Special Educational Needs and Children’s Mental Health Services

Yvonne Fovargue Excerpts

Wednesday 9th February 2022 Westminster Hall

[Yvonne Fovargue (in the Chair)]

Before we begin, I remind hon. Members to observe social distancing and to wear masks.

[Laura Farris (Newbury) (Con)]

I beg to move,

That this House has considered special educational needs and children’s mental health services.

It is a pleasure to serve under your chairwomanship, Ms Fovargue. It is timely to be holding this debate in Children’s Mental Health Week. Today I want to focus on one aspect of mental health—specifically, the conditions that fall under the wider banner of special educational needs.

The difficulty that families in West Berkshire experience in seeking a diagnosis has been raised with me since I was first elected, but it was not until I conducted a constituency-wide survey last summer that I understood the extent of its prevalence and urgency. For many people in West Berkshire, accessing CAMHS—child and adolescent mental health services—for diagnosis of a potential learning difficulty is an extraordinary uphill battle. Waiting times regularly exceed two years for an autism diagnosis and can be substantially longer. I know that this problem also exists in other parts of the country.

When I was preparing for this debate, I asked affected families to get in touch with me, and was overwhelmed by responses, which came from everyone from mums and dads through to headteachers and GPs. The Minister whom I expected to respond to the debate, the Minister for Care and Mental Health, my hon. Friend the Member for Chichester (Gillian Keegan), is not in her place, but I had a word with the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Lewes (Maria Caulfield), in advance. The issue as it affects West Berkshire is less about a lack of funding—the Berkshire West clinical commissioning group has received additional investment for this—and more about accountability and the adequacy of the service. I have had too many letters and emails to refer to them all, but I would like to tell hon. Members about three of my constituents, whose stories capture the issue more widely.

The first is Steffi Whelan, who told me about her 11-year-old son. He has been waiting more than two years for a CAMHS appointment. His problems began seriously in year 4. What began as outbursts of screaming in class evolved into something more disruptive. Sometimes he would tear up work or behave in a way that was completely unsustainable for the teacher. In time, he was moved from that primary school to another, and his parents have been told that he will not be emotionally able to move on to an ordinary secondary school. He is now nearing the end of year 6, and despite all of that, the family are still waiting for their first appointment.

Melanie Fenemore told me about her nine-year-old son, Archie, who was strongly suspected to have autism. Melanie was first referred to CAMHS in October 2018. She filled out a load of complicated forms, and in January 2019 was told that her son was on the waiting list and to expect a 20-month delay. In fact, she waited 27 months before he was seen in April last year. At the time of the assessment, the view was formed that he probably did not have autism spectrum disorder but had something more equivalent to attention deficit hyperactivity disorder, and he was referred to the ADHD team. Again, Melanie was sent a bunch of forms, which she described as “pretty much identical” to the previous ones, and her son was sent back to the bottom of a waiting list. The family have been told to expect a 36-month wait. If that projection is correct, Archie will have been on a waiting list for six years, from the age of six to 12, by the time he receives his first appointment. During this time, Archie’s mum tells me, he has

“expressed a desire not to be alive.”

He has a tendency towards violence, born out of frustration. She says:

“I am sometimes at the receiving end of Archie’s violent outbursts which hurt more as he gets older.”

The Buller family’s young daughter, Daisy, has been waiting more than two years for an autism diagnosis. By the time her mum contacted me last July, her daughter was self-harming and barely attending school, even though she was in the crucial year 10. Her mum wrote to me:

“This is 5 years since we first started struggling and we are no closer to helping my daughter. Simply one question Laura, in today’s age, how is this Ok.”

One headteacher of a primary school described the waiting times as “absolutely awful”, with another saying that the situation has got worse in recent years. Valiant efforts are made by West Berkshire Council to offer support through its Emotional Health Academy, but that is not a substitute for a clear diagnosis. A head at a primary told me that until they get a CAMHS diagnosis,

“The child may be excluded or at risk of exclusion, their anxiety will often worsen and they don’t attend school, the school can try but it cannot put in the support that it is required until there is an Educational Health Care Plan in place and CAMHS diagnoses are critical to this.”

The headteacher of Kennet School in Thatcham said,

“While schools will have an indication of what a pupils needs may be, a diagnosis through CAMHS leads to targeted work and accessing additional services to further support the child and their family. A huge part of a SEND diagnosis is the support”.

