Testing of NHS and Social Care Staff

– in the House of Commons at 3:59 pm on 24th June 2020.

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Photo of Jon Ashworth Jon Ashworth Shadow Secretary of State for Health and Social Care 4:04 pm, 24th June 2020

I beg to move,

That this House
expresses thanks to the heroic work of frontline NHS staff who have saved lives throughout the Covid-19 pandemic;
pays tribute to the at least 312 NHS and Social Care staff who have died of coronavirus in the United Kingdom;
recognises the impact that coronavirus will have upon the NHS to deliver routine care including mental health care without additional Government support;
notes that NHS waiting lists are projected to reach 10 million by the end of 2020, that cancer referrals fell 60 per cent during the peak of the coronavirus lockdown and that four out of five children have reported their mental health has got worse during the pandemic;
further notes that there is a backlog of NHS care that needs to be tackled and that it is vital to prepare NHS services to deliver safe care alongside care for coronavirus, including preparing for winter and ensuring necessary supplies of PPE and medicine;
is concerned that routine testing of NHS and Social Care staff is not currently in place;
and calls on the Government to implement a routine weekly testing programme for all NHS and Social Care staff to enable NHS services to safely resume and ensure the continuity of services throughout the winter alongside a functional, national, public test, trace and isolate system.

We have brought this motion to the House today to provide an opportunity for the House to reflect on the Government’s response in handling the pandemic, to thank our brave, hard-working NHS and social care staff for their extraordinary efforts—including, if I may say so, our student nurses who do a tremendous job on the frontline; I hope the Minister praises them and recognises their worth when she gets up to make her remarks—and to pay tribute to and remember over 300 health and social care staff who gave their lives during the pandemic. We have also tabled the motion to put to the Government a constructive, practical suggestion that we now consider necessary to prepare our national health service to meet the monumental growing burden of unmet clinical need and set out what we think is necessary to prepare us in case of a second wave of the virus.

The key to resetting the NHS and the safe easing of lockdown measures announced yesterday is a fully effective system that finds cases, tests cases, traces contacts, isolates, and then properly financially supports those who have been asked to isolate. We believe a key element of that must now be the regular testing, weekly if necessary, of all NHS and social care staff. This is what we are suggesting to the Government today, and we hope they will accept our constructive suggestion and find a way to make it work.

Throughout the pandemic, our concern as an Opposition has been to save lives and minimise harm. We have always thought that that means suppressing the virus, not simply managing its spread, and measures to crunch the virus down, as nations like New Zealand and Iceland have done, and not merely squashing the sombrero. It is why we on the Labour Benches called for a lockdown. Indeed, when I called for a lockdown in March not everybody in my party supported me at the time—many on our side were concerned about the extraordinary restrictions to civil liberties—but we supported the Government when they announced a lockdown and we co-operated with the Government in ensuring that the necessary legislation passed this House.

I also said, however, that a lockdown was a blunt tool. I said it would buy us time while transmission in the community reduced. We always recognised that we could not stay in lockdown forever. Lockdown has huge social repercussions, especially for children. This is not a debate about schools, but I was struck by the words of UNICEF, which warned:

“Children are not the face of this pandemic. But they risk being among its biggest victims.”

We have always understood that there would come a moment when we need to ease out of lockdown, but it has to be done safely.

Of course, nothing is risk-free. We can never entirely eradicate risk, as the chief scientific adviser reminded us yesterday. We cannot be complacent. This virus exploits ambivalence, and the reality is that there are many hundreds of infections every day. Globally, we have passed 9 million cases. The virus is accelerating across the world. There are outbreaks in South Korea and Germany, countries that have been far more successful than we have. The chief medical officer yesterday warned us to expect to continue to be in this situation way through the winter and way into next spring. We all know from our history books that about 100 years ago there was a deadly second wave of Spanish flu. A second wave must surely be a possibility with this virus.

We are tracking towards one of the worst death tallies in the world: over 65,000 excess deaths, with 26,000 excess deaths in care homes. Ministers cannot run away from the realities, no matter how uncomfortable they are. Today, we call on Ministers to outline a plan for the next stage and to prepare us in case of a deadly second wave. Let me deal with the points in the motion about the NHS.

Ministers boast that the NHS was not overwhelmed, that it coped and that 119,000 people were admitted to hospital for covid and they received exceptional care. They are right to make those claims. Thankfully, the desperate scenes in Lombardy hospitals that we witnessed on our TV screens were never repeated here. Naturally, I pay tribute to all our NHS staff involved in that and all the staff who ensured the building of Nightingale hospitals, developed new care pathways, and moved to digital care or returned to the frontline. But let us be absolutely clear: that surge capacity in the NHS, and the wider protection of the lockdown, has come at a cost, because millions are waiting for care. For those millions, this has not been a cosy hibernation, as the Prime Minister told us yesterday. It has been a time of struggle, of suffering and of distress.

Protecting the NHS has been on the back of cancelled operations, delayed treatment, and, arguably, the biggest rationing of services in the 72-year history of the national health service. It has been on the back of shielding some of the most vulnerable in society, who remain anxious and scared today for their personal health and safety as lockdown eases. Let us remember that, when we went into this crisis, we had 4.5 million on the waiting list. We had A&E targets routinely missed. Every winter, we saw the crisis in our hospitals of trolleys lined up in corridors. We have had some of the worst cancer waiting times in history, and now the NHS Confederation is warning that elective waiting lists could hit 10 million by Christmas. Yes, referrals are down, as the Minister for Health, Edward Argar, recognised yesterday, but that is because of unmet need in the wider community. Indeed, experts are predicting that about 1.6 million are being added to the waiting list every month. That means ever lengthening queues in our constituencies of people in pain waiting for care. The Minister will know that at the end of January, there were 521,000 people waiting for trauma and orthopaedic surgery, including hip and knee replacements, and probably another 42,000 added to the waiting list each week. That means that thousands of our constituents are waiting in discomfort and pain, often when pain-relieving drugs are inadequate.

Photo of Tim Farron Tim Farron Liberal Democrat Lords Spokesperson (Communities and Local Government), Liberal Democrat Spokesperson (Housing, Communities and Local Government), Liberal Democrat Spokesperson (North of England) (Northern Powerhouse), Liberal Democrat Spokesperson (Food and Rural Affairs)

I am extremely grateful to the hon. Gentleman for giving way. He is making a very important and well-presented case. In my constituency, at Westmorland General Hospital, the trust closed down the Kentmere ward, which is the adult mental health ward. It is fairly obvious that most Members will have had in their inboxes a lot of people presenting with higher degrees of mental health need than during normal times. That ward was closed down temporarily to take account of the crisis. Does he agree that now is the time, particularly with mental health issues, to look again at those temporary closures and to bring the Kentmere ward and other such wards back into service, to meet the needs of those struggling with mental health conditions?

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

The hon. Gentleman puts his case persuasively. My hon. Friend Dr Allin-Khan, who will be winding up the debate for the Opposition, will, I am sure, want to touch more on the mental health impact of the lockdown. It is undeniable that the lockdown has led to unquantifiable mental health problems festering in society, and statistics show an increase in anxiety and depression. There are particular issues around young people not being able to access child and adolescent mental health services. If services have closed, as happened in his constituency, then, yes, we need a plan to ensure that those services are reopened as quickly as possible.

Another area where we have had access to services restricted is in cancer, and cancer touches everybody. It touches every family. It has touched many Members in this House very individually and personally as well.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

I thank the hon. Gentleman for giving way. What is happening to our cancer services is very important, as he said. Some of the figures are incredible. There are 2.1 million people waiting for breast or cervical screening tests, which is 60% higher than in April 2019. Treatment rates for chemotherapy have fallen by 70%, surgery by 60%, and radiotherapy by 90%. That underlines very critically the severe problems for those with cancer and for those needing treatment right now.

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

The hon. Gentleman is ahead of me in making the points that I was hoping to go on to make. I am not surprised that he has made those points given that he is a Leicester City fan. I am very proud to have Leicester City football club in my constituency— hopefully we will do better next season. He is absolutely right in what he says, because the statistics on cancer are absolutely terrible.

Around 2 million people in England are currently waiting for cancer screening tests or cancer treatment, including chemotherapy. Today, we have a published analysis, which shows that those waiting more than six weeks for diagnostic tests—some of these will be for cancer of course—have increased from 30,000 to 469,000 as a result of the lockdown. Cancer referrals are down 60%, and 1 million people are missing out on breast, bowel and cervical cancer screening. That means that about 1,400 cases of cancer are going undiagnosed every month. In March and April alone, there were at least 500 more deaths from cancer than average, and research from University College London predicts that an estimated 17,915 additional deaths of existing and newly diagnosed cancer patients could occur in England in the next 12 months. That is why resetting our NHS and getting it started again is so vital.

We also know that covid attacks the lungs, so this is an especially frightening time for those with serious asthma, chronic obstructive pulmonary disease and emphysema. One in four people with COPD have had a regular GP or hospital appointment cancelled, or both. Some 24% of people on pulmonary rehab programmes have had their classes cancelled, and 600,000 people with asthma or COPD have missed their annual review. The more we know about coronavirus, the more we know it is also a cardiovascular issue. Those with cardio- vascular problems are the second biggest group of those with an underlying condition dying from covid now, yet about 30,000 elective procedures for heart disease have been deferred. Referrals to stroke units have declined, and excess stroke deaths in care homes are 39% higher than the five-year average. We are making these points not in a spirit of blame, but to re-emphasise the point that lockdown has come with huge costs and will inevitably mean that people will die or develop long-term illnesses unless there is now a plan to get the NHS up, running and working again.

Photo of Kieran Mullan Kieran Mullan Conservative, Crewe and Nantwich

It is important that we are clear as to exactly what the Opposition are calling for today. The motion asks for “routine weekly testing”, with no ifs, ands, buts or qualifications. Yet the hon. Gentleman said in his opening remarks that he is seeking routine testing weekly if it is necessary. So are the Opposition calling for weekly testing, no matter what? Or are they calling for what he said in his opening remarks, which is the possibility of weekly testing?

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

We are calling for weekly routine testing, as have many organisations and the Chair of the Select Committee on Health and Social Care. He penned an excellent article in The Daily Telegraph today, and I hope the hon. Gentleman has had time to study it, because it is superb. May I also take this moment to pay tribute to the hon. Gentleman, because I know he has returned to the frontline? I am sure all of us, from across the House, are grateful for everything he is doing on the frontline.

The other point I wish to make on this growing burden of unmet clinical need is that there is a social gradient in this, as always; there is a higher mortality rate among those who are poorer and more deprived. Through all these different conditions, the poorer someone is, the more likely they are to become ill quicker and die sooner. So we need urgent action from the Government to tackle this, and we believe that regular testing of NHS staff is a key part of that.

We also need a broader plan to tackle the growing burden of sickness and unmet need. Our NHS will need more resources. We have had years of financial starvation in the NHS. The Government’s funding plan of two years ago fell short of the annual 4% increase that experts said was needed before the pandemic, and the settlement of that long-term plan is surely inadequate post pandemic. We must remember that we entered this crisis after 17,000 bed cuts and years of budget cuts to capital settlements, which have left hospitals crumbling, reliant on out-of-date equipment and grappling with a £6.5 billion repair bill. NHS land and buildings have been sold off. Last year, more than 890 hectares of NHS land was put up for sale. So we will need large-scale investment in the real estate of the NHS to allow health services to reconfigure to treat covid and non-covid patients alike.

Ministers will say that the NHS will get what it needs, but the reality on the ground is very different. I am sure the Minister for Care will have studied today’s Health Service Journal ahead of the debate and will have seen trust chief executives complaining that the cash that they were promised has not been delivered. They need this cash now if they are to restructure any of their services ahead of the winter. I hope that she will update the House on when those chief executives are going to get the cash they were promised by her Department.

We will also need real investment in rehabilitation services for those suffering from covid. The more we know about this disease, the more we know that those coming out of hospital are probably doing so with significant long-term chronic conditions. They are going to need support, be it respiratory, neuromuscular or psychological. Community health services are going to see a huge peak in demand now that many have moved out of the community health sector.

Crucially, to reset services—this comes to the point that the hon. Member for Crewe and Nantwich put to us—we need to ensure that care can be delivered safely, which is why we believe that a mass-testing infrastructure for staff is now so important. We know that around a fifth of covid infections in hospitals are caught in hospital settings. Given the levels of significant asymptomatic and pre-symptomatic transmission, we need a proper targeted testing strategy as well. All healthcare workers should be tested regularly—weekly—because a study from Imperial suggested that that would reduce transmission in healthcare settings by up to a third.

