NHS: Long-term Strategy

Luke Evans Excerpts

Wednesday 11th January 2023 Commons Chamber

[Wes Streeting]

I am grateful for the right hon. Gentleman’s intervention, because it brings me directly to the Government’s amendment to the motion, which is not a plan but a litany of excuses for the situation across the United Kingdom, including in Wales. I will run through them. By way of excuse, they say that the situation is challenging across the United Kingdom, and they are right: in Wales, the NHS is struggling; in Scotland, the NHS is struggling; and in Northern Ireland, the NHS is struggling. What do all parts of the United Kingdom have in common? Thirteen years of Conservative underfunding.

I will tell the right hon. Gentleman that, as he knows perfectly well as a Welsh Member, the reason why the Welsh NHS struggles more than England overall is the age profile of the population, the number of disabled people in Wales and the level of deprivation. The same disparities between Wales and England overall also explain the enormous health inequalities within England, which is why health outcomes in my city—in London—are so much better than in so many parts of the north or south-west of England. And you know the way to deal with that? It is genuine levelling up. But if people want a Government who tackle health inequalities so that every person in every part of the United Kingdom gets good-quality healthcare, they need to elect a Labour Government here in Westminster. That is the truth that the right hon. Gentleman does not want to admit.

I know that SNP Members will not be here today, because we are talking about England, but here is another truth that Nicola Sturgeon does not want to admit either: people in Scotland will be better off under a Labour Government too. She knows that just as well as anyone else.

When Conservative Members are not talking about other parts of the United Kingdom, they say that health pressures exist right across the world, but international pressures do not explain why the average wait for an ambulance is 14 minutes in France, while heart attack victims and stroke victims routinely wait an hour for an ambulance here in England. International pressures do not explain why it is that, over the past year, one in six UK adults had a pressing need for medical examination or treatment but could not get access. They do not explain why this is the highest figure out of 36 European countries and almost triple the EU average. Their excuses about international pressures do not explain why cancer outcomes in England are behind other comparable countries. None of that explains why the state of the NHS is as bad as it is today, but perhaps the hon. Member for Bosworth (Dr Evans), who was trying to intervene, wants to stand up and justify why it is that, after 13 years of Conservative Government, his constituents are waiting an average of an hour for a heart attack or stroke case.

[Dr Luke Evans (Bosworth) (Con)]

I am grateful to the hon. Member for giving way, and there are two points that I would like to pick up, seeing as he has come back to me on the second one. The first one, about comparable data, is really important. Does Labour have a position on sharing data between Wales, for example, and England, because the data is not comparable, which makes it very difficult to work out what is going on? Secondly, a plan was brought forward by the Government. It is called the NHS White Paper, which was brought forward by the NHS to transform the NHS with the integrated care boards, which are now in place. The people on those boards—42 of them—are the best people to make that change.

[Wes Streeting]

I find it astonishing. The hon. Gentleman’s position seems to be this: the Government have a plan, after 13 years, and apparently that plan is in progress. So why is it that so many Conservative Members just this week have stood up to talk about the fact that their constituents cannot see a GP, they cannot get an ambulance when they dial 999, and they are waiting hours on end in A&E departments? I know they like three-word slogans, but is the latest Conservative slogan on the NHS really “Crisis, what crisis?”?

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[Wes Streeting]

My hon. Friend is absolutely right. We are spending £3 billion on agency costs that would surely be better spent on ensuring that we have a serious workforce plan, and on hospital departments that are staffed by regulars who get to know their shift, get to know their colleagues, and get to know their patients and communities.

Let me turn to what the Secretary of State for Department for Business, Energy and Industrial Strategy said about ambulance staff, because I think he irresponsibly suggested that ambulance staff have not committed to minimum service levels for category 2 calls today, which is just not true. I think he ought to apologise to ambulance workers.

[Dr Luke Evans]

rose—

[Dame Angela Eagle (Wallasey) (Lab)]

rose—

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[Dr Luke Evans (Bosworth) (Con)]

As a parliamentary candidate, I was once asked by a journalist, “We have 30 seconds left on the panel. How would you solve the NHS?” I said, “If I had that answer, I would not be sitting here with you.” Mr Deputy Speaker, you have given me four minutes to do it, and I will do my best.

