Future of the NHS

Mark Pritchard Excerpts

Tuesday 24th October 2023 Westminster Hall

[Daniel Kawczynski]

She has never worked in the private sector—

[Mark Pritchard (in the Chair)]

Order. If the hon. Gentleman wants to make another intervention, then he can try to do so. If the hon. Lady—

[Daniel Kawczynski]

The question is simple: has she ever worked in the private sector?

[Margaret Greenwood]

The answer, clearly, is yes, I have. What I am talking about is the national health service, which was set up as a public service—publicly run and publicly owned. That is what we are talking about here today. I am going to make more progress. [Interruption.] If the Minister wants to intervene, he can.

[Mark Pritchard (in the Chair)]

Order. Let me say something for the orderliness of the debate. Understandably, emotions run high around NHS issues, but there is a convention and there are protocols. If people want to make contributions they can make interventions or speeches, but Members may intervene only if the hon. Lady wants to take their intervention. I just caution everybody that I will not have any unruliness in this debate. The debate has been tabled and the hon. Lady’s constituents have a right to be heard.

[Margaret Greenwood]

Thank you, Mr Pritchard.

I was talking about ill health being a big factor behind inactivity in the labour market, and I will repeat a point. The Office for Budget Responsibility reported in July that the economic inactivity rate for 15 to 64-year-olds has increased in the UK by 0.5 percentage points since the covid pandemic, and ill health has consistently been a bigger factor behind inactivity in the UK than in most other advanced economies. The Government must understand that a Government that fails the NHS fails the wider economy.

As well as focusing on the importance of investing in the NHS for the good of the economy, the Government must focus on tackling poverty and inequality, not only as a matter of social justice but because we know that poverty is a key cause of ill health. As the King’s Fund has noted, poverty

“drives inequality in health outcomes and increases use of health services.”

In its recent research on the state of child poverty, the charity Buttle UK said that it had received some of the most distressing accounts of children in need that it had ever seen. Buttle was keen to stress that it was

“talking not just about significant hardship but life-changing and life-limiting deep poverty.”

Today we read that the Joseph Rowntree Foundation has found that more than 1 million children in the UK experienced destitution last year, meaning that their families could not afford to feed, clothe or clean them adequately, or keep them warm. This extreme hardship will have a profound impact on the individuals concerned and it will lead to greater demands on the NHS. The King’s Fund points out that

“poverty is...expensive, in direct costs to the state and in lost opportunity and productivity.”

We need to see a virtuous cycle of improvement when it comes to addressing poverty, funding the NHS and supporting economic growth. Sadly, under this Government we are seeing the reverse. Will the Minister take up this issue of the inter-relationship between poverty, NHS provision and the economy with his colleagues in the Department for Work and Pensions and with the Chancellor, and impress on them the importance of significantly increasing funding for the NHS and tackling the deep poverty faced by many people in our constituencies? The Chancellor will have the opportunity with his autumn statement to increase spending in the NHS, and to tackle poverty and inequality, and I ask the Minister to urge him to do that.

The impact of the Government’s squeeze on funding is being felt throughout the NHS. In May, it was reported that integrated care systems will have to make average efficiency savings of almost 6% to meet their financial requirements. According to the Health Service Journal, one integrated care board said of its financial plan for 2023-24:

“We do not have confidence that we can deliver it in full but are committed to trying.”

Sir Julian Hartley, the chief executive of NHS Providers, has described

“the efficiency challenge for 2023-24”

as being

“significantly harder than 2022-23”,

while one ICS director described their system as running out of the non-recurrent savings that made balancing the books last year “vaguely possible”. It is clear that the Government are simply not giving the NHS the necessary funding to meet the needs of patients.

Before I conclude, I want to pay tribute to those who work in the national health service. As I have touched on, many of them are exhausted because of the staffing shortages and many work beyond the end of their shifts because there are not enough staff to take over from them at handover times. They do so because they care deeply about the welfare of their patients.

I will specifically mention clinical support workers in my constituency in Wirral, who are currently on strike over back pay to recognise the years that they have been working above their pay band. I have joined them on the picket line in solidarity and listened to their concerns. They are immensely hard-working people who care deeply about their patients, and they deserve fair back pay that reflects the additional duties that they have been carrying out. I urge their employer, Wirral University Teaching Hospital NHS Foundation Trust, to continue engaging with the union, Unison, and to provide an offer that is acceptable to it and to staff.

What is the future of the NHS? I believe that the NHS faces an existential threat from the Government’s privatisation agenda and underfunding of the service. Patients and staff continue to suffer. There are further potential implications for staff as a result of the 2022 Act, not least the provision to remove professions from statutory regulation. The new NHS payment scheme contains rules for payment mechanisms, one of which is “local payment arrangements”, whereby

“providers and commissioners locally agree an appropriate payment approach.”

There are real concerns that that will impact national pay bargaining and the scope of “Agenda for Change”. Can the Minister give a commitment that the NHS payment scheme has not had and will not have any negative impact on the pay rates of “Agenda for Change”, pensions and other terms and conditions of all eligible NHS staff? Can he also commit to protecting national collective bargaining across the NHS? I appreciate that there is a lot of detail here; I would really like it if the Minister wrote to me on this point.

Without such a commitment, I fear that we could see a race to the bottom in the pay, terms and conditions of NHS staff, and so too an erosion of the quality of healthcare that we as patients receive over time. We need a Labour Government that will, among other things, improve GP access, boost mental health support, train thousands of extra staff every year, provide mental health support in every school and hubs in every community, and reform social care with a national care service. The next Government must also significantly increase health spending each year. History tells us that this works. It works in terms of the equity, efficiency and effectiveness of the NHS, and it works in terms of public satisfaction.

The NHS is arguably our country’s greatest achievement. We know that it is there for us, free at the point of use, if we become ill or have an accident—or at least it should be. Under the Conservatives, the service is being decimated, but there is still time for them to change tack, turn the situation around and give the NHS the funding it needs. Will the Minister impress upon the Secretary of State for Health and Social Care the importance of boosting investment in the NHS so that the needs of patients can be met and the economy can draw on a healthy workforce? Will he also call on the Secretary of State to be ambitious in his dealings with the Chancellor ahead of the autumn statement?

Finally, I want to thank health campaigners across the country who are fighting to save our NHS from privatisation and obliteration. I thank them for all that they do to fight for an NHS that is a comprehensive, universal, publicly owned and publicly run service that is there for all of us when we need it. People believe in the NHS, and I believe it is vital that we save it.

[Several hon. Members rose—]

[Mark Pritchard (in the Chair)]

Order. Before I call Anna Firth, could hon. Members check that their mobiles are switched off? There is one on at the moment that is receiving messages.

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[Mark Pritchard (in the Chair)]

Given the interest in this debate, I will impose a six-minute time limit. I call Marie Rimmer.

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[Daniel Kawczynski (Shrewsbury and Atcham) (Con)]

I pay tribute to the doctors, nurses, porters, kitchen staff and many other hard-working people at the Royal Shrewsbury Hospital, who do an outstanding job for my constituency of Shrewsbury and Atcham. My concerns are with management of the NHS trust and the chief executive. My right hon. Friend the Member for Ludlow (Philip Dunne) and I, with others, secured £312 million seven years ago—the biggest investment in the NHS in Shropshire for decades—for the modernisation and reconfiguration of A&E services.

