Covid-19 Update

Jeremy Hunt Excerpts

Tuesday 24th March 2020 Commons Chamber

[Matt Hancock]

I will go through the answers to the questions the hon. Gentleman reasonably asked. He asked about the most vulnerable. A programme of work is under way to ensure that those who need support because they are staying at home—especially those who are victims of domestic violence—get that support. It is incredibly important and difficult work, but we are doing what we can in that space. He also asked about prescription charges. Only around a fifth of people pay prescription charges, so those who are the least able to pay already get free prescriptions.

The hon. Gentleman asked about Sports Direct. Sports shops are not essential retail, and therefore they will be closed. I have seen a bit of the noise that has been going on around today about Sports Direct in particular. I want to be absolutely clear that sports kit is not essential over the next three weeks, so we will be closing Sports Direct, along with other non-essential retail. He also asked about fines for corporates as well as individuals—absolutely, those fines are available if that is necessary.

The hon. Gentleman asked about protective equipment, and he is quite right to do so, because as we discussed yesterday, having protective equipment for staff on the frontline—especially those in the NHS and social care, but also in other frontline services—is very important. We are moving heaven and earth, and the military involvement is ramping up the delivery of that equipment. He asked specifically about social care. I am glad to say that the current plan is to get protective equipment to all social care settings by the end of this week, and then we will have to keep going. We have put in place a hotline. If someone needs PPE and they are not getting it, they should call the hotline so that we know where the difficulties are in getting PPE to the frontline, and we can respond to those calls and get it to them. I feel that very strongly.

The hon. Gentleman asked about testing. As we have discussed many times, we are ramping up testing as fast as we can, including buying millions of tests. My team are currently buying these tests, which we will make available as quickly as possible. He asked about there being no machines ready to buy. I do not recognise that at all. I have not seen any leak, and I would not want to comment on a leaked email—certainly not one that I have not seen. It is true that we are bringing testing machines together to provide a more efficient testing system, and I am grateful to the universities that have put these testing machines into the system. This is a national effort, and they are playing their part. We are also buying machines where we can.

The hon. Gentleman asked about staff ratios, which have been publicised this morning. It is true that we are having to change the standard staff ratios for delivery of certain types of procedure, including ventilation. The reason is that we cannot easily train somebody to intubate a patient and put them on a ventilator. We are training those who we can train to the standards necessary, but this is an incredibly difficult task, and it is therefore safer to have the doctors who are trained to do it and experienced in doing it doing it to more people, with more support staff than in normal circumstances. That is absolutely necessary to respond to the quantity of need, because this is a very specialist part of the NHS and of medicine that suddenly has much bigger demand than could ever have been envisaged outside a pandemic scenario.

I pay tribute to the staff who will be working much more intensively and who are putting their vital skills at the service of the nation in order to save lives. I am grateful to all those who have worked with the royal colleges to ensure that we get these ratios right and stretch the capabilities we have as far as we safely can in the circumstances. Finally, the hon. Gentleman mentioned abortion. We have no proposals to change any abortion rules as part of the covid-19 response.

[Jeremy Hunt (South West Surrey) (Con)]

I thank the Health Secretary for the superhuman efforts he has taken to resolve the issues around PPE in the last week. The evidence is that we are in a much better situation now than we were a week ago. He will not mind if I follow up what the shadow Health Secretary said about testing. The concern is that we appear to be testing on a daily basis virtually no more people than we were over a week ago, when the commitment was to increase the daily number of tests from 5,000 to 25,000. Given that this is a vital part of the success of the suppression strategies in South Korea, Taiwan, Singapore and Hong Kong, can he give us an estimated date when we will get back to routine covid-19 testing in the community of all suspected cases? Even if that is three or four weeks away, a date means that there is a plan, and without a date, people will not be confident that this really is the plan.

[Matt Hancock]

Although I was not in the Chamber, I heard the comments that my right hon. Friend the Chair of the Health and Social Care Committee made about this yesterday, and he is right to push on this issue. I am not going to give him a date today, because we are in the middle of buying the tests that are needed, especially the new tests that have just come on stream. I have been able to give him the update that we have now purchased millions of these tests, which will arrive in the next days and weeks. I will be in a position to give him a more concrete timetable, and I will make sure he gets that as soon as we can make it public.

Coronavirus Bill

Jeremy Hunt Excerpts

2nd reading & 2nd reading: House of Commons
Monday 23rd March 2020 Commons Chamber

[Jeremy Hunt (South West Surrey) (Con)]

The Health Secretary is not in his place—understandably—but I want to start with a tribute to him. I think I am the only other person in this House who has sat behind his desk, and I can testify that even without a pandemic it takes years off your life. The Health Secretary has made himself exhaustively available. He has worked tirelessly, and no one could have done more or better to prepare the NHS for the crisis we now face. I also want to thank the shadow Secretary of State for the way that he has risen to the challenge of his role. All of us as parliamentarians are proud of the exchanges that we have had this afternoon and on many occasions.

Ordinarily, our role as MPs is to scrutinise every detail of legislation, to understand it and to try to improve it. There are many questions about this legislation, but we are in a national emergency and every day we delay could cost lives. So I support the Bill 100% and I encourage all colleagues to do the same. A week ago, the Government said we were four weeks behind Italy. That then changed to three weeks behind Italy, and today our mortality rates are just two weeks behind Italy. Our hospitals, especially in London, are filling up. We have had a critical incident at one, and others say they are running out of ICU beds. According to the papers, we have one nurse fighting for her life in an intensive care unit. One London hospital has seven doctors with the virus in just that one hospital. Yet still people are going to shops, parks, beaches and holiday homes as if nothing has changed. It may be too late to avoid following Italy, but to have any chance at all of doing so we must move now to lockdown rules that ban non-essential travel. It is time not just to ask people to do social distancing, but to enforce those social distancing rules—not next week, not this week, but right away. I support the call by the shadow Secretary of State to do that, and it is very important we do so as soon as we possibly can.

The Bill can help in two areas. The first is on protective equipment for staff. Last week, Sir Simon Stevens told the Health and Social Care Committee that there were sufficient national supplies of PPE, but there were distribution problems. Since then, I know that the Government have moved heaven and earth to try to resolve those. All hospitals have had deliveries, and I pay tribute to the Health Secretary and everyone in the Department for achieving that, but there is still a lot of concern on the frontline. The main reason for that is because on 6 March Public Health England downgraded the recommendations as to what PPE doctors should use. That appeared to be at odds with World Health Organisation recommendations. I understand that has now been clarified by Professor Keith Willett in a message sent out on Friday that does bring our advice more into line with WHO guidelines.