It enables the young person to

“understand themselves. Where a diagnosis is not yet given, this delays the essential step for the young person, causing more erratic behaviours and often fall-out at home as well as at school.”

The short point is that a timely CAMHS diagnosis is often crucial for life chances. It hardly needs to be said that a child who is repeatedly excluded can easily end up in a pupil referral unit. People with neurodiverse conditions are significantly over-represented in the prison estate and the youth estate. Their employment opportunities are often compromised, anyway—it is said that only one in five people with autism sustain full-time employment—and in teenagers there is a significant correlation with depression and self-harm. Timely diagnosis and the correct support is crucial for addressing that.

I want to focus on the Government response so that my speech does not sound like a barrage of criticism. I know that the Government attach significant importance to improving outcomes for those who are neurodiverse. The SEND review, to be published soon, is a testament to that, as is the work being done to ensure that children with autism will have a designated key worker within the next year or so. Hundreds of millions of pounds of additional funding was made available for CAMHS in the spending review, and I have to concede that West Berkshire is one of the first 25 areas that will pilot the schools-based mental health support teams.

I said at the start of my speech that Berkshire West CAMHS received significant investment from the Government last year—£1.6 million in April 2021. In fact, when I spoke to the service a few months ago, it said that funding was no longer the problem. The money will enable it to recruit another 27 members of staff that it so badly needs, although so far it has managed to recruit only 12.

Despite a detailed local transformation plan published last September, in which some laudable ambitions were set out, including a goal of reducing waiting times for diagnoses to just a year by next month, when I spoke to Berkshire West CAMHS, it conceded that there is in fact no fixed deadline for reaching that target, so it is not really a target at all; it is nothing more than a general ambition. There is no consequence if the service fails to reduce waiting times. I regret to say that that is not good enough.

The overall impression of Berkshire West’s child and adolescent mental health service is that there is a serious lack of urgency or accountability. Dr James Cave, the well-respected medical director of the Downland Practice in my constituency, wrote to me:

“I think it is important that you understand the depths of despair GPs feel about the local CAMHS service. Remote, unresponsive, closed, uncommunicative sums them up. It feels as if they are always looking for a way NOT to have to see a child. They demand detailed referral forms from us…and then find reasons not to see a child. If they do accept a referral the wait is forever and then often the intervention is a fixed predetermined intervention that does not take”

into account

“the needs of a child.”

I am not seeking to humiliate anyone, but families in West Berkshire are being failed, and it is my role and my responsibility to fight for them.

The Health Secretary has said time and again that the Health and Care Bill currently making its way through the House will deliver better accountability. Speaking in the debate in July, he stated:

“The third theme of the Bill is greater accountability.”—[Official Report, 14 July 2021; Vol. 699, c. 430.]

He said that people have the right to expect “clear lines of accountability” for how every priority is delivered. So my plea—a cri de coeur—from the many families in West Berkshire is that the Department demands better accountability from CAMHS in West Berkshire and across the country. We want details of how that £1.6 million will be spent, and firm commitments to reduce waiting lists, with consequences if managers fail to deliver.

The issue is not confined to West Berkshire, but it is stark within it, and I therefore speak today for the families that I represent and all those families across the country who are experiencing the same struggle.

[Yvonne Fovargue (in the Chair)]

As there is considerable interest in the debate, I will set a formal time limit of four minutes for speeches.

[Olivia Blake (Sheffield, Hallam) (Lab)]

I thank the hon. Member for Newbury (Laura Farris) for securing this important debate. I was not expecting to be called quite so early.

I will focus my remarks on my own personal experience of having ADHD, dyslexia and dyspraxia, none of which were recognised during my schooling. I want to highlight this because it is a journey of things going wrong and children not being fully supported.

By the age of 12, the average child with ADHD has received 20,000 more negative comments about their behaviour than their peers. “Lazy,” “distracted,” “too chatty,” “fidgety,” “failing to meet potential,” “disorganised” and “in disarray”: those were all comments that were levelled at me as a child, and they stick in my brain to this day and make me consider all my actions daily. This has led to huge feelings of anxiety and depression—a feeling that I am always doing something wrong. My ADHD was diagnosed only last year, and I have only just started taking medication, which has been life-changing.

