Health Protection (Coronavirus, Restrictions) (England) (No.3) Regulations 2020
Jo Churchill Excerpts(3 years, 7 months ago)
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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, Restrictions) (England) (No. 3) Regulations 2020 (S.I. 2020, No. 750).
It is a pleasure to serve under your chairmanship, Ms Ali, for what I believe is your first time in the Chair.
The regulations we are discussing came into force on 18 July. They were necessary to give effect to the announcement made on 3 July by my right hon. Friend the Prime Minister, setting out the Government’s goal to enable as many people as possible to live their lives as normally and as safely as possible. To achieve that, the Prime Minister set out the need to move away from blanket national measures towards targeted local measures.
I am aware that there are concerns in Parliament about allowing for timely scrutiny of regulations that have been laid and made in response to the public health emergency caused by coronavirus—in particular about the timing of debates—as I am sure I will hear again from the hon. Member for Ellesmere Port and Neston. We have listened to those concerns and have endeavoured to hold this debate as early as possible after laying the regulations, taking the summer recess into account.
Three main activities are being undertaken to support the shift in focus to managing localised outbreaks through proportionate local responses. First, local authorities have now drafted local outbreak management plans, which set out how they will deal with outbreaks in their local areas. Secondly, we have published the contain framework, which sets out national expectations about how and when upper-tier local authorities should take community protection actions to manage the transmission of covid-19. Thirdly, open businesses and venues have been asked to assist the NHS test and trace service by keeping a temporary 21-day record of their customers and visitors, which will help to contain outbreaks.
Local authorities have specific legal powers under existing public health, environmental health and health and safety laws. Those powers apply under a patchwork of triggers or, in some cases, require an application to the magistrate, which obviously leads to some delay before they can be enforced. They are not sufficient to enable local authorities to implement fully the community protections set out in the contain framework, or to do so with the speed needed to manage an outbreak effectively.
Although we expect local authorities to work on the basis of consent within local communities, there may none the less be situations in which local restrictive measures need to be put in place to contain the virus. We want to ensure that a uniform and sufficient suite of powers exists to enable local decision makers to take action locally and promptly, enabling the mitigation of local covid-19 outbreaks through a new and consistent set of regulations.
The Government’s ambition is to empower upper-tier local authorities to be able to implement targeted restrictions so that the need for the Government to impose more serious restrictions is reduced. Before these local intervention regulations came into force, local authorities did not have the power to impose fully the community protection actions set out in the contain framework. As a result, we introduced the regulations to enable local decision makers to take prompt and appropriate action.
The powers in the regulations are exercisable by upper-tier local authorities in England. A local authority may give directions imposing prohibitions, requirements or restrictions: in regulation 4, relating to individual premises; in regulation 5, to events; and in regulation 6, to outdoor public places. Before giving a direction, the local authority must deem that there is a serious and imminent threat to public health, and that giving direction is necessary and proportionate to control the incidence or further spread of coronavirus. In determining that, the local authority must pay due regard to any advice from its director of public health. Local authorities are supported in their decision making by guidance published alongside the regulations.
As Secretary of State, my right hon. Friend has the power to direct a local authority to use its powers under the regulations where he considers that the same criteria are met. Before doing so, he is required to consult with the chief medical officer or one of the deputy chief medical officers of the Department of Health and Social Care. To date, we have not had cause to issue such a direction to a local authority, but we have seen authorities moving swiftly to use their powers to protect their local populations.
There is a mandatory requirement for local authorities to review the continuing need for any directions given under these regulations every seven days. The regulations require that if, following the review, the local authority considers that any of the legal criteria to give the direction are no longer met, that local authority must revoke the direction and either not replace it, or replace it with a direction that does meet the necessary conditions. A similar duty applies to the Secretary of State, who must direct the local authority to revoke the direction if he considers that the restriction or requirement is no longer necessary. If my right hon. Friend directs a local authority to impose a direction, it is still for the local authority to terminate.
A local authority must notify the Secretary of State as soon as reasonably practicable once it has given a direction under these regulations. To date, 61 such notifications have been received from 23 different local authorities. To manage cross-boundary impacts, the local authority must also provide neighbouring authorities with notice when these powers are exercised. Neighbouring authorities are required to consider whether they should also implement any measures under their own powers. If a local authority decides to give a direction, it must publish that direction in writing and provide it in writing to any person named in the direction. The local authority must also take reasonable steps to give advance notice to specified types of person when making each type of direction, and ensure that the direction is brought to their attention.
The regulations permit someone affected by the direction to appeal to a magistrates court or make representations to the Secretary of State. If the Secretary of State determines that the local authority should have exercised its powers in a different way, having regard to the required conditions, he will direct the local authority in question to amend. To date, one individual has made representations to the Secretary of State, who upheld the direction given by the local authority.
The enforcement regime is broadly based on the provisions set out in the national regulations. This includes the prohibition notices for businesses or fixed penalty notices issued by local authority or other officers if a direction is breached, or for obstruction of police or local authority officers. There is a ladder regime of increasing fines for each FPN, from £100 to £3,200. That ladder takes into account FPNs issued under other national and regional lockdown regulations.
Police will also have the power to direct an event that contravenes directions to stop, and to direct people to leave, or remove people from a relevant area if need be. With regard to public outdoor places, the police will have the power to take action when it is necessary to do so. This includes directing a person to leave a restricted area, or removing them if need be. Offences are created for breaching a direction, obstructing a police or local authority officer, and failing to comply with a reasonable instruction or prohibition notice given under the regulations. Offences are punishable on a summary conviction by a fine. These regulations have their own six-month sunset clause, separate from all other regulations, and so will expire at the end of 17 January 2021.
Where are we now? Coronavirus is the biggest challenge that the UK has faced in decades. The resilience and fortitude of the British people in complying with the national lockdown that was introduced in March has been a truly national effort, and something we can all be proud of. It is, of course, welcome that we have been able to start easing the national restrictions in line with the road map, reflecting the continued decline in daily death rates and the downgrading of the covid alert level from 4 to 3. But we always knew that in reality the path out of lockdown would not be entirely smooth. It was likely that infection would rise in particular areas and workplaces, which we have seen, and we would need to be able to respond quickly and flexibly to those outbreaks.
We are now working closely with local authorities and at a national level to ensure we have the data and analytical capability to spot potential outbreaks quickly. We have and will continue to develop a range of tools and powers that will allow us to respond effectively and proportionately. These regulations have demonstrated our willingness to empower local authorities and take action where needed.
I am really grateful to all parliamentarians for their continuing engagement in this challenging process and their valuable scrutiny of the regulations. I commend the regulations to the Committee.
Jo Churchill
I thank in particular the hon. Member for Ellesmere Port and Neston and my hon. Friend the Member for Windsor, who have shown, in very different ways, exactly why the regulations are needed and how well they are working. Where people are talking together and using the information that is getting to the frontline, they are now able to respond and to act quickly.
In the initial stages, we were keen to have a national approach to protect the NHS, in order that we could then start to move the policy forward. That is what we have done by enabling the local authorities, Mayors and so on to talk together so that they—as both hon. Members alluded to—may deal with their local communities. They know their local communities best, and that has come across clearly.
I am sure that the hon. Member for Ellesmere Port and Neston will forgive me, but I will trot through as many of his points as I can remember that have a vague relevance to the regulations that we are discussing today. He will forgive me, perhaps, for not going off at a complete tangent and following him down the various paths on which he wished to take us. However, I thank him for his contribution.
The regulations are necessary, and they are important for three reasons. First, and most importantly, they empower local authorities to protect people in their area from this terrible virus. Giving directions is a difficult decision for local authorities to take, but they are in the best place to know the right interventions to impose in order to stop the virus spreading locally unchecked. They are often using the regulations as a warning shot and, in answer to my hon. Friend the Member for Windsor, they give the local authorities the power to be a little more attuned. We have seen that very much in Leicester: two particular roads appeared to be flouting the rules, and those two roads were targeted in a specific way, enabling the locality to respond to the challenge much more effectively.
Secondly, giving those powers to local authorities is important because they protect those of us who do not live in those areas. As a result of local interventions, outbreaks can be prevented or contained locally, stopping infection from spreading elsewhere, which is significant.
Thirdly, enabling local authorities to introduce these restrictions shows our absolute determination to respond to outbreaks of the virus in a focused way. As I have said, we will learn from the use of these powers as local authorities give directions for preventing transmission and respond to localised outbreaks.
These regulations are made under the Public Health (Control of Disease) Act 1984, which sets out a framework for health protection that requires much of the detailed provision to be delivered through these regulations. The regulations enable local authorities to impose targeted local measures to prevent and control outbreaks in their area. However, occasionally there has still been the need for the Government to impose more serious restrictions, as we have seen in Leicester and parts of the north of England, in what are often referred to as local lockdowns. If the possibility of imposing more serious interventions is being considered, local leaders, chief executives and the directors of public health are consulted by the NHS test and trace team, Public Health England and the joint biosecurity centre, to inform that decision making and to be consulted on it.
Today’s debate has provided an opportunity for hon. Members to debate the range of activities that the Government have undertaken in response to coronavirus. Moving to the specific points raised by the hon. Member for Ellesmere Port and Neston, we always said that there would be local outbreaks that would require local action, so I do not think that what we are doing in these regulations should come as any surprise. Will it cause confusion? Local authorities can already close premises for various reasons, such as environmental health reasons, so I do not think that it is unusual in our current environment for people to expect changes to come quite fluidly.
It is really important that we are able to act quickly and stop local outbreaks, and this is the right approach. To enable local authorities to have the power to do so, we have made another £300 million available to them to develop their plans. As we have heard, those plans are working, and as the hon. Gentleman himself said, they are very important in making sure that any action is attuned to the local area. That money is on top of the £3.7 billion provided to local authorities to support the response to the pandemic.
The hon. Gentleman asked whether the Secretary of State heard about things in good order; he hears as soon as is reasonably practicable about where these directions have been laid. As yet, however, we do not have any data on the fines or the fixed penalty notices; we will have it quite soon, when these regulations have been laid. That question made me smile wryly, because the summer recess was between the dates. Therefore, although six weeks have passed, there have been only a handful of parliamentary sitting days, so I think we have got on to things as speedily as possible.
An impact assessment is not required for regulations that last for less than a year, and these regulations are due to expire in less than a year, so there is no such requirement. In the other place, Baroness Thornton asked a similar question about how data was being used. Data is key to the scientific community, so that scientists can be availed of it to fight covid-19. At the start of this pandemic, only six short months ago, we had very little data. Now, as we have heard, we have the ability to drill down even to a postcode level, to know where somebody who may have had a positive test is. That data is now at our fingertips.
As of today, we have the capacity to do 357,873 tests. Although I would freely say that, yes, some of those tests are challenging, 84.3% of people taking tests have their results the next day, and over 42.2% of people taking home tests get their results within 48 hours. Some 16 million tests have been done in this country, and that has been built from a standing start. I pay tribute to Public Health England and others; it has been a broad coalition of the NHS, public health and private industry that has allowed us to do this amazing job.
Justin Madders
On the question of tests, the Minister gave the figure of some 375,000 capacity—
Justin Madders
The Minister will be aware that the number of tests processed each day is somewhere between 150,000 and 200,000. In the context of hearing about people’s problems with accessing tests, where does she think the issue is in getting that capacity to the right places?
