Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 13th April 2021 Commons Chamber

[Nadhim Zahawi]

I am grateful to my hon. Friend, and I echo his comments about the incredible work that is happening across the London borough of Sutton. I thank him for his work in promoting the vaccine, and according to the latest NHS figures almost 90,000 individuals have had their first dose of covid-19 vaccine in Sutton. To this end we are working closely with faith and community leaders to help to spread information about vaccines through trusted, familiar voices and in a range of different languages and settings. That also means leveraging the influence of celebrity figures such as Sir Lenny Henry and the powerful and incredibly moving “call to action” letter and video to black and Afro-Caribbean communities. This is really important. We are also working to support the vaccine programme over important religious observances such as Ramadan, which begins today. We are working with the Muslim community and reiterating the verdict of Islamic scholars and key Muslim figures within the NHS that the vaccine does not break the fast and is permissible, so come and get your vaccine.

[Karin Smyth (Bristol South) (Lab)]

What assessment he has made of the use of do not attempt cardiopulmonary resuscitation orders during the covid-19 outbreak.

[The Minister for Patient Safety, Suicide Prevention and Mental Health (Ms Nadine Dorries)]

In October 2020, I commissioned the Care Quality Commission to review how do not attempt cardiopulmonary resuscitation decisions were taken throughout the covid-19 pandemic and whether they had been inappropriately applied. We welcome the CQC report, which was published on 18 March, and we are committed to driving forward delivery of the recommendations through a ministerial oversight group, which I will chair, to ultimately ensure that everyone experiences the compassionate care that they deserve.

[Karin Smyth [V]]

I welcome the Minister’s comments. It is over a decade since I worked with clinicians on how to communicate end-of-life care, so I was shocked by some of the reports and by reading the CQC and Compassion in Dying reports. The lessons learned from coronavirus can and should be seen as a catalyst to having more open and honest conversations about this decision making and advanced care planning. Will the Minister commit to a public awareness campaign, including groups such as Compassion in Dying, Marie Curie and Hospice UK, to ensure that patients are fully aware and at the heart of these decisions?

[Ms Dorries]

I thank the hon. Lady for her question. That is exactly what we are trying to do at the moment. We have posted a public-facing message on the nhs.uk website, which informs the public about how DNACPR decisions should be taken and the process involved. There should be no blanket application of DNACPR notices. Every patient should be involved in the decision when a notice is applied, as well as the family, relatives and care workers, and where possible it should be signed by a clinician. This engagement with the NHS, the wider public and the voluntary and care sectors is ongoing, and we continue to monitor it.

Covid-19 Update

Karin Smyth Excerpts

Tuesday 9th February 2021 Commons Chamber

[Matt Hancock]

I am delighted to see that there are some parts of the country where the case rate really has come down a long way—down to 25. It is important for us to make sure we get the levels down across the country. We have seen before that when there are areas that are low, there is spread from elsewhere in the country. The experience of last summer was that tourists travelling to go on holiday within the UK did not contribute to an increase in levels. It was when levels elsewhere got much higher that we saw the transmission to other parts of the country. It is those judgments that will inform the road map proposals that the Prime Minister will set out on 22 February. I wish I could say more in more detail to my hon. Friend, but it is for the Prime Minister to set that out later this month.

[Karin Smyth (Bristol South) (Lab) [V]]

The news of the new mutation is obviously of great concern to the people of Bristol, but local public health officials have rapidly set up new testing centres, including five new collect and drop testing centres today. It is a massive effort locally, and hundreds of people have come forward voluntarily since Sunday to be tested. Will the Secretary of State join me in thanking those local public health officials in Bristol and the people who have come forward? Will he join me in encouraging more people in those postcode areas that have been identified to come forward for surge testing to help us understand this virus better?

Public Health

Karin Smyth Excerpts

Wednesday 6th January 2021 Commons Chamber

[Karin Smyth (Bristol South) (Lab) [V]]

Thank you, Mr Deputy Speaker. Retail, hospitality, care, building and trades are the biggest employers in Bristol South. There have been many job losses, but many people are working in those industries and they are keeping our city going. They have done everything the Government have asked of them and we now need to make sure that they are safe, that we get this vaccine delivered and that we open our economy.

I have worked for many years with local GPs and the NHS in the city, and I know them well. I have worked very closely with the team at Ashton Gate stadium, who are on standby to deliver the vaccine. We have a good standard of general practice in south Bristol and good collaboration. They have already started and the Ashton Gate team have been ready for weeks. However, they are all being kept rather in the dark about the expectations upon them and what is happening nationally with the roll-out.

We therefore have some basic questions that we would like the Minister to answer. They are basic project planning “why” questions. We know why we are doing this, but providers locally need to know what vaccine is coming. They need to know who is going to the GP. They need to know how far down the JCVI list we want GPs to go. They need to know how we want them to be called. I think that it is sensible to do the over-75s, care homes and perhaps the clinically vulnerable, but if GPs are going beyond that list, they need to know because, basically, they need to get back to their day job.