There are two sides to the coin on this issue. When children and young people are supported at home and in school with the love and understanding that they deserve and need, they can flourish, as I feel I have flourished. I thank my family for the support that they showed me throughout my education to enable me to get to where I am today.

However, I meet too many children whose stories are still the same: their needs are not recognised or are not severe enough to merit critical help, and they are stuck in the middle, reaching their potential in some subjects and failing in others. They also feel that they are not listened to, that they cannot access support and that there is something critically wrong with them. They internalise negative comments about themselves, which is really damaging in the long term.

There are also lots of huge positives to being neurodivergent. Neurodivergent people are more likely to be entrepreneurs, and to take the risk of setting up businesses. However, the dark side is that they are more likely to try illicit drugs and to get involved in crime. There really are bright and dark sides. To any young person who is struggling at school, I say: “Don’t worry. There is always something else for you to strive towards. You just need to find what you are good at, and you will relish that opportunity.” No one should be held back because they have a diagnosis of ADHD, autism, dyslexia or dyspraxia. All children should be supported to get the best out of themselves.

However, far too often our education system is one-size-fits-all. I am really proud to chair the all-party parliamentary group for special educational needs and disabilities. It is so important that we change the classroom and home environment for these children, so that their behaviours are understood, and they can fully experience school and get to where they need to be.

So many things have gone wrong during the pandemic. Some children with autism have flourished through online learning, but others have found themselves isolated from their friends, peers, teachers and support. Several organisations are yet to start providing the therapeutic interventions that they are meant to provide under children’s education, health and care plans, and this is causing huge disruption to the ability of those children to thrive. Three quarters of disabled children have seen progress in managing their conditions and overall development regress in the pandemic. This is urgent and critical. Those who receive a diagnosis of dyslexia should also be screened for ADHD or other neurodivergent conditions, because the crossover is huge. We are letting our young people down by not helping them to get the tools they need to understand themselves—first and foremost—and how they fit in with the world.

I hope that the Minister will think more about how we can intervene as early as possible to avoid young people becoming incredibly depressed and anxious about just who they are—because they are round pegs trying to fit into square holes. It is critical that we support young people to thrive and give back to our society and economy by being the great pioneers and entrepreneurs that we all want to see.

I also have the privilege of having someone with autism in my family—

[Yvonne Fovargue (in the Chair)]

Order. I call Aaron Bell.

Dame Carol Black’s Independent Review of Drugs Report

Yvonne Fovargue Excerpts

Wednesday 27th October 2021 Westminster Hall

[Yvonne Fovargue (in the Chair)]

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

[Dan Carden (Liverpool, Walton) (Lab)]

I beg to move,

That this House has considered Dame Carol Black’s independent review of drugs report.

It is a pleasure to serve under your chairmanship, Ms Fovargue. I refer Members to my entry in the Register of Members’ Financial Interests. The damning conclusion of part two of Dame Carol Black’s review, setting out a way forward on drug treatment and recovery, was that

“the public provision we currently have for prevention, treatment and recovery is not fit for purpose, and urgently needs repair.”

I have called today’s debate because the report’s recommendations are too important to be left gathering dust on ministerial bookshelves. I want Dame Carol’s words ringing in ministerial ears. She says:

“Government faces an unavoidable choice: invest in tackling the problem or keep paying for the consequences. A whole-system approach is needed…This part of my review offers concrete proposals, deliverable within this Parliament, to achieve this.”

Of the review, Dame Carol says:

“It calls for significant investment, but the payoff is handsome: currently each £1 spent on treatment will save £4 from reduced demands on health, prison, law enforcement and emergency services. I am hopeful that the recommendations will be welcomed by this government as they strongly support its crime reduction and ‘levelling up’ agendas.”

The 32 recommendations are a gift to the Government, and should be a moment for change. It is fitting that the debate falls on Budget day. The economic cost of drug misuse is upwards of £20 billion each year; yet the spending on prevention and treatment stands at just £650 million. The recommendations give hope that real change is possible. Addiction is a national crisis. Drug and alcohol-related deaths are the highest on record, at the very moment that treatment services are most ill-equipped to deal with the soaring need.

