Healthy Weight Programme: Funding for Local Authority Weight Management Services

Jo Churchill Excerpts

Tuesday 23rd March 2021 Written Statements

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

On 4 March this year, the Prime Minister announced an additional £100 million over 2021-22 to support people living with obesity to lose weight and maintain healthier lifestyles. I am pleased to confirm that the Government are dedicating £34.9 million of this new funding to support the expansion of local authority weight management services for adults, children, and families. Funds will be allocated via two ringfenced grants under section 31 of the Local Government Act 2003 and will be available to local authorities for 12 months from the beginning of the 2021-22 financial year.

The first grant will distribute £30.5 million among all local authorities in England to commission adult behavioural weight management services, based on population size, obesity prevalence, and deprivation. The funding is conditional on local authorities commissioning new, or expanding existing, behavioural weight management services, providing information on current service provision, and regularly submitting user data. This will be critical to demonstrate what works as we build a long-term approach to behavioural weight management services. The grant circular, setting out local authority allocations and the funding conditions, will be published on gov.uk today.

The second grant will distribute £4.4 million to test the expansion of behavioural weight management services for children and families and pilot an intervention to improve access to local services for children identified as overweight or obese through the national child measurement programme. All local authorities may submit an expression of interest for this funding. Funding will be allocated to local authorities according to the strength of their application and local need based on population size, child obesity prevalence and child-specific deprivation measures. The government will look to fund up to 10 areas, depending on the volume and strength of applications received. As with the adult grant, funding will be conditional on successful local authorities: commissioning behavioural weight management services for children and families; piloting an extended brief intervention linked to the national child measurement programme; providing information on current child and family service provision; and regularly submitting outcome data using a standardised dataset. The expression of interest for child and family weight management services will be announced on gov.uk today.

Public Health England will administer both grants and will be working closely with the Department of Health and Social Care to monitor and evaluate this important investment in behavioural weight management services.

[HCWS868]

Smoke-free Society by 2030

Jo Churchill Excerpts

Tuesday 23rd March 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Rosindell. I thank my right hon. Friend the Member for Clwyd West (Mr Jones) for securing the debate, and I am grateful to the hon. Member for North Antrim (Ian Paisley), my hon. Friend the Member for Dartford (Gareth Johnson) and the hon. Member for Strangford (Jim Shannon) for their comments. What joins us together is the passion shared across the House. Everyone wants to tackle the harms of smoking. Smoking kills.

I agree with my right hon. Friend the Member for Clwyd West that we have a good story to tell and should not be afraid to tell it. As he is aware, some good work has been done over the past couple of decades to drive smoking rates down. Rates are now at their lowest level, at just over 13% in England. It is one of the public health success stories. However, we have to do more. We cannot be complacent. There is wide variation, and smoking rates remain too high in certain areas of the country.

Like my right hon. Friend, I would look specifically at the levelling-up agenda in deprived areas, among the lesbian, gay, bisexual and transgender community, and among pregnant women and people with mental health conditions. Our focus on driving down rates across the country must be relentless. We must ensure that they are levelled where they are lowest and that no community gets left behind. The differential between good and poor areas is almost 10 times greater.

Fantastic work is being done to tackle health inequalities in different areas, including recently through the NHS long-term plan with regard to smoking in pregnancy. Its commitment to the maternity transformation fund has provided additional training to give midwives the knowledge, skills and confidence to offer brief advice to women during antenatal appointments, and upskilled practitioners to deliver stop- smoking interventions to those who need help.

[Mark Pawsey (Rugby) (Con)]

The Minister has spoken about having a good story to tell. Is not the take-up of vaping in this country a good story? She will know that we have a very active all-party parliamentary group on vaping. We are about to send her a report—it is currently in draft form—relating to the WHO conference of the parties in November. We took evidence and I wonder whether she agrees that the WHO’s negative view of vaping has been counterproductive. As my right hon. Friend the Member for Clwyd West (Mr Jones) said in his excellent speech, its attitude is partly responsible for the downturn in the number of people vaping. Given the level of interest in this debate, does the Minister think we ought to have a longer debate in order to consider these issues more fully?

[Jo Churchill]

I thank my hon. Friend for his intervention. Given that this is a 30-minute debate and there is a lot of interest in it, I agree that a longer debate might allow us to explore these things. I will comment on COP and the variety of products. We need to use everything in our armoury to encourage people to quit smoking.

We need to help people give up. We are working to ensure that no communities are left behind, as part of the bold ambition to be smoke-free in England by 2030. I listened carefully to my right hon. Friend the Member for Clwyd West talk about how we pack a punch in this area, but things will need to be evidence led. We will set out how we will deliver this later in the year, when we publish the new tobacco control plan for England in the summer. He asked me to reconfirm that we are on track for doing that, and I agree with him that it is a stretch to reach our target by 2030.

We know that the best thing a smoker can do is quit altogether. Covid-19 has brought into clearer focus the need for us to care for our health. PHE has issued guidance on the impact of covid-19 on vaping and smoking, and we know that if people smoke, they have an increased risk of contracting a respiratory infection. With covid-19, symptoms can be more severe if people smoke, but the evidence base is mixed.

As I have said, the best thing people can do to improve their health is to quit. However, it remains the goal of the Government to maximise the public health opportunities presented by e-cigarettes to reduce smoking. UK-regulated e-cigarettes are far less harmful than smoking, but I reiterate that they are not risk free, which I think plays to the comments made by the hon. Member for Strangford.

Research shows that e-cigarettes are effective in helping some smokers to quit, and therefore we need to support them. We will continue to discourage non-smokers from using them, monitor youth uptake and consider tougher regulatory proposals if we see an increase in youth rates.

There are about 3 million people currently using e-cigarettes in Great Britain. Half of those have quit smoking, which indicates that the other half are using them as part of a strategy. As my right hon. Friend the Member for Clwyd West said, and others have alluded to, it is not a panacea. The UK’s approach to the regulation of e-cigarettes has been, and will remain, pragmatic and evidence based. The current regulatory framework aims to reduce the risk of harm to children, protect against the re-normalisation of tobacco use, provide assurance on safety for users, and provide legal certainty for businesses. We are committed to ensuring that our regulatory framework enables this to continue but does not encourage non-smokers and young people to start taking up the habit.

We made a commitment through the 2017 tobacco control plan to monitor the safety, uptake and impact of the effectiveness of e-cigarettes and other novel nicotine delivery systems—and we have done just that. Public Health England has published a series of evidence reviews which further our understanding of their effectiveness in helping smokers to quit. The latest evidence review was published last month.

In our future tobacco control plan, we will consider further research on other emerging nicotine products that have the potential to help people quit—because there is no such thing as a safe tobacco product and all tobacco is harmful, including smokeless tobacco and other tobacco products that we have discussed today.

No assessment has yet been made of the safety of tobacco-free nicotine pouches. These products are not covered under the tobacco regulatory regulations, but rather the General Product Safety Regulations 2005, and the current numbers are from industry and therefore will need a degree of validation.

There are no plans to go further on snus at the moment because all tobacco products can cause harm. However, we are currently undertaking a post-implementation review on the Tobacco and Related Products Regulations 2016 and this is an opportunity for people to feed in and present new evidence for the Department to consider.

Non-nicotine vapes are regulated under the General Product Safety Regulations 2005, and we will review feedback from the post-implementation review if this area needs to be strengthened, including if the products are a health concern. We have paused a further evidence review due to the impact of covid on resources. However, we are looking for people to come forward, and Public Health England will publish its final evidence review, including a chapter on heated tobacco, later this year. The evidence suggests that these products still pose a risk to users, and, compared with e-cigarettes, we know far less about them. As such, we will be following the principle of ensuring that we have a full evidence base.

Under the Northern Ireland protocol, which the hon. Member for North Antrim referred to, things are in equilibrium at the moment. There is no difference. However, under the protocol, Northern Ireland is required to adhere to the EU’s tobacco products directive. We will work in collaboration with the devolved Administrations on matters that are reserved, and, along with that firm evidence, and in the interests of public health, put that forward.

As part of the regulatory review, the Government are undertaking post-implementation reviews. These will assess whether the regulations are meeting their objectives, and if there are gaps that need to be addressed. We have held a public consultation and we will review the responses.

The UK is a global leader and was very grateful to receive an award from the WHO for being instrumental in helping lower middle-income countries to tackle tobacco use. We are determined to tackle smoking and health inequalities both at home and abroad. We will take targeted action to support communities where rates may remain high. I would like to extend my thanks to hon. Members for debating this important subject.

Question put and agreed to.

HEALTH PROTECTION (CORONAVIRUS) (WEARING OF FACE COVERINGS IN A RELEVANT PLACE AND RESTRICTIONS: ALL TIERS) (ENGLAND) (AMENDMENT) REGULATIONS 2021

Jo Churchill Excerpts

Wednesday 17th March 2021 General Committees

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

I beg to move,

That the Committee has considered the Health Protection (Coronavirus) (Wearing of Face Coverings in a Relevant Place and Restrictions: All Tiers) (England) (Amendment) Regulations 2021 (S.I. 2021, No. 247).