We need to know where people are going to be vaccinated. Are the rest of us going to our GP or to Ashton Gate? We need to know when we are going. I understand the reluctance of Ministers to commit to dates—this is a complex manufacturing, distribution and delivery process—but I agree with the right hon. Member for Forest of Dean (Mr Harper) and my hon. Friend the Member for Sheffield South East (Mr Betts) about transparency. Crucially, those who are delivering the service need to know and we, as MPs on behalf of our constituencies, need to know when it is happening.

I have done a back-of-a-fag-packet estimation. South Bristol has about 16,000 over-65s, and GP practices can do roughly 500 to 600 vaccinations a day, so in roughly 30 days we could vaccinate all those over-65s in south Bristol. However, that depends on knowing when we are going to get the vaccine delivered and what the expectations are on the deliverers.

I will support these draconian measures tonight, but I do not want the Government to again impose on us here in Bristol the disaster of the national one-size-fits-all, crony-backed, whack-a-mole nonsense that we have had from them. Our local CCG is doing a good job. We have good collaboration on the ground in south Bristol with GPs and with the people at Ashton Gate stadium. They know what to do; they need support and clarity to get on with it and to make our city safe so that we can resume our normal working lives.

Covid-19

Karin Smyth Excerpts

Wednesday 18th November 2020 Commons Chamber

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

I beg to move,

That this House has considered covid-19.

Yesterday, there was an increase of 19,609 cases of coronavirus in the UK, and sadly we recorded 529 deaths. I am sure I speak for everyone when I say that our sympathies and prayers are with each and every family. It is a stark reminder, if we needed one, that we still have a long way to go in beating this disease and seeing our country thrive again.

I know that Members across the House will join me in wishing those who are currently unwell a speedy recovery and thanking all the staff across health and social care and key workers for all they do, but I would also like to mention one or two who do not always get a mention: those working in community health, including our health visitors and our pharmacists, and many of the volunteers who keep many of the shows on the road.

As the Office for National Statistics report on loneliness earlier today showed, these changes are taking a toll on our lives. They are taking a toll on individuals, families and businesses, so the news this week of further successful vaccine trials with Moderna and today’s update from Pfizer have given rise to the very real prospect of an effective vaccine in the near future. While I share that sense of hope with many, we still have some way to go, and we must never lose sight of the challenges that we face at the moment. A vaccine still has to go through a regulatory process, but it is right that the planning of the huge logistical exercise of a vaccine roll-out led by the NHS is now very much under way. Throughout this pandemic we have had to learn, and each week brings further understanding.

As more information continues to emerge on the risks of long covid, for example, we are reminded how this virus can remain a threat. I am sure hon. and right hon. Members will be pleased to hear that the NHS will have a network of 40 long covid clinics in place before the end of this month, bringing together doctors, nurses, therapists and other NHS staff to help those patients suffering from the lasting effects of this virus. That is an example of how our response to the virus has to continue to evolve and strengthen to protect staff, patients and the public, moving with the science as we learn more.

It is hard to overstate how little was known about the virus at the start of the year. We have done many things for the first time, and the learning curve has definitely been a steep one, but looking back, we have come a long way through this difficult year. We have always sought to base decisions on evidence, data and scientific advice, and we have been willing to reflect and adapt as we go. From repatriating individuals from Wuhan in the early days of the pandemic, we have constantly faced and met enormous challenges. In the words of General Sir Nick Carter back in April, distributing personal protective equipment, for example, was

“the single greatest logistical challenge”

in his 40 years of service. However, with others helping, such as the Army, we built those supply chains and responded to demand. In some areas, demand went up by 17,000% for eye protection, for example, and by approximately 4,700% for masks. So far, we have distributed more than 4.9 billion items of personal protective equipment to the frontline, and today we have a four-month stockpile in hand across all nine key lines, with a further 32 billion items of PPE on order. We have regularly delivered to more than 58,000 health and care organisations. I would like to pay tribute to Lord Deighton and his team for their extraordinary efforts in building resilience into the supply chain, to enable us to be as confident as we are today.

I am clear that none of this would have been possible without the incredible collaboration we have seen between industry, social care providers, our NHS, the armed forces and others. Industry and individual businesses stepped up to meet the challenge. At the start of the pandemic, only 1% of PPE was manufactured here in the United Kingdom. By the end of the year, we will be manufacturing 70% of the amount of PPE we expect to use from December to March in all key areas bar gloves. This enormous national effort has put our country on a strong footing today and for years to come. Following the launch of the PPE strategy in September, we are looking at sustainability and initiating a UK production site for gloves.

