Clinical Waste Incineration

– in the House of Commons at 1:33 pm on 16th October 2018.

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Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care 1:33 pm, 16th October 2018

(Urgent Question): To ask the Secretary of State for Health and Social Care to update the House on clinical waste incineration across the NHS.

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

Yesterday evening, the hon. Gentleman, in a point of order, repeated claims made by Healthcare Environmental Services regarding incineration capacity, and Yvette Cooper raised a point of order on the capability of Mitie to deliver waste management services for the NHS and on TUPE arrangements for staff employed by Healthcare Environmental Services. I would like to clarify why the statement that there is sufficient incinerator capacity is correct, and why the claims made by the company, which is currently subject to criminal investigation, should not be taken at face value, as appears to have been the case yesterday.

With regard to incinerator capacity, there have been quotes from Environment Agency and NHS Improvement officials, cited in the Health Service Journal in May and August 2018, suggesting that there is a shortage of clinical waste incinerator capacity. By the time of my statement on 9 October, far more due diligence had been conducted on the claims made by Healthcare Environmental Services. Analysis carried out by NHSI identified 2,269 tonnes of incinerator capacity in October. The trusts served by Healthcare Environmental Services produced 595 tonnes. The analysis shows that there is sufficient incinerator capacity for clinical waste and that the statement made to the House was therefore correct. The issue is whether HES is willing to pay for that capacity. The fact that Mitie has secured 1,000 tonnes of incinerator capacity demonstrates that it is available.

The right hon. Member for Normanton, Pontefract and Castleford questioned whether Mitie was capable of delivering waste management for the NHS. The Mitie contract was put in place rapidly on 5 October to ensure continuity of service following trusts exercising their step-in and then termination rights to end their contracts with Healthcare Environmental Services. Over that weekend, Mitie visited the NHS sites to understand their business needs and the frequency of collections required, and responded immediately to trusts where waste needed to be collected. It also located bins on those sites so that the collections could start. Putting a new contract in place so quickly clearly means that there needs to be a phased approach to Mitie providing 100% of the service previously provided by Healthcare Environmental Services.

Mitie is working closely with NHSI to ensure that the needs of the trusts are being met, and regular collection schedules are in place at sufficient levels to maintain all patient services safely. The trusts also have additional contingency storage in place on site, with the waste being collected correctly stored so that the NHS can contain its services. This storage contingency will remain in place until Mitie meets 100% of the waste collection frequency required by the trusts. There is no risk to public safety through the action taken by the trusts.

As regards TUPE, Mitie has written to Healthcare Environmental Services and its legal representatives to request complete information, in order to assess the situation with regard to the potential transferring of employees and to minimise disruption for those employees. Mitie has also set up a dedicated helpline and email address to support Healthcare Environmental Services staff at this uncertain time.

It continues to be the case that there is no risk to public safety through the action taken by these trusts and that all NHS trusts have been able to continue to provide operations in line with meeting our key objective.

Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care

All we are asking for from the Minister is full transparency. Last week, he told the House with great confidence that

“the suggestion in some quarters that this is an issue of a lack of capacity is simply not valid.”—[Official Report, 9 October 2018; Vol. 647, c. 39.]

Subsequently, we read in the Health Service Journal, as he mentioned, that NHS Improvement had concerns about capacity back in August and acknowledged that there were “national market capacity issues”. He has told us today that due diligence has been done since then. Why did he decide not to reveal in his statement last week that concerns were raised with him back in August? Was he aware when he came to the House and made his statement that these concerns had been raised in August? He tells us that extra due diligence has been carried out. Can he explain what that extra due diligence actually is?

The Minister has tried to reassure us again today that there are no public health implications to the measures that have been put in place since HES lost these contracts. Can he therefore explain his view of the various allegations currently circulating on social media, with photos and videos suggesting that waste is not being picked up from a health centre in Keighley, that hospital staff in Leeds are shifting waste in inappropriate overalls, that hazardous waste at Dewsbury is being stored in inappropriate shipping containers, and that up to 15 trusts across Yorkshire are storing waste illegally? Has he checked each and every one of those allegations? Can he tell us what his inquiries have revealed about them? If he has not looked into each and every one of those allegations, why not?

