world does not compromise our sovereignty; it strengthens our security, and no amendments to the accord have been proposed or agreed that would give the WHO powers to impose domestic public health decisions on the UK. The UK Government remain committed to negotiating a pandemic accord that enhances UK and global health security and is firmly in the UK’s national interest.

Member states of the WHO have until the World Health Assembly (WHA) in May 2025 to reach an agreement on the pandemic accord, following an extension agreed at the WHA in May 2024. Member states have reached provisional agreement on over 70% of the text, while negotiating on the principle that “nothing is agreed until everything is agreed.” At the latest round of negotiations, provisional agreement was reached on the issues of regulatory systems strengthening, and sustainable and geographically diversified local production.

On Monday November 11, a discussion was held by member states on whether to call a special session of the WHA in December with the aim of agreeing the accord before the new year. Given the number of outstanding issues on which consensus is yet to be found—including on prevention, One Health, technology transfer, and the pathogen access and benefit-sharing mechanism—and the legal form and status of the accord, member states chose not to call a special session in December. However, the Government remain committed to working with others to secure an effective agreement as soon as possible and will continue to work towards the May 2025 deadline, with the option to conclude negotiations earlier if this is deemed feasible while still delivering a good agreement.

As negotiations continue, we will keep working closely with the devolved Administrations, the Crown dependencies and the overseas territories to ensure that the process reflects their interests, and we will keep engaging with civil society organisations, institutions, academia and the private sector. The latest public version of the text and other relevant documents can be found online here: https://apps.who.int/gb/inb/index.html.

The International Health Regulations (2005) (IHR):

The IHR are an important, legally binding technical framework that helps to prevent and protect against the international spread of disease. Amendments to the IHR, were agreed by countries at the World Health Assembly that took place from 27 May to 1 June 2024. The amendments aimed to reflect lessons learned from recent global health emergencies, such as the covid-19 pandemic, including by improving information sharing and collaboration for public health emergency response. On 19 September 2024, the WHO’s director general formally notified all states parties of the official amendments adopted by the WHA. From this date of notification, the UK has 10 months to complete the domestic review of IHR amendments and then notify the WHO director general whether we wish to reject or reserve on any or all the amendments by 19 July 2025. Adopted amendments —that we have not rejected—would then come into force for the UK in September 2025.

Department of Health and Social Care officials have been leading work across Government to confirm the implications of the amendments for the UK. Officials are also working with their counterparts in the devolved Administrations and in our overseas territories and Crown dependencies, to ensure that all relevant territories are considered. This analysis will inform the decision about which amendments are in the UK’s national interest and whether we wish to reject or reserve on any or all of them before the July 2025 deadline. No decision has yet been made.

In parallel with the approach to the pandemic accord negotiations, respect for each country’s sovereignty has been a fundamental element of the IHR amendments. The UK Government will of course only formally adopt amendments to the IHR that are in the UK national interest.

The latest available full text of the agreed IHR amendments can be found online here: https://apps.who.int/gb/ebwha/pdf_files/WHA77/A77_ACONF14-en.pdf

Given the significance of the pandemic accord negotiations and the IHR amendments, and their potential to make our country stronger and safer, I am committed to keeping the House updated at relevant and important junctures.

[HCWS246]

Health and Social Care

Andrew Gwynne Excerpts

Thursday 21st November 2024 Written Corrections

The following extract is from the debate on the Infected Blood Inquiry on 19 November 2024.

[Andrew Gwynne]

Turning to a question raised by the hon. Member for Perth and Kinross-shire about the independence of IBCA, it is rightly operationally independent. Parliament would clearly expect the Government to have oversight of a scheme of this size and for there to be proper management, given the amount of public money going into the scheme. It is true that there are only two non-departmental public bodies that are independent of the Government: one is IBCA and the other is the National Audit Office. It is absolutely right for IBCA to have that independence.

[Official Report, 19 November 2024; Vol. 757, c. 234.]

Written correction submitted by the Under-Secretary of State for Health and Social Care, the hon. Member for Gorton and Denton (Andrew Gwynne):

[Andrew Gwynne]

Turning to a question raised by the hon. Member for Perth and Kinross-shire about the independence of IBCA, it is rightly operationally independent. Parliament would clearly expect the Government to have oversight of a scheme of this size and for there to be proper management, given the amount of public money going into the scheme. It is true that there are only two non-departmental public bodies that are independent of the Government: one is IPSA and the other is the National Audit Office. It is absolutely right for IBCA to have that operational independence.

Healthcare: Hampshire

Andrew Gwynne Excerpts

Wednesday 20th November 2024 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I congratulate the hon. Member for Winchester (Dr Chambers) on securing the debate, and echo his thanks to all health and social care staff who do incredible work in very difficult circumstances. We know that our NHS is broken. Whenever MPs from across the House come to me with issues affecting their constituencies, I repeat the same mantra: this Government will be honest about the issues facing our NHS, and serious about tackling them. Lord Darzi has already completed his review of the current state of the NHS, and his report laid bare the true scale of the challenges facing our health service.

We will not sugarcoat the problems faced by the health service in each and every part of the country, because colleagues from across the House are right to raise issues with me, and we will fix them together. We have already launched our national conversation on the future of the NHS, and we want patients, families and staff to join that conversation and make their voices heard. If Members have not already been to the website, the address is change.nhs.uk. Please let us have some sensible suggestions—not firing the Secretary of State out of a cannon.

In her spring Budget, the Chancellor of the Exchequer announced an extra £22.6 billion to protect NHS day-to-day spending. Every penny of that investment will come alongside vital health reforms; they are two sides of the same coin.

As the Secretary of State outlined last week, this Government intend to publish a league table of providers, allocating the best talent to the most challenging areas and ensuring that there are no rewards for failure. Where necessary, we will remove failing managers, and we will reward senior leaders who successfully improve performance.