Jo Churchill
I will briefly explain, in 30 seconds. We have always said that we would go to where the problem arose, so it is right and proper that where we have an issue of rising prevalence, we will take our mobile testing centres there. We have 73 regional centres, 21 satellite centres, 236 mobile centres and 72 walk-through centres. Ensuring that we can be fluid in our approach and that we get to those places where we see a rise in numbers is, in my opinion, the right approach. Do we have more to do? Yes, we do, but I think we can proudly say that we are hitting numbers that are now ahead of many other countries in Europe and across the world, and showing that we are building a world-class system that can help to protect people.
The argument is that we need more testing, we need to be able to trace and we need to build that capacity. That is why we have recruited another 18,000 into Public Health England, to back up that effort to test and trace. Supporting the local authorities, we have contact tracing, the daily situational report, the daily exceedance report and the daily surveillance reports, so that we can help people to get the granular information that helps them to target their local area.
As I said, an impact assessment is not required for regulations that last for less than a year, and these regulations will expire in six months. However, the Government are considering the economic impact of the regulations on businesses and individuals—that was another question the hon. Member for Ellesmere Port and Neston asked—and the personal impact on those with protected characteristics; on people’s mental health and wellbeing; on religious groups and many others. This is a highly complex situation that we are dealing with.
The dashboards for local authorities are updated daily with all the data received to midnight the previous day. We are ensuring that all local and public health bodies have the data they need for any plans they might be making for preparedness for potential outbreaks, and we produce detailed data in dashboards for local authorities to give them clarity regarding their local area.
We have started sharing that postcode-level testing and case data with local authorities, and it is available to them at any time. It is important that we send the positive message that, while this is work in progress, we are doing more and more each week to help them to get more information, because that is vital for unlocking the economy and opening our lives up as far as we can in this covid-tinged world that we are all having to get used to.
The Department for Education has published full guidance on the protective measures for schools, colleges and childcare settings, which should help to minimise risk. The guidance includes the PHE-endorsed system of controls that helps settings to implement those measures in order to prevent and control any infection. Those are outlined more explicitly in DFE guidance.
We have agreed to provide a monthly report to Parliament detailing the measures imposed by local authorities and Ministers under these powers, and will shortly be making a written ministerial statement setting out the record of the notifications received, which will be deposited in the House Library. The Secretary of State comes to the Dispatch Box to answer questions more than, I think, any other Secretary of State, and I am sure that when he next does so, the hon. Member for Ellesmere Port and Neston will have ample opportunity to ask his questions.
However, as of 2 September, the Secretary of State had been notified of the 61 directions that had been given by the 23 local authorities to which I alluded earlier. Examples of those directions given by local authorities include closing a funfair due to be held in an area where there was a high incidence of the virus; closing a large entertainment venue for failing to ensure social distancing measures were in place, or complied with by visitors; imposing restrictions on the organiser of a large social event to ensure guests complied with social distancing guidance; controlling people gathering in a street outside restaurants—trying to ensure people stay physically distanced while waiting to go inside areas is, of course, very important too—and prohibiting a planned food festival where in excess of 8,000 visitors were expected.
The extent of the powers means that local authorities can give directions, but they are not always necessary. For example, local authorities do not need any further powers to close nightclubs, as they can already be closed under the England-wide regulations. For raves, a local authority has the power to give a direction to impose prohibitions, requirements or restrictions to stop an event, in addition to pre-existing rave legislation. Indoor raves of more than 30 people are already illegal. There are further restrictions on holding gatherings of more than 30 people in public outdoor spaces, and stricter gathering restrictions in certain protected areas under regional lockdowns.
Only the Secretary of State can close a school using the powers in the Coronavirus Act 2020, but he can delegate that power to a local authority if necessary. For essential infrastructure, the regulations prohibit local authorities from giving a direction in respect of businesses that are considered essential. Guidance has been published in relation to what is essential infrastructure; that guidance is readily available, but includes registered childcare providers, airports, doctors’ surgeries, train stations, and nuclear facilities. In addition to the powers given to local authorities under the regulations, Public Health England, the joint biosecurity centre and NHS test and trace are consistently and continuously monitoring the levels of infection and other data on the prevalence of the virus across the country.
We continue to work closely with councils, local MPs and scientific experts to support local responses. Indeed, there are several people in this room to whom I have spoken about particular issues in their locality, to ensure we feed that information in so that we can make the best decisions. However, we have always been clear that we will need, and will take, swift and decisive action where necessary to contain local outbreaks by imposing more serious restrictions, often referred to as a local lockdown—for example, stopping people from different households meeting up with each other, or closing specific business sectors. Those nationally imposed measures at local level are in addition to the powers given to local authorities by the regulations that we are debating today.
I thank right hon. and hon. Members for the points that have been raised and the contributions that have been made. I will conclude by recording on behalf of the Government my thanks to the people of England for their ongoing observance of covid-19 guidance and legislation, helping to reduce the burden on our vital services and save lives through this crisis. As the hon. Member for Ellesmere Port and Neston has said, every life lost is a tragedy, so we still need to bear down and work hard to make sure that we do absolutely everything we can to ensure that is kept to a minimum. I commend the regulations to the Committee.
Question put and agreed to.
Resolved,
That the Committee has considered the Health Protection (Coronavirus, Restrictions) (England) (No. 3) Regulations 2020 (S.I. 2020, No. 750).
Oral Answers to Questions
Jo Churchill Excerpts(3 years, 7 months ago)
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Christian Matheson (City of Chester) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
The Government are clear that we will do everything we can to protect the most vulnerable. We will not tolerate the false advertising of alternative cancer treatments. It is dangerous, but it is also cruel, and we will ensure penalties are handed out for any breaches of the law. While there are no plans to bring complementary therapies into regulation at present, many are registered on voluntary registers accredited by the Professional Standards Authority for Health and Social Care, ensuring patients can access safe care.
Christian Matheson
My constituent Linda died of untreated breast cancer after she had been seduced, we believe, by advertising on the internet offering alternative therapies such as scans and pastes that were actually caustic to her body. She died alone in my constituency some months ago. Will the Minister consider bringing in tough restrictions on advertising on the internet, particularly as people are accessing internet therapies more now, and also tough restrictions on the people who practise these bogus therapies?
Jo Churchill
I thank the hon. Gentleman. I was really saddened to hear of the death of his constituent, and fully agree that we must protect people who are often so desperate to find something that will help them and give them hope of recovery. Under the Cancer Act 1939, all advertising of cancer services and treatments is prohibited wherever advertised—online or in the paper—including complementary or alternative services and treatments that purport to be able to cure cancer. We know the role that the internet can play in spreading harmful messages about alternative treatments. It is dangerous, and I have discussed the issue in its broadest sense with my Digital, Culture, Media and Sport colleagues. I give him an assurance that we are committed, across Government, to taking any further action needed. He knows that my door is always open, and I would be happy to continue this conversation at any point.
Mark Menzies (Fylde) (Con)
Alun Cairns (Vale of Glamorgan) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
The Prime Minister is clear that we must care for the health of our population. In July, we published the ambitious strategy to empower adults and children to live healthier lives, taking forward actions from the previous three chapters of the childhood obesity plan and laying out a series of initiatives. It sets out an overarching campaign to reduce obesity and has measures to get the nation fitter—to protect, importantly, against covid-19, to protect the NHS, but most importantly, to improve individuals’ health and wellbeing and quality of life.
Alun Cairns
There is strong support for the Government’s ambition to reduce obesity among children and young people, in particular. There are many calls for advertising bans for broadcasters for high salt and sugar content, for example, but those are not as straightforward as is suggested, because there is the risk of driving advertising online, which is far more targeted and, as some believe, might be much more effective in communicating the message to attract people to buy those products. Does the Minister recognise that this is a complex picture that needs lots of analysis before clear policies are decided upon?
Jo Churchill
I thank my right hon. Friend for that question. I know that as a keen marathon runner, he has a keen interest in us all keeping fit. I could not agree with him more: our children’s online watching is considerably greater than their watching of terrestrial television, and that is precisely why we have included a consultation in the online space to ensure that we have fully considered all the impacts that he just mentioned before we move forward and any changes to advertising restrictions before they are introduced.
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
Diabetic eye screening has continued throughout the pandemic for those at the highest risk. NHS England and NHS Improvement are working closely with service providers to ensure that where services took the decision to reschedule screening appointments during the pandemic, those services are restored as soon as it is safely possible to do so in order to minimise any risk to individual patients and with appointments based on clinical need.
Jim Shannon
It is nice to see you in your place again, Mr Speaker. I thank the Minister for her response, which is, as always, comprehensive. In relation to diabetes, I wish to ask about both screening and weight loss. What funding has been set aside for those who are morbidly obese and need gastric procedures urgently to set them on the path to better health, in line with the Prime Minister’s statement and reaction to the massively increased risk of death from covid-19 for those who are obese? It is important that we address all the issues.
Jo Churchill
As well as our world-leading obesity strategy, we have today announced a targeted dietary approach to diabetes. From next week, thousands of people will be able to access a rigorous weight-loss programme to help tackle type 2 diabetes. The diet and lifestyle plans have been shown to put diabetes into remission for many people who have been recently diagnosed. This will provide 5,000 more patients with the first stage in an NHS drive to increase access to the NHS diabetes prevention programme and builds on the commitment to get another 200,000 people into the life-changing programme. We know that diabetes increases the risks of other health challenges and coronavirus, so it is vital that we take immediate action to help people.
Kirsten Oswald (East Renfrewshire) (SNP)
Bambos Charalambous (Enfield, Southgate) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
Guidance to explain the Government’s policy on face coverings continues to be updated and fully takes into account groups with protected characteristics. This guidance makes it clear that there are exemptions for people who are unable, for a variety of reasons, to wear face coverings. We have also run a proactive communications campaign to ensure that people are aware that some people are unable to wear a face covering in certain circumstances.
Bambos Charalambous
Georgina Fallows is a rape survivor who suffers from post-traumatic stress disorder when her mouth is covered. Georgina and others like her have been challenged for not wearing a mask in shops and on public transport, and this causes further stress and anxiety. Does the Minister support Georgina’s campaign for a badge to identify people who legitimately cannot wear a mask, and will she consider raising awareness of this issue via a public information campaign?
Jo Churchill
I was incredibly sorry to hear what Georgina has been through, and fully understand that she and others who have undergone traumatic experiences cannot wear a face covering without distress. That is why our guidance and public messaging have been very clear that there may be people who should be exempt from wearing a covering for a variety of reasons. It is also clear that people do not need to prove it when challenged. We are actively engaging with stakeholders and charities to ensure that these messages sensitively get across, and we will continue to do so, but I would welcome a fuller discussion with the hon. Member about anything we can do further to help individuals such as Georgina.
Tony Lloyd (Rochdale) (Lab)
Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020
Jo Churchill Excerpts(3 years, 9 months ago)
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The Chair
Before we begin, I remind the Committee that Hansard colleagues would be most grateful if Members sent their speaking notes to hansardnotes@parliament.uk.
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, Restrictions) (No. 2) (England) Regulations (S.I., 2020, No. 684).
What a privilege it is to serve on the Committee for your very first time in the Chair, Mrs Murray. I hope it will be an enjoyable sitting for us all. The regulations, which were made on 3 July by the Secretary of State for Health and Social Care, my right hon. Friend the Member for West Suffolk (Matt Hancock), came into force on 4 July. We had previously amended the original regulations, but the amendments made at this stage resulted in a significant number of changes.