Most importantly, the advice now makes it clear that doctors should wear goggles if there is any risk of being sprayed, but obviously doctors would feel vastly more secure with more extensive protection, such as full-length gowns and FFP3 masks. Is not the solution just to order manufacturers to make more of that vital equipment—not just a little more, but massively more? If that needs legal powers, the Bill should give the Government those powers to require every factory that is able to devote itself to the production of that life-saving equipment to do so.

Numerous doctors have died across the world, including Dr Li Wenliang, the courageous Chinese doctor who first tried to blow the whistle on this virus. Twenty-three doctors have died in Italy. This weekend, France lost its first doctor. None of us wants that here. Given the total determination of the Health Secretary to protect our frontline staff, would he urgently look into whether we need to manufacture more of the highest-grade equipment?

[Dr Murrison]

Does my right hon. Friend share my dismay at my being told just now that masks and PPE that were meant to be delivered to my authority, Wiltshire, tomorrow, will now be delivered on 9 April? I am not sure what the situation is in Surrey, but that seems extraordinary. Does he also agree that it has to be the right PPE—it cannot simply be a paper face mask from B&Q, as we heard earlier? It needs to be appropriate, and people need to know how it works. When they wear it, they are likely to have to work harder, because wearing PPE is not easy or straightforward.

[Jeremy Hunt]

My right hon. Friend knows, as a clinician— and I am concerned—that in our desire to get PPE out we have not understood the vital role that local authorities play in this. Residents in care homes are extremely vulnerable, and their carers need that equipment, so I very much support his concern about that.

The second area where the Bill needs to do more is testing. A week ago today our strategy changed from mitigation to suppression. I strongly support that change in strategy. Suppression strategies are being followed very successfully in South Korea, Taiwan, Hong Kong, Singapore and China, which appear to have turned back the virus. Here, all our public focus has been on social distancing, but testing and contact tracing to break the chain of transmission are every bit as important, if not more important. Those countries that have turned back the virus rigorously track and test every case and every suspected case, then identify every single person with whom a covid-19 patient has been in contact to take them out of circulation. As a result, those countries have avoided the dramatic measures and some of the economic damage that we have seen in Europe.

South Korea has avoided national lockdown, despite having a worse outbreak than us; Taiwan introduced temperature screening in malls and office buildings, but kept shops and restaurants open—it has had just two deaths. In Singapore, restaurants remain open and schools are reopening, although working from home is discouraged. Again, in Singapore, there have been just two deaths. Ten days ago in this country, we went in the opposite direction, and stopped testing in the community. How can we possibly suppress the virus if we do not know where it is? So far, we have had 281 deaths, tragically. According to the modellers, there is about one death per 1,000 cases, which means that we have just under 300,000 cases in this country. According to the same modellers, the number of cases is doubling every five days, which means that at the end of next week we will have about 1 million cases or more in this country. Unless we radically change direction, we will not know where those 1 million cases are.

The Prime Minister talked about expanding testing from 5,000 to 10,000 to 25,000, which is welcome. He even talked about 250,000 tests a day, which would be more than anywhere in the world—I welcome that ambition, but ambition is not the same as a national plan, and we have not seen a national plan on testing.

[Munira Wilson]

The right hon. Gentleman may have seen reports today that some care providers are refusing to take patients being discharged from hospitals because those hospitals are unable to test them before discharge. Quite understandably, care homes are concerned about admitting patients who may be carrying the virus, given the other vulnerable people there. Does he agree that as testing is ramped up, not only health and care professionals but patients being discharged should be a priority?

[Jeremy Hunt]

I am very worried about that. A doctor in my constituency told me of exactly the same problem, and of course, the risk is that hospitals then fill up and do not have the space to treat people who urgently need hospital treatment.

We have an ambition to increase testing to 25,000 tests a day, but at the moment we are still only testing between 5,000 and 8,000 people every day. On Saturday, we tested 5,500, which is no significant increase on a week ago. It is not just South Korea that is testing more than us per head of population—Germany, Australia and Austria are as well. Now is the time for a massive national mobilisation behind testing and contact tracing.

If we have the antibody test, now is the time to become the first country in the world that says, “We are going to test every single citizen.” Now is the time to introduce weekly tests for NHS and social care staff, to reduce the risk of them passing on the virus to their patients. If the Francis Crick Institute in London is doing any research into anything other than covid-19 right now, it should stop—we need it to be designing tests. If the Sanger Institute in Cambridge is still decoding genomes, it should not be—we need it to process covid-19 tests.

And it is not just the science. Contact tracing is manpower-intensive, yet Public Health England has just 280 people devoted to this. We probably need 280 people in every city and county in the country. Every local government official doing planning applications, every civil servant working on non-corona issues and volunteers all should be mobilised in this vital national task.

As we have heard, testing is vital for NHS staff who are desperate to get back to work. Here is one tweet from a midwife called Katie Watkins, who speaks for so many:

“I know this is happening all over but had to call in sick for my clinical shift on labour ward today as my husband spiked a temperature last night. I feel fine and yet cannot go to work... Where are the tests for #NHS staff?? I could be helping but instead sat at home.”

Testing is also vital for the economy. If we are going to have a year of stop-go as we try to protect the NHS if the virus comes back, testing and contact tracing allows an infinitely more targeted approach and way to control the spread of the virus than economic measures that are much more blunderbuss and do much more damage. This Bill could help that by giving the Government powers to require any pharmaceutical company in the country to manufacture tests and any laboratory in the country to process those tests. It could stop the scandal of £375 tests being available to wealthy people in Harley Street when, in a crisis, every spare test should be used by NHS staff to get them back to work.

This Bill could help with something else being done very successfully in South Korea and Taiwan: the use of mobile phone data. In those countries, they look at the mobile phones of covid patients to identify other phones that they have been nearby when that patient was infectious. That has civil liberty implications, but in this national emergency, being able to do that would save lives, so those powers too should be in the Bill.

