Baby Loss Awareness Week
Jeremy Hunt Excerpts(5 years, 1 month ago)
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Jeremy Hunt (South West Surrey) (Con)
It really is an honour to follow two such extremely powerful and persuasive speeches. I particularly thank my hon. Friend the Member for Truro and Falmouth (Cherilyn Mackrory) for her courage in bringing Lily’s story to this House. It is actually a rather wonderful thing that she is giving such meaning to Lily’s life by talking about what happened so openly. The grief that she expressed so eloquently is shared by 1,700 families in our country every single year, so she is speaking for a lot of families up and down the country. Her words will resonate, so I thank her. It was not easy to do. But like many families who are bereaved, she has taken the decision to relive that grief over and over again to try to stop that tragedy being repeated, and I think we all salute her courage in doing so.
My hon. Friend said something that resonated particularly with me when she talked about the grief of fathers. I cannot claim to have experienced anything like the grief that she and her husband have experienced, but my father did, because my sister Sarah died when she was just six months old. I was there at the time. I was only two so I had no memory of it. During my father’s entire life—he died eight years ago—my mother used to tell us never to mention Sarah because he found it so hard. That reflects the comment of the hon. Member for Lanark and Hamilton East (Angela Crawley) that there is no timeline for grief.
Angela Crawley
Does the right hon. Gentleman believe, as I do, that fathers, like mothers and like any parent, have the right to have a grieving process and should have the right to paid leave in order to do so?
Jeremy Hunt
I thank the hon. Lady for giving me a moment to recover. She makes a very powerful argument. Without committing to supporting her proposal, I would hope that all employers would listen to her speech and offer that leave voluntarily on compassionate grounds, because that is the responsible and kind thing to do.
I want, in my brief comments, to talk about another group of people less often talked about who also feel this grief—the doctors, nurses and midwives responsible for a child’s care. Some people have used the phrase “second victim” to describe the agonising sadness people feel when they are responsible for a child’s care and that child dies. When I was Health Secretary, many times I asked people working in hospitals what the biggest tragedy and professional shock they had ever had was, and they would often say that it related to the death of a child. Even more acute is when that death was caused by an error. Those doctors, nurses, midwives and frontline professionals, who go into their profession with the highest and noblest of motives, have to live with the fact that perhaps because of an ordinary human mistake—the kind of mistake that all of us can make—something really terrible happened.
We as politicians, and those in nearly every other profession, make mistakes the whole time—a media appearance goes wrong, a speech goes down badly, we lose an election, or whatever it is—but the consequence is not someone dying. Frontline health professionals have the courage to go into a profession where they are taking that risk every day. When those tragedies happen, those frontline professionals want nothing more than to be completely open, transparent and honest about what happened so that we can learn from the mistake and put in place processes and systems so that it never happens again. But, in truth, we make it practically impossible for them to do that. They are terrified about losing their job, about the Care Quality Commission, about being struck off the medical or nursing register, about the reputation of their unit, about the reputation of their hospital, and about lawyers, who get involved very quickly.
When I was Health Secretary—I do not think this has changed even now—every week I signed off a multimillion-pound payment to a family whose child was disabled for life because of medical error that the NHS accepted. Most weeks it happened twice. Overall, the cost of that compensation for medical error in the NHS is £2.4 billion a year. Just under half of that relates to maternity. We have got to the obscene situation where we pay more in compensation to families when something has gone wrong than on the entire cost of every doctor and every nurse working in maternity units up and down the country. Why is that? It is because of a simple problem that the Health and Social Care Committee—I am delighted to see members of the Committee in their places on both sides of the House—is urgently asking the Government to address.
If, because of a mistake, a child is born disabled, the parents quite understandably want financial support to deal with the unexpected costs that the family will face for the whole of that child’s life. However, under the law, the only way to get that compensation is if a court agrees that there was clinical negligence. Quite understandably, parents will fight to get that compensation and, also understandably, the doctors, nurses and midwives become defensive if they are accused of clinical negligence. It does not have to be that way. We need a system where people are entitled to compensation as soon as it is accepted that a mistake was made without the necessity to prove clinical negligence.
The country with the highest safety standards and the lowest number of baby deaths in Europe is Sweden, which has about half our level of baby deaths. In Sweden, compensation is given more quickly just on the basis of a mistake being made, with the result not that they pay more but that they pay massively less, because they have half the number of tragedies that we have. Surely those of us who are passionate about patient safety will support that, and those who are—as we all are—worried about baby deaths will support that. Even people in the Treasury should understand that the way to reduce the obscene compensation bill is to make it easier for families in those terrible situations to claim compensation. If we had the same maternity safety levels as Sweden, 1,000 more babies would survive every single year. Just think of the heartache and the transformation in the lives of families up and down the country were we to do that.