[Karin Smyth (Bristol South) (Lab)]

I accept that it was an extraordinary time and that extraordinary measures needed to be taken, but as we have heard from the National Audit Office today, tried and tested processes and procedures were not used. Will the Minister say something about that report and why that was the case, why we had 11 ministerial directions by May and whether those lessons have been learnt by her Department and others that fell foul of the procurement procedures?

[Jo Churchill]

The NAO report to which the hon. Member refers highlights that we were acting with “extreme urgency” in a global market where demand exceeded supply. The report states that the situation in responding to the covid-19 pandemic was unprecedented, but that we

“secured unprecedented volumes of essential supplies necessary to protect front-line workers.”

[Karin Smyth]

Will the Minister give way again?

[Jo Churchill]

If the hon. Member will bear with me, I will continue.

The NAO report examined potential conflicts of interests involving Ministers and the awarding of contracts and found none. It states:

“we found that the ministers had properly declared their interests, and we found no evidence of their involvement in procurement decisions or contract management.”

The report recognises that there are robust processes in place for spending public money, to ensure that critical equipment got to where it needed to go as rapidly as possible while ensuring value for money. I welcome the report, because we can all learn.

--- Later in debate ---

[Jo Churchill]

I will come on to the area of cancer, in particular. Strides have been made in different ways of treating virtually, so that fewer people go into the hospital setting, and so on. I take the hon. Gentleman’s point about capacity, but that is why the Government have committed to building 40 new hospitals—because there is a need to ensure that sufficient capacity is available across the country for people.

[Karin Smyth]

Will the Minister give way?

[Jo Churchill]

I am going to push on a little bit and then I will give way again.

This enormous national effort has put our country on a strong footing for today and years to come. We are using the best of British ingenuity to help us to deliver in this area. Progress has also been seen in other areas. As the pandemic unfolded, the UK could not call on a major diagnostic industry. From a standing start of about 2,000 tests a day in March, our capacity is now over half a million tests per day. This matters, because it has often been said in this place that in order to beat the virus we need to draw on different parts of our armoury to help to get us through. Testing works. It helps to deny the virus the connections it needs to spread. Mass testing therefore offers us a chance to achieve that on a much bigger scale. We are making progress in city-wide testing in Liverpool. I thank Joe Anderson for his leadership in helping to deliver not only in testing but in other areas too. We are also rolling out a further localised approach to other areas with the help of directors of public health, among others, who know their local areas. Some 83 local authorities have now signed up to receive regular batches of lateral flow tests, which allow for a result to be seen in 15 minutes.

Further, I know that hon. Members will celebrate Monday’s announcement of two mega-labs coming on stream early next year—very high-throughput laboratories, one in the midlands and one in Scotland, adding a further capacity of some 600,000 tests per day. These are massive gains that we are achieving by embracing cutting-edge technology such as automation and robotics and harnessing the best of British industry and academia, meaning that we will not only be able to process more tests but that they can be processed quicker and at a lower cost. The mega-labs will be another powerful weapon in our defence against this deadly virus in order to get back to a more normal way of life, but more than that, they will form a permanent part of the country’s new diagnostic industry. They can help us to respond in the future and build further resilience.

I am excited at the potential for a new diagnostic industry to help to care and deliver across other disease types, not least cancer. Hon. Members will know that, informed in large part by my own experience, I was an advocate of improved cancer outcomes long before I came to this place or took on this role. Early diagnosis is the key to beating the disease, and with bold steps forward in diagnostics, I would like it to make it my mission—I am sure with many others across the House—that we seize new opportunities in cancer services so that covid-19 is not a derailer but an opportunity for a new phase in smarter, faster diagnostics.

--- Later in debate ---

[Alex Norris]

The hon. Gentleman gives a concerning example that shows how the system is struggling in general. I hope that the Minister will address that issue when she winds up the debate, and I will refer more directly to local authority public health shortly.

I do not want to carp on about what is not working without providing any solutions, so I come armed with three things that Ministers could do at a stroke of their collective pens that would radically improve test and trace in short order. First, we must better use NHS lab capacity to turn tests around. I very much welcome what the Minister said about megalabs, which we have eagerly anticipated for some months. However, there has been a large gap in which we have not had that lab capacity, and we will not have it for some time yet. In the meantime, let us put our NHS lab capacity to use in getting tests turned around.

Secondly, we should give control and resources to local authorities to run the tracing operation. They know our communities and already have a local presence. They are a trusted voice and, crucially, they do this routinely. They do this already. Admittedly, that is on a smaller scale—perhaps related to an outbreak of food poisoning linked to a takeaway—but they do it effectively. Let us support them to do it fully. Thirdly, we must develop a proper package of support for those who need to isolate—that is self-evident. Those three things could be done immediately, and we would all be better off if they were.