Finally, please do not take my word for it on testing. Dr Tedros Adhanom, the director general of the World Health Organisation, and virtually every epidemiologist at the World Health Organisation makes the same point: it is not possible to “fight a fire blindfolded”; social distancing measures and hand washing will not alone extinguish the epidemic; and

“our key message is: test, test, test.”

I know that time is short, but I want to touch briefly on two other issues. Some good points have been made about social care this afternoon. The Bill replaces local authorities’ duty to meet care needs with a power to meet care needs, except when it is a breach of human rights. Bluntly, there may be less provision of social care as a result. We understand in this House why that may be necessary, but if it lasts as long as a year, that will mean more pressure, not less pressure, on hospitals. If there was any lesson from my time as Health Secretary, it is that we need to invest in social care as well as in health. We need to ensure that these new measures do not have the unintended consequence of putting yet more pressure on hospitals that are already on the point of falling over.

My final point is on mental health. Under the measures in the Bill, someone can be sectioned not by two doctors, but by one, and that doctor does not have to know the patient. I understand why we have to take these measures, but obviously it causes huge concerns in the mental health community that someone could be locked up on the say-so of a doctor who does not even know them. I want a commitment from the Government that all cases will be reviewed on the basis of the current procedures as soon as this virus is behind us, and certainly within the first three months.

I end my remarks with a tribute to frontline staff, not from me, a politician, but from an eight-year-old constituent of mine called Tamsin. She says:

“I really want thank all the doctors and nurses who are working so hard to look after all the sick people…they are all risking their own lives to try and stop the coronavirus instead of being safe at home. I’m missing my Nana, Gamma and Grampy a lot because they have to be isolated at home but if they get sick they will need the doctors and nurses to help them get better. Doctors and nurses are amazing.”

Tamsin is right. We must not let them down.

Covid-19

Jeremy Hunt Excerpts

Monday 16th March 2020 Commons Chamber

[Jeremy Hunt (South West Surrey) (Con)]

I warmly welcome the measures announced today. People have debated when they were going to be introduced, but the Government have shown today that they have the courage to introduce very tough measures that will have profound economic consequences, which will reassure many people up and down the country. In the constructive spirit adopted by the shadow Health Secretary, I want to ask a couple of things about the measures that have been introduced.

First, the Secretary of State is advising people not to go to clubs, cinemas and restaurants. Will he also advise clubs, cinemas and restaurants to close their doors, so that there is absolute clarity that people should not, at this moment, engage in those activities? Secondly, if someone in a household is symptomatic, he is advising the whole household to self-isolate for 14 days. I understand the logic behind that, which was very clearly explained, but the World Health Organisation advice is to test and isolate every single suspected case of the virus, so would he explain why there is divergence?

Thirdly, to follow up the question asked by my right hon. Friend the Prime Minister—[Hon. Members: “Former”]—the former Prime Minister, is the advice to healthy over-70s who do not have an existing long-term condition that they should be part of a new shielding policy that is happening at the weekend, or is that shielding policies just for over-70s with an existing health condition?

[Matt Hancock]

On that last point, no—the shielding policy is only for those with existing health conditions. Those whom we are going to ask to participate in shielding, from next week, will receive a contact from the NHS, and we will publish the list of conditions that we consider necessary for shielding. On the point that my right hon. Friend makes about testing and isolating, I strongly agree with the World Health Organisation about the need for testing. I spoke at the weekend to Dr Tedros, head of the World Health Organisation, and we strongly agree on the need for testing. The question is how fast can we ramp up testing capability for the tests that we need—the blood tests to know who has had coronavirus and the bedside test or the home test, so that these tests can be expanded rapidly across the whole country? The first has yet to be invented, although we hope that it will be fairly soon, and the second has just been invented in the past few days, and we are in intense negotiations about rolling those out very rapidly.

Coronavirus

Jeremy Hunt Excerpts

Wednesday 11th March 2020 Commons Chamber

[Jeremy Hunt (South West Surrey) (Con)]

I thank both Front Benchers for the highly responsible way in which they are approaching this crisis, which shows Parliament at its best. I also thank the Health Secretary for his role in getting those very generous words for the NHS into the Chancellor’s speech this afternoon; they have been widely welcomed across the NHS and were much needed.

The chief medical officer says that we would have to be “pretty optimistic” to think we could contain the virus in this country. The deputy chief medical officer says that she thinks we may hit the peak in the next fortnight. We now have more reported cases in this country than there were in Wuhan when it went into lockdown. We know that the Secretary of State will rightly follow the science, but could I ask him to give his judgment to the House as to whether he thinks we still can contain the virus in this country and, if not, whether he expects to move to the delay phase very soon so that families up and down the country can start to prepare their loved ones for any precautions they might want to take?

[Matt Hancock]

I want to make two comments in response to my right hon. Friend. First, I want slightly to correct the point about the deputy chief medical officer, who said that in the next couple of weeks we may see the numbers starting to rise fast to their peak. We do not expect numbers to peak in the next fortnight. We expect them to continue to rise after that. The peak would be in a matter of a couple of months, rather than a couple of weeks. This is a marathon, not a sprint. Secondly, the World Health Organisation declaring this afternoon that the virus is globally now regarded as a pandemic indicates that the WHO thinks it will spread right across the world, and that will have a significant impact on the way in which countries around the world will now take forward their plans. Of course, the expectation that this may well happen was all within the plan that we set out. We will be discussing that at the Cobra meeting tomorrow.

Oral Answers to Questions

Jeremy Hunt Excerpts

Tuesday 10th March 2020 Commons Chamber

[Helen Whately]

Work has already been done by the regulating bodies. For instance, we are already speeding up the process for nurses from overseas who want to come here to work in the NHS. I would be very happy to have further correspondence with the right hon. Member about the specific problem, and would be delighted if he could send me an invitation to make the visit that he mentioned.

[Jeremy Hunt (South West Surrey) (Con)]

I congratulate the Department on securing the NHS visa but, as the Minister knows, it does not apply to nurses and care workers in the social care sector. What is the Department’s assessment of the gap there will be in the social care workforce as a result of this new immigration policy, and how are discussions going with the Home Office and No. 10 on that issue?

[Helen Whately]

I thank my right hon. Friend for his question. I am well aware of concerns in the social care sector, particularly in areas where there are higher vacancy rates. It is important that employers make sure that they are taking the steps they can take to make sure that social care jobs are attractive and, of course, well paid, as they should be. I recognise as well a role for Government in this, supporting the role of working in social care, and overall making sure that we come together and fix the social care crisis.

