Oral Answers to Questions

Rachael Maskell Excerpts

Tuesday 6th October 2020 Commons Chamber

[Karl Turner (Kingston upon Hull East) (Lab)]

What recent assessment he has made of the effectiveness of the NHS Test and Trace service.

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

What recent assessment he has made of the effectiveness of the NHS Test and Trace service.

[The Minister for Care (Helen Whately)]

NHS Test and Trace launched in May. Four months later, more than 150,000 people who have tested positive for covid-19 have been contacted, and 450,000 of their contacts have been reached so that they can self-isolate. We have tested more than 7 million people at least once and many, such as care home workers, more than once. Rapid expansion brings with it challenges. Working with local authorities, we will continue to improve test and trace, as it is an important part of our armoury to defeat this virus.

--- Later in debate ---

[Helen Whately]

There was quite a lot in that question. One thing I will say on schools is that enabling our children to continue to go to school is very much part of the whole strategy that we are using to tackle and suppress coronavirus, because education is so important. On the specific test and trace system to which the hon. Member refers, the Secretary of State spent an hour and a half in the Chamber yesterday answering colleagues’ questions about the performance of that system.

[Rachael Maskell]

In the light of the fact that infection levels in York have risen from 63.1 cases per 100,000 to 143.9 cases per 100,000 in just the past seven days, the local public health team is working with the university and local labs, and together they have put together a programme where they can test, process the testing and do contact tracing. This is a testing service that works for York, with test results the next day and tracers who understand local population flows. Will the Minister put the necessary resources in place to enable them to do their work and allow this to happen, because this is surely the game changer we need to beat this virus?

Covid-19

Rachael Maskell Excerpts

Monday 28th September 2020 Commons Chamber

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

Is this not why we need evidence-based interventions? The Secretary of State will have seen clips of what happened in my constituency on Saturday night at 10 o’clock, as the streets filled out with young people enjoying themselves and partying with no social distancing, clearly creating the worst of environments. Will he now review the policy of the 10 o’clock curfew to ensure that our streets and neighbourhoods are safe?

[Matt Hancock]

We always look at the effects of these policies. We have to take everything in the round, including the level of social distancing that might have been going on, were that to continue all through the night. One reason we brought in the policy is that we have seen it work in other countries, as the hon. Lady knows. None of these interventions on social distancing are ones that we take lightly or want to put in place. The central question is how we keep control of the virus in the best possible way, while reducing the impact on the economy and on education as much as possible.

--- Later in debate ---

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

I am grateful for the opportunity to speak in the debate. I completely agree with the hon. Member for Thurrock (Jackie Doyle-Price): Parliament must be empowered not only to scrutinise Government but to aid them as we walk through this crisis.

The economic and health crises are accelerating, and national concern is deepening. There are many significant issues that I want to raise. The Chancellor’s announcement last Thursday barely touches the economic crisis facing York because of how its local economy is structured. I am significantly worried that we will be one of the places worst hit by this economic situation. We need to resolve, and I need the Chancellor to understand, the particular issues facing my constituency. I am worried for the people I represent.

I would like to have a discussion with the Under-Secretary of State for Health and Social Care, the hon. Member for Bury St Edmunds (Jo Churchill), about local control over decision making under the auspices of our director of public health. In our city, we know that we can run a very effective testing regime and contact tracing mechanism. We know the flows of local people. I met scientists in my constituency on Friday who are leading the way in the delivery of testing. Their work could really aid the Government’s programme, and I would be most grateful if the Minister would be willing to meet me to discuss that.

I witnessed shocking scenes in my constituency on Saturday night at 10 o’clock. As the bell struck, the streets filled. Had the virus been in that crowd, it could have spread across the people present and perhaps to some of the most vulnerable people in my city. The people of my city have worked so hard; they deserve better.

I want to talk about some of the most vulnerable people in our communities. We have heard much in the debate about people in care homes. Care homes became closed environments where family, carers, other health professionals and even the Care Quality Commission were locked out. One thing we know is that closed environments become unsafe environments, which is why it is so important that this situation does not arise again.