My hon. Friend the Member for Erewash (Maggie Throup) made an important point about context, and it goes back to when the NHS was formed in the 1940s and 1950s. We have an ageing population. In the last two decades we have seen a 50% increase in the number of 100-year-olds. Many people over 70 have four, five or six medical conditions and are on multiple medications. Technology has moved far forward, too.

When I started training, a cholecystectomy to remove the gallbladder was open surgery that required a person to be in hospital for a week. It can now be done within 24 hours. When we started people on routine blood pressure medications such as ACE inhibitors—many Members will know ramipril—they had to stay in hospital to have their kidneys checked. We now start it routinely for millions of people across the country.

That is the pace at which we are moving in the west and the developed world, and we have to try to keep up. Throw in a pandemic and workforce shortages, and we can see why every western country with a developed care system is struggling. That is the backdrop of what we are dealing with.

On top of that, demand and supply have gone up, but they have not gone up equally. Services are working hard to provide more tests and more appointments than ever before, yet demand is growing partly because the pandemic led to later and more complex presentations. In the Health and Social Care Committee we have heard that there are 27.5 million GP appointments a month, which is up by 2 million on 2019, yet it is still not enough.

In my area of Leicestershire and Rutland, we have enough GP appointments for everyone to be seen seven times a year, but the problem is that appointment rates are disproportionate. Some young people never need to go, and many older people need routine follow-ups. This is the backdrop we are dealing with. Members on both sides of the House talk a lot about long-term plans, but I would like to focus on day-to-day stuff.

[Aaron Bell]

I am grateful to my hon. Friend for bringing us his experience from before he came into this place, and he is right to look at the long-term demographic challenges. Does he agree that they will require the NHS to become even more efficient and productive? That is not just something we are asking for; it is what the staff in the NHS want, because they are aware that they are still delivering analogue services in a digital age.

[Dr Evans]

My hon. Friend has hit the nail on the head, and that is where I want to focus my remarks, because simple day-to-day changes to make the working clinician’s life better in turn improve productivity, patient care and patient satisfaction.

As with the Sky cycling team, looking for percentage gains brings big outcomes. So let us go through a quick list of some things we could do. We could have a root-and-branch review of prescribing. How much time is spent with patients waiting for prescriptions in hospitals to be dispensed? How much time is wasted by GPs signing prescriptions on paper? We have electronic prescribing but the prescriptions still get printed out to be signed. A root-and-branch review of prescribing all the way through would solve that problem, making this system more streamlined and fit for the 21st century. It would also save wastage, because there is an estimated £1 billion-worth of medication in Mr and Mrs Jones’s back cupboard just in case.

What about the IT? I am talking not about singing and dancing robots, but simply about making the IT for the day-to-day clinician work like their mobile phone does. That is not too much to ask. We could address the interface between primary and secondary care, allowing secondary care to be able to book blood tests into primary care and vice versa. This stuff does not happen. We no longer send faxes but we still send letters instead, and we pay someone to scan them so that a doctor can have a look at them and sign them off. We could cap list sizes, on a graded time for GPs. We are recruiting more GPs and it is going to take time, but that is a way of ensuring demand and at the same time continuity of care.

What about all the other stuff associated with the administrative time of looking after doctors to make sure they are fit for purpose? There is so much red tape when someone tries to join a performers list or come off one, or start an induction in a hospital. This is simple stuff we can change now, today. We can further do that by enabling the new ICBs, because my biggest worry with them is that they are going to ask for permission not for forgiveness. These 42 regional areas will be able to design the difference that can stick for the future.

I was hoping we might be able to spend these few hours today talking about the wider picture, because this all comes from context. The biggest question this House has to answer is what is the purpose of the NHS and what should it do? We all agree with the principles of clinical need and not to have to pay, but how do we deliver that for the 21st century?

[Several hon. Members rose—]

NHS Workforce

Luke Evans Excerpts

Tuesday 6th December 2022 Commons Chamber

[Wes Streeting]

I strongly agree with my hon. Friend. As the Leader of the Opposition has said, the NHS is not on its knees; it is on the floor. How many times were we told during the pandemic that restrictions were needed to stop the NHS falling over? It has now fallen over, and for the first time in its history people no longer feel certain that, when they phone 999 or arrive at A&E, they will be seen in time. It is the first time in our country’s history that people have not felt confident that emergency medicine will be there for them when they need it.