Photo of Patricia Gibson Patricia Gibson Shadow SNP Spokesperson (Consumer Affairs)

The hon. Gentleman is eloquently outlining the challenges faced by the NHS in the wake of covid-19. Does he join me in welcoming the movement by the Scottish Government to ensure that social care workers who contract covid-19 are given additional funds on top of statutory sick pay, which is completely inadequate, in order to make sure that they do not lose out for testing positively as a result of their job?

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

The hon. Lady makes a very important point, which affects the debate more broadly: those who test positive or are asked to isolate need to be given the financial support to do it, and statutory sick pay in many circumstances will not be enough. There are millions of workers—2 million in this country—who do not qualify for statutory sick pay, and just saying that they can apply online for universal credit is not going to be enough.

We need more radical thinking from the Government. Other countries offer greater financial support to those who are asked to isolate. Other countries even offer hotel rooms to those who are asked to isolate if it is not appropriate for them to isolate at home because of the nature of their housing situation. The Government should be looking into those sorts of things, and I hope the Minister can respond to that.

The point I was making is that regular testing of staff, whether asymptomatic or not, is so important not only for the safety of those staff and patients, but for building confidence in the NHS more generally. The study from Imperial suggested that it would reduce transmission of covid in healthcare settings by up to a third. We believe that this is a constructive suggestion that we are putting to the Government, which they should take on board and explore. It is disappointing that they are seeking to amend the motion to completely strip that out. They are not even prepared to take it away and look into it. They just want to pass a motion congratulating themselves on their handling of the pandemic.

A testing strategy for staff and patients, as we are proposing today, is a demand supported by many across the NHS as key to restarting that NHS work.

“A clear testing strategy is now more important than ever”— says Chris Hopson from NHS Providers.

We

“need rapid testing available for all staff and patients, whether showing symptoms of COVID-19 or not”— says Cancer Research UK.

“It’s absolutely essential to regain public confidence that we are able to test our staff regularly”—says Derek Alderson of the Royal College of Surgeons. And, of course—Jeremy Hunt will not be surprised that I am going to quote him in this debate—it is a position shared by the former Health Secretary, now the Chair of the Health and Social Care Committee, who in today’s Telegraph makes the case with far greater eloquence than I could ever muster:

“Until we minimise the risk of asymptomatic transmission by introducing weekly testing for all NHS and care staff, we are failing in a basic duty of care to the people most likely to die if they get the virus.”

Photo of Jeremy Hunt Jeremy Hunt Chair, Health and Social Care Committee, Chair, Health and Social Care Committee

May I put on record my thanks to the hon. Gentleman for praising me in this House for the very first time that I can remember on record?

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

I praised him plenty of times from this Dispatch Box. The point is that this is a constructive proposal, which is not a party political point. There are clearly many people across the House who support this proposal. The right hon. Member, the former Health Secretary, also prays in aid in his article—I have it here for Members, if they have not had chance to peruse it—both Tony Blair and William Hague. So we now have a Front Bencher praising Tony Blair from the Dispatch Box—that is probably the first time it has happened on the Labour Front Bench for about 10 years.

Photo of Andrew Griffith Andrew Griffith Conservative, Arundel and South Downs

I am delighted to see that the hon. Gentleman has improved his reading material. I congratulate him on securing the debate, and on his constructive tone. In that vein, in addition to the proposals that he is setting out, will he recognise that we are able to start unlocking the economy today because of the herculean efforts made in areas such as PPE, and the contribution made by the private healthcare sector, which has a valuable role to play as we move towards more of the elective care that we now need?

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

I know that the hon. Gentleman is always keen to support those on his Front Bench. Indeed, he was one of the few Tory Members who actually supported Mr Cummings, tweeting:

“Another media non-story when there are so many important ‘real’
stories of this crisis”.

The Government were slow in getting PPE to the frontline, slow in ramping up testing, slow in going into lockdown, slow in getting tracing going and slow in protecting care homes. I am pleased that the hon. Gentleman recognises my constructive tone, but it does not mean that I will not highlight the failing of this Government in their mishandling of many aspects of the pandemic.

I must now move on, having spent some time in this mutual love-in with the former Health Secretary. I do not want to damage his career any further, although he is probably not on the Prime Minister’s Christmas card list at the moment.

I hope that the Government will engage seriously with our suggestion of regular testing for all NHS staff, because we believe that is a crucial part of an effective test, trace and isolate strategy. The problem is that the testing and tracing is still not as effective as it should be. Of course, we recall that testing and tracing was abandoned on 12 March, and the Government have been playing catch-up ever since. At Health questions yesterday the Secretary of State could not even tell us how many people were being tested on a daily basis. I hope that the Minister will now get us that information.

Local authorities are still not receiving localised data, which is very serious. At Thursday’s press conference—the Prime Minister has now got rid of the press conferences—the Health Secretary casually announced, in response to a question, that Leicester is experiencing one of the highest spikes in the country. Nearly a week later, the local authority still does not have specific postcode data on where the people who have tested positive are. The Secretary of State announced that last Thursday, and today is Wednesday. We do not have that data because the data protection protocols have still not been agreed. This is shambolic. The Government cannot announce that there is an outbreak in a particular part of the country but then not provide the local authority with the data it needs to put in place the necessary measures.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

I am always pleased to intervene on anyone, but especially a Leicester City supporter.

On systematic testing, the figures from Cancer Research UK are critical, as I am sure the hon. Gentleman is aware. Between 21,000 and 37,000 tests would be required every day across UK cancer services just to catch up. That underlines how important the testing is, and that is just for those who have cancer.

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

The hon. Gentleman is absolutely right, and that is why we have brought forward this debate. I think that we all understand why a lot of elective surgery and treatment had to be paused, but now that the lockdown is being eased, Government Ministers need to tell us how they are going to start treatment again, and how people who have been waiting for treatment, whether for cancer or for heart disease, or for a hip replacement, are going to get that important care.

We have a situation in which GPs cannot carry out tests, book tests or refer patients for tests. If someone goes to one of the Deloitte drive-through testing centres, or one of the centres where that role has been subcontracted to someone else, there is no requirement for the results to be sent back to their GP. GPs do not know who in their local area has been tested positive, because that is not going on their health records. This is shambolic. At the same time, the Government have given a £100 million contract to call centres run by Serco and Sitel, where tracers are complaining that it is chaotic and they have nothing to do. I do not know whether the Minister read the testimony, published in the British Medical Journal, of a clinician working in one of the call centres. They wrote:

NHS Professionals employed us as clinical tracers, but we were recruited by Capita…
Sitel provided access to the tracing applications and systems, and these all required different usernames and passwords. Synergy CRM assigned cases…CTAS captured contact tracing information, RingCentral was used for voice calls, and MaxConnect was used for storing knowledge about contacts. All of these systems were accessed through Amazon Workspace.”

This sounds a complete mess. At the same time, the chief executive of Serco is saying that this is an opportunity for it to “cement” its role in the NHS. Serco should not be an excuse for more NHS outsourcing and privatisation. Serco should be kicked out of our NHS, and local public health officials and GPs should be leading the tracing response.

And, of course, the Secretary of State has failed to deliver on his app, with months wasted and £11.8 million confirmed as down the drain by the Minister in the Lords yesterday. We are now in the dismal situation where there is an app for the Secretary of State himself, but there is not even an app for covid. You really could not make it up, Mr Deputy Speaker.

We believe that it is time for the Government to invest in public health services, to put GPs in the driving seat of testing, to give local authorities the localised data that they need and to begin a programme of routine testing of all NHS staff, whether symptomatic or not. We accept and understand that Ministers will have made mistakes throughout this crisis. It was an unprecedented pandemic, but Ministers have been slow, their response has been disorganised and the scale and nature of the pandemic, even though it was at the top of the risk register, at times underestimated.

However, Ministers can learn from their mistakes. They can take the advice of the former Health Secretary and they can take the advice of their former leader and former Foreign Secretary. They can start putting in place a programme for mass testing, starting with NHS staff, because we need it for our national health service. Our constituents are waiting in pain, agony and distress for treatment. It is time to deliver the care they deserve, and I commend our motion, constructively, to the House.

Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care) 4:31 pm, 24th June 2020

I beg to move amendment (a), to leave out from “medicine” to the end and add:

“and recognises the unprecedented action the Government has taken in its tireless efforts against Coronavirus to protect the NHS and save lives.”

The coronavirus pandemic is the most serious public health emergency that our nation has faced for a generation and our NHS and social care system has been well and truly on the frontline. Today, I would like to outline the work we have done to protect our NHS and social care from the threat of this invisible killer, as well as our work to safely ramp up services now that this virus is in retreat.

On protecting the NHS and social care, we have worked hard to boost the resilience of our health and care system, so it would not be overwhelmed, as we have sadly seen elsewhere across the world. A major part of this mission was our Nightingale hospitals. This was one of the most ambitious projects this country has ever seen in peacetime, building hospitals in just a matter of weeks in exhibition centres and conference venues. That hard work from so many meant that, even at the peak of the pandemic, there was more critical care capacity than there was when coronavirus first hit our shores, so our NHS was able to give outstanding critical care to everyone who needed it.

Our social care system has also been at the heart of the pandemic, and we have worked hard to give it the support it needs. In March, we announced £1.6 billion of funding for local government and £1.3 billion of funding via the NHS. In April, we announced a further £1.6 billion, as well as our comprehensive adult social care action plan. In May, we announced a £600 million infection control fund for care providers in England, which includes funding so that social care staff can be on full pay if they have to isolate due to covid. That work is bearing fruit, thanks to the dedication, expertise and compassion of care workers throughout the country.

Fifty-eight per cent. of care homes have had no reported cases of coronavirus. Every life lost in our care homes fills me with sorrow, whether it is from coronavirus or not. However, we are seeing a sustained reduction in the number of coronavirus deaths. This week’s Office for National Statistics figures for England and Wales show that the number of deaths in care homes has fallen once again—down from 536 to 360 in the last week.

This has been hard, but through this crisis we have strengthened our health and care system, and we are looking to see what lessons we can take forward as we look ahead to the winter.

Photo of Suzanne Webb Suzanne Webb Conservative, Stourbridge

Will the Minister let me know what steps the Government are taking to protect black, Asian and minority ethnic health and care staff?

Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care)

I thank my hon. Friend for that intervention. She makes a really important point. One of the things that I have put much thought into over recent weeks is making sure that our staff of black and Asian minority ethnicities have the protection that they need. Both for the NHS and for the social care system, we have supported the development of risk assessment frameworks to identify the risks, with recommendations on what steps can be taken. I am working with the system to make sure that those are put into practice.

Coming back to the lessons that we are taking forward, one of the things that has been a great success has been the adoption of new technologies such as, for instance, online GP consultations. Some 99% of GP practices now have video consultation capability, while hospitals have been doing virtual out-patient appointments and care homes have been using tablets—the digital kind of tablet!—to keep people in touch with their families. We are also seeing new ways of working to help those on the frontline to make quicker decisions and cut red tape. We will keep driving these important reforms so that we can give everyone a better experience of health and social care.

As the Prime Minister set out yesterday in the House, we have succeeded in slowing the spread of the virus. On 11 May, 1,073 people were admitted to hospital in England, Wales and Northern Ireland with coronavirus, and by 20 June this had fallen by 74% to 283. This has reduced the pressure on the NHS so it has been able to carefully ramp up important services. Hon. Members have raised questions about two specific services in the motion, and I will address them both.

First, coronavirus has had a real impact on many people’s mental health, so there is a lot of concern about mental health services remaining open and available. Our NHS mental health services have remained open for business throughout the pandemic, using digital tools to connect people and provide ongoing support. This has proved especially effective for young people. Throughout the pandemic, we have provided £9.2 million of additional funding for mental health charities. We understand that we may see an increased demand for mental health services in the months ahead, and we are preparing for this, together with the NHS, Public Health England and other partners.

Secondly, hon. Members have raised questions about cancer services—another area where we are working hard to maintain care. For example, we have been operating surgical hubs where providers work together across local cancer services to maintain access to surgery. Although some cancer diagnostics and treatments have been rescheduled to protect vulnerable patients from having to attend hospitals, urgent and essential cancer treatments have continued. The latest data suggests that referrals are back to over 60% of the pre-pandemic levels, partly due to the NHS Help Us Help You campaign. This campaign has an important message that I am keen to repeat today. Anyone who is worried about chest pains, fears that they might be having a heart attack or a stroke, feels a lump and is worried about cancer, or is a parent concerned about their child should please come forward and seek help, as they always would. The NHS will always be there for us if we need it, just as it has been there for all of us throughout this crisis.

Photo of Emma Hardy Emma Hardy Shadow Minister (Education)

On that note, will the Minister also encourage people suffering from vascular disease to seek appropriate treatment as quickly as possible?

Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care)

The hon. Lady is absolutely right. The Under-Secretary, my hon. Friend Jo Churchill, says to me that the hon. Lady is a very powerful campaigner on this subject. For that and for other conditions, people must absolutely come forward and get the help that they need. The NHS is there for that reason.

My third and final point is on testing. Testing for the virus and tracing how it spreads is critical to containing it as we ramp up services and ease the national lockdown. This is especially important for our NHS and social care system so that we can protect our colleagues and the people they look after. We have already built an immense national infrastructure for testing. Back in March, we had the capacity across all our testing channels to conduct fewer than 2,000 tests a day, whereas yesterday we saw more than 237,000 tests carried out. As we have built capacity, we have prioritised those in need. We started with the patients who needed a test, then expanded to NHS and social care workers and their families, then to other critical key workers, before we expanded to the wider community.

Today NHS England and NHS Improvement have written to NHS trusts and foundation trusts to outline further steps that must be taken in the NHS, including continuing to prioritise testing for all NHS staff with symptoms; extra testing of non-symptomatic staff when there is an incident, outbreak or high prevalence; and regular surveillance testing of staff which, on the advice of our chief medical officer, will be fortnightly or more frequently, depending on local or national epidemiology.

Photo of Clive Efford Clive Efford Labour, Eltham

On the testing figures that we get every day, after we take out studies that are being done through testing, along with double testing and those tests that are sent out through the post, are we not down to just about a third of the numbers that the Government claim are taking place? How can we have any confidence in what the Government say about what they are going to be doing about testing going forwards?

Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care)

The hon. Gentleman has talked about taking out large numbers of testing; as the Minister for Care, I have seen a huge demand from the social care sector for testing through those channels, so I would not take out other forms of testing. For example, testing through tests sent to people’s homes very much counts and should be considered as part of our testing programme.

We have put a rigorous focus on testing in care homes, too. We met our target of offering tests to all staff and all residents of care homes for over-65s and those with dementia in England by 6 June. We then announced that we were able to extend the testing programme to all adult care homes. Since the launch of whole care home testing, we have provided over a million test kits to more than 9,000 care homes, and we are now able to send out more than 50,000 test kits a day. We are also running a prevalence study to get a detailed picture of coronavirus infection in care homes. Phase 2 of that study has just gone live, meaning that 10,000 residents and staff across 100 care homes will have repeat swab and antibody tests.

Photo of Tim Farron Tim Farron Liberal Democrat Lords Spokesperson (Communities and Local Government), Liberal Democrat Spokesperson (Housing, Communities and Local Government), Liberal Democrat Spokesperson (North of England) (Northern Powerhouse), Liberal Democrat Spokesperson (Food and Rural Affairs)

The Minister is being generous in taking interventions. Does she agree that to keep care homes safe from the coronavirus, the testing needs to happen regularly, not just once or even twice, and it needs to include people displaying no symptoms whatsoever? Does she also agree that, particularly for those NHS sites that are deemed to be clean and that are attempting to be covid-free, which are often the places where surgery will take place, the regular testing of staff even on a weekly basis, whether or not they display symptoms, is essential, not only, for example, to bringing back the mental health and maternity services that are currently lost to Westmorland General Hospital, but to making sure that the whole of our health service can operate as normal?

Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care)

I absolutely recognise the importance of repeat testing, both in the NHS and in social care. Our policies, and the testing programmes that we have in place and are launching and taking forward, are based on the clinical advice as to what the right programme to have in place is. I have set out the programme for the NHS, which is based on the advice of the chief medical officer, and we have sought advice from the Scientific Advisory Group for Emergencies on what the repeat testing programme should be for the social care sector.

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

I am genuinely grateful to the Minister for giving way. We are trying to engage with the Government on what we think is a constructive proposal, and not to do the usual political knockabout. I did a bit of that yesterday at Health questions, as she knows, but today I am trying to adopt a different tone—

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

Trying, yes. Just so that we can understand this, is the Minister saying that the Government’s position on weekly testing of all NHS staff, whether symptomatic or not, is that that is not an appropriate clinical intervention—as distinct from saying, “We simply do not have the testing capacity at this stage, but it is something we would like to do in future”?

Photo of Helen Whately Helen Whately Minister of State (Department of Health and Social Care)

I am sure the hon. Gentleman was listening when I outlined the policy for the national health service. That is based on the chief medical officer’s advice. I think that is pretty clear. The Opposition’s position is not entirely clear, given that the hon. Gentleman started out saying “Weekly testing when necessary”, but said in his speech that it was weekly testing, whatever. On the other hand, we have been clear and the hon. Gentleman can look at the letter from NHS England and NHS Improvement to NHS trusts for further information.

I should move to the conclusion of my remarks—[Interruption.] Hold on, I thought we were not having any more political knockabout. We have established a national testing programme on a scale and at a pace that has never been seen before in this country. We will keep expanding that so that we can use high-quality testing to give confidence and certainty to anyone who needs it.

As I have set out today, there has been incredible action across our NHS and social care as we respond to this invisible killer. Thanks to the efforts of so many, crucial services have not been overwhelmed and all coronavirus patients who were admitted to hospital were able to receive urgent care. Because we have made such progress on slowing the spread of the virus, we have been able to ramp up other important services as part of our plan to get Britain back on her feet. However, we cannot be complacent and we must be ready for any increase in the rate of coronavirus infection and also for the winter, when, as hon. Members know, there is a greater risk of seasonal flu. As we keep ramping up services, we will ensure that we have the surge capacity to act quickly if necessary.

I want to finish by thanking the incredible NHS and social care staff who have been on the frontline of the pandemic. There has been a collective effort from so many, including healthcare professionals who have volunteered to return, and medical students, allied health- care profession students and nursing students who have stepped up at this important time for our country. The whole House and the whole nation are grateful to them for their heroic work.

Photo of Richard Thomson Richard Thomson Shadow SNP Spokesperson (Business and Industry) 4:46 pm, 24th June 2020

I record my thanks on behalf of the Scottish National party group of MPs for the work that NHS staff and care staff have done throughout these islands during the course of the pandemic to date. I do not think it is an exaggeration to say that theirs has been a superhuman effort, for which some have given everything they could, including, sadly, their lives. We remember the 312 staff UK-wide who have lost their lives in the service of others, including the seven healthcare workers and the 12 social care workers in Scotland. There are no words of mine, or, I suspect, anyone else that can thank them enough for their work. We should not underestimate the toll it has taken and will continue to take in the months ahead.

Throughout this time, we have clearly seen the value of public service and our public services. The weekly clap for carers showed people’s genuine gratitude and thanks to those who work to care for us and restore us to health. However, clapping is not enough. As we move towards what we generally term the new normal, I think the public would expect that new normal to be much better than the old normal that we came to take for granted.

My party is committed to the principle of fair working and does everything it can to ensure the safety and welfare of Scotland’s health and social care workforce. Work is taking place to provide a range of staff wellbeing services and to share that with people working in the health and social care sector. I will give some brief examples. On 11 May, the Scottish Government launched the national wellbeing hub, PRoMIS, which was created in partnership with key agencies, professional bodies and trade unions and will support all health and social care staff in Scotland.

My party has long advocated a real living wage, and since 2011 the Scottish Government have paid the real living wage to all their staff, including NHS workers, and that has recently been extended to all adult social care workers. Scotland was the first country in the UK to announce a death-in-service provision for NHS staff for covid-19-related deaths, including for frontline permanent and fixed-term staff, NHS locums, GP locums and NHS bank staff who are not included in the coverage provided by the pension scheme. Last month, the Health Secretary in Scotland also announced a scheme for care workers in respect of sick pay and death-in-service benefits, whereby a one-off lump sum of £60,000 will be payable to a named survivor, and that will be retrospective.

We are seeing infection rates reduce because of the way that people have heeded the strong message to stay at home, protect the NHS and save lives. That message has, at times, seemed to be under threat—not least when the Prime Minister, given a choice between protecting his chief adviser and the integrity of the public health messaging, inexplicably came down on the side of his chief adviser. I see Douglas Ross in his place. I am certain that he will have quite a bit to say later with which I will struggle to agree, but I want to record my respect for him saying publicly what many of his colleagues must have been saying in private, which he left the Government in order to do.

Photo of Douglas Ross Douglas Ross Conservative, Moray

As this debate is largely about testing, could the hon. Member perhaps get back to how the Scottish Government are doing on testing, given that they are only meeting a third of the capacity for daily testing?

Photo of Richard Thomson Richard Thomson Shadow SNP Spokesperson (Business and Industry)

I thank the hon. Member for that intervention, and I will come to that, if he is patient.

I am not privy to the scientific advice that the Prime Minister has access to, but the apparent ease with which some have been prepared to prioritise short-term economic considerations or individual liberty ahead of the need for collective wellbeing and avoiding a potentially disastrous second wave makes me glad that the rules being followed in Scotland are being decided in Scotland. I very much hope to be wrong, but the potential for a second wave of infection in parts of England seems very real right now, and I get the growing impression that if that is to be avoided, it may be more by luck than by judgment.

It is precisely because of the dedication of NHS and care staff, clear advice and the selflessness and self-discipline of millions of people that progress has been made. In Scotland, Test and Protect is fully in place, and without the boastfulness of saying that it is world-beating, it works and is in place. That has allowed Scotland to enter phase 2 of the route out of lockdown, which will allow NHS boards to begin moving out of a crisis response into the recovery phase, in line with the framework. That means that health boards will be able to start prioritising cancer surgery for those most in need of that treatment and to restart wherever possible urgent elective surgery that had previously been paused, as well as IVF treatment, following the necessary approvals. It means implementing the remobilisation plans for health boards and integrated joint boards, which deal with social care, to increase the provision in order to address the backlog of demands, to handle urgent referrals and to triage routine services. It will also see the reintroduction of some chronic disease management, including pain and diabetes services.

Inevitably, there will be a backlog to be dealt with, but due to the professionalism of the staff, I think we can have confidence that it will be dealt with as we begin the process of recovery. I know how difficult it has been for people who have had procedures or treatments postponed due to the pandemic, but the message is clear: Scotland’s NHS is open, as it always has been, for those who need it. Anyone with medical concerns should not hesitate to contact their GP or NHS 24 or attend hospital if their illness merits it.

Patient and staff welfare must be at the heart of the plan, as it has been through the emergency stage, and testing will be at the heart of that. The routine testing of the NHS workforce in Scotland will be extended from 8 July, as more services resume. That means that staff who work in specialist cancer services, provide long-term care for the elderly or work in residential mental health care will be offered weekly testing from 8 July. That builds on the routine testing, which is already offered to care home staff and aims to protect staff and patients by reducing the spread of the virus in hospitals and other healthcare settings. In addition, Healthcare Improvement Scotland will be resuming its inspection programmes.

We have seen the value of the public services and the ethos of public service. We have seen it in those who have helped to keep our NHS and care settings open, saving lives and providing care for those who have needed it. Many of those who have made the greatest sacrifice are those who have come here from other countries to work in our NHS and our care services. Because of economic and social circumstances, many have been at far greater risk from the virus than it was reasonable for anyone to expect, and we have particularly seen the worrying outcomes of coronavirus in the black, Asian and minority ethnic community. There is likely to be a number of intersecting factors in that, but it is important that they are properly understood and that the measures that come out of that are acted on. I am pleased to say that the Scottish Social Justice Commission will look at the figures that have come out in that respect to look at how we can change to address those issues.

In conclusion, there are things that it would be valuable for us to do. First, we need to value our public servants. It is nowhere near enough to clap: we need to care for our carers and families in life, as well as, sadly, sometimes in death. We should pay them what they are worth, provide them with the equipment that they need, show them that they are valued and give them reasons, whether financially or just in terms of plain decency, to believe that they have respect and that they are valued in what they do.

We need to value the contribution that many from our immigrant communities make to our health and care services. Getting rid of the immigration health surcharge is a very welcome step. The commitment of those workers to the NHS in the country that they now call home is not in doubt, and it is time that the Government considered in what other ways they could work to remove any doubt that there might be about our commitment to them.

Secondly, lest there be any doubt, for all the massive contribution of the private sector in overcoming supply chain challenges, it was a publicly owned, publicly operated, free-at-the-point-of-need health service and public services that rose to the challenge of caring for us in these times, often acting as the carer of last resort. That lesson has never been forgotten in Scotland. I wonder if it is time for this Government to remember that.

Thirdly, the virus has not gone away. There is no vaccine in immediate prospect. If we go too quickly, too far and too fast with easing restrictions, we risk very much undoing the good work that has been done. We need to honour the sacrifices that have been made by so many people by not rushing back to normal too soon. It would be a very bitter pill indeed if we were to do that, if we were to see a second wave and if the work done to date counted for less than it ought to.