I turn briefly to the other recommendations in the Select Committee’s report, published in July. One of the most important recommendations relates to staffing. When it comes to medical error, if there are not enough staff on a ward, the likelihood of mistakes will self-evidently be higher. Eight out of 10 midwives say that there are not enough midwives on their shifts, and Health Education England—the Government’s own body—says that there is a shortage of just over 1,900 midwives across the system. NHS Providers thinks that there is a shortage of about 500 doctors in maternity units and the Royal College of Anaesthetists says that there is a shortage across the system of about 1,000 anaesthetists. The cost of putting that right is between £200 million and £350 million a year. That is a significant amount. The Government deserve credit for already agreeing to put in £95 million a year, but that additional cost is as nothing compared to the £2.4 billion that we are paying in compensation every year. I hope that the Government will agree to put right that staffing shortfall. They have said this week that they are considering that.
Training is another vital issue. It is so important for doctors, nurses and midwives to have the time to learn from things that go wrong and to improve systems, but they can do that only if there is protected time for training in their busy schedules. I commend Baby Lifeline for the fantastic, proven training that it does, which has saved many lives. It is led by the inspirational Judy Ledger, who was inspired to do what she does by her tragedies. The report also talks about more screening and health inequalities, both of which were mentioned by my hon. Friend the Member for Truro and Falmouth.
I finish with two brief points. First, it would be wrong to say that this is an NHS problem. It is a tragedy that happens in all countries all over the world, and this year the World Health Organisation has made maternal and newborn loss the theme of World Patient Safety Day. The WHO says that, every day across the world, 7,000 babies die and the majority of those deaths are preventable.
Finally, we should remember the tremendous progress that has been made. In the last decade, the number of neonatal deaths is down by 25% and the number of stillbirths is down 30%. I commend Jacqueline Dunkley-Bent and Matthew Jolly in NHS England, who are leading the maternity safety transformation programme, and the many doctors, nurses and midwives who are supporting them. I also commend charities such as Sands and the Lullaby Trust as well as many others. Most of all, I commend the families who have campaigned through thick and thin, including James Titcombe, remembering his son Joshua; Derek Richford, remembering his grandson Harry; Carl Hendrickson, remembering his son Chester and his wife Nittaya; and Richard Stanton and Rhiannon Davies, remembering their daughter Kate. There are many others. Five babies die every single day. This is our moment to put it right.
Covid-19 Update
Jeremy Hunt Excerpts(5 years, 1 month ago)
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Sajid Javid
The right hon. Gentleman asked a number of questions, so I will quickly plough through them. We have made clear that plan A is absolutely our focus. It is the situation we are in. Vaccines remain a critical part of it, as do testing and surveillance. I thank him for his support for our vaccine programme, including his comments yesterday. He also asked me about plan B. It is absolutely right that the Government have a contingency plan, and the trigger, so to speak, for plan B, as I mentioned in my statement, would be to look carefully at the pressures on the NHS. If at any point we deemed them to be unsustainable—if there was a significant rise in hospitalisations and we thought it was unsustainable—we would look carefully at whether we needed to take any of those plan B measures. That would be informed by the data, and of course we would come to the House at the time and make the appropriate response.
It is really important to emphasise, as we cannot do enough, the importance of vaccines. We now know from data just yesterday from the Office for National Statistics that, in the first half of this year, 99% of those who died from covid-19 sadly were not vaccinated. That highlights the importance of vaccination.
The right hon. Gentleman asked about people who are immuno-suppressed. He will see that we set out more details on that in the plan we have published today, including treatments that either are currently available or may soon be available. I have mentioned the antivirals taskforce, which is doing great work. There are a number of possible new treatments, and it is something in which the UK is very engaged. He will know that, for those immuno-suppressed people who can take the vaccine, just last week, we announced a third dose as part of the primary treatment. That again is a reminder of the action we are taking. Our advisers are constantly looking to see what more we can do.
The right hon. Gentleman asked about the flu risk. It is a significant risk this year, not least because, for reasons we are all familiar with, there was not much flu last year. There is a lot less natural immunity around in our communities, and the flu vaccine, which is being deployed not only in the UK, but across Europe, has less efficacy than normal, but it is still effective and a worthwhile vaccine, and that is why we will be trying to maximise uptake with the biggest roll-out programme and communications programme that this country has ever seen for the flu vaccine.
On diagnosis, the right hon. Gentleman made a good point, and it is something that we are looking at with covid and flu jointly. On testing arrangements, I think I have set them out clearly in the statement. We have no plans to change the current arrangements, but of course we keep that constantly under review. However, as long as those tests are needed available free for the public, that will be the case. But as I say we will keep that under review.
In terms of infection control in social care settings, a substantial amount of funding is available. We have already made available for this financial year some £34 billion of funding in total for the NHS and the care system for a lot of these extra measures. That is a huge amount of funding. Much of it is going to essential work, such as infection control, and we will ensure that what is needed is there.