The Conservatives blame the crisis in the NHS on everything from the weather to the pandemic, and even NHS staff. Of course there is no doubt that the pandemic has made things worse, but the Government—the Conservative party—sent the NHS into the pandemic with 100,000 staff shortages. They spent a decade disarming the NHS, before sending it into the biggest fight it has ever faced. They cannot pretend that the NHS was well prepared. The problem for the Conservative party is that people are not stupid. Their memories are not that short. They know that the NHS was struggling to treat them on time before the pandemic, and they know who is to blame.

[Dr Luke Evans (Bosworth) (Con)]

Is not the point that health is devolved across four different nations, which are each led by a different party? Does this mean that the pandemic has hit all health services, including across the western world? This is a rising tide of the problem of the pandemic and dealing with an ageing population. This is not party political at all, and it is remiss of the hon. Gentleman to try to make it that. What does he say to that?

[Wes Streeting]

I would say two things. As I have already said, I accept that the pandemic made the challenge right across the United Kingdom worse. I also accept that, in every part of the United Kingdom, the NHS is under severe pressure. I would say two things in response. First, even if some of our friends on the SNP Benches do not want to acknowledge it, there is no doubt that every part of the United Kingdom would be better off with a Labour Government and every part of the NHS in every part of the United Kingdom would be better off if there were a Labour Government, because the investment that we are proposing in NHS staff today would benefit countries right across the United Kingdom. [Interruption.] In response to the outgoing hon. Member for Peterborough (Paul Bristow), do not say that politics does not make a difference. Do not expect the people to believe that somehow there was an inevitable sense of decline in the NHS. I am sure people remember that, when Labour was last in government, we delivered the shortest waiting times and the highest patient satisfaction in history.

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[Wes Streeting]

I wholeheartedly agree with my hon. Friend. As we see so often with this Government, they make promises but break them. They try to fool the public into thinking they are delivering more GPs—or indeed more police officers—when it was the Conservative party that cut them. They try to give with one hand, but they take with the other, and after 12 years people have had enough.

Of course, it is not only the promise to recruit more GPs that the Conservatives are breaking. We had the promise of 40 new hospitals, which the Secretary of State repeated today, yet in response to the question posed by the right hon. Member for Uxbridge and South Ruislip (Boris Johnson), the Secretary of State said that of those 40 new hospital schemes

“five hospital schemes are in construction, two are now completed and we aim to announce the next eight by the end of this year.”

So, where are the other 25? Where are these 40 new hospitals? As far as I can tell, they exist only in the imagination of the former Prime Minister. Yet the script has not changed—Ministers are still here claiming 40 new hospitals.

When I visited Leeds with the shadow Chancellor, my right hon. Friend the Member for Leeds West (Rachel Reeves), I saw a vast pile of dirt where a new building was due to go up. We heard today that the Government cannot even negotiate an agreement with the hospital to get the site working and get the new facilities built. With every minute, every month and every year of delay construction costs are going up, so taxpayers are left in the worst of all worlds: broken promises, no 40 new hospitals, and paying through the nose for the ones that are being built because of Government incompetence.

We see the tragic consequences of the shortages and broken promises in the NHS. My hon. Friend the Member for Rotherham (Sarah Champion) raised the tragic case today at Health questions of a five-year-old boy who had what his doctor described as the worst case of tonsilitis he had ever seen. He was turned away from hospital, with his parents told there were no beds and not enough doctors. His infection worsened and five-year-old Yusuf later passed away. His death certificate recorded the primary cause of his death as pneumonia and the secondary cause as tonsilitis. What kind of country are we living in when a five-year-old boy can die of tonsilitis? This is criminal.

I met Yusuf’s uncle, Zaheer Ahmed, last week, and I did not know what to say to that poor man and his grieving family, who lost that little boy in the most unimaginable circumstances. I invite the Secretary of State to meet Yusuf’s family to hear how that little boy was failed and to hear at first hand about some of their interactions with the NHS, which I thought were completely unacceptable and intolerable. On that note, I welcome the independent inquiry that has been committed to. That is really important for the family who have been failed in this heartbreaking case. We do not want to see more cases like that.

At the heart of the crisis in the NHS—as with so many of the problems facing our country—is a failure to plan. The NHS has not had a workforce plan since 2003. That would be unacceptable in a multinational company one one-hundredth the size of the NHS. The failure to plan means that short-term fixes are always favoured over what is in patients’ long-term interests. That is why the Government cut the nursing bursary and why, this summer, in the middle of the biggest crisis in the history of the NHS, they took the infuriating decision to cut a third of medical school places.