Forward Trust estimates that more than 2 million people are in need of help with alcohol, drugs or gambling, and its recent YouGov poll showed that 64% of people said that they knew someone personally struggling with addiction. Since I talked openly about my personal experience of addiction and recovery, I have been over- whelmed by the thousands of people who have reached out to tell me their personal stories—of the horror of addiction, and the blessings of recovery. The tragedy is that addiction is everywhere, yet remains so hidden.

In 2019 Dame Carol was commissioned by the then Home Secretary, the right hon. Member for Bromsgrove (Sajid Javid), to independently review illicit drugs in England. I thank her for her commitment and dedication over the last few years, and all those who contributed to this groundbreaking report. Most of all, I hope that my contribution today does justice to the absolute clarity that Dame Carol brings to these incredibly complex matters. Part one of her review was published on 27 February, and made for uncomfortable reading. The unflinching analysis detailed the extent of drug-related harm and the challenges posed by drug supply and demand, including the ways in which drugs fuel serious violence.

The Department of Health and Social Care swiftly commissioned Dame Carol to produce part two of her independent review, which focused on how to improve the funding, commissioning, quality and accountability of drug prevention, treatment and recovery services in England. Part two of her report, published in July, pulls no punches either. It says:

“Funding cuts have left treatment and recovery services on their knees. Commissioning has been fragmented, with little accountability for outcomes. And partnerships between local authorities, health, housing, employment support and criminal justice agencies have deteriorated.”

The report goes on:

“The workforce is depleted, especially of professionally qualified people, and demoralised. Vital services have been cut back, particularly inpatient detoxification, residential rehabilitation, specialist services for young people, and treatment for cannabis and stimulant users.”

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[Several hon. Members rose—]

[Yvonne Fovargue (in the Chair)]

A number of Members are waiting to speak. I am not imposing a formal time limit, but please keep contributions to four minutes or others will lose out. I call Rachael Maskell.

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[Yvonne Fovargue (in the Chair)]

I will be calling the SNP spokesperson at 5.10 pm.

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[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

It is a pleasure to see you in the Chair, Ms Fovargue. I commend all hon. Members who have spoken, with great insight and authority. They made many serious points, which I hope the Minister will respond to.

I pay particular tribute to my hon. Friend the Member for Liverpool, Walton (Dan Carden), for not only his superb presentation of the issues in the Black report but for the way in which he spoke with great eloquence and bravery about his personal story of addiction. I am not ashamed to say that it moved me to tears. I, too, have spoken about how addiction has affected my family and what it meant for me as a child growing up with a father who had a serious drink problem. I know that thousands of people who are, struggling with addiction, or see a loved one doing so, will have heard my hon. Friend’s speech. Although they may never get in touch with or meet him, his speech will have been a tremendous comfort to them, and we should all thank him for his bravery.

I will focus on the addiction crisis that we face as a country. I commend Dame Carol on her excellent report. Her 32 recommendations should be taken forward by the Government, and we need to hear from the Minister exactly what their attitude is to them. I offer to work with her on a cross-party basis on this public health crisis. In the last year, more than 7,000 people in England and Wales have died from alcohol-related causes. Alcohol-related liver disease is increasing. More and more people are dying from drug poisoning across England and Wales. There are, of course, particular issues in Scotland, which Members who represent Scottish constituencies rightly raised.

We are at risk of our society falling into a situation where deaths among those in their 40s and 50s are increasingly either the result of suicide or are drug or alcohol-related. They are called deaths of despair. For quite some time, this been a well known and tragic phenomenon in the United States, and we are at risk of seeing it become a feature here in the United Kingdom. My hon. Friend the Member for Liverpool, Walton is right that addiction is a national crisis, and spot on when he says that it is everywhere but well hidden.

We are having this debate on the day the Chancellor has presented his Budget, but even though this is a public health crisis, and we are still experiencing another public health crisis, public health did not feature in the Budget. As a number of Members have quoted, Dame Carol says:

“Government faces an unavoidable choice: invest in tackling the problem or keep paying for the consequences.”

The Chancellor ducked that choice today, and public health did not get the substantial increase in funding that it needs. As my hon. Friend the Member for Luton South (Rachel Hopkins) said, the Budget comes after real-terms cuts in recent years of £800 million to £1 billion, depending on how we calculate the figures. Those real-term cuts mean that drug and alcohol addiction services have lost £122 million in recent years—a 15% cut.