The right hon. Gentleman’s last question was about vaccine certification. I think I have made the Government’s position clear. It is not something we are implementing. We are not going ahead with any plans for that. For any Government to do something like that, it would be such a big decision, and it would have to be backed up by the evidence and the data. That evidence is not there, and I hope that we will never be in the situation that it is. To keep it in reserve is the right thing to do.
Jeremy Hunt (South West Surrey) (Con)
I welcome this announcement, particularly on boosters. Yesterday, I asked the Minister for Covid Vaccine Deployment, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), when we would hear about boosters. Just 15 hours later, the Secretary of State is making a statement. It is almost as if the Government are listening, and it is very good news. Nowhere wants to get back to normal more quickly than the NHS itself.
Will the Secretary of State commit that the backlog in mental health treatment will be treated every bit as seriously as the backlog in physical health? In particular, will he commit that the NHS and the Government will continue to adhere to the mental health investment standard, which says that mental health spending will increase at a higher rate than overall NHS spending, particularly when it comes to the extra money coming from the levy? Parity of esteem is supported by all parts of the House and legislated for in this House. There is a lot of worry in the mental health world that the money from the levy will not reflect the needs of the mental health backlog.
Sajid Javid
First, I always listen to the former Health Secretary. He always has some good advice, and I am pleased that he thinks the Government are moving quickly. He is absolutely right to raise the backlog in mental health. The Government are absolutely committed to parity of esteem. That is not just in law, but in our manifesto. I take this opportunity to reassure everyone who is particularly concerned and who may have raised this issue with my right hon. Friend that that commitment remains. The new funding that will go in over the next three years to help to deal with the backlog absolutely includes mental health funding.
Covid-19 Vaccinations: 12 to 15-year-olds
Jeremy Hunt Excerpts(5 years, 1 month ago)
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Nadhim Zahawi
I am grateful to the right hon. Gentleman for his support, for his points about guidance to the parents and of course to the children, and for his points about the long-term mental health consequences of this pandemic for school-age children.
I can confirm to the right hon. Gentleman that the NHS—it is incredibly efficient and well-equipped, because it has been running the school age vaccination programme for many, many years for other vaccines—will be the primary vaccination infrastructure that we will use to deliver this vaccine. If there are schools where that is unable to be delivered, we will use the rest of the covid vaccine infrastructure, including vaccination centres, to deliver that in a safe and appropriate way. My point is to reassure him and parents up and down the country that it will be the school age vaccination programme that has run in schools. Teachers and parents are well-versed in that process.
The right hon. Gentleman asked about vaccine uptake. He will recall that I said at this Dispatch Box on 13 February, in launching the vaccine uptake programme, that the NHS continued to put effort and resource into making vaccines available and easily accessible to the most deprived communities and to all ethnic groups. We will continue to redouble our efforts, including with the booster programme, which will come later this month. We have had the interim advice from the JCVI on boosting for flu and covid. The uptake of both should increase the uptake in those communities. We have spent a lot of time looking at that.
The right hon. Gentleman asked an important question about the consent process, and I want to spend a little time on that. As with all vaccinations for children, parental consent will be sought. The consent process will be handled by each school in its usual way and will provide sufficient time for parents to provide their consent. Children aged 12 to 15 will also be provided with information, usually in the form of a leaflet for their own use and to share and discuss with their parents prior to the date of immunisation and the scheduled time for it. Parental, guardian or carer consent will be sought by the school age immunisation providers prior to vaccination, in line with other school vaccination programmes.
In the rare event that a parent does not consent, but the teenager wants to have the vaccine, there is a process by which the school age vaccination clinicians discuss this with initially the parent and the child to see whether they can reach consensus. If not, and the child is deemed to be Gillick competent, the vaccine will take place. That is very rare, but on the whole this is something that the NHS is very well versed in delivering for other vaccination programmes.
Jeremy Hunt (South West Surrey) (Con)
This is an incredibly sensitive decision but, in an open society, the Government have done exactly the right thing, which is to be open. The narrow health benefits to children are marginal, but the broader health and social benefits are considerable. Most importantly, this is one of the last pieces of the jigsaw if we are going to be able to say we have done everything possible to stop another winter lockdown. However, the final piece of that jigsaw, learning from Israel, is to have booster jabs. Could the Minister tell the House when we will have a decision on boosters? Could he also confirm that we will have no problems with supply after the Valneva decision today and with flu jabs, if we are going to have this big expansion of jabbing later in the autumn?
Nadhim Zahawi
I am grateful to my right hon. Friend for his important question. He is right to identify that this is a sensitive issue, which is why it was right for the Joint Committee on Vaccination and Immunisation to take its time to look at the data from other countries on first doses and second doses and for the chief medical officers to then do the work unimpeded which they needed to do. It is right that we follow their advice tonight.