It is for that reason that the original regulations were revoked and replaced with a set of new regulations, to make the legislation clearer and easier for the public to understand. The SI has not been formally cleared by the Joint Committee on Statutory Instruments. Further changes were made following the announcement made on 9 July by the Secretary of State for Digital, Culture, Media and Sport, my right hon. Friend the Member for Hertsmere (Oliver Dowden), and a set of amendments to the regulations that were made on 10 July came into force on 11 July and 13 July. Those changes will be debated on 20 July.
I am aware that there are concerns in Parliament about allowing for the timely scrutiny of regulations that have been laid and made in response to the public health emergency caused by coronavirus, particularly relating to the timing of debates. I am sure that my right hon. Friend the Secretary of State for Health and Social Care will bring these matters to the fore today. We have listened to those concerns and have endeavoured to hold this debate as soon as possible after the regulations were laid.
I acknowledge the situation in Leicester and appreciate how hard it must be for the people who live there. Although the rate of infection is declining nationally, we have been clear that we must take swift action to keep people safe when local outbreaks are identified. It is now vital that everyone in the protected area in and around Leicester stays at home and avoids non-essential travel. Anyone with symptoms needs to come forward for a test and share their contacts with NHS test and trace if they test positive.
We will continue to monitor rates of infection across the country, to work with local authorities, and to take action locally where necessary. In the event that the local response is not sufficient to deal with an outbreak, including to prevent the virus from returning to general circulation, the Government will act rapidly. We are in the process of drafting new regulations to enable action to be taken, and we will be ready to reintroduce national measures if necessary to control the spread of the virus.
We are now in phase 3 of our recovery strategy, as the Prime Minister set out in the Government’s roadmap on 11 May. Through continuous review of the measures, we have gradually and cautiously replaced existing social restrictions with targeted measures to ensure that any remaining restrictions are proportionate and necessary. In his statement to the House on 23 June, the Prime Minister announced the changes that we are debating, which came into force on 4 July.
The regulations enabled the reopening of many businesses across different sectors of the economy—a welcome change for many and a significant moment in our journey to restart the economy. Most of the restrictions on social gatherings are no longer set out in legislation, but the Government continue to issue guidance to support the public in meeting friends and family in a safe and appropriate way. We understand how vital it is for people to maintain contact with friends and acknowledge the positive impact that has on wellbeing and mental health. As we have done throughout the pandemic, we are trusting the British public to remain alert and stick to the published guidance.
I will now outline the changes made on 3 July, which came into effect on 4 July. These include: easing the restrictions on gatherings and overnight stays by removing most of the relevant rules from legislation and issuing guidance to support the public to meet their friends and family safely; allowing more sectors to reopen, including hospitality, leisure, tourism, recreation and sport; allowing further public and community services to reopen; and continuing to require some businesses considered too high risk to remain closed. The regulations also provide new powers to close public open places where it is considered necessary to do so, to prevent, protect against, control or provide a public health response to the incidence or spread of coronavirus.
Mr Robert Goodwill (Scarborough and Whitby) (Con)
Last week I received a letter from someone who delivers complementary therapies. What consideration has the Minister given to allowing such treatments to recommence, as many patients seem to find them useful?
Jo Churchill
The opening of massage parlours, spas and so on was laid out in subsequent regulations, and they have been allowed since 13 July. Perhaps I can have a conversation with my right hon. Friend on the specifics of the type of treatment to give him a fuller answer on whether they are allowed. It is about the context. As we have seen with beauty parlours, which are reopening, there are still restrictions on facial treatments that require proximity.
Maria Eagle (Garston and Halewood) (Lab)
I think many of us have received such representations. Does the exchange we have just heard not illustrate that one of the problems with the regulations and the law is that their sheer complexity and swiftly changing nature make it difficult for even the most assiduous of observers to keep up to date with where we are? In that regard, the guidance to which the Minister has just referred is incredibly important. How will she ensure that people can understand the fast-moving current state of the regulations and the law?
Jo Churchill
I thank the hon. Lady. If she will excuse me, I will take another intervention from my right hon. Friend the Member for Scarborough and Whitby and then answer both.
Mr Goodwill
I support what the hon. Member for Garston and Halewood said. My constituent was a sports physiotherapist, but he was also representing people who do acupuncture, yoga or homeopathy, which are still not permitted.
Jo Churchill
What both my right hon. Friend and the hon. Lady are outlining is that the approach has had to be measured and consistent with Public Health England advice for specific areas. That guidance is available on gov.uk. My right hon. Friend has articulated different treatments, some of which need a degree of invasiveness. Guidance on that is incremental, and the Government are endeavouring to give people accurate information in a timely fashion.
However, I would readily say that there are times when there is perhaps a degree of confusion. At that point, if one refers to PHE guidance and gov.uk, one will find that it articulates why PHE is making changes incrementally. I am sure that no one on the Committee would have wanted us to open up at a more rapid rate and seen a rise in the R number. All of this is about us working permanently to keep control of the R number while trying to allow the economy to reopen.
On 6 July, the Secretary of State for Digital, Culture, Media and Sport announced that further amendments would be made to continue to ease existing restrictions and reopen many businesses and facilities. The changes being made, along with the updated guidance, have allowed team sports, rehearsals and outdoor performances to resume, with close contact services—including nail bars, salons, tanning booths, spas, massage parlours, body and skin-piercing services—and outdoor swimming pools and waterparks to reopen from 13 July. Those amendments will be debated on 20 July in the House. Our assessment that we are meeting the five tests, which we set out as considerations for change, mean that more restrictions will be lifted.
Covid-19 is the biggest challenge the UK has faced in decades.It threatens to take both our way of life and our loved ones from us. That is why the Government put in place strict social distancing measures, to slow the spread of the virus so that the NHS would not be overwhelmed. Thanks to the hard work and sacrifice of the public, and despite the extremely tragic loss of life, the UK has slowed the spread of the virus. We have been working with and consulting widely with businesses and organisations throughout the pandemic and continue to receive expert scientific advice from SAGE—the Scientific Advisory Group for Emergencies—the chief medical officer and the chief scientific adviser, as we continue to work on easing the restrictions as soon as it is safe to do so.
I have already noted that further amendments were made to the regulations on 10 July, which will be debated in due course. I am grateful to all parliamentarians for their continued engagement in the process and for their valuable scrutiny.
Jo Churchill
I thank the hon. Member for Ellesmere Port and Neston for once again asking for proper scrutiny. However, as he articulated the challenges, he also very readily showed how dynamic the situation is and why the challenge of using parliamentary procedure and the normal channels, which are scheduled through House authorities in conjunction with the Whips, leads to a disconnect.
The hon. Gentleman will also be very much aware that Parliament expressly gave the Government the power in section 45R of the Public Health (Control of Disease) Act 1984: it is under that provision that we are now having this debate. It gave the Government the power to respond quickly in an emergency, such as the one we now face, before they have to come to Parliament for the right and proper parliamentary scrutiny.
Given that just along the corridor in another Committee room Members are debating the lockdown regulations for Leicester, I gently push back against earlier comments: we are making great progress, and the assertion that this crisis is still not the complete focus of the Government is wrong. That is why we are coming forward in this way. The Government will keep the restrictions under review; as the hon. Gentleman said, the Secretary of State has a duty to keep them under review in a timely fashion and a duty laid upon him to make sure that he releases these restrictions as rapidly as possible. That is what we are involved in.
I do, however, hear the point that this is, once again, a timing issue for the Opposition in respect of being allowed to scrutinise measures in an effective way. I hope that my comments have set out, in part, where we are.
Matt Western
The point is that all the Opposition and Members from across the Committee are trying to do is help come up with the best legislation. It is a surprise that a lot of this is not being done in anticipation of what is likely to happen, so that we can help collectively to ensure that any inconsistencies are avoided. To use an example from my constituency, someone who provides beauty treatments asked me a very simple question: “Why is it that a barber can work on a man’s face, but I cannot work on a woman’s face?”
Jo Churchill
I agree that there are challenges to making guidance seem consistent, but we are led by advice from PHE and the risk assessments done in each individual business.
To answer my right hon. Friend the Member for Scarborough and Whitby, there is a duty on each and every business to ensure that it has done suitable and sufficient risk assessments to allow itself to restart. Yoga, for example, is an activity that can take place outdoors. However, there are restrictions on covered areas for indoor sports, so at the moment it cannot take place in an indoor sports venue.
We have made progress in the past few weeks. I hope that my right hon. Friend, who was previously a business Minister, welcomes the fact that we are reopening the economy for, among other things, people’s wellbeing—one of the biggest determinants of inequality is people’s ability to work, which has a long-term effect on their mental and physical health. It is important that we push forward and open businesses, with proper scrutiny from Public Health England, and ensure that they are safe places for work, for staff and for people visiting them.
My right hon. Friend spoke about having more oversight of the reviews and so on. We recognise that transparency is important in these times. SAGE has been publishing its statements, and the accompanying evidence as it is reviewed, to demonstrate how the scientific understanding of covid-19 has continued to evolve as new data emerges. SAGE’s advice has quickly adapted to new findings that reflect the changing situation.
My right hon. Friend mentioned the Imperial College study, which gratifyingly noted that the R number was lower than had been thought. That shows the benefits of the lockdown restrictions. I am sure all MPs agree that the vast majority of our constituents have behaved extremely responsibly. I trust them to continue to do so, notwithstanding the fact that over the past 17 weeks we have all had in our inboxes challenging stories of people who wanted to meet a grandchild or say their last goodbyes to someone.
This has been a national effort. The releasing of these regulations and guidance is the next step to ensuring that we get to where we want to be and start to resume life with our new normal, ensuring that social distancing still applies where possible—the advice is incredibly clear that social distancing is the primary measure for stopping the transmission. In places where that is not possible, we have the 1 metre-plus rule, with interventions such as Perspex screens in shops—or even in Parliament, as we now see in some of the Committee Rooms—to keep people safe, and the wearing of face masks.
I gently say that the face covering regulations come in on the 24th. We have been having conversations about enforcement with the National Police Chiefs Council and the College of Policing, and they have released guidance on each set of regulations. We are in daily contact with them to ensure that there is consistency around enforcement. People with inside businesses will not be expected to enforce.
The equalities impact has been considered throughout the restrictions across a range of protected characteristics, but the hon. Member for Ellesmere Port and Neston will have to raise the more specific instances for different protected groups with the relevant Department.
The hon. Gentleman asked two very specific questions on testing: on the Randox test and comments from yesterday. If he will forgive me, I will write with a more comprehensive answer on testing. He will be well aware that we now have the capacity in this country to test some 300,000 across the suite of tests per day. On the turnaround time, we get 91% of the tests done at either the satellite or mobile testing back within a shorter than 24-hour period, and 97.5% within the day.
Justin Madders
The Minister will be aware that some 3 million tests are unaccounted for. Is she able to advise what the understanding is on where those have gone?
Jo Churchill
As the shadow Minister well knows, some of the tests that are sent out are counted on the out and we do not have the ability to ensure that the test is used and sent back to us. As I said, I will write to him with full and comprehensive details on testing.
The hon. Gentleman may or may not be aware that in the Leicester local lockdown, we are going door-to-door in order to ensure that asymptomatic testing and testing throughout Leicester is ramped up. We are also using translation services, both on the doorstep and on some of the phone lines.
This has been an unprecedented situation. We are dealing with a new virus and we have ensured that each time we have taken the learning and tried to deliver an enhanced service. It is well recognised that the numbers we are testing have grown. It was a stretching target and we have matched it. We are now providing one of the most comprehensive testing systems—across mobile testing, satellite testing, the Lighthouse testing, home testing, testing in care homes and hospitals, which now stretches out into asymptomatic as well as symptomatic testing—ensuring that anyone is now able to ring and get a test.
