Dementia: Covid-19

Rachael Maskell Excerpts

Thursday 12th November 2020 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

I thank my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) for the way she set out so many of the complexities in this debate. We know that the intersection between dementia and covid is complex and that there are multifaceted challenges. I am sure we will not touch on them all in today’s debate.

I thank the Alzheimer’s Society, which is supporting people with dementia day and night through this crisis. I echo its call, and that of the Association of Medical Research Charities, for a significant and separate fund to be set up—a life sciences-charity partnership fund—to continue medical research through this time. We know that those charities’ funding has been massively hit and that they need support. I trust that the Minister will feed that back to the Chancellor ahead of the autumn statement that we are expecting.

We know that 27% of the people who have died had dementia. There is a correlation with older people, because of the resilience they have, but the figure is also disproportionate within that age population. Research is therefore absolutely necessary in order to understand what is happening. From my own clinical background, I have considered the impacts that dementia has on people with respiratory conditions, and there are certainly issues that need to be looked at in greater detail. I believe that that has mitigated against opportunity for people with dementia and created inequality. For instance, people with respiratory conditions often find it hard to comply with some of the treatment processes: positioning, secretion clearance from the lungs, and the ability to follow complex instructions such as huffing, coughing and taking deep breaths. When not under instruction, they are certainly not able to do that.

We have also seen environmental challenges to healthcare. At the beginning, we saw no PPE and barrier nursing, which have been well debated. As was said in this Chamber yesterday, 39% of people with dementia live in care homes, and 70% of care home residents have dementia. That environment, in itself, has become unsafe, but it has also become a place of isolation, which has a real impact.

There is a big question around the efficacy of access to healthcare. We know that there was a reduction in referrals to healthcare, which meant drugs not being administered, as well as no therapy, physio or secretion clearance, as I indicated. That could well have raised the number of people who had covid and who died from covid. We therefore need to look at the human rights of individuals with dementia.

When we consider the psychological, emotional and cognitive impacts of separation and isolation, which have been articulated so well in this debate, we know that harm has been caused. I therefore ask the Minister to look at the report of the all-party parliamentary group on ageing and older people, which looks at a commission on the human rights of older people, and to look at the work that has been done in Wales on having a commission and a commissioner to look at those issues. That is a way of ensuring that older people are part of the debate. That will include many people with dementia, although I appreciate that some people with dementia are younger.

That would be a way of putting protections in place, and of ensuring that we care for the carers. This is the point that I want to end on. We know that the majority of carers are saying that they are exhausted, they are anxious, they are having sleeping problems, they are depressed. They are not part of the conversation at the moment, and we need to bring them into it. Many are lonely and struggling at this time. We need to care for those carers as they not only take on more and more responsibilities, but provide vital care day in, day out.

Family Visits in Health and Social Care Settings: Covid-19

Rachael Maskell Excerpts

Wednesday 11th November 2020 Westminster Hall

[Rachael Maskell (York Central) (Lab/Co-op)]

It is a pleasure to serve under your chairmanship, Ms McVey. I should say to the hon. Member for Beaconsfield (Joy Morrissey) that I was really moved by the way she opened the debate, particularly the way she described Jamie’s story. It will be imprinted on my mind and, I am sure, on the minds of all hon. Members present.

When things do not add up, I ask questions. During the first lockdown, I had to jump through hoops just to obtain data to find out what was actually happening in our care homes. I spoke to managers, the local authority, relatives, staff and whistleblowers, then I put the jigsaw together. In the vast majority of care homes, residents were kept safe, and I thank the staff for their extraordinary work and for the ends that they went to in order to care for the residents. However, some care homes stood out. In the first period, around half of covid-related deaths in York were in care homes. Discharging patients into care homes—something I pleaded with the local authority not to do—seeded the infection. It then spread with the lack of PPE and no training in barrier nursing.

However, there was another conclusion to my inquiry: care homes became closed environments. One thing that we know about closed environments is that they are also unsafe. We have heard so many times in this place about the bitter experience of that. The plethora of informal inspectors were not there—GPs, community pharmacists and other professionals. They did not go in and see for themselves. Families did not go in either.

Families notice things. They notice if mum cannot reach a cup of tea, is looking unwell, has not eaten or is confused, and they notice if dad is slightly more unsteady on his feet, upset or withdrawn. But they were not there do that. However, one family noticed the eerie silence at one care home. Having been told that everything was fine, they learned that 15 people had died over a fortnight. They were not informed of the risk, only that the deaths had occurred. By the time it came to their deathbed visits, of course, it was all too late. During a deathbed visit to their mum, who had been fine, they found her emaciated, as if she had not eaten since their last visit in previous weeks. On another visit, they noticed that mum’s mobile was uncharged. On another, she had a fractured pelvis on discharge. That is why visits must occur; if they do not, these things go unnoticed.