On the booster campaign, we have received the interim advice from the Joint Committee on Vaccination and Immunisation—it was published on 30 June this year— on a potential booster programme, including flu and covid vaccine. I can reassure my right hon. Friend that the decision on Valneva will not impact our booster vaccination programme. We await the final advice. The JCVI has received the data from the COV-Boost study, where we looked at all the different vaccine brands—in some instances, full doses and half doses—as to which is the best vaccine to boost with.
I assure him that later this month we will begin a major booster programme. On flu—of course, the flu programme has already begun, and I assure him that we have the supplies for a major programme for both—we are looking at the really ambitious number of 35 million and, when we get the final advice from JCVI, the booster programme will be equally ambitious.
Covid-19 Update
Jeremy Hunt Excerpts(5 years, 1 month ago)
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Nadhim Zahawi
I am grateful to the right hon. Member for his support and his words on the vaccination of pregnant women and the protection that the vaccine offers them.
On the right hon. Member’s question about the JCVI advice on 12 to 15-year-olds, the JCVI looked at the very narrow impact of the vaccine on 12 to 15-year-olds, because that is very much its remit. It also advised that the chief medical officers should take a wider look. That is what they are doing as we speak. Panels of experts from local public health as well as other experts are looking at the impact of the vaccine on mental health and the disruption to education specifically for 12 to 15-year-olds. They will come back with recommendations. The JCVI is observing those panels and is very much in the room, as far as that is concerned.
It is also worth reminding the House that the Medicines and Healthcare Products Regulatory Agency has looked at the Pfizer and Moderna vaccines and has approved both vaccines as safe and eligible to be administered to 12 to 15-year-olds. It is not worth our pre-empting the report of the chief medical officers of England, Wales, Scotland and Northern Ireland. Throughout the pandemic, we have operationalised the vaccine programme; we prepare early and we prepare well. To give the right hon. Member a direct answer to his question, the NHS is prepared to administer a vaccine within five working days of any recommendation. That does not pre-empt any recommendation. We did the same when none of the vaccines was approved. Some colleagues will recall Brigadier Phil Prosser explaining at the press conference that we had built the equivalent of the infrastructure of a national supermarket chain and were growing it by 20% every week. We have done the same thing when it comes to all outcomes of the deliberations at the JCVI and what it will ultimately recommend.
On education, the Secretary of State for Education addressed many of the issues on the mitigation and controls in schools, as well as testing and the very successful adult vaccination programme that we have delivered, which is now also delivering protection for 16 and 17-year-olds.
I really want to address the point about flu and I hope that we can have a sensible discussion on it. We are being very ambitious on flu. The interim advice from the JCVI is wherever possible to co-administer flu and covid vaccines. Traditionally, flu vaccination begins earlier—it begins now. One of the suppliers, Seqirus, has had a border issue with its Spanish fill-and-finish factory, which it has used for many, many years. This is the first time that it has had this issue. It is meeting the Spanish regulator to see what the issue is. It is being very careful and estimating a one or two-week delay. This will not delay the overall flu vaccination programme at all. Its German and Belgian supply chain has been flowing normally. It is one of the suppliers, so I urge the right hon. Gentleman not to, as a knee-jerk reaction, talk about flu vaccine shortages. We are being incredibly ambitious on flu vaccines—including procuring centrally as well as the traditional procurement through GPs and pharmacies—with a big, big programme.
Wherever possible, we will co-administer. The only caveat I would place on that is that the JCVI has given us only its interim advice on covid. We are not yet there with the cov-boost data, which it will look at. It will give us its final advice on covid. If it chooses a vaccine that requires, for example, a 15-minute observation period, we have a very different challenge in co-administration, but nevertheless, wherever possible, we will co-administer. We have made it possible for vaccinated volunteers to administer flu and covid vaccines.
Finally, on funding, I am glad that the right hon. Member agrees that the £5.4 billion announced today is a good thing. I urge him not to speculate on how we will pay for social care and to wait for the announcement; I am sure that we can then discuss it in this place and in the media.
Jeremy Hunt (South West Surrey) (Con)
I have great respect for the excellent job that my right hon. Friend is doing. He will know that Israel shows that even a good vaccination programme does not stop the Delta variant driving up hospitalisations. However, Israel also shows that a booster programme brings down those hospitalisations in as little as two weeks. Given that the big lesson from last year is that acting early can stop the need for lockdowns, as happened in Taiwan, Singapore, Korea and a number of other places, is this not a moment for Ministers to say, “Look, we understand that the scientists want to take their time, but we have a reasonable idea of what they are likely to recommend, so we are going to get on with this booster programme before it is too late”?
Nadhim Zahawi
I am grateful for my right hon. Friend’s excellent question. I would say two things: first, in many ways, the decision taken by our chief medical officers in England, Wales, Scotland and Northern Ireland to increase the dosing interval, including for the vaccine that Israel uses—the Pfizer vaccine—from three to 12 weeks, with it now at an optimal eight weeks, was actually an inspired and clinically incredibly important decision, because it demonstrates, in real-world data, that the durability of the protection is increased over people who have had two jabs with a three-week dosing period. So we are in a slightly more advantageous position, if I can describe it as such.