Photo of Nigel Evans Nigel Evans Deputy Speaker (Second Deputy Chairman of Ways and Means)

As Members can see from the call list, this is a well subscribed debate. We will start with the Chair of the Health and Social Care Committee with a six-minute limit, and every other contribution will be four minutes.

Photo of Jeremy Hunt Jeremy Hunt Chair, Health and Social Care Committee, Chair, Health and Social Care Committee 4:57 pm, 24th June 2020

It is a great pleasure to follow Richard Thomson. It is the first time I have heard him speak from the Front Bench and it was a very thoughtful contribution. I hope we hear more from him.

I thank the shadow Health Secretary for having this debate and, indeed, for mentioning my article in The Daily Telegraph. If I ever was on the Prime Minister’s Christmas card list, that mention will be sure to get me taken off it—[Laughter.]

I particularly want to congratulate the Minister of State on leading this debate for the Government. As a veteran of many Opposition day health debates, I can say that she elicited a much calmer response from the Opposition than I ever did, and she deserves many congratulations for that.

We need to start this important debate by recognising that, as a country, we are in a transformed position because of recent changes to our response to the pandemic. We are now contacting around three quarters of the people we identify as testing positive for coronavirus and 90% of their contacts are being asked to isolate. That is the basis of South Korean test and trace, and it is incredibly important that we are in that position. I am sad in this respect that the Health Secretary is not here himself, because that would not have been possible if he had not taken the courageous decision to set the target of 100,000 tests a day at the start of April. Indeed, yesterday’s announcement about the gradual easing of our national hibernation would itself not have been possible if that had not been in place, and we need to recognise that.

The challenge we now have is that we do not know where about two thirds of new infections are happening, so we cannot feed them into the test and trace process. That is a challenge, because SAGE’s advice is that we ask about 80% of potential coronavirus contacts to isolate, and we are still some way off that. In fact, we are contacting about 700 people a day to get their contacts and there are about 2,500 daily new infections. If we do the maths, assuming that each person with coronavirus has about nine contacts, which is the current figure, that is up to a quarter of million people since the process started whom we would have liked to have asked to isolate but we have not been able to do so.

How do we meet that challenge? Well, the answer is to do something that the Government have already shown they are very good at, which is a dramatic expansion of testing capacity. The city of Beijing has about a third of the population of the United Kingdom, but its daily testing capacity is nearly double ours at around 400,000 a day, and many of those tests come back within 24 hours. We look forward to the triumphant announcement next week that we are meeting the Prime Minister’s target for all non-postal tests to come back within 24 hours by the end of this month, because speed matters.

If we expand our testing capacity dramatically, we can use it, for example, to deal with localised outbreaks, such as the one we have had in Ynys Môn, where my hon. Friend Virginia Crosbie is doing such a fantastic job in supporting her affected constituents. We can use it at airports instead of the quarantine policy, by testing people on arrival. We can use it for high-risk groups such as taxi drivers, who are particularly at risk. Most of all, we can use it for our frontline health and care staff. If we had Beijing levels of testing in this country, we would, in addition to the testing we are currently doing, be able to test every NHS frontline worker once a week. If we got it up another 200,000, we would be able to test every frontline care worker once a week as well.

Why does that matter? It matters because, according to the evidence submitted to SAGE on 20 April, up to 25% of the coronavirus patients in our hospitals caught coronavirus in the hospital. When we add on the people who catch their infection in care homes, what we end up with is that about a third of new infections are likely to be in healthcare settings—so-called nosocomial infections, which is one of the many new words we have learned over the course of this crisis.

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

The right hon. Gentleman is making a superb speech, and I agree with every word. I was struck by the Minister’s response to me when she made the point that the Government’s position is based on the advice of the chief medical officer. I would entirely understand if the Government said, “The resources are not quite there yet. We have not quite got capacity there. We need to build up capacity before we can test all the millions of NHS staff.” I think everyone would have thought that a reasonable position, and we would be urging the Government to go further. However, if the advice to the Government from the CMO is not the correct clinical approach, will the right hon. Gentleman, perhaps through his chairmanship of the Health and Social Care Committee, ask the CMO whether they will provide the Committee with that advice, and could that advice be shared across the House?

Photo of Jeremy Hunt Jeremy Hunt Chair, Health and Social Care Committee, Chair, Health and Social Care Committee

That is a reasonable question. I will certainly take that away. In fact, the CMO is coming before the Health and Social Care Committee in a few weeks’ time, and I am sure we will ask that question. My understanding is that the concern in the clinical advice is the question of false positives—people who get told that they have coronavirus when they have not. Those people might be in a very important frontline clinical role and be asked to isolate, and that might take them off very important work. To me the obvious answer is to give them a second, confirmatory test to establish whether they really do have the virus.

Weekly testing matters and is so important not only because, with around a third of new infections happening in healthcare settings, it will save a lot of patients’ lives and save the lives of frontline healthcare workers, but because it is the critical thing stopping the NHS getting back to its normal levels of activity.

Last week, the president of the Royal College of Surgeons, whom the shadow Secretary of State quoted, talked about the mountainous backlog we face in, for example, orthopaedic surgery. He said that the thing holding the NHS back is the time it is taking to set up what he calls “covid-lite” facilities, where there is a low risk of people having coronavirus. That is why testing is essential.

I do not want to take up any more time than I need to, but I want to make this point. Korea, Taiwan and Germany are all held up as examples of places that have been particularly effective in tackling coronavirus. All of them introduced test and trace, but they all did it when the virus was at an earlier stage with much lower levels of community transmission. If we want test and trace to be effective here, we need to introduce mass testing, starting with health and care staff, and we must not delay.

Photo of Stephanie Peacock Stephanie Peacock Shadow Minister (Environment, Food and Rural Affairs) 5:05 pm, 24th June 2020

It is a pleasure to follow Jeremy Hunt, the Chair of the Health and Social Care Committee, who spoke incredibly powerfully.

I would like to begin by placing on the record my thanks to the doctors, nurses and staff at Barnsley Hospital, who have been working tirelessly to keep our community safe. These have been very difficult times, and my thoughts are with families who have lost loved ones, with NHS and care staff who risk their lives every day to look after patients, and with key workers who are making huge sacrifices to keep our country running.

As a community, we have come together in the face of huge adversity. Like my neighbours in Barnsley, I have clapped for our carers. As a community and a country, we have expressed our gratitude to our NHS heroes and all our key workers, and I hope that the Government have been listening. Our applause must be translated into action.

When I met representatives of Barnsley Hospital and Public Health England, they told me that coronavirus has changed how people see care. Fewer people are going to A&E and attending regular check-ups for existing illnesses. At the same time, millions of routine operations, screening tests and treatments have been cancelled or suspended. We need a strategy to deal with the backlog in non-coronavirus care. The motion calls for a fully functioning test and trace system for NHS staff. Without it, the NHS cannot return to offering non-urgent and routine care appointments for everyone, and existing health inequalities in the UK will only get worse.

In Barnsley, winter death rates from flu and respiratory diseases are higher than the national average. I represent a former mining community with a large ageing population of ex-miners. Underlying health conditions brought on by their time down the pits have made them more vulnerable to this deadly disease. A recent survey by the British Lung Foundation, which has already been highlighted, showed that one in four people suffering from COPD has had a regular GP or hospital appointment cancelled.

Last month, 20 coalfield Labour MPs wrote to the Secretary of State, voicing the concerns of former miners who fear that if they die during this outbreak, their death certificates will make no mention of the industrial diseases that have caused them decades of ill health. We are still waiting for the Government to reply. I have heard of former miners who tested negative for covid-19 but had it recorded on their death certificate, purely because that is policy for anyone who dies in a hospital. If a death certificate does not mention a miner’s underlying health condition, their grieving family will be denied the compensation they are entitled to.

Industrial diseases have cut short the lives of far too many miners over the years, so I ask one very simple thing of the Government: please change the advice to medical practitioners so that poor health prior to this outbreak is recorded on death certificates. Covid-19 is not some great leveller. It feeds off existing inequalities and it hits communities with vulnerable people hardest. That needs to change.

Photo of Paul Bristow Paul Bristow Conservative, Peterborough 5:08 pm, 24th June 2020

Our NHS has done a remarkable job of looking after us during the covid-19 pandemic. It is entirely right that, in turn, we protect NHS staff and patients by maximising the effective use of PPE and, of course, through testing. In fact, that is a key part of getting the NHS back to tackling the many operations and treatments delayed by lockdown. I consider dealing with that backlog an even greater challenge.

The Prime Minister introduced the lockdown to protect our NHS. The Government were rightly concerned that our hospitals would be overwhelmed, as we saw happen in Italy and elsewhere at the start of the pandemic. It did not happen here. For that success, not just our NHS staff, but the Minister for Care and other Ministers deserve credit. We ramped up capacity, with former NHS workers coming back to serve. New hospitals were opened, and appropriate agreements were reached with the independent sector. This drive for increased capacity must continue.

Now that we are keeping the virus under control, we need a new national effort to clear the backlog. Led by the Secretary of State for Health and Social Care, and spurred on by the galvanising optimism of the Prime Minister, we should back our NHS to deliver again. It is essential to act. Most of us have heard about patients who have missed treatments or had operations cancelled. Even routine and delayable elective procedures such as hip and knee replacements are crucial for patients. Cataract operations restore sight for our grandfathers and grandmothers, and cardiac operations prevent heart attacks and extend lives.

The message should be loud and clear that the NHS is open for business, but it is also important to stress that official figures have been paused. We must treat the projection that there will be 10 million people on waiting lists as just that—a projection, not fact. Too many hon. Members on the Opposition Benches are eager to hear bad news. Yet there is a challenge ahead of us. The Royal College of Surgeons is absolutely right to call for a five-year strategy to tackle the waiting list situation. There is no blame in that. Although we need swift action, there is no quick fix.

We need to look urgently at long-term recruitment. Those who have joined the NHS during this covid pandemic must be encouraged to stay. Coronavirus is also affecting the capacity of operating theatres. Diagnostics underpin the clinical activity in hospitals and the capacity for MRI and CT scans, endoscopy and laboratory tests are limiting factors on everything that follows.

Back in March, the Secretary of State was right to negotiate a deal with the independent sector, and I hope that coronavirus has ended the lazy assumption that the independent sector and the NHS cannot work in partnership, because that has been a good thing and has helped our NHS to get through this period.

Finally, the NHS needs to become more productive. The people who tell me that are NHS staff themselves. We have already seen GPs switch to virtual appointments and consultations, and this has worked. Technology is crucial, but it is only a start: the NHS can change many care pathways to become more productive; and we can accelerate the uptake of existing treatments that keep patients out of hospitals.

We can and must be ambitious for the future of our national health service, precisely because there is so much good will and its staff are more valued than ever. We must not let the public down. We must not let NHS staff down. This is an opportunity for change, and I am confident that this Government will deliver.

Photo of Charlotte Nichols Charlotte Nichols Labour, Warrington North 5:12 pm, 24th June 2020

The coronavirus crisis has reaffirmed what Labour has always stated: that the NHS is the jewel of our country’s public services. We are beyond fortunate to have such brilliant and dedicated doctors, nurses and support staff, including cleaners, from around the world who are working for us in the health service—such as the student nurses from the University of Chester’s Warrington campus who have stepped up as part of the national effort and should be commended.

I begin by paying tribute to two of those staff whose lives were tragically cut short during the pandemic, and whose loss is keenly felt by their colleagues and across our community: Andy Collier, a nurse practitioner at Hollins Park Hospital in Warrington, and Joselito Habab, known as Jo to his colleagues, a nurse at Warrington Hospital. May their memories forever be a blessing.

We have been fortunate that heroic efforts have so far ensured that the critical care bed capacity has not been overwhelmed, and I hope we are now better prepared for the threat of an additional wave this winter. Critical care capacity at Warrington Hospital is now five times the normal capacity—an extraordinary undertaking by everyone involved—but we know that routine care has suffered, as well as admissions and treatment for stroke, cancer and heart attacks. The patient transfer list for planned procedures in Warrington has grown massively, and it is estimated that it could take up to 18 months to get completely back to normal. I would like the Government to support hospital trusts and CCGs to work collaboratively on regional patient transfer lists to better manage elective care capacity and ensure that we do not keep patients waiting any longer than necessary.

We face a huge cancer diagnostic backlog of 2.4 million people waiting for cancer screening, further tests or cancer treatment, and 93% of histopathology departments are understaffed. We know that early intervention in cancer care has a dramatic impact on health outcomes. Research by University College London and DATA-CAN, a health research hub for cancer diagnosis and treatment, suggests that there will be almost 18,000 excess cancer deaths next year.

Before the pandemic, the NHS and the social care system had significant staffing shortages. Stress levels for NHS staff were at a five-year high and only a third of staff felt that staffing levels were sufficient. Social care has one of the highest turnovers of any sector and a quarter of staff are on zero-hours contracts. A lasting consequence of covid must be more than memories of clapping; we must improve the pay and working conditions of NHS and care staff.

