Health and Care Bill

Wes Streeting Excerpts

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Edward Argar]

My hon. Friend puts his finger on a key issue, which is the dynamic nature of workforce trends, whether in terms of demand or supply, which is one of the challenges of a long-term projection—it would need to be a dynamic process. That is why we believe that the right approach is the one set out by my right hon. Friend the Secretary of State. His predecessor commissioned that framework review from Health Education England in July last year, and the Secretary of State has subsequently asked for further work to be done in a further commission that looks at a workforce framework over 15 years. That is the first time that has been done, as I heard him say at the Dispatch Box earlier today when talking about the Ockenden review, and it will be a hugely valuable tool for the NHS and for us when we make decisions in this place about priorities and prioritisation in healthcare. As always, I am grateful to my hon. Friend the Member for Waveney (Peter Aldous).

Before I go into more detail, I will make a point on which I suspect the shadow Secretary of State and I are in complete agreement. Although there may not be many things in this group of amendments that we agree on, I am sure that he will join me in recognising the amazing work done by our health and care workforce over the past two years, and not just in the past two years, which were exceptional circumstances, but every day of the year—day in, day out—whichever year it is. I put that on record because it is important.

[Wes Streeting (Ilford North) (Lab)]

indicated assent.

[Edward Argar]

The hon. Gentleman nods; as I say, I suspect that may be a rare moment of agreement on this group of amendments.

We continue to be committed to growing and investing in the workforce. This year we have seen record numbers of staff working in NHS trusts and clinical commissioning groups, including record numbers of doctors and nurses. The monthly workforce statistics for December 2021 show that there are more than 1.2 million full-time equivalent staff. Those workforce numbers come on the back of our record investment in the NHS, which is helping to deliver our manifesto commitments, including to have 50,000 more nurses by the end of the Parliament. We are currently on target to meet that manifesto commitment, as the number of nurses was a little over 27,000 higher in December 2021 than in September 2019.

The spending review settlement will also underpin funding the training of some of the biggest undergraduate intakes of medical students and nurses ever. In that context, I highlight the decision made, I believe, under one of my predecessors to expand the number of medical school places from 6,000 to 7,500, which has come on stream. Of course there is a lead time before those going through medical schools will be active in the workforce, but it is an important step forward.

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The Government’s amendments strengthen account-ability and improve the Bill. However, several of the amendments from the other place are either unnecessary or have unintended consequences, so we ask the House to reject them.

[Wes Streeting]

It was a great pleasure to see the Minister at the Dispatch Box, but I must warn him and the Minister for Care and Mental Health, the hon. Member for Chichester (Gillian Keegan), that the Government will not convince us that their position on workforce is right even by sending out the most charming members of their Health team. I will go into the reasons for that. I start with enormous thanks to Members of the House of Lords for the enormous amount of work that they put into making the Bill much better than it was when it left the House of Commons. In particular, I thank my noble Friends Baroness Thornton, Baroness Merron and Baroness Wheeler who showed great wisdom and stamina in forging huge alliances in the other place to get the consensus needed to make the improvements that we are discussing. I also thank Liz Cronin and Richard Bourne for supporting the shadow Lords team.

The NHS is facing the greatest crisis in its history. Covid has not gone away, and the covid pressures on the NHS certainly have not gone away. Instead, it is in the unenviable position of having to deal with those ongoing challenges at the same time as trying to address the significant backlog that existed before we went into the pandemic, when a record 4.5 million people were already on NHS waiting lists.

Today, we see that there is a staff shortage of 110,000 across the NHS as well as 105,000 vacancies in social care. Six million people are now waiting for NHS treatment—the longest waiting lists on record—and they are waiting longer than ever before. Cancer patients are not being seen by specialists on time; they are waiting too long for diagnosis when every day matters. Stroke victims are being left to wait hours for an ambulance—except in the north-east, where over the winter heart attack patients were told to phone a friend or call a cab. It is therefore no surprise to learn today that public satisfaction with the NHS is at its lowest level in 25 years, since 1997. Of course, that was the year when Tony Blair led Labour to victory at the general election and delivered shorter waiting times and the highest patient satisfaction in the history of the NHS. The Government could do a great deal of good by learning from the example left by the last Labour Government and trying to rebuild the legacy that they have trashed over the last 12 years.

It is not just patients who are dissatisfied with the NHS. I know from speaking to frontline staff and NHS leaders across the country that they are exhausted after their heroic efforts of the past two years. They are burned out, they are overstretched, and there are simply not enough of them. They are proud of the NHS and proud to work for the NHS, but, in too many cases, people are going home at the end of a long shift and agonising about whether they did the right thing, agonising about whether they made the right decisions for their patients and agonising about whether they had forgotten a crucial detail. It is getting worse, not better. Some 27,000 NHS workers voluntarily left the health service in just three months last year, the highest on record. The Health Secretary has admitted that the Government will not meet their manifesto commitment to recruit the 6,000 GPs we need to get people seen on time and we know that many cases will simply present in overstretched accident and emergency departments. Today, we heard about the consequences of the failure to safely staff our health service.

On that note, I want to place on record my thanks to the Secretary of State for Health for his response to the Ockenden review—and to his predecessor, the Chairman of the Health and Social Care Committee, the right hon. Member for South West Surrey (Jeremy Hunt) for commissioning the review in the first place—and the commitment to implement in full not its recommendations, because Donna Ockenden has not made recommendations, but the must-dos she has set out. I cannot imagine the trauma of losing a child and we owe it to mothers who have been through that suffering to ensure that they are never let down again. This is not a party political point. The review spans two decades under Labour and Conservative Governments. I want to acknowledge that and be honest about that. The clear finding is that we must safely staff our maternity wards. Today, midwives are leaving the NHS in greater numbers than it is able to recruit them. That is just one of the reasons why we need a workforce plan for the NHS.

[Geraint Davies (Swansea West) (Lab/Co-op)]

I have just returned from Lithuania, where I was speaking to the head of migration in a refugee centre who said that they are welcoming their neighbours not just because they should but because they are providing a very valuable addition to their workforce. They are taking tens of thousands of people. Given that 1.4 million EU citizens who are registered to work in Britain have decided to stay in Europe, should we not be opening our hearts and homes and recognise the benefits some of them would bring by working in the NHS?

[Wes Streeting]

I thank my hon. Friend for his intervention. It is certainly the case that refugees fleeing Ukraine—indeed, other conflict zones around the world—bring enormous skills to our country. For as long as they are here and living with us, we should enable them to make whatever contribution they wish. If some of the people from Ukraine or elsewhere want to work in the NHS, we should absolutely welcome them with open arms.

[Rachael Maskell]

I am grateful to my hon. Friend, who is making an excellent speech. This debate is concentrated on physical health, but if we look at workforce planning on mental health we know we are at a significant deficit. If we are talking about parity of esteem, surely Lords amendment 29 is absolutely imperative, so that we can start investing in the future of our mental health services?

[Wes Streeting]

My hon. Friend is absolutely right and she will know of our party’s ambitious commitments, outlined by my hon. Friend the Member for Tooting (Dr Allin-Khan), to ensure that patients receive guaranteed mental health treatment within a month. That would be revolutionary. It will require investment and require recruiting the people we need to help provide that care, but this country is living through a mental health crisis on top of everything else. This has been a deeply difficult two years for our country during the pandemic. Many people bear not just the physical scars and ongoing physical health consequences of long covid, but the grief, the loss and the injury to their mental health and wellbeing caused by this deadly pandemic. Many of those people who are suffering mental health crises are the very people who are still turning up for their shifts in the hospitals, still turning up for their shifts in the GP surgeries, and still turning up at work to help care for others even though they are in need of care themselves.

Lords amendment 29 does not commit the Government to hire thousands more doctors and nurses, although they should. It does not commit to new funding for the NHS, although it desperately needs that. It does not even commit the Government to finally publish the workforce strategy the NHS is crying out for, despite the fact that the NHS has not had a comprehensive workforce strategy since the Labour Government’s plan was published in 2003. All we are talking about today is an independent review of how many doctors, nurses and other staff the NHS needs for the future. That is not just a view put across by Labour Members: it is supported by many Members right across the House, including the Chair of the Health and Social Care Committee, the right hon. Member for South West Surrey, who is a former Health Secretary. It is not the first time that he has helped to unite the sector, although I remember the days when it was sometimes united in opposition to, rather than in support of, his proposals.

I will say this, actually: when the right hon. Member for South West Surrey took over as Chair of the Health and Social Care Committee, I was really nervous about the prospect of a former Health Secretary effectively marking his own homework, but on this issue, he has shown a degree of honest reflection and has genuinely contributed his experience to the debate about the future of health and social care in this country. Not only has he been honest about where he fell short, and where other Conservative Ministers may have fallen short, but he is determined to make sure that we improve the quality of the health and social care debate in this House. I very much welcome his contribution to the debate about the NHS workforce challenge.

[Jim Shannon]

Will the hon. Member give way?

[Wes Streeting]

How can I resist?

[Jim Shannon]

The shadow Minister is always kind in giving way. I want to back up his comments about the right hon. Member for South West Surrey (Jeremy Hunt). On Lords amendment 29, does the shadow Minister acknowledge that Macmillan Cancer Support said that it needs an additional 3,371 cancer nurse specialists? That would double the nurses by 2030, and it gives us a reason why we need to support Lords amendment 29 and why workforce safety is critical.

[Wes Streeting]

The hon. Gentleman is absolutely right. If I am honest, I suspect that the Minister and the Secretary of State for Health and Social Care also agree that Lords amendment 29 is needed. I suspect the truth is that they are not the ones blocking it. They are in a Treasury-imposed straitjacket from the Chancellor, preventing them from doing what they know to be necessary for the NHS, because the Treasury would rather stick its head in the sand and not acknowledge the scale of the challenge or the reality of the cost. It hopes that ignorance is bliss and that we can carry on as we are, and perhaps nobody will notice—even the 6 million people on NHS waiting lists.

[Matt Rodda (Reading East) (Lab)]

I wholeheartedly agree with my hon. Friend’s speech; he is addressing absolutely the issues that the sector faces. All of us support the NHS and want to see it thriving. Does he agree, however, that the challenge is about the Treasury and the Prime Minister and the lack of support and understanding from the Prime Minister and the Chancellor at this crucial time, when the NHS has gone through such a difficult period?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. To be honest, I do not know whether No. 10 or No. 11 is running the show. We hear that the Chancellor also blocks the Prime Minister from time to time. I can think of a few occasions during lockdown where that would have been good, if the Chancellor had bolted the door to the back garden, but we will not dwell on that now, Madam Deputy Speaker, because you will tick me off—

[Madam Deputy Speaker (Dame Eleanor Laing)]

No, we will not.

[Wes Streeting]

As you already are, Madam Deputy Speaker, but I could not resist.

The problem is that unless we face up to the scale of the workforce challenge, the Government simply will not deliver the shorter waiting times that patients need until they break out of their straitjacket. They should start today; otherwise, patients will be left wondering why they are paying more in taxes but waiting longer for care.

Government Members may argue that we do not need Lords amendment 29, because there is a planned update to “Framework 15”, Health Education England’s 15-year strategic framework for workforce planning—[Interruption.] My hon. Friend the Member for Bristol South (Karin Smyth) cannot wait; she is watching her inbox daily, waiting for it to arrive. The truth is that this is inadequate. Previous iterations of the framework have not quantified the staffing numbers needed. The Secretary of State was recently unable to confirm when he appeared before the Health and Social Care Committee that the revised framework will set out the required numbers of staff. The truth is that the recent past is littered with promises of workforce strategies and frameworks that have either not materialised or failed to deliver the action needed.