The Health Secretary likes to use Blackpool as an example of why we need to level up, pointing out the stalling life expectancy there. Blackpool, which has the highest mortality rate in the country for alcohol-related deaths and has the thirteenth highest number of deaths from drug poisoning, has had a £43 per person cut to public health funding in recent years. Manchester, which had the fifth highest number of deaths from drug poisoning in 2020, has had a £33 cut per person in public health funding in recent years. In 2020, Liverpool had the joint highest number of deaths from drug poisoning, with 89 people losing their lives, yet the city has had a £34 per person real-terms cut in public health funding. We look forward to the Minister telling us how local authority drug and alcohol addiction services are expected to cope if the cuts are not reversed—

[Yvonne Fovargue (in the Chair)]

Order. I am afraid I have to call the Minister.

[Jonathan Ashworth]

Will the Minister respond on the public health cuts? When will we see the investment in drug and alcohol addiction services that Dame Carol Black’s report calls for?

Covid-19:International Travel

Yvonne Fovargue Excerpts

Monday 24th May 2021 Westminster Hall

[Yvonne Fovargue (in the Chair)]

I remind hon. Members that there have been some changes to normal practice in order to support the new hybrid arrangements. The timings of debates have been amended to allow technical arrangements to be made for the next debate. There will also be suspensions between each debate. I remind Members participating physically and virtually that they must arrive for the start of debates in Westminster Hall. Members are expected to remain for the entire debate.

I must also remind Members participating virtually that they are visible at all times, both to each other and to us in the Boothroyd Room. If Members attending virtually have any technical problems, they should email the Westminster Hall Clerk. The email address is [e-mail]. Members attending physically should clean their spaces before they use them and as they leave the room. I also remind Members that Mr Speaker has stated that masks should be worn in Westminster Hall.

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[Mr Ben Bradshaw (Exeter) (Lab) [V]]

It is a pleasure to serve under your chairmanship, Ms Fovargue, and to follow the excellent speech by the hon. Member for Don Valley (Nick Fletcher). I thank all those who have signed the petition, including 300 of my own constituents. Many of them have heartrending stories of separation from family or other loved ones or of missing deathbed visits, weddings, funerals and baptisms. For some, this separation, with all its consequences for mental health, goes back well over a year, particularly if they were not lucky enough to be able to make use of the limited travel allowed to some countries by last year’s travel corridors.

Tonight’s debate is a useful corrective to the recent media coverage of travel, which has tended to focus on holidays. We should not have a problem with people taking safe holidays—I certainly do not—but this is also about the millions of people in Britain who have family or loved ones in another country, who have been unable to see them and who are longing to do so. More than one third of children born in the United Kingdom have at least one parent who was not born here. That illustrates the scale of the separation that many of our constituents are experiencing.

Outward travel from Britain in a normal year generates £37 billion for our economy and sustains 526,000 jobs. Inward travel generates £28 billion and sustains 450,000 jobs. That does not include the value of business and professional travel, which is estimated by the Business Travel Association to be even greater. Nobody—at least almost nobody—has been arguing that we should not have any restrictions on travel at all. Every other country that is similar to the United Kingdom in its economy and the impact of covid has had foreign travel restrictions, but my concern is that the Government, having perhaps not been cautious enough on travel earlier in the pandemic, are now being over-cautious, as we come out of it, given the evidence and the data, and especially given the success and advanced state of our vaccination programme.

Look at what other countries are now doing, Ms Fovargue. Vaccinated Americans are free to travel. Most of our European neighbours are free to travel with either proof of vaccination or a negative antigen test, which is cheaply and widely available, including at most airports. A number of countries, including Greece, Spain, Italy and Portugal—yes, they are popular holiday destinations for British people, but they are also countries with which people living here have many family and other ties—are already welcoming British people with open arms. They are at most requiring proof of vaccination or a negative antigen test, or, in the case of Spain from today, neither, but for most people in Britain, the fact that those other countries are ready to welcome us is meaningless because, with the exception of Portugal, all are on the Government’s orange list, requiring quarantine on return as well as multiple expensive PCR tests.