All Members of Parliament will recognise that there is nothing more important for their constituents than the safety and care of their families when they go to A&E. Imagine: we secured £312 million for that modernisation of our local hospital trust seven years ago, and still not a single brick has been laid. Those were not proposals envisaged by politicians or Ministers, but by 300 local surgeons, who were at the forefront of championing this modernisation and reconfiguration. Those 300 local surgeons are at the coalface of providing those services every day to our constituents. Yet, the NHS trust has allowed itself to be bullied by the Labour leader of Telford and Wrekin Council to prevent the changes taking place.

The Labour leader of the council does not have a single medical qualification, yet under the society we live in he can prevent those changes, which are propagated as being absolutely essential by local surgeons at the coalface of providing those services. There is no comprehension of the interdependence between these two hospitals for citizens across the whole of Shropshire and mid-Wales. Let us not forget that in Shropshire—you are a Shropshire MP and will know this, Mr Pritchard—

[Mark Pritchard (in the Chair)]

Order. For the record, while I am chairing, I am completely neutral. I take the hon. Member’s point, but this is a generic debate. He is talking about specifics, and the Chair is completely neutral.

[Daniel Kawczynski]

Yes. These two hospitals, 12 miles apart, cover the whole of Shropshire and mid-Wales, yet the Labour leader of Telford and Wrekin Council refuses to recognise their interdependence. No decision has been taken by the trust for seven years. I have attended hundreds of meetings with the local trust over that time to find out when it will finally take the decision to start construction. “It’s coming”, “It’s just around the corner” and “It’s nearly there”—that is what we have heard for the past seven years. That lack of accountability and transparency would never be tolerated in the private sector, and I speak as somebody who spent 13 years working in the private sector before becoming a Member of Parliament.

There is a massive turnaround of staff at the local NHS trust. I think I am on my seventh or eighth chief executive; there is no accountability, transparency or sense of urgency. Meanwhile, A&E services continue to deteriorate in our local hospital trust. Shropshire Community Health NHS Trust and Shrewsbury and Telford Hospital NHS Trust are the worst performing A&E trusts in the whole United Kingdom. As a Member of Parliament, I get heartbreaking letters from constituents about the difficulties that their family members have experienced in our local A&E services, because that £312 million has not been spent and implemented.

I speak as the only Conservative Member of Parliament to have been born in a communist country, where the state controlled everything. That is what my antipathy to this state control is rooted in. The socialist model created in the 1940s leads to inefficiency, poor value for money and corruption. We need to create the right regulatory and taxation framework to allow the private sector to thrive in this country. I completely disagree with the hon. Member for Wirral West (Margaret Greenwood); we need to allow private sector hospitals to thrive and to take on the NHS, and ultimately say to citizens, “If you need an operation, we will send you to a private hospital and pay for your operation there.” We cannot continue to allow this level of negligence, corruption and inefficiency, with £130 billion into the NHS just this year alone and horrendous outcomes. We need privatisation and competition for the NHS.

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[Janet Daby]

The Minister is nodding, so I take that as an indication that he is willing to do that, which is really good. I also implore him to consider that sickle cell is a long-life disease, a hidden disease, a disability, and very serious.

The disease, however, has not had the research funding that it really needs. Looking at people with cystic fibrosis and haemophilia, we that they have had so much more funding invested into medicines to improve the treatment of those illnesses. The National Institute for Health and Care Research funds research programmes, but sickle cell research is woefully inadequate compared with the diseases that I have already mentioned. According to the data produced by that organisation, approximately 18,000 people are living with sickle cell, compared with the 10,000 that are living with cystic fibrosis, but in 2017-18 over a million pounds more was spent on research for cystic fibrosis. In the present day, 2022-23, still over a million pounds more is being spent on research for cystic fibrosis compared with sickle cell. That is entirely unacceptable, especially when there are more people living with sickle cell. I do not wish to take away funding from other research, but I do want equality of funding. I am sure the Minister also wants this as well.

As I draw to a close, I have already mentioned that prevention has to be the ultimate way to help people live a good quality of life and to keep them out of hospital, and it also helps to take of care of the public purse. In conclusion, the NHS is a wonderful creation that has helped every single person in this Chamber, and indeed every single person in our country.

[Mark Pritchard (in the Chair)]

I am afraid that we are going to have to restrict the last two Back Bench contributions to five minutes each.

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[Jim Shannon]

I wholeheartedly agree with my hon. Friend and will go on to comment on that shortly. Given the circumstances of our NHS right now, on paper the future does not seem too bright. We have people waiting years for surgery and consulting appointments, people struggling to get appointments with their GPs and, in some cases, people waiting for 12 hours to be seen by a doctor at A&E.

However, we will always remain hopeful for the future of the NHS because of the people who work in it and who truly make it what it is: those who work the extra hour, in many cases without pay, after their shift ends to ensure everything is up to date; those who come into their work on their days off due to short staffing; and those who do not have lunch breaks either, as they are too run off their feet. They are the NHS staff who I know, and they are the NHS staff that my words speak to.

The key to fixing those issues lies within this very building. It is for our Government to make the decision to fund the NHS properly. I have constituents, friends and family members who contact me all the time about the condition of the NHS, especially in terms of funding. My hon. Friend the Member for Upper Bann (Carla Lockhart) is right to make that comment on behalf of the doctors, nurses and NHS staff who do so much.

Only this time last year I went to the picket line in Newtownards, one of the towns in my constituency, as the hon. Member for Wirral West said she did in her introduction to the debate. I joined the picket line because I felt that their request for pay was right, and that we should support them to the utmost of our ability. I hoped that would be the case—again, I look to the Minister for that. It is important that those issues are relayed to parliamentarians so that we can get the full scope of just how much people are struggling with the current rate of pay.

With sufficient funding and recognition of the issues, we can improve and build on our NHS. If we reflect on the NHS from 1948 to now, the enhancements are incredible. Medical technology is always being improved and new medicines are being discovered. Queen’s University Belfast is key to that, through the partnerships it has with business. We are finding more efficient ways of diagnosing diseases. As we look ahead to the next decade, we can expect to see more of those medical advancements as technology is always improving. It is incredible to see how far we have come. This week, Queen’s University Belfast has come forward with a new prostate cancer centre in Northern Ireland, which will be to the fore of finding treatments and the cure for that disease.

The next generations of nurses and doctors are going to feel the impact of our decisions today, so let us make the right ones, right now. We must build bridges and remind ourselves of the compassion that the NHS provides. We have a duty to deliver for the people we represent right across this great nation. They are telling us that currently things are just not good enough. I strongly encourage a regional discussion on the improvement of funding for the NHS so that no nation is left behind, and that, more importantly, all the NHS staff of the United Kingdom and Northern Ireland get paid suitable wages to help them make ends meet. We must ensure that the services are up to scratch to allow them to do their jobs to the best of their ability, as they all wish to do. We wish to support them in that.

[Mark Pritchard (in the Chair)]

We move on to the Front Benchers, who have 10 minutes each.

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[Preet Kaur Gill]

I thank the hon. Gentleman for his question, but I do not have the level of detail to be able to make any such commitment. He needs to speak to the Minister to ensure that the valuable investment they have been able to obtain for people in Shrewsbury is actually realised. That is really a conversation for him to have with the Minister.