The mental health challenge will be an enduring problem of this covid period. In spite of Government promises, mental health is still underfunded in the UK. The King’s Fund estimates that mental health problems account for 23% of the burden of disease in the United Kingdom, but addressing that still makes up only about 10% of Department of Health and Social Care spend. Alarmingly, Mind says that almost a quarter of people who tried to access mental health support in early June failed to get any help.

I praise the efforts of mental health staff at North West Boroughs Healthcare NHS Foundation Trust and in the voluntary sector in Warrington at an extraordinarily difficult time, but it is clear that more investment and focus is needed. Covid has affected, and will continue to affect, every part of our lives. It has forced us to change our entire way of living. Coming out of it will give us the opportunity to make changes to our society for the better. That must start with our health service.

Photo of Stephen Hammond Stephen Hammond Conservative, Wimbledon 5:16 pm, 24th June 2020

At the beginning of the motion before the House, there is something with which we can all agree. As this is the first chance that I have had to speak, I put on record that the constituents of Wimbledon are served by three outstanding hospitals: St George’s, St Helier and Kingston. The heroic efforts of frontline staff, and indeed all NHS staff during this period, had been extraordinary. I also thank primary care and social care staff, who have helped many in my constituency.

I read the motion carefully and listened carefully to the shadow Secretary of State. In essence, the motion seems to be about three things: first, the backlog of operations and care that need to be provided; secondly, winter preparations; and, thirdly, testing. I agree with my right hon. Friend Jeremy Hunt, the former Secretary of State and now Chair of the Select Committee, that the decision to stop track and trace at the beginning and the advice to centralise testing were wrong.

It takes courage for anyone to admit that they were wrong and to put it right, and that is what the Health Secretary did. Although we are here to talk about the need for mass testing, we should acknowledge the amount of capacity that has been put in place. Having listened to my hon. Friend the Minister for Care, I ask her to make sure that the symptomatic and asymptomatic testing initially of health and care workers, and beyond, is in place. There is obviously more to do, but her confirmation that the chief medical officer has said that we should see that on at least a fortnightly basis, if not more regularly, is a good start. That should be welcomed across the House, because it is a huge step in the right direction.

I could talk a lot more about winter preparations, as for a little while I was in charge of trying to ensure that that happened and that it happens every year. The motion fails to recognise not only that preparations have to be made, but that, if we are to reduce the number of operations and care that people need and have not received due to covid, medium-term preparations also need to be made.

We should recognise that part of that is the building of new hospitals and the providing of new care. That should happen for local constituents across the country, but I want to talk particularly about south-west London. I find it extraordinary that part of my local political scene is the “save our hospital” campaign that comes out year after year. I have a Government I am proud to support putting £500 million of investment into a development scheme to increase the quantity and quality of care and improve access to great care, some of which would have helped during the covid crisis because there would have been a larger acute care hospital, yet my local Labour opponents are rejecting this. It seems extraordinary that we have a motion today that asks the Government to do exactly what they are doing, while at local level that preparation is being put in place for the medium term. Not only is Labour denying access to care now, but it is denying the quantity and quality of care we need for the future and increasing health inequalities by not supporting that investment.

Photo of Emma Hardy Emma Hardy Shadow Minister (Education) 5:20 pm, 24th June 2020

I start by paying tribute to all the health and social care workers, right across my constituency. They have my deeply felt thanks and gratitude.

I will concentrate on my role as chair of the all-party parliamentary group on vascular and venous disease, because I am deeply concerned by the impact covid-19 has had on people who suffer from vascular disease. I have spoken about vascular disease before. It is a killer disease that few seem to know about, despite the devastation it causes to so many lives. Between 15% and 20% of British people over 70 are affected by peripheral artery disease, which can cause painful chronic leg ulcers and is the main cause of amputations in England. As I have said previously, every hour in England someone has part of their foot removed; every two hours in England someone loses their leg.

As chair of the APPG, I have heard evidence from NHS frontline workers and patient representatives deeply concerned by the burden borne by people with vascular disease because vascular services have experienced reductions in their capacity to deliver care during the crisis. Some people with vascular disease are too frightened to seek treatment. As Mr Naseer Ahmad, the Manchester amputation reduction strategy director, says, “One of the biggest problems we face is fear.” I believe the lack of a comprehensive and universal covid testing regime, combined with stories of patients who enter hospital covid-free only to contract the disease while in hospital, is driving that fear. That has inevitably led to people who otherwise would take themselves to hospital staying at home while their condition worsens. To make matters worse, clinicians have expressed fears that many people who have had their non-urgent operations cancelled may have deteriorated since that decision was made.

Photo of Paul Bristow Paul Bristow Conservative, Peterborough

Does the hon. Lady agree that for people with peripheral artery disease, it is often urgent referral that makes the difference between saving a limb and losing it? Unfortunately, during the crisis, that urgent referral to secondary care and multidisciplinary teams may not have happened. We must guard against that as we try to save limbs.

Photo of Emma Hardy Emma Hardy Shadow Minister (Education)

I absolutely agree. As Dr Dan Carradice, a leading consultant on this condition at Hull Royal Infirmary, says, time is ticking, and the more quickly we can deal with this, the more urgently we can save limbs. Because of the delay, we have seen over the past few months a growing wait for lower limb amputations, many of which could have been avoided with timely diagnosis and appropriate treatment.

We cannot allow this situation to continue. Patients must be confident that they can visit their hospital safely. One vital way the Government could restore trust is to have a routine weekly testing programme for NHS and social care staff, so that patients know when they enter hospital that they are not likely to contract covid-19. Every day, the number of people seeking treatment is growing. Dr Una Adderley, programme director of the national wound care strategy, has described a “tsunami of unmet need” on the horizon as certain vascular services have been deprioritised.

Of course I recognise the huge pressure the NHS is under, but I believe that more can be achieved for people with vascular disease if they are given the focus they need. We need to create safe, covid-19-negative pathways and services for vascular disease in the community and in hospitals. I recognise that these are not straight- forward tasks, and as chair of the all-party group I will be writing to the Secretary of State for further details on exactly how this could be achieved. We also need a comprehensive approach to vascular disease in the NHS long-term plan, because there are huge regional inequalities, with patients in Hull being 46% more likely to need a major amputation than the England average. As I said before, time is tissue, so I look forward to getting a date in the diary for the Minister for Health, Edward Argar, to visit Hull, as he promised in a previous debate—but of course, only when it is safe to do so.

I note that the Government wish to change the wording of the motion away from the need for a weekly testing programme to instead celebrating and recognising their own efforts. With the greatest of respect to the Government, the highest and most well regarded praise tends not to be written by oneself. I would encourage them to seek to earn that praise rather than pen their own, and one way in which they could do that would be to prioritise the hundreds of thousands of patients suffering from vascular disease in the UK.

Photo of Douglas Ross Douglas Ross Conservative, Moray 5:25 pm, 24th June 2020

It is a pleasure to contribute to the debate. Because the motion mentions cancer referrals, I hope that it is in order to put on record the best wishes—and, I am sure, the love—of everyone in the House for our hon. Friend Tracey Crouch, who has bravely announced on Twitter today that she has been diagnosed with breast cancer. It has been caught early, and she is getting excellent treatment from her local health board, and I think all Members on both sides of the House know what a fighter she is. I know that she will be back in her place very soon. Tracey was my proxy when I was on paternity leave, and I know that, because she has a proxy under the current system, she will continue to represent her constituents to the absolute best of her ability. We wish her, and her partner and young son, the best in these difficult times.

I also want to use this debate as an opportunity to put on record my thanks for the outstanding work done by the nurses, doctors and staff at Dr Gray’s Hospital in Moray, in our GP surgeries across the area and also in our care homes. For a large part of this pandemic, our care home staff have been the unsung heroes. Yes, there was a focus on the NHS at the outset of the pandemic, but right from the off, our care home staff were looking after residents who, very early on, had stopped seeing friends and relatives. Going above their own caring duties, the staff also had to replicate a lot of the contact that the residents had with the outside world, and I really want to pay tribute to all the care home staff in Moray and across the country.

Sticking with Moray for one more moment, I am grateful to use the opportunity of today’s debate to confirm that the update on Moray’s health and social care today once again gave us the positive news that, in the past seven days since the last update, there had been no covid-related deaths in Moray and that the total remained at 86. We are making positive progress. That progress is possible because of the Government support that has been given at UK and Scottish level, but ultimately it is because of the way in which the public have responded to this crisis, and we should never forget what they have done.

I want to focus briefly on the remarks made by Richard Thomson. He made a very good speech, but he danced around the edge of some of the issues that I was hoping he would mention. I noted that, in The Herald in Scotland yesterday, there was an opinion piece that said that there was no basis for the argument that Scotland had handled this crisis any better. Anyone listening to the hon. Gentleman —or indeed any SNP representative in this place or at Holyrood—would think that the crisis had been handled so much better there than in any other part of the United Kingdom. However, as that opinion piece in The Herald said, there is no real evidence to support that.

When I intervened and asked the hon. Gentleman what he felt about his Government’s record on testing, he did not really answer my question. Given that we have the capacity for 15,500 tests every day in Scotland, why are the Scottish Government overseeing only about a third of those tests? By the end of this month, if the Scottish Government had matched testing to capacity, they would have done 500,000 more tests. Testing is an important element as we come out of the pandemic and open up our businesses, our communities and our hospitality sector, which is seriously concerned about the announcements from the Scottish Government that it is not able to reopen as quickly as in other parts the United Kingdom. The fact is that we have that capacity at our fingertips but it is not being used. I think the Scottish Government should go away and reconsider, and try to use as many tests as they can to help us to get out of this.

In the last few seconds remaining, I want to put on record my thanks for what is being done by UK Government Ministers and Ministers across every devolved nation. This is a time when we all have to pull together, and I think we are seeing that. We need to continue to do that and I think today’s debate has allowed us a further opportunity to do so.

Photo of Olivia Blake Olivia Blake Labour, Sheffield, Hallam 5:29 pm, 24th June 2020

I, too, would like to thank and praise the efforts of all frontline workers, in particular from the NHS and local government, on test and trace, and throughout the coronavirus epidemic.

It has now become clear that the Government were quite slow to implement testing for everyone, including NHS workers. Thankfully, the teaching hospitals in Sheffield were a lot quicker to provide tests for their staff—nearly 10 days before it was recommended. They used their in-house expertise to provide tests early to keep health workers on the frontline before the spike in the pandemic. It is not enough for the Government to leave that to individual hospitals. We need Ministers to properly resource a national routine testing regime for all NHS workers that can keep staff safe, keep patients safe, prevent the spread of infection, keep health workers and support staff at work, and get the NHS back on track.

There is a stark difference between how my teaching hospital in Sheffield approached its use of in-house expertise and the Government’s wider approach to testing and tracking. We have heard about the complicated system involving multiple private companies. It is still unclear to me why Serco was given the track and trace contract. It has no expertise in this area, has already had to apologise for breaching data protection rules and was previously fined £1 million for failures to deliver on other contracts.

Rather than private companies with little or no medical and testing experience, we should learn from the healthcare professionals and public health experts who are working hard to respond to local public health emergencies. That means ensuring realtime testing data is shared with public health directors—a frustration that I know is felt up and down the country—or whoever, whether GPs or local authorities, is responsible for dealing with local outbreak responses. It means supporting local campaigns, charities and mutual aid groups to provide soft intelligence to help to monitor outbreaks.

That also means thinking through the needs of individual communities, such as those that do not have English as their first language. The testing and tracking system is vital and a huge part of our national response to the covid-19 crisis, but we also need clearly communicated social distancing measures, workplace health and safety audits, and robust supply lines of PPE. The Government have been slow to act and we now need to ensure that the tracking system we put in place is informed by expert opinion, properly integrated with response teams on the ground and sensitive to the needs of communities.

On care homes, we have seen outbreaks in one in three, which is shocking. When we found out that earlier on in the crisis that there was a cap on tests in care homes, we could see that managers may have been placed in the difficult position of choosing between testing residents and staff. Testing of patients discharged to care homes must not be forgotten. We must make sure that that remains in place for the long term.

We need to make sure that we encourage those who are about to become parents to access maternity services if they have any concerns about a reduction in movement. We have seen a sad and desperately tragic increase in stillborn births and in complications in births, so that is really very important. Finally, we need to make sure there is not a bottleneck in diagnosis and that the longer-term implications of covid-19, such as fibrosis, are in the horizon planning too.