[Paul Holmes]

On failing organisations, just before the general election a cross-party group of MPs, including Labour MPs, had a meeting with the then Secretary of State, my right hon. Friend the Member for Louth and Horncastle (Victoria Atkins), about the performance and management of Hampshire and Isle of Wight ICB. Members of Parliament from across the political divide have serious concerns about its leadership, communications and funding—not Government funding, and I welcome the increased funding, but the way that it is distributed to services in Hampshire. Frankly, I do not think the leadership is up to running that ICB. Will the Minister agree to meet me and other Members from across the House to discuss the urgency of the situation? Will he find out from his civil servants where the request for a two-week action plan went and come back to Hampshire MPs?

[Andrew Gwynne]

I am sure the officials in the Box will have noted the concerns the hon. Gentleman rightly raised about his ICB. I will ensure that that is communicated back to the Minister for Secondary Care, my hon. Friend the Member for Bristol South (Karin Smyth), so she can look in more detail at those concerns and communicate with the Hampshire MPs. If a meeting is necessary at the end of that, I am sure she will be more than willing to meet him and his colleagues.

We want to ensure that every part of our NHS is working as well as it can and, as I say, good performance will be rewarded as part of our reforms. Alongside a college of executive and clinical leadership, that will ensure the NHS continues to develop and attract the best talent to top positions, bringing the best outcomes for patients and taxpayers alike.

Let me turn to some of the specific issues that the hon. Member for Winchester raised. On local hospital provision, patients deserve to have safe, compassionate and personalised care in a fit-for-purpose environment. That is why this Government have committed to building and refurbishing hospitals across the country. The new hospital programme includes a new hospital for north and mid Hampshire and a major refurbishment at Winchester to provide specialist and emergency care. As part of the proposal, I am aware that the local trust explored changes to the current obstetrician-led maternity services at the Winchester site. I know the hon. Member has been a strong champion of that, having raised it with the Prime Minister in October.

As announced in the Chancellor’s autumn Budget, my right hon. Friend the Secretary of State will set out further details of the review of the new hospital programme in the coming months, alongside a new and realistic schedule for delivery. The Hampshire hospitals scheme is in scope of the review, and I acknowledge the local concern over the proposal and the impact on the Winchester site and on maternity services.

[Damian Hinds (East Hampshire) (Con)]

My constituents use both Winchester hospital and Basingstoke hospital, as well as others, such as Frimley Park, the Queen Alexandra and Guildford. I understand that a clinical assessment was made about urgent treatment and services at Winchester, but there is a need for a new hospital in or near Basingstoke. In what the Minister said about a review of the new hospital programme, I accept he says a statement is coming soon, but will he confirm that it is about timing and that he or a colleague will come forward to the House soon with the certainty that people in Hampshire need?

[Andrew Gwynne]

Absolutely. I will try to be as unpartisan as I can, but the hospital programme that we inherited from the right hon. Member’s Government did not have anything like the money it needed to back it up. Conservative Members can shake their heads, but it is true. It had nothing like the money needed to bring forward those hospitals. As I have said, we will review that. Our intention is to bring forward those schemes, but that has to be done in an achievable programme, with the finances to back it up. When we announce to the House how we will schedule the hospital programme, I expect that all the answers he wants will be there. We intend to introduce the hospital building programme, but it must be done with money—we cannot build them with fresh air.

[Dr Chambers]

any potential new hospital is decades away, while the hospital we have needs to be maintained and improved. The quickest way forward is to provide 160 new social care packages for Winchester hospital. Will the Minister meet me and the chief executive officer of Winchester hospital to work out how we can deliver those packages as quickly as possible, and provide good A&E, hospital and social care services for everyone in and around Winchester?

[Andrew Gwynne]

It is crucial that we have the best possible health and care services in place for today’s needs while we plan for the future. I understand the hon. Gentleman’s concerns, and I will ensure that they are communicated back to the Minister for Secondary Care, so that she can consider them. I will ask her to report back to him on that. Ultimately, all decisions are best made locally, so that they can cater to local interests, and are clinically led. This is no exception. I know that the hon. Gentleman’s trust will consider all feedback from the public consultation held earlier this year, including from those who will access the new facilities, as well as wider bodies of evidence. The result of the public consultation on location and services will be put to the local integrated care board, and we look forward to hearing the outcome of that.

[Dr Chambers]

I apologise for intervening again so soon. One of my main concerns about the public consultation is that the NHS had assessed sites in Winchester as suitable, but they were not then included in the consultation. The people of Winchester want to know why those suitable sites were not included in the consultation. Can the Minister assure me that that will be addressed by the ICB, and anyone else publishing the consultation?

[Andrew Gwynne]

As I said before the hon. Gentleman’s intervention, ultimately these are local decisions, and they must be clinically led. If the trust has decided that certain outcomes that he would like to see are out of scope of the consultation, we must take it as read that there are sound clinical reasons for that. If he thinks otherwise, I am sure that he can bring that up with my hon. Friend the Minister for Secondary Care, but ultimately we must be guided by the clinicians. They know, more than we Ministers in Whitehall will ever know, what the better outcomes for their areas are.

The hon. Gentleman mentioned primary and community care. We know that patients nationally and in Hampshire find it increasingly difficult to see a GP. We are committed as a Government to fixing the front door to the NHS, to ensure that patients receive the care that they deserve. If patients cannot get a GP appointment, they end up at accident and emergency, which is worse for them and more expensive for the taxpayer. That is why we will shift the focus of the NHS out of hospitals and into community. One of our three big shifts is from hospital to community; the others are from analogue to digital, and from sickness to prevention. Those three things, taken as a whole, could be quite transformative in how we deliver primary care.

[Gregory Stafford]

I agree entirely with the Minister on the shift from hospital to community. I do not want to labour the point that I made when I intervened on the hon. Member for Winchester (Dr Chambers), but in the Hampshire part of my seat, we have a debate about whether we will still have Chase community hospital or a new health hub there. They are both essentially local services. The ICB is dragging its feet and will not make a decision on which it will be. Local people do not know what will happen, and decisions are being kicked down the road by the ICB. As my hon. Friend the Member for Hamble Valley (Paul Holmes) said, the leadership of the Hampshire and Isle of Wight ICB is not fit for purpose. Will the Minister meet us and them to ensure that we can get this moving?