On testing information, pillar 2 is being fed back into local areas so that they have a much clearer idea of what their locality looks like, as per the number of tests.
Justin Madders
It is indisputable that the number of tests has significantly increased, but what has happened to the false negative rate? We heard earlier on that it was about 30%. Is it still in that area?
Jo Churchill
If the hon. Gentleman will forgive me, I have said that I will write to him on testing. I fear that we are straying slightly from the point of today’s debate on the regulations. I thank everyone for their contribution—
Justin Madders
The Minister is about to finish, but it is really important that we hear from her about the statement in paragraph 7.4 of the explanatory notes, which says:
“There is recognition that these changes may lead to an increase in transmission rates”.
What is the scientific advice in relation to that risk? How is the Minister going to be able to report back and monitor that, particularly in terms of parliamentary scrutiny?
Jo Churchill
As far as the R rate is concerned, as the hon. Gentleman knows, the Secretary of State meets regularly with the chief scientific adviser and the chief medical officer, plus SAGE, the new and emerging respiratory virus threats advisory group—NERVTAG—and the Joint Biosecurity Council. All that information is fed back into the decisions that are then made in and around the R number. If he will forgive me, I am going to push on, because I feel we are straying off into areas away from the regulations.
We will continue to keep the restrictions placed on individuals, businesses and society under continual review over the coming weeks and months. The new regulations debated here today have been a major step in the gradual return to normality for individuals, businesses and society as a whole, and, as we have heard, that is something we welcome.
I am pleased that, as of 10 July, we have continued to take those steps and have made further amendments to reduce restrictions in a safe way. We appreciate that restrictions have placed a significant strain on individuals. The Government will only continue to impose restrictions that are necessary and proportionate, but we remain prepared to impose further restrictions should that become necessary.
Today’s debate has provided an opportunity for hon. Members to debate the range of activity that the Government have undertaken in response to coronavirus. I commend the regulations to the Committee.
Question put and agreed to.
Resolved,
That the Committee has considered the Health Protection (Coronavirus, Restrictions) (No. 2) (England) Regulations 2020 (S.I., 2020, No. 684).
Independent Pharmacies
Jo Churchill Excerpts(3 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
I am grateful to my hon. Friend the Member for Isle of Wight (Bob Seely) for securing the debate and to the hon. Members who contributed to it. We are all pretty much in agreement about the value of our pharmacies. Our community pharmacies are an integral part of our healthcare system. We have often spoken in this Chamber and elsewhere about how assiduously my hon. Friend looks after the health needs of those on the Island, with its unique ecosystem.
As has been said, community pharmacies across the country, including those on the Isle of Wight, are at the very heart of our community. Everyone agrees that they play a vital role in providing medicines and health advice to all those who cross their threshold—the hon. Member for Halifax (Holly Lynch) said she did that while at school. Many pharmacists have told me that during lockdown they have had to develop a different relationship with their customers, because the whole setting and how they advise has changed. Rather than having a friendly chat, they have had to help many of their older customers navigate their way through the new system. The role of pharmacies is more important than ever in the covid-19 pandemic. Their sensible approach has helped to spread the public health message. They are integral to the prevention agenda.
I say that because, although the pandemic continues to challenge all parts of the health and care system, local pharmacies have remained open throughout. They have truly been the frontline. They have adapted to the pandemic by making their businesses covid-secure. They have innovated and shown immense resilience in responding to the challenges brought about by the pandemic.
The Health and Social Care Secretary and I—indeed, all colleagues in Government—are hugely grateful for the unequivocal commitment shown by community pharmacies. I am immensely proud to be the pharmacy Minister. I want to take this opportunity, as I have done before, to thank all those who have gone above and beyond during this crisis, helping those in our community who have walked through the shop door because they are frightened or require assistance. Pharmacies have always been there.
As the House may recall, last July we agreed a landmark five-year deal, the community pharmacy contractual framework, which committed almost £13 billion to community pharmacy or about £2.6 billion a year. It is the joint vision for how community pharmacy will support delivery of the long-term plan. Community pharmacists are part of our community life, and independent pharmacists account for almost 40% of the market. They are integral to the success of delivering the five-year deal and supporting the NHS. As we have heard this evening, patients value the diversity of pharmacies and the different settings in which they interact with their communities.
Maintaining access to NHS pharmaceutical services continues to be a key priority for the Government. 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 local, physical NHS pharmaceutical services.
During this crisis, the Government have put in place a financial package to provide support to all businesses, including independent pharmacies. Under the NHS contractual arrangements, we have made available £370 million in advance payments to help pharmacies with their cash flow. We have also provided additional funding for the new medicine delivery service for shielded patients to ensure that the vulnerable get their medication, and covered the cost of bank holiday opening. We are increasing the reimbursement prices for the most commonly prescribed generic medicines by £15 million a month from June.
We have responded to concerns from the sector by pausing some work in order to prioritise day-to-day activities and enable an environment that provides space to do the day job safely and, importantly, supports the health and welfare of staff. That is particularly important given the high proportion of community pharmacy staff from black, Asian and minority ethnic backgrounds. For example, 43% of registered pharmacists come from such backgrounds. We need to provide the right environment to keep everybody working at their optimum level.
This year’s pharmacy quality scheme comprises of two parts: an essential element that focuses solely on covid-19 activities, including individual covid-19 risk assessments, and a second part that will be in the usual spirit of the scheme. I urge all community pharmacists to participate in this year’s pharmacy quality scheme, especially the essential element, which will reward community pharmacies for undertaking steps to keep patients and staff safe during the pandemic.
As my hon. Friend the Member for Isle of Wight will appreciate, we are in regular conversation with the pharmacy contractors’ negotiating body, the Pharmaceutical Services Negotiating Committee. We have met stakeholders regularly throughout the pandemic to ensure we have that ongoing dialogue that is so important. We will continue to work closely with the PSNC, NHS England and NHS Improvement to consider what further support and funding contractors will need during the pandemic and as we move into the recovery phase.
We have just entered discussions on firm proposals for additional funding put forward by the Government to meet the extra costs incurred by pharmacists at the peak of the pandemic. To respond to this crisis, we have a need to reprioritise certain community pharmacy contractual framework services. The immediate challenge will be to restore those services and programmes planned for the 2020-21 period where we can do so and where it remains the right thing to do. I stress that we will work by talking to the profession, because this has been an extremely difficult time and, as everybody has said, pharmacists have responded amazingly to the demands that have been put on them.
There is also an opportunity to learn from the pandemic and facilitate changes that may have been more difficult previously. We will continue to build capacity and capability, test new services for potential future commissioning, and focus services on the areas that have the most impact on the population’s health. Community pharmacies have demonstrated how they can increase the uptake of flu vaccinations, as my hon. Friend the Member for Isle of Wight said. That will be particularly important this winter, when we know that there will be increased uptake. I am keen for community pharmacies to do more in partnership with GPs in their local area and for them to be as one with their colleagues and treated like other members of the entire NHS family that we value so much. I sometimes feel that those in community pharmacies feel that perhaps we could go a little further in saying a big thank you to ensure that they feel part of the valued broader primary care network.
Isle of Wight community pharmacists are exceptional; indeed, in the past they have won awards for their work on the administration of hepatitis B and hepatitis C vaccines. We want to consider the role of community pharmacists in future vaccination programmes to maximise access.
The hon. Member for Halifax mentioned the anticipated loss of some 3,000 pharmacies; on this morning’s Zoom call with the National Pharmacy Association, the Secretary of State was clear that that would not happen on his watch and that any loss of pharmacies stopped when he arrived. Like me, he sees the value of community pharmacists. There are now 11,500 pharmacies throughout England, which is an uplift of some 12% since 2010.
I agree with my hon. Friend the Member for Peterborough (Paul Bristow) that this period has shown how vital pharmacists are and the importance of the role that they play for us all.
The Medicines and Medical Devices Bill, which goes to the Lords next week, will introduce legislation that will pave the way for further consultation on what more the Government can do to support dispensing arrangements and a better skill mix in community pharmacy. With such a highly skilled workforce, if we can free up pharmacies to better use their skills for patient-facing services, helping to alleviate pressures not only on pharmacies but in primary care, that will help the whole sector and be a recognition of the high skill level that we have. We will help people, including those on the Isle of Wight, to adopt innovative practices, including the greater use of digital and technology. We will of course engage with the sector on any proposals that we make. Any regulations in this policy area would come before Parliament.
I thank my hon. Friend the Member for Isle of Wight again for securing this important debate. I know that the coming months will continue to be challenging for Tim and the other community pharmacists that my hon. Friend mentioned, but it is really important that they know quite how much they are valued by Members from all parties, but mostly by their communities. I am personally committed to continue to do all that I can to support community pharmacies, which are an essential part of our lives, our high streets and our NHS family.
Question put and agreed to.
Testing of NHS and Social Care Staff
Jo Churchill Excerpts(3 years, 10 months ago)
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The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
Like all other Members from all parts of the House and from all four nations, I add my thanks to all those in the NHS and across social care, although actually it is broader than that. There are those in primary care, our community health teams, those who have adapted the way they work in addiction services and so on, because all these things have had to change at pace.
When we started to get the news towards the end of January that this was a pandemic, we started to realise that we were dealing with a completely unprecedented time, and all those people stepped forward. We have heard repeatedly this afternoon that more people stepped forward to make this a journey of collaboration and innovation. We have seen changes right across the national health service and the services that we have had to build to make decisive changes.
I gently say that 12 weeks ago, as we went into lockdown, many of those services were very different: the delivery of PPE to just over 200 national health trusts has now ramped up to 58,000 providers; we have developed Clipper and local resilience forums to help us with the distribution of PPE throughout these extremely complex changes; and a large amount of work has been done on vaccines and testing. All these things are a tribute to collaboration and we need to thank the innovation of not only private industry, as my hon. Friend the Member for Witney (Robert Courts) mentioned, but the Army. This truly has been an effort of public service, and as we have come together—as we have done across the House—we have achieved so much more.
How do we carry on achieving more? There was a challenge before we went into the crisis, and the decision to postpone non-urgent elective treatment was the right one, because it allowed us to have the capacity required to help us to manage increased demand in the NHS. Throughout the outbreak, we have ensured that patients who require urgent treatment have been able to access it and, like many Members, we encourage people not to delay in coming forward for treatment as they normally would, should they require it. NHS has a firm “Help Us Help You” message.
We heard of how, as my hon. Friend the Member for North Devon (Selaine Saxby) put it—I do not think I can put it better—we achieve much more by working together and focusing on what we do best. How do we drive down waiting times and have routine services return as quickly as possible to their normal provision? We must ensure that that is done in a safe and managed way to maintain capacity but avoid any further surge in covid. As outlined in the guidance already issued to the NHS, the restarting of routine electives should prioritise long waiters first and make full use of all contracted independent-sector hospital and diagnostic capacity.
Cancer was mentioned by severable Members. Urgent cancer care and treatment has continued throughout the pandemic. We know how important it is that referrals, diagnostics and cancer treatment reach pre-pandemic levels as soon as possible. Urgent action should now be taken by hospitals on the two-week-wait referrals, and they should provide two-week-wait out-patient diagnostic appointments at pre-covid-19 levels. That is easy to say but really hard to achieve.
