Social Distancing: 2 Metre Rule

Tobias Ellwood Excerpts

Monday 15th June 2020 Commons Chamber

[Edward Argar]

We have a very close working relationship with the Government in Northern Ireland. We will continue to maintain that and to share information as appropriate, as we have done throughout this pandemic. I pay tribute to the work of the Government in Northern Ireland in tackling it.

[Mr Tobias Ellwood (Bournemouth East) (Con)]

The Lancet reports that there is a 2.6% chance of catching covid-19 at 1 metre and a 1.3% chance of catching it at 2 metres. The World Health Organisation recommends 1 metre. It is now time for the Government to decide. The Minister knows that this will be game-changing for reopening our schools and reopening our economy, but also for impeding the spread of this pandemic. He speaks about making the right decision at the right time. One metre is the right decision; now is the right time, not in two weeks.

[Edward Argar]

I am grateful to my hon. and gallant Friend for that question. The WHO says that the distance should be at least 1 metre, so it is not prescriptive in that respect. We should make sure that we note that. He makes a very powerful case for getting our economy, and particularly our small businesses and hospitality businesses, moving again. We are making good progress in tackling this disease, and we do not want to put that at risk. The review will give us the scientific evidence to make an important decision on the way forward.

Covid-19 Update

Tobias Ellwood Excerpts

Tuesday 24th March 2020 Commons Chamber

[Matt Hancock]

I will ensure that that is looked into.

[Mr Tobias Ellwood (Bournemouth East) (Con)]

Will the Secretary of State join me in paying tribute to the army of volunteers in Bournemouth and across the country—the individuals, businesspeople, charity groups and local organisations—who want to be part of the solution, and to help the elderly and vulnerable, allowing us to adapt to this new way of life? Yesterday, a 30-day lockdown was spoken of; this will require some form of enforcement. Can he say what role the armed forces might play in that?

[Matt Hancock]

The armed forces are doing an absolutely fantastic job of supporting civilian efforts, for instance in the NHS on the logistics of delivery of protective equipment and much more; but the armed forces will not be involved in the enforcement of the law. That is for the police, who will levy fines, starting at £30 and escalating if people continue to flout the rules.

Coronavirus Bill

Tobias Ellwood Excerpts

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

[Mr Tobias Ellwood (Bournemouth East) (Con)]

I join others in commending the spirit, tenacity, determination and grit of those on the frontline, not just in the health service, but in the police and other services—the growing team out there who are trying to keep our country together during these difficult times. I commend the Government’s work to provide the necessary medical support through mobilising the NHS at the start, and the economic support for businesses and employees. I also commend their provision of support to 1.5 million of the most vulnerable people in the country.

This emergency legislation is unparalleled in modern times. It grants enormous powers to the state and is expected to be approved in the shortest of time periods. I very much welcome the Health Secretary’s assurances that the measures in the Bill are temporary, proportionate to the threat, only to be used when strictly necessary and only to remain in place for as long as is required to respond to the crisis.

As the Bill is being debated tonight, we should remember that the Cobra meeting is taking place. British nationals abroad are being called back to the UK. There is every expectation that there will be either a national lockdown or localised lockdowns. The armed forces have already been mobilised. The Ministry of Defence has had planners in various Departments for a number of weeks, but we should expect to see more of them providing fantastic assistance to a number of agencies across the nation. We must not forget that the armed forces are also preparing their own manpower—that which is needed to watch our backs—because while the national focus is absolutely on the coronavirus, our armed forces have a duty to ensure that we can sleep at night. They protect our skies, shores and seas as well. We must not forget that they have a day job to do, as well as their contribution to the nation. We should remember that this decade was on track to be one of the most dangerous since the cold war. Complex and diverse threats remain out there, and a wily competitor will take full advantage of the global turbulence, not least because threats are no longer so much territorial but come from a cyber and digital capacity.

The Government have focused on their role—on the power of the Government to tackle the crisis—but, as has been repeated again and again in the House, we all can and must play our part in reducing the spread of this deadly virus. Life is not on hold, as some commentators have claimed; we must adjust to a new normal. We must face the reality and understand that life will now be different, not only as we tackle the virus, but afterwards as well.