[Andrew Gwynne]

I hear loud and clear what Conservative Members say about the leadership of their ICB. I hope that the ICB management will obtain a copy of today’s Hansard and read not only those comments, but the Minister’s reply. I expect them to make decisions in a timely fashion, so that there is some certainty for the local population about the new make-up of health and care services in that area—not just for the sake of patients and the local population, but staff. As we redesign services and change towards more preventive, community-focused care, some parts may become obsolete, and it is absolutely crucial that we take the workforce, as well as the population, on that journey of change in services. I very much hope that the hon. Gentleman’s ICB leadership will have heard the message from the Minister at the Dispatch Box, which is that they really need to crack on, make a decision, communicate it and work with Members of Parliament, the public and staff on whichever changes they propose.

I return to primary and community care. As I said, our manifesto commits to moving towards a neighbourhood health service, with more care delivered in local communities, so that problems are spotted earlier. We will bring back the family doctor by incentivising GPs to see the same patient, so that ongoing or complex conditions are dealt with effectively. In doing so, we will improve continuity of care, which is associated with better health outcomes for patients, and our plan will guarantee a face-to-face appointment for all those who want one; we will deliver a modern booking system that will end the 8 am scramble. That is crucial in improving access to general practice.

The hon. Member for Winchester rightly raised the huge problems with dentistry in his area, which are not that uncommon across the whole country. I do not believe that the previous Government’s dentistry recovery plan went far enough; too many people were still struggling to find an NHS appointment. We are working to ensure that patients can start to access additional urgent dental appointments as soon as possible, and we will target the areas that need the most—the so-called dental deserts. Integrated care boards have started to advertise posts through the golden hello scheme. This recruitment incentive will see up to 240 dentists receive payments of £20,000 to work in the areas that need them most for three years. The common reason why children aged five to nine are admitted to hospital—this is absolutely shocking in the year 2024—is tooth decay. We will work with local authorities to introduce supervised toothbrushing for three to five-year-olds in the most deprived communities. These programmes are proven to reduce tooth decay and boost good practice at home.

To rebuild dentistry in the long term, we will reform the dental contract with the sector, with a shift to focusing on prevention and the retention of NHS dentists. To be fair, this has been an issue for all Governments, going back to the Labour Government who introduced the dental contract. They did so for the right reasons, but in 2010, we recognised that the dental contract was not working in the way we envisaged, and that it had to change. It is shocking that 14 years have passed since then with no real action having been taken—we are determined to fix that. At the same time, we will not wait to make improvements to the system to increase access and incentivise the workforce to deliver more NHS care. We are continuing to meet the British Dental Association and other representatives of the dental sector to discuss how we can best deliver our shared ambition of improving access for NHS dental patients.

I have to say that the statistics for Hampshire and Isle of Wight integrated care board make sorry reading. Only 36% of adults were seen by an NHS dentist in the 24 months to June 2024, compared with 40.3% across England, and 54% of children were seen by an NHS dentist in the 12 months to June 2024, compared with 56% across England. In 2023-24, there were 46 dentists for every 100,000 people in the hon. Gentleman’s trust, whereas the national average across all ICBs in the same year was just under 50 dentists, and in 2024, the general practice patient survey success rate for getting an NHS dental appointment in the past two years in the Hampshire and Isle of Wight ICB area was 72%, compared with 76% nationally. They are not great statistics nationwide, but they are certainly not brilliant in the ICB of hon. Members present, and we look for real improvements there.

Turning to the pharmacy sector, we want to take pressure off GPs by increasing the services offered in community pharmacies. There is so much more that our pharmacists could and should be doing to deliver basic healthcare services on the high street and in the community, as part of the shift from hospital to community. That would free up thousands of GP appointments in cases where people do not really need to see a general practitioner for their condition. We are committed to looking at how we can further expand the role of pharmacies and better use the clinical skills of pharmacists as more become independent prescribers—that is where the potential gets really exciting. Now that the budget for Government has been set, we will resume our consultation with Community Pharmacy England shortly. I hope Members will understand that I am unable to say more until that consultation has concluded. Suffice it to say that Pharmacy First and community pharmacies have a huge role to play in improving health outcomes in the community.

[Jim Shannon]

In my former role as an Assembly Member back home, we had a very close relationship with pharmacies. The consultation process that the Minister is outlining for England would be very much welcomed in Northern Ireland, so can I ask the Minister a favour? When that consultation concludes, will he share his findings with the Northern Ireland Assembly, and particularly with the Minister in Northern Ireland? What the Minister is hoping to achieve is what we would also like to achieve.

[Andrew Gwynne]

The hon. Gentleman raises an important point. No part of the United Kingdom holds a monopoly on wisdom, and if we are doing something good or if there is innovation in one part of the United Kingdom, it is incumbent on Health Ministers across the devolved Administrations and here in Whitehall to share best practice—to work together and, where possible, take a four-nation approach. I hope I can reassure the hon. Gentleman that since this new Labour Government came into power, we have really tried to reset our relationships with the devolved Administrations and with the various Ministers. I have had several meetings with Mike Nesbitt on a range of health issues that appertain to the whole United Kingdom on which we want to ensure there is consistency of approach. I am more than happy to communicate further with Mike Nesbitt and colleagues in the Northern Ireland Executive on how we reform our health and social care services in England to see whether things can be taken by them in Northern Ireland. Vice versa, if there are good ideas from Northern Ireland, I am more than happy to consider them in how we transform NHS services in England.

The hon. Member for Winchester mentioned social care, and he is right to raise winter resilience. I have spoken about fixing the front door to the NHS through primary care reforms. We also have a serious job to do to fix the back door and ensure that patient flows through the system are not held up because of a lack of social care. On winter resilience, I hope he will understand that we are working to ensure that there are no crises and that we tackle the issues of social care. Getting beds in appropriate places is a key part of our plan.