[Dr Luke Evans]

Will the hon. Gentleman give way?

[Wes Streeting]

The hon. Gentleman has been to medical school; does he think that it was a good idea to cut the number of places this summer?

[Dr Evans]

When we talk about Labour’s record on training, the hon. Gentleman may forget that, in 2007, the medical training application service ended up in judicial review. Many of my colleagues moved out of disciplines that they loved dearly because of Labour’s mess in making those plans. He has been speaking for almost half an hour, setting out his exposé of what is going on in the health service, but I am yet to hear a plan. I hope that he will spend the next half an hour telling us about the detailed plan of how we get to 10,000 new medical places, because when it comes to firms in hospitals, there is not enough space for medical students to get that experience, so I am looking for him to solve that problem.

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[Steve Barclay]

The hon. Lady mentioned the summer, and I think she knows that I visited the Jean Bishop integrated care centre and looked at the great innovations and brilliant work that her constituents, among others, are doing there. I looked at how it is bringing social care and the NHS together through an integrated model and how there has been new investment, supported by the amazing fundraising within the local community and by NHS funding. It would be great to get a bit of balance about the amazing feedback I heard from both staff and patients at the Jean Bishop integrated care centre who are working innovatively. I hope the hon. Lady would agree that the innovation of a centre such as the Jean Bishop is what we need to see in more places across the NHS. To her wider point, there are challenges in social care; she raises a fair point. That is why, despite the many competing pressures that the Chancellor faces, he has allocated £500 million for this year. It is also why he then committed the £2.8 billion for next year and the £4.7 billion for the year after—the biggest ever increase in that funding. But it is not simply about the funding increase; it is also about using new models such as that integrated care model to deliver far better care.

[Dr Luke Evans]

Is that not precisely the point? The NHS will gobble up the money, so it is about how we use the system. The integrated care systems and integrated care boards—established through the White Paper that the NHS asked for—are doing exactly that. They are trying to join up primary care, secondary care, social care, preventive health, county councils and borough councils all in one place to make a better stand on how we can produce healthcare that is better for our constituents and better for the taxpayer. Will my right hon. Friend make sure that, when he goes to the integrated care board chairs, he gives them the chance to solve the problems and unleashes the power to do exactly that, because they know best?

[Steve Barclay]

My hon. Friend raises an extremely important point. It is not just about the significant funding increase that the Chancellor has allocated; it is also about how that funding is deployed, in particular through using population level data for the integrated care system to bring health and care together. One area that the hon. Member for Ilford North and I agree on is the impact of delayed discharges across health and our hospital trusts as a whole. We often see that manifested in ambulance handover times, which are so impacted by that.

On the investment that is going in, my hon. Friend the Member for Bosworth (Dr Evans) is right to say that it is also about how it is deployed. Again, missing from the Opposition motion was any reference to the commissioning of the former Labour Secretary of State, Patricia Hewitt, to look at how to take on board how that funding is spent in an integrated way. It would also be remiss of me not to draw the House’s attention to the £5.9 billion of capital funding that we are using to transform diagnostic services by making the most of new technologies and improving the equipment for our frontline staff, making it easier for them to deliver the patient outcomes that we need. That is investment, along with the investment in care, that this Government can be proud of.

In the motion, the shadow Secretary of State refers to a shortage of workforce, but he ignores the locum doctors and bank nurses that make up a significant proportion of the NHS workforce. He ignores the record numbers of doctors and nurses that we now have working in the NHS, with a 3% increase on last year in both doctors and nurses.

I am sure you will be surprised, Mr Deputy Speaker, given your background in Wales, to discover that we cannot see what the vacancy rate is in Wales because the Welsh Government stopped collecting workforce vacancy statistics in 2011. You would have thought that the motion would be an opportunity for the Opposition to encourage their Welsh colleagues, given the importance that they say applies to vacancy statistics. You would have thought they would be keen to see that information from across the Union of the United Kingdom. I thought that Labour was a party of the Union. Why would it not want to have that transparency across Wales on the vacancy figures? But the motion was silent on that point. Perhaps in closing, the relevant shadow Minister will make a commitment to encourage the Welsh Government to have that same level of transparency.

