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Part of the debate – in the House of Commons at 4:07 pm on 16th March 2020.

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Photo of Justin Madders Justin Madders Labour, Ellesmere Port and Neston 4:07 pm, 16th March 2020

First, I welcome the Minister back to his place after his period of self-isolation. I am sure that all parts of the House will agree that the current coronavirus crisis has demonstrated beyond all doubt just how important our public services are. We all know that this is a very serious time and that our constituents will be concerned. I know many are frightened by the way the crisis has escalated over the past week or so, so I start by sending our condolences to all those who have already lost a loved one including, sadly, one gentleman in my constituency. I also send our gratitude to those who are already working flat out to do their best to limit the impact of coronavirus, whether they are in the NHS, the rest of the public sector or the private and voluntary sectors, which are making a vital contribution as well.

As the Minister will know, we are supportive of the national effort to contain and delay the spread of the virus, and it would be irresponsible of us as an Opposition to make any attempt to exploit the pandemic for party political gain. I thank the Minister for his kind words in that respect. Equally, it would be irresponsible of us to ignore the concerns being raised by the public, the scientific community and the sector more widely. It is critical that we ask important questions on their behalf, especially when the limits of public service will be tested like they have never been tested before.

We know that many aspects of life will have to change or stop altogether, albeit temporarily, but it is hoped that accountability, transparency and the ability of Opposition parties to scrutinise Government decisions will continue. We are under no illusions that, at this time, our ability to do that comes with a particular responsibility, so I hope the House will understand that I will focus mainly on the challenges of the immediate crisis facing us and ask some of the many important questions that have been raised. I appreciate that there will be a statement later, and I will understand if the Minister refers some responses to that, but we will have slightly more time in this debate to discuss important concerns that have been raised with us by many in the country.

Let me turn to the Budget, as this is a financial debate. We have previously acknowledged the extra funding announced in the Budget for the NHS and social care as part of the covid-19 response. That is something we have long called for, but there remain unanswered questions about how that funding will be precisely allocated. Can the Minister tell us exactly how the extra funding will be allocated and what will happen once the money is depleted? The NHS said last week that it needs to scale up intensive care beds sevenfold. That new pot of money is going to run out at some point, and it will need topping up. Will another Budget be necessary then, and what will the process be for determining resources at that point?

While we welcome the extra funding, we are aware that it is in the context of the NHS already facing extreme pressure, as usually happens over a busy winter period. We know from the last NHS winter report two weeks ago that 80% of critical care beds were occupied and that 93% of general and acute beds were also occupied. We know that the proportion of people being seen within four hours at A&E is the lowest on record, and the target has not been met since July 2015—the best part of five years. We know that the number of people on waiting lists in England is the highest it has ever been—nearly 4.5 million people are on a waiting list for treatment—and the waiting list target has not been met for nearly four years. Sadly, some cancer targets have not been met for over six years.

Those figures should tell us that the NHS is already stretched to capacity and that we are not starting from the optimum position. But it also tells us why the Government’s strategy of delay is one that has to be supported. Even if we take at face value the Government’s insistence that they have provided enough NHS resources to deliver the commitments in the long-term plan, we must surely all accept that the covid-19 outbreak will lead to an increased demand on trusts, meaning that resources in the system will have to be reallocated. Should trusts be expending time and resources on working on control totals and end-of-year accounts at this precise moment?

Will beds from the private sector be made available to covid-19 patients, and at what cost? What will the process be for trusts that have particularly large outbreaks and increased demand? Is any audit being undertaken of disused hospitals or other public sector facilities that may be required at some point? For example, is there any way that the brand new Royal Liverpool Hospital building could be brought on stream more quickly? Are the Government sourcing more ventilators, and when can we expect to see those available? Many manufacturers export all around the world. Will steps be taken to ensure that the NHS is at the front of the queue when those goods are produced?

I want to say a few words about the workforce. We know that, before we entered the crisis, the NHS was already short of over 100,000 staff, including 43,000 nurses and 10,000 doctors. The impact of staffing shortfalls manifests itself across the whole spectrum of NHS performance, as I have just outlined. It is therefore more critical than ever that those people who work in the NHS and whose good will we rely on already get adequate protection. It is evident that, in order for patients to have the best care possible, the NHS must support its staff to ensure that they stay well and can provide that vital care. That means a continuous supply of the right equipment and facilities. Personal protective equipment is vital in that respect. I hope we will hear, either in the Minister’s response or the statement later today, about what is being done to secure supplies of equipment and whether there is enough capacity in the system to ensure continued supply.

We would also be grateful for more information on the plans mooted to get retired staff back into the health service. Will some of the money announced in the Budget be used to deal with the anticipated increase in the wage bill that that would mean? Can we have an explanation as to how those people would be protected given that, by definition, the majority of them are likely to be over 70? What oversight will be put in place to ensure that they are delivering safe care if the revalidation process is to be suspended for retired returnees? Those on the frontline who I have spoken to are concerned about identifying the point at which an individual has been away from practice so long that it becomes impractical to reintegrate them in a safe and effective way. Will guidance be issued on what that point might be? What consideration has been given to those in the existing workforce who might be in a more vulnerable category because of their age or an underlying health condition?

A major concern is the lack of clarity about when people should be tested. We are hearing of many frontline NHS staff displaying symptoms but not being tested. What does that do for morale, if nothing else? The World Health Organisation has said that we should be continuing to test and contact-trace those suspected of having the virus. As a matter of importance, we should have a full explanation of exactly why we are currently diverging from WHO advice. It has been reported that labs are overwhelmed and tests are now taking several days to come back with results. Is the current ambiguity on testing policy a question of capacity rather than anything else? Will the Government be putting more resources into those labs, and if so, when will this materialise? It seems to us that continued testing is vital not only to stop the spread of the disease, but to understand when its peak has been reached. It may also be that efficient and accurate testing means fewer people having to self-isolate unnecessarily, which of course has an unnecessary economic knock-on effect.