I carried out an investigation into care homes in York. The staff are tremendous, their efforts exceptional and the delivery of care outstanding, but we know that risks are introduced into the system. First, we must review the discharging of patients who are covid-positive into care homes and ensure that transitional arrangements are in place, so that infection is not introduced to the most vulnerable people. We also know that care staff are working above their professional competencies, particularly in the delivery of palliative care. To deliver the very best care, we need to ensure that proper training and proper staffing levels are in place.

In the light of the debate we will have on Wednesday about the Coronavirus Act 2020, I call on the Minister to review the recording of mortality. In one care home in York, 52 members of staff were sick during the peak of the crisis. Over that fortnight, 15 people died in the care home. None of them was recorded as dying with covid or possible covid. We know that that is not true, because staff tell me that they were displaying signs of covid and they died rapidly. They had all the signs, but the way that deaths were recorded and the fact that no tests were undertaken means there is no way of verifying that. Clearly we need a testing regime to address that, but we also need to go back to how deaths were recorded in the past, which brings more independence into the system. I plead with the Minister to take that back to the Department. It will dignify the families to know the reasons why their loved ones passed.

It is the right of residents and their families to know whether there is infection in a care home. We need to ensure that that information is communicated, so that they can make their choices accordingly. We need data to be available. I had to jump through hoops to get data about my local care homes. That should not be the case. We need to ensure that there is proper governance in place. When governance switched to the director of public health, we saw safety improve and infection prevention and control measures brought in, and then mortality rates fell. Over the coming days, I trust that we will find mechanisms to ensure that visits continue risk-free, in order to support people’s holistic wellbeing in the difficult period ahead.

Covid-19 Update

Rachael Maskell Excerpts

Thursday 17th September 2020 Commons Chamber

[Matt Hancock]

This is the central point: if people do not have symptoms, but they have been close to somebody who has tested positive or has symptoms of coronavirus, unfortunately they have to self-isolate because of the biology of the virus, which can incubate for up to 14 days. Even a negative test does not release them from that obligation, because they may well get a false negative. That is at the core of how we control this virus. The more colleagues around the House explain that principle, the more we will relieve pressure on the testing system and break the chains of transmission of the virus. It is an incredibly important point for us to communicate to all those we serve.

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

Increasingly, we have a Health Secretary who is out of control of a virus that is out of control. Next weekend, 40,000 students will come to York. We were promised a testing centre next month. November is now the earliest that we will have a walk-in centre where people can have a test. What discussions has he had with his colleague the Secretary of State for Defence about strategic planning, because it seems that his Department is incapable of planning for this virus?

[Matt Hancock]

We of course have to ensure that the provision of testing centres is where the virus is most virulent. Actually, we do have military planners involved in that process, and it is very important to get it right.

I should also say that we have just had two speakers from Luton, and I forgot to mention the money to improve Luton Hospital, which is one of the best in the country. I am delighted that it has made the case successfully for the expansion of its A&E, which will serve all the people of Luton.

Axial Spondyloarthritis

Rachael Maskell Excerpts

Thursday 17th September 2020 Commons Chamber

[Tom Randall]

I pay tribute to the hon. Gentleman’s work. He was an active member of the APPG long before I was in this place. On the issues that he identifies, on which I will go into more detail in a moment, he is absolutely right.

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

I am grateful to the hon. Gentleman for bringing forward this debate. Before coming to this House, I was a physiotherapist. I ran an AS group for swimming and exercise and really know the benefits of that. The Chartered Society of Physiotherapy was in touch with me just this week to say that, because of covid, it is experiencing a real shortage of physios for the future and that 2,339 more physios are needed. Does he agree that we need to look back at the NHS work plan to ensure we have the right practitioners in place to support people like him?

[Tom Randall]

Physiotherapy can play a key role in managing the symptoms of AS, and we should all support the work that physiotherapists do with patients.

Covid-19 Update

Rachael Maskell Excerpts

Thursday 16th July 2020 Commons Chamber

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

Over the past few weeks, I have exposed a significant risk of covid-19 in some York care homes. Those findings have wider application. Measures in the Coronavirus Act 2020, poor decision making and poor governance have undoubtedly led to increases in infection and mortality, and there are serious questions over the recording and reporting of deaths. Will the Secretary of State or one of his Ministers urgently meet me before the recess to discuss these tragic findings, so that lessons can be learned and lives can be saved?