It was whistleblowers who informed me that, at one care home, people contracted covid but their death certificates with marked with their underlying health condition. Covid was not put on the death certificate, because there were fears of reputational damage to the care home. The staff’s concerns were dismissed, and they were bullied. Even when the CQC came at my calling, they were shifted out of sight or moved to other shifts. Families would have noticed such issues.

Families must be proactively communicated with at all times and supplied with the information that they need to make care choices. As one relative said,

“We would have brought mum home had I known there was covid. It took her life.”

I am sure we were all distressed to see a nurse who went to take her 97-year-old mum home being arrested for doing what any of us would do in those circumstances. Families must visit and must have the choice where care is provided.

A constituent wrote to me this week, having celebrated his 60th wedding anniversary in September. He and his wife are both in their 80s and were told they could not visit. He said:

“When your whole existence is dedicated to the love you have for one another, it tells you something is very wrong.”

A distressed daughter told me this week that her father “couldn’t visit mum”. What are we doing to people? This is just so wrong. People are separated because our care system does not allow spouses to join their life partners unless they pay extortionate fees that they cannot afford.

I urge the Minister to look at that issue in the care sector. Not only must we give choice around visiting, but it must become a human right for older people. Visits can be facilitated with dedication and focus, PPE supply, and lateral flow testing to open up more opportunities and create safe spaces. We need to ensure that indemnity insurance does not prohibit the care home sector from pursuing that.

On the vaccine, the most vulnerable and those wishing to visit them must be prioritised. We must also ensure that there are clear and easy routes for staff, residents and relatives to raise any concerns they may have. We all know that we need to look into the eyes of those we love—hold them, and know that they are safe.

Coronavirus Regulations: Assisted Deaths Abroad

Rachael Maskell Excerpts

Thursday 5th November 2020 Commons Chamber

[Matt Hancock]

I would be happy to have that meeting with Mr Conway. I have spoken to others in the same circumstances who have made the case strongly. The compassion of the case cannot be overstated. I also respect the fact that many hon. Members, as has been reflected today, have deeply held views. We should make sure that the conversation happens; that there is, rightly, a debate about the topic, as there is in many other countries right now; and that it is conducted in an evidence-based, sensible and compassionate way.

[Rachael Maskell (York Central) (Lab/Co-op)]

Clearly, we are debating the most sensitive of issues, and we need more investment in the research and practice of palliative care. I ask the Health Secretary what additional resources will come forward, because at the end of October the grant funding for covid-19 and hospices came to an end. Of course, we are entering a further period of lockdown in which charity shops will be shut and fundraising opportunities will come to an end. Hospices need resourcing now, so what additional support will he bring forward?

[Matt Hancock]

The hon. Lady is absolutely right to raise that issue. We provided more than £150 million of extra funding to hospices during the first peak. Locally, many clinical commissioning groups fund their local hospice and contribute to that support, but we always keep it under review, because hospices are such an important part of the provision of end-of-life care.

Covid-19

Rachael Maskell Excerpts

Monday 2nd November 2020 Commons Chamber

[Matt Hancock]

Of course, self-isolation following contact or following a positive test, or in quarantine from abroad, is absolutely critical, and we have brought in measures to improve self-isolation, such as the £500 payment and strengthening the enforcement around it, and we are always looking for what we can do to strengthen self-isolation; the Prime Minister was absolutely right in what he said earlier, and there is a huge amount of work under way on it.

[Rachael Maskell (York Central) (Lab/Co-op)]

Two weeks ago, I asked the Health Secretary about the button that was meant to be on the app to release a reference code for people to claim the £500. The Health Secretary specifically came to the Dispatch Box to say that they just needed to press that button. That button does not exist—it did not exist then and it still does not exist today—so why did he make that intervention and how is he going to rectify the situation so people can claim that £500?

[Matt Hancock]

Yes, the button is coming; it is in development. The hon. Member for Twickenham (Munira Wilson), who made the previous intervention, also spoke about the app. There was an upgrade to the app towards the end of last week, and I want to put on record my thanks to the app team, who have done such a great job in improving the app by, as the hon. Member for Twickenham said, improving the targeting so that more people are targeted and more people get the message. The app is also now getting fewer false positives so people can have more confidence that if they are contacted by the app and told to isolate, they need to do so. The button will come.

--- Later in debate ---

[Rachael Maskell (York Central) (Lab/Co-op)]

If we had had a short circuit break at the beginning of autumn, fewer people would have been sick and fewer people would have died. The reality now is that we face a long, harsh lockdown at the very time people need support. I am worried about the loneliness those long dark nights will bring and the impact on people’s mental health. It is damaging not only for people, but for our economy.