My right hon. Friend makes an important point on boosters. The booster programme is probably the most important piece of the jigsaw yet to fall into place before we can transition this virus from pandemic to endemic status. I reassure him and the House that the NHS has all the plans in place to deliver the booster programme in what will, in some weeks, probably break our record, which we set in phase 1 of the vaccination programme. The JCVI has given us its interim advice on who needs to boost. It has added, obviously, the immunosuppressed to categories 1 to 4 and it has rightly recommended that we go big on flu. I am equally worried about that. Flu has been non-existent because of the severe social isolation of lockdowns and a big flu season could be detrimental as well. We are ready to go. As soon as cov-boost reports, which is imminent, we will be able to operationalise a massive booster programme.
Covid-19 Update
Jeremy Hunt Excerpts(5 years, 3 months ago)
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Nadhim Zahawi
The right hon. Gentleman asks who is included in the 3% pay rise recommended by the independent NHS Pay Review Body. They are the 1 million NHS staff, including nurses, paramedics, consultants and, of course, salaried GPs. The junior doctors he mentions have a separate, multi-year pay rise over three years, amounting to 8%.
The right hon. Gentleman asks about the capacity for testing. I looked at that before coming to the House, and the capacity currently for PCR tests is not 600,000 but 640,000 a day, according to the latest data that I looked at. He asks about schools. There will be two supervised tests for schools. He knows that in Monday’s statement we announced our acceptance of the JCVI guidelines on vaccinating vulnerable children, vaccinating children who live with vulnerable adults, and vaccinating those who are 17 but within three months of their 18th birthday. The JCVI will keep under review the vaccination of healthy children as more data becomes available from countries such as the United States of America and Israel.
The right hon. Gentleman asked a question around the covid vaccination pass and nightclubs, other crowded unstructured indoor settings such as music venues, large unstructured outdoor events such as business events and festivals, and very large structured events, such as business events, music and spectator sport events. They are the ones that we are most concerned about. We have seen other countries, whether it is Holland or Italy, opening nightclubs and having to reverse that decision rapidly. What we are attempting to do, and the reason we have the covid vaccination pass in place, is to work with industry while we give people over the age of 18 the chance to become double-vaccinated. It would be hugely unfair to bring in that policy immediately. Giving people until the end of September is the right thing to do, while at the same time allowing businesses to open safely, using the app now—because the app went live and the industry is very much engaging with it.
There are no easy decisions on anything to do with this virus. That is the one thing we have learned. The most effective tool we have against the virus is, of course, the vaccine programme, followed by the tool of self-isolation. If we want to get back to normal and get our lives back, we need to transition this virus from pandemic to endemic—from pandemic to manageable menace—as quickly and as safely as possible. If we release all restrictions now, including self-isolation, which I am sure a number of colleagues will ask about today, we risk the number of infections, which the shadow Secretary of State worries about as I do, rising rapidly. That could risk the transition of this virus.
We are working flat out with industry. I commend companies such as Lidl, which knows it is under pressure but will work through it with us. We will allow critical, frontline and key workers and health and social care workers to get back to work if they take a negative test, as I announced on Monday. By 16 August, everyone who is double-vaccinated will be able to do that.
Jeremy Hunt (South West Surrey) (Con)
May I start by wishing you and your family a ping-free summer, Mr Speaker? Thank you for upholding the values of this House over the past few months.
The Minister of State will have heard of YouGov, which said this week that a tenth of the people who had the NHS covid app have deleted it, and that a further fifth are considering doing so. Given that he made his living from listening to public opinion, does he not think it is time for the Government to listen to public opinion and immediately scrap the 10-day isolation requirement for double-jabbed people who are pinged, in favour of having to isolate until they take a negative PCR test? Otherwise we risk losing social consent for this very important weapon against the virus.
With your permission, Mr Speaker, I would briefly like to ask you about the issue we were not able to ask Ministers about in the House yesterday, which is the decision on NHS pay. I support the decision to accept the pay review body’s recommendations. It is the right thing to do, but it costs £1.5 billion. Can the Minister confirm it will not be paid for by cuts to other parts of the NHS budget? If it is going to be funded through a new national insurance rise for health and social care, as The Times says today, will he confirm that the funding for social care will be ring-fenced, so that we do not have a situation in which social care, once again, loses out because of pressures in the NHS?
Mr Speaker
The right hon. Gentleman said “you,” but I was not responsible for the decision yesterday.
NHS Update
Jeremy Hunt Excerpts(5 years, 3 months ago)
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Jeremy Hunt (South West Surrey) (Con)
May I start by echoing the Minister’s thanks to Lord Stevens, who is about to step down as chief executive of the NHS? One of my proudest achievements as Health Secretary was to secure a £20 billion annual rise in the NHS budget, and that would not have been possible without a close partnership with Lord Stevens. Indeed, he taught me a number of things about how to negotiate with the Treasury. He is someone who believes in the NHS to his fingertips, and he will be missed in all parts of the House, both on the Opposition Benches, but also on this side, where we have long forgiven him for his new Labour origins. We wish him well for the future.