We have seen the consequence of failure and of a test and trace system that is struggling, and that is another lockdown. This time last year we were banging on doors in the cold and the rain, and none of us supported the lockdown because we want to keep family members away from each other, or to shut businesses in our community or anybody else’s. However, the failure to break the transmission rate of the virus leads us there.

There are two important things that I wish the Government would communicate more. This is not a choice between lockdown and the economy; it is not a choice between lockdown and non-covid healthcare treatment in the NHS. We must have the lockdown for those purposes, and the longer we delay putting restrictions in place, the worse are the long-term impacts on our economy. If we do not introduce regulations to reduce the transmission of the virus, the greater are the pressures on our hospitals, and the less likely they are to be able do other treatments. Those things are not in tension; they are very much complementary.

The failures of test and trace may have led us to a lockdown, but that lockdown buys us time to sort out problems in the system. We must see progress. Lockdowns alone will not tackle or eradicate the virus, but they buy us time to put in place the things that do. We have now had two weeks of lockdown, but we have not heard about what is improving in the test and trace system, or what will be better, including in the next two weeks. Ministers really need to say this today, so we can be sure and confident that the time is being used wisely. Otherwise, when we leave lockdown, this will all recur again, something that none of us wants.

We are all very wary of Christmas. Depending on which newspaper Members read, they may have woken up yet again to see that the Government’s plans, this time regarding yuletide festivities, had been briefed out to national newspapers. Putting aside the discourtesy to the Speaker and Deputy Speakers, to all of us and to this place in general, that is all well and good, but those plans are only going to be feasible if the right efforts are put in place now and this time is used wisely.

It also ought to be stated that this lockdown is longer and more painful than it needed to be because, once again, the Government acted too slowly. The scientists told them they needed to lock down, as did we, but for two weeks the Prime Minister disregarded reality, which meant that the situation worsened. That has meant that the lockdown will be longer and harder, and also meant that we lost the benefits of the school holidays. These are mistakes that cannot be repeated in the future.

As we exit lockdown, the Government need to be honest with the British people—not in off-the-record briefings to mates in the media, but to the British people—about what will come next, both at Christmas and in the return to a tiered system. I know from our experience in Nottingham that trying to negotiate restrictions was painful, even when we wanted them at the beginning of October as our infection rates increased precipitously. We could not get the initial restrictions we wanted, because the Government were moving to the tiered system and it did not fit their timeline. We then managed to get into the tiered system at tier 2; the next day, the Government said that they wanted us to move into tier 3 and were going to call us, which they did not for a further week. Eventually, we had the painful negotiations about what that actually meant for Nottingham: we brought those restrictions in on the Friday, and by the Saturday, the national lockdown had leaked out. The system has not worked for Nottingham, so we need to know that in any return to a tiered system, the Government are going to work much more quickly and in a more agile manner. Every day wasted is a day when the virus thrives, so we need to be better upon exit.

Turning to the vaccine, we strongly welcome the Government’s efforts in this area: they were right to pre-order doses across a wide portfolio, and they were also right to back British. With our excellent research and our proud record in this area, we should be in the vanguard of it, and patriotic about our efforts to tackle this global issue. Last week, I responded on behalf of the Opposition in an excellent Westminster Hall debate on the covid-19 vaccine, secured by the hon. Member for North Herefordshire (Bill Wiggin), the day after the news broke that the Pfizer-BioNTech vaccine had achieved success in a phase 3 study. Since then, we have heard similarly positive news about the NIH-Moderna vaccine candidate, which is likely to be followed by other candidates, whether that of the University of Oxford and AstraZeneca, the candidate referenced by the Minister, or candidates developed elsewhere. I understand that overnight, there have been further promising developments for a Chinese candidate.

During that debate, colleagues and I raised the challenges and considerations that need to be addressed to make sure that this is handled and executed well. I will not repeat those contributions in the level of detail we went into then—they are on the record in Hansard for people to read. However, the theme was that we cannot repeat the slowness or logistical challenges that we saw early in the pandemic with regard to the procurement of personal protective equipment and testing: no Nottingham people being sent to Llandudno or Inverness for their healthcare this time, please, Minister.

As we have done throughout the pandemic, we on the Opposition Benches will work constructively with the Government to support viable vaccines being secured, ensure the right groups are being prioritised, develop an effective delivery programme, counter vaccine hesitancy—that is critical—and continue to support these efforts globally. A failure on any of those points will undermine the whole process, so it is absolutely crucial that we come together, and I am sure that Ministers will welcome that.

However, I want to briefly reference a point that my hon. Friend the Member for Bristol South (Karin Smyth) made regarding the NAO report. Again, we understand—as that report did—that the Government were having to do things that would normally take 18 months’ worth of planning in hours and days, and that comes with some efficiency trade-offs. However, we did not hear clearly enough in the Minister’s opening statement a sense that that has been reflected upon, and we did not hear what will be different in future to make sure those mistakes are not repeated.