In the long term, there are no quick fixes. The Dilnot reforms were announced by the previous Government, but it is fair to say that, when we came into office, we found that the money apparently set aside for the Dilnot reforms had already been spent on other NHS pressures. Laudable though it may have been to spend that money to try to get waiting times and waiting lists down and to fix some of the problems that that Government had created, it left us with a bit of a social care issue, given that the reform money had gone, had disappeared and was no longer there to be spent.

Over the next decade, this Government are committed to building consensus on the long-term reform needed to create a national care service based on consistent national standards, including engaging across the parties. It is good to see the shadow Secretary of State, the right hon. Member for Melton and Syston (Edward Argar), in his place, and I am sure he will be very willing to work with us, as indeed will the Liberal Democrats. We genuinely want to make sure that we get cross-party consensus on the future of our adult social care, so that we can finally grasp this nettle once and for all, and to fix it without it becoming such a contentious issue, as it became, sadly, in 2010 and 2017. Neither of the two main parties has a good story to tell on this, because we have both shamefully used it as a political football from time to time. It is now appropriate that we set aside those politics and get on with fixing social care. I hope that, in due course, we will be able to move forward on that agenda.

I assure the hon. Member for Winchester that we are acutely aware of the problems with mental health services. We both agree that waiting lists are unacceptably high. Indeed, the people of Hampshire and most of England are not getting the mental health care they deserve. He has spoken previously about Lord Darzi’s report, which has shone a searing spotlight on the waiting lists that young people face, in particular. I am immensely proud that this Government are intent on tackling the issue head on, with specialist mental health professionals in every school in England. That is our aim. These NHS-funded mental health support teams in schools and colleges will work with young people and parents to manage mental health difficulties and to develop a whole-school approach to positive mental health and wellbeing.

[Damian Hinds]

Can I just check whether I heard the Minister correctly? Did he say there would be a mental health specialist in every school in England?

--- Later in debate ---

[Andrew Gwynne]

Yes, that is our manifesto commitment. There will be mental health specialists for every school in England. In Hampshire, there are mental health support teams assigned across the area, including schools in Winchester, Eastleigh, Andover and Havant. In addition, we will introduce young futures hubs in every community and recruit an additional 8,500 mental health workers across children and adult services. We have also set aside £26 million in capital investment for new mental health crisis centres, and we are expanding NHS talking therapies, alongside individual placement and support schemes.

This Government are committed to fixing the NHS so that patients, including those in Hampshire, can access excellent care when they need it. It is true to say that every Labour Government have inherited an NHS in a far poorer state than that which they bequeathed to their successors. It turns to this Labour Government to fix our NHS once more.

Question put and agreed to.

Infected Blood Inquiry

Andrew Gwynne Excerpts

Tuesday 19th November 2024 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

I stand here as the Minister for Public Health and Prevention, humbled and with a large degree of humility. The Department of Health and Social Care is rightly hated and despised by the infected blood community. We let them down. For that, I am personally sorry and my Department collectively is sorry.

I say that in a heartfelt way because for the past decade and a half, both as shadow Public Health Minister and as a Back Bencher, I have raised the issue of the infected blood scandal on behalf of the campaigns and of my constituents who were infected and affected. Now that I stand here as a Minister in the Department responsible, I feel it is incumbent on me to give that heartfelt apology. It is too late coming for so many, but I hope that those who are still here and their families and loved ones will accept it in the spirit in which I give it: I am sorry. We let you down and we must make sure it never ever happens again.

I welcome the two new Opposition spokespeople, the right hon. Member for Basildon and Billericay (Mr Holden) and the hon. Member for Kingswinford and South Staffordshire (Mike Wood). I want to start in the way the right hon. Member for Basildon and Billericay finished, by assuring him that the Government will work collectively and constructively with Members from across the House, from whichever party they come and whichever part of the United Kingdom they represent. This is an issue that has stained the body politic of our country for too long, and it is incumbent on us to work together across parties and across artificial divisions to make sure that we get the best deal for our constituents and their families.

I also thank all right hon. and hon. Members who have contributed to the debate. I thank my hon. Friend the Member for Blyth and Ashington (Ian Lavery) and my hon. Friend the Member for Gedling (Michael Payne), who made an incredibly powerful maiden speech, setting out how he will be a champion for the people of Gedling in the years to come. The people of Arnold, John and Joan, and his husband Kyle are all rightly proud of him today, from wherever they were viewing the speech. I also thank my hon. Friend the Member for Eltham and Chislehurst (Clive Efford), who has played such a pivotal role in this campaign over a large number of years, as well as my hon. Friends the Members for Swindon North (Will Stone) and for Portsmouth North (Amanda Martin).

On the Opposition Benches, I thank the right hon. Member for Salisbury (John Glen), who led on this matter in his former ministerial position. We thank him for his work. I know that sometimes I was frustrated with him, from just behind where he is sitting, but I appreciate the work he put in behind the scenes as well as at the Dispatch Box. The hon. Member for Perth and Kinross-shire (Pete Wishart) has similarly been a tireless campaigner, as has the right hon. Member for East Hampshire (Damian Hinds).

The infected blood scandal is one of the most appalling in our nation’s history. It was an institutional failure of the highest order, spanning decades. From the national health service to the civil service to Ministers across successive Governments, at every level, those the public trusted to protect them fell short in ways that were both tragic and catastrophic. They let down victims, their families and our country. In the course of this debate, we have heard the names: Sean, Gary, Thomas, Jean, Ade and Joe. They remind us of the real people—those who are deceased, those who were infected, and those who are affected. They are real people, not statistics, and it is important that we never forget that. Victims were denied the truth; many passed away before they saw justice. The state worked to protect itself, and those people paid the price.