There is no doubt that the NHS needs serious reform if it is to serve for the next 75 years. Since the Prime Minister and Health Secretary made a pledge in January for 5,000 more beds in time for winter, the number of hospital beds in England has fallen by almost 3,000. After a promise to clear all patients waiting 78 weeks or more for treatment by April this year, which was a shockingly low bar, the number rose last month from 7,300 to 9,000 patients. Despite making it one of their flagship five pledges to cut waiting lists, the Government have again broken their own record this month, with the number of patients waiting now at 7.8 million.

This Government cannot be trusted with the future of the NHS. Whether it is the social care crisis or the RAAC—reinforced autoclaved aerated concrete—scandal, the Government have literally failed to fix the roof while the sun was shining. The NHS will not survive another five years of this. Labour’s 10-year plan of change and modernisation will build an NHS fit for the future, shifting the focus of healthcare from the acute sector into the community to boost prevention, diagnose conditions earlier and provide treatment closer to people’s homes.

In closing, I want to put on the record my deep thanks to all our NHS staff for going above and beyond for patients, and especially everyone at the University Hospitals Birmingham trust in my constituency, which is the largest trust in the country.

[Mark Pritchard (in the Chair)]

The Minister of State may speak for 10 minutes, but there are a couple of extra minutes as well. In addition, the convention is to allow the mover of the motion a couple of minutes to wind up, so he has a lot more latitude than usual.

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[Will Quince]

I have to make some progress—I am conscious of time.

In addition, we have digital transformation and technology, which are critical to the future of the health and social care system. Embracing digital provides a significant opportunity for us to improve clinical service to deliver better care for patients and reduce pressures on the NHS. That is why we are investing around £1.5 billion a year in digital transformation to run live services and drive those transformation ambitions. That also includes plans to improve our NHS app, digitise the frontline and improve services. We are also working with trusts to deliver things such as electronic discharge and electronic bed management systems, which also improve efficiency within the NHS.

The hon. Member for Lewisham East (Janet Daby) mentioned NIHR research, which I want to touch on briefly. We spend around £1 billion a year on that, but the Government do not commission research directly; indeed, it would be totally wrong for any Minister or shadow Minister to direct our clinicians and researchers to look into a particular area. However, we encourage and rely on organisations to come forward with bids for research, which clinicians then look at. That is rightly independent from Government, and I will be happy to work with the hon. Member to see how we can get more research into that area.

I wanted to say so much more, but time is short and I want to ensure that the hon. Member for Wirral West has time to respond. The hon. Member for Birmingham, Edgbaston (Preet Kaur Gill) touched on the life sciences space. We are putting a huge amount of work into life sciences with the Life Sciences Council and the life sciences vision, and we have launched the dementia, mental health, cancer, obesity and addiction missions, with more than £210 million in Government investment and world-leading chairs to support them. There is also our additional investment in genomic medicine, which the hon. Member rightly touched on and which is a hugely exciting field. The ability to screen for and identify the prevalence of future disease and the ability to screen babies in future will be hugely exciting. This is definitely the future of medicine.

This is a hugely important debate and I have far more to say, as you can tell, Mr Pritchard. The NHS is a vital part of the fabric of our public life. It is beloved by the public and rightly held in the highest esteem. The Government believes in the NHS; I believe in the NHS. That is why we are taking the right long-term decisions to protect its future.

[Mark Pritchard (in the Chair)]

Margaret Greenwood to wind up. The Minister has very generously given the hon. Member three rather than two minutes.

Aortic Dissection: Patient Pathways and Research Funding

Mark Pritchard Excerpts

Tuesday 13th December 2022 Westminster Hall

[Jim Shannon (Strangford) (DUP)]

First, I commend the hon. Member for Mid Derbyshire (Mrs Latham). It is never easy coming to Westminster Hall to lead a debate; it is even harder to come and tell a personal story—one that is so heartbreaking for the hon. Lady. She has made us more aware of the condition. We sympathise greatly with her on the loss of her son Ben. We support her and what she asks for.

No parent should have to go through the horror of losing a child. I have the greatest respect for the hon. Lady for coming here today and talking about it, which is often the hardest thing to do. As my party’s spokesperson on health, it is great to be here to support wholeheartedly her call for better patient pathways and more funding for aortic dissections. She set out a really good case and has asked for a number of things. I endorse what she has asked for and will give some factual background to the debate.

Aortic dissection kills over 2,000 people a year. The UK statistics are clear: three to four people per 100,000 are diagnosed with aortic dissection each year. It typically presents with abrupt onset chest, back or abdominal pain that is severe in its intensity, or is described as ripping or tearing, particularly in the patient with a high-risk condition such as Marfan syndrome or a family history of aortic disease.

The hon. Lady was right to refer to diagnosis. We often refer to diagnosis in these debates, and she has asked for work on that. The Chair of the Health and Social Care Committee, the hon. Member for Winchester (Steve Brine), has taken her thoughts on board, and I know that next year, or whenever the inquiry is done, when the hon. Lady makes her contribution, we can expect a fairly good response from him. He will never be found wanting in that regard. It is good to have him here to hear the story.

By improving diagnosis of aortic dissection in terms of familial connection, we can improve patient pathways to get better treatment and easier maintenance of the disease. Aortic Dissection Awareness UK & Ireland is the national patient charity for aortic dissection in the UK. It was founded by a small group of people who were diagnosed with aortic dissection in 2016. The charity provides vital information and support for patients and families affected by the condition, which the hon. Lady outlined so well, including the families who are left to deal with what happens. The charity works with healthcare providers to improve diagnosis and treatment and reduce healthcare inequalities. It partners with researchers to bring forward new insights that will improve future care for aortic dissection patients. In addition, the Aortic Dissection Charitable Trust research advisory group has been actively promoting research in the field of aortic dissection, aiming to save lives and improve the quality of life for those suffering from the condition now and in the future.

The hon. Lady asked very clearly for more to be done. The Minister and all of us were listening intently to her contribution. It would be very hard for anyone in this House not to respond in a positive fashion to her requests. More needs to be done across the whole of the United Kingdom of Great Britain and Northern Ireland, especially in co-operation with the devolved nations. This is something we should all work together on. We can always exchange ideas in these debates. The hon. Lady and I have both participated in debates in the past 24 hours. There was an Adjournment debate last night and a debate this morning at 11 am—the Minister has been kept extremely busy. We always have a helpful response from her and I look forward to something similar this afternoon. We owe a duty of care to the hon. Member for Mid Derbyshire, and I am sure the Minister will respond in a positive fashion.

We also need to produce a research strategy that is developed and implemented as a support network for all. The Royal College of Emergency Medicine has made the diagnosis of acute aortic syndrome and dissection one of its top 10 priorities, and we must do the same across the whole of the United Kingdom of Great Britain and Northern Ireland. I encourage the Minister to engage with her counterparts in Northern Ireland and other devolved Administrations to ensure that we approach this in collaboration, with all of us asking for the same thing and all working together to achieve the same goal and ensure the correct patient pathways and sustainable funding for aortic dissections.

Again, I commend the hon. Member for Mid Derbyshire; I think we were all particularly moved by her contribution. This debate would be suitably concluded with the support that the Minister can give us. I very much look forward to hearing from the two shadow Ministers: the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar) and the hon. Member for Enfield North (Feryal Clark).

[Mark Pritchard (in the Chair)]

We now come to the Front Benchers, who will have five minutes each, and then the Minister will have 10 minutes.