Back in February, as our vaccination programme was roaring ahead compared with those in the rest of Europe, there was a front-page headline in the German tabloid newspaper Bild Zeitung along the lines of, “The Germans are green with envy because the Brits will get to the sunbeds first this year”. That was a comment on our stellar vaccination programme. It may sound glib for me to press the point, but the Germans and other Europeans are already on the sunbeds in Spain, Greece and Italy. The British, by and large, are not.

We were promised and led to expect a vaccine dividend, but when it comes to foreign travel, we have the opposite. The British are not only under tighter travel restrictions than our European neighbours; we are more restricted than we were last summer, despite having the most-vaccinated population in Europe after Malta.

Some will say in response, and I am sure that the Minister will say later, “Ah, but the variants.” Of course, we must be on guard against new variants, against which the vaccines might not provide such a strong defence. However, we already know—the Government confirmed it this week—that the vaccines are successful against all the known variants. If the post-vaccine reality is that we have to live with the virus, and on that there seems to be a consensus, then, yes, by all means have a red list of countries of concern, but are we really going to keep our borders effectively closed and restrict travel from places that do not pose a risk, with all that entails in prolonged family separation, lost jobs and even greater damage to our economy?

The Government themselves claim to take a risk-based approach, so perhaps the Minister could answer these questions. Why does she believe that Germany, which overall has a very good record in dealing with covid and just as much concern for its citizens as we do, and other comparable countries are allowing their citizens more freedom than we allow ours? Can she explain why the long-awaited green list of countries was so limited, when infection rates in America and across Europe have been falling rapidly and vaccination rates increasing rapidly? Why was Malta, which has a higher vaccination rate and a lower covid rate than the UK, left off the green list? It would be really helpful, to the public and to our long-suffering travel and transport sectors, if the Government published their criteria for deciding whether a country is red, amber or green. The European Union has done that. Why can’t we?

The Government say they still have an islands policy, as they did last year, but that was not apparent when they published their green list, as numerous Greek and Spanish islands, which have lower infection and higher vaccine rates than Portugal, were not on that list. So, will the Minister confirm that we still have an islands policy, and that that will be clear in the next review?

What conversations has the Minister had with her Home Office colleagues about the unacceptably long waits and the mixing of people arriving from different traffic-light countries at Heathrow airport? It is welcome that there is belatedly to be a designated terminal for people arriving from red-list countries, but the rest of Europe already operates digitisation for arrivals and that must surely be possible here, especially for people arriving from green-list countries.

Will the Minister ensure that the inconsistency between what the Government in Britain say about travelling and what the Foreign Office advice says is addressed? That inconsistency has only added to the confusion for the public and for the travel industry.

When a pre-arrival 20-minute antigen test is enough for Germany and most of our neighbours, why is the UK still insisting, even for green-list countries, on an expensive pre-return PCR test, which has to be in English, Spanish or French and so is not available everywhere, and another PCR test after someone has returned?

The sacrifices that people have made over more than a year, along with our very successful vaccination programme, should mean that, as we adapt to living with covid, the UK is in a better place and ahead of other countries as we emerge from this terrible period. However, when it comes to travel, we are not ahead; we are behind our main neighbours and competitors. That is already having consequences in prolonged heartache, and worse, for our constituents who are separated from family and other loved ones, and in the jobs that are lost in our vital travel and transport sectors. Before the pandemic, we were world leaders in those sectors, but “Global Britain”, as the Government like to refer to us, is losing income, business and trade to our competitors in other countries, because those countries have opened up for travel ahead of us.

All I ask is that the Government bear all that in mind, alongside their desire to restrict people’s freedoms to protect public health, when it comes to the important decisions that they have to take on travel in the days and weeks ahead.

[Yvonne Fovargue (in the Chair)]

Will Members try to keep their contributions to five minutes, so that we can get the Minister in?

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[Yvonne Fovargue (in the Chair)]

I thank hon. Members for adhering to the time limits, which allows 10 minutes for each Opposition spokesperson and the Minister. I call Martyn Day.

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[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Ms Fovargue. I start by thanking the hon. Member for Don Valley (Nick Fletcher) for introducing this important debate on international travel and covid-19, following the e-petition signed by more than 100,000 people. As he set out very clearly, all those people have particular personal circumstances—involving long-term relationships and parents and children—that mean that they are in a very difficult situation. Unfortunately, I think that, with the situation that we have seen with the Indian variant, things are not going to get any easier anytime soon.