Coronavirus

Jeremy Hunt Excerpts

Monday 9th March 2020 Commons Chamber

[Matt Hancock]

Let me start by concurring with what the hon. Gentleman said about the legislation. It should be taken through on a cross-party basis. I should of course be happy to talk to him about the proposals in that legislation, and also to ensure that the clinicians are able to explain why they are necessary and proportionate. I am grateful for the tone that he has taken throughout, recognising that our responses are led and guided by the science.

The hon. Gentleman asked about the NHS and its preparedness. There are record numbers of nurses and doctors, as I said. The 8,700 increase in the number of nurses over the past year is welcome in this context. We are, as he said, scaling up intensive care beds, and making sure that we have as much availability of ventilation equipment and, crucially, the skilled and trained people to use it, because ventilation equipment, without trained people, is dangerous. On that subject, we are making sure that we have the oxygen needed to go into those ventilation kits, working with oxygen suppliers to make sure that that is available.

The hon. Gentleman also asked whether GPs would have access to the protective equipment that they need, and the answer is yes. We have stockpiles of protective equipment and, again, we will release it at the right time. I am working closely with NHS England to make sure that that happens.

The hon. Gentleman asked about social care. He is absolutely right to draw attention to the importance of making sure that the staff in social care are well enough supported, including if they are sick and, critically, because many people in residential social care are some of the most vulnerable. Those living in the community in receipt of social care are likely to be vulnerable, whether because of prior health conditions or because they are elderly, or both. That is an area of significant attention, and we will update the existing guidance this week with further information for social care providers.

The hon. Gentleman asked about public health budgets which, of course, are going up. He also asked about home working and the cancellation of large events. We are not at this stage proposing the cancellation of mass events, because we are following the scientific advice that that is not what is proposed at this stage. Home working and flexible working are things that, in many cases, are advocated anyway. People will make their own decisions as to when that is appropriate. What we are saying from the Government point of view is that people should follow the public health advice so that, for instance, if they are returning from an affected area and they have symptoms they should stay at home, and that means home working. Over the weekend we added northern Italy to the list of places to which the Foreign Office does not recommend travel except in exceptional circumstances. We recommend that people returning from northern Italy self-isolate if they are symptomatic.

The hon. Gentleman asked about the food supply. We are confident that food supply will continue, even in our reasonable worst-case scenario. We have been talking to the supermarkets for some time about this scenario. I appreciate that on Friday there was discussion about whether every single supermarket executive had been involved in those talks. If any further supermarket executive wants to be involved in those conversations they should get in contact, but those conversations have been ongoing, and it is important, especially as we ask more people to self-isolate and stay at home, that we can ensure that we get supplies that are needed to the people we are asking to stay at home.

The hon. Gentleman asked about statutory sick pay, and I can confirm that we are proposing to put changes to statutory sick pay in the legislation, and I am happy to go through the details with him in the talks that I mentioned at the beginning of my response.

Finally, on Parliament, of course, this is a matter for the whole House. I know that the Commission met this morning, and I think that parliamentary scrutiny of decisions of the magnitude that we are having to take in response to coronavirus and their novel nature is incredibly important, and I will do all that I can to ensure that Parliament remains open.

[Jeremy Hunt (South West Surrey) (Con)]

I commend the Health Secretary for the way in which he is handling the crisis and ask him to reflect on what we now feel we have learned from the situation in China, given that yesterday was the first day when reported new cases in the UK exceeded reported new cases in China. The chief medical officer told the Select Committee that he hoped that a smaller proportion of the population in the UK would get the virus, given what we can learn from what happened in China, but one of the reasons for growing concern among our constituents is that the only number out there is the 80% reasonable worst-case scenario. Is it not time for the Health Secretary to share his central estimate of what proportion of the UK population he thinks will get the virus, even though we would all understand that that estimate might change over the passage of time?

[Matt Hancock]

I pay tribute to the Chair of the Select Committee for the way in which he has handled this—for instance, in demonstrating the need for transparency in the questioning of the chief medical officer last week. I will take away his point on the need for a central estimate. The figures out there relating to the proportion of people who will get the virus are a reasonable worst-case scenario. On the central estimate, there are still things that we do not know about the spread of the virus through China—in particular, whether the degree to which the slowing of the increase in cases in China is because the virus has reached a large proportion of the population and there is a large proportion who are not symptomatic, which would mean that the mortality rate was lower than otherwise thought; or whether the significant measures that the Chinese have taken are having a significant effect, and that therefore, as and when they are lifted, the virus will continue to spread. Either of those options is possible, and we do not know which one it is, but whichever it is, the approach that we are taking in the UK is the right response to both of those scenarios.

Coronavirus

Jeremy Hunt Excerpts

Tuesday 3rd March 2020 Commons Chamber

[Matt Hancock]

I am grateful to the hon. Gentleman for the constructive approach he has taken from the start, and I will seek to address all the questions that he has raised. His first point was about statutory sick pay. For those who need to self-isolate for medical reasons to protect others, that counts as being off sick. They do not need to go to a GP, because there is a seven-day allowance for self-declaration. I hope that that addresses that point directly—[Interruption.] We keep all matters on this under review because, broadly, I agree with him on the principle that he has set out. On the NHS, he asked about resources. We have already increased resources to the NHS and we stand ready to do so if that is necessary.

The hon. Gentleman asked about doctors and revalidation. In legislation, we are proposing to make revalidation simpler. We will bring forward those measures, and of course we will engage with the Opposition on the potential measures as and when that is necessary.

On public health allocations, we have already been clear that the public health grant is going up in aggregate. As my right hon. Friend the Communities Secretary set out last week, we have seen a 4.4% real-terms increase in local authority budgets this year, and the social care budget is going up by £1 billion. I think that that takes into account the issues that the hon. Gentleman raised.

The hon. Gentleman also raised engagement with the World Health Organisation We have supported the WHO with extra funding. On engaging with the EU, I have regular engagement with colleagues from across Europe, and some of the reports I have seen in the newspapers are not accurate, because the questions of engagement with the EU on matters of health security are a matter for the negotiations, as set out on Thursday in the negotiations document.