Ambulance Services and National Heatwave Emergency

Mark Pritchard Excerpts

Wednesday 13th July 2022 Commons Chamber

[Maria Caulfield]

The hon. Gentleman shakes his head, but he stood at the Dispatch Box just now and said that Labour would do better. It is not doing better in Labour-run Wales; it actually has either similar response times or worse response times.

I have set out a plan. It is clear that the hon. Gentleman has not read the heatwave plan for England, which was published earlier this year, because he would have the answers there. We are making sure that all NHS trusts are prepared. I am happy to work with each and every Member across this House to make sure that the ambulance service, our A&Es and hospital trusts have the support that they need, but if all he wants to do is play politics, I think that is extremely sad.

[Mark Pritchard (The Wrekin) (Con)]

Would the Minister like to put on record her thanks to all the hard-working ambulance crews of the West Midlands Ambulance Service, particularly those working throughout the county of Shropshire? Does she agree with me that this is not just about ambulances, but about local authorities—in my case, Shropshire Council and the borough of Telford and Wrekin—working alongside acute trusts such as the Shrewsbury and Telford Hospital NHS Trust? A collective effort is required, not a single effort by a single ambulance service.

[Maria Caulfield]

I thank my right hon. Friend, who is absolutely right, because a number of factors are influencing the wait times at A&E. While delayed discharges are not increasing, there are still a significant number of them, which means that the NHS and local authorities have to be working together. That is why we have created the integrated care boards, which Opposition Members voted against, to better co-ordinate care between health and social care so that we can have better systems in place to discharge patients sooner. As I have said, we have 1,200 void beds, which is either due to infection control measures because of covid rates increasing or because patients cannot be discharged. I will be meeting every single ICB in the coming days, because as part of our winter preparation, we need to improve co-ordination in those areas.

Abortion Services Commissioning: Northern Ireland

Mark Pritchard Excerpts

Tuesday 14th December 2021 Westminster Hall

2.30 pm

[Mark Pritchard (in the Chair)]

Before we begin, I remind Members that they are expected to wear face coverings when not speaking in the debate, in line with current Government guidance and that of the House of Commons Commission. Members are asked by the House to have a covid lateral flow test twice a week if coming on to the estate. This can be done either at the testing centre in the House or at home. Please give one another and staff members space when seated and when entering or leaving the room.

In addition, I wish to make a short statement about the sub judice resolution. I have been advised that there are active legal proceedings in the High Court in Belfast between the Society for the Protection of Unborn Children—SPUC Pro-Life Ltd—and the Secretary of State for Northern Ireland and Minister for Health. I am exercising the discretion given to the Chair in respect of the resolution on matters of sub judice to allow full reference to those proceedings, as they concern issues of national importance.

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[Alex Davies-Jones]

I thank the hon. Member for his contribution to the debate. We do disagree in our personal views on abortion. The full consultation process was carried out. Ultimately, at the heart of this issue are the women and girls who need these services, sometimes desperately. They are being denied their fundamental human rights in law to access these services. Abortion is a personal choice for anyone to make, and those women and girls need to be at the heart of this debate.

The commissioner, Alyson Kilpatrick, was briefing Stormont’s Committee for Health on the Northern Ireland Human Rights Commission’s position on the private Member’s Bill, which seeks to make it illegal to protest or hold demonstrations inside exclusion zones. She said that protesters

“can use the media. They can use various other platforms. They can campaign and protest outside decision-makers’ premises. In fact, the Bill also allows them to protest relatively near to abortion clinics… What it does not allow is for protesters to invade the space and upset, unnecessarily and disproportionately, people who want to avail themselves of the service. They have absolutely every right to say that they disagree, but they do not have a right to impose that on people who are in the process of accessing the service.”

It is therefore vital when debating the situation with abortion services in Northern Ireland that we bear in mind the difficulties that some women and girls face even when those services are available to them.

The commissioning and indeed availability of abortion services is complex. Put simply, every single day that passes denies women and girls the safe, local service they are entitled to. At any time, that would be deemed unacceptable. In a pandemic, it is morally unjustifiable. While it can be dangerous to draw comparisons, I do often consider how the dialogue around other equalities differs from the conversation around abortion. I consider it my duty as an elected representative to challenge these inequalities at every opportunity.

Let me be clear: as someone representing a devolved area, I understand well the sensitivities around the devolution settlement. The balance of our political system relies on the deep respect for devolved powers. Contrary to what other Members may think, I truly believe that that respect is not a contradiction to my overwhelming belief that the United Kingdom is at its best when we work together to uphold fundamental rights. The obligation to uphold said rights lies with this Parliament and this UK Government. Where those rights are denied, as they currently are, the Government have a moral and legal duty to act.

We all need to be honest here. The Northern Ireland Executive are failing women and girls in their obligation and that cannot continue. Quality healthcare and safe, local abortion services are a basic right, and the time to act has long come and gone. For the sake of women and girls in Northern Ireland, it is vital that access to services is commissioned immediately. It is clear that we cannot rely on the Northern Ireland Executive to do so alone. I, therefore, urge the Minister to provide an update on her discussions with the Minister for Health in the Executive. I hope she is able to provide the reassurance that I and so many women and girls in Northern Ireland desperately seek.

[Mark Pritchard (in the Chair)]

Before I call Ian Paisley, will hon. Members please check that their mobile devices are on silent?

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[Fiona Bruce (Congleton) (Con)]

It is a pleasure to follow the hon. Member for Upper Bann (Carla Lockhart), my co-chair on the pro-life all-party parliamentary group. I commend her for her informed and sensitive speech and for all that she does to be a voice for the unborn in this place.

I rise to speak in this debate to support the right of the Northern Ireland Assembly, representing the people of Northern Ireland, to determine the way forward on abortion—a matter devolved there for some 100 years. I will also highlight the problems arising from the 2020 and 2021 regulations.

I agree that this is a sensitive matter; it is one of fundamental importance in terms of the lives of the unborn, respecting the wishes of the people of Northern Ireland, and respect for the long standing Sewell convention of devolution—that the UK Parliament does not normally legislate in respect of devolved matters without the consent of the devolved legislature. Before I move on to the particular problems of the 2020 and 2021 regulations, I will first refer to two other issues: the Secondary Legislation Scrutiny Committee and the House of Lords Select Committee on the Constitution Abortion (Northern Ireland) Regulations 2021. There were multiple submissions to the Secondary Legislation Scrutiny Committee earlier this year as it considered the Abortion (Northern Ireland) Regulations 2021. Those submissions illustrated the worrying damage that imposing such changes could inflict on the Union. I will quote just one, which says that the Secretary of State’s new powers would

“give him complete control of policies related to abortion and education in Northern Ireland, which are devolved matters. They will take away from the people of Northern Ireland any power to affect any abortion policy the Westminster government choose to impose”,

and that,

“given the current unrest in the province, these measures could do untold damage to the already fragile Northern Ireland Assembly and the Good Friday Agreement.”

Those are profound implications.

I turn to the House of Lords Select Committee on the Constitution, which published a report on the Abortion (Northern Ireland) Regulations 2021 in April highlighting several constitutional issues arising from the regulations. The Committee stated:

“The 2021 Regulations raise an important issue concerning devolved competence. On the one hand the Secretary of State cites a statutory duty, arising from section 9 of the 2019 Act, to make the 2020 and 2021 Regulations… On the other hand, one of the governing parties in the Northern Ireland Executive opposes the Regulations as an unwarranted interference with the devolution arrangements… The prospect of different laws on abortion operating in Northern Ireland would cause substantial legal and political difficulties, and risk undermining the devolution arrangements. We urge the Government and the Northern Ireland Executive to adopt a more constructive approach to resolve this matter.”