This statement is about the NHS. The biggest pressure facing the NHS, apart from covid patients themselves, is the covid backlog, and I draw to the Minister’s attention the concerns that I and a number of people have as we face these enormous waiting lists. The previous Labour Government had considerable success in bringing down waiting lists, to their credit. They would also say that there were unintended consequences in terms of lapses in parts of the system with the safety and quality of care. Will the Minister, as we once again try to bring down waiting lists, agree that the Government will redouble their focus on safety and quality of care so that we do not have to relearn the lessons of Mid Staffs, Morecambe Bay and a number of other sad tragedies?
Helen Whately
I thank my right hon. Friend for his question. I know that in his time as Health Secretary, he did a huge amount to raise the standards of safety and have a greater focus on patient safety in the NHS. That is still clearly making a difference today. He is absolutely right that we need to ensure that we focus on that as we work to bring down the backlogs from the pandemic. It is not only that; I am mindful of making sure that we continue to support our NHS workforce as they, on the one hand, look after patients with covid and, on the other, work to reduce the backlog. That pressure is continuing, but I am determined that as we bring down the backlog, staff will continue to be supported and will, in fact, continue to have time off, annual leave, the breaks they need and the wider support so that we look after our workforce as well as providing the care that patients need.
Covid-19 Update
Jeremy Hunt Excerpts(5 years, 3 months ago)
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Nadhim Zahawi
The hon. Gentleman raises a number of important questions. Pfizer supply remains consistent, and we have every confidence that the manufacturer will continue to deliver, as it has done, according to the delivery schedules. Being able to continue to vaccinate the over-18s with their first dose, and of course their second dose by the end of September is not a question of supply. Equally, as we did a few hours ago, jointly with Minister Humza Yousaf and the Ministers from Northern Ireland and Wales, we can take a decision that we will all follow JCVI advice on vaccinating vulnerable children and those who live with vulnerable adults, as I described in my statement.
On our capability in the UK to manage this pandemic, I hope, with the booster campaign in September, to transition from pandemic status to endemic status. With the wall of vaccinated adults—I think 87.9% have had a first dose in the United Kingdom, and 68% of all adults have had two doses—it is the right precautionary pragmatic decision to transition, and return our country to as normal a place as possible. We will get those businesses that were almost first in and now last out of the pandemic, back and up and running.
Jeremy Hunt (South West Surrey) (Con)
Thanks to the efforts of the Minister we have one of the best vaccine programmes in the world, so I hope he does not mind me expressing two concerns about our current strategy. First, if we are to introduce covid vaccine passports for nightclubs by the end of September, which I support, why are we waiting until then, and giving more weight to the concerns of people who want to go to nightclubs than to the additional extra cases that waiting two months is likely to cause, at a time when that growth of new cases is such a concern?
Secondly, on the NHS app, people who have been double jabbed know that if they are pinged they are less likely to have the disease. They are therefore starting to ignore the request to self-isolate, and in some cases to delete the app. Before we lose social consent, should we not replace the requirement to isolate for 10 days with a requirement for someone to isolate until they have had a negative PCR test, thus using that testing capacity that the Minister talked about to keep our national show on the road?
Nadhim Zahawi
I am grateful to my right hon. Friend for his two excellent questions—rather than one—which I shall try to address in reverse. He will have heard the announcement in my statement about the NHS app and frontline social care or healthcare staff, as well as critical workers. Part of the reason we want to do that is that we want to maintain the ability of that workforce to do what it does best. As my right hon. Friend rightly outlined, they will do that with a negative PCR test and seven days of lateral flow testing. The clear clinical advice from the Chief Medical Officer and the expert team is that 16 August will be the most appropriate time to do that, for the rest of the economy as well. As we open up—we are now at step 4—and are getting more people double jabbed and protected further, especially younger parents, teachers and other professions, this is the appropriate measure to take on 16 August.
On the issue that my right hon. Friend raises on nightclubs, by the end of September 18-year-olds will have received their second dose. We will work with the industry to ensure that we get the covid pass right—now and in September—while we collate the evidence.
Health and Care Bill
Jeremy Hunt ExcerptsWednesday 14th July 2021
(5 years, 3 months ago)
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Jeremy Hunt (South West Surrey) (Con)
To reorganise the NHS as one of your first acts as Health Secretary is what Sir Humphrey would describe as brave. I support this Bill, because it contains changes that the NHS has asked for. I take the Secretary of State at his word that there is more to come on social care, and he has said that he will pursue the idea of independent safety and quality inspections of the new integrated care systems to make sure that they are outward facing and focused on the needs of patients.