At the outset, I would like to say what a pleasure it is to serve under your chairmanship, Sir Edward. I thank every person and organisation that has mobilised to fight the coronavirus disease. It is not possible to name-check everyone, but I want to single out for thanks those involved in the deployment of the vaccine, including people working in the NHS, social care, primary care and community pharmacies, as well as returned healthcare staff and the Army. I thank scientists, pharmaceutical companies and those running clinical trials for the development of new vaccines, antivirals and all manner of therapies to combat the threat of a mutant virus. Lastly, I thank the general public for continuing to follow the lockdown rules.

The attitude of the public remains resolute, and I appreciate that huge sacrifices are being made by many, but the actions that people are taking now are protecting their families and loved ones, as well as the families and loved ones of others. Our focus remains on the roll-out of the vaccine, the development of a sure-fire system to battle any mutations, and an exit strategy from this dreadful pandemic. Thanks to the incredible efforts of the NHS, medical professionals and volunteers across the country, we are making huge strides in vaccinating the most vulnerable. Over 24 million people had their first dose by 15 March, and everyone eligible in the highest four priority cohorts has been offered their first dose.

I want to update hon. Members on the steps that the Government are taking to ease lockdown restrictions and allow us all to start to reclaim our lives. The “COVID-19 Response—Spring 2021” document provides a road map out of the current lockdown in England. The approach focuses on data, not dates, and each step has a “no earlier than” date five weeks later than the previous step, to allow time to assess the impact of the previous step and provide a week’s notice before the changes occur.

The steps for easing restrictions will be taken at the same time across England in a national approach, in the absence of significant regional disparity. At each step, we will make an assessment against the following four tests: the vaccine deployment programme continues successfully; the evidence shows that vaccines are sufficiently effective in reducing hospitalisations and deaths among those who have been vaccinated; infection rates do not risk a surge in hospitalisations, which would put unsustainable pressure on the NHS; and the assessment of the risk is not fundamentally changed by new variants of concern.

We are here today to discuss the first set of measures, which were introduced on 8 March 2021. The first measures in steps 1 and 1A of the road map were implemented through the Health Protection (Coronavirus) (Wearing of Face Coverings in a Relevant Place and Restrictions: All Tiers) (England) (Amendment) Regulations 2021. These are amending regulations to ease the social contact restrictions in order to permit people to leave home for the purpose of outdoor exercise and to meet another person outside their household. In line with the reopening of schools, they reopen wrap-around childcare to enable parents to go to work or seek work, or to attend educational training, a medical appointment or a support group.

The regulations also amend the all-tiers regulation to ensure that voting in polls on 6 May 2021, and the supporting activities in the weeks preceding the polls, can take place in a way that minimises transmission risk while allowing for meaningful campaigning activity.

The face-covering regulations are amended to make it mandatory for face coverings to be worn in indoor venues used as polling stations, count venues and postal vote opening venues in England. This will apply to poll workers, observers and people casting their votes at polling stations, and to vote counting venues, to ensure that the May elections are observed as safely as possible. That will help safeguard voters, counters and other staff, supporting the elections and ensuring the consistency of rules in indoor settings that are used for local elections.

Furthermore, the regulations facilitate the 2021 census, which will take place on 21 March, by ensuring access digital access to public services from certain closed venues, such as community centres. That will enable people without access to the internet at home to complete their census returns.

Finally, the regulations introduce a requirement for people travelling out of the UK from England to provide their reason for travel on a declaration to travel form. The instrument introduces fixed-penalty notices for failure to comply with those requirements. We must be cautious as we look to ease restrictions. The virus is still prevalent, with significant pressure on the NHS. We have approximately 8,000 patients in UK hospitals as of earlier this week, which is still too high. However, the number of covid patients in hospital has been decreasing since the peak on 18 January 2021, when some 39,000 patients were in hospital.

As noted in the Scientific Advisory Group for Emergencies minutes published on 22 February, the size of the epidemic is reducing, with admissions now falling in all regions and hospital occupancy declining. The measures are also clearly working to reduce transmission. That shows that we are taking the necessary action to help to keep us all safe. The data so far suggests that both the Pfizer-BioNTech and the Oxford-AstraZeneca vaccines are effective against the dominant strains of covid.

The success of the vaccination roll-out, alongside falling infections and hospitalisations, is paving the way for a cautious and gradual lifting of restrictions. Before 29 March, we expect to lay a statutory instrument to replace the previous regulations with new provisions that enable the road map to come into force. It will be for debate and approval by Parliament before the Easter recess. I again pay tribute to the fantastic staff in the NHS and social care sector, who are working tirelessly to protect the vulnerable and save lives. I commend the regulations to the House.

--- Later in debate ---

[Jo Churchill]

I thank the hon. Gentleman for once again laying out some challenges around the timing, and in his speech he articulated very well what the challenge is: he flipped from wanting to look backwards at the same point where he wanted to look forwards several months. I will go through the issues that he raised to the best of my ability. As he said, many are only newly in train; I commit to write to him on the three or four issues that he raised.

Arguably, the point of the road map is that it is a cautious unlocking and a sustainable path out of the lockdown. The devolved Administrations are setting out how it will be eased in Scotland, Wales and Northern Ireland, and we recognise the impact that restrictions thus far have had. I am sure that the hon. Gentleman also would, which is why there is an argument for making sure that things are dealt with at the right speed.

Allowing people to meet one member of another household outside and allowing individuals to gain support for childcare reasons or for finding or attending work must all be positive steps forward. As I said, by taking a cautious approach we are going to protect the NHS and the social care system, making sure that we are on a sustainable footing and that things are iterative.

When it comes to the challenge of timing, we are on a continuum. The SI today covers not only things that have already become available to people, but things in the future. The hon. Gentleman said that there had been 12 months’ notice of the elections being changed, but he would surely agree that we have spoken many times, both in the Chamber and Committee, about how challenging forecasting is. The journey with the covid pandemic has been very iterative. By laying out how we see the elections taking place and by opening up on 8 March and 29 March, we have given a very clear set of instructions about what people can do.

Guidance on elections has been issued by the Minister for the Constitution and Devolution; as the hon. Gentleman knows, the issue does not sit within my portfolio. I am sure that he will make himself aware of that guidance in due course. On polling stations, we have been in contact with local authorities. The hon. Gentleman is right that there is a challenge. There are people who are quite rightly exempt from wearing masks. I think it was the hon. Member for Enfield, Southgate (Bambos Charalambous) who came to me with a constituent of his who finds it very difficult to wear a face mask. We have worked to try to show that there are exemptions, and people who are exempt should not be challenged; they should be allowed to go about their business.

However, there are also those who may enter the polling station having forgotten a mask, so we have been in contact with local authorities. We will provide them with free face masks so that they can enable people to vote safely if it is a matter of the masks having been forgotten. Finally, there will be people not working with us on the regulations, but we should not restrict them from casting their democratic vote. There has to be a balance.

I move on from polling stations. The census is important. The hon. Gentleman said that the Opposition would have done much more, but I would gently say that they did not do those things up to 2010. We are going to do the census because it is important that we understand where people are. As he rightly says, people have changed some of their habits, and people now live and work in different parts of the country. It is important that we have the regular drumbeat of a census.

I am sure that the Minister for Universities will be well aware that there are young people who—with no disrespect to the hon. Gentleman’s household, which I am sure is a happy one—would rather be living in their student digs. She is obviously making more information available on that.

On the declaration of travel forms, as the hon. Gentleman said it is very early. I would also gently say that we would not consider a holiday a suitable reason for travel, so we are not dealing with a proliferation of the forms, but I will write to him, as I will do on point 2 about the ramifications of the rectifications. I will also clarify that for him.

We have introduced a new fixed-penalty notice for failure to complete the declaration of travel forms. Just as the passenger locator form works coming in, there is an element of trust, but in that particular case the carrier is also responsible for ensuring that somebody going on to their onward nation, if that is a red route, goes into a quarantine hotel, and if it is an amber route, has an onward place to go and isolate.

Enforcement agencies will use fixed-penalty notices as a last resort. We will use the “engage, encourage, educate, enforce” approach, because we cannot always guarantee that people have avoided something belligerently; perhaps they were just not aware of the situation. On vaccine passports, I cannot put it better than the hon. Gentleman did. We all await the Chancellor of the Duchy of Lancaster to come back to us on 12 April with more information.

I thank everyone for the sacrifices that each and every one of us has made in our families and in our lives, keeping ourselves and our loved ones and others safe. Our road map reaffirms our commitment to protect citizens of the UK and provide a credible route out of lockdown.