I must echo the tributes that have been made to Sir Brian Langstaff and his team by Members from across the House. Their steadfast pursuit of the truth finally brought this decades-long scandal to light. Sir Brian and his team have set us on a path towards beginning to right the terrible wrongs that were committed. They uncovered a litany of collective and personal failures, as many hon. Members have highlighted by sharing stories from their communities and constituencies. Each one is significant in its own right and together they add up to a complete disaster.

Sir Brian found that this national scandal could have been prevented. It was already known that these treatments were contaminated, yet the warnings were disregarded time and again. People in positions of power and responsibility had multiple opportunities to halt the transmission of these infections, but, on each occasion, they chose not to act.

Many in this House have campaigned for justice for a long time, giving voice to those who had been repeatedly silenced. In particular, I wish to pay tribute to my right hon. Friends the Minister for Policing, Fire and Crime Prevention and the Secretary of State for Wales. I thank my hon. Friends the Members for Gower (Tonia Antoniazzi), for Hornsey and Friern Barnet (Catherine West), and for Newport East (Jessica Morden), and the hon. Member for Thirsk and Malton (Kevin Hollinrake). I also thank the former Member for Worthing West, Peter Bottomley, and the now Mayor of Manchester, Andy Burnham. In this debate today, we have again heard from my hon. Friends the Members for Eltham and Chislehurst and for Blyth and Ashington, the hon. Member for Perth and Kinross-shire, and the former Paymaster General, the right hon. Member for Salisbury.

As a Government, we will do our utmost not to repeat the mistakes of the past. We were elected on a manifesto that committed to act on the inquiry’s findings and to put right historical injustices. The public rightly expect nothing less of this Government than fulfilling our moral obligation to compensate victims, and we aim to do so without delay.

In October 2022, the previous Government spent £440 million on initial interim payments of £100,000 to the living infected. Following the publication of the inquiry’s final report in May, a further £728 million was paid as a second interim payment of £210,000 to all UK-registered living infected victims. The Government have also committed, in legislation, to paying £100,000 to the estates of the deceased infected to recognise those who have not yet received a payment and to ensure that some of those affected—such as parents, children and siblings—are supported. That scheme opened on 24 October. We recognise that money can never make up for the heartbreak that victims and their families have experienced, and much of the inquiry’s criticisms apply to the way that my Department—the Department of Health and Social Care—and its predecessors operated.

[Alex Baker (Aldershot) (Lab)]

My constituent Brendan lost his left leg while serving with the British Army in 1979. Decades later, he discovered that he had been infected with hepatitis C during the operation that saved his life. I know having talked to Brendan that, while he is pleased that the Government have committed to providing compensation, he is keen for us all to understand that, because of his community’s lived experience, there is an inherent distrust of the state. His instinct on being told that the state will spit out a number is understandably not to trust the process. Will the Minister reassure Brendan that all compensation offers will include a detailed breakdown of the data and rates used to make the calculations?

[Andrew Gwynne]

I can give my hon. Friend and Brendan the commitment that we will do just that, to reassure those who rightly have lost all trust in public authorities, and particularly in my Department, because of the dreadful actions that led to their infection. She has my assurance that we will do what we can to reassure Brendan and many others like him who rightly have no trust left in us that we will rebuild that trust.

[Sir Julian Lewis (New Forest East) (Con)]

I am sorry not to have been here for the opening speeches. Does the Minister recognise the fundamental similarity between the way in which the victims of this scandal and those of the Post Office scandal, and no doubt other terrible scandals, were treated by the state? Does the Government have any plan, possibly on a cross-departmental basis, to try to educate the bureaucracy that when terribly difficult and potentially expensive things like this crop up, they should not follow this well-worn path of denial and cover-up?

[Andrew Gwynne]

The right hon. Gentleman raises an important point. Indeed, it was acknowledged by my right hon. Friend the Paymaster General and Minister for the Cabinet Office in his opening speech that this is just one of a number of scandals that follow a similar pattern—when the scandal has been uncovered, rather than trying to protect the victim, the state has tried to protect itself. It is absolutely crucial that the state learns not just from each individual scandal, but collectively; that it is the same mindset that has led us to all these different scandals with similar outcomes for victims. That level of learning has to be genuinely across Government, and I know my right hon. Friend will lead on that in the Cabinet Office.

The Government will set out our formal response before the end of the year, but given that there is absolutely no time to waste, I want to take this opportunity to update the House on the work already under way to address some of the inquiry’s recommendations. To prevent future harm, the Department continues to explore options to enhance candour and openness across the national health service. To empower patient voices, the NHS is reviewing clinical audits related to haemophilia services to identify any gaps in patient involvement, alongside work on a new clinical service specification, which will set standards for services across England. To protect haemophiliacs, the NHS has convened an expert group to hear advice from the specialised blood disorders clinical reference group. A dedicated taskforce has been set up to consider its recommendations. The General Medical Council is working with NHS England and others to look at ways to ensure that lessons learned are reflected in training for doctors, nurses and other healthcare professionals.

Let me be clear to the House: the Government do not see this scandal in isolation. Sadly, repeated patient safety failings have eroded public confidence in our health and social care system, so we are taking steps to fix the culture of the national health service. My right hon. Friend the Secretary of State for Health and Social Care has been clear that we will not tolerate NHS managers who silence whistleblowers. Openness and honesty are vital to ensuring patient safety. NHS staff must have the confidence to speak out and come forward if they have concerns. There will be no more turning a blind eye to failure.

Our wider reforms to NHS performance will provide greater transparency for the public who pay for it. Measures will ensure that top talent is attracted to the most challenged areas, and persistently failing managers will be sacked. That is about ensuring that the right people are in post to lead our NHS with the resources they need to do their job. If we get that right, we will be able to look back on this moment as a turning point for patient safety and for leadership.