When it comes to the biggest challenge facing the NHS today, which is workforce gaps, the Bill says little or nothing. Independent forecasts say today that we are currently short of 400 psychiatrists; 1,400 anaesthetists; 2,000 radiologists; 2,000 midwives; 2,000 to 2,500 emergency care consultants; and 2,500 GPs. We have more nurses but we are short of learning disability, mental health and community nurses.
Steve Brine
It is unquestionable that we have a challenge with the GP workforce. It is about numbers, yes, but does my right hon. Friend agree that constituents have a big challenge with access to general practice? We currently do not have the right balance between telemedicine and in-person medicine.
Jeremy Hunt
There is a big issue, and my hon. Friend is aware from his time at the Department of Health that its root cause is capacity in the system. These capacity issues taken together are why the Health Foundation says that, in just over a decade, we risk a workforce gap in the NHS of about half a million people. That is why this is such a big issue. I urge the Secretary of State to think about that during the Bill’s passage.
Joy Morrissey (Beaconsfield) (Con)
Does my right hon. Friend agree that that is also the case for the rehabilitation services used by stroke victims? There is a vital link between occupational therapists and physios, but we do not have the proper workforce in place for at-home care after a stroke.
Jeremy Hunt
My hon. Friend is absolutely right. These issues are about not just doctors but all associated health professionals, allied health professionals and indeed the social care workforce. It is important to note that they predate the pandemic. That is why, when I was doing the job of my right hon. Friend the Secretary of State, I set up five new medical schools and increased the number of doctor, nurse and midwife training places by a quarter, but we need to go further.
When the number of clinicians we train is decided by haggling between the Department of Health and the Treasury in a spending round, there is always the risk that it will be eclipsed by more short-term considerations. The truth is that we have a short-term emergency with workforce burnout, so I urge my right hon. Friend to look at the simple and sensible solution proposed by the Health Foundation and all the royal colleges in The Times today to legislate for Health Education England to have a statutory responsibility to publish annual independent workforce projections across the health and care system for the next five, 10, 15 and 20 years. That would show how many training places are needed, which would start to tackle this problem and the obscenity of spending £6 billion every year on locum doctors and agency workers. That cannot be the best use of funds.
Frontline health and care workers are exhausted. They know that there is not an instant solution, because they know it takes three years to train a nurse and seven years to train a doctor, but we can at least give them the reassurance that there is a long-term plan in place. That is not in the Bill, but it needs to be. Given the dedication that we have seen from health and care staff over the last year, it is the very least that we owe them.
Steve Brine
The hon. Lady makes a sensible point. There is obviously a process in place whereby that can happen, but if she is asking whether I agree with a liberal immigration policy to help our health service, then absolutely, yes I do. Addressing the cancer workforce and the wider NHS staffing picture is not an omission from the Bill—we cannot legislate staff shortages out of existence—but if we do not address that issue and face up to our long-term structural gaps, many of the reforms around tackling the backlog and building back better will not amount to a row of beans.
Jeremy Hunt
I congratulate my hon. Friend on the extraordinary work he did when he was a Minister on early diagnosis of cancer. Is he aware that the Health and Social Care Committee has just opened an inquiry—we had our opening session yesterday—into that issue, and into how we can get the right workforce in place to deal with those important matters?
Steve Brine
I was aware of that, and I am pleased to hear it. The Select Committee will soon have Cally Palmer before it—she is the national cancer director and one of the best in the business—and I look forward to following what she says. In advance of the comprehensive spending review, the Bill should include a requirement on the Government to publish modelling of the future supply of the entire healthcare workforce.
On primary care, I welcome the formal creation of integrated care systems, but we need them to realise their potential, and to do so fast. If they are going to work, general practice needs to embrace the wider primary care family, which means finally to recognise the potential of community pharmacy, ophthalmology and dental services as vehicles of prevention as much as of treatment.
Finally, if we move upstream of the Bill, what we do must be about prevention. We hear talk this weekend of a waiting list touching 13 million people. Let us tackle that for sure, but let us also get behind the food and drink clauses in part 5, and think about the future and our children as much as about the present. Several years ago I was fortunate to write up the high fat, sugar and/or salt proposals as part of chapter 2 of the child obesity plan, and I am pleased that the 9 pm watershed is legislated for in the Bill. I pay tribute to Jamie Oliver and his Bite Back 2030 campaign, and the young people involved with that, as well as to Cancer Research UK for its support. I realise that not everyone on these Benches, or perhaps outside, supports that move, and I agree that it will have little impact if that is its grand sum. Ministers need to take the tackling obesity strategy that was published last year, implement it all, and then go again.
I welcome the clauses on the fluoridation of water supplies. Let us stop debating whether we do that and —to borrow a phrase—follow the science.
In conclusion, the Bill is worthy of support on Second Reading. There will be an awful lot of work to do in Committee and the other place, but I will certainly support it this evening.