Let me turn to the Minister’s claim that we have record numbers of doctors and nurses—it is today’s equivalent of, “You’ve never had it so good.” We all know—he knows this very well—that the population is growing and ageing, and as it does so, we need the numbers of nurses, doctors and carers to keep up. This is a question not just of recruitment, but of retention. When I ask frontline staff, “What would make the single biggest difference to your morale? What would be the thing that keeps you going even though you are exhausted, stressed and burned out?”, their answer is very simple: they just want to know that the cavalry is coming and that significant numbers of staff will be recruited to help provide the support they need. Their greatest fear is that the people who have slogged their guts out to get us through the pandemic will be left alone as they try to help the NHS to recover from the pandemic and from the problems that existed before it. If we are not careful, we will risk losing those staff, creating even greater pressures—a greater cost to patient care, a greater cost to patient safety and a greater cost in recruiting and training new doctors and nurses. With the best will in the world, and with the best training available at our brilliant medical schools, doctors and nurses take years to develop the skills and experience to make them outstanding clinicians. Those are the people we risk losing at this very moment.





While I have the opportunity, may I say to the Minister that I cannot understand why there are 791 medical school graduates who still do not have a junior doctor post? These people are qualified, they are ready and there is a shortage—get them to work!

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[Katherine Fletcher (South Ribble) (Con)]

Along with Mr Speaker and Mr Deputy Speaker, I have been in a similar position in Lancashire with the A&E unit under threat at Chorley and South Ribble Hospital. Contrary to the hon. Gentleman’s point, I have found that even with a meeting with the Speaker and Deputy Speaker of the House and the Health Secretary, and with a very compelling case as to why the local trust has made the wrong decision, there is nothing in law to allow them to do anything about it. I therefore very much welcome the amendments to ensure that local bureaucrats are not too tied in.

[Wes Streeting]

I really do understand the hon. Member’s point. She would like to be able to save her services and lobby her colleagues in Government to make those decisions, but—speaking from experience—saving our accident and emergency department was not about using politics or political pressure to change the decision. Public support was really important and we did our fair share of parliamentary petitions, marches and everything we could to keep the pressure up, but in the end it was about the evidence base that we put together to save the department.

When it comes to matters of clinical provision and of providing the best services for patients, clinical factors have to be paramount. I worry about how decisions turn into a political football either side of a general election and become a party political knockabout, when the primary consideration should be patients’ safety and concerns. Although I have cited an example in which saving our A&E was the right decision, I can think of cases right across the country in which communities feel very strongly, and we understand why, but passion, emotion and sentimental attachment to particular services do not always align with the clinical interests of local populations. Patient safety and evidence must come first. I really worry about the introduction of a party political knockabout in that context.

Ministers have argued that the new powers are necessary to ensure democratic oversight of health service decisions, but the existing system allows appropriate democratic oversight and allows contentious service change decisions to be resolved. I do not believe that the wholesale upheaval of the system and the introduction of sweeping new powers for the Secretary of State are justified.

Let me now deal with some of the other amendments— very briefly, as I am conscious of time. We support Lords amendment 48, which requires the Secretary of State to ensure that health service procurement does not violate the UK’s international genocide obligations. The amendment is consistent with the UK’s obligations under the convention on the prevention and punishment of the crime of genocide.

Lords amendment 89 deals with a related issue, prohibiting organ tourism involving both forced organ harvesting and black market organ trafficking. We welcome this change in the Bill, which amends the Human Tissue Act 2004 to prohibit UK citizens from travelling to countries such as China—although the wording of the amendment is not country-specific—for the purpose of organ transplantation. The restrictions are based on ensuring that there is appropriate consent, no coercion, and no financial gain. In some parts of the world, organs are not given freely but are taken by force, and we must bear that in mind in the drafting our legislation.

Lords amendment 57 is intended to retain the current safe haven for patient data

within NHS Digital, and to prevent NHS England from taking on responsibility for it. Keeping patient data safe is important. It can be powerful when it is used well, and has enormous potential for better population health and better clinical outcomes in individual cases, if data is used wisely, safely and ethically. The amendment will keep statutory protections in place for a patient data “safe haven” across health and social care, required for national statistics and for commissioning, regulatory and research purposes. It also ensures that NHS England does not take on this responsibility, because of a potential conflict of interest in its role.

Lords amendments 42 to 46 deal with procurement. We welcome these changes. The years of the pandemic have also been years of crony contracting. After the scandal of billions in taxpayers’ money being handed out to mates for duff PPE and testing contracts, and PPE literally going up in smoke—along with taxpayers’ money—we hope that this is the start of Ministers’ looking again at where they went wrong during the pandemic.

This afternoon the House faces a simple choice. We must decide whether we are going to be honest with ourselves, with the NHS and with the country about the genuine staffing challenge in health and social care—and whether we are going to have a more responsible and grown-up political debate about how we meet that challenge—or whether we prefer to be the ostriches of the Treasury, with our head in the sand, pretending that these issues will go away, hoping for the best, hoping to squeeze a bit more efficiency out of the NHS through new efficiency targets. That really will not cut it. The recruitment of staff already announced by the Government really will not cut it.

For as long as we allow this situation to continue, patients will wait longer. They wait in agony. Their health outcomes are worse, and they lose confidence in the national health service. It is the greatest institution that this country has ever built, and it is going through the greatest crisis in our history. Let us be honest about that—with ourselves, with the NHS, and with the country—and support their lordships in their amendment.

[Sir Iain Duncan Smith]

I shall try to be brief. I rise to speak to amendments (a) and (b) in lieu of Lords amendment 48, which refers to genocide. Along with 19 colleagues, some of whom are present, I tabled amendment (b) to recognise first a problem for the Government, and secondly an absolute imperative for all of us here.

The problem for the Government with Lords amendment 48 is, I understand, the inclusion of genocide. There is a reason for that. I disagree with the Government about this, but that is where they are. The Government talk of a “competent court” having to decide questions of genocide. We have been through this again and again recently, but the fact is that we will never get a decision from a competent court when it comes to countries of the scale and dimension of China, either because they veto it in the Permanent Assembly or because they are not members of the International Criminal Court, so we cannot get them that way.

I recognise that the purpose of this is really more to do—quite rightly—with slave labour, so the title of my amendment alludes to slave labour. That is much more focused, and makes clear what I should like to think we are all after. I abhor the genocide that I absolutely believe to be taking place in Xinjiang, and I think we need to take much greater action on that, but in the context of the Bill, the purpose of the amendment was to make clear to the Government that a significant number of Members—and more would have signed it had I bothered to ask them—are very keen to see such a measure included. I say those words carefully, because I have read what the Government have written down and I have discussed this at length with the Minister and the Secretary of State, and I fully accept what they are trying to do here with this amendment on review, but that amendment on review cannot tighten up the time because it can only be post hoc, as it were, after the Bill goes through. My determination is that, by the time this Bill comes back from the Lords, we will have an amendment specific to modern slavery in it.

The reason I say that is that this is clear, with a reference even in the last two days to the use of equipment made by slave labour in Xinjiang in at least one of our hospitals. That equipment has been tested, so there is no excuse for not knowing. There is a company called Oritain—there are others—that now has the digital and genetic fingerprints of all the products from these areas. It has spent 10 years getting this information, and it can test a product and tell us not only where in rough terms it comes from but even which factory made it. There is no excuse now. This is being used in the United States, which has declared genocide, for testing these products.

The NHS is a phenomenal purchaser and has huge capability to change people’s direction. I say to the Minister that I understand that behind closed doors—if any closed doors exist in Government generally, but these ones—some members of the Government have asked the Secretary of State to do an impact assessment. We love impact assessments in Government. Most times they mean absolutely nothing because they tell us what happened before, but not what will happen in the future. That is because almost every time the Government try to forecast the future, we get it wrong. Even the Office for Budget Responsibility manages that quite regularly.

What difference would an impact assessment make to this amendment in my name and that of 19 other Members? For example, an impact assessment might tell us that we should no longer buy from a particular area because we are certain it provides through slave labour, but that the procurement would be, say, £20 million more expensive as a result. Does that impact assessment then mean we cannot do that because we do not want to lose £20 million—or £20 billion or whatever it happens to be—because that is too expensive, and that we will on balance therefore purchase from a known slave labour provider? Is that what we are saying? Is that what the impact assessment will say to us? I say to those who call for an impact assessment: be careful what you call for. There is a simple impact here: are we to purchase equipment made by slave labour?

I have also heard that someone else in the Government has said that the balance is between provision for those who need it here in the UK and our use of a product that comes from a place using slave labour. I say: be careful of that comment. It is not a choice we have to make. Our choice is to care for those here in the UK, but also to care for those who are being brutalised and beaten into product production and often losing their lives; we have to have a care for them as well. There is no choice here. It is simple: do we or do we not wish to have products in circulation in our NHS, of which we are all very proud, that were made by slave labour? This is the single point.

I understand the problem with Lords amendment 48; it is that the Government will never recognise genocide, so that amendment would never have a bearing or an effect because they would simply say, “We do not recognise that genocide has taken place in that area and therefore we are let out.” It is let-out for them. This amendment of ours is very specific. It deals with slave labour, and we can prove slave labour. So I say to my hon. and right hon. Friends: this unites the whole House. If this comes back amended either by the Government or by somebody in the House of Lords, I give a little warning—not a threat—to my Government that the choice when this comes back will be: do you support the use of slave labour or do you not support the use of slave labour? There is no other choice. It is not a moderated choice. It is very simple for us. I will vote against slave labour for an amendment coming back from House of Lords, and I believe that many of my colleagues here—all of them, I hope—will do the same. I am certain that that will be the case for those on the Opposition Benches.

I have huge regard for my hon. Friend the Minister, and very much so for the Secretary of State. I have spoken to them at length, and I believe them to be completely onside with my argument. I ask a wider group in the Government to stop it. This is more important than moderated impact assessments, which mean nothing; this is about human lives. When it comes to human lives, the best impact we can have is ending brutality, intolerance and slave labour. If we can bring that to an end, it would be the biggest impact we ever have, and we could be proud of it.

Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 1st March 2022 Commons Chamber

[Sajid Javid]

We will keep under review the testing offer that we will provide over the coming weeks and months. We continue to consider whether any changes are necessary, but as we learn to live with covid we will target our free asymptomatic testing offer on vulnerable people. That includes, of course, those who are immunocompromised. Such individuals will also be eligible for antiviral treatments through a free priority PCR test service.

[Wes Streeting (Ilford North) (Lab)]

I associate myself and everyone on the Opposition Benches with the Secretary of State’s remarks and warmly welcome the support that the Government are providing to the people of Ukraine and the Ukrainian army. We all stand with the people of Ukraine in their fight for freedom and democracy.

Turning to matters closer to home, the Secretary of State asked the Chancellor for £5 billion to cover essential covid costs—ongoing covid costs—and he came away with nothing, so where will the cuts now fall in the NHS budget?

[Sajid Javid]

We must all learn to live with covid. The Government have been very clear about that, and we set out a very detailed plan. As infections fall, cases fall and rates of hospitalisation for covid fall, which means we can now have this type of plan. It is a properly funded plan that focuses on vaccines, treatments and targeted testing, and that builds in resilience should there be future variants of concern. It is right that this plan is funded by the Department because it is our No. 1 health priority.