Can the Minister assure us that incineration sites to which tonnes of waste from HES facilities are now taken are big enough to safely manage this waste, that the drivers transporting the waste are suitably qualified, and that the incinerators now being used are designed to deal with hazardous waste? Last week I asked him to give us a cast-iron guarantee that there is no risk to public health at any of those sites, or where the waste is currently being incinerated. Will he give us that absolute guarantee today? All we want from the Minister is complete and utter transparency. We have not had that so far.

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

The hon. Gentleman seems to be spending a lot of time on social media and not looking at the data on what is being done. There was a time when Opposition Members were used to the complexity of legal agreements and contracts and would have understood that mobilising 17 NHS contracts and maintaining NHS operations on those sites requires a significant amount of work. It takes time for Mitie to mobilise that contract—[Interruption.] If he gives me a moment, I will address directly the different concerns that he raised.

The hon. Gentleman’s first concern was that a statement given in October, with up-to-date information based on the work done leading up to it, was in some way incorrect because it did not pick up on early discussions within NHSI, which was only notified on 31 July. Obviously the concerns raised by HES about a lack of incinerators needed to be looked into. Having been looked into, those concerns were found not to have merit. The evidence for that is the fact that the new supplier, Mitie, has been able to secure 1,000 tonnes of incinerator capacity. If the hon. Gentleman’s central charge is correct, he will need to explain how Mitie has been able to find available incineration capacity when HES was unable to do so.

The hon. Gentleman asked when I was notified. I was not notified of the internal discussions among officials in August; I was not dealing with the issue at that point. The issue is what the House was informed of when the statement was made.

On the allegations on social media, I have not checked every single tweet that the hon. Gentleman has looked at, but the fact is that of the 17 trusts, three have had the stock of waste on their sites cleared and 12 are due to have theirs cleared by the end of the week, with two remaining, as Mitie mobilises from around 80% of service delivery now to 100% in the coming weeks.

The right hon. Member for Normanton, Pontefract and Castleford has made some legitimate points about TUPE and about Mitie scaling up, which I am sure she will come on to. Those points were not addressed, surprisingly, in the shadow Secretary of State’s comments, but I am happy to pick them up in due course. One of the advantages of Mitie is that it should deliver greater resilience, because it is not looking to deliver all the elements of the contract in the way that HES is. It is bringing in other firms, such as logistics suppliers and disposal firms, so there will be greater resilience in the contract, but we can address any specific concerns that the right hon. Lady has, given her constituency interest.

Photo of Rebecca Pow Rebecca Pow Conservative, Taunton Deane

I thank the Minister for his clear words. I remember just how emotive the whole issue of incineration can be, because I was a news reporter at the time of the foot and mouth and BSE sagas, and it is something that worries the public. Can I have an assurance from the Minister that there is an industry-wide agreement that there is enough capacity everywhere to deal with incineration?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

My hon. Friend is right to identify the concern there has been following comments on social media and certain media reports about incineration and the nature of this clinical waste. As I said in my statement, I am happy to confirm that there is sufficient capacity, as Mitie has demonstrated. It is worth reminding the House that just 1.1% of the waste under discussion is anatomical, and many of the media reports do not reflect that.

Photo of Neil Gray Neil Gray Shadow SNP Spokesperson (Work and Pensions)

The business concerned, Healthcare Environmental, is based in Shotts in my constituency. Waste incineration—where and how it happens—is always an emotive and controversial issue, and it is imperative that we get strong regulation right. But it appears that the UK Government have influenced, shall we say, that regulation in order to deal with an issue that the company claims was contained and it had a plan to deal with.