[Karin Smyth]

I appreciate my hon. Friend having picked up on the point I made. The Minister very carefully read out a statement in reply to my question about the Government’s response to the NAO report. I am concerned that she was saying that the Government stand by what they did in that period, and do not think that the way in which those contracts and large procurement processes were handled was a problem. It may be that the Minister wants to correct the record, but if that is the case, does my hon. Friend agree that that is deeply worrying?

[Alex Norris]

I heard the point that the test had been clear that nothing wrong had been done, which, frankly, is a very low bar. I do not think anybody would say that there was nothing that happened in the early procurement phases that we would not perhaps want to change or do better later. I hope that the Paymaster General in winding up might reflect on that.

Perhaps this is the best place to say that the announcement on long covid will be very much welcomed by a lot of people, including my good friend Jo Platt who has been campaigning on this for many months, as well as living with her long covid. This is a story for lots of people up and down the country, across all our constituencies, who are living with the after-effects of this horrible virus over and over again. The act of knowing that they are being heard, as well as the 40 clinics, will be a real tonic to a great number of people, so we very much welcome that.

I turn to inequalities. At the beginning of the pandemic, we talked about the virus being a great leveller, not distinguishing between us depending on our lives, our jobs and our postcodes, but nine months on we know that to be patently untrue. Sixty per cent. of those who died were living with disabilities. Those of Bangladeshi heritage are twice as likely to die as those who are white British. Those of Chinese, Indian, Pakistani and black Caribbean ethnicities are 10% to 15% more likely to die than I am. Mortality rates in the most deprived communities are more than twice those of the least deprived communities. This pandemic has shone a light on our inequalities, whether that means the inequality in work, in housing or in income, and these inequalities have had tragic consequences for some and, in the aggregate, are catastrophic for all of us.

When we beat this virus, which together we will, what comes out of it must be a fair settlement that recognises these inequalities as bad and tackles them head-on. That is why it is already concerning to see again—of course, leaked to national newspapers—that the overseas aid budget is the first on the chopping block. In 2010, the Government chose to target those who had the least to pay for a crisis that they did not cause, and these reports are a sign that maybe this is the plan again. We will not let them repeat this in 2020. It simply would be hugely unjust.

Before I finish, I would like to take this opportunity to thank our incredible NHS and social care staff for all they have done for us. They are truly the best of Britain. Similarly, the pandemic has revealed the key workers all over our communities and all over our economy, so this week, during Respect for Shopworkers Week, I would like to say a special thank you to those working in our shops, keeping us fed, but still facing rising violence and abuse every day. The Government should take better action to protect you—the Government could, of course, adopt my private Member’s Bill and I encourage them to do so—but whether it is that or through another mechanism, we will fight for you until they do.

In conclusion, now more than ever we must stand together as a country, as families and as communities, and show once again that at a moment of national crisis, the British people always rise to the challenge, support those who need it and pull together. That involves not only recognising successes, but assertively tackling the failures that have held us back during the pandemic. If we address these, we will beat this virus.

--- Later in debate ---

[Karin Smyth (Bristol South) (Lab)]

Back in March, when our worst fears were confirmed and the first lockdown hit, I thought that some aspects of the UK Government’s response would be taken as read. I worked in public health and emergency planning before entering this place, and I know at first hand what a response should look like in the most basic terms and what it should feel like. I expected usual processes to function and best practice to kick in, and for muscle memory and accepted norms to initially, at least, shape our response. And I expected all that to happen underpinned by Government support.

I accept that the extraordinary nature of those months, as the Minister said in opening this debate, was unusual, However, as the National Audit Office report states, there were 11 ministerial directions. I do not accept that the virus was unexpected: the scenario planning was based on a threat of this type. I do not accept that the NHS was prepared: the Government were consistently warned that running at 95% capacity was not sustainable. And I do not accept that the way in which the response was led is beyond scrutiny.

What we heard from the Dispatch Box earlier was worrying, and I hope that the Paymaster General will clarify the situation when she winds up the debate. Essentially, the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), said, “Nothing we have done was corrupt.” However, issuing a ministerial direction is serious. It is about regularity, propriety, value for money and feasibility —and these contracts do not stand that test. One of the contracts for free school meals, for example, was with Edenred, a French company. There was no formal tender process under the emergency regulations, despite existing processes and companies being able to provide those critical school meal vouchers back in early spring. That took so much time and energy from schools in my constituency. It affected vulnerable children and that is totally unacceptable.

We may not be able to scrutinise the Government as we should because we passed the Coronavirus Act 2020, but the Select Committee on Public Administration and Constitutional Affairs, of which I am a member, will continue to do its job. I hope the Government will consider a more open and transparent way of operating in the coming months and that they will look at our report—the Minister gave evidence to the inquiry—in order to learn some of the lessons of what we should have used from the Civil Contingencies 2004. I am afraid time precludes me from talking about that in more detail, but we should return to that in this place.