[Matt Hancock]

I am very happy to ensure that the social care Minister meets the hon. Lady as soon as possible.

Covid-19: R Rate and Lockdown Measures

Rachael Maskell Excerpts

Monday 8th June 2020 Commons Chamber

[Matt Hancock]

My hon. Friend is absolutely right that there has been very encouraging progress, and all the significant data point in the same direction, which is downwards. That is incredibly important. It is a testament to the efforts of everybody across the whole United Kingdom, because everybody has played their part in the social distancing. The more that we do this as one United Kingdom, the better. Of course there are sometimes substantive reasons for local variation—sometimes, for instance, north of the border—but ultimately this country is coming through this and we are winning the battle against this disease.

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

Local directors of public health need comprehensive, granulated data in order to do their job. Currently there are holes in the data that they are receiving, particularly on testing, in order to then follow through on tracing. So when—not “soon”, but when—will they actually receive that comprehensive data, together with the local R value, in order to then keep our communities safe?

[Matt Hancock]

They get data now, we want them to get better data, and we will keep improving the data flows. It is as simple as that.

Wuhan Coronavirus

Rachael Maskell Excerpts

Monday 3rd February 2020 Commons Chamber

[Matt Hancock]

When a virus such as this strikes, it causes a series of difficulties, especially in the epicentre, and it is clear that the health system in Wuhan is struggling to cope. Collecting the information is therefore necessarily difficult, even with the best of intentions. I understand that there is a lot of noise about this issue on the internet. The most important thing is to try to get the best information we can, analyse it, respond and follow the science wherever possible.

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

I particularly thank Public Health England for the advice it has provided throughout the weekend, but levels of concern remain high in York. Not only is that impacting on the local economy, but people are concerned. That concern could be alleviated by better communication and if the statutory bodies—including the local authority, the university, the police and other authorities—are kept better informed about what is happening. Will the Secretary of State meet me to discuss what has happened in York and learn from that so that it can be repeated in a better way elsewhere?

[Matt Hancock]

I agree with the hon. Lady that through experiencing a challenge such as this, when things are moving fast and information flows very quickly, we can always improve the way in which those flows occur. The Minister leading on this will be happy to meet the hon. Lady to discuss these matters because, as she rightly identifies, we must constantly seek improvement. I pay tribute to the approach she has taken, given that the two cases identified in England so far involve residents of her constituency.

Oral Answers to Questions

Rachael Maskell Excerpts

Tuesday 29th October 2019 Commons Chamber

[Matt Hancock]

My predecessor, my right hon. Friend, is an assiduous campaigner for South West Surrey. There is no better spokesman for South West Surrey than my right hon. Friend. He has raised this issue with me in private over recent weeks since these concerns were raised. I have in turn raised it with the chief executive of the NHS, and I can confirm that the walk-in centre will stay open.

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

The primary care mental health service in York is not being cut; it is being scrapped. Will the Secretary of State urgently meet me to save this service?

[Ms Dorries]

I am happy to help and to meet the hon. Lady to talk about that. No primary care mental health services should be cutting given the amount of funding we are putting in, but I am happy to meet and discuss it with her.

Health Visitors (England)

Rachael Maskell Excerpts

Wednesday 23rd October 2019 Westminster Hall

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

It is a pleasure to serve under your chairmanship, Mr Bone. I thank the hon. Member for East Worthing and Shoreham (Tim Loughton) for introducing this important debate. The Labour Government recognised the decline in the number of health visitors and therefore put in train a health visitor implementation plan. As head of health at Unite—I refer Members to my declaration in the Register of Members’ Financial Interests—I was delighted to see that plan come to fruition during my time there. The ambition to raise the number of health visitors by 4,200 was a steep challenge, but a necessary one. We have heard the reasons why. Health visitors are the backbone of early intervention by health services. They are the pioneers of public health, and are instrumental in addressing health inequality. At a time when there are real challenges on children’s health, it is so important that a workforce is there to deliver that service.

Unfortunately, as we have heard, the numbers have fallen by 31% to date, from a peak of 12,292. That is having a serious impact not only on young people and their opportunities but on staff. We know from the work that the Community Practitioners and Health Visitors Association has carried out that 85.3% of health visitors are experiencing stress. They have case loads that are unsafe. It is therefore vital that the Minister put a statutory caseload figure on the books. It is important that health visitors work to criteria under which they can cover their caseloads. In York, we have only 29 health visitors to cover our city, which has a population of nearly 10,000 children. That clearly is not safe at all.