Can the Minister confirm whether special dispensation has been granted to a municipal site in Slough that apparently does not have a licence to deal with hazardous waste, to incinerate this waste in a way that would otherwise have been inappropriate? Can he confirm that the waste has been handled by unlicensed individuals and been moved against normal regulations? Can he clarify what role the Cabinet Office has had in this issue and whether the UK Government have had any relationship with Healthcare Environmental’s competitor, Stericycle? The focus last week was on Healthcare Environmental, and now the focus appears to turn to Government actions. With 400 jobs under threat across the UK and 150 in my constituency, is it not time we had an independent inquiry into this whole mess?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

The hon. Gentleman is right to recognise that there is a significant impact in Scotland, given the services that HES supplies, and it is worth reminding the House that HES is still trading and clearing waste from a number of NHS sites. However, given that it has been subject to a series of actions by the Environment Agency and is subject to a criminal investigation, it is worth treating HES’s claims with a degree of caution.

The Environment Agency is of course an independent agency, so it is for the Environment Agency to look at how waste is being processed, and a strict legal framework applies to that. The specific concern about Slough has not been raised with me, but I am happy to take that away and write to the hon. Gentleman.

The Cabinet Office has been in active discussion with the NHS and the Department of Health and Social Care, as have Scottish officials, who have worked very constructively with officials in England. This has been seen as an issue that affects Scotland as well as England, and it is one on which officials have worked collaboratively.

Photo of Anne Main Anne Main Conservative, St Albans

Can my hon. Friend reassure patients who might be concerned that their operations have been delayed in any way, shape or form by this whole fiasco that at no point were any members of the public put at risk by the treatment or non-treatment of this particular sort of clinical waste?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

My hon. Friend is absolutely right to focus on that. The key risk in respect of this supplier was that the NHS’s ability to continue to perform operations would be affected if it could not clear its clinical waste. I am happy to reassure her that all 17 trusts affected have been able to maintain their services, which ultimately is the key issue for patients and our constituents.

Photo of Yvette Cooper Yvette Cooper Chair, Home Affairs Committee, Chair, Home Affairs Committee

Can the Minister confirm that the staff are being offered TUPE transfers? I have heard from constituents who have been told that they are not, and clearly it is completely unfair for staff to be stuck in limbo like this. Can he say whether he has considered breaking up the contract and treating incineration separately, what the additional cost of the new contract might be and which part of the NHS is paying?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

The right hon. Lady raises an important point. I am happy to meet her to discuss these issues, given her constituency interest. I understand that she met members of staff on Friday. I very much urge HES employees who are listening to the debate to phone Mitie’s dedicated helpline and provide their details. The key issue is that Mitie has requested information from HES that it has not provided. In order to assess whether TUPE legally applies and the work patterns and issues of the staff involved, Mitie relies on HES providing information that, to date, has not been provided. The key issues in giving reassurance to staff are for them to contact the helpline and for HES to provide the information requested.

Photo of Julian Knight Julian Knight Conservative, Solihull

I congratulate the Minister on the measured way in which he is dealing with this unpleasant situation. Can he confirm that the Environment Agency will suspend HES’s remaining permits if enforcement action does not return it to full compliance?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

My hon. Friend will be aware that the Environment Agency is an independent body, so it will be for the Environment Agency to reach a decision as to whether such a suspension should be raised. I can reassure the House that the issue is subject to great scrutiny at present and that the Environment Agency is looking at it very closely.

Photo of Jamie Stone Jamie Stone Liberal Democrat Spokesperson (Armed Forces), Liberal Democrat Spokesperson (Defence)

It seems to me that there are two ways of looking at issues such as this. Factoring in numbers, statistics and logic is one way and leads to one conclusion, but when we think about human decency and human dignity it becomes something entirely different. The public’s confidence in the methodology is absolutely paramount at this stage. First, does the Minister recognise that, and secondly, can he tell me what he is doing to restore that public confidence?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

The hon. Gentleman is absolutely right, and I very much recognise that. The emotive nature of the topic and the way in which some of the headlines have been written do cause alarm. We are being very strategic. First, we are ensuring that our key priority, which is continuity of service in hospitals, is maintained. Secondly, we are ensuring that a supplier is mobilised as quickly as possible. He will recognise that to mobilise a supplier over so many contracts, where those contracts are not uniform—there are different legal provisions in them—is a complex issue. Thirdly, where there is an interregnum with regard to contingencies and waste that needs to be stored on site, we are ensuring that that is done in the safest way possible and that the waste is then cleared at the earliest opportunity.