Photo of Harriett Baldwin Harriett Baldwin Conservative, West Worcestershire 5:34 pm, 24th June 2020

Thank you, Madam Deputy Speaker, for giving me the opportunity to put on record my thanks to everyone who works in the NHS and the social care sector in Worcestershire, as well as all those involved in gold command who have been able to bring together the work of the county councils and the district council, and all the critical workers who have kept the county going over the past three months. It is remarkable how well prepared they were and how able they were to cope with the peak without ever running anywhere near being overwhelmed in the system.

This debate allows me to put on record my condolences to the family of Julie Omar, a very well regarded nurse who lived in Malvern. In April she very sadly passed away at home with symptoms of covid-19. From the outpouring from the community and those with whom she worked at Redditch Hospital, it was clear that she was an absolutely remarkable woman. I did not know her personally, but clearly no words will ever be able to make up for the loss of such a remarkable individual. I hope that, by paying tribute to her work here in Parliament, it will help her family to come to terms with their loss.

This afternoon, I want to speak about innovation in three key areas: innovation in organisation; innovation in treatment; and innovation in testing. Clearly, there has been massive innovation in all three areas throughout this crisis.

First, on the organisational side, it has been amazing to see not only the new Nightingale hospitals being built, but so many GPs—I think almost all of them now—able to deliver tele-medicine. The innovation has allowed us to ramp up the ability to deal with such high volumes. There was also the appointment of Lord Deighton, who has been able to make such a remarkable difference through innovation in terms of the PPE supply chain. It is really exceptional how that has been dealt with. I would like to request that we put someone of that calibre in charge of planning how we ramp up and innovate organisationally to deal with the backlog of more routine treatments that are needed for so many of my constituents now.

Secondly, on innovation in treatment, I am very proud that it has been UK scientists who have discovered the important role that dexamethasone can play in treatment. It is such a cheap treatment and will, I think, be a help all around the world where the infection still runs rampant. May I also suggest an improvement in terms of treatment here? For those who have been asked through NHS 111 to stay at home with symptoms of covid-19, would it be possible to start to send oxygen saturation monitors to their home to ensure that they do not present at hospital far too late, when they are beyond treatment?

Finally, on innovation in testing, which is the subject of today’s debate, can we have an update from the Minister on testing, which has risen remarkably from five a day to 200,000 a day, but which needs to find other innovations in terms of speed and methods. The saliva testing pilot in Southampton, for example, would enable our airline industry to get going again.

Photo of Munira Wilson Munira Wilson Liberal Democrat Spokesperson (Transport), Liberal Democrat Spokesperson (Health and Social Care) 5:37 pm, 24th June 2020

I join Members from across the House in paying tribute to our NHS and care workers, who have made immense sacrifices and put themselves at great risk on behalf of all of us. We owe them a huge debt of thanks. I mean all the staff in health and social care, including clinical staff, allied healthcare professionals, cleaners, porters, administrators and managers. Whatever their role, we salute them and thank them. However, time and again, they have said to us, “Don’t clap for us every week. Give us the PPE and the testing that we need to stay safe on the frontline.” Sadly, I do not have time today to talk about PPE, and the thrust of the motion is on testing. I would just say that I was surprised to hear the Minister’s comments about care homes and all the testing that has been made available in care homes. The National Audit Office report, published earlier this month, said that 25,000 patients were discharged from hospitals into care homes at the height of the pandemic. We know that since the start of the pandemic close to 14,000 people have died in care homes in England from covid-related causes, yet it took until 8 June to offer tests to care home staff and residents, and even then that did not include learning disability care homes. The case for a full independent public inquiry is, frankly, unquestionable.

There remain issues with testing. I fully agree with Jeremy Hunt,  who is no longer in his place, that we need a huge further scale-up of testing, including weekly or regular testing of health and social care staff. That needs to be part of a robust test, trace and isolate regime, which, sadly, as health leaders and the World Health Organisation have said, is still lacking. We have seen the app in disarray and we know that local authorities still do not have the data and the resources they need to trace effectively. Health leaders have called today for a “lessons learned” exercise so that we are ready for a second surge; I urge the Government to heed their advice and do that exercise quickly so that we are ready.

I wish to use the time I have remaining to talk about mental health, which is referred to specifically in the motion, with regard to two groups: frontline workers and children and young people, who are also referred to in the motion. From talking to trust leaders and leaders in the social care sector, we know that staff are exhausted and traumatised. There is concern about the potential for post-traumatic stress disorder further down the line. We need to see a big package of measures to support our frontline workers. I welcome the fact that a helpline has been put in place. It needs to be available 24/7 to health and social care staff. We also need to look at some of the measures that the military have in place to support staff, with fast-track access to mental health services and standardised access to mental health services up and down the country. That does not currently exist for our frontline health and careworkers.

As children and young people have been out of formal education for many months and away from their friends, there is likely to be an explosion in the need for mental health services for children and young people. Waiting times were already huge—in some cases six months for my constituents. We need a detailed, cross-departmental Government plan that goes well beyond what the NHS long-term plan has in place, to support our children and young people. They are our future, the recovery will be built on their backs and they need to flourish.

Photo of Siobhain McDonagh Siobhain McDonagh Labour, Mitcham and Morden 5:41 pm, 24th June 2020

We now know that coronavirus is not the great leveller. We know that it exacerbates social difference and the problems of health and social inequality. If someone is a black doctor, a black nurse, a black cleaner, a black paramedic or a black person in social care, they are more likely to contract and die of coronavirus than their white counterparts. We also know that if someone is a black man not in the health service, they are more likely to die from coronavirus. If someone is a black woman, they are more likely to die than their white counterparts. If they are taken to hospital, they are more likely to enter intensive care.

We know that it is not fair—it is not a balanced foundation. The Government have pledged to look into the issue with an inquiry, yet in nine days’ time, the NHS in my area intends to agree a plan that will move services away from black and ethnic minority areas to those that are whiter and more wealthy. When asked, “How can you do this without looking at coronavirus and its impact on the NHS?”, they said, “Okay, we’ll do the research, but we are not telling you about it.” Under pressure and embarrassment, they have produced their research: four pages, and not one word about the impact of coronavirus on black or ethnic minorities. There is no defence of their decision to take services away and no acknowledgement of the problem that exists. That is without even considering the fact that the black community in my constituency and around me in south-west London are more likely to have diabetes and hypertension, and black women are five times more likely to die in childbirth.

Do black lives matter? Perhaps we have to prove that they do. I ask the Minister directly: will she intervene to say that, yes, black lives matter, and that we need more than four pages that do not even give any acknowledgement of the problem that exists for black and ethnic minority people in our country and in my bit of south-west London?

Photo of Kieran Mullan Kieran Mullan Conservative, Crewe and Nantwich 5:44 pm, 24th June 2020

I want to begin by thanking all the staff at Leighton Hospital, which serves my constituents in Crewe and Nantwich, who were so welcoming to me during my time on the wards recently. Because I am an MP and because I have a public profile, I have received a lot of thanks for going back, when actually the real thanks and gratitude should go to those staff who are there day in, day out full-time.

I know coronavirus presented a very real risk that was not an ordinary part of the job, but one of my key aims in this place is to get across to all Members of this House that the day-to-day stresses many face working in public services are there all the time. NHS staff often go above and beyond, and take decisions and carry a weight of responsibility that would be quite alien to most people. I want to use the recognition of the incredible work of NHS staff at this time to highlight the need to continue with this recognition going forward. We are at risk of finding it increasingly difficult to recruit and retain staff, as the rest of our modern workforce sees shifts towards a better work-life balance and flexibility in their employment.

We know that testing and tracing is key to the battle against coronavirus. We also know that health and social care settings are going to be the area that will need particular attention. In fact, I saw during my brief time back treating patients that, as services begin to look more like they did before coronavirus, the challenge for health and social care providers will increase in some ways. For a period, the task was clear and focused. Almost everything being done was geared towards treating coronavirus patients and keeping as many people as possible safe. Now, individual staff and managers need to weave steps to contain coronavirus throughout the increasing return of normal services. Organising wards into covid and non-covid is actually a simpler way of managing the flow of patients when that is the primary and overriding concern. When we reach the point of needing to be vigilant and to isolate individual patients among the delivery of normal services, that presents unique challenges of its own.

It is important that, wherever possible, normal services do return, because we know there is increasing evidence that diagnoses have been missed or delayed. This was an unfortunate inevitability of the clear and necessary message to the public about being careful in making use of the NHS at the height of the pandemic. So we must see how we can target messages. There is an increasing tendency to rely on social media online advertising for our public health messaging, and we need to use media that are going to best reach the at-risk groups for not seeking health advice.

On delivering rapid and ongoing testing, I feel compelled to challenge the narrative that the Secretary of State in Whitehall can click his fingers and instigate a flawless testing regime across the many thousands of individual wards, units, GP practices, treatment centres, care homes and in-home care providers that make up our health and social care sector. Clearly, the long time in opposition and the loss of so many previous Labour Secretaries of State for Health from their Benches have led to amnesia among the Opposition about the reality of instituting national approaches uniformly in the NHS. Any guidance is sent to hundreds of thousands of staff and is interpreted by them individually and locally by their managers.

Weekly testing is not a magic bullet. We must not let there be any distraction from the key and overriding concern that keeping outbreaks contained is most importantly about individual NHS staff and patients maintaining social distancing as much as possible within healthcare settings, because without that, even with regular testing, we will lose groups of staff from frontline services at times when we cannot afford to do so. We must not underestimate the enormous task a weekly testing regime would place on the NHS. There needs to be clear evidence for its benefits over other approaches. I note that the British Medical Association and others have said the same thing—that actually the evidence base for a mandatory weekly approach is not necessarily there. I hope, when responding, the Opposition spokes- person, Dr Allin-Khan, will spell out exactly what evidence they feel they have that means weekly testing is the one and only way to do it.

Photo of Rushanara Ali Rushanara Ali Labour, Bethnal Green and Bow 5:48 pm, 24th June 2020

This virus has cruelly taken so many lives, and so many of us have lost friends, relatives, neighbours and loved ones across our country. We pay tribute to all those NHS workers and careworkers and others in our country who have paid the ultimate price to protect people.

That is why it is so important that we focus on the areas where we can act to protect our NHS and key workers and that we ensure there are proper, effective and efficient ways of providing them with the testing that is required, so that they do not have to continue with some of the failures that they had to work within: there was a lack of PPE at the beginning of this crisis and they had to make incredibly difficult decisions and work under incredible pressure during the beginning of the crisis. One senior Asian doctor said to me at the beginning of the crisis in my constituency, “We are going to be collateral damage because of some of the things this Government are doing.” We have to make sure we learn quickly and protect people. I hope that Ministers will look at where the mistakes have been made and make sure we learn fast and provide the testing, so that NHS and careworkers do not have to put themselves, and their colleagues, patients and families, at risk by not knowing the results of tests quickly.

We also know about the high death toll among BAME NHS and care workers, and the Government’s own inquiry has highlighted the wider inequalities that my hon. Friend Siobhain McDonagh talked about. We know about the different kinds of family structures—intergenerational families—among BAME health staff, those with higher health inequalities and health risks, which means they face additional challenges. The risk assessments are therefore crucial, and testing falls within that framework. It is vital that we take action and the Government heed the advice about testing. Since the end of March, excess deaths have increased by 44% nationally, but the figure for care homes is much higher, at 93%. That means 27,000 more people have died in care homes than would normally be the case at this time of the year, and that is a scandalously high number. If there is one thing we can do, it is make sure that care workers, who are there to protect those in care homes, are given the testing kits and that the testing is done for them quickly, because they faced considerable neglect at the beginning of this crisis.

A few weeks ago, I asked the Health Secretary, in the Chamber, about providing testing in acute settings. He did not have an answer, but he said he would write to me. Despite numerous reminders, via social media and in writing, I still have not been given an answer, and I hope that the Minister here today can respond to that point about acute settings in hospitals, because it really concerns people in the NHS.

In conclusion, we need to make sure that we learn the lessons quickly, because the risk of a second wave is grave and real. We have to work together to act, and I hope that the Government will therefore heed the advice and ensure that the testing is provided within the timeframe necessary to protect people in the NHS and the care service.

Photo of Ben Spencer Ben Spencer Conservative, Runnymede and Weybridge 5:52 pm, 24th June 2020

First, I wish to pay tribute to the work of all our NHS and care staff in Runnymede and Weybridge—thank you. The pandemic has affected us all and the response to it has been from all quarters. NHS leaders such as the NHS Confederation have said that we need “Reset, not just recovery”. The response to this pandemic gives us a once-in-a-lifetime opportunity to build back better.