I agree.

I now turn in detail to the problems arising from the 2021 and 2020 regulations. Some of these points have been touched on, very eloquently, before; forgive me, Mr Pritchard, if I touch on them again. They are worth repeating. The 2020 regulations allowed the Westminster Government to introduce a completely new abortion framework to Northern Ireland—even broader than the already extremely permissive regulations applicable here. For example, the regulations allow for an abortion, without the need for any ground or reason to be given, for any pregnancy up to 12 weeks. That, effectively, permits sex-selective abortion, as it is now possible to tell the sex of an unborn child between seven and 10 weeks.

Government Ministers here have repeatedly stated that sex selection is not a lawful ground for the termination of pregnancy. When sex-selective abortion was debated in Westminster in 2015, a Minister described it as an “abhorrent practice”. In permitting abortion on demand up to 12 weeks, the regulations go far beyond the law in Great Britain. Indeed, they are even more permissive than required by the CEDAW report, which I will come on to shortly.

The 2021 regulations are even broader, as they deal not only with abortion but with wider issues such as sex education. However, no formal consultation has taken place on the regulations. The Government relied on a mere six-week consultation on the 2020 regulations—six weeks that ran during the general election campaign of 2019 and in the lead-up to Christmas that year.

Then there is the question of the cost of implementing this new framework for abortion in Northern Ireland, which is shrouded in confusion. There was no impact assessment for the 2020 regulations. It appears that the UK Government—the Minister may correct me—have given no indication of how costs will be borne, arguing that this is a matter for the Department of Health in Northern Ireland. However, the Department of Health in Northern Ireland considers this funding to be a matter for the UK Government.

There is the further legal point of controversy as to whether the obligations in the Northern Ireland (Executive Formation etc) Act 2019 were a one-off, so that the 2020 regulations met them, which is the view of the former Attorney General for Northern Ireland, John Larkin QC, or whether those obligations are continuing, which I understand is the view of the Government.

It is critical to remind ourselves, as colleagues have done, that the minor UN CEDAW committee was not the UN speaking as a whole, which was often the impression that we were given when we were discussing the Northern Ireland (Executive Formation etc) Act 2019. Those discussions were far too brief. I remember one important debate on the Bill, on 18 July, that lasted just one hour. On another occasion, if I remember correctly—and I stand to be corrected—we were asked to look at House of Lords amendments in just 17 minutes, which was totally inadequate for the consideration of such important legislation.

That CEDAW committee was not the UN speaking as a whole and, as we have heard, its recommendations are neither binding nor international law. That has been specifically confirmed by the Northern Ireland Office itself in its explanatory memorandum to the Abortion (Northern Ireland) Regulations 2021, which states, with reference to paragraphs 85 and 86 of the CEDAW report:

“In particular, those recommendations are not binding and do not constitute international obligations.”

The whole premise on which we passed the 2019 Act was false.

On the basis of those non-binding recommendations, the Government seek, through the 2021 regulations, to give the Secretary of State sweeping powers to direct not just Ministers but civil servants and health bodies in Northern Ireland to implement a broad abortion framework. That is a far wider group of people and bodies than envisaged by the Northern Ireland Act 1998, which allows the Secretary of State to give direction to Ministers or a Northern Ireland Department only in certain circumstances, namely,

“for the purpose of giving effect to any international obligations”

—and we have agreed today, I hope, that the CEDAW recommendations were not international obligations—or for the purpose of

“safeguarding the interests of defence or national security or of protecting public safety or public order”.

The wide-ranging powers given to the Secretary of State by the 2020 and 2021 regulations cannot be justified on any of those grounds.

I turn now to commissioning. There is no reference to what services might be commissioned in either the 2020 or the 2021 regulations. The regulations are now, as Mr Pritchard has said, the subject of a pending court decision, which makes for a further legal complication. The requirement to commission services under the direction of the Secretary of State may disappear if that legal challenge is successful, leaving a legal loophole. What is particularly concerning about the commissioning, however, is that the regulations do not include any proposed inspection arrangements for premises conducting abortions, whether NHS or private. It would appear that the Northern Ireland Regulation and Quality Improvement Authority has no powers to inspect any premises to compare with those of the Care Quality Commission in England. If that is the case, that omission is doubly concerning when we consider recent reports by the CQC of abortion clinics in England. In the last few weeks, a British Pregnancy Advisory Service clinic in Middlesbrough was rated inadequate after inspectors found that medicines were not stored safely and that systems to protect people from abuse were not “effective”, while a Doncaster BPAS clinic was put into special measures following an inspection. It is essential that proper provision for the inspection and regulation of abortion services is in place in Northern Ireland.

As mentioned, abortion remains a devolved matter that rests with the competency of the Northern Ireland Assembly. The Northern Ireland (Executive Formation and Exercise of Functions) Act 2019—which, in section 9, includes the order-making power under which the regulations were created—was imposed on Northern Ireland at the behest of parliamentarians from other parts of the UK. No Northern Ireland MP in Westminster supported the passing of that Act.

The Northern Ireland Assembly have been up and running for some time. It not only has the legislative competency to act on abortion-related matters but, as we have heard, it is in the process of doing so through the Severe Foetal Impairment Abortion (Amendment) Bill. Respect for the competencies of that Assembly and the devolution settlement surely dictates that all other abortion matters should be determined by the Assembly, particularly since abortion has been a devolved matter for so long.

The Severe Foetal Impairment Abortion (Amendment) Bill seeks to address the discriminatory nature of abortion law implemented in Northern Ireland under regulation 7 of the 2020 regulations, which permits abortion up to birth on the grounds of disability. It is a matter of increasing concern across the UK in terms of its discriminatory aspect, as we heard in the House only two weeks ago in a debate on the proposed Down’s syndrome Bill.

Application of regulation 7 would very much go against the progressive tide of thinking in that respect. The fact that abortion up to birth for serious foetal disability is already in effect in GB is no reason to implement it in Northern Ireland—particularly as it is now considered to be deeply concerning and ill-defined legislation. I know that because my son was born with a club foot. I do not consider that to be a serious disability. We have seen it corrected; no one looking at my son today would know that he had been born with that disability.

Even the CEDAW report on which the regulations rely stated:

“In cases of severe fetal impairment, the Committee aligns itself”

with the UN

“Committee on the Rights of Persons with Disabilities in the condemnation of sex selective and disability selective abortions, both stemming from…negative stereotypes and prejudices towards women and persons with disabilities.”

With great sadness, I conclude that imposing the ill-thought-through and hurried-through regulations would demonstrate a profound lack of respect for the people of Northern Ireland and their elected representatives. As I have repeatedly said in this House—I refer to my remarks on 8 July, 18 July and 9 September 2019, and on 8 January 2020—the hurried handling of the issue of abortion, which is a devolved policy area, and the Northern Ireland (Executive Formation) Act and the subsequent introduction of regulations has been, in my opinion, unconstitutional, undemocratic, legally incoherent and utterly disrespectful to the people of Northern Ireland.

[Mark Pritchard (in the Chair)]

I ask the hon. Member for Strangford (Jim Shannon) to wind up at about 3.38 pm, to allow the Front-Bench Members 10 minutes each.