Photo of Andrew Jones Andrew Jones Vice-Chair, Conservative Party

I thank my hon. Friend for the reassurance that there is enough capacity in the incineration system to deal with this issue, but will he confirm that the delays caused by Healthcare Environmental Services have not had an impact on the capacity for patients to receive the treatment that they need?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

My hon. Friend is absolutely right that the issues we have experienced with the supplier have not affected the NHS’s ability to maintain its service. That has been our key objective throughout, and that continues to be the case.

Photo of John Howell John Howell Conservative, Henley

Will the Minister confirm that, after the NHS trusts had terminated their contracts with HES, a new contract was given almost immediately?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

My hon. Friend is absolutely right. One of the key issues was to have alternative provision in place as quickly as possible so that we were not in the situation of waste being stored on site beyond the absolute minimum. It is a tribute to officials in the Department and in the NHS, the Department for Environment, Food and Rural Affairs and elsewhere, that a quite complex set of legal arrangements has been mobilised in such a short period to ensure that services are maintained.

Photo of Marcus Jones Marcus Jones Vice-Chair, Conservative Party

While the backlog is being cleared, will my hon. Friend confirm that any waste will be kept in a secure and safe fashion? Will he also be more exact about when he thinks the backlog of waste currently in the system will be cleared?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

There are two different components to that. There is the waste on sites, such as at Normanton, where HES has allowed a degree of waste to be stored, but I think my hon. Friend’s question is driving at the waste on hospital sites. As I said in my statement—[Interruption.] If Jonathan Ashworth waits for the reply, he will hear that the stock on those sites is being cleared. Perhaps he has been busy checking social media again. The bulk of the sites will be cleared by the end of the week; there will be two remaining beyond this week. We are very much focusing on that issue.

Photo of Philip Hollobone Philip Hollobone Conservative, Kettering

Will the Minister confirm that, had he not taken action, the failure of Healthcare Environmental Services to dispose of the clinical waste properly would have presented a serious risk of clinical waste backing up in hospitals and other healthcare facilities? Due to his taking effective action in a timely way, that has been avoided and healthcare delivery has not been interrupted.

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

I thank my hon. Friend for that question. There has very much been a Government-wide effort to ensure that waste did not build up, for the reason he mentions—the ability of the NHS to maintain its services and continue to operate if clinical waste could not be removed from the site. There is a varying degree of contingency capacity on different sites, so certain hospital sites would quite quickly exhaust that capacity if it was not cleared. That is why, as my hon. Friend John Howell said, the ability to mobilise the contract quickly was so important.

Photo of Eddie Hughes Eddie Hughes Conservative, Walsall North

Will the Minister assure the House that good governance will be in place to ensure that the new provider can dispose of the waste very safely?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

I am very happy to give my hon. Friend that assurance. There are lessons to be learned from the HES contract, and I am keen that we do so, but as I commented earlier, the contract with Mitie—through the use of different logistics firms and different waste sites—will actually build greater resilience into the arrangements for clearing clinical waste.

Photo of Tom Pursglove Tom Pursglove Vice-Chair, Conservative Party

Building on that point, will my hon. Friend ensure that there is an overarching review of local processes to make sure that failings of this sort by a contractor cannot happen again anywhere in the country ?

Photo of Steve Barclay Steve Barclay Minister of State (Department of Health and Social Care)

I am very happy to give my hon. Friend that reassurance. It is important, where a supplier has got into difficulties such as this, that we learn the lessons and ensure that they are part of contract procurement moving forward.