[Jeremy Hunt (South West Surrey) (Con)]

I would like to commend the Health Secretary for the calm way in which he has been dealing with this crisis and for his very clear public messaging. He called me last Friday to tell me that there had been a coronavirus outbreak in my constituency. I would like to thank the staff at the Haslemere health centre for their extraordinary commitment in working over the weekend so that the health centre could be open again on Monday morning. This shows, however, that some of the people at greatest risk are our frontline health workers. One study in China showed that 7% of the people who got the virus in Wuhan were health workers. Will the Health Secretary confirm whether hospitals, GP surgeries, care homes and nursing homes have enough face masks, gloves and hand gel, and will he outline any other measures he is taking to ensure that NHS staff are kept safe?

Maternity Services: East Kent

Jeremy Hunt Excerpts

Thursday 13th February 2020 Commons Chamber

[Ms Dorries]

I thank the hon. Gentleman for his collaborative tone on this issue. I think he may have missed my last comment, which was that NHS England and NHS Improvement will be commissioning an independent inquiry. That has been decided this morning, so that will happen.

On the hon. Gentleman’s first question about what is happening to support the trust now, NHS Improvement is in there. As I said, the chief midwife, Jacqueline Dunkley-Bent, has sent in some of the best midwives, obstetricians and neonatologists in the country from outstanding trusts to support the trust. They are having twice-daily huddles on the wards, which is where multi- disciplinary teams get together and discuss on an ongoing and regular basis what is happening on the wards, what disciplines are involved and what measures are being taken. We have fresh eyes looking at the cartography that measures foetal heart rates and contractions. We have a second pair of eyes reading those cartography read-outs, so it is not just down to one midwife.

A huge amount of support has gone into the trust. As I said, it is today a safe place for anyone to give birth. We are also asking HSIB to go in to do that deep dive to look at historical issues. Whether that will continue in light of the fact that NHS England is commissioning an independent inquiry is something I need to find out when I leave the Chamber. However, I want to reassure the hon. Gentleman and everybody that this is an issue that I take very, very seriously.

Babies bring joy and happiness when they arrive, and every family—every mother, every father and, indeed, every grandparent—is entitled to know that when they or their relative is in hospital, the delivery will happen in a safe environment, with the very best care. I can say that that is the case at East Kent now, and I—we all—will strive to make sure that it is the case at every hospital.

[Jeremy Hunt (South West Surrey) (Con)]

I thank my right hon. Friend the Member for North Thanet (Sir Roger Gale) for tabling this urgent question and for speaking so powerfully. I also thank the Minister for her work to respond to this. I, for one, hope that she continues in her role after the reshuffle because of her incredible commitment to patient safety.

What worries members of the public is that the NHS appears to be much better at transparency about care failures, but not always much better at learning from those failures. Does the Minister agree that that underlines the vital importance of the independent investigations that HSIB does into every Each Baby Counts incident, and the need for safe spaces so that doctors, nurses and midwives can talk openly and freely about what they think went wrong? Will she also consider publishing the report that CQC has already done into what is happening to reassure families that we are indeed confronting all these difficult issues?

[Ms Dorries]

My right hon. Friend is absolutely right. One of the issues in dealing with the ongoing problem—this is a bit like the airline industry—is that we need to generate a culture in which NHS staff feel able to speak up without fear of blame or litigation and we can take learning forward. Another issue is that when we have inquiries, we should take the recommendations and ensure that they are implemented. That piece of work is also going forward, along with HSIB and inquiries. We should look at implementing absolutely everything that we can to make sure that the safest possible environment exists.

Wuhan Coronavirus

Jeremy Hunt Excerpts

Tuesday 11th February 2020 Commons Chamber

[Matt Hancock]

I am grateful for the support of the Opposition for the measures we have taken. The best way to deal with an outbreak like this is on a bipartisan basis. The approach the House has taken has thus far helped to enable as efficient and capable a response as possible to what is obviously a very difficult situation. I entirely agree with the hon. Gentleman that the use of the powers we brought into force yesterday must be proportionate. Enforcement, too, needs to be reasonable. That is a very important consideration.

The hon. Gentleman is right to ask about NHS 111. We will ensure that NHS 111 services have support available. We have plans in place to expand support for those taking the calls on 111 if necessary. Thus far, we have not had to do that. Compared with the huge scale of the millions of calls to NHS 111 that are made, the number concerning those who think they may have coronavirus is still relatively small, but of course we stand ready to do that if necessary.

On timing, as far as I understand it business managers have not yet scheduled the debate on the affirmative procedure for the statutory instruments I presented yesterday. They are made affirmative—as in, they become law—the moment they are signed and thus are law now. They remain in force, with the requirement for Parliament to debate and pass them within 28 days. We will ensure that that happens. They then stay in force for two years, or until the end of the public health emergency is declared.

The hon. Gentleman asked about links with the local authority in Brighton. That is an incredibly important question. I understand that the links have been very close and that the public health officers in Brighton have been working very closely with Public Health England. I thank them, as well.

The hon. Gentleman asked about access to capital for GPs. If GP facilities or other parts of the NHS need capital upgrades, we will of course look at that. In the first instance, though, it is very important that people do not go immediately to their GP, but rather call NHS 111. If they do go to A&E, we will ensure that pods are available so that people are separated from the vast majority of those going to A&E, as we do not want them to be contaminated.

The advice remains absolutely clear: if you suspect that you may have coronavirus, call 111 and do not leave home until you have spoken to a clinician.

[Jeremy Hunt (South West Surrey) (Con)]

I thank the Health Secretary for the way he has handled this crisis. We are all very aware that appearances before this House are only a tiny fraction of the huge amount of work going on behind the scenes. I also thank the shadow Health Secretary for the non-partisan way his party is approaching this public health crisis.

One of the most distressing things we see on TV in relation to what is happening in China in the affected province is people being denied basic hospital treatment because the hospitals are full, whether because of coronavirus or another illness they happen to have. Will the Health Secretary give some idea of the preparations that are being made to protect people who will continue to have urgent illnesses, such as cancer, which will continue to need to be dealt with very promptly, even in such a situation as the virus exploding in the UK?

[Matt Hancock]

This is a very important strand of our prepare and mitigate policy to ensure that should things get worse here the NHS is fully prepared. The NHS has the capability now to cope with the very highest level of intensity and isolation with 50 cases, and the capability to expand that to 500 cases without an impact on the wider work of the NHS. If the number of cases gets bigger, we will of course need to take further steps. As my right hon. Friend knows from his time in my shoes, extensive plans are already in place for how they should happen if we reach that eventuality.