I want to suggest two things that could make a difference over the lockdown period we will have to endure. They could make the difference that turns the tide and ultimately saves lives. The first suggestion is local contact tracing. I present it to the Minister with evidence for why we need localised test analysis and contact tracing. On testing, the delay in getting results is far too long. The local resilience forum in North Yorkshire said that after 24 hours, only 16% of tests are returned; after 48 hours, 60% are returned, and after 72 hours, 96% are returned. That is too long to wait to lock down the virus. If we could process those tests locally—test locally and process locally—we could have the results overnight. The University of York Aptima, a local laboratory, has the capability to do that in York. We need some seed funding from the Government, then we can process more than 6,000 tests a day in our city alone.

The evidence on contact tracing is clear. We have heard this evening that Serco turns round only 48% of contact tracing. City of York is already at 83% and had they had more effective data, which they could if they ran the system, they believe they could get to 100%. Indeed, last Wednesday, they did. The difference is stark. A quick response is key to getting on top of the virus—testing quickly, contact tracing quickly and isolating the virus quickly, as opposed to isolating people and the economy. The evidence is clear and I hope that the Government will respond to the suggestion of a localised system of public health.

Just over a week ago, the case rate in York was 307.2 per 100,000 cases. Since we have been doing our own contact tracing, it has fallen to 189.4 per 100,000 cases. That is the evidence the Government need to hold on to to recognise that local contact tracing is effective. It delivers, it saves lives and it will ultimately see off this virus with some of the other measures mentioned.

Secondly, as we unlock the economy, I want to suggest a new approach. When we deal with public health in workplaces, we give workplaces the all clear and certify that they are safe. If a work or community environment is covid secure and certified to be so, it should remain open. As we just heard with the golf example, they do not carry the risk of the virus. If those places are not secure, improvement notices should be issued and venues should remain closed. That is a simple, public health approach, which will make a difference without harming the economy further.

Those are two simple suggestions that can turn the ship around and make the ultimate difference. We need to do that because we cannot risk the NHS, we cannot risk our economy further and ultimately, we cannot risk lives. I trust that the Minister will respond positively this evening.

Covid-19

Rachael Maskell Excerpts

Thursday 22nd October 2020 Commons Chamber

[Jonathan Ashworth]

I am truly grateful for that reassurance, because the Secretary of State will understand that many people in those areas will be concerned and Members will want to get their points of view on the record on that front.

The virus has caused a pandemic because it exploits ambivalence and takes advantage of our human vulnerabilities. It undermines our biological defences and spreads through human social behaviour and clustering. We know that people with long-term chronic conditions in particular are vulnerable, and we know that there is a greater burden of illness in our more disadvantaged areas, which covid cruelly exaggerates. We know that as we entered this crisis, we had less resilience as a society. We entered with life expectancy falling for some of the poorest and stalling nationwide, and life expectancy is a summary of our overall health.

In the past 10 years, the amount of life in good health has decreased for men and women. Our child mortality rates are some of the worst in Europe, and poor health and chronic illness leave communities acutely vulnerable to disease, so it should come as no surprise to any of us that some of the boroughs currently fighting the most virulent fires are some of the very poorest in our country, with the very worst life expectancy.

I welcome the progress being made on diagnostics, therapeutics and vaccinations, which the Secretary of State has updated us on today. We welcome the expanding of mass testing, including the saliva testing and the lateral flow testing. I hope, by the way, that the Secretary of State will invest in our great universities, which are developing some of this saliva-based testing, because they will need the equipment and the labs to process it. He will probably need to invest in robotics and artificial intelligence to do some of that, because there are not enough staff to do it at the moment, and I hope that is part of his agenda. As well as all that, because the virus is now endemic, we will need a health inequalities strategy to get on top of this virus for the long term.

In the immediate term, we also need to adjust our behaviours to bring infection rates down, which is why I have supported the difficult restrictions that the Secretary of State has had to impose, and it is why we are saying we need clarity all the time from Government. But people also want to know that there is light at the end of the tunnel, because it is still not clear to families in Bury, Heywood and Penistone and all those other places that have been put under lockdown in recent days how they will escape it.

We still do not know whether the restrictions across the north will be lifted when the national R falls below 1 or when local regionalised R values fall below 1. We still do not know whether restrictions will be lifted across the north when hospital admissions stabilise. Yesterday, the Prime Minister said that decisions are

“based on a number of things including the R—also, of course, rates of infection, rates of admission to hospital and other data.”—[Official Report, 21 October 2020; Vol. 682, c. 1053.]

He did not tell us what that other data is. Perhaps the Minister responding to the debate can outline how an area in the north in tier 3 gets out of those restrictions. I know that the areas will be reviewed every four weeks, but what are the criteria to inform those reviews?

I represent Leicester, where we are in tier 2, but we have been in a version of restrictions for 114 days. We went directly from national lockdown to local lockdown. In fact, we endured tougher restrictions than those currently designated for tier 3. Our hospitality closed, our non-essential retail closed and—I did not agree with this—our schools closed as well. All those measures together did help to bring infections down in Leicester to about 55 per 100,000—to be frank, many Members would bite your hand off for 55 per 100,000 now—and even at 55 per 100,000 we remained in a version of lockdown.