[Wes Streeting]

Hang on a minute. So one minute the Secretary of State is asking for £5 billion from the Treasury, and the next minute he has found the money within the Department. Either he was trying to pull a fast one on the Treasury, because he had the money he needed, or he has not got the money he wanted and therefore the cuts are going to fall within existing budgets. Members do not need to take my word for it; it was reported in The Times that the Health Secretary threatened that, if he did not get the funding, it would mean delaying investment in social care, fewer elective surgeries and cuts to the hospital building programme. Having, I think, not tried to pull a fast one on the Chancellor, is he now pulling a fast one on patients, and is it not really the patients who are going to pay the price for his failed negotiations?

[Sajid Javid]

First, the hon. Gentleman should not believe everything he reads in the press. We would think he knew that by now. As I said, when it comes to funding our plan for living with covid, it is right that it continues to be the No. 1 priority of my Department to keep this virus at bay and that it is funded by the Department. When it comes to funding, this is the hon. Gentleman who, with all his colleagues, voted against extra funding when he was given the opportunity.

Elective Treatment

Wes Streeting Excerpts

Tuesday 8th February 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I thank the Secretary of State for advance sight of his statement, but it falls seriously short of the scale of the challenge facing the NHS and the misery that is affecting millions of people stuck on record high NHS waiting lists. We have been waiting some time for his plan to tackle NHS waiting times. We were told that it would arrive before Christmas; we were told that it would arrive yesterday; and it is not clear from his statement today that the delay was worth the wait. There is no plan to tackle the workforce crisis, no plan to deal with delayed discharges, and no hope of eliminating waits of more than a year before the general election in 2024. I wonder whether the Conservatives will be putting that on their election leaflets. The only big new idea seems to be a website that tells people that they are waiting for a long time, as if they did not already know.

Perhaps the Secretary of State can tell us whether the plan itself contains two other measures that have been floated in the press: the cancellation of patients’ follow-up appointments, whether they need them or not, and an offer enabling people to seize the opportunity to travel hundreds of miles around the country, if they can find a hospital in England that does not already have a waiting list crisis of its own. What we did hear was a series of reannouncements, including some perfectly sensible proposals for community diagnostic and surgical hubs. We welcome those, but the Secretary of State cannot pretend that they meet the scale of the challenge.

The Secretary of State reaffirmed the Prime Minister’s commitments on cancer, announced only yesterday. He announced a new target that no one should wait more than two months for cancer diagnosis, but there is already a target for the vast majority of cancer patients to be treated within two months of referral. Can he tell us which target he is aiming to meet? Is it the target that has not been hit since 2015, or the target announced yesterday, which seems to lower standards for patients because the Government consistently fail to meet them? The Prime Minister has also announced that three out of four patients should receive a cancer diagnosis within 28 days, but that is an existing target which was introduced in April and has never been met, and nothing that the Secretary of State has announced today gives me any confidence that it will be met in the future. Given that half a million patients with suspected cancer are not being seen in time, it seems that the Secretary of State declared a war on cancer after more than a decade of disarming the NHS, and is now sending the NHS into battle empty-handed.

Indeed, it is hard to believe that this is the announcement that the Secretary of State wanted to make. One Government official briefed Robert Peston that the plan was being blocked by the Chancellor, who is, “reluctant to rescue the Prime Minister”. Putting to one side the appalling spectacle of the Tory leadership crisis impacting on life and death decision making in Government, it seems from the statement that the Chancellor has won the day. What other explanation can there be for a plan to recover the NHS and bring down waiting lists that does not contain a workforce plan? The single biggest challenge facing the NHS is the workforce challenge. There are 93,000 staffing vacancies in the NHS today. The NHS is understaffed, overworked and, if the Secretary of State is not careful, he will lose more people than he is able to recruit. This is not a new development, and it should not be news to him.

In April, the NHS called for a national workforce plan. Polling from the Health Foundation found that the public want more staff with fewer workload pressures. The Secretary of State himself told the Health and Social Care Committee in November that his plan would include a strategy for the workforce crisis. We know the NHS wants a workforce plan and the public want a workforce plan. He promised a workforce plan, so where is it? There is not even a budget for Health Education England let alone a serious plan to recruit and retain the workforce that we need. Instead, he is proposing new NHS reservists. Who are they? Where are they coming from? How many does he imagine there will be? How does he imagine that they will make a dent in the 93,000 vacancies? It seems more “Dad’s Army” than SAS.

Then there is the issue of wider NHS and social care pressures that impact directly on waiting lists and waiting times: the pressures on GP practices that see people ringing the surgery at the crack of dawn in the hope of getting through before the appointments have gone; the pressures on social care that lead to delayed discharges from hospital, as we saw in more than 400,000 cases in November alone; and the missed opportunities and the wasted money that comes from a failure to invest in community services that lead to people turning up at A&E at greater cost to patient health and at greater cost to the taxpayer.

This plan falls well short of the challenge facing our country. Six million people are waiting for care. Cancer care is in crisis, with half a million patients with suspected cancer not seen in time. Heart and stroke victims are waiting more than two hours for an ambulance when every minute matters. It is clear from what the Secretary of State said today, from what his colleague, the Minister for Health, the hon. Member for Charnwood (Edward Argar), said yesterday, and no doubt what will be heard repeated in the Tory scripts in the days and weeks to come, that the Conservatives are hoping to blame the state of NHS waiting lists on the pandemic—the “covid waiting lists”, they called them. But this is not a covid backlog; it is a Tory backlog. After a decade of Tory mismanagement, the NHS had: record waiting lists of 4.5 million before the pandemic; staff shortages of 100,000 before the pandemic; 17,000 fewer beds before the pandemic; and 112,000 vacancies in social care before the pandemic.

In conclusion, it is not just that the Government did not fix the roof while the sun was shining, they dismantled the roof and removed the floorboards. With the ceiling of their ambition that the Secretary of State outlined today being to go back to where we were before the pandemic, it is now clear that the longer that we give the Conservatives in office, the longer patients will wait.

[Sajid Javid]

I am surprised with the argument and the tone of the hon. Gentleman. It is 2022, not 2024. We have all come to expect the scaremongering that we have just heard from the Labour Benches at election time—that has happened in every election campaign since the war—but what I did not expect is this scaremongering from the hon. Gentleman on the plans to recover in the wake of a deadly pandemic.

I am astonished and disappointed that the hon. Gentleman is willing to stand there and claim that there is no covid backlog. [Interruption.] That is what he just said. He just said that there is no covid backlog. He is well aware that this country has just gone through its biggest health challenge in history. He is also well aware that there has been a national mission across the NHS to deal with that challenge and to recover from it. I paid tribute to the hon. Gentleman just last week in this House—perhaps I was just a bit too early—when he rightly supported the nation’s vaccination programme, because he understood just how important it was. Perhaps some of his Back Benchers have now got to him, so instead of standing up for the British people, he is just thinking about his own leadership prospects in his party—perhaps that is what is actually going on.

Today, instead of doing the right thing and backing the NHS—backing the hundreds of thousands of doctors, nurses and everyone working heroically across the NHS—the hon. Gentleman decided to play party politics. A moment ago, he heard me talk about the 10 million people who the NHS estimates have stayed away from the NHS and who need reassurance from both sides of the House about what the NHS is doing. He should reconsider his approach and work together in the national interest.

Elective Care Recovery in England

Wes Streeting Excerpts

Monday 7th February 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

(Urgent Question): To ask the Secretary of State for Health and Social Care if he will make a statement on the publication of his Department’s plan for elective care recovery in England.

[The Minister for Health (Edward Argar)]

The covid-19 pandemic has had a huge impact on healthcare systems everywhere. The NHS has performed incredibly, caring for covid and non-covid patients alike and delivering the vaccination programme that has helped us to open up this country once again. Throughout the pandemic, we had to take steps to ensure that we could treat those with the greatest clinical need and that we provided a safe environment for those who needed covid care.

As a result, there is undeniably a huge covid backlog that needs urgent attention. The number of people waiting for care in England now stands at about 6 million, and we know that that figure will get worse before it gets better. Furthermore, our best current estimate is that about 8.5 million people who would normally come forward for treatment have not done so during the pandemic. However, we are pulling out all the stops to help the NHS recover and ensure that patients are receiving the right care at the right time.

Hon. Members will be aware that the Government will have invested more than £8 billion in the NHS in the three years from 2022-23 to 2024-25. As part of the new health and social care levy, we will be putting huge levels of investment into health and social care over the coming three years, and all the time we are announcing new solutions to the problem of how we can ensure that the NHS is on the firmest possible footing for the future.

On Friday we launched a call for evidence that will inform an ambitious new vision for how we lead the world in cancer care. As the Prime Minister announced earlier today, we are setting out some tough targets for the NHS on cancer. We want to ensure that 75% of patients are diagnosed or have cancer ruled out within 28 days of a GP referral, and to return the backlog of people waiting more than two months for their cancer treatment to pre-pandemic levels by March 2023. Today the NHS has also announced the launch of a new platform, My Planned Care, which will provide patients and their carers with relevant and up-to-date information ahead of planned treatment, including information on waiting times for their provider.

I am under no illusions about the fact that our health system is facing an enormous and unprecedented challenge. That is why we are doing everything in our power to support the NHS and its patients, recovering services to reduce waiting times and deliver more checks, operations and treatments. We are faced with a once-in-a-generation challenge. We know that we must get this right. We are working with the NHS and across Government to deliver a targeted and far-reaching plan for elective recovery, and we will update the House at the earliest possible opportunity.

[Wes Streeting]

Thank you for granting the urgent question, Mr Speaker.

This is not a covid backlog; it is a Tory backlog. We went into the pandemic with NHS waiting lists already at a record 4.5 million, and now 6 million people are waiting on those lists—more than ever before. More than 1 million are waiting for scans and tests used to diagnose cancer, and the NHS itself is waiting—waiting for the Government’s plan to deal with the backlog. So where is it? It was due to be published today but was pulled last night. It is like something from “The Thick of It”, but the reality is worse than fiction—a photo op without a plan; the Government’s own NHS recovery plan just another cancelled operation. But there is no need to worry, because there is a website coming that will tell people that they are waiting a long time, even if there is no plan to ensure that they do not-.

Then there is the “reason” for the delay. Briefings from the Department for Health and Social Care claimed that the Chancellor had blocked the plan. As one Government official said,

“it’s pretty obvious it’s about Treasury reluctance to rescue the PM”.

Is this where the shambles of the Conservative party is taking us? Is the Chancellor seriously playing political games while 6 million people wait for care? No wonder the Health Secretary has not bothered to show his face this afternoon. He is probably still recovering from the embarrassment of this morning’s media round, where the big announcement was literally that there was no announcement. So it has been left to the Prime Minister to clear things up, which tends to go almost as well as breakfast television with the Culture Secretary. No wonder she has been dispatched to the middle east.

Let me turn to the “tough targets” that the Minister mentioned. Today the Prime Minister announced a new target that no one should wait longer than two months for cancer diagnosis, but there is already a target for the vast majority of cancer patients to be treated within two months of referral, and it has not been hit since 2015. Is this not just another example of the Conservatives lowering standards for patients because they consistently fail to meet them? The Prime Minister has also announced that three out of four patients should receive a cancer diagnosis within 28 days, but that is an existing target that was introduced last April and has never been met.

The waiting list crisis is the chickens coming home to roost after more than a decade of Tory failure. The Treasury blocked a plan for staffing and it is now blocking the plan to cut waiting times. Is it not now clear, amid the chaos, confusion and spectacular incompetence on display, that the longer we give the Conservatives in government, the longer patients will wait?

[Edward Argar]

I am grateful to the shadow Secretary of State. As he said, 2 million of those on the waiting list have entered that waiting list since the pandemic began. There is undoubtedly a huge covid backlog, as we had to put in place infection prevention and control measures and ensure the availability of beds for those with covid. I am with him, I suspect, on at least one point, which is that I, like him, entirely understand the impact that this has on people’s lives, their anxiety and their health outcomes. That is why this Government are determined to tackle that waiting list. As I said, this is a once-in-a-generation challenge and it is absolutely right that we make sure we get the plan right. We need to ensure that we have the right plan, delivering the right outcomes.