Question put and agreed to.

Resolved,

That the Committee has considered the Health Protection (Coronavirus) (Wearing of Face Coverings in a Relevant Place and Restrictions: All Tiers) (England) (Amendment) Regulations 2021 (S.I. 2021, No. 247).

Ring-fenced Public Health Grant to Local Authorities: 2021-22

Jo Churchill Excerpts

Tuesday 16th March 2021 Written Statements

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

Today l am publishing the public health allocations to local authorities in England for 2021-22.

Funding for local government’s health responsibilities is an essential complement to our plans to invest strongly in both the NHS and social care, and an important element of our commitment to focus on prevention of ill health.

Through the public health grant and the pilot of 100% retained business rate funding for local authorities in Greater Manchester, we are spending £3.324 billion on local authority public health in 2021-22. This includes baselining of local government funding for pre-exposure prophylaxis for HIV.

The 2021-22 grant will continue to be subject to conditions, including a ring-fence requiring local authorities to use the grant exclusively for public health activity. This may include public health challenges arising directly or indirectly from covid-19.

In addition to this baseline funding for public health, we have already announced £80 million for local government funding of drug treatment as part of a wider crime package announced in January 2021, and over £70 million for weight management services through the NHS and local government.

Further, we are providing in total around £10 billion of support for local government in responding to covid-19.

Full details of the public health grants to local authorities can be found on www.gov.uk. This information will be communicated to local authorities in a Local Authority Circular.

Attachments can be viewed online at: http://www. parliament.uk/business/publications/written-questions-answers-statements/written-statement/Commons/2021-03-16/HCWS850.

[HCWS850]

Covid-19: Community Pharmacies

Jo Churchill Excerpts

Thursday 11th March 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Sir Graham. I am incredibly grateful to my hon. Friend the Member for Thurrock (Jackie Doyle-Price), not only for securing the debate today, but for her work as chair of the all-party parliamentary group on pharmacy, and across the health space more generally.

All those who have participated today have shown how important pharmacy is to every one of us. The voices of my hon. Friends the Members for Barrow and Furness (Simon Fell), for Harrogate and Knaresborough (Andrew Jones), for Bolton West (Chris Green), for Carshalton and Wallington (Elliot Colburn), for Henley (John Howell), for Winchester (Steve Brine), for Isle of Wight (Bob Seely) and for Southend West (Sir David Amess) joined those of the hon. Members for Strangford (Jim Shannon), for Birmingham, Selly Oak (Steve McCabe), for Coventry North West (Taiwo Owatemi), for Halifax (Holly Lynch) and for Bootle (Peter Dowd). Everyone recognised how important community pharmacy is in their community, and I want to join in the thanks given to that community today and say how much I value what it does on the frontline. As my hon. Friend the Member for Harrogate and Knaresborough said, pharmacy workers are key, skilled frontline workers and deliver over and above, every day, to our communities. I repeat the thanks of the Prime Minister and the Secretary of State for Health and Social Care, and add my gratitude.

The fact that pharmacy workers are a key part of our NHS family, as my hon. Friend the Member for Thurrock said, and have risen unfailingly to the many, varied and enormous challenges of the pandemic should not go unnoticed. There are 11,210 pharmacies sitting at the heart of our communities. They are easily accessible: 80% of them are within 20 minutes for someone walking there. They are highly rated, as many hon. Members have said, and highly trusted. Throughout the pandemic they have stayed open and served their communities. They have provided vital pharmaceutical services. Medicines are not something that people can choose to have or not have.

I am immensely proud to stand here as the Minister for pharmacy, and I thank everyone involved in community pharmacy for their hard work, whether they talk to patients every day or are involved in the vaccine roll-out or the broader team. From the times I have spoken to them, I know that they are tired. They have worked unbelievably hard for the past year. I do not think that, when this started, anyone anticipated that it would go on week after week. They have been working evenings and weekends, and I would like to thank them for it.

Hon. Members might recall that we agreed a five-year deal back in July 2019, before the pandemic. It commits almost £13 billion to community pharmacy—just under £2.6 billion a year—and was the joint vision of Government, NHS England and the pharmaceutical negotiating committee, the PSNC, for how community pharmacy will support the delivery of the NHS long-term plan, and patients.

As we have heard from many, particularly my hon. Friend the Member for Southend West, there is so much more that pharmacies are saying they want to do for our communities. Having spoken to many pharmacists and their teams, I know that using their full skillset is something they would welcome. It is what they want to do and what they want to see happen.

Over the period of the five-year deal, community pharmacy will be more integrated into the NHS and will deliver more clinical services, taking pressure off other areas in the NHS, as the first port of call for minor illnesses. That recognises, importantly, the skill base in the sector. To that end, more than 2,800 pharmacists each year go into training at the current time; there are more than 10,000 in training at the moment. We are making sure that, as the current cohort come out, they are equipped to be part of that future high-skilled workforce, enhancing their skills for consultation and so on.

[Jim Shannon]

One of the advantages that I am sure the Minister is coming to is that GP surgeries and A&Es will potentially have fewer people to see if the pharmacies take over that role.

[Jo Churchill]

I thank the hon. Gentleman for that point.

We are already making good progress on the journey. The community pharmacist consultation service went live in November 2019, enabling NHS 111 to refer patients into community pharmacies for minor illnesses or the urgent supply of prescribed meds. We have had more than 750,000 referrals so far.

In November 2020, we expanded that service to GP surgeries, so GPs can now formally refer patients to community pharmacies for consultation. In February, we introduced the discharge medicines service, enabling hospitals to refer discharged patients into a community pharmacist for support with their medicines. There will be more services introduced over the financial year.

Those services are to do what pharmacists and their teams do best, and that is to help patients. My hon. Friend the Member for Southend West spoke about hepatitis C. I assure him that, as of last year, we gave access to hepatitis C testing to those pharmacies that chose to take up that option.

I agree with my hon. Friend the Member for Winchester that there is great potential in hub and spoke dispensing. I also agree with the hon. Member for Nottingham North (Alex Norris) that there is already experience to learn from in the sector.

As set out in the community pharmacy contractual framework five-year deal, we want to make dispensing more efficient and, by doing that, free up pharmacist time to provide more clinical services—they are highly skilled, and we know they want to do that. The Medicine and Medical Devices Act 2021 paves the way for us now to progress legislative change to enable the better use of skills in pharmacies, something that several Members this afternoon have alluded to. There is a large amount of will to make sure that the whole team can use their skills appropriately and perhaps free up the pharmacist a little more for him or her to concentrate on other areas.

We have already started informal engagement with stakeholders—that started this week—which will be followed by a formal consultation. I am afraid I cannot give hon. Members an exact date, but I will commit that I want that to be as soon as possible—I want us to get on with this. I thank my hon. Friend the Member for Winchester, who knows the sector extremely well, for his comments about the opportunities that lie therein. I am sure that many hon. Members will want to work to develop that.

New services will develop and expand the role of community pharmacy across three key areas. Several hon. Members alluded to the fact that pharmacies would be expert in helping with prevention, urgent care and medicine safety and optimisation. Those are all areas in which growth is envisaged in the short, medium and longer terms.

That brings us to the pressure. I am well aware of the pressures community pharmacies are under. Not only has the last year brought quite unprecedented circumstances, but it has not allowed some things to go on that we thought would be embedded by this point. Throughout the last year, we have had conversations with community pharmacy and stakeholders, and have tried to respond as best we can by putting in place a package of measures and support for the sector.

Most community pharmacies have been able to access some general covid-19 business support, including various rates reliefs and some retail, leisure and hospitality grants, and we estimate that there has been access to about £82 million in grants. There has been extra funding for bank holiday openings, when—particularly looking back to last Easter, for example—the sector has responded phenomenally by remaining open and giving patients access across long holiday periods; for a medicines delivery service for shielded patients, which has been mentioned and has been hugely appreciated; and for a contribution to ensure that social distancing measures can be in place in every pharmacy.

We are still talking, however. We have provided personal protective equipment free of charge via the PPE portal, and have reimbursed community pharmacies for PPE purchased. We have also provided non-monetary support, such as the removal of some administrative tasks, flexibility around some of the opening hours, support through the pharmacy quality scheme for the sector’s response to covid-19, and the delay to the start of new services, all of which have been requested.

Between April and July 2020, an advance payment of £370 million was made to support community pharmacies with cash-flow pressures, which were extremely acute. Those were caused by several issues, including a sharp increase in prescription items in the March-April period, higher drug prices, delayed payments from the pharmacy quality scheme, and extra covid-related costs. Acting swiftly and providing those advance payments helped to alleviate immediate cash-flow concerns, but since then pharmacies have been paid for the increased items that they have dispensed, reimbursement prices were increased to reflect higher drug prices, and payments have been made under the pharmacy quality scheme.