NHS Funding Bill

Jeremy Hunt Excerpts

Legislative Grand Committee & 3rd reading: House of Commons & Legislative Grand Committee: House of Commons & Programme motion: House of Commons & 3rd reading & Programme motion
Tuesday 4th February 2020 Commons Chamber

[Jeremy Hunt (South West Surrey) (Con)]

It is a great pleasure to follow the hon. Member for Ellesmere Port and Neston (Justin Madders). We were on opposite Front Benches for many years, but I always had great respect for his detailed understanding of healthcare issues and the integrity of his approach. He once wrote me a private letter. I will not divulge its contents; suffice it to say that it demonstrated his recognition that we are human beings on this side of the House. That was a rare admission from a member of the Labour party, and I am very grateful to him for it.

I will not be supporting the hon. Gentleman’s amendments and new clauses, but I think he is right to raise the issues that he has raised, and I want to propose some different ways of achieving his objectives. I am very pleased that he has raised the issue of mental health and mental health funding, and I therefore wish to speak to amendments 1 and 2 and new clauses 1, 2 and 3.

I think that all hon Members have knocked on the doors of constituents—I did as Health Secretary—and been confronted by people who have been given a totally inadequate service in relation to their mental health or that of their children. One person I met, who was not a constituent, was a very remarkable gentleman called Steve Mallen. He had a son, Edward, who had an extraordinarily promising life in front of him. Edward had secured a place at Cambridge, he was very musical, he had friends; and then, in the year before he was due to go up to Cambridge, he had a six-month period of severe mental illness and ended up killing himself, five years ago this Sunday. I think that all of us have to have people like Edward Mallen at the back of our minds, and to remember, as we enjoy a normal weekend, that for Edward’s family Sunday will be a very, very challenging day.

I believe we could all come up with stories like that. I mentioned Steve Mallen because he has chosen to relive the grief that he feels for his son Edward. He made a promise at Edward’s funeral that he would campaign to ensure that other people received the mental health provision that Edward did not receive. He subsequently set up the Zero Suicide Alliance with an inspirational NHS chief executive called Jo Rafferty, who runs Mersey Care. It is a fantastic project, and I am pleased to say that the Health Secretary has agreed to a meeting to discuss continued funds for the alliance. As we think about people like Edward, it is important to understand just why funding for mental health has not increased at the rate at which it should have, and why we do not have the service provision that we should have.

[Stephanie Peacock (Barnsley East) (Lab)]

Does the right hon. Gentleman share my concern about the fact that the mental health charity Combat Stress has said it is unable to accept any more new cases? Support for the charity, which helps military veterans, has fallen in the last few years, and 90% of its income consists of public donations.

[Jeremy Hunt]

I am well aware of the fantastic work done by Combat Stress, and I think it is important for it to receive the funds that it needs. However, when we look at the root cause of the problems in mental health funding, we see that on both sides of the Committee there is some culpability, and that on both sides it was completely unintentional. I hope that the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth), will forgive me if I start with the other side.

The truth is that when targets were introduced in the 2000s for A&E and elective care waiting times they were hugely effective, but they were introduced only for physical healthcare. As a result, during the austerity period when the budgets of clinical commissioning groups or primary care trusts were under pressure, money was sucked out of community and mental health services. That is at the heart of the problem that has bedevilled mental health care. The position changed in 2012, because a Labour amendment to the Bill that became the Health and Social Care Act 2012 instituted parity of esteem between mental and physical health. We were the first country in the world to do that.

As a Conservative, I am always deeply sceptical about legislating for principles, because I am not totally convinced that it ever changes anything, but that amendment did bring about a significant and very practical change, which I discovered myself as Health Secretary. No Health Secretary and no NHS chief executive ever wants to have to say publicly that the proportion of funding going to mental health has fallen on his or her watch, because that would be a direct contradiction of the principle of parity of esteem. That is why, since this became law, we have seen the proportion of funding of the entire NHS budget going into mental health either stabilised or starting to go up. That should put to rest some of the Opposition’s concerns about the risk of a decreasing proportion of NHS funding going into mental health, but it does not solve the problem.

The issue when it comes to mental health services for our constituencies is not about political will or funding; it is about capacity. We have an enormous number of ambitious plans on mental health. I unveiled one—in 2016, from memory—that said we would treat 1 million more people by 2020 and increase spending by several billion pounds. The mental health “Forward View” had some very ambitious plans, and we had the children and young people’s Green Paper. There are also targets to increase access to talking therapies, which are essential for people with anxiety and depression. But if we do not increase the capacity of the system to deliver these services, in the end we will miss the targets. For example, the children and young people’s Green Paper is an incredibly important programme, with a plan for every secondary school in the country to have a mental health lead among the teaching staff who would have some of the basic training that a GP would have to spot a mild mental health illness, anxiety or depression, or a severe one such as OCD or bipolar, and therefore know to refer it—[Interruption.] I am getting a look. I understand, and I will draw my comments to a close—

[Steve Double (St Austell and Newquay) (Con)]

No, you are meant to face the Chair.

[Jeremy Hunt]

Thank you. I am sorry—I am new to this Back-Bench stuff. Apologies for not facing the Chair. I will now do so more diligently.

The point I wanted to make, Dame Rosie, is simply that the children and young people’s Green Paper requires an increase in the children and young people’s work- force of—from my memory as Health Secretary—9,000 additional people. The CAMHS workforce is actually only 10,000, so the Green Paper alone requires a near doubling of the mental health workforce. Far be it from me to teach experienced Opposition Members how to scrutinise the Government or hold them to account, but if they really want to know whether we are going to deliver on those promises, looking at the workforce numbers in children and young people’s mental health in the CAMHS workforce is the way to understand whether we are going to be able to deliver those extra commitments.

[Mark Tami]

Is not that the key point? Young people’s experience of CAMHS on the ground is that they just cannot get an appointment. Rather than being seen in the early stages, as they should be, they often get seen only when they have become suicidal or have tried to commit suicide. That is the wrong way round.

[Jeremy Hunt]

The hon Gentleman is absolutely right. On both sides of the Chamber, we are totally committed to the NHS and totally committed to transforming mental health services, but I am afraid that young people are regularly turned away from CAMHS and told, “You are not ill enough yet. Come back when things get worse.” Why is that such a tragedy? Because half of all mental health conditions become established before the age of 14, and the way to reduce the pressure on the NHS is to intervene early. That is what does not happen.