[Dr Evans]

The Secretary of State hits the nail on the head when it comes to comparing the different countries across the Union, because different countries choose to use different statistics on waiting times to manage their staffing. Does this not confirm the argument we should have a unified way of using those statistics across the four nations?

[Steve Barclay]

I very much agree. In fact, in the spirit of co-operation, I would be happy to write to Sir Ian Diamond at the Office for National Statistics to encourage that, if the Welsh Government were willing to make that commitment. I do not know whether the Opposition would be willing to sign up to encouraging the Welsh Government to have that level of transparency. They seem reticent about having that transparency.

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[Munira Wilson]

rose—

[Dr Luke Evans]

rose—

[Steve Barclay]

I will give way to the hon. Lady first and then to my hon. Friend.

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[Steve Barclay]

I have said that I am going to give way to my hon. Friend the Member for Bosworth (Dr Evans), and then I am going to wrap up. As I was saying, sometimes there are areas where it is more difficult to recruit and we need to look at the data on that.

[Dr Evans]

When it comes to retention, pensions are a big issue, and the Opposition Front-Bench team have picked up on that. One recommendation from the Select Committee was to mandate for recycling to try to help with that. What other work is being done to try to ensure that senior colleagues with the most experience are incentivised to take on the extra lists and try to deal with the backlog, in all four corners of the country?

[Steve Barclay]

We are uniquely placed in having a Chancellor who has not only a deep understanding of health issues, but an understanding of recent Health and Social Care Committee reports. Obviously, that is an issue that we, with Treasury colleagues, will keep under review.

The motion ignores the vital work that the Government are doing to back health and care, the £6.6 billion of investment in our NHS that was announced in the autumn statement, and the social care investment of £2.8 billion and £4.7 billion next year. This Government are investing in our health and social care. We have always put the NHS workforce first and we always will.

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[Chris Stephens]

The hon. Gentleman knows of my affection for his constituency—many members of my family live there. He raises an important point about rural communities, and in relation not just to the NHS but to the other challenges he outlines. He makes a pertinent point about what all the health services need to consider when applying their services to the areas that he has the privilege of representing, and I thank him for that.

The Secretary of State talked about the autumn statement, but it will not deal with the increasing cost of food and energy, and all the other pressures facing staff. There must be a serious discussion about the NHS workforce, about retention, about giving staff career opportunities and also about wellbeing. I thank NHS staff for what they have done not just during the pandemic, but when I and family members have had health challenges. The work they do and the miracles they perform on a daily basis should be recognised in this place.

[Dr Evans]

It is worth stressing that point. For all the Daily Mail headlines about the NHS, we must not lose sight of all the good work that goes on unrecognised for the countless thousands of people who go to hospitals, GP surgeries or mental health services and get excellent care. If two patients are on similar pathways but one receives excellent care and the other receives poor care, should not the emphasis be on moving more towards excellent care and less—if not an outright stop—towards poor care?

Oral Answers to Questions

Luke Evans Excerpts

Tuesday 1st November 2022 Commons Chamber

[Maria Caulfield]

I thank the hon. Lady for her question. The Government introduced the first women’s health strategy to make issues such as endometriosis a high priority. Of course it will take time—we published the strategy only in the summer—but work is happening already. The women’s health ambassador is working to better inform young women about the signs and symptoms of endometriosis, so that they cannot be fobbed off with advice such as, “This is just a normal period.” Better and mandatory training for healthcare professionals in women’s health is being introduced and we are working with the royal colleges to streamline the referral process.

[Dr Luke Evans (Bosworth) (Con)]

Early diagnosis in endometriosis and many other conditions is important, so I welcome the news that a community diagnostic centre was approved in Hinckley last week. That will bring MRI, ultrasound and CT scans to the heart of my community, but we are looking for more. For the likes of endometriosis, people sometimes need to have a day case procedure. Will the Minister meet me to discuss having a day case unit in Hinckley? A bid is going through that I am keen to see ensured, so that we can get the diagnosis of things such as endometriosis in the heart of my community.

[Maria Caulfield]

My hon. Friend campaigned hard for the CDC in Hinckley and I am glad that he has been successful. Community diagnostic centres will provide a range of tests to speed up the diagnosis process. I am happy to meet him, because they are just the start of a huge opportunity, particularly for conditions such as endometriosis, to get diagnoses as soon as possible.