This motion invites us to look to at the future, but in doing so we need to look at the big picture. The lockdown has had a huge impact on lives and livelihoods; it has damaged our economy. The health of our nation is its economy. People often speak about health and the economy as separate issues, but they are not. Be in no doubt: poverty is just as deadly as any coronavirus, but its effects can be slow and silent. Almost every disease is highly associated with poverty and socioeconomic deprivation—I am talking about diabetes, cancer, high blood pressure, strokes, mental illness, and drug and alcohol addiction—with early childhood experiences laying down health risks that play out over a lifetime. As the economy suffers with lack of opportunities and jobs, poverty and socioeconomic deprivation worsen, and, as a result, so does the health of the nation—it just takes much longer to see the effect.

However, that future is by no means inevitable and to avoid it we must reset, not merely recover. Today we need an immense public health response to prevent the illnesses that are caused by this crisis but which will be detected only in years to come. Our response must come from all quarters of government, impacting all society. A few examples are cutting air pollution from our aeroplanes and motorways such as the M25, preventing lung diseases and protecting our planet; protecting green space so that people can exercise, and reduce and prevent childhood and adult obesity; and early interventions in schools preventing adult mental illness. The best example I can give of joined-up working is meals on wheels—a lifeline to many but also preventing malnutrition and illness in older people. You see, adult social care and related support is a public health measure. This is an area that we must take forward and fix.

None of the areas I have mentioned fall directly under the NHS, but all have a profound public health impact on disease, and ultimately a profound impact on the care the NHS needs to offer. We cannot look at the issue of healthcare as we do today and limit it to the NHS. We have to see healthcare as embedded in all our communities and linked to all our other policies as diverse as infrastructure, education and local planning. Only through this can we meet the challenges that healthcare faces, and not purely the challenges that we face from covid. As we reset and restart the NHS, now is the time to unleash it—to unleash healthcare—from its silo.

Photo of Abena Oppong-Asare Abena Oppong-Asare Labour, Erith and Thamesmead 5:55 pm, 24th June 2020

I start by paying tribute to all the amazing NHS and social care staff who have continued working throughout this crisis, putting themselves and their loved ones at risk. Sadly, we know that at least 300 NHS and social care staff have died from covid-19. Although we have stopped clapping every Thursday, we should not forget the sacrifice and the contribution that they have made to protect us all throughout this crisis. I would like to take this opportunity to pay tribute to my constituent Esther Akinsanya, a nurse who died from covid.

Covid-19 has put the NHS under unprecedented strain at a time when demand for health and care services was already at an all-time high. Millions of operations, treatments and appointments have been cancelled. One constituent, a member of the Association of Disabled People, told me that they had had 17 appointments postponed until 2021 and that the impacts on their long- term health would be detrimental. Another constituent, from Bexley, contacted me concerned that their routine cancer check-up had been cancelled and they had not been informed of when it would be rescheduled. The Government’s slow response on testing and PPE has put at risk not just thousands of NHS and social care staff but members of the public who have had to have their appointments cancelled.

It is essential that our NHS services can resume safely, but for this to happen we need regional testing for NHS and social care staff. We need a plan to test, trace and isolate people with suspected covid-19, and access to adequate PPE, including preparation for the potential for a second spike in the virus.

Photo of Matt Rodda Matt Rodda Shadow Minister (Transport) (Buses)

My hon. Friend is making an excellent speech and I thank her for the points that she makes. I would like particularly to highlight the issue that my right hon. and learned Friend the Leader of the Opposition pointed out so eloquently at PMQs today—that we simply do not have a robust enough system at the moment and we really do need to advance this rapidly if we are to avoid the risk of a second spike.

Photo of Abena Oppong-Asare Abena Oppong-Asare Labour, Erith and Thamesmead

My hon. Friend makes a very strong point with which I completely agree.

The organisation EveryDoctor, which has been representing doctors throughout the crisis, has reported that between mid-April and the end of May, 42% of the UK doctors it surveyed did not have access to adequate PPE. The Government have failed NHS and social care staff by failing to implement PPE guidelines in line with those from the World Health Organisation. Over a month into the crisis, NHS staff were failing to be provided with long-sleeved gowns, which were deemed essential by the World Health Organisation. We have heard these concerns from multiple organisations and from NHS and social care staff at first hand. We cannot allow a lack of PPE and testing to be a contributing factor in the cancellation of any more appointments going forward. With the risk of a second spike in the virus, we must put practical measures in place to urgently protect staff and patients.

NHS trust leaders have asked the Government to provide the following: first, external testing support, and details on when it will be available; secondly, clarity on the turnaround time for processing test results—the turnaround time for some health and care providers is currently three to seven days—and finally, clarification on whether testing capacity is being made available to support a range of services to recommence, or whether certain services are being given priority.

Last week, during a meeting of the Select Committee on Housing, Communities and Local Government, I asked whether the problems with the contact tracing app first reported during the testing stage on the Isle of Wight had been rectified, but I did not get an answer. Will the Government now give NHS and social care staff the answers and support they need so that long-overdue services can resume and staff can be reassured that all available measures to protect their wellbeing and that of their patients have been taken?

Photo of Flick Drummond Flick Drummond Conservative, Meon Valley 6:00 pm, 24th June 2020

As other Members have said this afternoon, all through this crisis the staff across the health and care system, whether NHS staff or those working in the private sector, have made huge efforts and sacrifices to look after people who need their help. I therefore welcome this opportunity to pay tribute to them, and to honour those who have given their lives while fighting to save others. A huge number of people in Meon Valley have contributed to the response to covid-19, working in our hospitals and care homes, or by providing support to neighbours and relatives, alongside other key workers.

The motion states that at least 312 people working across the NHS and social care have died during the outbreak, but I think it is important to get another analysis, such as the one that the Office for National Statistics released in May, which covers England and Wales. I realise that there have been different approaches to collecting data across the devolved Governments, so I hope that my hon. Friend the Minister will press them to produce similarly definitive data so that we can make informed judgments about the effectiveness of measures over time, and the risks to those in minority communities working in the NHS and in care homes. Every death caused by this illness is a tragedy for a family, and for friends and colleagues, and I feel their loss.

The motion mentions preparedness for the coming winter, when we may need to protect our NHS again, and that means protecting those who work for it. We need to establish and maintain routine testing for staff in all areas of healthcare, which I hope will become a simpler process if the trial currently underway in Southampton, based on saliva samples, gives positive results.

However, although the burden of covid is easing, there is a risk that we will see a surge in demand for health services unrelated to it, as the diagnosis of other conditions has been suppressed during the outbreak. I know that GPs and hospital staff are anxious to get back to normal and have been contacting patients. Already the figures show an average reduction of 33% in the use of the emergency departments at my three local hospitals, in Winchester, Southampton and Portsmouth, so people need to know that the NHS is open for business.

It is vital that staff get an opportunity to recover. Most have been working non-stop since January, and they need a break. If we do see a second wave this winter, we must be ready to deal with it effectively and properly from the outset. The last few months have been deeply traumatic for health and care staff, and I urge the Government to ensure that all staff who need it get mental health support. I welcome the round-the-clock mental health support line, but I hope that every care setting has procedures in place to help colleagues. We also know that the period of confinement has been very difficult for the many people with mental health needs. We talk about parity of esteem for mental health, and this is the time to prove that it actually gets parity.

Lastly, I pay tribute to my right hon. Friend the Secretary of State for Health and Social Care and those in his Department, who, like all key workers, have not stopped and have been quick to respond to events and to us as MPs. This has been an unprecedented coronavirus for this country. We have put in place many measures very quickly. I thank everyone who has been part of that, on behalf of my constituents in Meon Valley. I am confident that we are much better prepared for the future.

Photo of Robert Courts Robert Courts Conservative, Witney 6:04 pm, 24th June 2020

It is a great honour to speak in this important debate on testing for NHS and social care staff. I would like to take this opportunity to put on record the boundless thanks of the people of Witney and West Oxfordshire for everything that social care staff and the NHS have done to care for them throughout this crisis. I know that their gratitude is profound and will never be forgotten.

We have now performed more coronavirus tests than any country in Europe, except for Russia. Given the point we started from and the challenges we have had to overcome, that is a significant accomplishment. We have developed a world-leading diagnostics industry virtually from scratch in a matter of months. That extraordinary achievement is a huge credit to the Government and to the Secretary of State for Health and Social Care. If we can put the politics to one side for a minute, it is a shining example of what we can do in this country when we all pull together.

It is absolutely right that NHS and social care staff are prioritised for testing. They are on the frontline of the fight against the pandemic, and they should be at the front of the queue when it comes to testing as well. I welcome the fact that we are now in a position where any care worker who needs a coronavirus test can apply for a priority test, and there is not a restriction on the number of tests they can take, but I want to look at how we can do better for them.

We have only been able to expand our testing capacity so significantly and rapidly thanks to the collaboration of the NHS and expert healthcare providers in the private sector. One of the main lessons of this pandemic has been that, during a time of crisis, ideological questions in the realm of healthcare have been put to one side. The priority is ensuring that testing equipment is acquired, PPE is procured and ventilators are produced. That involves teamwork from the private and public sector, and I am pleased that testing is just one of a number of areas where that has borne fruit.

We need to look at what we can do in the future. We need to look at whether there is more that Public Health England, which is operationally independent of Government, could have done to sponsor and to bring on that partnership at an earlier stage. We could look at Germany, which is very good at this aspect of diagnostics and that partnership model, which is one reason why it has done so well during this crisis.

I would like to spend a few moments talking about one of the major employers in my constituency: Abbott. Its diabetes operation is in Witney, where it manufactures FreeStyle Libre diabetes devices, which are life-changing, and I have spoken about them in the House before. Abbott is at the forefront of the nation’s testing regime, albeit its diagnostics section is in the constituency of my right hon. Friend Mrs May. Abbott has developed a coronavirus antibody test with a specificity and sensitivity of greater than 99%. I had a brilliant call to hear about that, and I am delighted that PHE has now assessed and approved it. The Government have rightly increased their investment in that test and signed a contract to provide over 10 million antibody tests in the coming months.

Antibody testing is not a silver bullet. There is much more work that we need to do. We do not know whether someone acquires resistance to coronavirus once they have had it and recovered, and we do not know how long any resistance will last, but our immunological research is world-leading. I would like to stress that we would not be in this position without the efforts of Abbott, which is an American private healthcare company. We should not view the relationship between the NHS and private healthcare as an adversarial one; it is a collaborative one.

Photo of Ruth Jones Ruth Jones Labour, Newport West 6:08 pm, 24th June 2020

As someone who has worked in the NHS as a physiotherapist for 32 years, I am proud to speak in this important debate on the heroic efforts of NHS staff throughout the covid-19 crisis. While I miss my former colleagues, I now have the opportunity to sing their praises from these Benches and defend the NHS whenever possible.

We come together at a difficult time for our nation, as we continue to grapple with the effects of covid-19 and the havoc and devastation it has brought to our country and to so many people in it, in Newport West and right across the United Kingdom. We mourn with all those who have lost a loved one. We remember all those who have lost their life, and we can and should in this debate today commit ourselves to doing whatever we can to prevent further loss of life now and in the future.

In making that commitment, I would like to pay tribute to all those working in our NHS in Newport West, in Wales and up and down the UK. As we approach the 72nd birthday of the NHS, to those workers I say: thank you for your compassion and sacrifice. Thank you for always going the extra mile, and thank you for standing firm in the wake of years of Tory austerity. Perhaps one of the best ways to say thank you is to ensure that NHS workers across the board get a decent pay rise. Like many other Members across the House, I have received numerous emails from constituents asking me to obtain a pay rise for all NHS workers. I point out to the Secretary of State that the weekly clapping on a Thursday night was great, but a much more useful thank you would be the delivery of a decent pay rise to ensure that those on the lowest pay in the NHS can be lifted out of poverty. Please remember that when negotiations begin for our next round of the NHS pay talks.

Newport is one of the most diverse parts of Wales and I am proud of our city and its diversity. It is a matter of deep regret, however, that our cherished diversity has seen us on the frontline in the fight against the devastating impact of the coronavirus on black and minority ethnic communities. A report commissioned by the Welsh Labour Government under the First Minister was published on Monday, and it calls rightly for action to tackle the structural and systemic racism that may have contributed to the higher-than-average BME death rate. I welcome the First Minister’s commitment that this is a priority for him and his Government, and I assure my constituents that it is a priority for me and my colleague Jayne Bryant, who represents our community in the national Parliament of Wales, too.

A few weeks ago, a new comprehensive risk assessment was launched by the Welsh Labour Government to support people from BME backgrounds in the NHS and social care in Wales. I hope that the Minister, in winding up, will outline what plans there are to do the same thing in England. This is important, particularly when we reflect on the fact that the first 10 doctors to die in the UK from covid-19 were from BME backgrounds.

I note that the Wales TUC has made it clear that the pandemic is hitting people who are poorer harder and that language barriers in our community have impacted on the speed at which information is being fed to certain communities, so there is work for us all to do here. Members across the House and, importantly, our constituents will know that the coronavirus pandemic is putting the NHS under an unprecedented strain at a time when demand for health and care services was already at an all-time high.