The hon. Gentleman mentioned delays, and I have to say that this plan is delayed. This is a plan we anticipated publishing in December. The reason that we did not do that was because of the omicron variant and the impact it has had on our health services over the winter. We have made sure that we get this plan right.

The hon. Gentleman also mentioned Her Majesty’s Treasury. I have to say, speaking as a Minister in the Department of Health and Social Care, that we could not wish for better partners than Her Majesty’s Treasury and this Chancellor. They have shown strong support to our health and care system throughout the pandemic, with record levels of funding to support it through the pandemic and to help performance to recover subsequently.

Even before the pandemic, when the current Secretary of State for Health was Chancellor, this Government had already put in place a £33.9 billion increase in funding, enshrined in law. It was one of the first pieces of legislation passed by this Government after the election. We have also set out our long-term funding plans through the health and care levy, which I recall the hon. Gentleman’s party did not support.

Covid-19: Purchasing Effort

Wes Streeting Excerpts

Thursday 3rd February 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I thank the Minister for advance sight of the statement. But what a disgrace that the Secretary of State did not come to the House today, to account for the inexcusable and unacceptable level of waste in his Department, or when the Department first published the accounts, or two days afterwards, when they were reported on the front pages of several newspapers and on broadcast news. Perhaps the Secretary of State’s silence and absence tell us that he is relaxed about losing billions of pounds of taxpayers’ money, or perhaps it is simply that he is too ashamed to show his face. He had to be dragged to the House and when he was, he bottled it and sent his deputy.

The Department of Health and Social Care snuck out its annual accounts on the final day on which they were legally required, 10 months after the end of the financial year, and, I am sure by total coincidence, at 5.30 pm on the day Sue Gray published her update. Buried on page 199 was the revelation that the Department lost a staggering £8.7 billion on PPE. That is more than two thirds of the Department’s total spend on PPE written off as losses, double the amount it is spending on the hospital building programme, and almost as much as we spend on the salaries of every nurse in England for an entire year. Why? Because the PPE was unusable, going out of date, and bought in at eye-watering prices because the Government were in a state of desperation having run down our supplies before the pandemic arrived.

We know that many Conservative Members privately—sometimes even publicly—agree with Labour that the national insurance rise is an unfair hit on working families facing a cost of living crisis. How will they explain to their voters that, taken together with the £4.3 billion they handed out to fraudsters, this Government have thrown away more than a year’s receipts of the national insurance rise that they are now imposing on working families?

It is not just that the Conservatives are the party of high taxes because they are the party of low growth; they are the party of high taxes because they are the party of waste and incompetence. Think of what the NHS could have done with those funds. It could have reduced waiting lists and waiting times, improved access to GPs and rebuilt hospitals for the 21st century.

Of course covid came as a shock, but that does not explain why the Conservative Government ran down Britain’s supply of PPE before the pandemic, leaving us exposed to price hikes and profiteering. Perhaps the Minister can explain why a global pandemic necessarily leads to Conservative party donors and the former Secretary of State’s pub landlord receiving special treatment and hundreds of millions of pounds of taxpayers’ money.

It is not just PPE. Why did the Department fail to collect shipments from ports on time, costing taxpayers £111 million in additional fees? Why did the Department fail to pay its bills on time and incur late fees of £1.6 million as a result? Why did the Department spend £250 million on testing materials, ventilators and medical equipment, none of which can be used?

Is not it the case that when this Conservative Government thought no one was watching, they abandoned any pretence of being careful stewards of public finances, bunged millions to their mates and donors, and now working families are footing the bill? What would Mrs Thatcher, the grocer’s daughter, whose father instilled in her the value of thrift, make of this lot?

Is not the truth that the Conservative party has changed? You cannot trust this Conservative party to show respect to the people or to Parliament. You cannot trust this Conservative Party to keep taxes low. You cannot trust this Conservative Party to spend taxpayers’ money wisely. Indeed, the only thing that has not changed about the Conservatives is the age-old truth that you cannot trust the Tories with the NHS.

[Edward Argar]

It is always a pleasure to appear opposite the shadow Secretary of State. I will not take it as a personal affront that he would prefer it to be the Secretary of State rather than me.

The hon. Gentleman raised a number of important points. He cited Mrs Thatcher, and suggested that the Government had changed their position. If we are talking about sudden changes in position, I feel that I should quote the present shadow Chancellor, the hon. Member for Leeds West (Rachel Reeves)—formerly shadow Chancellor of the Duchy of Lancaster—who, in April 2020, wrote to my right hon. Friend the Chancellor of the Duchy of Lancaster:

“We need Government to strain every sinew and utilise untapped resources in UK manufacturing, to deliver essential equipment to frontline workers. This must be a national effort which leaves no stone unturned.”

She was right. I agreed with her sentiment then, and I still do—and we did do that—but it appears that the Opposition do not agree with it any more.

Let me turn to the hon. Gentleman’s other points. He kept suggesting—it makes a good headline for him, I am sure, but sadly I fear it is simply inaccurate—that this is money lost or wasted. It is not. As the hon. Gentleman knows from his days as a shadow Treasury Minister, this is a reflection of buying PPE at the height of the market, at the height of a global pandemic—

[Wes Streeting]

Why? Were there not enough masks?

[Edward Argar]

I will come to that point in a moment. It is a reflection of that, and now, in accounting terms, a reflection of what its value is today.

The hon. Gentleman should also be aware that the vast bulk of that £8.7 billion is down to exactly the same reason: PPE purchased at the height of the market. Now that we have a stable market, we have a sustainable supply. I make no apologies, and I know that my right hon. and hon. Friends will make no apologies, for doing exactly what the shadow Chancellor said we should do, which was to strain every sinew to make sure that the NHS had the PPE that it needed. We achieved that.

[Wes Streeting]

She did not say “by giving a contract to a pub landlord”.

[Edward Argar]

That is an important point, and I will turn to it in just a second.

The hon. Gentleman was also wrong to say that the money was thrown away. He knows that that is not what has happened here. He knows that this is about stock that has been written down in value, not written off. He knows that the vast bulk of that remaining is fit for use. We set very high standards in the NHS, but it is fit for use in other settings, and we are ensuring that we explore those other avenues, so that it can be used.

The hon. Gentleman talked about pub landlords. He will have heard my right hon. Friend the Member for West Suffolk (Matt Hancock) make this point in the Chamber. No contract was awarded to that individual, so I would caution him to be a little bit careful about the allegations he makes, and to check his facts before he does so.

Let me now turn to one of the broader themes raised by the hon. Gentleman. He talked about running down PPE stocks. Can he name any country in Europe that did not also have to buy vast amounts of PPE at the height of the pandemic, at the height of the market? This pandemic was unprecedented. We learned more about it with every day that passed. When we first started purchasing PPE, we were confronted with horrific pictures from hospitals in Bergamo in Italy. We saw the challenges that were faced, and we moved fast to ensure that our frontline had what it needed. We strained every sinew, and we got the PPE that our country needed.

Vaccination: Condition of Deployment

Wes Streeting Excerpts

Monday 31st January 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I thank the Secretary of State for advance sight of his statement, and also for his regular contact and briefings on this issue at both ministerial and official level. He is right to say that Labour worked with the Government to ensure maximum take-up of the vaccine across health and social care, and we do not regret that decision. Indeed, we welcome the decision that he has come to today.

Let me be clear from the start: vaccines are safe, effective, and the best defence that we have against the virus. Whether compulsory or not, it remains the professional duty of all NHS and care workers to get themselves vaccinated, just as it is the duty of all of us to protect ourselves, our loved ones, and our society from the greater spread of infections and hospitalisations, and from the need for harsh restrictions that impact on our lives, livelihoods and liberties. The debate over this policy is about whether the state should mandate the vaccine for health and care staff, or whether it should take a voluntary approach. It is not a discussion about the need to get vaccinated, the arguments for which are overwhelmingly one-sided. With five million people in the UK still to have their first jab, we cannot afford to take our foot off the pedal in getting the message out.

Labour Members supported the initial policy in early December. Since then we have seen a significant increase in vaccinations among NHS staff, with tens of thousands more staff now protected. I say an enormous thank you to the NHS trusts that worked tirelessly to persuade hesitant staff of the need to get vaccinated, and to those colleagues who have given up considerable time to have supportive conversations with their peers. I thank the health unions and royal colleges which, despite their misgivings about the mandatory nature of the policy, nonetheless did everything they could to encourage their members to get vaccinated.

Clearly, things have now moved on, in terms of both our overall levels of infections, and in our understanding of this latest variant. It has also become clear that to follow through with this policy could see tens of thousands of staff forced to leave their roles, at a time when our health service is already understaffed and overstretched—indeed, that has been a particular anxiety on these Benches and right across the House. However, efforts must continue to persuade those staff who are still hesitant.

What lessons have the Secretary of State and his Department learned from the Welsh Government, where 95% of staff were double jabbed by November without any mandate? What can we learn from the Welsh Government’s approach to persuasion, and how can we emulate their success? In light of today’s decision, it is all the more important that health and care workers are empowered to do the right thing and isolate when they need to, without the fear of being unable to feed their families. One in five care homes do not pay staff their full wages to isolate. If we are to learn to live well with covid, that must change. Labour’s plan for living well with covid includes making all workers eligible for proper levels of sick pay. Why have the Government still not sorted this? I appreciate that those are also Treasury issues, but that approach is penny-wise and pound-foolish when it comes to protecting public health.

The Labour party supported this measure in December, put the national interest before party politics, and made sure it had the votes needed to pass through the House. We understand the difficulties faced by the Government in coming to today’s decision, and we will continue to be as constructive and helpful as we can be in a national crisis, just as Labour has been throughout the past two years. I welcome very much what the Secretary of State said this afternoon about welcoming Labour support for this policy, and indeed about our wider support for the vaccination roll-out, but let me end on a point of criticism, which is not in any way levelled at the Secretary of State. Given the way that the Labour party has handled its approach to the pandemic response, and the constructive way that we sought to work with the Government, it is not unreasonable to expect the Prime Minister, and others in his party, to stop pretending that that has not been the case. Perhaps he might stop seeking to turn the pandemic—the greatest threat we have faced to our nation for more than 70 years—into a party political mud fight. Surely we can do better than that, and I would like to think that the Secretary of State and I have been leading by example.

[Sajid Javid]

Once again, I thank the hon. Gentleman for his approach to this policy area and to vaccinations in general. He is absolutely right in the comments he has made on that and the importance of working across the House and working together on such an important issue in the national interest, as he has done. I very much welcome that approach. Not all countries take such an approach to such an important issue, and they have sadly paid a price for that. I believe that one of the reasons we have such high vaccine uptake in this country is the cross-party approach that has been taken, and I thank him once again for that.

The hon. Gentleman is also right to point to the safety and effectiveness of the vaccines, as independently set out by our world-class regulator, the Medicines and Healthcare products Regulatory Agency, and other reputable regulators across the world. No one should doubt the safety and effectiveness of the vaccines. It is because of the success of this country’s vaccination programme that we are able to open up again in the way that we have and to start returning to normal life.

Very importantly for the people we are talking about today—the fantastic people working in the NHS and across social care—one of the key reasons we have been able to keep down the pressure on the NHS in particular is that so many people have come forward and got vaccinated. That is why it remains troubling that some people, in particular in the NHS, still refuse to get vaccinated, even when they know it is safe and effective, and do not do the responsible thing and act in a professional way.