Rural Healthcare

Luke Evans Excerpts

Wednesday 12th October 2022 Westminster Hall

[Anne Marie Morris]

That is an exceptionally fine point. I have no issue with it because we have a similar problem in Devon. The solution is not just about more recruitment and doing things in the same way, because the people to be recruited do not exist. We need to look at doing things differently, by creating new career paths with shorter training periods and trying to train, so we can then recruit, locally. Generally, people will follow a career where they are trained. We need more rural training for doctors and nurses, and that training needs to be not in the local city, but in the rural areas. For example, in Plymouth we have a fine medical school— Peninsula Medical School—but the challenge is that the experience that the individual trainee doctors and nurses gain is not rural, and it needs to be.

[Dr Luke Evans (Bosworth) (Con)]

My hon. Friend is making a fine point. From my experience, there is an opportunity: young doctors who are becoming GPs tend to be between the ages of 27 and 35. At that time, most people are looking to set up their family, go to school and get married. If we extend some of the career opportunities by extending training in those areas, they are more likely to bed down roots and gain a skill to become a GPSI—a GP with a special interest—in those areas. Does she believe that is a formula that the Government should look at?

[Anne Marie Morris]

I absolutely agree, and it is an excellent suggestion. In a similar vein, when we are asking primary care networks and others to deal with the backlog, it is important that we try to give them much more freedom in how they address the problem. I talk to many of my local commissioners, and they say that they are having to make decisions that they know are right, even though they are not currently in the guidebook as best practice. We need to give them that trust to be able to do the right thing.

C is for care. Members will not be surprised to hear that the adult social care discharge fund, although welcome, is not going to be enough. The reality is that the bed count is often low in rural areas. In the south-west, we have the lowest bed count per head of population; I think it is the lowest in western Europe, although I am happy for the Minister to correct me. It seems to me that we used to be moving towards saying, just in time, “Let’s have care in the community.” However, because of the shortage of care in the community, and the lack of proper validation that it works other than whether people are readmitted, we need to put a halt to closing community hospitals and to look at how they can be used. Some could be repurposed. Perfection can often be the enemy of the good.

Teignmouth Community Hospital in my constituency is on the closure list, but to me that is not a wise decision. There are no nursing care homes in the area. Without that residential care, and without adequate care in the community, removing the only other source of beds is not the way to solve the backlog problem.

Procurement of Evusheld

Luke Evans Excerpts

Wednesday 12th October 2022 Westminster Hall

[Caroline Ansell (Eastbourne) (Con)]

rose—

[Dr Luke Evans (Bosworth) (Con)]

rose—

[Robert Jenrick]

I will make one further point, then I will come back to my hon. Friends. That does not mean that there is not a role for Ministers in interrogating the evidence, listening to the voices of those with the contrary view—both in the House and in the public domain—and ensuring that we get all the information that we need before we make informed decisions. That is the approach that I have tried to take in the three weeks in which I have been in post, and will take going forwards.

[Robert Jenrick]

I hopefully will answer as many of those points as I can in the time available. I will go to my hon. Friend the Member for Bosworth (Dr Evans) next, and then make some progress.

[Dr Luke Evans]

I entirely agree with the point about making sure that we have clinically robust evidence. We saw during covid with ivermectin how poor data influenced a debate that was sparked across the world. That said, one thing we do have control over is how quickly we look at the regulation. Is there anything that the Minister can do to speed up the decision making? That is within his gift.

[Robert Jenrick]

Yes, there is, and I hope I will be able to shed further light on that in my remarks, but given that there is relatively little time, sadly, for this debate, let me set out first the process that we have been through; I hope that that will give some comfort to those in the Chamber and listening to the debate that the issue has been handled in a very rigorous way.

Our regulator, the Medicines and Healthcare products Regulatory Agency, gave conditional marketing authorisation to Evusheld in March 2022, but—this is an important point to note—it did so noting a lack of data regarding how it responds to the omicron variant. The lack of supporting data has been noted by other respected regulatory authorities, including the European Medicines Agency and the Food and Drug Administration in the United States. Although the MHRA licenses drugs, the National Institute for Health and Care Excellence assesses the clinical and cost-effectiveness of them. The normal process would therefore be that NICE proceeds to investigate Evusheld, and that is happening as we speak. As the hon. Member for St Albans said, that process is due to conclude in April next year, but yesterday, I met NICE’s chief executive, Sam Roberts, to review her work and to seek reassurances that her work could proceed at a faster pace, and she has committed to reverting to me as soon as possible with a new timetable.