The health visitor implementation plan was good, though very rushed. Often mentoring was being stretched from a one-to-one relationship, which is the norm, to one-to-six. That is what I heard from some health visitors in training. No sustainability was put into the plan after its implementation. Therefore, with an ageing workforce, we saw rapid decline and people moving elsewhere in the health service—partly because they were placed in local authorities that, under the austerity measures, decided to cut back not only on opportunities for training and development but on pay.

Such cutbacks had a significant impact, and downgrading was part of it. For people who went to work in outsourced services, for which we obviously cannot get hold of information about true numbers through freedom of information requests, we know that conditions were even worse, and that people have left the service after their training period. That is a massive loss to our service as a whole.

I will rapidly move on to what needs to be introduced—a new, and properly resourced, health visitor information plan. There was a promise in the report on young people by the right hon. Member for South Northamptonshire (Andrea Leadsom) that the comprehensive spending review would resource the future programme, but of course we have not had the comprehensive spending review. It is therefore urgent that the Government put money on the table to deliver that.

We also need to ensure that we bring services back into health that have been outsourced, so that there is proper monitoring of the service and it is seen as a statutory service to be delivered. I am very interested in the ideas that have been proposed in today’s debate that it either be moved back into the NHS or into a proper partnership between health and local government. The reality is that the right relationships need to be built for health visitors to deliver the programme.

Finally, we need to ensure that the right stakeholders are brought around the table. It has been brought to my attention that some consultation has taken place on how we should move forward on such issues as the number of mandated contacts and so on, but not all the stakeholders are there. I urge the Minister to meet the CPHVA, which is the lead organisation representing health visitors, and to ensure that included in that cohort are people working in the profession who can really reflect what it is like on the frontline today.

Community Pharmacies

Rachael Maskell Excerpts

Wednesday 2nd October 2019 Westminster Hall

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

It is a pleasure to see you in the Chair, Sir David. I thank my hon. Friend the Member for Halifax (Holly Lynch) for securing today’s debate.

A couple of weeks ago, I went to visit a local community pharmacy in my constituency, and the superintendent pharmacist sat me down to tell me his tale of woe, which has been echoed across the Chamber this morning. He runs seven pharmacies across the city, serving 20% of the population, but he has seriously struggled over the past three years and is wondering whether he will be there next year. He has ploughed in tens of thousands of his own money just to keep the business afloat. That certainly highlights how many single-handed pharmacies have closed in the city.

Part of this is about the Government funding cuts, not least to the establishment payment, which covered things such as rent, regulatory registration and insurance. Part of it has also been about the loopholes for the clinical commissioning group and how it is now buying branded generics and not giving the headroom that pharmacies used to have. For instance, if people were purchasing a drug at, say, 60p and it had a value of 90p on tariff, there would be headroom of about 30p. That money was then ploughed back into the business to run other essential health services and to ensure that there could be free deliveries of pharmaceutical products to the community. Pharmacies just do not have that headroom any more.

The situation is made far worse by the multinational companies—we have heard about Boots, Lloyds and the others—which have the buying capacity and the space to be able to drive up the price at the wholesalers, which in turn means that the independents pay more when they go to purchase their pharmaceuticals. I have always called it the Walmart model, because that is how many of these companies operate. They try to push out the competition by making it impossible for the independents to participate in the market. That is certainly what we see here.

There is a toxic combination of cuts, CCGs facing tough financial lines—the CCG in York is always struggling—and, on top of that, the wider market pressures. Of course, the multinationals can spread their risk. They sell other products, and they are owned by multinational corporates, which gives them a further cushion in their operations. The impact is that, where some of those big companies have bought up independents, they are then closing them in crucial communities.

Clifton in my constituency is an area of high deprivation, with one of the lowest ages of mortality in the city and a real need for a community pharmacist, but Lloyds has pulled out of that community. That means that while people are waiting, say, three weeks to go and see their GP, they cannot just pop down the road to their community pharmacy as an alternative, because it is simply not there.