Now, months later, after all the sacrifice we took in Leicester—after months with our businesses closed, with the mental health impact of people not being able to see their loved ones and families denied the opportunity to visit a care home to see their grandmother or mother—our infection rates in Leicester are 219 per 100,000. The Secretary of State will therefore have to forgive me when I express some scepticism that his approach will work and suppress the virus to the levels sufficient to bring the R value down, because although the early restrictions in Leicester did have an impact, after months we are still under restrictions with infection rates over 200 per 100,000.

The Secretary of State updated us on the situation we are in. He has been good at updating the House repeatedly; I have no criticism of him at all on that front. The growth rate in the virus is slower than in March—it is more muted, thanks to the great sacrifices of the British people, with hand hygiene, social distancing and everything we are doing—but it is not plateauing. We are dealing with an autumn resurgence, and for all the heat and fallout we have had across the House this week, the truth is that the virus is at worrying levels everywhere. The national R is between 1.3 and 1.5. The R across the south-east is between 1.3 and 1.5, across the south-west between 1.3 and 1.6, and across the east of England between 1.3 and 1.5.

Of course, admissions to critical care are currently concentrated in the north and the midlands, but while at this stage in the first wave those admissions to critical care were beginning to come down, they are continuing to go up. It is right that improvements in care mean that people are less likely to die. That is a good thing, and we all celebrate that, but general and acute beds are filling up with covid patients across the north and across the midlands.

We know that the Prime Minister has rejected a circuit break for now—he does not rule it out indefinitely. We think he should have taken advantage of next week’s half term. He decided not to do that. But we should remind ourselves that SAGE advised the circuit break on 21 September. A month later, on 21 October, we had these grim statistics: 191 deaths; 996 hospital admissions; 6,431 in hospital; 629 on ventilation; 26,688 tested positive; and 249,978 cases in the past 14 days. Many will ask how much of that could have been avoided, had the Prime Minister gone along with SAGE’s advice a month ago.

Today, the Chancellor said in his statement that we have to find a balance between saving lives and protecting livelihoods, but I do not believe that the two are in conflict. It is not a trade-off. Actually, I do not believe the Secretary of State thinks it is a trade off—the tone of his remarks was very different from that of the Chancellor earlier. Saving lives and protecting livelihoods go hand in hand. I worry that the approach the Government are currently taking—while understandable, because nobody wants to be in a lockdown, and none of these decisions are easy or do not have negative consequences; I think we are all mature enough across the House to appreciate and understand that—means that there will, by necessity, have to be tougher, deeper action in the weeks to come, not only in autumn. Winter has not hit us yet.

Professor John Edmunds of the London School of Hygiene said yesterday in one of the Select Committees that

“there’s no way we come out of this wave now without counting our deaths in the tens of thousands…I think we are looking at quite a bleak situation unless we take action…I don’t think we should be taking action just specifically in the highest risk areas, but I think we need to take action everywhere”.

A similar sentiment was expressed by Sir Jeremy Farrar, who is also on SAGE. For balance, Professor Van-Tam said at the press conference this week that he disagreed, but also that

“we may have to push on the pedal a little harder”

to get it under control.

I know the Secretary of State is a decent man. He has been very good throughout this crisis in talking to me privately; one would expect a Secretary of State and a shadow Secretary of State to have those discussions. Whenever I have asked for briefings, all the way back to January, he has ensured that the chief medical officer would give me confidential briefings, as I am sure that every Member across the House would understand and appreciate. So I know he is a decent man. I know he is not playing games or anything like that. I know that these are difficult judgment calls of extraordinary gravity. I know there is no easy solution. Everything has trade-offs; everything has negative consequences. But we also know that unless we take decisive action, the consequences could be even worse. No one should pretend to the House that that is not the case. There is a worry that by not taking action now, we will, in the words of Professor David Hunter, an epidemiologist at Oxford,

“all wind up in tier 3 eventually.”

According to Times Radio yesterday, Government sources were telling it that the Government are now planning a three-week circuit break next month across all tier 2 and tier 3 areas. If that is the case, then the Government should probably level with us so that we can all start preparing for it.

This is not just about minimising harm and deaths from covid. As the Secretary of State said in responding to questions from my hon. Friends, we have a huge responsibility and duty to minimise harm and deaths from non-covid conditions as well. We have to avoid the situation that we were in in the spring, when the immense lockdown, which was actually a number of different interventions all at once, meant that to build surge capacity in the national health service, we had to cancel elective operations to free up general and acute beds, and much important diagnostics work and treatment got delayed. That has left us with a situation today where 110,000 people are waiting beyond 12 months for treatment, compared with just 1,600 in January; 3 million people are waiting for breast, bowel or cervical screening, and more people are waiting for treatment.