Elective Treatment

Luke Evans Excerpts

Tuesday 8th February 2022 Commons Chamber

[Sajid Javid]

I welcome the hon. Gentleman’s comments. With respect to life-saving tests and scans, including for cancer, the plan sets out a huge amount of new investment in diagnostic capacity. One area of investment is the new community diagnostic centres, some 69 of which have already opened across England in convenient places such as shopping malls and car parks, which people can access much more easily and get their results from much more quickly.

[Dr Luke Evans (Bosworth) (Con)]

I welcome the plan. I am most intrigued by the “my planned care” website, because one of the biggest problems for clinicians is that they spend a lot of time chasing admin. It is a great opportunity for pre-operative checks and for people to know where their follow-ups are. Will the Secretary of State look at expanding it to out-patient settings? People over the age of 80 may well have four, five or six specialists, so trying to keep track of their letters, of where they should be and of their appointments is really difficult.

During covid, 29 million people downloaded the NHS app and we had the fantastic covid dashboard, so we have seen what we can do with technology to help our patients and clinicians. Will the Secretary of State encourage the NHS to build on the measures that he is bringing forward to help with the backlog?

[Sajid Javid]

Yes. My hon. Friend is absolutely right to talk about the importance of technology in delivering world-class care. He will know that I have already announced that the parts of our health system that contribute to the best use of technology, NHSX and NHS Digital, will become part of the wider NHS so that we have a more joined-up strategy. “My planned care” will start as an online platform, but will move to an app-based service as soon as possible. My hon. Friend is right to talk about the importance of having something similar for out-patient care; we are already on it.

Public Health

Luke Evans Excerpts

Tuesday 14th December 2021 Commons Chamber

[Dr Luke Evans (Bosworth) (Con)]

The Secretary of State is absolutely right. I am overjoyed that boosters are the key to getting the country out of this issue. I have raised, over the past couple of weeks and last week in PMQs, the issue of the 15-minute wait post-Pfizer. I wonder if the Medicines and Healthcare products Regulatory Agency or the Joint Committee on Vaccination and Immunisation have come to a conclusion on that, because that would free up a huge amount of capacity when it comes to delivering the boosters?

[Sajid Javid]

My hon. Friend did raise that point yesterday. It is being looked at very urgently. I am sure he will agree that if it is done, it should be done in a safe way that our regulators are happy with. I can confidently say that I expect an urgent update later today as soon as I leave this Chamber.

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[Dr Luke Evans (Bosworth) (Con)]

I applaud the Government for their massive scale-up and huge ambition in respect of the booster programme. It truly is the way out for our nation, and I commend them for their approach. Critics will argue about whether the target of the end of this month will be reached, but we must not listen to them. Their myopic political point scoring will be forgotten in the light of the fact that the Government are doing everything they can to get jabs into arms, because that is the way out. However, I accept that further measures are necessary.

The Government will have my support on both the mandating of face coverings and the change in isolation procedures. While masks are of course inconvenient, they are a relatively easy way of reducing the risk of not only covid, but other viruses such as flu. Let us not forget that the number of flu admissions places a huge amount of pressure on the NHS, so a reduction in both conditions—as evidenced—makes sense to me.

Those who argue about the nuance of settings for masks often miss the point. I have heard on numerous occasions, both in the Chamber and among the public, the question, “How does the virus know whether it is in a restaurant or a shop?” Of course the virus does not know, but that is not the point. The point is this: what are the easiest measures which, when applied to the population as a whole, will reduce the risk as far as possible? The Government have to balance that at mass levels. What measures can be implemented to reduce the risk of covid, while mitigating the instant economic and non- covid damage that could occur in vulnerable sectors such as hospitality? A change in the self-isolation procedure suggests itself. This is a difficult but fair balance.

Let me now say something about mandatory vaccinations for NHS workers. I spoke about the issue during a debate in the House on 13 July, and I am not going to rehash the entire argument; I urge anyone who wishes to look up my speech to do so. However, for me the argument still stands as it did then. It was based on the duty of care for those in positions of responsibility to the most vulnerable. That stands even more starkly today. One only undertakes that commitment in their decision to pursue this career and the precedent already exists. However, that argument must not be used as a slippery slope argument for mandatory covid vaccination for the general population. I was glad to hear the Health Secretary confirm that that would not be the case, because I do not believe that the House, or indeed most of the UK population, would accept that.