The work done by protected hubs and to ensure that rapid diagnostic centres have been pushed out has been important. During the outbreak, the Secretary of State and I have regularly met the national cancer director, Dame Cally Palmer, to discuss progress not only on how we were dealing with cancer during the crisis, but on restoring cancer services as quickly as possible. We will keep a laser focus on that.
The NHS has continued to deliver over and above. Guidance has been issued and further guidance to restore urgent non-covid services in a safe way while ensuring that surge capacity can be stood up again, should it be needed, is already being planned. Preparations for going forward have already begun: we are learning lessons from where we have been but also driving ourselves to where we need to go. My hon. Friend the Member for Runnymede and Weybridge (Dr Spencer) said that we should think about what we can learn, how we can reset and how we can make sure that as we go forward we can take the best of what has changed, develop it and weave it in.
Stephanie Peacock
I really appreciate the Minister giving way. I just wondered whether she could respond to the question that I put in my contribution to the debate, which is around the relaxation of guidance on death certificates for those suffering from industrial diseases. I am just asking the Government to revise their guidance so that anyone who has an industrial disease has that recorded on their death certificate.
Jo Churchill
If the hon. Lady will forgive me, I will write to her on that exact point after the end of this debate. If I segway off, I will not make the points that I would like to make.
I was very grateful to my right hon. Friend the Member for South West Surrey (Jeremy Hunt), who said that the decision by the Secretary of State to put in a stretch target for testing was indeed courageous—something with which many hon. Members, I am sure, would agree. That dramatic expansion of testing has got us to where we are today.
My hon. Friend the Member for Peterborough (Paul Bristow) spoke of improving care pathways and the joint work between the private sector and the NHS, being ambitious and changing methods of working to meet demand. My hon. Friend the Member for Wimbledon (Stephen Hammond) spoke articulately about the issues, including the stretch target, but also about preparation and how we make sure that our hospitals are ready and fit for the future. My hon. Friend the Member for Moray (Douglas Ross) talked about how challenging it is but pointed out how the four nations have worked together. I join him in supporting the fact that we are stronger together. I have missed out my hon. Friend for—
Jo Churchill
I am sorry. I put Worcestershire, but I knew that it had a bit of the compass before it.
My hon. Friend the Member for West Worcestershire (Harriett Baldwin) spoke of innovation. She said that the appointment of Lord Deighton had led to a revolution in the UK manufacturing of PPE to support all our NHS workers as we drive forward. Some 2 billion items have been ordered to be made in this country. She also mentioned innovations by our GPs, pointing to the fact that the number of surgeries delivering video consultations has risen from 3% to 99%. She talked about innovations in medicines and treatment, and about the first effective treatment to save lives. On testing, she said how proud she is of everything that is going on there.
My hon. Friend the Member for Crewe and Nantwich (Dr Mullan) talked about managers and workloads as normal services return. He, like many hon. Members, brings to the House his experience from the NHS. One thing struck me in particular—that we target messages at the right groups. We know that health inequalities are persistent and stubborn, so we must get the messaging right as we go forward.
My hon. Friend the Member for Meon Valley (Mrs Drummond) spoke about the importance of preparedness, including assisting staff. This afternoon, mental health came up repeatedly and ensuring that helplines are in place to assist all our NHS recover and gain resilience throughout the next phase.
Jo Churchill
I am sorry, I will not give way, as I have only a minute left.
On testing, we are continuing to prioritise our frontline NHS staff with symptoms for testing and testing asymptomatic NHS staff where appropriate, where there is an incident. We are surveying the health and care settings in Public Health England’s SIREN study and monitoring prevalence. Although the CMO has recommended that testing happens fortnightly at the moment, all these issues are currently under review.
At the start of this crisis, we made sure that NHS capacity was always there at the time of need. The goal was clear that, however tough things got, the NHS would never fall short of that founding promise to be there for somebody who needs it. It meant taking difficult decisions and, as we rebuild and refocus on delivering for all those on the waiting list, I want to put on record my thanks to those on the frontline for their heroic efforts.
At the same time, the NHS has been instrumental in carrying out the world’s first successful clinical trial and, in just a few months, it has achieved much. The NHS is also playing a crucial role to help to operate one of the largest and most comprehensive test and trace systems in the world, with capacity for 280,000 tests today. I have gone on the record many times to say that our colleagues in the NHS and across the public services are always there for us. If you are concerned about anything, you should seek help. The NHS will always be there for you. But what we have discovered from the speech by the shadow Secretary of State—
Mr Nicholas Brown (Newcastle upon Tyne East) (Lab)
claimed to move the closure (Standing Order No. 36).
Question put forthwith, That the Question be now put.
Question agreed to.
Question put accordingly (Standing Order No. 31(2)), That the original words stand part of the Question.
Oral Answers to Questions
Jo Churchill Excerpts(3 years, 10 months ago)
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Mary Glindon (North Tyneside) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
Essential and urgent cancer treatment has continued throughout the pandemic and cancer specialists, as always, are discussing the best treatment options with their patients. We are working to ensure that referrals, diagnostics and cancer treatment are back at pre-pandemic levels across the whole of England as soon as possible. Due to covid-19, the 21 cancer alliances in England have established hubs to ensure dedicated cancer care away from hospitals dealing with the virus. From the end of April, local systems and cancer alliances have continued to identify ring-fenced diagnostic and surgical capacity for cancer in line with issued guidance. Regional cancer senior responsible officers must now provide assurance that these arrangements are in place to help minimal regional variation.
Andrew Gwynne [V]
I thank the Minister for that comprehensive reply, but she knows that people living with cancer are experiencing cancellation and delays to treatment all over the country, and that is causing anxiety and distress to many families. In getting people urgently back into treatment, will she look at the 12-point plan for restoration, recovery and transformation of cancer services outlined by Macmillan Cancer Support, Cancer Research UK and 23 other cancer charities, to ensure that cancer does not become the forgotten C during the coronavirus crisis?
Jo Churchill
I regularly engage with cancer charities and would be delighted to look at them to see where we are making good headway and where, perhaps, we could have discussions about other things that need to be targeted. While I have the hon. Gentleman on the screen, I would also like to highlight the fact that the Greater Manchester cancer alliance has led the way in its response to this pandemic. It was one of the first to establish a surgical hub model to ensure that cancer surgery was able to continue and that the local cancer system as a whole responded well. The alliance has also been looking to accelerate the rapid diagnostic centre to help promote diagnostics, so I thank everyone for that.
Mary Glindon [V]
As the Minister knows, being diagnosed with cancer is devastating, and one of the most important things to get patients through this difficult time is for them to be able to focus on their treatment. What message does the Minister have to comfort those people who are worried and stressed because they still cannot access the treatment they need because of covid-19?
Jo Churchill
I would say that, as soon as people notice any signs that might worry them, they should seek help. We have worked at pace to ensure that services have been resumed and are able to deliver for patients. Ensuring both early diagnosis and that patients can access the treatment that they need swiftly is our key ambition. We know that, following the guidance that has been delivered, we are achieving that throughout the system. Covid-19 has upended all our lives, and some decisions have been made to ensure the safety of patients, but we are now firmly back on track and will ensure that patients get the care they need.
Alex Norris (Nottingham North) (Lab/Co-op)
Yesterday, the One Cancer Voice network of 25 charities published plans for restoring vital cancer services. I wrote to the Minister on 17 April with my own suggestion. Ideas included advanced radiotherapy, new models of chemotherapy, better cancer pathways and renewed screening and communication plans. This is not just about rebuilding what we had, but about making services better. If the Government are slow to do that, we face a cancer bubble that risks thousands of lives. Will the Minister commit to working with those charities and with me and other interested parliamentarians to form a cancer recovery plan to head off this looming crisis?
Jo Churchill
I assure the hon. Gentleman that, just as we have seen from working closely on the Medicines and Medical Devices Bill that is going through Parliament, there are lessons to be learned. There have been improvements in certain areas of radiotherapy in which it has been determined that fewer treatments actually mean a quicker and—I would not use the word “gentler”—an easier path for the patient. I would be happy to continue working both with him and with the cancer charities to ensure that we can improve that pathway for patients.
Mrs Pauline Latham (Mid Derbyshire) (Con)
Ms Karen Buck (Westminster North) (Lab)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
There was a passionate debate on this issue last Thursday. As I said then, there is no doubt that covid-19 has upended our lives. The virus cruelly discriminates by many factors, including age, gender and ethnicity. There are still gaps in our understanding of occupational risks and co-morbidity that need attention. My hon. Friend the Minister for Equalities will be taking forward important cross-Government work with the Equality Hub, Public Health England and others.
Ms Buck
We now know the full extent to which covid and other health inequalities affect black and minority ethnic communities, and the extent to which that is reflected in regional inequalities, but does the Minister also understand how much such inequality prevails within boroughs? In my local authority, there is a 16-year life expectancy gap between the poorest communities and the wealthiest, which reflects the disparity with black and minority ethnic communities. Will she ensure that an equalities review tackles inequality within boroughs as well as between them, and will there be funding to support that?
Jo Churchill
We know that health inequalities are stubborn, persistent and difficult to change—we knew that before covid-19, but that is not a reason to accept them. We fully agree that more needs to be done to reduce the disparity in health outcomes within the BAME community and the broader community. That is why we will ensure that the work on health inequalities goes on at pace.
Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
Tim Farron (Westmorland and Lonsdale) (LD)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
I thank the hon. Gentleman and the other members of the all-party group on radiotherapy and cancer for meeting me and officials recently. It is expected that each of the 50 NHS trusts that provide radiotherapy will be able to deliver stereotactic ablative radiotherapy no later than 31 March 2021. Increased external quality assurance capacity means that we could complete the roll-out process for all commissioned indications quicker than that. I am sure the hon. Gentleman would agree that such a result would be fantastic.
Tim Farron
I very much welcome the Minister’s response and thank her personally for her excellent attention to this matter and the progress that she has helped to make possible. Of course, with a 60% drop in the number of cancer referrals and a 20% drop in the number of people starting cancer treatment, we have late diagnoses and a backlog that could, tragically, kill more people than covid. Will the Minister therefore go further and faster and deploy expanded radiotherapy treatment this summer to clear the backlog? Will she commit to appointing a radiotherapy tsar and to a rolling radiotherapy fund, so that we can stop more lives being unnecessarily lost?
Jo Churchill
The hon. Gentleman will know which parts of that are still open for discussion between us, but we are of course driving hard to make sure that patients get their radiotherapy and treatment as quickly as they can. The NHS has a “Help Us Help You” campaign: it is open for business and people should make sure that they attend any appointment they are called to.
Cherilyn Mackrory (Truro and Falmouth) (Con)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
As my hon. Friend knows, one of our key commitments was to diagnose more cancers earlier. Through NHS England and NHS Improvement, the Government have committed over £1.3 billion to deliver this, including with an overhaul of screening programmes and new investment in state-of-the-art technology to transform the process of diagnosis and to boost research and innovation. I am sure that he will welcome the fact that 18 rapid diagnostic centres towards our target of 40 are already up and running, as well as the introduction of personalised care plans, which he and I both consider very important.
Steve Brine
I do welcome that; I have visited many of the centres. Before the pandemic, we were battling to meet the cancer targets that I helped to set and that my hon. Friend now looks after so ably. Would she confirm that we have not lost sight of the 75% ambition in the long-term plan, and whether there will be a revision to the cancer section of the long-term plan in the light of the backlog of the stuff that we know? Of course, there is also plenty of stuff that we do not yet know that we know, as a result of presentations not coming forward through primary care.