We are still in discussions with the PSNC about the reimbursement of covid-19 costs incurred by community pharmacy, and I can reassure the House that the Government will take a pragmatic approach. I expect to deduct any agreed funding from the £370 million advance payments, and to discuss timescales around the advance separately with the PSNC, being very mindful of the pressures. We need to assure ourselves that community pharmacies are financially stable. Without that stability, they cannot deliver those services.

I am aware of the concerns that current funding is not enough, and I need to work with the sector to look at things in much more detail, because pharmaceutical services are complex, and there is a range of different providers. The hon. Member for Nottingham North mentioned that he has a Boots in his constituency, but that is a very different operation from many of the individual pharmacists, such as Tim, who has a pharmacy on the harbour in the constituency of the hon. Member for Isle of Wight.

Whether they are independent, small-chain or large-chain pharmacies, no two pharmacies are the same. The solution has to be one that we can tailor. A balanced and considered approach must be taken to maintain the variety and vibrancy that we all recognise as absolutely key in the pharmacy network. People and patients absolutely value the diversity that best suits them and their own needs. We need a sustainable funding model that works for all types.

I have heard the concerns about pharmacy closures, and I can assure Members we monitor the issue very closely indeed. Our data shows that, despite the number of pharmacies reducing since 2016, there are still more than there were 10 years ago. We have seen more closures in deprived areas, as many Members have said. However, importantly, there were more in deprived areas, so making sure that there are still more pharmacies in deprived areas is extremely important.

Proportionally, the closures reflect the spread of pharmacies across England, with closures tending to be where they are clustered. The most recent data shows that three quarters of the closures were part of large chains, and that aligns with consolidation announcements made before the pandemic. It is important that we protect access to pharmaceutical services. The pharmacy access scheme protects access in areas where there are fewer pharmacies and higher health needs so that no area is left without access to a local NHS pharmacy.

It is important to recognise that covid-19 is also an opportunity, which many Members have alluded to. The pandemic has shown across healthcare the value of our highly skilled community pharmacy teams, and how they can contribute and receive more funding. Commissioning community pharmacies to operate the medicines delivery service has been vital to ensure that vulnerable constituents have received their medicine. Community pharmacies have delivered the biggest flu vaccination programme ever, vaccinating more people than ever before.

There are currently around 200 pharmacy-led covid-19 vaccination sites, with a target to double that number by the end of this month, and there have been 60 more this week alone—on many of the questions around vaccines, I will defer to the Minister for Covid Vaccine Deployment. I expect more to follow, and NHS England is looking to designate more pharmacy-led sites, including sites that can deal with up to 400 vaccinations a week in areas where there were not sites that could deal with large quantities of vaccine, which initially put some sites off.

We are considering the important role of community pharmacy and how that can play out in future as we learn to live with covid-19 and having vaccinations. In addition, community pharmacies are taking part in pilots of antigen testing at lateral flow test collection sites. If those are successful, community pharmacies will be able to provide a valuable service to their local area and will be paid to do it.

The community pharmacy continues to be part of local PCNs, and I know it stands ready to take its full part in primary care as we learn to live with the disease. Those examples show how community pharmacy is helping the broader healthcare family fight covid-19. The Government are keen to make better use of the clinical skills, while giving pharmacies opportunities to generate more income above the £2.5 billion per year that the five-year deal went to—and there are opportunities.

Finally, I once again thank my hon. Friend the Member for Thurrock for this important debate. The past year has tested all pharmacies, and the following months will continue to be challenging. I am personally committed to doing everything I can to support all community pharmacies in what I view as their essential role as part of the NHS family, which, again, many have spoken of. This is a responsibility on all of us. Pharmacies bring incredible value to local communities and their patients. We are beginning to see the light at the end of a troubling tunnel, and we would not have made it this far without the contribution from community pharmacy. I look forward to having the conversation to ensure that we get a sustainable funding model not only with colleagues but, mainly, with the sector.

Patients with Heart Failure

Jo Churchill Excerpts

Thursday 11th March 2021 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Mundell. I thank the hon. Member for Strangford (Jim Shannon) for securing the debate, and for his tenacity in waiting a year before we could be here to discuss what is an incredibly important subject. He is right: it is vital that we keep this serious disease on the agenda.

I was interested in the comments from the hon. Member for Birmingham, Selly Oak (Steve McCabe), who was also in the Chamber with us for the last debate, about his own experience in 2012. I am glad to see that he is a living testament to how well people can recover from heart incidents with the right treatment and in the way they live their lives.

Although in recent years we have made enormous progress in understanding more about heart disease, I acknowledge that it remains high on the list of biggest killers in England, and there is still a lot of work to do. I would like the hon. Member for Strangford to extend my good wishes to his constituent Tara, about whom he spoke. Key to improving the quality of life that we want to see for everybody is ensuring that those who are diagnosed younger and who probably do not have the co-morbidities that we have spoken about in others have access to those good services.

We must, in particular, ensure that we intervene earlier, that we have the right care, and that we have the right rehabilitation services and support. I hope to explain what we are doing, and I am more than happy to have further conversations with the hon. Members for Strangford and for Birmingham, Selly Oak in their capacity as chairs of the APPG, and knowing their keen interest in health matters in particular.

I want to extend my thanks to all those on the frontline who have worked so hard, particularly in the area of cardiac services. They did recover, but they have dropped again during this second wave, so we know there is work to do. Heart failure is a key priority for NHS England and Improvement. One ambition in the NHS long-term plan is to raise awareness of the symptoms of heart failure and to ensure early and rapid access to diagnostic tests and treatments. The British Heart Foundation report found that people are still concerned and worried about coming forward, so if anyone is worried about any symptoms, I very much urge them to come forward. The NHS is open and is here to help.

NHSE has a programme of work to support the ambition, overseen by clinical professionals from across the country. It remained a priority during the covid-19 pandemic. We know that cardiac rehabilitation saves lives. It improves the quality of life and reduces, as several Members have said, the hospital admissions that occur when people do not access services. In scaling up and improving the promotion and awareness of cardiac rehabilitation, we aim to improve quality of life and to reduce hospital admissions.

In the long-term plan we set out steps to ensure that by 2028 the proportion of patients accessing cardiac rehabilitation would be among the best in Europe, with 85% of those eligible accessing care. It is a long way from where we are now and will need a lot of hard work in the intervening years. We estimate, however, that this will prevent up to 23,000 premature deaths and 50,000 acute admissions over a 10-year period. NHS England and NHS Improvement is developing cardiac networks that will support the regional delivery of the long-term plan ambitions and address the regional variations in health inequalities that the hon. Member for Strangford alluded to throughout his speech.

The long-term plan also commits to improving rapid access to heart failure nurses so that more patients with heart failure who are not on a cardiology ward can receive specialist care and advice. Better personalised planning for patients will reduce nights spent in hospital and also reduce drugs spend. NHSE is accelerating some of the positive lessons learnt from the pandemic, such as the enhanced use of digital technology for cardiac rehabilitation and the greater application of remote consultations, enabling us to bring forward the delivery of some of the ambitions for patients with heart disease.

NHSE is working with Health Education England to develop a new e-learning for health course, which aims to support healthcare professionals in learning more about heart failure and heart valve disease so that they can better recognise the symptoms of heart failure and diagnose, manage and support patients further. We anticipate this will be made available on digital platforms in late summer this year, so they are working at pace.

We are also establishing community diagnostic hubs to more rapidly diagnose heart failure patients, which will include echocardiograms, blood tests and NT-proBNP testing, making sure that that NT-proBNP testing is available to all general practices.

Hon. Members will be aware that high blood pressure can often be a component factor of heart failure. To increase support for people at greater risk, NHSE plans to increase the number of people who have access to remote blood pressure monitoring and management. The NHS at home programme remains committed to addressing health inequalities, and we have introduced targeted blood pressure monitoring systems for patients who are clinically extremely vulnerable and have high blood pressure, including individuals from black, Asian or ethnic minority backgrounds in areas of high deprivation. We are making sure that we target communities who are worst affected because, as we know, the statistics are often worse in areas that are socially and economically deprived and where health inequalities are greater.

We are also targeting those aged over 65 because age is a large component here. This intervention will allow people to monitor their blood pressure from their home, which is something that we know they prefer, and to avoid trips to their general practice by communicating results to their primary care clinician via a digital platform or, for those who may not have access, a phone call to the practice. From April 2021, a further 198,000 blood pressure monitors will be available for primary care.

The NHS at Home scheme is a self-management scheme to enable patients with heart failure and heart valve disease to look after themselves in their own home. However, they will work with a specialist clinician, and patients will be supported to understand their medications, how to reduce their salt intake, and how to monitor and record their daily weight and blood pressure, as we know that fluid retention is associated with the disease. They will also be helped to recognise—this is really important—symptoms if their condition is deteriorating, so that they seek help in a timely manner. We know that many people wait too long before they reach out for help and services.