We will keep going to work with those people in a positive way to try to persuade them about the benefits of vaccination and to provide them with the information they need. We will continue with the work of one-to-one meetings with clinicians if necessary and encouraging them to make that positive choice, but it will be about encouragement and helping them to come to the right decision. We will learn and look at what other parts of the UK have done in making sure that we have the very best practice and have learned from each other.

Finally, on the point that the hon. Gentleman raised about sick pay, I understand what he is saying. I just point to the fact that we have kept rules in place to allow sick pay to be claimed from day one, and a hardship fund is in place to give extra support where needed.

Oral Answers to Questions

Wes Streeting Excerpts

Tuesday 18th January 2022 Commons Chamber

[Maria Caulfield]

I reassure the hon. Gentleman that cancer has been an absolute priority throughout this pandemic, and treatment and services have continued. I thank all those working in cancer care for making sure that has happened. Ninety-five per cent. of people started treatment within a month of diagnosis throughout the pandemic, and there have been more than 4 million urgent referrals and 960,000 people receiving cancer treatment during that time.

[Wes Streeting (Ilford North) (Lab)]

Geoff Cosgrave was admitted to hospital in mid-November with kidney cancer that had spread through his lymph nodes and lungs. Last week, his wife Glynis contacted me in desperation because he was unable to access treatment to clear the blockage in his lungs as the thoracic ward at the nearby hospital had closed because of staffing shortages. After frantic and desperate chasing by his family and NHS staff, he was finally admitted to Bristol Royal Infirmary last week, but unfortunately his condition had deteriorated so he could not receive treatment. Geoff died on Friday and I am sure the whole House will want to send their deepest condolences to Geoff’s family. [Hon. Members: “Hear, hear.”] Glynis wants me to place on record her family’s enormous thanks to the NHS staff who cared for Geoff, and to ask the Minister what the Government are doing to address the serious understaffing in the NHS, and the covid pressures that are having an impact on cancer care, so that no family has to suffer what the Cosgrave family are experiencing right now.

[Maria Caulfield]

I thank the hon. Gentleman for his question. I put on record—I am sure this is shared by the whole House—our sympathy for Geoff and his family. There is no doubt that despite cancer being a priority throughout the pandemic, there have been pressures on the system. I again thank the staff, as Geoff’s family have, for carrying on throughout. I want to reassure the hon. Gentleman that the NHS is focusing on recovering cancer services to pre-pandemic levels; an additional £2 billion of funding was made available to the NHS and there were 44,000 more staff from October 2020. We are absolutely committed to getting back on track for pre-pandemic levels. Cancer has always been a priority. That is no comfort to Geoff and his family, but hopefully they can be assured that we are doing all we can.

--- Later in debate ---

[Sajid Javid]

My hon. Friend raises an issue that is very close to my heart, and the hon. Member for Rhondda (Chris Bryant) rightly raised it a moment ago, too. The pandemic has exposed huge health disparities in this country. It is clear to me that we need to go much further on cancer, not only to catch up on cancer referrals, diagnosis and treatment and radical innovation, but to improve the persistently poor outcomes that patients in this country have long experienced compared to those in other countries. It is time we launched a war on cancer. I am working on a new vision to radically improve the outcome for cancer patients across the United Kingdom, and I will have more to say on that in due course.

[Wes Streeting (Ilford North) (Lab)]

Keeping the Secretary of State on the subject of cancer, half of all patients with suspected breast cancer are not seen within the recommended two weeks. In two months, the number of patients who were not able to see a specialist in the target period has gone from 5,000 to 23,000—a far steeper increase than for all other forms of cancer—so I ask the Secretary of State: has breast cancer care been deprioritised?

[Sajid Javid]

Of course it has not been deprioritised. No cancer has been deprioritised. As the House has heard again today, we have seen an impact on healthcare across the country because of this terrible pandemic, including, sadly, on cancer care. Whether we are talking about breast cancer or other forms of cancer, they all remain a priority, including during the omicron wave; the NHS has made it absolutely clear that cancer remains a priority. As I said—I hope the hon. Gentleman agrees—we need to do more on cancer. I know that he cares deeply about this; he is right to have raised it twice in the past hour, and I hope that he will work with the Government on it.

[Wes Streeting]

I am going to raise it a third time, because it is very clear that breast cancer care is worse than care for other forms of cancer. The Secretary of State needs to account for that and tell us what he will do about it. On cancer more broadly, it is not good enough to return to the situation pre-pandemic, because as much as he wants to blame covid pressures for delays in cancer treatment, we went into the pandemic with waiting lists at 4.5 million, and with staff shortages of 100,000 in the NHS and of 112,000 in social care, which impacted on broader NHS performance. Where is the plan to fix the workforce challenge in the NHS? That is the biggest single challenge that will impact on his mission—the mission we all share—to improve cancer outcomes for everyone in the country.

[Sajid Javid]

The hon. Gentleman will know that survival rates from cancer were increasing before the pandemic, but as I think the whole House understands, the pandemic has had an impact on all other types of healthcare, including cancer. This is a challenge throughout the United Kingdom. He talks about waits for breast cancer treatment; those are longer in Wales, so this is an issue throughout the UK. It is right that we continue to focus on the workforce. We have 44,000 more health workers than we did in October 2020, and we will continue to build on that.

Covid-19 Update

Wes Streeting Excerpts

Thursday 13th January 2022 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I thank the Secretary of State for advance sight of his statement. I also pay tribute to Professor Sir Jonathan Van-Tam, who has provided outstanding public service throughout the pandemic. It was not the government resignation we were looking for, but the timing brought to mind the now infamous and deleted tweet from the UK Civil Service:

“Can you imagine having to work with these truth twisters?”

JVT already has a knighthood, but working with the Prime Minister he must have the patience of a saint. On behalf of the whole Labour party, we thank him for his service and wish him well for the future. He is truly a national treasure.

We welcome the announcement the Secretary of State has made on the reduction of the covid isolation period to five days, on condition that two negative tests are produced. So let us hope that he sorts out testing. Before Christmas, he told us that there were no issues with supply, but over Christmas NHS staff and other key workers were unable to access tests because the Government had not noticed that the deliverers had shut up shop for Christmas. Workforce shortages are one of the biggest challenges facing the NHS and the wider economy during the current wave of the omicron variant. This measure will help people get back to work faster and safely, which is great news for the Prime Minister, who, through a terribly unfortunate coincidence of timing, is isolating today, unable to face the cameras or the public. How good of the Secretary of State to help the Prime Minister back to work in time to face the music again at Prime Minister’s questions next week—the Leader of the Opposition looks forward to seeing him.

But what took the Secretary of State so long? Is it really because the Government had misread the policy of the Biden Administration? How many days does the Secretary of State think the NHS has lost and the economy has lost because they could not read the policy being used in the US? The Secretary of State has been briefing that it is UKHSA’s fault—how brave of him to blame officials. But the CDC—Centres for Disease Control and Prevention—advice to the Biden Administration is open access and available on its website. Did he not read it? Doesn’t anyone in this Government take responsibility any more—or is “blame the staff” now the essence of the ministerial code?

We are not out of the woods with covid-19 yet. We hope that the omicron variant has passed its peak in London, but we know it is yet to peak across vast swathes of England and that NHS services are under enormous pressure. Today, we learned that NHS waiting lists were at an historic 6 million before the omicron wave arrived. Twenty-four hours in A&E is not just a television programme; it is the grim experience of patients in too many cases. Week after week, we see more evidence of unacceptable delays for patients.

Now we know that the Government are lowering standards and normalising longer waits in the NHS: 12 hours to be seen in A&E, two years for referral to treatment and an hour just to be transferred from an ambulance into hospital—assuming someone can get an ambulance and has not been told to phone a friend or call a cab if they are suffering from a stroke or suspected heart attack, as has happened in at least one trust in the north-east of England. Does the Secretary of State really believe those waits are acceptable, or is it just the case with this Government that when they break the rules, they change the rules?

The Secretary of State will want to blame pandemic pressures alone, but we went into the pandemic with NHS waiting lists already at a record high of 4.5 million, staff shortages at 100,000 and social care vacancies at 112,000. Patients are paying a heavy price with delays, and the country has paid a greater price with lockdowns, because a decade of Tory policies left the NHS without the capacity and resilience to withstand the annual pressures of winter, let alone the unique pressures of a global pandemic. Where is the workforce strategy for the recovery? Where is the elective care recovery plan? Where is the sign that this Government have any understanding of the responsibility they bear for the crisis, let alone a plan to fix it for the future?

Finally, can I ask what on earth the Secretary of State thought he was doing yesterday when he leapt to the Prime Minister’s defence? His first duty is to public health. He also has a duty to the health and social care workforce. If doctors and nurses had brought their own booze to work, they would have been fired. The Prime Minister has undermined trust and confidence at a critical moment in the pandemic. Who is he to ask others to do the right thing when he does not practise what he preaches?

In conclusion, the Secretary of State has a duty to inoculate the Government’s pandemic response from a toxic, radioactive Prime Minister. The public have concluded that the Prime Minister is unfit for office. The Secretary of State needs to be careful in his defence that they do not draw the same conclusion about him.

[Sajid Javid]

First, I notice that the hon. Gentleman did not mention the huge increase in booster vaccinations in this country since he last stood at the Dispatch Box facing me. He just heard me say it, so he knows we are the most boosted country in Europe and the most boosted of any large country. He knows how much that has helped, yet there was not one word of thanks from him to the NHS, the volunteers, the military and everyone who helped to do that. There was not one word of thanks from the hon. Gentleman. It will be noted by the British public. I did notice, though—[Interruption.] Would the hon. Gentleman like to return to the Dispatch Box? I will sit down.

[Wes Streeting]

I am not sure that is in order, but what I said from a sedentary position is that the Prime Minister is not fit to lick the boots of NHS staff in this country.

[Mr Deputy Speaker (Mr Nigel Evans)]

Order. We will not have that again, please. No interventions like that, please.

Surgical Fires in the NHS

Wes Streeting Excerpts

Thursday 16th December 2021 Westminster Hall

[Wes Streeting (Ilford North) (Lab)]

It is a pleasure to see you in the Chair, Ms Rees. I apologise on behalf of the shadow Minister for patient safety, my hon. Friend the Member for Nottingham North (Alex Norris), who is isolating, so I am afraid that you are stuck with me, the shadow Secretary of State for Health, which at least gives me the opportunity early on to place on the record my commitment to patient safety.

I congratulate the hon. Member for Strangford (Jim Shannon) on securing this important debate and on underlining—in terms of the policy detail and what the data tells us or does not tell us, as well as in very stark human terms—why this issue is so significant. As he said, I have no doubt that there would have been more hon. Members present for this debate if it were not for the omicron risk and the fact that this is the final afternoon before the House adjourns for Christmas.

Surgical fires are a serious patient safety issue. In the contributions we have heard today—from the hon. Member for Strangford and the spokesperson for the Scottish National party, the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar)—the case for further action to prevent these incidents is clear.

Although rare, surgical fires can cause serious harm to both patients and healthcare professionals, and, as we have heard, in some cases they tragically result in life-changing injuries. The Department for Health and Social Care has declared that it does not know how many surgical fires happen across the NHS, because it does not collect such data centrally, but we know that they happen. In the period between 2010 and 2018, there were a total of 96 recorded surgical fire incidents declared by NHS England acute trusts and Welsh health boards. A search of the NHS’s National Reporting and Learning System for the period between January 2012 and December 2018 identified 37 reports of surgical fires. There is a discrepancy between those two figures. In my opinion, even one preventable incident of surgical fire in the NHS is one too many.