My worry is that we will end up building a greater backlog in treatment if we do not act. General and acute beds are filling up. We have a number of hospitals cancelling electives already. Bradford has just suspended non-urgent surgery. Birmingham is talking about suspending non-urgent surgery. It is happening in Nottingham. We know that Merseyside is under considerable pressure; the Secretary of State outlined it. It has just been revealed in the Health Service Journal that we are heading into this winter with 2,000 fewer beds than we had last winter. Today the Royal College of Emergency Medicine has warned that over half of A&Es across the country are caring for patients in corridors due to the lack of beds—and we are not even in winter yet. Our overcrowded A&Es are not ideal at the best of times, but during a covid pandemic it is obviously highly dangerous to be treating patients in corridors of A&Es. The president of the royal college, Katherine Henderson, has pointed out that this situation

“will put more lives at risk than it ever did before.”

If the Government really want to drive down infections, suppress the virus and ensure that general and acute beds are not overwhelmed and more operations are not cancelled, then they have to seriously consider what steps they need to take to go further. Unless the Secretary of State or the Minister is going to get up at the end of this debate and say, “Actually, we’re going to do a circuit breaker over half-term next week”, I accept that the Government have probably missed that window of opportunity now, but at some point they will have to take further action.

We could have avoided much of this if test and trace had been more effective. The Secretary of State is spending £12 billion on this programme. Twelve billion pounds is a colossal amount of money. Some of it is going on consultants who earn £7,000 a day, but where on earth is the rest going? We are throwing around figures in this covid debate, and we are becoming quite complacent and relaxed about them, but £12 billion is an extraordinary amount of money; we could probably run the NHS for a month or so on that. We learn today that the system is contacting only 59.6% of contacts, which is the equivalent of failing to contact 101,000 people. That is not world beating; it is a world-beating shambles. I really hope that the Government look at stripping all the failing private outsourcing firms, such as Serco, of these contracts and putting local public health teams in charge. That would be much more effective.

[Rachael Maskell (York Central) (Lab/Co-op)]

I want to pick up a point about the app. It is telling people to self-isolate, but it does not give them the code that they need for the process, so they cannot claim their £500. That is creating chaos across local authorities. Does my hon. Friend agree that the Government need to get on top of this quickly?

[Jonathan Ashworth]

Absolutely. There have been problems with the app. When I am in Leicester, it tells me that I am in an area that is both medium and high alert. Leicester has been under lockdown for 100 days, so how can the app say that in the part of Leicester where I live?

Down Syndrome Awareness Month

Rachael Maskell Excerpts

Thursday 22nd October 2020 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

I am grateful to the hon. Member for securing this debate, having worked with people with Down’s syndrome for many years. I put on the record my huge gratitude to the Once Seen theatre company in York, where people with Down’s syndrome act. Their acting is so powerful and so moving, because it is about life experience. Does she agree that we need to put on a platform so much of the talent that people with Down’s syndrome have?

[Dr Cameron]

Absolutely. I am thankful for that intervention, which exemplifies our debate and the change in the narrative that all of us across this House wish to see. We should be promoting the excellent work of those individuals and groups with Down’s syndrome who are achieving so much in society.

Up About Down is a campaign run by the Windsor Essex Down Syndrome Association, a fantastic charity that has being raising awareness about Down’s syndrome through positive and accurate information since it was founded in 1990. It is all about changing the narrative surrounding Down’s syndrome; it is about looking beyond medical prognoses and seeing the individual stories and successes of individuals with Down’s syndrome who live happy and fulfilled lives and who are crucial contributors to local communities, economies and industries. It is absolutely in that spirit that I bring this debate before the House.

In 2019, an article was published that caught my eye, entitled “10 brilliant breakthroughs by people with Down Syndrome”. It highlighted Zack Gottsagen, a theatre major graduate of the Dreyfoos School of the Arts who starred in

“a modern Mark Twain style adventure story, The Peanut Butter Falcon, which tells the story of Zak…a young man with Down syndrome, who runs away from a residential nursing home to follow his dream of attending the professional wrestling school of his idol”.

The article also highlighted Heba Atef, who

“became the first-ever Egyptian flight attendant with Down syndrome to embark on a special flight from Cairo to Khartoum…the ‘Journey of Humanity’ took place under the sponsorship of the UN International Committee and was specifically tailored for people with special needs.”

The article notes that the Swindon Advertiser reports that

“a scaffolder living with Down’s syndrome was named Britain’s number one apprentice. His boss, the owner of Coles Scaffolding company Martyn Coles, said Todd had great determination. ‘He comes in every day and proves people wrong. Winning the award just shows he can do it.’”

Emmett Kyoshi, a teenage artist living with Down’s syndrome in Chicago, hosted his third art exhibition in 2019,

“showing the world that the extra chromosome he was born with is anything but a disability.”

Then there are Madeline Stuart—the world’s first catwalk model with Down’s syndrome—and Francesca Rausi, who have been credited for proving society’s perception of beauty wrong. They had the opportunity of walking at New York Fashion Week and meeting some of Hollywood’s biggest stars; again, they changed the narrative.