Cervical Screening

Mark Pritchard Excerpts

Monday 19th July 2021 Westminster Hall

[Mark Pritchard (in the Chair)]

Hon. Members will be aware that social distancing is no longer in operation. I remind hon. Members that Mr Speaker has encouraged us all to wear masks. I also remind hon. Members that there have been some changes to normal practice in order to support the hybrid arrangements that we have today. I remind colleagues participating both physically and virtually that they must arrive for the start of the debate, as I think they have today, and Members are expected to remain for the entire debate, please.

I must also remind Members participating virtually that they must leave their camera on for the duration of the debate and that they will be visible at all times, both to each other and to those of us here in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerks’ email address, which is westminsterhallclerks@ parliament.uk. Members attending physically should still clean their places when they leave, to ensure that other hon. Members can come into a place that is clean.

[Tonia Antoniazzi (Gower) (Lab) [V]]

I beg to move,

That this House has considered e-petition 317336, relating to cervical screening.

It is a pleasure to serve under your chairship, Mr Pritchard, for this really important debate. I apologise for not being able to be there in person today, but I thank the House for these hybrid proceedings because I was pinged last week.

I will begin by putting on the record my huge thanks to Caitlin, who is Fiona’s sister, for speaking to me last week about Fiona’s case and the way that it has affected her whole family. I also thank Fiona’s friends, Melissa Macdonald and Niamh Foley, who started the petition, and all those who have signed it, which led to this debate being held today.

As a woman, I know that we all sort of dread getting the call-up for our smear test. For most women, it is not painful, but it is uncomfortable and awkward. What can someone even chat about when the nurse is having her little look? But why should it be like that? We have all been there; the nurse has seen it all before. It is just not spoken about, so we feel a sense of shame about it. It is time we stopped being so coy about it, because that may well persuade more women to go for screening and ultimately it may save lives.

Cervical cancer is one of the most common cancers in women under 35, and 99.7% of cervical cancers are caused by human papillomavirus, or HPV. In recent years, testing for HPV has meant that it is easier to identify who is at greater risk from cervical cancer at the earliest stage.

During covid, England had an attendance rate for smear tests of 72%, which means that more than one in four women are not going for screening when invited to do so. The wonderful charity Jo’s Cervical Cancer Trust has a number of ideas to increase the uptake of smear tests, and I suggest that the Minister meets it to discuss ways of increasing the number of women being tested; I know that she has a keen interest in women’s health.

I was really moved when I spoke to Caitlin, because I got a real sense of how difficult it must be to lose a sister, especially at such a young age. Fiona was only 30 when she died. She was married to Andrew and was the mother of two young children. When Fiona died, Ivy was only four and Harry had just turned two. As Caitlin said, Fiona used all her strength to stick around for Harry’s second birthday.

Fiona was called for her first smear test in 2015, but she was pregnant with Ivy and so was told not to go. When she was called again, she was pregnant with Harry, but there was no follow-up to the first appointment. Fiona never received a reminder to go to her smear test in the interim. This situation is not about someone missing appointments when called to attend them; Fiona went to every appointment that she was meant to go to.

Fiona’s cancer was finally diagnosed after a routine smear test in 2018. She did not have any symptoms, but there seemed to be a lot of hold-ups and delays before her cancer was diagnosed. Caitlin mentioned that it could perhaps have been because of Fiona and Andrew moving from England to Scotland that Fiona received her first invitation. That raises questions about communications between the devolved Administrations and about what procedures are in place to make sure that communication between different trusts and devolved countries is clear.

A hysterectomy was performed and Fiona then went through chemotherapy and radiotherapy as a belt-and-braces approach to dealing with the cancer. After that, Fiona had a number of visits to A&E, including one where the doctor later admitted that she knew the problem was cancer and not a hernia, but did not say anything as Fiona was seeing a specialist soon after.

Most of us are not medical experts. We rely on doctors to tell us the truth because we do not know what is going on, and that vulnerability is really exposed when we hear such stories. I know it is extremely rare to hear stories such as Fiona’s, and the vast majority of our doctors, nurses and other health service staff really care, but it is shocking none the less.

Before covid hit, cancer services were already struggling due to severe staff shortages. Despite the incredible efforts by staff, a backlog has built up. Relying on current staff, who again have not had a pay rise, to clear the backlog on top of delivering regular services will only lead to burnout. It is just not sustainable. Research from Macmillan Cancer Support in 2017 showed that 2,500 specialist cancer nurses were needed to maintain cancer services. By 2030, we will need 3,700 new nurses—an increase of 124% on 2017 levels. Those figures will also have been hugely impacted by the pandemic. The Government have come forward with their own cancer workforce strategy, which is inadequate, and I implore the Minister to reconsider the plans that they have and come up with something that will really help those living with cancer.

Everything that happened to Fiona came before the pandemic hit last year. We have heard countless times about the delays in diagnosis and treatment that the last 16 months has caused. Approximately 1.5 million smear tests take place every year. With the pressure on the NHS since March 2020, that could mean 1.5 million women missing out on a vital tool in diagnosing cervical cancer.

We know that the rates of covid infection are on the up. Hospitalisations for covid are rising, and some NHS trusts across the UK are already cancelling operations as they are at capacity. The recklessness of so-called “freedom day” in England and the removal of all the measures that have been in place to keep us safe is therefore unbelievable. Putting the immunosuppressed at risk, such as those going through cancer treatment, is downright dangerous, and I am glad that the devolved nations have taken a more cautious approach.

What will the extra pressure on the health service mean? Another delay in getting a smear test. And what will that do to the outcomes for so many young women? What will the Government do to make sure that those women who miss out are not left behind, and to stop a knock-on effect on testing? We are looking at new ways forward. Fiona’s case has highlighted some of the gaps that were there before the pandemic started, and things have only deteriorated since covid hit. We must work together to make sure that cancer services are the best that they can possibly be, and that our cancer workforce is protected and given all the tools that it needs to continue to save lives.

When Fiona got really ill, her daughter Ivy used to ask why mummy had to spend so much time in bed. To stop another family having to answer those questions, I want the Minister to answer the questions that Fiona’s family and friends, and all of those who have lost someone to cervical cancer, need answers to. What procedures are in place to make sure that women like Fiona do not fall through the cracks? How does that work across the devolved nations? What is the current screening backlog? What plans to increase the cancer workforce are currently in place?

Caitlin finished our meeting by saying that any change that could come from this debate—if one life is saved, or if one family does not have to go through what her family have been through—would make it worth it.

[Mark Pritchard (in the Chair)]

Before I call John Lamont, I have to say that even though the attendants have been fantastic in helping with the air conditioning, it is still very warm, so if hon. Members want to remove jackets, they should feel free.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is pleasure to serve under your chairmanship today, Mr Pritchard, as I often have in this Chamber, and I very much look forward to the Minister’s response. I very much look forward to speaking in this debate on cervical cancer screening.

I stand here to speak on behalf of my female constituents, whom this directly affects, and I speak in complete support of the e-petition, which had 146,000 signatures. Cancer is a tragedy that all of us know only too well. I am sure it has touched the lives of everyone in the room today. I am sure the Minister will not mind me saying that she has been directly affected, and we are very pleased to see her here as a survivor.