The Bill is unprecedented, but if the powers are used to their full, that is because too many Britons continue to ignore the guidelines and are part of the problem, not the solution. The Queen sent more than a message to the nation last week; it was an instruction. Let us change our routine, as the country has done in the past. Everyone must play their part, for the greater good, towards the common goal of saving lives. This is a national crisis—not a national holiday, which some people seem to be taking it as—and every person, authority, business, charity and laboratory must turn their efforts either towards helping to save lives and supporting our NHS, or towards helping us all to adapt to the new normal, because life will not go back to what it was for months or years to come. The world has changed; we must all play our part in the solution.

Coronavirus

Tobias Ellwood Excerpts

Wednesday 11th March 2020 Commons Chamber

[Mr Tobias Ellwood (Bournemouth East) (Con)]

My right hon. Friend rightly talks about chronology: feeling ill, dialling 111 and then going to take the test itself. However, may I echo the concerns about the self-test capability? He points out the difficulties with accuracy. I am concerned that about one fifth of the UK workforce might be off ill, many of whom may not develop the full symptoms. Will he look at our ability to advance a capability to self-test in the near future? That would eliminate many of the workforce going off unnecessarily.

[Matt Hancock]

Absolutely—in fact, there was a very big conference in London today on precisely this issue. We are working with dozens of companies on it. We will work with anybody and scour the world for a solution, as my right hon. Friend describes. I just add one thing: he talked about how I had described what people should do if they feel ill—they should call 111—but also, going to the 111 website is really, really important, because that takes pressure off the call centres and many people can get the answers they need without talking to someone.

Coronavirus

Tobias Ellwood Excerpts

Monday 9th March 2020 Commons Chamber

[Matt Hancock]

Yes, absolutely. There should not be data protection problems here, but sometimes there are perceived to be, so cracking through those is important as well.

[Mr Tobias Ellwood (Bournemouth East) (Con)]

May I echo the concerns about suspending Parliament? Whatever the threats and the challenges we face in this country, Parliament must continue to do its business and do its duty. The Secretary of State has a responsibility, and the Government have responsibility for the people in the UK and for those overseas. How is he working with the Ministry of Defence on the support it might provide, both domestically and internationally, in looking after our citizens abroad?

[Matt Hancock]

I agree with my right hon. Friend wholeheartedly on the first point. On the second, it is absolutely true that the MOD is working alongside the Department for International Development, and of course the Foreign Office, to support Brits overseas.

NHS Patient Data

Tobias Ellwood Excerpts

Thursday 27th February 2014 Westminster Hall

[Andrew Gwynne (Denton and Reddish) (Lab)]

It is a pleasure, as ever, to serve under your chairmanship, Mr Amess. I congratulate the hon. Member for Mid Norfolk (George Freeman) on securing this timely and important debate and on his extremely thoughtful and powerful opening contribution. I congratulate other hon. Members on their contributions, too.

I know how strongly the hon. Member for Mid Norfolk feels about this issue, and he is right. He has been instrumental in establishing the Patients4Data group. I commend also the work of the co-founder, Graham Silk, and of Patients4Data in campaigning for the opening up of data in the national health service. That group has been very good at bringing the issue of patient data to the forefront of debate on health policy across England. I was pleased to share a platform with the hon. Gentleman earlier today at the summit that he hosted in Parliament.

It goes without saying that a growing population, an ageing population, the rise of co-morbidities and the necessary drive to improve the quality of care and treatments available to patients mean that, in future, the success of the NHS will increasingly rely on the data to which it has access. Indeed, if we take as a starting point the fact that the health and social care worlds, through both desirability and financial factors, are heading towards proper and full integration, it goes without saying that in breaking down the structural silos between the NHS and social care and, within the NHS, between community services, acute services, primary care services and mental health services, we also need to break down the information silo mentality in the NHS.

Genuine “whole person” care will require “whole person” information. Let me put the current controversy over care.data to one side for the time being. The fundamental principle is to create a system designed to link together medical records from general practice with data from hospital activity and eventually extend that to cover all care settings inside and outside hospital. As even my hon. Friend the Member for Leeds East (Mr Mudie) said, no one wants to wreck that. It is a really good thing for the future of health and social care in this country.

The improvement of health care in England depends on the removal of the barriers between primary and secondary care—between the GP, the surgery and the district general hospital, and between social care providers and traditional health care providers. Integration is the key to meeting the needs of patients, and the availability of integrated data is central to shaping the services that will meet those needs. It is in that context that the need for data sharing should be seen.