Where patients have suffered heart failure, doctors, nurses, the valuable pharmacists who we spent the previous debate talking about, and allied health professionals can provide support to patients in the multidisciplinary teams that the hon. Member for Strangford spoke about. It is anticipated that this will lead to a reduction in hospital admissions and increased quality of life, which is a key component, with better patient and carer knowledge about how to manage their condition. It will also improve primary, community and specialist team communication.

From 1 July 2019, all patients in England have been covered by a primary care network, and the development of the primary care network directed enhanced service for cardiovascular disease prevention and diagnosis is ongoing, with the phased implementation of new PCN services expected in 2021-22. This emphasises the importance of early diagnosis in the management of patients with heart failure and heart valve disease in primary care, in line with the published NICE guidance.

The quality outcomes framework—QOF—is an annual reward and incentive programme for general practice surgeries in England. Although the specific requirements were stepped down in 2021 to release general practice capacity in order to support the pandemic response, I am pleased that the QOF will be returning later in 2021. This will include the updates that were previously agreed to support moves towards earlier diagnosis and management. GP surgeries are asked to capture data in order to evidence that they have fulfilled the QOF requirements, which encourage the earlier confirmation of heart failure diagnosis and improve pharmacological management.

As several Members have said, data is absolutely key in this space for making sure that we know where patients are and that they are being managed. I am pleased to say that this update also means that patients with heart failure can have an annual review in order to enable better management of their care, which goes to the point about making sure there is sufficient contact. NHS England has had sight of the British Heart Foundation report and thanks it for sharing it, and I have been assured that the national medical director has written back on the matters that were included.

I hope that I have demonstrated that the Government, the long-term plan and the workforce have a key ambition to improve the lives and health outcomes of people living with heart failure in this country. Everybody has to play a part, including the individual. As the hon. Member for North Ayrshire and Arran (Patricia Gibson) said, lifestyle plays an important part, so making changes that can help prevent heart failure—healthier eating, reducing salt intake and exercising more—is particularly important. As several hon. Members have said, it is often a disease with comorbidities, and many of those changes will help health overall.

We can all agree that this agenda really matters. Once again, I thank the hon. Member for Strangford for highlighting this important issue. If we continue to make an impact on the lives of people with heart failure, there will be significant benefits for the NHS and, mostly, enormous benefits for those who are affected. To conclude, I say to people that, if they have any of the signs—breathlessness and so on—or any worries at all, they should come forward to seek help.

Healthy Weight Inquiry

Jo Churchill Excerpts

Thursday 4th March 2021 Written Statements

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

Last year, in response to growing numbers across the country living with excess weight and obesity, the Government published our new strategy, “Tackling obesity: empowering adults and children to live healthier lives”. Worryingly, during the covid-19 pandemic, evidence has shown that people with obesity are more likely to be admitted to hospital, to an intensive care unit and, sadly, to die compared to those of a healthy body weight. This is as well as being at a heightened risk of other diseases such as diabetes, heart disease and some cancers.

So today I am delighted to announce that the Government are committing an additional £100 million over 2021-22 to support people living with obesity, to lose weight and maintain a healthier lifestyle.

More than £70 million will be invested in weight management services available through the NHS and local authorities. The funding announced today will mean up to 700,000 adults have access to support that can help them to lose weight, from access to digital apps, weight management groups or individual coaches, to specialist clinical support. This funding will also support GPs and other health professionals to help make weight management an integral part of routine care. It will encourage clinicians to have conversations about weight with their patients and enable them to refer patients to new services.

£30 million will be used to fund a variety of initiatives that will help individuals maintain a healthy weight. This includes providing access to the free NHS 12-week weight loss plan app and continuing the successful Better Health marketing campaign to motivate people to make healthier choices. Some of the funding will go towards improving services and tools to support healthy growth in early years and childhood. This will assist up to 6,000 children, and their families, to grow, develop and maintain a healthier weight whilst providing many more with advice on lifestyle changes to promote a healthy weight.

Evidence suggests that people who have access to structured weight management services are more successful in losing weight than people who try to manage alone. Losing weight reduces the risk of developing diabetes, high blood pressure, heart disease and some cancers. This funding will support a breadth of new services so that people can find an approach that works for them.

I am also very pleased to announce that Sir Keith Mills, who has pioneered reward programmes through Airmiles and Nectar points, has been appointed to advise on developing a new approach, “Fit Miles”, to support people to eat well and move more, using incentives and rewards.

Drawing on a wealth of experience and best practice from around the world, Sir Keith will support the Government to develop and test innovative approaches with public and private partners that use incentives and rewards to help people make healthier choices.

This additional funding will complement other policies announced in last year’s obesity strategy that will change the wider environment and empower people to make the healthier choices. From restricting advertisements for food and drinks high in fat, salt and sugar, banning unhealthy promotions and consulting on alcohol calorie labelling, to requiring large businesses to provide calorie information—these actions are helping us all make healthier choices.

The Department of Health and Social Care is working closely with NHS England and Improvement and Public Health England to ensure this programme of funding helps those who need it most. This funding will support people across the country achieve a healthier lifestyle. The Department of Health and Social Care will provide further detail on this programme of work in the coming weeks and months.

[HCWS823]

Oral Answers to Questions

Jo Churchill Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Yasmin Qureshi (Bolton South East) (Lab)]

What recent discussions he has had with Cabinet colleagues on the adequacy of isolation support for people who have tested positive for covid-19.

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

The Government have put together a range of measures to support people through the current crisis. These include Test and Trace support payments for those on low incomes, support for renters, help with utilities, the £500 million local authority hardship grant, the £170 million covid winter grant scheme and a £7.4 billion package of additional welfare support in 2021. The Government keep all elements of their covid response under review, as is right, to support people.

[Kim Johnson [V]]

I thank the Minister for providing that information, but the lack of financial support to those self-isolating has resulted in an extremely low adherence rate. Seventy per cent. of those who apply for financial support are rejected. Will the Government consider increasing funding to cash-strapped local authorities to ensure that people have the financial means to self-isolate to control the spread of the virus?

[Jo Churchill]

I thank the hon. Lady for her question. We are continuing to work across Departments and with local authorities to monitor the effectiveness of the self-isolation support provided to people who have tested positive, their close contacts and their families. She is right that we continually look at this to ensure that we have the correct information. Currently, with NHS Test and Trace, we are carrying out surveys of reported compliance with self-isolation for people who have tested positive. The results are not published yet, but we have a clear set of parameters and the funding has been allocated to councils to assist with discretionary grants. Those are local decisions, and I have often heard it said that decisions should be local, but I ask her to wait until my right hon. Friend the Chancellor reports during the Budget next week on what additional support we will be giving.

[Imran Hussain [V]]

Last November, I wrote to the Health Secretary to raise a number of serious concerns that have been raised with me by many of my constituents who are unable to claim their self-isolation support payment because of failings with the privately run Test and Trace system. Three months later, I have still not had a response. We all know how keen the Health Secretary is to avoid scrutiny of the contracts that his Department have issued, but he cannot bury his head in the sand and pretend that these problems do not exist. Can I get an assurance from the Minister that I will get a response and that the problems that I have raised will be addressed?

[Jo Churchill]

The Health Secretary has assured me that he has seen the hon. Gentleman’s letter. It is important that people understand that they need to self-isolate and they are given the right assistance. This is why the discretionary payments have been made to councils, so that we can make those decisions locally to support people.

[Mr Speaker]

Let us head up to Bolton, to Yasmin Qureshi. [Interruption.] No, we cannot, so we will go first to shadow Minister Justin Madders.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

The Government’s road map yesterday said:

“While self-isolation is critically important to halting the spread of the disease, it is never easy for those affected.”

We agree with that. We have been making that point for months, along with most of the expert advisers in the Government, which is why creating a scheme that only one in eight people qualify for was never going to work. Will the Minister tell us why, despite yesterday’s announcement, it is still the case that only one in eight people who test positive will actually qualify for a self-isolation payment?

[Jo Churchill]

I thank the hon. Gentleman for his question. It is important that we have targeted support and that we support the people who need assistance, so that they can self-isolate. It is, exactly as I outlined in my first answer, what we have been doing, and as my right hon. Friend the Prime Minister said yesterday, we will continue to look after people through the pandemic. Our undertaking is to make sure that we protect people, whether they are self-isolating or unable to work for other reasons, such as shielding, throughout the duration of the pandemic. The hon. Gentleman will be hearing much more about that from the Chancellor next week during the Budget.

[Mr Speaker]

Let us try Yasmin Qureshi again.

[Yasmin Qureshi [V]]

Thank you, Mr Speaker. My constituent, a shop worker, has a daughter who was sent home from school to isolate. She will not get paid, will not get sick pay and is worried about losing her job. She needs money to put food on the table for her family. Will the Minister tell the Chancellor that we cannot keep the infection rate down if people are not given adequate financial support?