Closer to home, Positive about Down Syndrome told me about Tom, who lives in London and has two part-time jobs as a barman and catering assistant and is also an award-winning weightlifter; Bethany who works for West Mercia police; and Hayley from Essex, who loves singing and acting and is part of a drama group performing at the London Palladium. These few accounts represent the stories of so many: those students with Down’s syndrome who are in college or university; those who have jobs and hobbies; those who are moving home, winning awards, falling in love, getting married and achieving great things.

For each of these stories, there are also children who have dreams and aspirations. I heard about Rebecca, who wants to perform on stage; Ben, who wants to be a postman; Jessica, who wants to be a pop star; Jack, who wants to play football for Nottingham Forest or Manchester United; Hollie, who wants to be a vet; James, who wants to be a police officer; and Samantha, who wants to be a make-up artist. I am sure that I speak for every parent when I say that we support and absolutely share in the dreams of our children every single day.

A sense of fulfilment and purpose that people with Down’s syndrome have from their work is a common thread connecting many of the accounts that I have mentioned. With that in mind, I draw particular attention to the work of the Down’s Syndrome Association and the importance of its WorkFit scheme. The WorkFit scheme was set up to train and assess employers who want to include those with Down’s syndrome in their workforce. All employers registered with WorkFit receive training, which includes their duties under the Equality Act 2010, and practical advice on how to make reasonable adjustments. The Down’s Syndrome Association is in constant dialogue with companies and organisations that have employees placed with them through WorkFit, to answer any queries they may have, and to work through any challenging situations. The programme was set up in December 2011, and to date it has placed 416 individuals with Down’s syndrome in a range of full-time, part-time and volunteer roles, as well as in adapted internships.

In recent weeks the Government announced the kickstart scheme, and I want to ask the Minister whether young people with learning disabilities, or disabilities, could perhaps be further supported through that scheme, or through an internship or apprenticeship. The excellent Speaker’s internship scheme for people with disabilities was developed in 2016, and perhaps there is more that hon. Members could do to support the training, inclusion, skilling and work of those who have Down’s syndrome.

I am delighted to chair the new all-party group for inclusive entrepreneurship, which was established to remove barriers and raise the profile of entrepreneurs with protected characteristics, particularly disabilities. We must also change the narrative more broadly from disability to ability, and from being solely about employees to people having the potential to become employers. Will the Minister consult colleagues in government, and find out whether there are particular supports and schemes for which those with disabilities can perhaps be given funding or additional support for adaptations, so that they can start their own businesses with their skills, talents and abilities?

A study by Mencap found that 62% of adults with learning disabilities in the UK want to work, although only 6% have a paid job. We need to address that, and we must all play our role in our constituencies, and by working across the House and across parties, to ensure an inclusive employment programme for everyone across the UK. In this time of covid a recession could occur, and many jobs are already at risk. We would not wish one of the outcomes of covid to be a further tragic impact on those with disabilities.

Government mantras of “building back better” and “levelling up” can and should include people with disabilities and Down’s syndrome, making every aspect of society richly diverse and productive. I will conclude with a quote from a young lady, Kate Powell, which was provided to me by the Down’s Syndrome Association:

“Being a person with Down’s Syndrome makes me proud. I am a person to make a difference to a lot of people. That’s me. We may find things difficult, everyone does. We should tell people about Down’s Syndrome—the more people the better. Being a person with Down’s Syndrome I can do anything in life. We may need help to do the things we want to do in life. It is good to see people with Down’s Syndrome achieving their dreams. That’s my dream.”

That, Madam Deputy Speaker, should represent all our dreams.

--- Later in debate ---

[Rachael Maskell]

I appreciate that this is a really sensitive topic, but we know that coming into the world is a real challenge for somebody with Down’s syndrome. Will the Minister go away and look again at the conversations that are had with parents who are diagnosed in pregnancy with somebody with Down’s syndrome and see how we can change that conversation, so that people can understand the positivity of bringing up a child and raising someone into adulthood with Down’s syndrome?

[Helen Whately]

The hon. Member makes a really important point. It is clearly a very difficult and sensitive topic, but it is absolutely the case that if, during pregnancy, any abnormality is detected or suspected there should at no stage be any bias towards abortion, which is what, as I understand it, she is referring to. I want to make that absolutely clear. It must be the case that all health and care staff involved in the care of a woman or a couple who might be considering the termination of a pregnancy must adopt a non-directive, non-judgmental and supportive approach. That absolutely should be the case throughout our health system. Should anyone experience anything different and find that that is not the case, they should raise it, because women and couples should be supported in a positive way so that they can make the right choice for them. I am choosing my words carefully given that this is a very sensitive topic.

While I have the opportunity, I want to talk briefly about the importance of the Oliver McGowan mandatory training in learning disability and autism, which the Government have committed to rolling out to make sure that all health and social care staff receive training in learning disabilities and autism. That is really important to make sure that people with those conditions get the right and appropriate care when they are in the health and care system, including, I should say, for end-of-life care, making sure that do not attempt CPR—cardiopulmonary resuscitation—orders are used appropriately.