Let me make it clear to the House that Labour supports the principle behind the proposal. Whole-person care must have at its heart a whole-person approach to information. It is important that key statistics drawn from that data set can be used to further clinical research or even future service planning. Let us not forget that if it were not for medical data sharing, the link between thalidomide and deformities at birth would never have been identified, and it would have taken decades longer to establish clearly and definitively the link between smoking and lung cancer, which the hon. Member for Worthing West (Sir Peter Bottomley) mentioned. Good medicine is determined by access to good data.

If we are to improve the lives of our children and reduce health inequalities, we must ensure that data are readily available to researchers. Making data at the local GP practice level available for the first time will give us an unprecedented insight into local health outcomes. Which GPs are over-prescribing antibiotics or antidepressants? What factors are causing delays to early diagnosis of cancer? If we are truly to tackle health inequalities, which are a huge issue in a constituency such as mine, we need a joined-up approach. That is simply not possible without ready access to data.

Most people readily recognise the clear benefits of a data-sharing scheme, but there is rightful concern about how the care.data initiative has been implemented so far. Mistrust of care.data is not surprising given the nature of the data involved and the typically haphazard communication about the scheme, particularly the opt-out programme for patients who do not wish to take part. Many people did not even know that the scheme was happening in the first place, at least until the recent media reports. To be fair, if the only information that someone has about care.data is what they have read in the newspapers, they will probably get on the phone to their GP to make an appointment to opt out straight away.

I do not know whether it is the result of incompetence, a reflection on how we live our lives today or a combination of both, but the conventional methods of public information campaigns simply have not worked. Every home in England should have received the leaflet entitled “Better information means better care”, which my hon. Friend the Member for Leeds East happily brought with him.

The blunt truth, however, is that most people either have not received the leaflet or have not looked at it. Questioning of Ministers during the recent Committee stage of the Care Bill, in which approval for care.data sits, revealed that even Ministers do not know whether every house has received the leaflet, what the opt-out rate is or what the regional variations are.

Although I do not get to see much TV these days—such is the nature of the job we do—the first I saw of the advert for care.data was on BBC “Newsnight” last week. That is an important point for Governments of all political persuasions. As I said at the summit earlier, if we think back to the success of some of the big public health campaigns, such as the “AIDS: don’t die of ignorance” campaign nearly 30 years ago, we remember the hard-hitting TV adverts, the big posters with the tombstone on and the powerful leaflets. Today, as my hon. Friend the Member for Leeds East pointed out, we are bombarded with so much junk mail—pizza menus, UPVC window offers, supermarket offers and, dare I say it, even the odd political leaflet—

[Mr Tobias Ellwood (Bournemouth East) (Con)]

It is a two-horse race.

[Andrew Gwynne]

It certainly is a two-horse race in my constituency; do not let the Liberals tell you otherwise. The point is that it is very easy for someone to miss the leaflet about care.data even if they received it. I received it and I read it, but I think that is probably the neurosis of politicians; when a leaflet comes through the door, we automatically think that our opponents have started the general election 16 months early.

Many of my neighbours, who I assume must have received the leaflet, claim that they did not. Likewise, we can easily skip the adverts on TV. In my home, we have Sky Plus, that wonderful technology that allows us to press fast forward as soon as the advert break starts and skip all the adverts. Conventional methods now fail to penetrate with the vast majority of the general public. We probably need to implement a more personalised approach to make the public aware of the scheme, of the benefits, of the implications and of their individual rights.

Incredibly, we have heard stories of people who want to opt out of the system and have had to make an appointment with their already overburdened GPs to do so. I do not think that that is necessarily the right approach. GPs are already struggling to use their time to deliver good quality general practice and primary care services, and perhaps an easier way to allow people to opt out using a variety of methods should be explored. As the Minister will be aware, the chief executives of Mencap, Sense, the Royal National Institute of Blind People, the National Autistic Society and Action on Hearing Loss have written to the Secretary of State expressing concerns that information about care.data is not being communicated in an accessible way to disabled people, who are consequently being deprived of the opportunity to make an informed choice about the future of their medical records.

We want care.data to work, and it is in everyone’s interests that it does, but—this is where the pause is welcome—the Government need to get a grip before the aims of the project are lost on a suspicious public anxious about what care.data is for and how their personal data will be used. That risks compromising a project that I think we all recognise to be vital. The proposal by the hon. Member for Mid Norfolk for the Government to establish a working group of campaigners and opponents—their inclusion is important—to try to resolve the differences is a sensible way forward. Consensus is the key here.