[David Simmonds (Ruislip, Northwood and Pinner) (Con)]

In support of what my right hon. Friend has said, I think that one of this Government’s great initiatives in respect of children’s mental health in the past decade has been the work done through the health and wellbeing boards. I know that this was strongly supported by him when he was Secretary of State and by other Ministers since. Every local authority, using its connections with the schools and general practitioners in its local area, has a plan that reflects local need. This has evolved over the years to change the commissioning priorities at local level, which is reflected in what is purchased from NHS providers to address local need. I offer as an example an online counselling service that has been introduced to serve my constituents. The feedback from young people is that it is tremendously more accessible than what was there previously, and it is a lot less expensive than the type of services previously being commissioned. That demonstrates the commitment we have on the Government Benches to addressing children’s mental health.

[Jeremy Hunt]

My hon. Friend has huge experience of this in local government, and he is absolutely right. The big surprise for me when we were conceiving of the children and young people’s Green Paper was the willingness of NHS professionals to accept that the people who know the kids best are their teachers, rather than GPs, because the teachers see them every day and are probably going to be better at spotting a mental illness and being able to do something about it.

[Barbara Keeley (Worsley and Eccles South) (Lab)]

I would like the right hon. Gentleman to consider whether he supports an important proposal that we put forward at the general election. It was that there should be a trained counsellor in every school to spot mental health problems. Putting that burden on to teachers and others in the teaching profession is the wrong way forward. In Wales, we have the experience that having trained counsellors in schools relieves the pressure on CAMHS. If we want to take children’s mental health seriously and relieve the pressure on CAMHS, we should do this. I have a couple of schools in my constituency that have trained counsellors, and it really helps. The other thing that we proposed was to have a mental health hub in every local authority area, so that children and their families in crisis would have somewhere to go where there would be professionals and charities that work in mental health. Those ideas that we put forward really should be considered, and I wonder whether the right hon. Gentleman supports them.

[Jeremy Hunt]

They are both interesting ideas. The plan at the moment is that resource will be given to schools for a teacher to volunteer to devote a proportion of their time to this, and that there will be funding for them to do so, similar to the way in which schools have a special educational needs co-ordinator who is a teacher devoted to the special needs of the pupils in that school. I personally would have no objection if that were a separate counsellor, but this needs to be a resource inside the school—someone who is regularly at the school and who knows the children there. That is the important thing.

With permission, Dame Rosie, I would like to comment on some of the other amendments and on some of the comments made by the hon. Member for Ellesmere Port and Neston. He rightly talked about the issues around maternity safety, and I agree that it is vital that we continue the maternity safety training fund. That is not directly the subject of one of his amendments, but it is indirectly connected to it. Twice a week in the NHS, the Health Secretary has to sign off a multi-million pound settlement to a family whose child has been disabled for life as a result of medical negligence. What is even more depressing is that there is no discernible evidence that that number is going down. The reason for that is that when such tragedies happen, instead of doing the most important thing, which is learning the lesson of what went wrong and ensuring that it is spread throughout the whole country, we end up with a six-year legal case. It is impossible for a family with a child disabled at birth to get compensation from the NHS unless they prove in court that the doctor was negligent. Obviously, the doctor will fight that. That is why we still have too much of a cover-up culture, despite the best intentions of doctors and nurses. This is the last thing they want to do, but the system ends up putting them under pressure to do it. That is why we are not learning from mistakes. I am afraid that that is the same thing that was referred to in the Paterson inquiry report that was published today: the systemic covering up of problems that allowed Mr Paterson’s work to carry on undetected for so long. The hon. Member for Ellesmere Port and Neston is absolutely right on that.

I think it is a fair assessment of safety in the NHS to say that huge strides have been made in the past five or six years on transparency. It is much more open about things that go wrong than it used to be, and that is a very positive development. But transparency alone is not enough. We have to change the practice of doctors and nurses on the ground, and that means spreading best practice. Unfortunately, that is not happening, which is why, even after the tragedies of Mid Staffs, Morecambe Bay and Southern Health, we are facing yet another tragedy at Shrewsbury and Telford—I see my hon. Friend the Member for Telford (Lucy Allan) in her place, and she has campaigned actively on that issue. The big challenge now is to think about ways to change our blame culture into a learning culture.

[Jerome Mayhew (Broadland) (Con)]

I declare an interest in that, a long time ago, I was a personal injury barrister, including in cases of medical negligence. Does my right hon. Friend think a possible solution to the resistance to blame in the national health service might be the adoption of a no-fault compensation scheme much like that in the personal injury sphere in New Zealand, for example?

[Jeremy Hunt]

My hon. Friend makes an important suggestion. We considered such a thing when I was at the Department of Health and Social Care, but we decided that it would be very expensive. One of the tragedies is that many people who suffer actually make no legal claim because they are so committed to the NHS, so we have a system that gives huge amounts of money to one group of people and nothing at all to those who decide that they do not want to sue the NHS.

We need to look at tort reform, because most barristers and lawyers working in this field want the outcome of their cases to be that the NHS learns from what went wrong and does not repeat it. Unfortunately, that is not what happens with the current system. The involvement of lawyers and litigation causes a defensive culture to emerge, and we actually do the opposite. We do not learn from mistakes, and that is what we now have to grip and change.

I want to say something positive, because if we do change that we will be the first healthcare system in the world to do it properly. We are already by far the most transparent system in the world, mainly because people in this place are always asking questions about the NHS—and rightly so. Healthcare systems all over the world experience the same problem. It is difficult to talk openly about mistakes because one can make a mistake in any other walk of life and get on with one’s life, but if someone dies because of the mistake, that is an incredibly difficult thing for the individuals concerned to come to terms with. That is why we end up on this in this vicious legal circle.

On capital to revenue transfers, I was a guilty party during my time as Health Secretary. There were many capital to revenue transfers because we were running out of money, so capital budgets were raided. I fully understand why the Opposition wanted to table amendment 3, but I respectfully suggest that the trouble is that it would result not in more money going into the NHS but in more money going back to the Treasury from unspent capital amounts. The real issue of capital projects is getting through the bureaucratic processes that mean that capital budgets are actually spent.