I said in July that I hoped that we had turned a corner and that there would be more local work and a more local response. I genuinely thought that we might, but we have not, have we? As my hon. Friend the Member for Nottingham North (Alex Norris) has outlined, we will continue to try to make positive suggestions, but it remains the case that people in Bristol South are being disproportionately hammered by covid compared with other parts of the country. For the young and the very old, those on low incomes or in insecure work, those living in houses in multiple occupation, those from black and minority ethnic communities, those from multi-generational households, the cooks, cleaners and retail and hospitality workers, and those who rely on the Government, their inequalities are being exacerbated. This is made worse by the fact that the Government have lost time and wasted valuable knowledge that they could have used locally to manage the system better.

On the Select Committee on Public Administration and Constitutional Affairs, our inquiry has shown that the disconnect between the local and the national has been deeply problematic. In early May, we heard evidence from Sir Ian Diamond of the Office for National Statistics about how we could have utilised much of the data that is available much better, but again the Government have been too slow, and we need them to try to be much better. I think lessons are being learned, but I do not think they are being learned by Ministers and the Cabinet; the political direction and leadership are desperately worrying. We want the Government to do much better, and it is not too late to reset—it really is not. Our lives and our families depend on it, but it is crucial that the Government build back trust and admit where they have got things wrong. People will understand that. We need to empower local capacity and knowledge to lead the work, shape local solutions to the challenge, and deliver on the ground so that we can all have our lives back.

Coronavirus Regulations: Assisted Deaths Abroad

Karin Smyth Excerpts

Thursday 5th November 2020 Commons Chamber

[Matt Hancock]

I respect my hon. Friend’s views, which are deeply and sincerely held, and I respect the fact that the House will debate all views. It is right that that debate is taken forward and led by Parliament, rather than by Government, as my hon. Friend just demonstrated.

[Karin Smyth (Bristol South) (Lab)]

I congratulate my co-chair of the all-party parliamentary group on choice at the end of life, the right hon. Member for Sutton Coldfield (Mr Mitchell), on securing this urgent question, and I thank you for granting it, Mr Speaker. I have sought to change the law since entering the House. In the last five years, I have learned that many colleagues are worried about safeguards. There is an assumption that the law is currently safe, but it is not. In June, here in London, a man threw himself in front of a heavy goods vehicle on the North Circular. He was suffering from throat cancer and knew his tumour would continue to strangle him. He could not bear it. He took his own life because this country denied him the option of choosing the timing and manner of his death. I appreciate that this is a sensitive and difficult issue, but is it not time that we recognise that the law is not compassionate or safe and leaves behind bereaved families and members of the public because of the absence of a safeguarded choice at the end of life?

[Matt Hancock]

The hon. Lady draws a distinction between those who have a terminal illness and the broader issue of suicide, which is an important part of this debate. I respect her sincerely held views. The exchange between my hon. Friend the Member for Congleton (Fiona Bruce) and the hon. Lady exemplifies why it is right that Parliament debates and decides on these matters.

Public Health: Coronavirus Regulations

Karin Smyth Excerpts

Tuesday 13th October 2020 Commons Chamber

[Karin Smyth (Bristol South) (Lab)]

Bristol, in tier 1, has fortunately been able to maintain low transmissions, and hence admissions to hospital and, so far, deaths. We want it to stay that way. My experience of working in the local health system is that this is in large part due to good relationships that have been hard developed over many years, particularly through local resilience forums. There are good relationships with Public Health England and directors of public health. Working together is sustaining some very good work locally, but there is no room for complacency. We recognise that the economy—wealth creation—is crucial to good local health, and we need support from the Government for both those things.

In the short time available, I want to highlight issues around isolating, shielding, and test and trace. As well as reducing social contact, which the Secretary of State talked a lot about, the key to transmission reduction is isolating, but isolation support is woeful and for communities with little money, which face higher unemployment, the situation is worsened. We have to be much more honest about the incentives and the way they work to support people who are isolating. It is hard and the knock-on effects on families are substantial and disruptive. Again, we need local public health people who know their communities to help support those who are isolating. We need much more support for people who are shielding. People do not understand why it is now different from how it was back in March.

Across the House, we all know that the test and trace system is not working. It is causing chaos for the frontline, particularly care home managers and school leaders. There is a balancing act to be done here. Again, we need local support to inform those school leaders and care home managers about how to interpret the guidance. That cannot just be done through the algorithm. It is a disgrace that the test and trace system is not led by a civil servant whom we can hold to account. I do not know how we can hold the Baroness—I do not know whether the courtesies of the House allow me to name her—to account for the system. That must be changed. It is crucial that we can hold people to account.