We must take every necessary step to catch cases sooner rather than later. The petition for Fiona’s law applies to women in England. However, I speak on behalf of my constituents and the women of Northern Ireland. It is estimated that some 3,200 women will be diagnosed with cervical cancer every year in the UK. Eighty people in Northern Ireland are diagnosed every year, and roughly 20 to 30 of those women will, sadly, pass away from the disease. The Public Health Agency in Northern Ireland has said that early detection and treatment can prevent seven to 10 types of cervical cancer. As the hon. Member for Berwickshire, Roxburgh and Selkirk (John Lamont) mentioned, Northern Ireland offers screening every two years. I would like to see it done better. I would like to see it every year; that is the best way to do it. The request is for early detection and treatment as the way to prevent cervical cancer.

It is important to remember that screening is not a test for cancer; it is a test to help prevent it. That is what we are trying to do, and that is why, to assist in preventing cervical cancers, we must do more to ensure that women have screening appointments regularly. Current legislation states that women between the ages of 25 and 49 will be invited for screening once every three years, and those aged 50 to 64 every five years. That is in line with the NHS’s long-term plan to detect 75% of cancers at stage 1 or 2.

I cannot stress enough the importance of screening appointments for women. First, I can only imagine that it is not a comfortable or easy procedure to go through, but I do believe that the prolonged interval of three years only increases the anxiety. Secondly, yearly screening would allow for more effective diagnosis, but it also provides an opportunity to make a procedure that a lot of women dread having more familiar and comfortable, if that is possible.

The UK’s leading cervical cancer charity, Jo’s Cervical Cancer Trust, report that 51% of women admitted to delaying their screening, that 24% delayed for over a year and that 9%, one in 10 women, have never attended a screening. Those are shocking figures, but they are understandable at the same time. These are lives being lost, and because of the frequency of cervical screening it is getting worse.

There needs to be more communication about screening so that people are aware of what they are going into. That would then provide confidence and would increase the numbers attending, which would ultimately result in lives saved: more mothers, more daughters, more sisters, more grandmothers and more wives living longer and healthier lives. My wife went through it. She did not for one second wish to go. She found the whole thing very uncomfortable and, honestly, a little embarrassing. Obviously, we encouraged her. My mother encouraged her, and I think that probably helped—from lady to lady is probably better. She went for the tests and got the all clear.

Cancer of all kinds has destroyed lives and families for too long. We must do all we can to increase early diagnosis, as the petition calls for, especially in the light of the impact of the pandemic, which has seen a further decrease in screening figures. We need to get back on our feet and allow women yearly screenings. I urge the Minister to undertake discussions with the UK National Screening Committee to ascertain why it feels that women do not warrant screenings every year.

To anyone who is offered a cervical cancer screening, I say please go. I say to the Government that the encouragement from the Minister will start here. More must be done to get more frequent appointments, more awareness of the benefits and more discussion around the appointment itself, because there is nothing more promising than the prevention of disease.

[Mark Pritchard (in the Chair)]

Before I call Mike Kane, there has been a slight adjustment to the call list. I will call Dr Philippa Whitford after Mr Kane, and then Alex Norris.

--- Later in debate ---

[Mark Pritchard (in the Chair)]

Would colleagues please leave the room via the door marked “Exit” and observe social distancing? Thank you again to our excellent technical teams.

Covid-19: Vaccinations

Mark Pritchard Excerpts

Monday 11th January 2021 Commons Chamber

[Nadhim Zahawi]

The hon. Lady asks an important question. In any manufacturing process—especially a new one—it is always lumpier at the beginning, and there are more challenges. There are a number of tests done by both the manufacturer and the regulator; the batch testing at the end of the process is done by the regulator, to make sure that the batches meet the very high standards that we have in the United Kingdom. That will begin to become much smoother and stabilise, and we have a clear line of sight through to the end of February, hence why we are confident that we can meet the target of offering a vaccine to the top four most vulnerable cohorts on the list of nine from the JCVI by the middle of February.

We thank the hon. Lady’s local GPs, but it is important for them to remember that the central team that is doing the distribution is running at about 98.5% accuracy at the moment, which means that 1.5% of deliveries are not as we would like them to be. We will get better at that. As Brigadier Prosser said, this is like standing up a supermarket chain in a month and then growing it by 20% every couple of weeks. It will get better. The focus of the central team is to try to give primary care networks —GPs like hers—as much time and notice as possible, so that they can plan ahead and get the four cohorts in for their jabs. It is always difficult at the outset, but it gets better by the day and will do in the weeks ahead.

[Mark Pritchard (The Wrekin) (Con)]

Would the Minister like to join me in thanking NHS staff in Telford and Wrekin and Shropshire for having vaccinated more than 15,000 people already? Could he also reassure my constituents who have received a letter from NHS England inviting them to have a vaccination in Birmingham or even Manchester—an hour and 45 minutes away—that if they wait just a few more days, they can choose, if they wish, to have a vaccination very locally?

[Nadhim Zahawi]

I absolutely join my hon. Friend in congratulating and thanking the heroes of the NHS and the volunteers in Telford and Wrekin and Shropshire for vaccinating 15,000 people—15,000 of the most vulnerable people to covid who, in a couple of weeks’ time, will have that protection. He is right, I can confirm, that anyone receiving a letter where it is inappropriate or not possible for them to travel that distance to a national vaccination centre does not have to do so. They will be able to be vaccinated in their primary care network at a time and place that is convenient to them. With the national vaccination centres—seven went live today, and there will be more next week, more the week after and 50 in total by the end of the month—we are trying to effectively add to the throughput that I described earlier.

Covid-19: R Rate and Lockdown Measures

Mark Pritchard Excerpts

Monday 8th June 2020 Commons Chamber

[Mark Pritchard (The Wrekin) (Con)]

Of course, the international R rate matters too. I welcome the Prime Minister hosting the global vaccine summit in the UK last week, which raised an astonishing $88 billion. Given that the UK is the largest contributor to Gavi, the Vaccine Alliance, what support are this Government giving to low-income and developing countries, particularly in the Commonwealth and overseas territories?

[Matt Hancock]

That is an incredibly important point, because being able to get a vaccine everywhere around the world is incredibly important to us here at home. Of course, our top priority is access to the vaccine for the citizens of this country, but we are also using our aid budget to ensure that, should a vaccine work and become available, we can not only deliver it here but be good global citizens. As my hon. Friend says, we have put more into this than any other country on the planet.

Oral Answers to Questions

Mark Pritchard Excerpts

Tuesday 5th May 2020 Commons Chamber

[Matt Hancock]

Yes. The shadow Secretary of State has asked questions in a responsible and reasonable way, and I welcome his support for the test, track and trace pilot on the Isle of Wight that we announced yesterday. His question is quite right; we have piloted the testing of asymptomatic NHS staff in 16 trusts across the country. Those pilots have been successful, and we will be rolling them out further.

[Mark Pritchard (The Wrekin) (Con)]

What progress has been made on the development of a covid-19 vaccine.

[The Secretary of State for Health and Social Care (Matt Hancock)]

The development of a coronavirus vaccine is in its early stages but progressing rapidly. The Government have backed two promising vaccine candidates from the University of Oxford and Imperial College, and we are making over £45 million available to those teams—alongside the hundreds of millions that we are making available to the global vaccine search.

[Mark Pritchard]

I am grateful for the Secretary of State’s response. The World Health Organisation has undoubtedly made mistakes over covid-19 and needs deep reforms, but this global pandemic requires a global response. How is the UK liaising with the WHO so that we work together globally to beat this virus?