Jo Churchill
There are lessons to be learned; that is essence of my hon. Friend’s question. I have met both Cally Palmer and Professor Peter Johnson throughout the crisis, and our focus on cancer has remained. Ensuring that we deliver on the long-term plan is a key objective, and I am sure that my hon. Friend will work with me on that.
Paul Holmes (Eastleigh) (Con)
Medicines and Medical Devices Bill
Jo Churchill ExcerptsTuesday 23rd June 2020
(3 years, 10 months ago)
Commons ChamberRead Full debate Medicines and Medical Devices Act 2021 View all Medicines and Medical Devices Act 2021 Debates Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Consideration of Bill Amendments as at 23 June 2020 - (23 Jun 2020)
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
I beg to move, That the clause be read a Second time.
Mr Deputy Speaker (Mr Nigel Evans)
With this it will be convenient to discuss the following:
Amendment 21, in clause 1, page 2, line 6, at end insert—
“(5) In making regulations under subsection (1), the appropriate authority must give primary regard to the safety of human medicines.”
This amendment requires the appropriate authority to consider patient safety first when making regulations under subsection (1).
Amendment 20, page 1, line 5, at end insert
“for a period of three years following the day on which this Act is passed.”
This amendment provides a sunset provision for the Bill requiring the Government to return with primary legislation.
Amendment 19, in clause 2, page 2, line 26, at end, insert—
“(o) the origin and treatment of human organs used in the process of developing or manufacturing medicines”.
This amendment empowers the appropriate authority to make provisions on the process of developing or manufacturing medicines in relation to the origin and treatment of human organs.
Amendment 22, in clause 8, page 5, line 34, at end insert—
“(5) In making regulations under subsection (1), the appropriate authority must give primary regard to the safety of veterinary medicines in relation to animals, humans and the environment.”
This amendment requires the appropriate authority to consider animal, human and environmental safety first when making regulations under subsection (1).
Amendment 23, in clause 12, page 7, line 27, at end insert—
“(3) In making regulations under subsection (1), the appropriate authority must give primary regard to the safety of medical devices.”
This amendment requires the appropriate authority to consider safety first when making regulations under subsection (1).
Government amendments 1 to 18.
Jo Churchill
This Bill is an opportunity. It is necessary to ensure that we have the ability to continue to update our regulatory frameworks after the end of the transition period. We must ensure that we continue to be able to respond swiftly to pressing need. This is not a standstill Bill, however. It is designed to underpin the way in which the UK approaches the life sciences sector and innovation in health from 2020 onwards—an approach where we promote, to the best of our ability, patients’ access to cutting-edge treatments and encourage the cultivation of new, safe and patient-focused technology, balanced with the need to take swift and effective regulatory and system action, to ensure that patients do not experience adverse outcomes.
I put on record my gratitude to Members from all parts of the House. On Second Reading and in Committee, they have approached the Bill with a consensus that I hope will continue in the other place. We have all understood the principles behind the Bill, and any differences of opinion and scrutiny have been firmly in the best interests of patients and in the interest of ensuring that the Bill goes to the other place in good shape.
Our experience of the health system is a personal one. We have relationships with our GPs and clinicians, and some of us have long-term health conditions or short-term immediate needs that require surgical intervention. We all want to know that the health system is taking all possible steps to prevent harm to patients and that the regulator and the health system work in partnership to identify when something is going wrong and to take swift corrective action. We would hope that in the event that we experienced an adverse outcome or reported concerns to our doctor, GP or surgeon when something was not working properly, the patient, system and statistical significance of that outcome would be understood and properly addressed; and the clinician, the system and the regulator would engage with the patient on required action.
We also want to ensure that, where required, the regulator will continue proactively to engage with the manufacturer of a medical device and ensure that information is supplied alongside that device or improvements are made so that we learn from the patient experience. Finally, we want to ensure that data is available to drive regulatory or system action, to limit the use of that device or remove it from the system so that our experience as patients results in changes to prevent future harm and suffering, even if that risk cannot be removed completely.
I will first speak to the amendments tabled in the name of the Secretary of State for Health and Social care, before I move on to those tabled by hon Members present. I thank all those who have shown an interest in this area, particularly my hon. Friend the Member for Newton Abbot (Anne Marie Morris) and the hon. Member for Central Ayrshire (Dr Whitford), who put forward their own amendments. Both were extremely well intended and thoughtfully drafted and there have been further thoughtful contributions from all parties and both Houses in thinking about what an amendment to that effect might need to deliver.
Alex Norris (Nottingham North) (Lab/Co-op)
It is a thrill for a Government Minister to move my amendments, although that might be giving me false hope. But I just wanted to put on record for colleagues that the purpose of amendment 21 is to make patient safety the uppermost priority.
Jo Churchill
I thank the hon. Gentleman for his intervention. We are in completely unusual times: I get to respond to his amendments before he has actually spoken to them himself, but we will crack on.
I recognise that the hon. Gentleman said at the time that he wished to return to these issues during the proceedings and I was expecting him to do so. We agree that patient outcomes and patient safety are matters that we would expect the House to consider very seriously.
Amendments 21, 22 and 23 all seek to establish a hierarchy of considerations applied by the Secretary of State or the appropriate authority when making regulations under the Bill, making safety the primary consideration. It is important to say at the outset that there is a consensus on both sides of the House on patient safety. It matters to us as individuals and as MPs representing our constituents, who rightly wish to know that their safety and their animals’ safety is of uppermost importance when we look to make regulatory change.
Jo Churchill
I am most grateful to hon. Friends and hon. Members for their contributions. This is not a stop-gap Bill to get us through the transition; it is a proportionate approach to regulating an industry that moves quickly, with regulators that want to take effective action but are renowned for working with the industry in the best interests of patients. It is about setting a new direction and making clear what the UK wants after the end of the transition period.
Let me turn to the points that hon. Members made. I reiterate to the hon. Member for Nottingham North the commitment to consult when the Cumberlege report is published. We are keen to take account of its recommendations and ensure we are taking the necessary steps to protect patients, as patient safety is paramount to the future of medicines and medical devices regulation. We have of course had routine engagement with the review team, as would be expected, to ensure it is adequately supported and resourced to conduct its review.
I believe that the situation for pharmacies is quite the contrary to what the shadow Minister outlined. For hub-and-spoke dispensing, we intend to give smaller community pharmacies the same opportunity that large pharmacy businesses already enjoy. We will support them, and remove the legal barrier that allows such an arrangement only when the spoke pharmacy and the central dispensing hub are part of the same retail pharmacy business. That would level the playing field for smaller community pharmacies, rather than put them under threat. As I outlined in Committee, particularly during covid, all 11,600 of our community pharmacies have gone above and beyond. They have kept their doors open and have been there every single day for our constituents. I thank them once again. We have committed to consulting before making regulations, and that applies to any changes to rules on pharmacy registration. It means that no changes can be made without first undertaking proper consultation.
I understand the passion of the hon. Member for St Helens South and Whiston (Ms Rimmer) on the subject she raised. As the hon. Member for Strangford (Jim Shannon) alluded to, we are talking about a thoroughly abhorrent process. As I indicated, the Foreign and Commonwealth Office regularly raises concerns with China, including on the extensive use of the death penalty, and on the treatment of religious and ethnic minorities, which sit at the heart of this. I look forward to having a conversation with her after she has had that meeting, in order to understand what was discussed and to continue the conversation further.
I thank the hon. Member for Strangford for his kind words and for highlighting that we have a unique ecosystem here; we have brilliant academics, such as those he mentioned from Queen’s and others from right across the UK. We have a world-leading life science industry, employing some 240,000 people, and they are working to bring the best products to patients. We want to ensure that in and around clinical trials we have a regulatory system that maintains and enhances the UK as a site for global co-operation in research and allows us flexibility to achieve what is best for patients.
On clinical trials, the Government value the strong, collaborative partnerships we have across Europe in the areas of science, research and innovation, and we want to continue to support those opportunities. We are committed to ensuring that the UK maintains its position as a global science superpower and continues to collaborate with Europe on scientific research. The Prime Minister has made it clear that the UK sits ready to consider a relationship in line with non-EU member states’ participation in Horizon Europe, provided that that represents value for money and is in the UK’s interest.
The Bill, as drafted, does not breach the Northern Ireland protocol and the powers in the Bill are capable of being exercised compatibly with the protocol. We will ensure that that is the case. We are clear that the protocol provides that where a GB authority currently approves goods for sale, it will continue to be able to do so, in order to have that free-flowing movement.
To the hon. Member for Westmorland and Lonsdale (Tim Farron), who never misses an opportunity to remind me that he would like more services close to his constituents, I say: I hear you, again. Following Health oral questions this morning, I can say that I know we both share that commitment to drive patient access to radiotherapy and treatments together. Many hon. Members know that that is dear to my heart, having had cancer on more than one occasion. I came here to try to get more cancer nurse specialists and to make sure that on their journey those who have metastatic cancer, which is rarely spoken about in this place, are treated as people who still have full lives to live. Living with and beyond cancer is something we should embrace. The next round of negotiations with the EU will start shortly and we will continue to explore with the EU what future relationship arrangements can look like.
In conclusion, I would like to thank everyone for their efforts in getting us to this place.
Patrick Grady (Glasgow North) (SNP)
I was not in the Chamber earlier, but just before the Minister comes to a conclusion, I wish to thank her for her comments about the engagement she has had with my hon. Friend the Member for Central Ayrshire (Dr Whitford), who has not been able to participate in person in the process of this Bill. I know, however, that my hon. Friend has been grateful for the engagement on a cross-party basis, for the comments the Minister made about the amendments tabled by the Scottish National party in Committee, for the commitments the Government made in response to them and for their engagement with the Scottish Government. I just want to place on the record our thanks for all that and my sympathy with the amendment tabled by the hon. Member for St Helens South and Whiston (Ms Rimmer). A number of my constituents, like those of several other Members, have raised concerns about these issues of forced organ harvesting, and I hope some of that can be considered as well.
Jo Churchill
I thank the hon. Gentleman for his contribution. These are unusual times, so it was my pleasure to work with the hon. Member for Central Ayrshire (Dr Whitford) to do what we could to ensure that the Bill proceeded with a degree of consensus, as it was to work with her on access to off-licence drugs some years ago.
Our consideration of the Bill has been led by good sense and common ground, and by general understanding and consensus about its purpose. I am grateful to everyone who contributed along the way. I think the themes we heard today and in Committee—the paramount importance of patients; the need to ensure that we carefully consider and scrutinise legislation and that it is made after consultation; and the use of data to underpin better regulation and improve safety—were the right ones for us to consider. Although it is not necessarily part of regulatory scrutiny, I am grateful to the hon. Member for St Helens South and Whiston for raising the important issue of the UK’s continued promotion of human rights and ethics.
I am grateful to the Clerks for their help; these are unusual circumstances, but I have felt no less supported and, working towards ensuring that we can make progress in the other place, we will continue to use imagination. The Bill is a framework for where we want to go. It will allow us to ensure that the regulation that governs critical areas that matter for us all and are likely to affect us all indirectly is up to date and supports the thriving life sciences sector and patients. To that end, I commend the Bill to the House.
Question put and agreed to.
New clause 1 accordingly read a Second time, and added to the Bill.
Clause 14
Fees, information, offences
Amendment made: 1, page 8, line 35, leave out “efficacy” and insert
“performance, including the clinical effectiveness,”.—(Jo Churchill.)
This amendment clarifies the matters relating to medical devices the recording of information about which may be the subject of provision in regulations under Clause 12(1).