[Sorcha Eastwood (Lagan Valley) (Alliance)]

I apologise, Madam Deputy Speaker; I was in Committee at the start of the debate, but I did have my name down to speak. Some of my constituents were impacted by the scandal, and it has taken them this long to summon the courage to come forward. Obviously, I represent them and Northern Ireland. We have talked about the Hillsborough law and the need for a duty of candour. Does the Minister agree that it is important that that is rolled out not just in England and Wales, but right across the UK, so that, as he said, those families are never again impacted in that way?

[Andrew Gwynne]

I hope that I can reassure the hon. Lady that although health is devolved across the four nations, and I can speak only on behalf of the NHS in England on a number of the recommendations, both the Department of Health and Social Care and the Cabinet Office are working closely and collaboratively with Ministers in the devolved Administrations. Indeed, I and my right hon. Friend the Paymaster General recently had a meeting with Ministers from Scotland, Northern Ireland and Wales to talk about how to take forward the recommendations, on a four-nation basis where possible, and with mutual support across the four nations where there are individual recommendations pertinent to the devolved parts of the United Kingdom. I hope that that reassures her that we are working together. Although I cannot comment on the changes that will be needed for health services in Northern Ireland, which are a matter for the Minister of Health in Northern Ireland, Mike Nesbitt, I am quite certain that those services will carefully and closely consider our work here in England, and the work in other parts of the United Kingdom.

We have waited too long for these actions. People have waited too long for compensation. Indeed, right hon. and hon. Members have waited too long for this debate. More than 3,000 people died before they saw justice; families and our country were let down. There was a level of suffering that is so difficult to comprehend, because questions were not asked at the time, institutions did not face up to the failings, and facts were covered up. Now we know the truth. As we reflect, we are making a concerted effort to improve, because that loss need not be in vain.

I will respond to some of the questions raised throughout the debate, and will refer to other questions directly in the relevant part of my contribution. Should I miss anything because of time constraints, I will write to Members. In opening for the official Opposition, the hon. Member for Kingswinford and South Staffordshire talked about destigmatisation of HIV and hepatitis C. I hope that he understands that the Labour party made a clear manifesto commitment to ending HIV transmission in England by 2030. Officials at the Department of Health and Social Care, the UK Health Security Agency, NHS England and a broad range of system partners are now working together to develop a new HIV action plan, which we aim to publish by summer next year, and destigmatisation will be a key part of that plan.

My hon. Friend the Member for Blyth and Ashington asked about psychological support for family and friends. I reassure him that NHS England has established the infected blood psychological support service in England, which supported its first patients in late August. That includes supporting not just the infected, but the families and friends affected.

I want to turn to departmental failings. The report outlines a comprehensive condemnation of the organisation of blood services, licensing decisions, blood safety and patient safety, with harm compounded by the reaction and handling of Government. I again recognise humbly the criticism of the Department that I stand at this Dispatch Box to represent and its predecessors, and I am committed to ensuring that a tragedy such as the infected blood scandal can never happen again. This Government will prioritise patient safety to ensure that the NHS treats people with the high-quality, safe care they deserve.

Repeated inquiries and investigations have highlighted significant issues with patient safety, which has caused a deterioration in public confidence, as we heard from my hon. Friend the Member for Aldershot (Alex Baker) in an earlier intervention. We must absolutely fix that. The Health Secretary has been clear that we will not tolerate NHS managers who silence whistleblowers. A culture of openness and honesty is vital to ensure patient safety. We want NHS staff to have the confidence to speak out, and we will give them that.

The hon. Member for Eastleigh (Liz Jarvis) raised the question of the safety of blood products. While no medical treatment can be completely risk-free, current safety standards for blood donation and transfusion are rigorous, and England’s blood supply is one of the safest in the world. Processes are in place throughout the blood donation journey to ensure the safety of blood and blood products, including the donation safety check form, testing for specific infections, donor deferrals, regulations and informed consent. According to Serious Hazards of Transfusion, the risk of serious harm because of blood transfusion in the United Kingdom is low, at one in 11,000 blood components issued.

Turning to timelines, so far more than £1 billion has been paid in interim compensation payments to victims of the infected blood scandal. As we heard earlier, applications opened on 24 October for interim payments of £100,000 to the estates of deceased people whose deaths have not been recognised. Parliament has now approved regulations that give the Infected Blood Compensation Authority the powers necessary to pay compensation through the core route to the infected, both living and deceased. The Infected Blood Compensation Authority has begun to process its first claimants under the infected blood compensation scheme.

[Jim Shannon]

In my intervention on the hon. Member for Perth and Kinross-shire (Pete Wishart), I asked about the siblings who qualify. One sibling seems to be worth more than another sibling, and that seems absolutely wrong. I understand that there has been no reply to that in the Minister’s summing up. Maybe he is coming on to it—if he is, I apologise—but I would love to have a response, because my constituents have asked me to ask that question and ensure that we have a response.

[Andrew Gwynne]

I can assure the hon. Gentleman that the Minister for the Cabinet Office is carefully considering this matter. If the hon. Gentleman would like, the Minister for the Cabinet Office will write to him, but he is considering it.

We expect the Infected Blood Compensation Authority to begin making payments to people who are infected under the infected blood compensation scheme by the end of this year. Payments to the affected are expected to begin in 2025, following a second set of regulations.

Turning to a question raised by the hon. Member for Perth and Kinross-shire about the independence of IBCA, it is rightly operationally independent. Parliament would clearly expect the Government to have oversight of a scheme of this size and for there to be proper management, given the amount of public money going into the scheme. It is true that there are only two non-departmental public bodies that are independent of the Government: one is IBCA and the other is the National Audit Office. It is absolutely right for IBCA to have that independence.

[Clive Efford]

On that point, the National Audit Office is directly accountable to Parliament through the Public Accounts Commission. Is the intention to create a similar sort of arrangement, as envisaged by Sir Brian Langstaff, in which there is direct accountability to Parliament, rather than to the Department?

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[Andrew Gwynne]

I should clarify for my hon. Friend that IBCA is operationally independent—that is important —but it is absolutely right that Members of this House are able to scrutinise its operations, its working and, indeed, its use of public money. We are talking about a great deal of public money, and IBCA has to be democratically accountable to this House, albeit operationally independent of Government Ministers in its day-to-day business.