[Matt Hancock]

We do work globally, and we do work together. As the Prime Minister made clear yesterday, we have committed £744 million to the global response to coronavirus. We are significant funders of the WHO, and I am grateful for its work. We are also a significant funder of the Coalition for Epidemic Preparedness Innovations, which is leading the global search for a vaccine. In fact, we are making the largest contribution of any country in the world to the global search for a vaccine, and three of the top 10 vaccine candidates are being developed here in the UK.

Coronavirus Bill

Mark Pritchard Excerpts

2nd reading & 2nd reading: House of Commons
Monday 23rd March 2020 Commons Chamber

[Mark Pritchard (The Wrekin) (Con)]

On the point about testing, will the Secretary of State be absolutely clear? Does the current test that is available show whether somebody has got covid-19 or has perhaps previously had it? Does it do both, or does it do just one? If it does just do one, when are we likely to have a test that does both?

[Matt Hancock]

Tests for both have recently been developed. The test for whether someone has coronavirus, which we call the case test, was first developed here by Public Health England, and that is being expanded. The antibody test, which tests whether someone has the antibodies that make them immune to coronavirus, has now been developed, and we are buying it in large quantities.

--- Later in debate ---

[Matt Hancock]

Yes, this is what I have been spending the weekend on—absolutely; it is incredibly important.

Turning to the second part of the Bill, which is about easing the burden on the frontline and follows from that intervention, that refers not only to the NHS frontline but to the dedicated public servants who guard our streets, who care for our children, and look after communities, in local government—in short, all those who keep the UK running safely and securely. By cutting the amount of paperwork that they have to do, by allowing more remote working, by delaying some activities until the emergency has ended, we can keep essential services going while we get through the pandemic.

Some of the measures are difficult, and not what we would choose to do in normal times. For instance, the Bill will modify temporarily mental health legislation, reducing from two to one the number of doctors’ opinions needed to detain someone under the Mental Health Act 1983 because they pose a risk to themselves or others. In circumstances in which staff numbers are severely affected, the Bill allows for the extension or removal of legal time limits governing the short-term detention of mental health patients. The Bill also allows for an expansion of NHS critical care by allowing for rapid discharge from hospital where a patient is medically fit. NHS trusts will be permitted to delay continuing healthcare assessments, a process that can take weeks, until after the emergency has ended. The people who need this support will still receive NHS funding in the interim.

The Bill contains powers allowing local authorities to prioritise the services they offer, as we discussed earlier in relation to social care, and that prioritisation, while challenging, is vital. The measures would only be activated in circumstances where staff numbers were severely depleted. They do not remove the duty of care to an individual at risk of serious harm or neglect. We do not take any of these measures lightly. I hope that many will not have to be used, but we will do whatever it takes to beat this virus.

[Mark Pritchard]

I am grateful to the Secretary of State for giving way. He is being very generous. On frontline care, particularly those working in intensive care units around the country, may I press him again? When will those staff be tested? There are many staff who want to go to work, but are afraid that they may be carrying the virus. For those who are at work, if they are tested and they have the virus, they want to isolate so that they can return as quickly as possible to the frontline. When are they going to be tested?

--- Later in debate ---

[Matt Hancock]

I agree with my hon. Friend.

[Mark Pritchard]

Will my right hon. Friend give way?

[Matt Hancock]

I will take one more intervention, and then I will make some progress.

[Mark Pritchard]

I am grateful to the Secretary of State for giving way; he is being very generous, but these are important issues. On the issue of social distancing, is there something that he feels might happen tomorrow that is not happening today, as far as people’s behaviour is concerned? People are gathering in their thousands on the beautiful landmark of the Wrekin in my constituency. It is right that people should have exercise for their physical and mental health and wellbeing, but social distancing is not being followed by many, whether it be in the Wrekin or Holland Park, Hyde Park, St James’s Park or counties around the country. What behavioural changes does he expect? Is it not the case that we will have lockdown, and would it not be better to have it today rather than next week?

[Matt Hancock]

My hon. Friend makes an important point. We are absolutely clear that we are prepared to take the action that is necessary.

The fourth part of the Bill contains measures for managing the deceased in circumstances where many of those involved in the registration and management of death will themselves be self-isolating. We want to ensure that those taken from us by the virus are treated with the utmost dignity, while protecting public health and respecting the wishes of bereaved families. Among other measures, the Bill will expand the list of people who can register a death to include funeral directors. It will mean that coroners only have to be notified where there is not a medical professional available to sign a death certificate. It will allow death certificates to be emailed instead of physically presented. It will remove the need for a second confirmatory medical certificate in order for a cremation to take place, and it gives local authorities the power to take control of elements of the process if needed. Those powers would only be used if absolutely necessary and on clinical advice, but we plan for the worst, even while we work for the best.

--- Later in debate ---

[Jonathan Ashworth]

I agree with my hon. Friend. I did note that the Secretary of State talked about the comprehensive public health advertising campaign. We welcome that campaign, but we encourage the Secretary of State to use his offices to see whether that comprehensive campaign can become even more comprehensive. Can we have more adverts on television and more adverts on radio stations? Can we have a leaflet going through every door, explaining what social distancing means, explaining what shielding means? Before this virus took hold, the words “social distancing” and “shielding” were probably not often used in the Chamber, so if they are not words that we are familiar with, we can bet that our constituents are not entirely familiar with them either.

[Mark Pritchard]

The shadow Secretary of State will know Telford and Wrekin very well as he has visited them many times in the past 12 months due to flooding and other issues. I am grateful for his visits despite the fact that he is a member of the Opposition. Is he aware that, today, the Labour-led council made a decision, which I support, to close all the public parks, play areas and open spaces that it runs, and that that in turn will put more pressure on the other open spaces that are not currently run by the local authority? May I encourage him to continue to press the Government to move quicker to this lockdown that we all want to avoid, but that will ultimately save lives.

[Jonathan Ashworth]

I must tell the hon. Gentleman that my attempts to change the political complexion of Telford and Wrekin have completely failed to date, but I am grateful to him for his comments about the Labour council. I think that this is the nub of the matter. I have a point to put to the Secretary of State while he is still in the Chamber. Sadly, it has just been reported on social media that the case fatality figures are continuing to climb and there is some discussion that we are seeing now an exponential growth in line with Italy. I appreciate that there are different demographic issues in different nations, but, clearly, people are concerned that our death rates are increasing at a rate that suggests that we could be heading to an Italian-style situation. We all know what is happening in Italy. The point is that clinicians are warning us that our intensive care bed capacity and our high-dependency unit capacity, could very quickly be overwhelmed. We have already seen a critical incident at one hospital, and no doubt we will see more in the coming days. This is a crisis and it is a crisis that demands an overwhelming Government response.

Covid-19

Mark Pritchard Excerpts

Monday 16th March 2020 Commons Chamber

[Matt Hancock]

I understand why some parents are concerned, but the evidence is that children are not badly affected by this virus and it is important to take that into account. The hon. Gentleman makes the point about people who need to go to work not being able to because of childcare responsibilities, and that is very serious in terms of the impact that it could have and is therefore very important to take into account.

[Mark Pritchard (The Wrekin) (Con)]

In the past two hours, the Prime Minister has said that school closures will be kept “under review”. In the event of a school needing to close, who takes the final decision—is it the Government, the local education authority or the headteacher?

[Matt Hancock]

It is the headteacher, and there are discussions with regional schools commissioners in such cases in England. We are looking to address that issue in the Bill.