Clause 35
Offence relating to information
Amendments made: 2, page 18, line 36, at end insert—
“(2) A person to whom information is disclosed under regulations under section (Information systems) commits an offence if the person uses or discloses that information in contravention of those regulations.”
This amendment and Amendment 3 provide that a person who discloses information in breach of regulations made under the new clause inserted by NC1 commits a criminal offence.
Amendment 3, page 18, line 37, after “subsection (1)” insert “or (2)”.—(Jo Churchill.)
See the explanatory statement for Amendment 2.
Clause 38
Power to make consequential etc provision
Amendment made: 4, page 21, line 41, leave out “and 12(1)” and insert
“, 12(1) and (Information systems)(1)”.—(Jo Churchill.)
This amendment enables regulations made under the new clause inserted by NC1 to make consequential and other provision.
Clause 40
Consultation
Amendments made: 5, page 22, line 11, leave out
“sections 1(1), 8(1) or 12(1), or paragraph 9 of Schedule 1”
and insert
“a provision of Part 1, 2 or 3”.
This amendment and Amendment 6 have the effect that the Secretary of State is required to consult before making regulations under the new clause inserted by NC1.
Amendment 6, page 22, line 29, after “section 12(1)” insert
“or (Information systems)(1),”.—(Jo Churchill.)
See the explanatory statement for Amendment 5.
Clause 41
Procedure
Amendments made: 7, page 22, line 32, leave out
“section 1(1), 8(1) or 12(1), or paragraph 9 of Schedule 1,”
and insert
“a provision of Part 1, 2 or 3”.
This amendment has the effect that regulations made under the new clause inserted by NC1 are to be made by statutory instrument.
Amendment 8, page 22, line 42, leave out
“section 1(1), 8(1) or 12(1)”
and insert
“a provision of Part 1, 2 or 3”.
This amendment and Amendments 9 to 17 enable regulations under powers in the Bill which are subject to negative procedure to be combined in a single statutory instrument with regulations under powers which are subject to affirmative procedure, or with regulations under powers in other legislation which are subject to negative procedure.
Amendment 9, page 23, line 12, leave out
“to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 10, page 23, line 13, at end insert
“if the only regulations under a provision of Part 1, 2 or 3 that it contains are regulations to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 11, page 23, line 14, leave out
“to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 12, page 23, line 16, at end insert
“if the only regulations under section 1(1) or 8(1) that they contain are regulations to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 13, page 23, line 18, leave out
“to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 14, page 23, line 23, at end insert—
“, if the only regulations under a provision of Part 1, 2 or 3 that it contains are regulations to which subsection (9) applies”.
See the explanatory statement for Amendment 8.
Amendment 15, page 23, line 24, after “to” insert
“—
(a) ”.
See the explanatory statement for Amendment 8.
Amendment 16, page 23, line 36, at end insert
“, and
(b) regulations under paragraph 9 of Schedule 1”.
See the explanatory statement for Amendment 8.
Amendment 17, page 23, line 37, leave out subsection (10).—(Jo Churchill.)
See the explanatory statement for Amendment 8.
Clause 43
Commencement
Amendment made: 18, page 24, line 15, at end insert
“, and
(d) section (Information systems)”.—(Jo Churchill.)
This amendment provides for the new clause inserted by NC1 to come into force two months after the Bill is passed.
Bill read the Third time and passed.
Madam Deputy Speaker (Dame Rosie Winterton)
I will now suspend the House for three minutes.
Covid-19: BAME Communities
Jo Churchill Excerpts(3 years, 10 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
I, too, congratulate the hon. Member for Brent Central (Dawn Butler) on securing this debate, and I thank the Backbench Business Committee for granting it. I thank all hon. Members for their contributions. To those listed by the hon. Member for Tooting (Dr Allin-Khan) I want to add my right hon. Friend the Member for Basingstoke (Mrs Miller), my hon. Friend the Member for Runnymede and Weybridge (Dr Spencer), my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes) and my hon. Friend the Member for Dudley North (Marco Longhi), to name but a few more.
I think everybody would agree that this debate has been thoughtful and considered, and the topics and challenges that hon. Members have discussed have certainly been broad. The contributions have highlighted to me, as I have sat here for the past three hours, the sheer complexity of the issue. Health inequalities sit in my portfolio. Before covid, they presented enormous challenges; with covid, they have become even more challenging.
Members have passionately articulated the findings, and I concur that they are deeply concerning. There can be no doubt that covid-19 has upended all our lives. As the hon. Member for Tooting said, everybody knows somebody who has been touched. One of the challenges that the hon. Member for Slough (Mr Dhesi) and my hon. Friend the Member for Wealden (Ms Ghani), whom I failed to mention, articulated is that everybody is somebody’s uncle, brother, wife or mother. Everybody has been touched by the challenge of not being able to say goodbye, to carry a coffin, to say those last goodbyes. That is the human face of this dreadful disease, which has changed the way we live and work.
Throughout it all, many frontline organisations have been no less than heroic for turning up on the frontline—not only the doctors who have turned up every day, but everybody in the team. The one thing I have noticed is how people have become teams. People have referenced the fact that those who help around the hospital, cleaning, portering and so on, are just as integral. It has become to feel like those are words of truth and not just expressions. If anything comes out of this appalling situation, it is that we will carry some of those brighter spots forward.
The hon. Member for Tooting said that the BAME community is not a homogenous group: I agree. That highlights one of the challenges. Early in this crisis, it became very clear that some groups of people were more vulnerable to coronavirus, which is why PHE was commissioned to undertake work on who was most at risk and why.
To hon. Members who raised the PHE report, I want to say that it was not censored or delayed. Professor Kevin Fenton has been engaging with significant numbers of individuals and stakeholders to collect views and ideas. Nothing has been removed from the report that was released on Tuesday. It is still in the process of being thought about, because it raised the challenge of additional areas that were not looked at, such as occupation, co-morbidities and so on. Duncan Selbie, the head of PHE, has clarified the matter in writing, and a written ministerial statement was laid to clarify the point to the House. The research was done at pace and I thank those involved for pulling it together so quickly.
Far from being a great leveller, covid-19 cruelly discriminates, but it discriminates more broadly than we have probably touched on today. People who are old, people who—as was mentioned by several Members—live in cities, people who work in public-facing jobs and people from BAME backgrounds are at a heightened risk.
This early research also revealed gaps in our knowledge. As we have clearly heard, the situation is complex. My right hon. Friend the Member for Basingstoke highlighted the importance of how we address the situation. Crucially, we do not know how different risk factors overlap and interact. I know that the calls for action now are heartfelt, but we need to understand different risk factors, including co-morbidities and occupation, so that we can ensure that there is a standardisation in the data and recommendations actually do what we need them to do. For example, we need to understand how much of the increased risk for those from BAME communities is driven by co-morbidities and occupation. This challenge was highlighted by the hon. Member for Poplar and Limehouse and my right hon. Friend the Member for Romsey and Southampton North.
We do not have all the answers, as the Welsh Health Minister acknowledged recently. People from BME backgrounds have made enormous contributions to the healthcare system and other key areas including transport, public services and the care sector, as my right hon. Friend the Member for Chipping Barnet (Theresa Villiers) articulated. We must address the injustice of these ethnic disparities right across the board; so many hon. and right hon. Members have pointed out the breadth. That is precisely why the Prime Minister announced on the weekend the establishment of a commission to examine ethnic disparities in this country. It will have an independent chair, will report by the end of this year—within a very short timeframe—and will play an important role in driving the agenda forward. It will be overseen by the Minister for Equalities, my hon. Friend the Member for Saffron Walden (Kemi Badenoch).
Helen Hayes
Let me simply ask the Minister this: how many more preventable BAME deaths will we have seen by the end of the year?
Jo Churchill
The articulation of the challenge is not simple, and to frame it as if it is does an injustice to all those people who are living with all the various challenges. We have worked to shield people, irrespective. It is important that we act on the evidence. I am really sorry. I am so aware that I have sat and listened, and I will think. Inequalities are stubborn, persistent and difficult to change, but that is no reason to accept them. As hon. Members have said, this is a shared problem and the response must be a shared one too. That is our goal.
Jo Churchill
I am so sorry but there has been so little time at the end of the debate, and I want to leave the hon. Member for Brent Central some time to speak.
Coronavirus Impact: BAME Community
Jo Churchill Excerpts(3 years, 10 months ago)
Written StatementsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
Today, Public Health England has published the result of ITS work to engage with individuals and organisations within the BAME community, to hear their views, concerns and ideas about the impact of covid-19 on their communities. As the House will know, my hon. Friend the Equalities Minister will be leading on the next steps, working with PHE and others. Copies will be deposited in the Libraries of both houses and are available on PHE’s website, https://www.gov.uk/government/organisations/public-health-england
[HCWS296]
Public Health
Jo Churchill Excerpts(3 years, 10 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Parliamentary Under-Secretary of State for Health and Social Care (Jo Churchill)
I beg to move,
That the Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 3) Regulations 2020 (S.I, 2020, No. 558), dated 31 May 2020, a copy of which was laid before the House on 1 June, be approved.
The amending regulations we are discussing today were made by the Secretary of State on 31 May and were laid before the House on 1 June. I must note that the regulations were amended again, on 12 June, with changes coming into effect between 13 June and today. Hon. Members have previously raised concerns about that sequencing, which I would like to address directly.
Mr William Wragg (Hazel Grove) (Con)
I thank my hon. Friend for giving way at this early point. I can inform you, Madam Deputy Speaker, that I do not intend to inflict a speech on the House later and will be withdrawing from our proceedings. May I just ask the Minister briefly why the Government have chosen to use the urgent procedure with regard to the regulations?
Jo Churchill
I thank my hon. Friend for that. If he will allow me to go through what I wanted to say, I hope it will be clear why we have used that procedure.
The rapid and frequent amendments to the regulations have been critical to ensuring that the Government can respond to the threat from the pandemic and its impact. The use of the emergency procedure has enabled us to respond quickly, begin a cautious return to normality and reopen the economy as soon as possible. I recognise that there may be frustrations that we have had to run parliamentary process in parallel during these unprecedented times, but I believe that we have demonstrated the advantages of our flexible constitution. I wish to make it clear that these are extraordinary times and measures, and we are definitely not setting a precedent for how the Government engage with Parliament on other matters and in more usual times. I am very grateful to all hon. Members for their patience and continued support during these difficult times.
Mr Mark Harper (Forest of Dean) (Con)
May I just pick the Minister up on the point made by my hon. Friend the Member for Hazel Grove (Mr Wragg)? The thrust of the amendment No. 4 regulations—I accept, if you will give me a little latitude, Madam Deputy Speaker, that they are not the ones that we are debating, but I think the Minister referred to them in her remarks—was announced on Tuesday or Wednesday last week. I do not see what would have prevented a draft of those regulations being laid for debate on Thursday, so that the House could have taken a decision on them before they came into force. Would that not have been better, particularly because they are legally quite complicated in how family support structures are translated into law? That would have been better for our legislative process.
Jo Churchill
I thank my right hon. Friend for those remarks. I will certainly take that back and feed it in, because I know that he is not alone in feeling that we could improve the time sequencing slightly, in order that we get to a place where these matters are debated fully. I reiterate, however, that these are unprecedented times, and being able to debate complex differences between the timings needs to be thought about.
Jo Churchill
If my hon. Friend will forgive me, I am going to make a little progress and then I will of course take another intervention.