In the light of the pandemic, one thing that has been raised with me, particularly for those who are caring for those with disabilities, is the importance of day services and respite services. I have been working really hard, including with the Social Care Institute for Excellence, on guidance to support the reopening of day services and to encourage local authorities to make sure that those are reopened.

To conclude before we are out of time, I am so glad that we have had this debate and been able to talk about the contribution that those with Down’s syndrome make to our society, and, to use a phrase from the excellent speech by the hon. Member for East Kilbride, Strathaven and Lesmahagow, to have made our contribution to changing the narrative. It is crucial that we should celebrate the achievements and contributions of those with Down’s syndrome to our society, so we have been and are taking action to support those with disabilities, including Down’s syndrome, but I believe that we can always do more and go further. So I say, let’s do that. Let’s do more and go further to support people with Down’s syndrome to achieve their dreams.

Question put and agreed to.

Covid-19 Restrictions: South Yorkshire

Rachael Maskell Excerpts

Wednesday 21st October 2020 Commons Chamber

[Rachael Maskell (York Central) (Lab/Co-op)]

I note the agreement reached in South Yorkshire, and I fear that York is rapidly heading in the same direction, with a sharp increase in infection. Does the Minister recognise that each local authority has different economies, different complexities and different vulnerabilities, and therefore it is really important to start dialogue early with local political leaders as well as ourselves to get the right deal to prevent an escalation in tiers, but also to ensure that we get on top of the Track and Trace system to make sure that that is done locally and is effective?

[Edward Argar]

I am grateful to the hon. Lady. I think she actually made the case very well for the approach that the Government are adopting, which is local tiering, rather than a blanket national approach, because she is absolutely right that different areas of the country are different and have different circumstances. To her substantive point about early engagement and continued engagement, I am very happy to say that I am very happy to work with her. We can start that off, if she wants, with a conversation about the data and so on. I am very happy to ensure that those channels of communication are open.

Covid-19 Update

Rachael Maskell Excerpts

Programme motion
Monday 19th October 2020 Commons Chamber

[Matt Hancock]

There is no health data that is transferred, but of course once this House has voted for an enforceable rule, it is important for all of our constituents and communities that we enforce it. So that is a necessary consequence of the House having voted for the self-isolation rules to be made mandatory, which I think was the right decision. On the financial support that the hon. Lady asks for, we have put in place £500 per self-isolation to support people on low incomes to make sure that they are able to do the right thing.

[Rachael Maskell (York Central) (Lab/Co-op)]

To prevent further restrictions being placed on York, we have to lock down this virus, not lock down people and the economy. We know that the key to this is local contact tracing, and the reality is that the shadow contact tracing undertaken by my local authority has been more accurate, more effective and more responsive. That is the key to getting on top of this virus, so when will the Secretary of State release all the data to local authorities and give them the resources they need so that they can do the job properly and get on top of the virus?

[Matt Hancock]

We are absolutely putting more resources into contact tracing in York. It is only because of the combined effort of the national and local team that we are able to do the work that she describes, because the national system can deal with the cases who are easy to get in contact with, or who prefer to do contact tracing over the internet, rather than on the phone, which is a lot of people. That means that the local authority, as in the case that the hon. Member describes, can do its work locally, so it is about having a team effort.

Covid-19 Update

Rachael Maskell Excerpts

Thursday 15th October 2020 Commons Chamber

[Matt Hancock]

Yes, I was working on the issue of how we can safely allow visiting—especially by people who have been married for 70 years, which is an extraordinary achievement in and of itself—in a way that is safe, according to the risk level and the background rate of infection. Of course, testing can be part of the solution, as can the proper use of personal protective equipment. We have more nuanced rules in place now than during the first peak, and I would be happy to work with my hon. Friend to try to ensure that we get this right.

[Rachael Maskell (York Central) (Lab/Co-op)]

I welcome the Secretary of State’s greater attention on York, as announced today, but although we are in tier 1, I am concerned that there are areas of the country in tier 3 with a lower infection rate. Certainly, I do not believe that the measures in tier 2 will be sufficient to stop the spread of infections in our city, which, as he will know, are rising incredibly sharply, including in the older population. York experiences real challenges every winter because of the capacity issues in our hospital, and I am concerned that, without taking more acute action now, we will be in serious difficulty in just a few weeks’ time.

[Matt Hancock]

We are expanding capacity at the hospital in York. Of course, in York there are two overlapping epidemics, one among students and one among the general population. As the hon. Lady says, though, the spread is increasing among the older population, who are of course the most at risk from covid. The number of cases increased by 60% in York over the last week, so I welcome her support for the measures that we are taking, and I am happy to continue to talk to her about what more might be needed, because this is best done on a cross-party, cross-community basis. My message to everybody in York, a city I know and love, is that it is very important that all of us abide by these rules and reduce social contact. That way we can start to get the increase in the number of cases in York coming down.