Oral Answers to Questions
Jeremy Hunt Excerpts(5 years, 3 months ago)
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Sajid Javid
The hon. Lady will know that the NHS long-term plan that has been set out by this Government is committed to a transformation in mental health services and mental health spending; some £2.3 billion extra is being invested by 2023-24. In addition, she will be aware of the mental healthcare White Paper and the mental health recovery action plan. I hope these are all initiatives she will support.
Jeremy Hunt (South West Surrey) (Con)
May I welcome the Secretary of State to his place? I am sure he will do an excellent job. As he thinks about a 24-hour A&E for Chorley, I hope he will also think about the urgent need for a cancer institute at the Royal Surrey County Hospital as only second on his list.
The Secretary of State will know that this morning the Health and Social Care Committee published a worrying report about the inhumane treatment given to 2,000 people with learning disabilities and autism in in-patient units, often because no community provision was available. When he brings forward his plans for social care, will he make sure that there is adequate funding for local authorities to give care to such people? Will he also make sure that care workers are always paid the minimum wage, including for the time taken to travel between appointments?
Sajid Javid
I welcome my right hon. Friend’s comments and the work that he and other Members do through the Select Committee to scrutinise the work of the Department. He just referred to some of that work, especially in his comments about learning disability and autism, which will remain a huge priority for the Government and certainly for my Department.
My right hon. Friend also rightly raised the issue of care workers and the minimum wage; it is worth pointing out that the Care Act 2014 requires local authorities, when they provide funding, not just to support the minimum wage but to take account of the costs that care workers might incur, such as travelling costs. I look forward to working with my right hon. Friend and the members of his Select Committee.
Covid-19 Update
Jeremy Hunt Excerpts(5 years, 3 months ago)
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Sajid Javid
The right hon. Gentleman started by saying that he supports a balanced approach in a sustainable way, and that is exactly what I have set out today from this Dispatch Box. That is the Government’s approach, so I agree with him. We as the Government have set out the detail, but I am still not sure what his plan actually is. However, given that he set out those objectives, I hope he can support this plan. He talks about the risks that are involved, and I have been very up front about that. The Government have been up front: there is no risk-free way forward. Opening up is not without risk, but ongoing restrictions are not without cost, and I hope he appreciates that.
The right hon. Gentleman raised a number of questions, and one of his first was about hospitalisations. As I have said, case numbers are going up and we expect them to continue going up, but the most important difference today versus the last wave is vaccination—the wall of defence that our country has built—which has meant that hospitalisations, although they are rising as case numbers rise, are rising at a rate that is a lot slower than before. I have set out specifically regarding test 3 in a road map that we believe the pressure, with all the data we are seeing at this point, is not unsustainable for the NHS.
The right hon. Gentleman talked about vaccinations, and I am pleased he is highlighting that, especially for more young people to come forward. As I mentioned in my statement, we are ahead of the plans we set out when step 4 was temporarily pushed out by four weeks. He also asked about the vaccination of children. He knows that we have a group of expert science advisers—the Joint Committee on Vaccination and Immunisation—and this is something it is actively looking at. At some point, we will reach a final decision, but I hope he will agree with me that we should take the scientific advice on that and consider it very carefully before making such a move.
On air ventilation units, some of the £90-plus billion extra the Government have provided to the health and care system during the course of this pandemic has of course gone on air ventilation units, and we should continue to support that. A lot of extra funding has also gone to people to support them financially if they are asked to isolate, and it is important that that is both kept under review and continues to be taken seriously.
The right hon. Gentleman mentioned lateral flow tests and something about charging for them. That might be his policy, but it is not this Government’s policy. I do not know where he has got that one from, but we have no plans to charge for lateral flow tests.
Lastly, 19 July is a step forward on our road map. As we have clearly set out, the pandemic is not over, but it is a very significant step forward. The right hon. Gentleman talked about reviews. I have just said that we will have a review in September to make sure that we are properly set up for autumn and winter.
Jeremy Hunt (South West Surrey) (Con)
The virus today is a totally different creature from a year ago, with only one in 40 new cases being hospitalised, an average age for new cases of 25, and all over-40s being offered two jabs, accounting for 99% of the age group that have had covid fatalities to date, so the Government’s approach is entirely reasonable. However, does the Health Secretary agree that there remain, to paraphrase the late Donald Rumsfeld, a number of unknown unknowns and known unknowns, not least the impact of long covid, the potential for vaccine escape and the potential for new variants? Will he reassure the House that if the data deteriorates beyond what is currently envisaged, he will not hesitate to take decisive action, not just to save lives but to head off the need for a further lockdown which would be enormously damaging for our jobs and businesses?
Sajid Javid
I am very happy to give my right hon. Friend that assurance. He made some excellent points. I thank him for his support for the Government’s action, but he is right to point out that there is still uncertainty for us and countries across the world in dealing with this pandemic. I am very pleased to assure him that if that risk matrix changes, for example with variants of concern, we will not hesitate to take the appropriate action.