Although surgical fires are preventable, the absence of national guidelines has resulted in an inconsistent approach within UK hospitals to their prevention, with fewer than 40% of healthcare organisations in England having specific protocols and training programmes in place to address the prevention and management of surgical fires. Among healthcare organisations across the UK, 50% of healthcare organisations in Northern Ireland have specific surgical fire prevention guidelines, compared with 38% in England, 20% in Wales and 10% in Scotland, and only a limited number of trusts across the UK—23—have protocols and training programmes that specifically address surgical fires.

We know that these incidents occur as a result of particular circumstances, yet the majority of local trusts rely on general fire safety guidelines, in which there is often no mention of surgical fire risks and prevention processes for them.

The hon. Members who have spoken in this debate have discussed the findings of the expert working group’s report, which was published last year, so there is no need for me to go over the report’s recommendations; we have already heard them. However, it would be good to hear from the Minister this afternoon as to whether she has had the chance to consider those recommendations and understands where the Department intends to go in taking action to respond to them.

As the hon. Member for Strangford said in his opening speech, the report also supported surgical fires becoming classified as a never event. The NHS in England defines never events as

“serious incidents that are entirely preventable because guidance or safety recommendations providing strong systemic protective barriers are available at a national level and should have been implemented by all healthcare providers.”

Patient groups have argued that surgical fires should be classified as never events. They argue that if they were classified in this way, they could be monitored and investigated as such. Staff would also be empowered to manage incidents in the appropriate way.

However, the Government have recently said that they have no plans to revise the NHS never events policy and framework to classify surgical fires in operating theatres as never events. As the hon. Member for Strangford pointed out, the reason for that is that we currently have no national guidance or safety recommendations to prevent surgical fires in operating theatres. I endorse what he said. I think that the way to address that is to ensure that we have national guidance and safety recommendations and then to update the NHS never events policy. It would be good to hear from the Minister what progress, if any, has been made in developing that guidance and, if the Government intend to act in that way, when it might be published.

I would also like briefly to address some wider issues related to patient safety that are relevant to the debate. Unfortunately, in the last financial year prior to the pandemic 472 serious patient safety issues were classified as never events across the NHS in England. Clearly, that figure demonstrates that there is work to be done across the NHS to ensure everyone gets the best care and that improvements still need to be made. In striving for that, we of course need to listen carefully to the experiences of the patients affected and to ensure that staff feel safe to come forward during patient safety investigations and that processes are transparent, so that lessons can be learned.

We also need to do more to ensure that the environments in which care is delivered are safe. Currently, there is a £9.2 billion repair backlog across the NHS estate. That means that broken pipes and crumbling buildings are putting patients at risk. In the past financial year there were more than 1,600 serious patient safety incidents with an estates and facilities cause.

Although I am responding on behalf of the Opposition, I am sure the House and the Minister will indulge in me making a parochial constituency point. Whipps Cross hospital is in urgent need of redevelopment and refurbishment, and I think that is very much on the Government’s radar—I am led to believe that Whipps Cross is near the top of the list. The Minister may not be able to reply on Whipps Cross this afternoon—I appreciate that it is probably without the scope of what she was expecting to talk about—but the issue is none the less on the record for the Department to consider, and we will be very persistent about it on a cross-party basis locally.

Chronic workforce shortages across our health and care services are also putting patients at risk. We went into the pandemic with 100,000 vacancies across the NHS, including a shortage of 40,000 nurses. I am struck whenever I speak to staff working in the NHS, including the shadow Minister for mental health, my hon. Friend the Member for Tooting (Dr Allin-Khan), who has enormous experience in this respect, that too often staff are coming home from work worried about staffing shortages, patient safety and whether they have been able to deliver the best care. That is really important for patient safety and the confidence of staff working in challenging environments. In June, a report by the Health and Social Care Committee warned that staff burnout caused by workforce shortages was at an emergency level and posed

“an extraordinarily dangerous risk to the future functioning of”

healthcare services.

Last month, NHS leaders warned that pressures on the system were likely to have an impact on patient safety, and a survey revealed that nine out of 10 felt that staffing pressures were putting patients’ health at risk. It is clear that the NHS is now in desperate need of a serious plan to provide the modern, safe facilities and equipment that patients deserve, alongside a long-term strategy to recruit and retain the staff to deliver safe, quality care. The safety of patients must be the golden thread running through every aspect of healthcare delivery, and I want our healthcare system to be the safest in the world. I hope that the Minister will consider the points raised in the debate carefully and assure the Members present that the prevention of patient safety incidents, including surgical fires, is of paramount importance to her Department.

Since this is the last day before we rise for the recess, and in the light of the wider challenges facing the country, I wish you, Ms Rees, and all hon. Members and staff throughout both Houses of Parliament a very merry Christmas. I say a special thank you to Ministers and staff at the Department of Health and Social Care, the agencies for which they are responsible, the entire workforce across health and social care, the armed forces and the emergency services for all that they are doing to get our country through the pandemic, to respond to the challenges of the omicron variant and to get Britain boosted. I ought to wrap up, because I am due to get my booster later this afternoon, and I do not wish to miss my appointment. I look forward to hearing what the Minister says, and I wish her and all her civil servants and colleagues in the Department of Health and Social Care a very merry Christmas and a happy new year.

[Christina Rees (in the Chair)]

I echo everything the hon. Gentleman said in wishing everyone a merry Christmas and thanking them for everything they do.

Public Health

Wes Streeting Excerpts

Tuesday 14th December 2021 Commons Chamber

[Wes Streeting (Ilford North) (Lab)]

I begin by acknowledging that there are sincere and deeply held views on both sides of this debate and, indeed, on both sides of the House. I respect those who take a different view from the one I will be outlining on behalf of the Opposition, but we owe it to our country to have a debate worthy of the finest traditions of this House.

In the light of comments made in recent days by at least one Conservative MP comparing these measures to the situation in Germany during the 1930s, it should not be for me, as shadow Secretary of State, to point out that we are not living in the 1930s and that the Secretary of State and his team are not Nazis. On their shoulders rest the health of our nation and the responsibility to protect our NHS. Indeed, it is a responsibility we all share. They need our support, and they are owed better treatment than they have received from some on their own side in recent days and even this afternoon.

No matter how dysfunctional the Conservative party has become, the country can rely on Labour. We will act in the national interest, as we have throughout the pandemic, by putting public health before party politics and supporting the motions under consideration this afternoon. We do not do so lightly. Throughout the pandemic we have asked the British people to make big sacrifices to support the national effort against coronavirus—sacrifices that have impacted on lives, livelihoods and liberties. Whenever this House considers such measures, we owe it to the British people to explain why they are necessary. We believe these measure are a necessary response to the omicron threat, necessary to protect ourselves, necessary to protect the ones we love and necessary to protect our NHS.

We cannot yet be sure about the severity of the omicron variant, but we can be certain it is spreading, and spreading fast—faster than any other variant. Even if a smaller proportion of omicron victims are hospitalised, the rapid advance of the virus through the population could see large numbers of people admitted to hospital during the months in which the NHS is under greatest pressure. There should be no complacency about this. The winter months present the greatest pressures on the NHS in any normal year and, as we know, this is far from a normal year. The NHS is contending with winter pressures, a serious backlog, the delta variant and now the omicron variant. When people invoke the story of the boy who cried wolf, of the warnings that came before but never materialised, they should remember that, in the end, there was a wolf.

Many of the challenges facing the NHS are understandable, given the unprecedented challenges of the covid-19 pandemic, but we have to be honest and acknowledge that confronting these challenges has been made much harder because we went into the pandemic with NHS waiting lists at a record 4.5 million, 100,000 staff vacancies and 112,000 vacancies in social care. It is not just that the Government did not fix the roof while the sun was shining; they dismantled the roof and removed the floorboards.

Now the NHS is locked in a race against time: a race against the fastest variant of covid-19 we have seen to date and a race to get as many people boosted as possible before the end of this month. The Opposition support the Government in that task, and let me say on behalf of all of us in the Labour party to every NHS worker, every GP, every pharmacist, every public health official in local government, every member of our armed forces and every volunteer stepping up to meet this enormous task that we are with them 100%. If anyone can do it, they can.

[John Stevenson]

Can the hon. Gentleman explain why the Labour party did not support mandatory vaccinations for care workers but has changed its mind for NHS workers?

[Wes Streeting]

I will outline our position on that, but the hon. Gentleman will have to be patient because I will come on to that later in my speech.

We need to buy the NHS and its helpers some time. The measures put forward for consideration today are an attempt to do just that by slowing the spread of the virus whilst trying to protect Christmas so that people can enjoy the festive season safely, by limiting our interactions in the workplace, by wearing face coverings in settings where the virus finds it easier to spread, by testing before we attend large indoor gatherings, and by getting behind the booster roll-out to ensure that everyone is protected.

[Mr Perkins]

My hon. Friend is absolutely right that we are all very conscious of how important this time of year is to the hospitality sector, but does he agree that the greatest threat to the hospitality sector is not restrictions of the type that are before us today, but the sense that the virus is out of control, and widespread cancellations across the sector? So these restrictions enable the hospitality sector to survive in this really difficult time, but also enable us to take proportionate steps to ensure that the spike does not get out of control.

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. Indeed, one of our primary reasons for supporting the measures for consideration today is that we on the Labour Benches support business, and we want to support it through a particularly difficult time, when normally trading would be at its busiest.

The goal in the end must of course be to learn to live with the virus. That means effective vaccination, antiviral treatments, and public health measures that have minimal impacts on our lives, our jobs and our businesses. So let me take each of the measures in turn and explain why Labour supports them, and no doubt take interventions.

First, on mask wearing, no one enjoys wearing a mask—I certainly do not, but it is nothing compared with the costs that more draconian restrictions have on our lives, livelihoods and liberties. Masks are simply a price worth paying for our freedom to go out and live our lives during this pandemic. They are proven to be effective, and not only that, but in times of rising infections, when people are feeling increasingly cautious, it is vital to our economy that people feel safe boarding a busy bus or entering a crowded theatre. In our view, the Government should never have got rid of the requirement to wear masks in those settings, but we know why they did. We have counted, in recent weeks, hon. Members on the Government Benches not wearing masks. I am glad to see that compliance has risen somewhat considerably. We know that the Prime Minister no longer has the authority to lead his own party, but I am grateful that Members on the Government Benches have at least listened to their Health Secretary.

Turning to the vaccine pass, and testing to enter nightclubs and large events, I welcome the fact that the Government have listened to representations from Labour and responded. The Labour party has argued consistently against vaccine passports and insisted on people having the option of showing a negative test. Further, we argued that such passes should not be required for access to essential services. On both counts the Government have listened and amended the proposals, and we can support the measure before us today. It is not a vaccine passport. It is, in effect, a default requirement to show a negative test to enter venues where the virus is most likely to spread, with an opt-out available to those with an NHS covid pass.

[Lloyd Russell-Moyle (Brighton, Kemptown) (Lab/Co-op)]

My hon. Friend makes a very good point on that. Is not the reality that if we did not introduce these measures there would be a danger that our night-time economy—pubs, venues and other events—would have to shut completely? So this pass is actually a pass for freedom to allow us to continue to enjoy activities that otherwise would be shut down, and the libertarians opposite should be welcoming it, not bemoaning it.

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. Let me be clear: we in the Labour party support this approach because we support British business. This is about giving people the confidence to go out and about despite the presence of omicron.