[Jo Churchill]

I thank the hon. Lady for her question. I would also like to point out that, in her area, 93% of cases are being tracked and people are being spoken to, which highlights the great work that is being done on the ground locally in that area. We are providing support, and I would urge her constituent to reach out to the council, because it is important that we give people the support they need in order to isolate. As I say, she will be hearing more on that subject from the Chancellor during the Budget next week.

[Paul Maynard (Blackpool North and Cleveleys) (Con)]

What plans he has to reform the public health improvement functions of Public Health England.

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

We are currently considering the best future arrangements for Public Health England’s important health improvement functions. We have been engaging with key stakeholders throughout the process and will be setting out further details of our approach in due course. We are excited about creating the national institute for health protection to ensure additional capacity so that we have future capability and a laser-like focus on areas of health inequality.

[Paul Maynard [V]]

I very much welcome the plans to reform Public Health England’s health protection functions, and I note with interest the Secretary of State’s new powers of direction in some public areas, such as obesity. Blackpool has some of the most severe public health challenges in the country. Further discussions about the health promotion functions of Public Health England were promised when the NIHP was announced, so can the Minister say now how other areas of public health promotion that are not referred to in the White Paper will be addressed?

[Jo Churchill]

I thank my hon. Friend for his question, and I recognise the challenges that Blackpool faces. I read with interest the Blackpool town prospectus, which highlights the public health challenges, and I am looking forward to talking to the clinical commissioning group lead about them later this week. We remain convinced that place-based approaches will have the best results, where we can target interventions in the right way when they are needed. I think my hon. Friend is alluding to other areas such as work, housing and so on. Discussions are going on with other Departments, but those specific initiatives are for those Departments themselves. As the details of the national institute for health protection are outlined, these things will become clearer. I know my hon. Friend cares deeply about his constituents and their health, and I look forward to working with him and others in the future.

[John Howell (Henley) (Con)]

What steps his Department is taking to reform mental health legislation.

--- Later in debate ---

[John Mc Nally (Falkirk) (SNP)]

What steps his Department is taking to support dental services during the covid-19 pandemic.

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

We are committed to supporting all NHS dental services through the pandemic. NHS practices receive full funding for the first three quarters of the year, minus agreed deductions in England, and NHS dental contractors will continue to be supported while they meet reduced activity targets. NHS England and Public Health England continue to communicate regular updates, enabling practitioners to prioritise urgent care and reduce waiting times in what are challenging circumstances.

[John Mc Nally [V]]

The British Dental Association has raised concerns that punitive financial penalties for not meeting the Government’s unrealistic activity targets are pushing NHS dentists in England to prioritise quick check-ups rather than catching up on the backlog of more time-consuming symptomatic cases. Will the Minister consider a more realistic approach to service recovery and commit to reforming the dental contract in England so as to promote preventive dental care in future?

[Jo Churchill]

As anybody will know, I have been heavily engaged with the dental profession over recent months, because I agree that a preventive approach to dentistry is certainly one that we need to be moving towards. The activity target is expected to increase availability for patients, who are the important part of the equation. It is important that we support the profession but enable patients to have access and reduce waiting times and backlogs. The target is based on careful modelling—on data—and takes into account guidance on infection prevention and control and social distancing measures. We recognise that there may be exceptional circumstances, which is why there are exceptions to the target level. NHS commissioners have the discretion to deal with exceptions and support dental practices. I have a meeting with everyone again on Thursday.

[Mark Pawsey (Rugby) (Con)]

What steps he is taking to ensure that improvement work on district hospitals is taken forward under the health infrastructure plan.

--- Later in debate ---

[Siobhan Baillie (Stroud) (Con)]

What steps his Department is taking to support people suffering from long covid.

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

The Government are working hard to set up patient-focused, evidence-based and effective support for people with long covid. In October, NHS England and NHS Improvement announced a five-part package of measures, including the establishment of 69 multi-disciplinary assessment services. Last week, almost £20 million of research funding was committed to helping identify the causes of long covid and the effective therapies to treat people who suffer from some of the chronic symptoms.

[Siobhan Baillie]

My constituent Emma Samms, the actress, has pulled together a reunion of the cast of “Dynasty” to add some glamour to fundraise for research into long covid. In Gloucestershire, we are also setting up a clinic. We clearly need to learn an awful lot more about the symptoms. Will my hon. Friend join me in praising those initiatives and continue to reassure us that we will provide full support to GPs, hospitals and patients for this awful disease?

[Jo Churchill]

I thank my hon. Friend for her question. I am delighted to join her in congratulating Emma, who I know is using her experience of having had covid to launch such an innovative fundraising idea. I already have a Dallas-style hairdo, because I have not been to the hairdressers for some months. I just need some shoulder pads. I thank her and all volunteers and fundraisers for their marvellous job in coming up with some really great ideas to support research.

[Emma Hardy (Kingston upon Hull West and Hessle) (Lab)]

What steps he is taking to help enable face-to-face family visits to care homes.

--- Later in debate ---

[Mick Whitley (Birkenhead) (Lab)]

What recent assessment he has made of the effect of the covid-19 outbreak on cancer care and treatment.

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

The tremendous efforts of our NHS cancer workforce are helping to ensure that those who need treatment can continue to access it without delay. The NHS has been clear, as have Ministers, since the beginning of the pandemic that continuation of urgent cancer care must be a priority. The NHS has established covid-secure cancer hubs, consolidated surgery, centralised triage to prioritise patients based on clinical need, and utilised the independent sector for capacity.

[Bambos Charalambous]

Staff at North Middlesex University Hospital have done an incredible job under difficult circumstances, delivering cancer care and treatment, but despite that the Government have acknowledged that more than 30,000 people are missing a diagnosis of cancer compared with 2019. With the cancer recovery plan due to expire at the end of March, can the Minister please set out her commitments to beat the backlog after March? How will a renewed cancer recovery plan help meet the ambitions for cancer care set out in the NHS long-term plan?

[Jo Churchill]

I am concerned, like the hon. Gentleman, about those who have not come forward and those who are not currently accessing treatment. I reassure him that once people do come forward, there is a speedy path to treatment. The numbers of those who are entering treatment, both on two weeks and on 31 days, is ahead of what it was at this time last year, and we are seeing enormous efforts from the cancer workforce. I am meeting this afternoon with the all-party parliamentary groups on radiotherapy and on cancer, and we will be discussing the recovery plan, which he is right goes to March. However, every single trust has been given a target to produce a plan for ongoing assessment of how it is addressing the backlog going forward.

[Mick Whitley [V]]

Macmillan Cancer Support estimates that more than 40,000 people are missing a cancer diagnosis across England, including around 60 people in my constituency of Birkenhead. Behind each statistic is a family member and loved one whose prognosis and survival chances are being severely affected by the disruption caused by the pandemic. Can the Minister tell me what additional funding will be made available to ensure that missed cancer diagnoses are caught as soon as possible?

[Jo Churchill]

I thank the hon. Gentleman for his question. The latest official data for December, as I say, suggests that two-week wait GP urgent referrals were 7% higher than for the same month last year, 62-day GP urgent referrals were 6.7% higher, and urgent referrals for cancer were 151% higher than in April, showing the month we were most impacted. As I say, we are straining every sinew to make sure that cancer services not only recover but go on and are better to deliver more care for patients.

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

Going into this pandemic, staff shortages were already causing increased waiting times for cancer treatment. Despite being short-handed, our wonderful NHS cancer staff have done a heroic job maintaining services while fighting this virus, but given the size of the backlog, cancer services will need to go above and beyond pre-pandemic levels for a significant period of time—straining every sinew, as the Minister says. They need extra resources to be able to do so. Next week’s Budget must contain these resources. Has the Minister asked for them?

[Jo Churchill]

Cancer has been prioritised with funding throughout the pandemic. It is, as I say, a key priority. Not only have we invested in radiotherapy equipment to the tune of some £325 million but there is a £160 million initiative to provide covid-friendly cancer treatments that are safer for people. We still have the same objective in the long-term plan to diagnose more cancers early, and appropriate funding, such as the billion pounds targeted at the NHS to drive down cancer backlogs and to ensure that people can access care, is part of that strategy.

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

What estimate he has made of the level of covid-19 vaccination among (a) black and (b) white people in the most vulnerable groups.

Covid Security at UK Borders

Jo Churchill Excerpts

Monday 1st February 2021 Commons Chamber

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

I welcome today’s debate on a matter that is rightly of huge public interest. As the hon. Member for Torfaen (Nick Thomas-Symonds) said, we have had a challenging time, but I know that everybody across the House will be cheered by the news of the vaccines, and the number rolled out over the weekend—nearly 1 million, at 931,204—is quite staggering. As of today, over 9.2 million people have now received the jab, and every elderly care home resident in England has been offered the vaccine. The roll-out will accelerate in the coming months, and with the combined news that the UK today has secured another 40 million extra doses of the Valneva vaccine, in addition to the 60 million we already had on order—taking our national total to over 400 million vaccine doses—we know that, with each jab, we have clearly moved that step closer to the more normal life that people crave. It is our strong vaccine portfolio that offers great hope not only to the people of this country, but across the world, because unless we are all safe, no one is safe.