I also thank the hon. Gentleman for raising the very important issue of the effect on the travel industry. Like him, I have local independent travel agents in my constituency. It seems at the moment that they are in the worst of all worlds: they have the workload from having to deal with cancellations and rebookings, but they do not have the ability to access additional support funds, and of course they cannot furlough all their staff, so I think that there is an argument for greater long-term support for that particular industry. The hon. Gentleman also raised a very important question about the cost of tests for people re-entering the country—a topic that we will come back to later.

There were a number of very good contributions today. My right hon. Friend the Member for Exeter (Mr Bradshaw) set out several important issues, including the economic impact of this situation on the travel industry and the hundreds of thousands of jobs that rely on it. His most important point was that many countries are allowing in those who are vaccinated without additional checks. At the moment, in the terms of our policy on letting people into this country, no distinction seems to be made between those who are vaccinated and the unvaccinated. It would be useful to hear from the Minister why that is the case.

Most hon. Members talked about the importance of the economics as well as the personal situations. My hon. Friend the Member for Ealing, Southall (Mr Sharma) has a particular interest, given all the employees of Heathrow in his constituency. I think he said that what they really need is clarity and certainty; indeed, a lot of Members referred to that.

As we have heard, the petition calls on the Government to class in-person interaction with family members and unmarried partners as a reason to travel. I am sure that, on a human level, we can all understand that—many of us have not been able to see our loved ones as we would have liked during the lockdowns—especially when we consider that in 2019 more than 20 million trips were made by air out of the UK for the purpose of visiting family and friends. The current situation means new parents not being able to see their families, and grandparents not being able to meet up with grandchildren—actually, many people have not met their new family member for the first time.

The timing of this debate is apposite, given last Monday’s announcement that holidays abroad are no longer illegal, but there are of course, as we have heard, different rules for different countries. It should have been a simple colour-coding scheme—amber, red and green, according to each country’s risk. But of course, as we saw last week, there are as many different interpretations of what amber means as there are countries on that list.

We saw on Tuesday the Environment Secretary saying that people could fly to amber-list countries if they wanted to visit family or friends—something that the signatories of this petition would of course like to see—but then in the afternoon the Health Minister in the other place said that nobody should travel outside Britain this year at all. Later the same day, though, the Welsh Secretary said that some people might consider holidays abroad as essential.

That was three Ministers with three different interpretations in just one day, so it was left to the Prime Minister—the paragon of precision in this place—to clear up any confusion or contradiction at Prime Minister’s questions last Wednesday, when he came up with his own definition that people could still travel in “extreme” circumstances. That, of course, is also open to interpretation, but it does at least set the bar a little higher—until we remember that the new rules that he has actually brought in make it easier for people to travel to amber-list countries.

In fact, it is even easier than that, because if someone returns from an amber-list country, they can halve the time that they spend in self-isolation by paying for an additional test after five days. It is hardly a consistent message when it comes to what extreme circumstances in relation to international travel means. Perhaps the problem is that there is no definitive answer—it is all guidance. We have had issues in the past year where there has not been a clear-cut distinction between guidance and law. The Foreign Office website tells us:

“Whether travel is essential or not is your own decision… Only you can make an informed decision based on your own individual circumstances and the risks.”

That is the nub of the problem: everyone can have their own view on what is essential, which means there is ambivalence at the heart of Government policy, which I am afraid the virus is set to exploit.

We have spent the last year painstakingly legislating for every facet of life where covid could intrude, from when people could leave home or leave the pub to how many people can attend a funeral, yet when it comes to one of the biggest threats to our future prosperity—variants from abroad—this Government are inexplicably and recklessly letting people interpret the rules for themselves. The ambiguity over amber has to end. People should not travel to particular countries. Do not let them—it is not difficult.

I cannot believe that the more than 100 countries on that amber list all have the same level of risk. As Members have said, it is clear that more clarity and transparency are needed about why countries are on that list. One might conclude that it has been left deliberately vague so that the Government do not have to compensate the travel industry for all the cancellations that would happen if there were proper laws in place on restricting international travel. Last week, it was reported that 1,300 flights, carrying up to 54,000 passengers a day—[Interruption.] Ms Fovargue, should I continue?