[Pete Wishart]

I congratulate the right hon. Gentleman on securing the chairmanship of the Health and Social Care Committee, and I look forward to joining him on the Liaison Committee. He is a former Secretary of State, so he surely understands and appreciates that this Bill has a significant impact on Scotland, because it will affect our budgets through the Barnett consequentials. Does he think it is right that we are excluded from tabling or even voting on any amendments?

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[Jeremy Hunt]

I do, because this Bill about the NHS in England. It would be nice if we occasionally had a word of thanks, because the Bill will result in a lot more money being made available for the NHS in Scotland. The hon. Gentleman should, if I may say so, welcome that, because I think that will be as welcomed among the Scots as it will be welcomed by the English.

My point about capital to revenue transfers is that it is a big deal to get a hospital building project off the ground. So many get delayed because hospital management teams are very busy. They may have struggling A&E departments and are trying to meet other targets and to deal with safety issues—whatever it is—and they do not have the management resource to invest in putting together the case that, quite rightly, the Treasury and the Department of Health and Social Care demand is extremely rigorous and thorough. That is why things get delayed. If we want to ensure that these 40 hospitals get built, the Government should consider a central team at the Department of Health and Social Care to put at the disposal of hospitals that we want to build extensions or new buildings, so that they can actually navigate those hurdles—[Interruption.] I am getting nods from the very capable Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar), so that might be under consideration.

[Alex Cunningham]

I am grateful to the former Secretary of State for giving way. I admire his admitting his role in converting capital to revenue, and I am sure he regrets that he was unable to build the hospital we need in Stockton to close the health inequality gaps in our society. If he has any influence left in Government, perhaps he will have a word in some ears and say, “They really do need a new hospital in Stockton-on-Tees.”

[Jeremy Hunt]

I can be honest with the hon. Gentleman and say that I regret not being able to build lots of hospitals around the country in that period, because funding was short. Now, however, we are in a different situation. It is important that we build these extra hospitals, but there will be some big challenges in ensuring that we do so.

[Dr Whitford]

I thank the right hon. Gentleman for giving way. I welcome his suggestion of a central design team, because the NHS is over 70 years old and we seem repeatedly to reinvent the wheel. Does he recognise that it is not just about building new hospitals, because maintenance has also been allowed to slide? There are leaking roofs and leaking sewers, and patients are still in hospitals that are basically not fit for use. Maintenance is most urgent.

[Jeremy Hunt]

I agree with the hon. Lady. Maintenance is a big issue in many hospitals. A number of hospitals are still essentially prefab buildings that should have been torn down a long time ago, and there are others where maintenance can solve the problem. I think we have to attack all of that, and I welcome the fact that there is a real commitment from the Government to do so.

Finally, I want to talk about new clause 4, which relates to whether the Government are giving enough to the NHS to meet the current waiting time targets for elective care, A&E, cancer and so on. I welcome the Opposition’s focus on this matter, because the public absolutely expect us to get back to meeting those targets. It was an important step forward for the NHS that we did bring down waiting times, and I have often credited the previous Labour Government for that happening, as I hope the Labour party will credit this Government for the focus on safety and quality in the wake of Mid Staffs. However, as we focus on safety and quality, I would not want to lose the achievements that were made on waiting times, because it is fundamental to all patients that they do not have to wait too long for care. Indeed, waiting times themselves can be a matter of patient safety.

[David Simmonds]

My right hon. Friend mentioned targets and people getting access to care. The hon. Member for Harrow West (Gareth Thomas) referenced Pinn Medical Centre, which is in my constituency, and the impact on Northwick Park Hospital in his constituency. This is a really good example of when the issue is not with the total sum of funding but with how the NHS is spending it. If the system can afford £300 to pay for each A&E attendance, I am sure it can afford £70 for those patients to attend a walk-in centre instead. This is not about an arms race and who can spend the most, but about who can bring the most focus to spending the money in the way that benefits patients and our constituents the greatest.

[Jeremy Hunt]

My hon. Friend neatly makes the point that I was hoping to make next. I will elaborate on the brilliance of his insight and simply say that when we think about waiting times it is very important that it is not just a debate about money. I appreciate that the Bill is about money, and that is why amendments have been tabled about money, but I want to give the example of the annual cycle of winter crises that we seem to have in the NHS now. I looked up the figures and, over the past five years that I was doing the job, in the first year I gave the NHS £300 million to avoid a winter crisis; in the second year, £400 million; in the third year, £700 million; in the fourth year, £400 million; and in the fifth year, £400 million. In four of those five years, we still had a winter crisis. That is because in the end it is not about money as much as it is about capacity.

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[Patrick Grady (Glasgow North) (SNP)]

The third final point.

[Jeremy Hunt]

It was always the final point, and it is very much the final point.

The other area that is essential for capacity is the social care system. My hon. Friend the Member for Ruislip, Northwood and Pinner (David Simmonds) talked about how money can be wasted. One of the biggest wastes of money is that we pay for people to be in hospital beds, which cost three times as much as care home beds, because we do not have the capacity in the social care system. It is very important that we encourage people to save for the future and protect people against losing their homes, but if we want to see a change in the NHS in the next five years it is fundamental that we increase the ability of local authorities to deliver adult social care to people who cannot afford it. At the moment, they do not have enough to do that, and we must put that right.

[Patrick Grady]

Finally, here we are, in the English Parliament after all these years. Isn’t it great? The Mace is down, the signs are up, and the dream of David Cameron has finally been realised. For the first time since 1707, English Members of Parliament will get to vote on English legislation to the active exclusion of the rest of us. I wonder if the Minister could have even dreamed, when he and I were but lowly Back-Bench members of the Procedure Committee back in 2015 and scrutinising the EVEL processes, that this is where we would end up today.

On 19 September 2014 David Cameron promised, in response to the independence referendum in Scotland, that we would have English votes for English laws. Three general elections, two Prime Ministers and countless Leaders of the House later, here it is in all its glory. I wonder, given the responses and speeches that we have heard today, whether anyone on the Government Benches really understands what is going on. We are debating clauses and amendments to a Bill that has been certified as being only relevant to England, but as the amendment themselves demonstrate, and as we have heard in speeches, it will have implications for health spending policy across the whole of the United Kingdom—and very serious issues, too—for mental health, for the construction of hospitals, and for the difference between capital and revenue spending on the NHS.