As hon. Members recognise, however, the challenges posed by covid-19 are still here today and we must continue to make the difficult decisions to protect the whole population. There is no question but that new variants pose new threats—threats that we must overcome to protect the progress of the vaccine programme and, of course, to protect the sacrifices that everybody has been making for many months now. It has meant that we have had to take tough action at our borders, which we have done. Earlier in the pandemic, border restrictions were about stopping the onward transmission of infections from countries with higher infection rates, but the new variants from abroad pose a different and new set of risks, and we do not yet have a full picture of those risks.

Of particular concern is a risk of having a variant that escapes the vaccine. We have a high degree of confidence in the vaccines, and confidence that the vaccine will work against the variant that was first identified in the UK, but we have also begun studies on the variants that were first identified in South Africa and Brazil in four laboratories. We will continue to work with our scientists and the UK vaccines taskforce to understand how quickly a new vaccine could be rolled out if needed.

We have also launched our new variant assessment platform, working in partnership with the World Health Organisation, which offers genomic expertise— something we lead in—to help other countries across the world, because, as I have said, we are only safe when everyone is safe. Much of what the hon. Member for Torfaen suggested sounded a little like he wanted to shut down against the entire world. Only a few months back, he, the hon. Members for Oldham West and Royton (Jim McMahon) and for Wigan (Lisa Nandy) and the right hon. and learned Member for Holborn and St Pancras (Keir Starmer) asked us when we were going to lessen quarantine. We have to have a flexible programme, where we build a response.

[Nick Thomas-Symonds]

I am very grateful to the hon. Lady for giving way on that point, because it is absolutely right that I mentioned the blunt tool of a 14-day quarantine back in June last year. That was because the Government did not have their own test, trace and isolate system up and running to avoid the blunt tool of a 14-day quarantine. The point was about the failure of the Government, not the inconsistency of the Opposition’s position.

[Jo Churchill]

As with all science, we are learning more but, as we do, we must continue to do all we can to protect this country.

It is right that new border restrictions are tougher. On 18 January, the UK temporarily closed all travel corridors and added a requirement for anyone coming to this country to have proof of a negative covid test taken in the 72 hours prior to departure. All travellers have had to complete a passenger locator form, which must be checked before they board and then self-isolate on arrival for 10 days. Our stay-at-home regulations are clear: it is illegal to leave home to travel abroad for leisure purposes. Going on holiday is not a valid reason for travel.

We have also banned all direct travel from over 30 countries where there is a risk of known variants, including southern Africa, South America and Portugal. This is a ban on entry for all arrivals, except British, Irish and third country nationals with resident rights in the UK, who have been in the travel ban countries in the past 10 days. But as the Prime Minister said on 27 January, we must not be afraid to go further if necessary, and on the 27th, my right hon. Friend the Home Secretary outlined the further steps that we have been compelled to take, and I will lay them out.

With regard to those entering the UK, first, the police have stepped up checks and are carrying out more physical checks at addresses to make sure that people are self-isolating. Secondly, we are continuing to refuse entry to non-UK residents from the countries already subject to the UK travel ban. Thirdly, we are introducing a new managed isolation process in hotels for those who cannot be refused entry, including those arriving home from countries where we have already imposed international travel bans. They will be required to isolate for 10 days, with very few exceptions and only where strictly necessary.

With regard to those travelling out of the UK, first, we have increased our enforcement of the existing rules, because people should be staying at home unless they have a valid reason to leave. We will introduce a requirement for people to declare their reason to travel, which will be checked by carriers prior to departure and again at the border. Secondly, we are increasing police presence at airports and ports, and those without a valid reason for travel will be turned around and sent home or face a fine. Thirdly, this week we are again reviewing the list of exemptions from isolation so that only the most important and exceptional reasons are included. I am clear that our approach must be firm but flexible, and not the one-size-fits-all approach advocated by the hon. Member for Torfaen.

[Yvette Cooper (Normanton, Pontefract and Castleford) (Lab)]

The Minister referred to police checks. The data published last week showed that, when the police are doing these very minimal checks at the moment, if they find that nobody is home—so clearly nobody is self-isolating at that address—they take no further enforcement action at all. Does she not think that is crazy?

[Jo Churchill]

And that is why we are working as quickly as possible across Government and using everything at our disposal to ensure that we have an efficient method of ensuring that people are doing what the vast majority are doing. We not only have the police stepping up; we also have the isolation assurance service. The number of people sampled per day for calls is 1,500 out of those who arrive. We make a total of 3,000 IAS calls a day and send another 10,000 texts. These are repeated contacts with individuals, and it is a considerably different picture now from the one that may have been the case back in the middle of last summer. As I say, we have started, and this is a flexible, firm approach that can be stepped up and down.

The hon. Member for Torfaen spoke about a blanket ban across all countries and for all things, but actually, with regard to making sure we are safe, it must be firm and flexible so that we can ensure not only that we keep ourselves safe in this country but, as the pandemic takes its course, that we can respond appropriately. This blanket ban from all countries that he is talking about—

[Jim McMahon (Oldham West and Royton) (Lab/Co-op)]

It’s not a ban; it’s a quarantine.

[Jo Churchill]

I apologise—the hon. Member for Torfaen is talking about a blanket quarantine from all countries. He mentioned an exemption for hauliers. What about other exemptions? What about elite sport, or medical emergencies, or the plethora of other issues, particularly around security, which I know he is extremely exercised about? He also knows, as I do, that there are specific minute details that this blanket ban—

[Nick Thomas-Symonds]

Of course we would need exceptions, but surely the Minister must agree that the starting point has to be a comprehensive position, and that that is what will secure our borders.

[Jo Churchill]

No, the right point is to work as quickly as possible across all the different Government Departments that are involved to ensure that we have the correct policy so that we are doing the appropriate thing, rather than having a blanket ban and then repeatedly coming back and saying, “What about this. What about that?” We need to ensure that we have an appropriate system that has been reviewed and thoroughly looked at by all the different Departments involved—the Home Office, the Department of Health and Social Care, the Department for Transport, the Cabinet Office and others—so that everybody has made sure that there are no gaps in the system.

This is not just about what the Government are doing; it about what we are all doing. In so many ways, our efforts begin not at the border but at home, with the actions we take to stay at home. The hon. Gentleman spoke of how we can protect the NHS in order to save lives, and in that respect every one of us plays a vital role in driving the rates of the virus down and denying it the opportunity to mutate and give rise to new variants.

As we take the necessary steps at the border, we recognise the challenges they present to industry. We continue to support our air transport sector, including airlines, airports and related services, and by the end of April the sector will have received some £3 billion of support through the covid corporate finance scheme and the job retention scheme. I am sure the Under-Secretary of State for Transport, my hon. Friend the Member for Witney (Robert Courts) will talk more about this, but last Friday we launched our airport and ground operations support scheme, which will support eligible businesses through this difficult time, with airports and ground handlers in England eligible to receive up to £8 million each. That will help them to continue to prepare for a future when international travel is ready to take off again, because we must have a system that fits our playing our part in the world.

It sounds to me that by working out a policy that expects quarantine from everyone, far from looking at ourselves and far from being outward looking, Labour is proposing that we close our doors. That cannot be right if we are all going to walk together and beat this virus. I want to reflect that the Government and indeed the whole country take pride in our being global Britain, a place with a history and culture of being open, outward looking and supportive. Even as we are compelled to take tougher steps at our borders, that spirit lives on, through our leading role in COVAX, boosting global access to covid-19 vaccines; through our new variant assessment platform, bringing British expertise to the world; and through that vast, powerful network of medical and scientific communities collaborating on a worldwide scale so that we can overcome this global challenge. The hon. Member for Torfaen and I agree that medical science can bring so much to helping people in this country .We have spoken about it before, but actually the challenge is bigger now and if we are to meet that challenge, we must remain open and outward looking, while having a proportionate and measured approach to ensuring that the right restrictions are in place for people quarantining.

Finally, even though the perilous situation we face today means we must put so much of our international travel on hold, there is no brake on our ambition to help the world become safer or to do what is our first duty: to safeguard public health, protect the NHS and keep people safe here at home.

[Mr Deputy Speaker (Mr Nigel Evans)]

Before I call Stuart C. McDonald, let me remind everybody who follows him that there is a three-minute limit on contributions. For those who are delivering theirs outside this place, there is a clock in the bottom right corner of their monitor or device. Please could you keep one eye on that, so that you are not going to be cut off. For everyone who makes a contribution in the Chamber, the usual clocks will be in use.