I accept that the legislation was rushed through in March, and perhaps there was a reason for not using the Civil Contingencies Act 2004 or the public health legislation we are debating today. The Public Administration and Constitutional Affairs Committee has scrutinised this, produced our report and we now need to move to a better way forward. We cannot keep dragging the Government here week after week to do our job, which is to agree to disagree, to scrutinise and to hold to account, based on our experience, the work we do in Committees and our work locally. It would improve the legislation. It would improve local trust, and ultimately that supports the front line and saves lives.

Coronavirus Act 2020 (Review of Temporary Provisions)

Karin Smyth Excerpts

Wednesday 30th September 2020 Commons Chamber

[Nick Thomas-Symonds]

Moving swiftly on.

In England, the number of tests, the availability of tests and the turnaround time simply are not good enough. So dire is the situation that the Prime Minister is arguing with the Health Secretary over whether testing even matters. The Health Secretary has said that

“finding where the people are who test positive is the single most important thing that we must do to stop the spread of the virus”,

and I agree with him. I agree with the Health Secretary. The shame is that the Prime Minister does not appear to, because he has said the complete opposite. The Prime Minister has said:

“Testing and tracing has very little or nothing to do with the spread or the transmission of the disease.”—[Official Report, 22 September 2020; Vol. 680, c. 822.]

Yet again, the Prime Minister refuses to take responsibility for his own actions and his own failings.

The testing of care home residents and staff is critical to saving lives, yet in England there have been repeated delays to the roll-out of testing, and people have waited days for their results. We are also witnessing chaotic scenes at our universities as students are locked down for the want of testing. The Prime Minister has been talking about a “moonshot”, but it is time he stopped looking up at the sky in vain hope and focused instead on what is happening in the everyday lives of families and businesses up and down the country. The failure to show that grip and strategic leadership has severely hampered the way in which the UK Government work with other Governments, as my right hon. Friend the Member for North Durham (Mr Jones) said. Some have not even been properly informed of lockdown plans for their own areas. Let us take yesterday as an example, when we had the chaos of the Prime Minister himself unable to outline what additional restrictions his own Government were implementing for the north-east of England. It is, frankly, an embarrassment, and people deserve better. If the Prime Minister actually bothered to communicate with some of the devolved Governments, he might learn something. In Wales, the tracing system is significantly better. The percentage of contacts that has been reached has been consistently higher than in England, and the Prime Minister ought to follow that best practice.

Let me turn to some of those most at risk in our society. The Health Secretary claimed to have thrown a “protective ring” around care homes in England. If that is what the Government call the shambles they presided over, I would hate to see what they consider a mess to be. Again, the Prime Minister tried to shift the blame, insultingly suggesting that

“too many care homes didn’t really follow the procedures”,

and that was when the Government’s own advice at the start of the pandemic said that people in care homes were “very unlikely” to be infected. The truth is that too many care homes were left high and dry. There was not enough support, insufficient personal protective equipment and a lack of testing. I am sorry to say that some of the most vulnerable paid the price and, sadly, paid the ultimate price. Yet again, care workers, who should be lauded by the Government, were denigrated.

That failure on care homes is particularly relevant as we discuss and debate this legislation and its renewal, because the Act contains provisions that allow for the so-called “easement” of legal safeguards. The Health Secretary said that he thinks those are still necessary, but why are they still necessary? I read carefully the analysis that he published, which did not answer the question. He tried in his speech to make a positive case for it on the basis of prioritisation, but he must realise that that does not deal with the deep concern there is about the situation in our care homes, and he must surely understand that every vulnerable person, throughout this pandemic, must have the standard of care that they need.

We also have significant concerns about the curtailment of the use of GPs to sign death certificates. Again, the Health Secretary said that he wanted to continue with that provision. What assessment has been made about the use of this power? Why does it need to continue? Will he also tell us what its impact has been? Ministers have no excuse for being caught unawares, as they have had months to get to grips with this. We cannot afford for action to protect our care homes and other services to be as slow and chaotic as it was at the start of this pandemic.

On a more positive note, I welcome what the Health Secretary said about the easements under the Mental Health Act; they have not been used and I welcome his assurance that they will not now be used. But what about the easements under the Children and Families Act 2014? He did not mention that Act, and I assume from the silence that they will be continuing. He must bear in mind those with special educational needs and vulnerable children, whose rights should not be rolled back as a consequence of this pandemic. Some of the most vulnerable people have borne the brunt of this virus and this Government’s failings.