[Neale Hanvey]

I thank the shadow Secretary of State for giving way. I wonder whether he shares my concern about reports over the past couple of days that there has been an absence, or a lack, of lateral flow devices to be sent out for testing. What is also alarming is the lack of support for the domestic diagnostics market and the manufacturers in this country of lateral flow devices that are much more accurate and reliable and superior to the current Government lateral flow devices. If these devices are to make a difference, we must have the best quality devices in place.

[Wes Streeting]

I agree with the hon. Gentleman. Of course, in order for this measure to work as effectively as we would wish, there has to be an adequate supply of lateral flow tests. I heard what the Secretary of State said yesterday about the availability of testing, but it is no good if the tests are in the warehouse; they need to be available to people where they need them, when they need them. We have had supply issues and those really do need to be resolved, not least in the light of other measures, which I will come to shortly.

[Sammy Wilson]

Does the shadow Secretary of State not accept that rather than giving confidence to people, these measures, and the background against which they have been introduced, have actually reduced confidence? We have predictions of 75,000 deaths and we are telling people that they cannot go to venues unless they have certain tests; the experience in Northern Ireland is that the hospitality industry has already lost millions of pounds in orders coming up to the Christmas period because people are afraid to go out.

--- Later in debate ---

[Wes Streeting]

I will say to the right hon. Gentleman that it is my understanding from dispatches from the shadow Secretary of State for Northern Ireland, my hon. Friend the Member for Hove (Peter Kyle)—of course, Northern Ireland is ahead of England on this—that he had a perfectly nice time out last night enjoying the best hospitality that the people of Northern Ireland have to offer. I think people are drawing confidence from this. Let me also say that we should draw on the experience of other countries. Look at countries with strict covid passport rules, such as Italy, France and Denmark; all have seen their retail and recreation sectors fare far better than those here in the UK because there has been consistency and confidence.

With passes and lateral flow tests, venues can operate at 100% capacity, punters can be confident that they are safe to attend and enjoy themselves, at this time of year the show goes on, and everyone stays in a job. Without these measures, with rising infections and more hospitalisations, we would risk seeing the Government forced to impose more draconian measures on these sectors, shutting down our cultural sector and collapsing the economy once again. I think we should be confident about this.

Let me address the tension—it is a reasonable question —in the message that people should work from home if they can but that they can go out. I make no apology for trying to safeguard social interactions between people, their families and their friends at Christmas time. I also make no apology whatsoever for supporting our hospitality industry, which has been battered by the pandemic and which enjoys our support—our confident support, our full-throated support, and our support at the table and the bar in the coming days.

[Mr William Wragg (Hazel Grove) (Con)]

Can we take it from that that the hon. Gentleman is in favour of extending the certification, or vaccine passport, to all venues?

[Wes Streeting]

For now, we think the Government have struck the right balance. The measure is limited to nightclubs and larger venues. However, as the Secretary of State knows, we listen to the chief medical officer, we listen to the chief scientific adviser, we listen to the scientific advisory group for emergencies, we listen to the NHS and we make decisions based on evidence. If ever the Government want to come forward with further proposals, we will consider them in a genuinely bipartisan way and we will act in what we believe to be the national interest. I do not think anyone would expect less of us.

[Munira Wilson (Twickenham) (LD)]

With the covid passes, there is the option of using a lateral flow test or double vaccination. Does the hon. Member recognise that double vaccination, which many people will use, gives a very false sense of security? We know that someone can be vaccinated and still transmit. Most of the people we know getting covid at the moment have already been vaccinated. Double vaccination is not very effective, and it will give a real false sense of security.

[Wes Streeting]

I think the hon. Member should look at the evidence from our friends on the continent, which is that this approach not only works in giving people confidence to go out and enjoy themselves, but encourages people to take up vaccination. On that basis, I think the Liberal Democrats ought to reconsider their position.

[Holly Mumby-Croft (Scunthorpe) (Con)]

The shadow Secretary of State has obviously spoken to lots of people and he is really concerned about transmission. Could he tell the House the Labour party’s view on how much transmission is reduced by two vaccinations?

[Wes Streeting]

I direct the hon. Member to the SAGE advice, which is that there is some evidence—I would not put it any stronger than that—on the reduction of transmission. As I say, our primary reason for supporting the measure is to give people the confidence to continue to access hospitality and an added incentive to take up vaccination. On both those tests, our friends on the continent have shown us a better, effective way forward. I dare Government Members to suggest that France, for example, given its history and culture, is not a country that values liberty strongly.

Let me move on, because I must make progress. For the passes to work, people must be able to access tests easily and readily. We cannot continue with the situation in which tests are out of stock and unavailable to the public who are required to take them—not if covid passes are required to work and not if close contacts of covid cases are to be able to take the daily tests required. This morning, the Government’s website showed PCR tests unavailable throughout England, and the only region where lateral flow tests are available today is the south-east. We need immediately to resolve such technical issues and the practical issues of test delivery. The measure on daily testing is the one measure that seems to have united the House in agreement, so the Secretary of State really needs to get a grip and ensure we have access to the tests we need.

On the flexibility to work from home, we have called for workers to be given that flexibility for months and we support the guidance for them to do so where possible. I have addressed the contradiction in respect of people working from home and going out to Christmas parties. We want to protect people’s ability to enjoy Christmas safely this year, which is one of the key arguments for the measure. By limiting people’s interactions at work without disrupting their ability to do their work, we thereby lower contacts and infections and hope to preserve people’s ability to go ahead with the social interactions that they cherish most at this time of year.

As the Prime Minister rather clumsily and unhelpfully tried last week to open a “national conversation” on mandatory vaccinations for the country at large, I wish to make it crystal clear that we do not support mandatory vaccinations in general. I welcome what the Secretary of State has said this afternoon—not the first time he has had to clean up the Prime Minister’s mess. We believe the vaccine is safe and effective and that everyone should choose to have it. I cannot give any stronger endorsement than to say that I have had my first two jabs and will be having my booster on Thursday. I would not take the vaccine or recommend it to others unless I believed it was safe.

I recognise that mandatory vaccination for NHS staff is a difficult issue for colleagues from all parties and in our NHS, but the NHS has asked us for it, patients want it and we are persuaded that the threat of omicron makes it even more important for staff to be vaccinated to protect themselves and to protect the public they serve.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I draw the House’s attention to my declaration, as a practising NHS doctor, in the Register of Members’ Financial Interests.

I commend the hon. Gentleman for the consensual way he is approaching today’s debate and for the many points he has made with which I agree. On mandatory vaccinations for NHS staff, before I could train in medicine I had to have a Bacillus Calmette-Guérin injection for tuberculosis and a hepatitis injection; otherwise, I could not have practised medicine. It was about protecting my patients. It is the duty of all healthcare professionals to put their patients first, which is why it is absolutely right that they should have mandatory covid vaccinations. Does the hon. Gentleman agree?

[Wes Streeting]

I strongly endorse what the hon. Gentleman said. Infection control is going to be a real challenge this winter because of the nature of the omicron variant. By ensuring that the NHS workforce is fully vaccinated, we will protect not only patients but staff, who already put themselves in harm’s way enough. As the hon. Gentleman, who speaks with real knowledge and expertise, said, this is not a new precedent: NHS staff are already required to inoculate themselves against other diseases. It is a professional duty. The NHS clearly believes that the April deadline gives sufficient time to persuade the workforce to protect themselves, their patients and their loved ones without there being an exodus of staff.

[Dr Julian Lewis (New Forest East) (Con)]

I supported the requirement for people working with vulnerable people in care homes to be vaccinated or, if they would not be vaccinated, to be removed from direct contact with vulnerable people. Can the hon. Gentleman tell me—I did not get a chance to ask the Secretary of State—whether this proposal for members of the NHS who have not been vaccinated will affect only frontline staff who interact with the vulnerable, or whether it will apply to people throughout the NHS who might have no contact with the vulnerable? That will affect the way I cast my vote today.

[Wes Streeting]

I hope I can reassure the right hon. Gentleman that it will not be a case of saying to people, “If you don’t take up the jab, that’s it—you’re out.” There will also be the opportunity for redeployment to other roles where vaccination would not be mandatory. I hope that gives him the reassurance that he needs.

[Barbara Keeley]

My hon. Friend is handling his speech in just the right way. There is a balance of rights here, and patients have a right to be treated by staff who are fully vaccinated to protect them. I have a constituent who is clinically extremely vulnerable. She contacted me to say that she was not willing to go to her necessary hospital appointments once she realised that the hospital staff were not fully vaccinated. Does my hon. Friend agree that we have to think of that pretty large number of clinically extremely vulnerable people in this country?

[Wes Streeting]

My hon. Friend is absolutely right.

We have heard the arguments in outline: this is about protecting staff and patients; it is not a new precedent; and there is a professional obligation, which makes it slightly different from the experience in the social care workforce. I will come on to talk about what the Government need to do. Those are broadly the arguments—

[Simon Hoare (North Dorset) (Con)]

Will the hon. Gentleman give way?

[Wes Streeting]

If the hon. Gentleman just lets me make this point, I will certainly give way.

Those are broadly the arguments, but I would ask Members on both sides of the House to think about those NHS staff who go to work every day feeling unsafe because their colleagues are not vaccinated. If that is not persuasive enough, I ask them to think about how they would feel if a loved one were treated in a clinical setting or care home by an unvaccinated member of staff through whom they contracted covid and, with it, serious illness or worse. If I lost a loved one through serious illness in those circumstances, I am not sure that I would be very forgiving about the decisions made by Members of this House.

[Anthony Mangnall (Totnes) (Con)]

I appreciate the point that the hon. Gentleman is making, but that is not what the results of the survey of NHS staff in the healthcare and social care workforce found, which was that 55% of people in the NHS were against this proposal. How does he respond to that?

[Wes Streeting]

I have no doubt whatsoever that opinion in the workforce is divided. I do not dispute that, and it is divided partly because people resent the mandate. Ultimately, however, it comes down to this. It is not just about the broad arguments I have outlined or the specific cases we might be confronted with without this protection; we have to ask whether we as a House think it is acceptable for people working in health and social care, who have a duty of care to their patients, to say, “I am making a choice to put them at greater risk. I am working against the very principles that encouraged me to sign up to my vocation in the first place.” That is why, on balance, I think it is the right measure, but I will come on to talk about the way in which we need to take the workforce with us and what we need to do ahead of April.

[Andy McDonald]

My hon. Friend is setting out his response to these proposals with great care. On the vexed issue of mandatory vaccinations, does he acknowledge that 97% of those in my trust have been properly vaccinated and that a significant proportion of the remaining 3% are new starters making their journey towards proper vaccination? It is therefore not that clear. We have heard the responses from the British Medical Association, Unison, the Royal College of Nursing, Unite, the Chartered Society of Physiotherapy, the GMB and the Royal College of General Practitioners, who are opposed to making vaccination mandatory and prefer persuasion to coercion. Does he not think that we should be adopting that approach?

[Wes Streeting]

That is a helpful intervention from my hon. Friend. Let me be clear: I absolutely acknowledge the views that have been put forward by the royal colleges and by staff trade unions. Government ought to take them seriously and work heavily with them in this next phase, where there is still a window for persuasion. I also point the Government to the success that the Welsh Labour Government have had in persuading the workforce; there is much to learn and time available, and we have to work in a spirit of partnership.

[Several hon. Members rose—]

[Wes Streeting]

I will say more about that in a just a moment, because the hon. Member for North Dorset (Simon Hoare), at the back, has been very patient.