All over the world we are seeing the devastating impact of this disease. It has already radically altered our way of life, and it has, very sadly, taken loved ones away. That is why the Government put in place social distancing measures to slow the spread of the virus and protect our NHS, in order to save lives, and they have been successful. Despite the tragic loss of life, the UK has slowed the spread of coronavirus. Our health system was not overwhelmed and it retained sufficient hospital beds, ventilators and NHS capacity. I am extremely grateful to the public for their continued compliance with these measures, which have been instrumental in us reaching this point.
Now we must begin to recover and slowly rebuild our way of life. The Government’s objective is to return to our way of life as soon as possible, restarting our economy in a safe and measured way that continues to protect lives and support the NHS. On 11 May, the Prime Minister made a statement to the House outlining the Government’s road map for easing restrictions. We have entered phase 2. This involves gradually replacing the current social distancing restrictions with smarter measures that have the largest effect on controlling the epidemic but the lowest health, economic and social cost.
Mr Wragg
I am extremely grateful to my hon. Friend the Minister, to whom I pay full tribute for her incredibly hard work, for indulging me with this intervention. Would it not be possible for the Government to at least lay a written statement on their reasoning as to why some measures have been relaxed and others have not?
Jo Churchill
If my hon. Friend will indulge me as I go through my opening speech, I will address that in my concluding remarks. There is transparency in relation to the SAGE minutes, which are readily available and give a clear example of why decisions are being made and the scientific basis for them.
We are very aware of the burdens that these regulations have placed on society and on individuals. The 1 June amendments play a significant role in reducing the restrictions and lifting some of that strain. It is necessary for the Government to respond quickly to the reduced rate of transmission and to protect individual rights. At all times the regulations in place must be proportionate and necessary. Following on from the small change made to the 13 May amendments, which were debated by a Committee of this House on 10 June, these amendments go a step further. We recognise the toll placed on individuals and families unable to meet loved ones, and have amended the regulations to allow for groups of six to meet outdoors. We hope that these amendments will relieve that burden to some extent.
I will now outline the changes made on 1 June, which include allowing increased social contact outdoors, in either public or private space, for groups of up to six people from different households; enabling elite athletes to train and compete in previously closed facilities; opening some non-essential retail while expressly providing for businesses that remain closed; ensuring that venues such as community centres can open for education and childcare services; and ensuring that those required to self-isolate on arrival in the UK can stay in hotels. We have also amended the maximum review period to 28 days. This longer review period ensures that we will be able to fully take into account the impact of any previous amendments before making further changes.
Sir Charles Walker (Broxbourne) (Con)
I have looked at the regulations. Am I right in thinking that people are still prevented from staying over at a friend’s house or a partner’s house, or has that been amended as well?
Jo Churchill
It is my belief that they can stay over if they are within the guidelines of the social bubble—that is, if they are a single person. There are several distinct areas and I am happy to discuss them with my hon. Friend, or to write to him to clarify them. They are clearly laid out in the regulation of what is or is not applicable.
The Government continue to work on the process of gently easing restrictions as it is safe to do so, in line with the ambition set out in the road map. Working alongside scientists and experts, we must act swiftly to respond to current infection levels and our assessment of the five tests that have been set out previously. I am sure that we all support the aim to protect and restore livelihoods by only keeping in place restrictions that are proportionate and necessary. We of course remain ready to reimpose restrictions if the need emerges in the future, although we all hope that that will not be the case.
Mr Harper
I am grateful to my hon. Friend for giving way. In asking her a question, may I respond to my hon. Friend the Member for Broxbourne (Sir Charles Walker)? The reason for the confusion goes back to the point that I just made. My hon. Friend asked about what has been called the “bubbling” of households, the putting of households together, which was announced at one of the press conferences last week. It has been turned into legislation, which was laid before this House on Friday, but we are not yet debating it. So we are debating one set of amendments, but a new set has already come into force and the reason for the confusion is that we are not yet debating it. I think that rather proves my point that we should really have debated that legislation in advance of it coming into force. I hope that my hon. Friend’s confusion, and he is not a man easily confused, demonstrates the point about why that is important.
Jo Churchill
I thank my right hon. Friend the Member for Forest of Dean (Mr Harper) for the clarity with which he put that.
I have already noted that further amendments were made on 12 June and have now come into force. Those will be debated by this House in due course. I am grateful to all parliamentarians for their continued engagement in this process, and for their continued scrutiny, which is rightly and importantly exercised for each set of amendments.
Jo Churchill
I thank all hon. Members who have spoken. The debate has exemplified quite how challenging and complex this situation is. Throughout it, we have discussed both opening up and not opening up at the same point. The regulations state that the Secretary of State should ensure that restrictions are lifted at the earliest opportunity if no longer necessary for public health. These measures are incredibly restrictive, and we should not leave them in place a moment longer than we need to, but we have to go with caution. Parliamentary scrutiny is essential, but we could not justify to the public keeping the restrictions in place longer while we await a debate.
The changes are broadly consistent with the road map that the Prime Minister laid out to this House on 11 May. Over the coming weeks and months, we will continue slowly to ease the restrictions put on individuals, society and businesses by the regulations, if and when it becomes safe to do so. The amendments debated today play a significant role in that gradual return to normal life. This requires a constant and careful review of the evidence and of the impact both of measures remaining in place and of the amendments we have made to them. We are being guided by the science, and the Government are making changes only where we are confident that it is safe to do so.
Peter Kyle
Let me quickly put on the record my thanks to the Minister. At the very beginning of the outbreak back in February, when the first outbreak was in my constituency, she briefed me daily and was constantly available as a source of information at that point, so I thank her.
Can the Minister explain to the House why, on issues such as zoos, in the few days it has taken to get this statutory instrument to the Floor of the House, there has already been a U-turn? Why is there so much confusion about this announcement?
Jo Churchill
I would argue that this is a dynamic situation. For example, with zoos, scientific evidence indicates quite clearly that open spaces are much safer for people to be in, so a degree of logic applies. It is very difficult to argue that we do not want things opened, while at the same time requesting that businesses and so on are opened. There has to be a degree of walking slowly, and I hope to come on to that. Several Members raised the fact that there appear to be inconsistencies, but I would argue that the Government are maintaining only the restrictions that are necessary and appropriate at any given time.
Justin Madders
I want to come in on the point made by my hon. Friend the Member for Hove (Peter Kyle). Paragraph 23C of schedule 2 deals with aquariums and zoos, including safari parks, and we just need to be clear about the Government’s position on that. Are they now saying that that paragraph is no longer going to be applicable, or are zoos part of this? I would be grateful if the Minister could clarify that, please.
Jo Churchill
Zoos have been closed as a consequence of the restrictions since they came into force on 26 March. Until 1 June, zoos were in effect closed as a consequence of regulation 6, which required people not to be outside their homes other than for a reasonable excuse. I think we would all agree that that does not include visiting a zoo. Aligned with the scientific advice on 12 June, the regulations were signed to permit outdoor areas of zoos to open, but obviously not the inside areas.
The debate today has provided an opportunity for the Government to hear the concerns of a wide range of society through the contributions made by right hon. and hon. Members, and I now turn specifically to the debate. First, I would like to say that I have heard the frustrations. Regulations have to be made urgently, given the impact they have on individual rights and to respond to the latest possible evidence. Debates are organised and scheduled through the usual channels, which, I would just say, are not always as fleet of foot as others.
In response to the hon. Member for Ellesmere Port and Neston (Justin Madders) and my right hon. Friend the Member for Forest of Dean (Mr Harper), the Secretary of State keeps the restrictions and requirements under constant consideration throughout the 28 days. It is a continuous cycle, rather than a fixed point in time for a review. If I understood the argument of my right hon. Friend the Member for Forest of Dean correctly and we took it to a logical conclusion, it would mean that as we lifted restrictions, it would actually take longer were we to be iterative over those 28 days, rather than processing easing as we currently are.
Jo Churchill
Yes, finally, although I am sure the House would appreciate it if we just pushed on.
Justin Madders
I appreciate the Minister’s tolerance in letting me intervene again. Can we be clear on the reviews? I appreciate why the Secretary of State will be doing that on an ongoing basis, but the Opposition would like to see those reviews in some documented form so that we can understand the basis on which restrictions are eased and implemented.
Jo Churchill
To that point, I will address the comments that the hon. Gentleman made about transparency. In recognition of these unprecedented times, SAGE has been publishing statements and the accompanying evidence it has reviewed to demonstrate how the scientific underpinning and understanding of covid has continued to evolve. As new data emerges, SAGE’s advice quickly adapts to new findings and reflects the situations.
I would like to turn to the impact assessments.
Julian Sturdy (York Outer) (Con)
Before the Minister moves on, will she clarify the move from 21 days to 28 days? If the matter is under constant review, which she says it is, I still cannot understand why we have moved from 21 to 28 days. Will she clarify that for me?
Jo Churchill
My understanding is that, as the situation is abating, to push the review out to 28 days while making a constant assessment is deemed the right thing to do to allow a more fluid process.
A full regulatory impact assessment is not required for regulations that last for less than a year. As the regulations are set to expire six months after they come into force, they therefore fit that criteria. However, the Government are considering the economic impact of the regulations on businesses and individuals, as well as the personal impact on those with protected characteristics, on people’s mental wellbeing and on religious groups and many others. As I say, this is an extremely testing and complex situation.
On testing, we have delivered a national response and have rapidly scaled up testing. From some 2,000 tests a day only back in March, we now have the capacity to conduct over 200,000 tests a day across the entire testing programme. Increasing our testing capacity is one of the greatest national mobilisations we have ever seen, and I thank the hon. Member for Hove (Peter Kyle) for his kind words. Back in February, the numbers of cases were such that we could trace at that point.
Moving on, my hon. Friend the Member for Broxbourne (Sir Charles Walker) said how important it is to get businesses open and to get back to work, and I could not agree more. The hon. Member for Westmorland and Lonsdale (Tim Farron) explained the challenges in the tourism industry. My hon. Friend the Member for Mid Worcestershire (Nigel Huddleston) is looking at the unprecedented impact that covid-19 is having on the tourist industry in order to deliver some of the changes that I am sure my constituency of Bury St Edmunds would like to see, as it relies heavily on tourism. I, for one, cannot wait to get back to the hon. Member for Westmorland and Lonsdale’s part of the world. The first walk we ever do when we go there is Swedish Bridge, but to go round the horseshoe or along the coffin trail would be a delight in the current circumstances.
For my right hon. Friend the Member for Forest of Dean, I can make clear that Her Majesty’s Government have given clarification on exactly what is provided for in the regulations and what we additionally suggest as guidance to come out during the review period. There is a complexity in the guidance, and I take on board his broader points. I agree that everybody has so far followed the guidance in a remarkable way.
I thank all Members for their contributions during the debate and provide assurance that we have listened and will take the House’s views into account as measures are kept under review. As I said when I opened the debate, we are incredibly grateful to the public for their sacrifices and their efforts to follow these tough measures. I also pay a fulsome tribute to our NHS and care workers and all the key workers for their ongoing hard work to keep our vital services running, to save lives and to keep all of us safe. I commend these regulations to the House.
Question put and agreed to.
Resolved,
That the Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No.3) Regulations 2020 (S.I, 2020, No. 558), dated 31 May 2020, a copy of which was laid before this House on 1 June, be approved.
Madam Deputy Speaker (Dame Eleanor Laing)
In order to allow the safe exit of hon. Members participating in this item of business and the safe arrival of those participating in the subsequent item of business, I am suspending the House now for three minutes.