[Pete Wishart]

This is a really important point—both myself and the hon. Member for Eltham and Chislehurst (Clive Efford) have now raised it with the Minister. He has rightly identified the experiences of so many people caught up in this crisis, and the fact that they do not trust the Government or Government institutions. Would it not be more of a comfort to them to know that IBCA is like the National Audit Office: accountable to Parliament, rather than to Government?

[Andrew Gwynne]

I agree with the hon. Gentleman, which is why IBCA is operationally independent—that is the crucial thing here. It does not have the fingerprints of Ministers all over it, because that is where the distrust comes from. It operates independently, but as a public body it is accountable to this House for how it spends that money and how it operates as an organisation. While IBCA is operationally independent to ensure a separation between Executive Ministers and the functioning of that body, it is accountable to this House. I think that is absolutely the right balance.

[John Glen]

I endorse what the Minister has said about the way in which IBCA has been set up. It seems to me an entirely sensible arrangement that respects the need to have some distance from Government, but clearly there cannot be a bespoke arrangement for every single entity that is set up. This was the point I was trying to make, respectfully, about Sir Brian Langstaff earlier: he did a brilliant job, but some aspects of this issue will need a slightly different judgment made by Ministers. I welcome the decision that the Minister and his colleagues have made.

[Andrew Gwynne]

I thank the right hon. Gentleman for that intervention. I hope that Members across the House can see why we have set IBCA up in the way we have. It is for precisely that reason: we have to have that operational separation from Ministers and the Executive, but there also has to be political oversight from all quarters of this Chamber, because this is a public body spending public money—and a great deal of public money at that.

As I have said, we are aiming for the second set of regulations to be in place by 31 March 2025. That will support our intention that payments to the affected begin next year. There are important details, especially in relation to Sir Robert Francis’s recommendations, the majority of which the Government have accepted, that must be worked through ahead of the second set of regulations. This includes details such as the eligibility criteria for people who are affected, and how the Government should define the parameters of the definition of unethical testing.

Turning to payments, the selection of those who have been contacted for first payments was a decision for the Infected Blood Compensation Authority. The first group of people who are receiving invites to claim are: first, those who are known to be already eligible for compensation; secondly, those registered with support schemes, which means we are likely to have much of the necessary information for these people already; thirdly, those from areas across the UK; and fourthly, those who represent a range of infection types and of severity within those infections.

Let me turn to some of the questions raised about this area. The hon. Member for Eastleigh mentioned people dying before compensation is awarded. I hope I can reassure her that when a person with an eligible infection has, tragically, died before receiving compensation, we will ensure that their personal representatives can claim compensation on behalf of the deceased’s estate. I hope that clarifies the point for her.

My hon. Friend the Member for Swindon North talked about the exclusion of victims with hepatitis B from the compensation scheme. People with chronic hepatitis B and those who die in the acute period are eligible for compensation, as are their loved ones as affected. I suggest that my hon. Friend writes to the Minister for the Cabinet Office with his constituent’s details, so that we can look more closely at his case. My hon. Friend the Member for Eltham and Chislehurst asked whether there will be payments by the end of the year. The answer is yes, and as I have said, there will be payments to the affected from next year, when we have the new regulations in place.

The right hon. Member for East Hampshire asked about the steps taken to provide accessible information on compensation. I want to spell out to him that Sir Robert recommended that there should be a higher award of £15,000 for children subject to unethical research at the school in his constituency. That is why there is a difference, which I hope clarifies that point for him. As I have said, at the start of November the Infected Blood Compensation Authority invited the first cohort of people to make compensation claims.

Candour in the civil service and in Government was raised by my hon. Friend the Member for Eltham and Chislehurst and the hon. Member for Perth and Kinross-shire in their contributions. The King’s Speech set out the commitment to bring forward legislation to introduce a duty of candour for public authorities and public servants. This legislation will be the catalyst for a changed culture in the public sector. The Prime Minister confirmed at the Labour party conference that legislation on the duty of candour would be delivered by this Government. He confirmed that the duty will apply to public authorities and public servants, and it will include criminal sanctions. The Bill will be introduced to Parliament before the next anniversary of the Hillsborough disaster in April 2025.

In closing, today I hope the House has heard how we are starting to deliver compensation and how we are starting to respond to the inquiry recommendations. Admittedly, they are still small steps, but they are steps in the right direction. This work is far from over. We owe it to the victims and their families to see it through, and we will of course regularly update the House as this progresses. I reiterate on behalf of the Government and the Department of Health and Social Care, and as a mere ordinary Member of Parliament for Gorton and Denton, representing some of the infected and affected, that we are truly sorry. We let you down. We will learn from these lessons, and we must never ever let anything like this happen again.

Question put and agreed to.

Resolved,

That this House has considered the Infected Blood Inquiry.

Oral Answers to Questions

Andrew Gwynne Excerpts

Tuesday 19th November 2024 Commons Chamber

[Abtisam Mohamed (Sheffield Central) (Lab)]

3. What steps he is taking to improve mental health support services.

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

Lord Darzi found that mental health waiting lists have surged, with more than 100,000 children waiting a year for their first appointment. That is why we will recruit 8,500 more mental health workers, provide access to mental health support in every school and roll out young futures hubs in every community. I am delighted to tell my hon. Friend that a Bill to modernise the Mental Health Act 1983 was introduced in the other place on 6 November. That was a promise that we made before the election—a promise that we kept.

[Abtisam Mohamed]

I welcome the Minister’s comments. My brother has very complex mental health needs. We as a family know at first hand the difficulties not only of accessing the services and of the long waiting times, but the challenge of support staff who are not constantly on a churn and the lack of community-funded support services. Our experience is no different to that of many other families. Will the Minister meet me to discuss how we will make mental health services more accessible in communities, invest more in preventive services and fund more community-based provision?