Local Contact Tracing

Rachael Maskell Excerpts

Wednesday 14th October 2020 Commons Chamber

[Jo Churchill]

I will push on a little and then I will give way to my hon. Friend.

Today’s motion talks about local contact tracing, which has been rolled out since August and is something that NHS Test and Trace is actively driving forward in its commitment to local systems. Since August, NHS Test and Trace has provided local authorities with dedicated teams of contact tracers working alongside local public health officials to assist and give a more specialist service. Local public health officials can access and use the data shared by the NHS on a daily basis. Together we can increase the number of people contacted. We have more than 95 lower-tier local authorities across the country that have gone live with local tracing partnerships. There are more going live in the coming weeks, and any local authority that wants to be involved can be. The national programme is doing an unbelievable job of helping people who might unknowingly be putting their loved ones at risk, but so is the local programme.

In England we have reached more than 650,000 people who have tested positive and their contacts and advised them to self-isolate. Every person who tests positive is contacted by NHS Test and Trace, which consistently reaches more than 80% of contacts when details are given. Because everybody, whether national or local, is locked on to the same system—this is vital—we can see how the virus is spreading. It gives us important knowledge. All the data that we publish on NHS Test and Trace include data on local performance. At this point, I recommend to everyone the coronavirus dashboard, which has been improved and updated, and gone live only this morning. It gives fantastic information about what is happening locally. As local testing partnerships are rolled out, we expect to see performance improving further.

[Rachael Maskell (York Central) (Lab/Co-op)]

As my hon. Friend the Member for Leeds West (Rachel Reeves) set out, the system is not working. The statistics speak for themselves and, while the system in Wales is delivering, it is not in England. Will the Minister say why the private companies do not just hand the test and trace system over to local directors of public health? Are there any financial penalties or anything in their contracts that preclude them from doing so?

[Jo Churchill]

We are better together. It is as simple as that. It is about a national programme. Let us imagine that the national programme is the spine and the local authorities are the ribs that wrap around us. The combination of the rigid spine and those solid ribs protects the organs, and this is what test and trace will do. We need both elements of the system.

--- Later in debate ---

[Rachael Maskell (York Central) (Lab/Co-op)]

It is nearly nine months since the first case of covid came to my constituency and, in that first instance, we had an effective test and trace system. But my goodness, what has happened since? We know from across the world that effective test and tracing is beating the virus but here in the UK the virus is beating us. That is why it is essential that we get on top of the essential ingredients of an effective test and trace system. Filling the pockets of all these private companies with contract after contract is failing, and we know why that has been done—the lack of investment in our NHS and in public health for years. That has meant that they are bereft of the resources they need.

We need to turn this round and we have the opportunity of this debate to address the issue effectively. We know from the statistics that my hon. Friend the Member for Leeds West (Rachel Reeves) set out earlier that, if about two thirds of people who have been tested are then transferred to the contact tracing system, only 17% of them are reached. That means that fewer than half the people are effectively contact traced. That simply is not good enough in the midst of this pandemic. Time is of the essence and we need to address this now Any transfer that we see to local authorities must also see the transfer of resources. We cannot just see the transfer of risk without the money coming with it to back it up and enable local authorities to run effective systems locally.

I have talked to my local director of public health and she has led an excellent fight to put the case not only for local testing but for saying where we need the centres to be. We need another testing centre in York and we have been working with the university and a local lab to prove that we have a test processing and trace system for our city. That is what we need for a fast turnaround of results. Time is of the essence with this virus and the faster we get the results, the faster we trace people who are potentially carrying the virus. We will then be able to lock the virus down, which is what we want to do.

I am confused, and I am sure I am not the only one, as to why York today is in tier 1 when the infection rate there is higher than in some of the places in tier 3. It does not make sense. I want the Minister to explain the rationale for that. Yesterday, there were 95 infections in York, and 246.4 per 100,000 and growing fast. We need to understand the rationale, not least because the infection is transmitting in our city and we know that because we have been holding a mirror tracing system that has seen it go from household to household. Yet tier 1 does not bar such contact. If we are really serious about understanding how to stop the virus, we need to go through the proper processes and involve the local directors of public health who could tell the Government that we need the controls to stop the spread at this critical time before it gets completely out of control.

It is because of the failures that I have described that the Labour party has been saying that there will be a need for a circuit break. If the Government could respond with proper measures, we would not need it. The Government only need look in the mirror to see why we are in this place.

Some incredible science is being done in our universities and local labs, and I look forward to my meeting on Friday with the Minister on what is being done in York, where the capacity, efficiency and effectiveness of testing can seriously outstrip many of those procured labs which the Minister and her Government have already engaged in.

This is a real opportunity. We have to use the best science, and I trust that we will be able to do so.