The Government must understand that the data do not belong to them or to the NHS, but to each of us individually. That should be the starting premise. The combined data that the NHS holds about me are mine and no one else’s, and that should be enshrined. Only then will the Government be able to make the case that inappropriate use of the data could never be sanctioned.

Let us be honest—if the data are mine and they are recognised to be so, that is empowering for me as an individual and a patient. “No decision about me, without me” has been the mantra of Ministers of all political parties in the Department for some years, but how about “no information about me, without me” as the next guiding principle? Our most intimate details are wrapped up in this system. The Government will be able to shore up public and institutional support only when they have convinced the public that the data will not and cannot be abused, and when they have been honest about the potential risks.

The data are owned by the patient, and all parts of the NHS must be their legal custodian. Rights and proper responsibilities must go together—the legal responsibility to use data for necessary purposes, and only for necessary purposes, with proper safeguards in place and, to agree with my hon. Friend the Member for Leeds East, tougher sanctions to underpin them. We need to convey to the public the laudable intention behind the proposals, because even professional trust in the programme is so low that a poll for the Medical Protection Society found that 80% of family doctors believed that the system could undermine public confidence in the principle of medical confidentiality.

NHS

Tobias Ellwood Excerpts

Wednesday 5th February 2014 Commons Chamber

[Kevin Barron (Rother Valley) (Lab)]

First, I thank my right hon. Friend the Member for Leigh (Andy Burnham) for tabling the motion, because it gives us an opportunity to examine the whole issue of competition. Hon. Members will recall that I intervened on the Secretary of State on the subject of when competition came in to health care in this country, and he said that it had always been there. The hon. Member for Stafford (Jeremy Lefroy) and the right hon. Member for Sutton and Cheam (Paul Burstow) will recall, as they served on the Committee for the Health and Social Care Bill, that when I intervened on the right hon. Member for Chelmsford (Mr Burns), a Minister at the time, to ask what the Competition Commission and the Office of Fair Trading had got to do with the mergers of NHS trusts, he did not answer me. I asked that question during a clause stand part debate and he did not know that the question was coming. It was not part of an amendment and it was not flagged up to the advisers as being something likely to happen. I raised it on several occasions in that Committee and on the Floor of the House during an Opposition day when he was winding up, and he did not answer me then either.

We have now got the answer, and it came in November. My right hon. Friend mentioned what the then outgoing NHS chief executive said to the Health Committee last November. Commenting on the new rules, he said:

“I think we’ve got a problem, which may need legislative change.”

Of course, that is absolutely right, because we had legislative change when the Health and Social Care Act 2012 came in—that is the truth. It changed statute: it meant that the OFT and the Competition Commission can interfere in health care. That is what it did and that is what it was meant to do. That is what the Opposition questioned and voted against at the time—that is the truth.

My right hon. Friend talked about the cost of all this in terms of the Freedom of Information Act and the millions of pounds spent on external competition lawyers. My local Rotherham hospital has spent tens of thousands of pounds on London lawyers, and for what? There is no prospect of a merger or anything else. This money is seeping out of the local health pot, just so that advice about competition law can be got from lawyers based in London. This is real: if people want to do anything, they are going to have to take legal advice about doing it. That is the truth.

I have to say to my right hon. Friend the shadow Health Secretary that he may have an ally in the Minister of State, Department of Health, the hon. Member for North Norfolk (Norman Lamb). I am told that he said last week:

“I have a problem with OFT being involved in all these procurement issues…I think that’s got to change. In my view it should be scrapped in the future.”

I wait to see how he is going to address these things—if he did indeed say that—when he winds up this debate. If he did say it, I agree with him, as would many others out there.

I wish to make a couple of other points, one of which is about what happened in Bournemouth and Poole, where a merger was blocked by the Competition Commission last autumn. When it was blocked, the chief executives of the Bournemouth and the Poole hospital trusts said in a joint statement that they were “deeply disappointed” by the decision. They said:

“The benefits of merger, which included increased access to consultant care and new patient facilities, will now be much more difficult to deliver, which is disappointing for both our patients and staff.”