That is building more pressure on the independents, because people go to them to get the free delivery now that, as we have heard, the big companies have seen a gap in the market—surprise, surprise—and are charging their drug delivery tax to get more resource. That means that the independents, which are trying to provide that community service, are delivering further and further afield, which is costing them more, and they have less resource to do that with. We need to address the drug delivery tax to ensure that, as my hon. Friend the Member for Halifax set out, we get these products to those people in our communities who are incredibly vulnerable.

I draw the Minister’s attention to one other scandal in the industry, which is that companies such as Boots are paying only 9% corporation tax. As a result, the Government are losing out on £1 billion a year. If we think about the scale of the cuts and the £200 million that has been removed, it does not take long to realise that, if Boots was forced to pay its corporation tax, we would not see pharmacies struggling and going to the wall, or communities suffering and losing those essential community services.

I ask the Minister to go back to the Treasury and make sure that those tax loopholes are closed. Boots moved into a multinational company, which I believe is 49% American-owned, and it is now registered in Switzerland, so it does not have to pay the same overheads. That is another inequality built into the market that must be addressed. The pressure cannot continue, or we will lose our community pharmacies. As I said, one pharmacist, who oversees seven pharmacies, does not think he will be there next year. That is seven communities across my constituency and York Outer that will not have a community pharmacy on the street corner.

It is vital, therefore, that the new Minister gets to grips with this issue. She must make sure that the right investment goes into our communities, that those loopholes are closed for the CCGs and for tax, and that the drug delivery tax is not put on pharmaceutical products.

--- Later in debate ---

[Jo Churchill]

If the hon. Gentleman will just bear with me for a second, he will hear me largely repeating what the right hon. Member for Rother Valley said when he so beautifully laid out the skills and expertise that lie in the pharmacy sector, and how they can be utilised better.

As I said, the deal sets out a programme of work we shall be working on. Our aim is that collaborative working across the system will deliver an integrated and accessible community health service for all. I want to name-check the hon. Member for Strangford here because, as he articulated, communication lies at the centre of this issue. One instance might be the digital expertise that the hon. Member for Washington and Sunderland West said exists in Gateshead, where people’s greater readiness to get services from pharmacists, and the fact that pharmacists can do more, is having a positive effect for patients.

First, pharmacists told us that we must utilise and unlock the potential of the highly skilled pharmacy teams that are embedded in communities throughout the country, including in the constituency of the hon. Member for Halifax, with everyone celebrating what pharmacists can deliver. That is why the settlement aims to deliver more fulfilling, patient-facing careers for community pharmacists and technicians, as highly valued members of the NHS team. Additionally, populations will be helped by much better services.

Secondly, pharmacists told us that they wanted continuity. The settlement funding over five years gives certainty, and gives community pharmacists the confidence to invest in their business. However, there is no one size fits all. Being in the centre of a town is not the same as being in a rural village. Looking at these things in the round is why we want this to be collaborative.

[Rachael Maskell]

How will the Minister measure the impact of the settlement, particularly on independent pharmacists? If more of them close or are struggling financially, what other interventions does she plan to make?

[Jo Churchill]

As I said, there is no one size that fits all. As the hon. Lady articulated in her speech, the difficulty is that we are not looking at a system where businesses are run on the same scale model. At any one point, there are single pharmacists. She stated that the pharmacy she visited was part of a seven-strong business. Then there are the multiples. We need to look at what is the best scheme. However, I would argue that independents have a much higher footfall from their local population, because they are more trusted than many of the multiple pharmacies due to the continuity that comes from their having been in their communities for longer. There are opportunities there for independents.

We know we will need to design new ways of working to make a success of this, and we will need patients to be confident in how they use the services. The enhanced role for community pharmacy will support patients in getting access to help where required and in using the NHS in the best possible way. When people are suffering from minor conditions such as earaches or sore throats and need health advice, we want them to think “Pharmacy First”.

We want to build on that, with other parts of the NHS proactively signposting to local pharmacists. We want everyone to recognise the high-level skills held by pharmacists and to get people to understand that we need them as a first-line service to go to. That will grow trust in the system and spread the load. We will, of course, need to reform the way we work to free up pharmacists’ time so that they are able to deliver these new services.