[Simon Hoare]

I am grateful to the shadow Secretary of State for giving way. May I endorse and welcome what he said at the start of his speech with regard to comments about the Nazis? I called that out yesterday and he was right to do so at the Dispatch Box. I was looking through my inbox from the start of the pandemic and lockdown, and almost every person working in the care sector or the NHS in my constituency was saying, perfectly legitimately, “When the vaccine is available, we must be at the front of the queue, because we are dealing with the vulnerable and it is our duty to get vaccinated.” I do not think that has changed, and I think he is absolutely right, as is the Secretary of State, to say that those caring for the most vulnerable in society should, to try to reduce the risk that they face, be vaccinated.

[Wes Streeting]

I agree with the hon. Gentleman. We have a big effort to boost the booster this month and we have to boost the workforce as well, and make sure that people are supported.

[Dame Angela Eagle]

rose—

[Kim Johnson (Liverpool, Riverside) (Lab)]

rose—

[Wes Streeting]

This is a difficult decision—two Members from the same region—but my hon. Friend the Member for Liverpool, Riverside (Kim Johnson), right in the corner, has been very patient, so I will give way to her. I will then come to my hon. Friend the Member for Wallasey (Dame Angela Eagle).

[Kim Johnson]

I appreciate my hon. Friend giving way. He is making an excellent speech; however, the British Medical Association has identified some serious concerns about mandatory vaccines—the fact that we have a chronically under-staffed NHS. Does he believe that this policy is likely to have a significant impact and cause more harm than good?

[Wes Streeting]

That is such an important point, and I am grateful to my hon. Friend for making it. There is a reassurance I would like to offer her and a call to action that I would like to issue to the Government. The reassurance is that there were concerns about what would happen to the social care workforce, which very much influenced Labour’s position on that statutory instrument at the time, but we did not see the collapse in the social care workforce that was warned of and there was lots of evidence that there was a positive impact on take-up.

I say to the Secretary of State and his team that if they are asking the health and social care workforce to do their duty as professionals, the Government must show greater respect to their professional voice and experience—on pay, conditions and workload. It is often said that the NHS runs on goodwill, so I would like to see the Government showing greater goodwill in return and engaging with the royal colleges and staff trade unions, not just on the plan for vaccine roll-out to their members, but on the debate about the future of our health and social care systems and the big workforce challenge.

On vaccinations, there is still precious time to do the work on persuasion. I have met the trade unions in recent days, including a great meeting with Unison yesterday—I should declare that I am a member of Unison. Unison had some really helpful advice and practical feedback about the kind of conversations with occupational health that are making a big impact in giving staff the confidence to choose to take the vaccine well ahead of the deadline. Of course we would much rather persuasion than compulsion.

[Ms Marie Rimmer (St Helens South and Whiston) (Lab)]

In St Helens, 99% of care home staff are vaccinated, and at Whiston Hospital, the best one in the country, 91% have had the first vaccine, 89% the second vaccine and 64% the booster. That has all been done with persuasion, not with the threat of the sack. These people are in a vocation. It is not just a job to them; they believe in the patients. We must not get to the stage where we are threatening people. The GPs have even been involved in persuading the care home staff. Everyone has been involved for some considerable time and that is the way to do it—

[Madam Deputy Speaker (Dame Eleanor Laing)]

Order. Let me just make this clear: more than 40 people wish to speak this afternoon and if people make interventions, it is simply not fair on those at the end of the list who will be trying to speak later on. The hon. Lady is only one of many. The shadow Secretary of State is being very fair, as was the Secretary of State, in answering all the questions, but I must ask people to be reasonable.

[Wes Streeting]

It may have been a speech rather than an intervention, Madam Deputy Speaker, but I thought it was a very good one, and I welcome what my hon. Friend has said.

[Dame Angela Eagle]

Will my hon. Friend acknowledge that anti-vaxxers are using vicious and very effective psychological propaganda to upset and worry people who may be vaccine hesitant, particularly about issues with fertility, whether the vaccine is halal and all those things? Does he agree with me that the Government should do much more to counter this very vicious and damaging propaganda?

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. This comes back to the point I made about the Government engaging with the staff trade unions and the royal colleges. Whatever their policy position on having mandatory vaccination, the Secretary of State will find in them willing allies who want to help the Government to persuade colleagues to engage with them and to deal with some of these dangerous conspiracy theories that are knocking public confidence, and creating real fear and anxiety entirely without basis. When the Minister for the Cabinet Office concludes later, I hope that he will set out how the Government plan to engage and that he will give an undertaking to work with the staff trade unions and the royal colleges, because that would do so much to achieve the objectives that we all share, but also to raise morale in the workforce, who often feel that they are slogging their guts out for the Government, but do not get the hearing they deserve.

[Bob Seely]

The hon. Gentleman is making a very good speech, and I apologise for interrupting him, but on a point of science, will he just accept that he has got it a little bit wrong? Someone having the vaccine does not stop them spreading it; it just makes it much less likely that it will harm them badly. Someone can have the vaccine and still spread it, and to imply otherwise is just wrong.

[Wes Streeting]

The hon. Gentleman has called repeatedly from a sedentary position that I do not know the science, but I have said nothing of any sort to contradict the points he has just made.

With respect to Conservative Members, particularly those who oppose these measures, what they are missing is that it is indisputable that the booster does provide greater protection than the first and second jabs, that vaccination—full stop—provides better protection, and that if we are talking about NHS pressures and workforce pressures, the biggest danger is that the virus sweeps through the health and social care workforce, knocks a load of people out in the middle of the busiest period for the NHS, and then the system topples over. I do not know why it has to be explained again and again to Conservative Members that the objective is to protect the NHS and to stop it toppling over at a critical time. The points about the severity of the virus and the efficacy of the vaccine in preventing transmission or serious illness are largely secondary. We know that the virus is spreading, and doing so rapidly, and we know that if it rips through the health and social care workforce, that is the biggest risk to the NHS—that is what will topple it over. Conservative Members’ constituents will not thank them one bit if they allow that to happen.

[Clive Efford (Eltham) (Lab)]

My hon. Friend is making an excellent speech and putting his case very forcefully. On the issue of coercion versus persuasion and involving trade unions and the royal colleges in NHS managers taking the staff with them, what was not respected by the Secretary of State when he was asked about redundancies is that this is a retrospective change in people’s terms and conditions, and even people who are vaccinated will be resistant to the change being imposed upon them. We have to go forward carefully and take the staff with us. Will my hon. Friend urge the Government to work with the royal colleges and trade unions to take this forward?

[Wes Streeting]

My hon. Friend makes such an important point. Going back to the staff surveys, particularly given that the overwhelming majority of staff are vaccinated, it is not that they do not want their colleagues to be vaccinated, but that they have concerns about the way in which the Government are going about this. We accepted from the Government and from NHS England a very clear view that omicron has raised the stakes in this regard, which has had a big bearing on our position. It is very difficult for me and my colleagues on the Labour Benches to put ourselves in a position that is on the other side of the argument from the NHS and from the public, but the point about engagement is really important. The Government must work with and take the workforce with them. It is not good enough for us to just clap for the NHS, or clap for carers; we must work in partnership with them and respect that these are people who have given their lives to public service and caring for others. They do care. They will instinctively be on the right side, but they just need some persuasion, some patience and genuine engagement and that is where the Government have gone slightly wrong.

[Graham Stringer (Blackley and Broughton) (Lab)]

My hon. Friend started off his speech in an excellent way and has got better as he has gone through it. I say that, but I will almost certainly not be in the same Lobby as him on some of the votes this evening. There is a general point to the specific point that he is making on vaccines, which is that the Government should be clear, explicit and transparent on every issue that they raise if they want to take with them people who are not just worried about vaccines but worried about this whole affair. Repeatedly, the Government have refused to do a cost-benefit analysis on the impact of their policies. We have before us now a number of statutory instruments without impact assessments. Does he agree that that information should be available?

[Wes Streeting]

Let me say to my hon. Friend that, in his intervention, he started off well, dipped in the middle and then got better at the end. He made some absolutely fair points about impact assessments and transparency. In fact, I can see the Vaccines Minister waving impact assessments at me, so I am sure that she will make them available to my hon. Friend.

It comes back, as we have discussed at various points today and previously in relation to these sorts of restrictions and measures—it is how I began, and will begin to close, my contribution—to how we really cannot be complacent when it comes to public support, public compliance and public consent for the measures that we are considering. We know that we have asked so much of the British people and they have played their part. We also know that recent events have dented their trust and confidence and their willingness to comply, because they have seen No.10 saying one thing and doing another. That makes it even more important that, when we discuss measures that impact on people’s lives, livelihoods and liberties, we have these sorts of exchanges, look over the evidence rigorously, test each other’s assumptions and come to a conclusion.

With some of the exchanges that we have heard today, people across the country on both sides of these arguments can at least take some reassurance from the fact that, when these matters are under consideration, we do take them seriously. The Government could do a little better sometimes on bringing measures forward in advance of their implementation and on setting out the rationale and argument, and not just assuming that, because measures have been supported by the public previously, they will be supported today. I think we have public support for the measures under consideration this afternoon, but we should not be complacent about it. That is why it is right that we spend so much time exploring these issues.

[Several hon. Members rose—]

[Wes Streeting]

I shall take one or two more interventions and then I shall conclude.

[Seema Malhotra (Feltham and Heston) (Lab/Co-op)]

My hon. Friend is making a very important point: we need to make decisions on the evidence that is available. Does he agree that having the debate today and passing these measures tonight is urgent? We have heard that the doubling rate of omicron is shortening. If we are to protect the public, our families, our communities, and the NHS in the run-up to Christmas and beyond, these measures need to pass today.

[Wes Streeting]

I agree with my hon. Friend, and particularly in this city. The reproduction rate of this virus is shortening every day and the numbers that the Secretary of State set out in his opening remarks should concentrate minds before people walk through the Division Lobby this afternoon. Fun though it might be to see the Government in hot water and struggling in votes, it is not in the national interest and that should be the thing at the forefront of our minds.

[Sara Britcliffe (Hyndburn) (Con)]

Does the hon. Gentleman agree that one thing that will reassure Members across the House is a commitment from the Government at the Dispatch Box that, if further restrictions were to come into play, a vote will be had in this House?

[Wes Streeting]

I agree with the hon. Lady. I appreciate that she is a newer Member of the House but I dare say she watched our proceedings before being elected, and we cannot have spent so much time talking about parliamentary sovereignty only to then throw it out of the window in the next Parliament, so her point is well made. The shadow public health Minister, my hon. Friend the Member for Denton and Reddish (Andrew Gwynne), and I have already agreed: he will bring the dinner, I will bring the pudding, and we will see if the Commons shop is doing crackers on discount if we meet over Christmas.

Finally, and seriously, we think there are areas where the Government can go further without impacting on people’s lives, livelihoods and liberties and should do so. On ventilation in schools, young people have borne the brunt of this pandemic and we owe it to them, to their education and to the staff who support them to make sure that their schools are properly ventilated. They cannot wait until October next year for a review to be published; we need action now. In winding up, can the Minister for the Cabinet Office say something about that? On jabs for young people, the Christmas holidays seem to us to be an ideal time to get young people vaccinated, so when do the Government think we can see action on that front?

Finally, on statutory sick pay, as we have heard very powerfully from my hon. Friends, there are people out there who are forced to choose between doing the right thing by their families and doing the right thing by public health because they simply cannot afford to isolate at home. So we again implore the Government to act by making sure that higher statutory sick pay is available to people immediately so that they can afford to do the right thing.

We have not played games with these votes: we are not exploiting the divisions in the Conservative party to inflict defeat on the Government for the sake of scoring political points. The threat facing the country is too serious and Labour takes our duty to the country seriously. The Tories may be in disarray but the public can rely on Labour to keep the country safe, to do the right thing and to support these measures today, and we trust the British people to do the same.