On the topic of slippery slopes, that leads me on to the final regulation—that of the lateral flow test and the covid pass exemptions for certain venues. I am against vaccine passports. I do not believe they are practical, moral, ethical or indeed evidence-based in a scientific rationale. The closest comparison we have is Scotland, and the Scottish Government’s 70-page report does not provide the evidence for passes. To introduce such a huge change in the health management of our nation requires a full and thorough debate and I do not believe it will be done justice tonight. I am so pleased that the Government have listened and added lateral flow tests as an alternative because at least that provides a choice, but I cannot support covid passes. I worry about the slippery slope. What businesses, what society interactions, what infections might come in scope in future months or years?

In closing, looking to the future, I said in the House on 16 June 2021 that what was most needed was a full debate on the risk that we as society are prepared to tolerate when it comes to covid for those vaccinated and for those unvaccinated who will never get vaccinated, and the trade-off between covid and non-covid health implications, health protection measures and our economy, society and liberty. I hope that the House will bring such a debate next year.

Covid-19 Update

Luke Evans Excerpts

Monday 13th December 2021 Commons Chamber

[Sajid Javid]

We of course keep under review the support that is available throughout the pandemic. It is important that the House decided to extend the availability of sick pay from day one. There is also a hardship fund that is administered by local authorities.

[Dr Luke Evans (Bosworth) (Con)]

I commend the Health Secretary for bringing forward the boosters and aiming so high to get them out. One of the key things is to make sure that we have enough vaccinators and staff to do it, as well as volunteers. In that vein, will he ask the integrated care systems—all 42 of them—to review the bureaucracy they have around signing people up to give vaccinations, and potentially even to allow people from GP practices to work in hospitals and vice versa, because one of the practical issues over the past year has been that people have been turned away or have lost interest because of the paperwork around vaccinating. Given the challenge ahead, I would be grateful if he considered asking for that approach.

[Sajid Javid]

My hon. Friend speaks with great experience, and he is right to ask how the training programme for vaccinators, especially volunteer vaccinators, can be streamlined. That work is going on at urgent speed both within the NHS—within the ICSs—and in support of the fantastic work that St John Ambulance has been doing in this space.

Covid-19 Update

Luke Evans Excerpts

Wednesday 8th December 2021 Commons Chamber

[Sajid Javid]

We do work very closely together across the Union, and I have regular contact with my counterpart in Northern Ireland. I have not been able to discuss these particular measures with him today, but I know that we will do so shortly.

[Dr Luke Evans (Bosworth) (Con)]

I am grateful to the Secretary of State for coming to this House first, and for providing a copy of his statement. In it, he said that

“we will introduce mandatory certification, based on vaccines or tests, for nightclubs and large events.”

Could he explain if this will look like the Euros, when people had to present whether or not they had had a test? Failing that, if we are to have mandatory certification, which is the concern for Conservative Members, will there be an explicit vote on the regulations?

[Sajid Javid]

The NHS covid pass already has an in-built capability to allow for either a vaccination or the result of a negative lateral flow test, and next week there will be a debate on these regulations and a vote.

Public Health

Luke Evans Excerpts

Tuesday 30th November 2021 Commons Chamber

[Alex Norris]

I have given way to the hon. Gentleman before; I do not rule out doing it again, but will not do so immediately.

On ventilation, which links in to education settings, throughout this pandemic we on these Benches have called for a radical upgrade in the ventilation of public buildings, particularly schools. We know that is not something we can just click our fingers and do; it is more expensive and time-consuming and much harder to do than asking people to wear a mask, but it is a particularly effective intervention. Some 18 months into this pandemic, can the Minister update the House on how many public buildings now have proper ventilation systems as a result of decisions taken during the pandemic?

[Dr Luke Evans (Bosworth) (Con)]

Have the Opposition done any analysis of how much it would cost to implement ventilation en masse across educational settings?

[Alex Norris]

The hon. Member goes slightly further than I did in saying that ventilation should be rolled out immediately across all schools. Of course, that would have significant financial implications. It would also, of course, be very good for British business. We are saying that, as has been clear throughout the pandemic, better ventilation in public buildings should be a significant part of building regulations in general. What I seek from the Minister is a sense that any of that, never mind all of it, has been done at all.