We have also seen, across our communities, that the impact has not been evenly felt. Black, Asian and minority ethnic communities have been some of the worst-hit by the virus itself and by the economic fallout, Disabled people and those with underlying health conditions have made up 59% of the covid deaths to date. Despite that, the Government have not done enough work on equality impact assessments on measures or made the necessary evidence available so that we can openly debate and vote to address these deep inequalities. Today, we are faced with an all-or-nothing motion, but let me put the Government on notice that we will not tolerate any discrimination in our society as a consequence of the implementation of these measures. That is why I say to the Government today that they should not be waiting another six months; they should be publishing a monthly review of the impact of this virus on individuals and groups, together with those detailed impact assessments. If the Government continue with the easements under the Care Act 2014, as they say they will, or under the Children and Families Act 2014, they must report regularly to this House about the impact of what they are doing,

[Karin Smyth (Bristol South) (Lab)]

I hope my hon. Friend agrees that the way the Secretary of State has approached this matter today is disappointing. Many of us sit on Select Committees and have scrutinised the way in which this Act has come forward, and are willing to spend more time doing that properly. That is our job as legislators. The approach has been most unsatisfactory, so I completely support my hon. Friend when he says that we need it to be better. There are recommendations in many Select Committee reports, and my hon. Friend should press the Secretary of State to take note of them.

[Nick Thomas-Symonds]

My hon. Friend is absolutely right. She saves me from coming to another part of my speech. Quality scrutiny is available across the House on a cross-party basis, and we have had no credible explanation for why this debate is limited to 90 minutes.

The rights that I have referred to, relating to the easements that the Government are pushing forward, protect vulnerable people—those who need care, those with mental illness and children with special educational needs across the country. We cannot simply put their rights to one side.

On rights, there is a real issue with schedule 21. My right hon. Friend the Member for Leeds Central (Hilary Benn) put his finger on it: the power to detain “potentially infectious persons”, which, as far as I can make out, could include virtually anybody. So far, it has been used for 141 prosecutions, each and every one of which was found to be unlawful when it was reviewed. I cannot think of any other piece of legislation in parliamentary history that that could be said about. All the Health Secretary said was that the guidance had changed and he would keep it under review. With a provision like that, he needs to speak to the Home Secretary and the Justice Secretary and do so much better. A provision that has resulted in 141 unlawful prosecutions cannot be right.

I say to the Health Secretary that the Government have to be transparent and accountable. They must come back not in six months’ time, as set out in Act, but every month to answer for the use of these powers.

Testing of NHS and Social Care Staff

Karin Smyth Excerpts

Wednesday 24th June 2020 Commons Chamber

[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.

[Karin Smyth]

Will the Minister give way?

[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—

Oral Answers to Questions

Karin Smyth Excerpts

Tuesday 23rd June 2020 Commons Chamber

[Matt Hancock]

Absolutely. When we set up the loneliness strategy in 2018, when I was the Culture Secretary, I had no idea that covid-19 would make it so vital. I very much hope that, in England at least, the measures the Prime Minister is due to set out very shortly might help in that regard. Covid has underlined the importance of loneliness as an issue that we must directly and actively tackle.

[Karin Smyth (Bristol South) (Lab)]

At the start of the crisis, as a former emergency planner for the NHS, I thought the Government would trust the local well-established emergency planning systems that were in place and they had my support. However, they have wasted time and money. My hon. Friend the Member for Leicester South (Jonathan Ashworth) is quite right to criticise the Government, because that has led to excess deaths and time lost. It is welcome that we are now supporting the local, but will the Secretary of State tell me why, when his friends at Deloitte have been set up to do the testing at Bristol airport, the complaints process is run through an NHS trust?

[Matt Hancock]

Because this is a big team effort by a combination of public and private sector partners. I pay tribute to Deloitte, without which the testing programme would not be possible. I pay tribute to all the pharmaceutical companies and I pay tribute to Amazon, which has delivered the home testing with remarkable success. Instead of trying to divide, we should unite and bring people together.

Coronavirus

Karin Smyth Excerpts

Monday 9th March 2020 Commons Chamber

[Matt Hancock]

This is a very important point. One thing we will be doing during this period is encouraging people who need to see their GP or to have an out-patient appointment for something that is not to do with coronavirus to do so via Telemedicine if it is both clinically and practically possible. That is even more important in rural areas, and absolutely critical for reducing the amount of infection through GPs.

[Karin Smyth (Bristol South) (Lab)]

Before I entered this place, I worked as an emergency planner for the NHS. I would like to pay tribute to my former colleagues and to say that I am pleased that the Secretary of State is following their expert advice. Most people will not go into hospital or go to their GPs; they will be supported in the community. Critically, they will be supported by the wider services of local government and the voluntary sector. Will the Secretary of State expand on what conversations he is having with his counterpart in the Ministry of Housing, Communities and Local Government to support the wider public health and social care provision of local government?

[Matt Hancock]

We have extensive work under way to provide exactly that support. It is also available through the Office for Civil Society, and through volunteers as well. It is very important that we offer the opportunity for people to volunteer in these difficult circumstances, but we have to do so in a way that the voluntary efforts can then plug in and add to the professional efforts that are, as the hon. Lady says, providing a great service to this country.