[Andrew Gwynne]

I will be pleased to meet my hon. Friend. This Government think it is unacceptable that too many people are not receiving the care that they deserve, and we know that waits for mental health services are far too long. We are determined to change that with the measures I set out in my opening. The Government have also introduced NHS 111 for mental health so that people who are in crisis or are concerned about a family member or loved one can now call 111 and speak to a trained mental health professional.

[Josh Babarinde (Eastbourne) (LD)]

Facilities such as leisure centres and swimming pools—like the Sovereign Centre in Eastbourne where I learned to swim—are critical in supporting people’s mental health locally. Will the Minister support me in putting pressure on the Ministry of Housing, Communities and Local Government to expand the criteria of the towns fund to allow us to be able to spend it to invest in our leisure centres and sports and fitness facilities for local people?

[Andrew Gwynne]

I am grateful to the hon. Member for his question. We are a mission-led Government and, of course, tackling health inequalities is a job not just for the Department of Health and Social Care, but for all Government Departments. I will be very happy to raise the role that Ministers can play in improving mental health and wellbeing in my bilaterals with the Ministry of Housing, Communities and Local Government.

[Jerome Mayhew (Broadland and Fakenham) (Con)]

4. What estimate he has made of the number of new dental training places needed in the east of England.

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[Mark Ferguson (Gateshead Central and Whickham) (Lab)]

T7.   Usher syndrome is a rare inherited disease that can lead to both deafness and blindness. As chair of the Usher syndrome all-party parliamentary group, I have met many of those who suffer from Usher syndrome. What assessment has the Department made of the adequacy of support for those suffering from Usher syndrome and their family members?

[The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)]

The UK rare diseases framework aims to improve the lives of people living with all rare diseases. I am more than prepared to meet my hon. Friend to look at the adequacy of support available to people with Usher syndrome.

[Sarah Olney (Richmond Park) (LD)]

T8. Last Friday, I met GPs at the Fairhill medical practice in north Kingston in my constituency. They have told me that the increase in national insurance contributions will add £50,000 a year to their costs. Can the Secretary of State tell me whether GPs can expect to see an across-the-board cut in the NICs payable by GPs to help them manage to continue delivering services for families in the area?

[Dr Beccy Cooper (Worthing West) (Lab)]

T10. The renewed focus on prevention in our health system is welcome, but under the previous Government, the public health grant that facilitates much of that work was cut by 28%. Has the Minister, in partnership with the Treasury, considered when we might be able to address that public health funding issue, which is essential to enabling progress in prevention?

[Andrew Gwynne]

We will confirm the 2025-26 local authority public health grant allocations in due course. Local government plays a critical role in delivering the Government’s health mission and driving action on the prevention of ill health. We are committed to working in partnership with local government to tackle the wider determinants of ill health.

[Martin Wrigley (Newton Abbot) (LD)]

T9. I have been shocked this week by all the major GP groups in my constituency detailing their financial situations. They are all close to the edge and are considering the options of bankruptcy, redundancies or handing in their contracts. What urgent respite can the Secretary of State give them?

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[Wera Hobhouse (Bath) (LD)]

Respiratory health conditions are one of the main drivers of NHS winter pressures, yet only 32% of asthma sufferers in Bath and across the country can access the most basic level of care. What will the Government do to improve access to basic levels of care for the 68% of asthma sufferers who are currently missing out?

[Andrew Gwynne]

NICE is reviewing its guidelines for the diagnosis, monitoring and management of chronic asthma, and an updated version is due to be published in late November 2024. I am happy to meet the hon. Lady to discuss it further.

[Andy McDonald (Middlesbrough and Thornaby East) (Lab)]

Women with spinal cord injuries face significant challenges in accessing core health services, including breast screening, cervical screening and gynaecological care. Research shows that women with disabilities, including spinal cord issues, are 30% less likely to attend routine breast screening appointments, in significant part due to the physical inaccessibility of the screening equipment. Will the Minister meet me and representatives of the all-party parliamentary group on spinal cord injury to discuss these unacceptable disparities and ensure that women receive the equitable and accessible care they deserve?

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[Jacob Collier (Burton and Uttoxeter) (Lab)]

My constituent Ollie Horobin’s life has been completely transformed after contracting covid, leaving him wheelchair-bound with a feeding tube and battling debilitating symptoms every single day. His story is a stark reminder of the devastating impact that long covid can have. Will the Minister commit to meeting Ollie and me to hear about his experience at first hand, and prioritise further research into the causes, treatments and long-term impacts of extreme long covid?

[Andrew Gwynne]

As somebody who still suffers from long covid, I know how debilitating and complex it can be, and I am committed to improving support for people affected by it. There are now more than 100 long covid services across England, and £57 million is being invested in long covid research. I recently co-chaired a roundtable on strategies to stimulate further research into treatments. I am more than happy to meet my hon. Friend and Ollie for further discussion.

[David Mundell (Dumfriesshire, Clydesdale and Tweeddale) (Con)]

Opt-out testing for HIV at A&E has been a great success since it was announced last year, particularly in identifying those who were not aware they had the disease and among difficult-to-reach communities. Can the Health Secretary confirm whether the programme will continue?

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[Karl Turner (Kingston upon Hull East) (Lab)]

My constituent Craig Eskrett was diagnosed with motor neurone disease 12 months ago. He says that the services are there in the local NHS trust, but there is a distinct lack of co-ordination. Will the Minister meet me to discuss what improvements can be made to co-ordinate those services for sufferers of MND?

[Andrew Gwynne]

My hon. Friend raises a real issue about how we join up the whole of the patient journey. Once diagnosed, patients need appropriate treatment and wraparound care. I am more than happy to meet him and his constituent.

[Richard Foord (Honiton and Sidmouth) (LD)]

At the weekend in Devon, I met a psychiatric nurse who previously worked in London and has been recruited to the south-west. She does not have a start date, and is still subject to routine checks after waiting months. Can the Secretary of State expedite these routine checks, given waiting lists for mental health?