[Yvonne Fovargue (in the Chair)]

I think we will pause until the bells have finished.

[Justin Madders]

Saved by the bell. Although I am not sure whether I am or whether—[Interruption.]

[Yvonne Fovargue (in the Chair)]

Justin Madders, would you like to continue?

[Justin Madders]

Thank you, Ms Fovargue. It is almost as if someone does not want me to carry on speaking, but I will not be put off that easily.

We have all seen images from airports of people from red, amber and green countries mixing and standing side by side for hours in conditions where the virus can be transmitted. That makes a mockery of the sacrifices that people have made over the last year. Then, they move through the airport, on to public transport and go back to their homes, without proper controls in place.

I asked the Home Office how many visits had been made to check on people who are supposed to be quarantining at home after returning from abroad. I was told that there is no data on that, because it is an operational matter for the police. In short, the Government do not know whether people are complying with these rules. The Government could be overcompensating that lax approach by having so many countries on the amber list. As the hon. Member for Bromley and Chislehurst (Sir Robert Neill) said, it is not clear how a country gets on or off that list. It seems that putting lots of countries on the amber list is a quick and easy way of solving some of the issues in the rest of the system.

The hon. Member for Richmond Park (Sarah Olney) mentioned the cost of tests for those who have to quarantine at home. Actually, it is not just the cost of those tests but the service that people are receiving that is a problem. Hundreds have had complaints about these firms, which are listed on the Department of Health and Social Care’s website. Some people have either not received their tests or not got them in time. Some have not got their results at all and have been left in limbo.

Last year, some of these private companies did not exist, and some had zero experience in the area they are benefiting from, but with the Government’s open-door policy it seems they can request to be put on the list on the Government website if they declare that they meet the required standards and either they are UK Accreditation Service-accredited or they have applied for accreditation but do not yet have it. As of March, the UKAS website said it had received 80 applications from such companies and had accredited nearly 30 such providers, but many more than that are listed on the Department’s website as providers of day two and day eight testing—when I checked this afternoon, it was 333.

I do not know about the Minister, but I find it astonishing that for one of the most critical parts of our defence against covid we are relying on companies to self-certify that they can do the job, and less than 10% of them have been properly accredited to provide the service. We must get much more rigorous in our testing and ensure that these companies can do the work accurately and safely. Will the Minister update us on how many companies are now accredited and what the Government are doing to investigate how they are operating to ensure that they are doing what they are supposed to do?

Why do these restrictions at the border matter? It is because the emergence of new variants of concern is the biggest single risk to the road map. We have seen outbreaks of South African, Brazilian and now Indian variants in this country and, once again, the Government have been too slow off the mark to deal with the Indian variant. It was first identified back in February, yet travel from India was not banned until more than two months later. During that time, travellers from India came into the UK without any need to quarantine at a hotel. The consequences are now clear in the clusters of outbreaks we see.

There is a suggestion that the Prime Minister delayed adding India to the red list until he decided that he had to cancel his trade visit to India. I suppose we will add that to the long list of questions he will have to answer at the inquiry. If it is true, it is another serious error of judgment from him. In the meantime, will the Minister confirm whether decisions to place countries on particular coloured lists are all to do with health issues and not also trade deals and other such considerations?

We need to get this right now. A comprehensive, easily understood system that does not undermine the gains we have made is necessary. The Government finally decided to introduce a hotel quarantine system only in February, over a year after cases first arrived in this country. That is inexplicable. That they continue with an ineffective system that is clearly not working and is creating the injustices we have heard about today is also inexcusable. They have failed with their inadequate covid border protections. They were late to home quarantining, late to mandatory border testing, late to hotel quarantine and late to add India to the red list. We cannot afford to have the Government be late to fix the ambiguity and confusion over the amber list as well. The public have made huge sacrifices, which must not be undone now by laxity and ambiguity. The Government need to get a grip of the situation as a matter of urgency.

Covid-19: Lung Cancer Pathway

Yvonne Fovargue Excerpts

Wednesday 2nd December 2020 Westminster Hall

[Jo Churchill]

Yes, of course. Are we allowed the extra minute or two, Ms Fovargue?

[Yvonne Fovargue (in the Chair)]

I do not think so, no.

[Derek Twigg]

Just on the issue of GPs, it is important that they see these types of patients face to face.