Medicines and Medical Devices Bill

Jo Churchill Excerpts

Consideration of Lords amendments & Ping Pong & Ping Pong: House of Commons
Wednesday 27th January 2021 Commons Chamber

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

I beg to move, That this House agrees with Lords amendment 1.

[Madam Deputy Speaker (Dame Rosie Winterton)]

With this it will be convenient to discuss the following:

Government motion to disagree with Lords amendment 2.

Government motion to disagree with Lords amendment 3.

Lords amendments 4 to 10.

Lords amendment 11, and Government amendments (a) to (d) thereto.

Government motion to disagree with Lords amendment 12.

Government motion to disagree with Lords amendment 13.

Government motion to disagree with Lords amendment 14.

Lords amendments 15 to 21.

Lords amendment 22, and Government amendments (a) to (c) thereto.

Government motion to disagree with Lords amendment 23.

Government motion to disagree with Lords amendment 24.

Government motion to disagree with Lords amendment 25.

Lords amendments 26 to 29.

Government motion to disagree with Lords amendments 30 and 31.

Lords amendment 32, and Government amendments (a) to (c) thereto.

Lords amendments 33 to 39.

Government motion to disagree with Lords amendment 40.

Lords amendments 41 to 47.

Government motion to disagree with Lords amendment 48.

Government motion to disagree with Lords amendment 49.

Government motion to disagree with Lords amendment 50.

Government amendments (a) to (c) in lieu of Lords amendments 2, 3, 12 to 14, 23 to 25, 30, 40 and 48 to 50.

Lords amendments 51 to 56.

[Jo Churchill]

I am extremely pleased to be back at the Dispatch Box to speak to this Bill. It is a changed Bill since we last looked at it but one that still has the patient at its heart. I am pleased that it comes back to us with the same spirit of consensus and collaboration that it left us with.

Since we had the Bill’s Third Reading, the pandemic’s evolution and the importance of the regulation of clinical trials, the roll-out and regulatory approval of a vaccine, and the ability of healthcare professionals to get medicines into patients has bought into sharp focus precisely how essential this Bill is. The Government made a number of amendments to the Bill through the other place in response to Committees of the House, the report of the independent medicines and medical devices review, led by Baroness Cumberlege, and, importantly, as a result of genuine, cross-party discussions on how to make this Bill better.

I am glad to say that the Bill still—and for those who know me, this is my passion—puts patients first: patients who will have the opportunity to trial new treatments; patients whose safety is paramount; patients who need to see quick and effective action from regulators in the event of an emergency. The Bill that left us on Report had a new change to it, anticipating Baroness Cumberlege’s report. The medical device information system, which will transform post-market surveillance of medical devices and improve the ability to track down patients and prevent harm, followed talks across this House and in the other place. I reiterate my thanks in particular to the hon. Members for Washington and Sunderland West (Mrs Hodgson) and for Central Ayrshire (Dr Whitford) for their contributions to that effort.

We said on Report that we awaited the conclusions of the Cumberlege review and that we would take steps when the review was published. I can tell the House now that we have, and Lords amendment 1 establishes a Patient Safety Commissioner—a champion for patients in relation to medicines and medical devices. I pay tribute to all those who have spoken here and in the other place of the impact of harm on patients and on women—those who have not been listened to whose stories are difficult and heart-wrenching. Much was said during the Bill’s passage in the other place about the whole system change to enshrine the voice of patients at the heart of the process and our commitment to it. The Patient Safety Commissioner will act within and outside the system. They will be an advocate for patients and ensure that the patient voice is primary. The commissioner will be able to seek information, make reports without fear or favour and expect responses, and, more importantly, get change.

Lords amendments 1, 41, 47, 54 and 56 together provide for both the appointment of a Patient Safety Commissioner and regulations to support this appointment. I congratulate Baroness Cumberlege and her team, and thank her and others who contributed to getting this into the Bill so quickly after her report.

Lords amendment 31 provides for a small but important change that was also recommended in that review: a power to put the devices expert advisory committee on to a legislative footing.

I am very conscious of the passion and commitment shown by the hon. Member for St Helens South and Whiston (Ms Rimmer) when we were last discussing the Bill. She has shown admirable determination. I am pleased to draw her attention to Lords amendment 8, which the Government were happy to support in the other place. That important amendment provides for provisions about the origin and treatment to be made in relation to the regulation of human medicines.

We have had two reports, one from the Delegated Powers and Regulatory Reform Committee and one from the House of Lords Constitution Committee.

--- Later in debate ---

[Jo Churchill]

When taking a Bill through the House, we always hope that it will be one that hon. Members from both sides can understand, support and improve. Our intention to have a gold standard of medicines and medical device regulation in this country, and to put the patient at the heart of it, has been long understood and has very much formed the foundation stone of the Bill.

I am very grateful for the support of hon. Members here; the spirit of collaboration is how we get this Bill done now—today. I would like to address one or two of the questions that hon. Members brought up. I reiterate my thanks to the hon. Member for Nottingham North (Alex Norris). He was right when he said that the timing of the Cumberlege report was fortuitous. In this House, we have been able to make sure that patient safety has been addressed. He was also right to say that it was a collective effort, and he and other Members were right in saying that the Bill very much reflects the voice of campaigners who often feel that their voices go unheard. Today, they have not gone unheard.

[Mark Tami]

May I also mention the former Member for Pontypridd, Owen Smith, who is no longer in the House? He set up the all-party parliamentary group on surgical mesh implants, which did so much work to highlight this issue.

[Jo Churchill]

Indeed.

This has been a long time coming, and Members from both this House and the other place have been involved. I pay particular tribute to Janet Peck and Susan Morgan, the constituents of my hon. Friend the Member for Totnes (Anthony Mangnall), and their quiet determination to make sure that their challenges were seen and noticed. The Government then took the right decisions in helping them make sure that this does not happen to others. That was the right thing to do.

The hon. Member for Nottingham North asked me to address two or three points. We plan to respond in full to the report later in 2021. It has been incredibly impactful and has already served to put patient safety at the top of the agenda for the whole health and care system. If it had not been for the covid-19 pandemic, I think we would be discussing little else than patient safety because of the Bill before us. Just as covid-19 impacted on the publication of the report, it has impacted our response time. But I assure the hon. Gentleman that that response will come later in the year.

The hon. Gentleman also asked about the speed of the appointment of a patient safety commissioner. I very much want the right person. I cannot give a precise time, but I want to underscore the importance of patient safety and our belief that the patient safety commissioner will and must be effective in amplifying the voice of patients and improving patient safety in the use of medicines and medical devices. I hope that the process will not take too long, but we must appoint the right person, who will truly give the right voice.

On hub and spoke, which the hon. Gentleman and I both agree is so important, there will be a full public consultation. The Government will then report to Parliament, and include a summary of the concerns raised in the public consultation. To ensure that we get the right model to assist pharmacy going forward, we intend to be totally transparent.

To the hon. Member for Strangford (Jim Shannon), I can give an unequivocal yes. We have a thriving life science sector in the UK, contributing over £80 billion a year to the economy and over a quarter of a million jobs. We want to ensure that the UK remains an important market for medicines and medical devices, and to bring products to market here.

As I close, it is perhaps unusual to be pleased that there have been quite so many changes or challenges on a Bill, but I think they have been the right changes and the right challenges. To that end, I thank all hon. Members who have challenged and who have assisted in those changes. I also thank all those who have assisted behind the scenes—the Bill team, my officials and so on. We have arrived at a Bill that I think carries the support of all sides and of both ends of the Parliament, and one where patients, the sector and the public can understand how we do good work and how this Bill will work for them.

Lords amendment 1 agreed to, with Commons financial privileges waived.

Lords amendments 2 and 3 disagreed to.

Lords amendments 4 to 10 agreed to.

Government amendments (a) to (d) made to Lords amendment 11.

Lords amendment 11, as amended, agreed to.

Lords amendments 12 to 14 disagreed to.

Lords amendments 15 to 21 agreed to.

Government amendments (a) to (c) made to Lords amendment 22.

Lords amendment 22, as amended, agreed to.

Lords amendments 23 to 25 disagreed to.

Lords amendments 26 to 29 agreed to.

Lords amendment 30 disagreed to.

Lords amendment 31 agreed to.

Government amendments (a) to (c) made to Lords amendment 32.

Lords amendment 32, as amended, agreed to.

Lords amendments 33 to 39 agreed to.

Lords amendment 40 disagreed to.

Lords amendments 41 to 47 agreed to.

Lords amendments 48 to 50 disagreed to.

Government amendments (a) to (c) made in lieu of Lords amendments 2, 3, 12 to 14, 23 to 25, 30, 40 and 48 to 50.

Lords amendments 51 to 56 agreed to, with Commons financial privileges waived in respect of Lords amendment 54.