They went on to say:

“We recognise that the Competition Commission has a statutory role to perform”—

my argument is that it never had such a role before a change in the law—

“and specific criteria which it must use to assess benefits, but we believe that the outcome of the process is fundamentally wrong. The assessment of the merger was always weighted to put competition ahead of benefits to patients, and we do not believe the NHS is best served in this way.”

The Government amendment to our motion today states that

“clinicians are in the best position to make judgements about the most appropriate care for their patients.”

That is not the case in Bournemouth and Poole. The Competition Commission has decided, against clinicians’ wishes, to stop the merger going ahead. That is the truth, and that is how we should read the amendment. It is false in what it says. It then goes on to say that it

“notes that the rules on tendering are no different to the rules that apply to primary care trusts.”

That is not true. The rules changed when the Health and Social Care Act was passed. That is why competition and changes in the health service are matters for lawyers now. [Interruption.] The hon. Member for Bournemouth East (Mr Ellwood) might represent one of the hospitals, but his hospital and his local clinicians stopped the merger because the Competition Commission said that it was wrong. This is about competition law, and not about providing patient services.

[Mr Tobias Ellwood (Bournemouth East) (Con)]

This came in in 2002.

[Kevin Barron]

Let me touch briefly on the matter that is in today’s press. The Secretary of State said that we had to keep people out of A and E; he is absolutely right. If I made an addition to our motion today, it would have been around the issue of alcohol. Alcohol is a major problem in accident and emergency departments throughout the land. It used to be an issue on Friday and Saturday nights, but now it is an issue seven nights a week in cities. Not that long ago, the Prime Minister said that the Government were considering putting a minimum price on a unit of alcohol to reduce binge drinking and to improve public health. Today we had an announcement from the Minister for Crime Prevention, the hon. Member for Lewes (Norman Baker)—not from the Department of Health—that the Government are to ban the sale of cheap alcohol in England and Wales because they want to cut back on alcohol-related crime. People who work daily with the problems of alcohol and alcoholism have expressed views on the matter. The Alcohol Health Alliance, which includes the medical royal colleges, said that the impact of the ban on selling at below duty plus VAT would be negligible. It will affect about 1.3% of sales.

Eric Appleby, the chief executive of Alcohol Concern, said:

“The idea that banning below-cost sales will help tackle our problem with alcohol is laughable, it’s confusing and close to impossible to implement. On top of this, reports show it would have an impact on just 1% of alcohol products sold in shops and supermarkets leaving untouched most of those drinks that are so blatantly targeted at young people. The government is wasting time when international evidence shows that minimum unit pricing is what we need to save lives and cut crime.”

I could go on, but suffice it to say that the Government have completely dumped the idea that alcohol is a threat to the public health of this country. The measure will not stop people bingeing. It will not stop alcohol-fuelled people turning up at A and E. The truth is that some 50% of people who turn up at A and E get no treatment at all. We should be looking at the societal effects that are driving people into A and E departments—whether it is closure of walk-in centres or the fact that too many people are falling down because they have had too much to drink and believe that they have a right to block up A and Es and potentially slow down treatment for those who are facing an emergency. The Government are ducking the issues related to alcohol and are ducking the problems in A and E departments up and down the land. It is about time they showed some courage and did something positive. Alcohol is a public health issue, not a crime issue.

Oral Answers to Questions

Tobias Ellwood Excerpts

Tuesday 16th July 2013 Commons Chamber

[Mr Hunt]

The hon. Gentleman is absolutely right. If this is to work, we need a slick system that is easy for hospitals to operate. We have done this in another area, as the NHS successfully and seamlessly invoices insurance companies for the costs of coping with road traffic accidents. At the moment, however, if hospitals declare that someone is chargeable for their NHS care, they do not get paid by the NHS for that care, meaning that they have to collect the money themselves from overseas, so the incentives for hospitals are wrong and we need to sort them out.

[Mr Tobias Ellwood (Bournemouth East) (Con)]

20. I welcome the Government’s initiatives to tackle health tourism, but what is being done to help hospitals on the front line, such as Bournemouth hospital, better to identify chargeable visitors?

[Mr Hunt]

We are considering whether something can be done with the NHS number. At the moment, people can visit any GP and, completely legally—whether or not they are entitled to NHS care—get an NHS number. That number can then become a passport that can be used throughout the system, so we are examining whether there is a way of giving people either a temporary NHS number, or a different NHS number, that can be tracked through the system so that if they undergo complex medical care that is chargeable, we are able to trace that and collect the money from them.