Despite these extraordinary pressures, the NHS in all parts of the UK has achieved an extraordinary amount over the last few months. In 1948, Nye Bevan noted that the NHS must meet everyone’s needs, be free at the point of delivery and be based on clinical need, not the ability to pay. That is our collective mission and that will be my focus now and into the future.

Photo of Selaine Saxby Selaine Saxby Conservative, North Devon 6:12 pm, 24th June 2020

I had always known that I was very lucky to be the MP for North Devon and, in their response to the pandemic, I have nothing but humble words to say for the people of North Devon and the surrounding areas. We have been spared a large amount of the pandemic, fortunately—with regards to the actual virus—but our response was still there. That is not to take away from anyone who has lost loved ones during this time; my thoughts and prayers are with them all.

I want to take this opportunity to thank the health staff in North Devon and the exemplary leadership that has been shown, particularly by our director of public health, Dr Virginia Pearson, the clinical commissioning group, our NHS trust and the incredible team at the North Devon District Hospital, which is the smallest mainland hospital—small but perfectly formed—who, during this pandemic, looked after one patient with the virus for a full 75 days in intensive care before enabling them to go back home again. I thank all the teams there. We have learnt that when we work together, we can really do things well, and letting people focus on what they are good at has enabled some great outcomes in North Devon. I thank my care home staff, the social care staff, and particularly Natasha Koerner, who has led, motivated and looked after those teams throughout the pandemic.

In addition, the mental health of staff has been a concern throughout this, and I am very fortunate in my constituency to have a remarkable woman, Michaela Willis, who, in the first few weeks of the pandemic, phoned me to say that she used to run the National Bereavement Partnership and she was thinking that she would like to come out of retirement and reform it. I am very proud that that national initiative comes from this tiny village in North Devon and is there for all of us and staff right across the health service to phone in to and, I hope, to find some comfort, some way forward and help at this very difficult time.

While thinking about people who have taken extraordinary steps perhaps beyond their normal role, I would like to take the opportunity to thank Applegate and its chief executive Stuart Brocklehurst, who at the start of the pandemic recognised that PPE might be a concern. He has set up a non-commercial covid-19 hub, which is nationally shipping PPE behind the frontline, not straight into the NHS. He has helped those small new producers of PPE in the UK and is matching them with supply. Last week alone, his hub shipped 30 million items of PPE. I thank him for this step behind the fantastic efforts of our health team and Lord Deighton to ensure that our PPE response was great.

As we consider a second wave, which we hope we will not see, I am delighted that plans in North Devon are already well under way. As the MP, I have been briefed, our hospital is prepared and our Nightingale is still under construction but almost finished. I say a massive thank you to the team here and also to everyone in North Devon at this difficult time.

Photo of Helen Hayes Helen Hayes Shadow Minister (Cabinet Office) 6:15 pm, 24th June 2020

I rise to speak in this important debate as a co-chair of the all-party parliamentary group on adult social care. I pay tribute to everyone working in social care throughout the coronavirus pandemic along with staff in our amazing NHS. They have been on the frontline of a pandemic that has taken a brutal toll on our most vulnerable residents and on many staff.

Throughout the coronavirus pandemic, a working group of the APPG, drawn from members across the social care sector, has held a virtual meeting every week. Those meetings have been an invaluable opportunity to understand exactly how harrowing the crisis has been for the social care sector and how forgotten and ignored many of those who have striven to care for our most vulnerable residents have felt. It has also been a useful reality check on the mismatch between what the Government have claimed about support for the care sector and the situation on the ground.

Week after week, members of the APPG working group raised the difficulties they found in obtaining PPE in the quantity and to the specification needed. Week after week, they reported the lack of access to testing. Members of the working group who manage their own care at home have reported almost total abandonment by the Government in the early weeks of the crisis—no PPE, no guidance, no testing and often no care as the risks of coronavirus infection were too high for home care to be delivered. All that was happening while the coronavirus death toll in the care sector spiralled higher and higher. The part of our society with the greatest vulnerability has suffered the greatest losses from the pandemic. For months now, the Government have failed to put in place the key provision the care sector needs to keep its residents safe: frequent, comprehensive, regular testing.

At the beginning of the crisis, no testing was available to care homes, even for symptomatic residents. We know that hospital patients were discharged into care homes without confirmed coronavirus status and that some of them took the infection back with them into homes that were previously coronavirus-free. When testing centres were opened, they were situated in inaccessible locations and had to be accessed in a private car, putting testing out of reach for thousands of low-paid care workers who cannot afford to run cars. A constituent of mine runs a large care home in south London. She told me recently that they had just completed comprehensive testing of all staff and residents in the home, after many weeks of waiting for access to tests, but that the last two tests they had completed were positive, one of them from a staff member who was asymptomatic. She asks how, knowing that an asymptomatic staff member had been at the care home, they could be sure that they were coronavirus-free without the ability to test all staff and residents again immediately. I ask the Minister to confirm in her closing remarks when care homes and carers delivering home care will be able to access frequent, regular testing to enable the protection of vulnerable people.

The Prime Minister promised a world-beating testing system. The social care sector would settle for one that functions at all. Will the Minister also address the situation facing care staff who have been shielding? The Government have announced an end to shielding, but without comprehensive testing to demonstrate that a care home is coronavirus-free, it will be impossible for them to return to work safely. The crisis has exposed a social care system that is fragmented and underfunded and that has been pushed to breaking point. Within that system, there have been many acts of extraordinary courage, compassion and creativity in our care homes but it is clear that the responsibility for the devastation of coronavirus in the care sector lies firmly at the Government’s door. Coming out of this crisis, the Government cannot continue to neglect and ignore social care, but must build a system that is properly funded and in which staff are properly paid and recognised.

Photo of Tom Hunt Tom Hunt Conservative, Ipswich 6:19 pm, 24th June 2020

It seems like a very long time ago, but I remember making a visit to Ipswich Hospital in February, before the lockdown, when it was still unclear how widespread covid-19 would become. During the visit, I inspected a number of isolation pods that had been constructed in anticipation of a virus. The set-up was a real tribute to the forward thinking and expertise of our NHS staff.

Since then, the efforts of all staff at Ipswich Hospital have been nothing short of exceptional. They have taken on considerable extra risk to take care of the rest of us, and I would like to use this opportunity, on behalf of our town, to thank them and those who work in our social care sector for all the work they have done over the last few months. Of course it is important that we ensure that they have access to as much testing as possible so that they can do their job confidently and so that valuable NHS staff are not self-isolating as a precaution when they may not have covid.

Mental health is mentioned in the motion. We really need to consider the impact of covid-19 on the wider mental health of our country. The mental health aspects of covid will be with us for a lot longer than the virus itself, and it is important that we do everything we can to confront this issue head-on across society in the coming months and years.

Throughout this crisis, I have been in close contact with Suffolk Mind about the important work that it has been doing to support those whose mental health has been impacted by covid-19. To put it starkly, four out of five people in Suffolk feel disconnected from the wider community, and similarly high numbers of people feel that their needs for community interaction are no longer being met. I therefore urge the Minister to take into careful consideration people’s mental health, and the ways in which it has been impacted by covid-19, over the coming years.

Let me also touch on the issue of waiting lists, the extra pressure that covid-19 places on our NHS, and the knock-on impact that has on the treatment of illnesses such as cancer, which has been mentioned, and on the provision of knee and hip replacements. There is a significant challenge in hospitals up and down our country to get on top of waiting lists to ensure that people do not have to wait months—that they do not have to experience delays or cancellations—for hip and knee replacements.

However, when looking to confront that nationally, we should still look to do everything we can to keep orthopaedic services as local to patients as possible. I draw attention to the situation at the hospital in my constituency. Yesterday, I signed a cross-party letter with the leader of Ipswich Borough Council to say that, as the local and national representatives of Ipswich, we do not believe that the plan to open an orthopaedic centre in Colchester is in the interests of the people we represent.

I urge the Minister to take that into consideration, to meet me to discuss my concerns and those of my constituents, and to discuss a way forward that addresses delays and cancellations to hip and knee replacements but in a way that keeps care as close to people as possible.

Photo of Bob Seely Bob Seely Conservative, Isle of Wight 6:23 pm, 24th June 2020

It is a pleasure to follow my hon. Friend Tom Hunt. I intend to make two brief points, both to the Minister specifically and more generally. First, I want to thank the NHS staff on the Island, thank Islanders for using the app and thank care home staff; and secondly, I want to reinforce some points about the fragility of health services in unavoidably small hospitals. I am aware that the Minister has heard that before from me, and I fear that she will hear it in the future too.

First, I thank NHS staff on the Isle of Wight for the remarkable work they have done, and I thank the leadership team under Maggie, Darren and Paul for the work they have done to reconfigure St Mary’s Hospital incredibly quickly. All the feedback that I have had from people who have been in the hospital has expressed a massive thanks to all the NHS staff on the Isle of Wight.

Secondly, I thank Islanders for using the sadly ill-fated app. About 75% of Islanders who could download it did so, which reinforces my efforts to develop a relationship with the Government in which we get to pilot schemes on the Island. We know that social scientists like isolated communities to pilot schemes on. For me, the best way to get the Isle of Wight to the front of the queue is to ensure that we pilot national schemes. We have had four in the last year. The app was the least successful, although we actually ran a pretty successful test. It cost £11 million —rather less than the £11 billion that new Labour spent on the IT system back in the early 2000s, but we will park that for the moment. We are testing drones flying into St Mary’s, which is excellent, and that drone test is going well. We are one of the hospitals testing dexamethasone, if I have said it correctly, which is potentially a fantastically good treatment for covid. We are also one of the health authorities piloting the use of telemedicine, which clearly is especially important as we have an isolated community separated from the mainland by water. I am grateful to Islanders, and I make no apologies for trying to get pilot schemes for the Island and I will continue to do so.

I also thank nursing home staff who have been extraordinarily diligent. I have spoken to many, including Belinda in Sandown, and Ian Bennett. I am grateful for their advice and the feedback that I got from many other people who work in care homes. I did visit one that had an outbreak of corona, and it was a pretty distressing situation. I am very much involved with many people who work in the care home environment.

I have a series of questions about care homes. The more we can test staff—fortnightly, if not weekly—the better. It would be good to know from the Government when the care badge scheme will be launched. The crisis in care homes has brought home the importance for us all of ensuring that our social care is fit for the 21st century. I know that is a much bigger issue which this Minister, and other Ministers, are dealing with.

My final point is on significant additional pressures to unavoidably small hospitals. There are 12 in England and Wales. The Minister knows the facts and figures, and she has been good enough to talk to me about this in the past. We put the additional extra costs of running an unavoidably small hospital on an island at about £12 million a year. The NHS long-term plan sets out a 10 year strategy and it says it is unable to find evidence of specific unavoidable costs, but I beg to differ. I think we have evidence of what those unavoidable costs are, both generally in terms of unavoidably small hospitals, but also specifically in the case of the Isle of Wight. In fact, we have specifically listed and itemised those additional expenditures when compared to a hospital that has a more average size population. As the Minister knows, St Mary’s is about half that of a normal district general hospital.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 6:27 pm, 24th June 2020

I thank the Labour party for bringing this debate to the House for consideration, and the way it was promoted as well, which I thought was very positive. It is helpful for everyone to be able to see the same things. I also want to put on record my thanks to all the NHS staff across the whole of the United Kingdom, but especially in Northern Ireland. Those on the frontline have worked extremely hard and long hours, faced with the coronavirus outbreak, and we owe them a great deal. I live on a farm outside Greyabbey, and at 8 o’clock on a Thursday night we could hear the clapping from three miles away down in the village by those who came out to show their appreciation. We do owe those staff a lot.

There seems to be light at the end of the covid tunnel, and I am thankful for that, but we must remember the more than 40,000 families that have been plunged into the ongoing darkness of the loss of a loved one. That must be remembered in every covid-19 debate we have in this House as a salient reminder of those who have passed away. Our thoughts and prayers remain with them all.

The recent advice in Northern Ireland has been put in a very clear way: shielding will pause at the end of July. It has been put in that way to make people aware that the war has not been won. The war will not be fully won until we have a vaccine in place for this strain and a basis in place for future mutations. I thank Queen’s University, Belfast for the sterling work that it is doing in that area.

One of the main ways to win the battle has been isolation and containment. My mother has been in self-isolation for some 14 weeks. She is 88, almost 89, and she had a chance to go and do a bit of shopping. She went mad the day she got out, and was touring round all the shops. She has a real buzz for going round the shops, and I think everyone in Newtownards must have said to themselves, “She’s back!” She was, and she did plenty of shopping.

We need to have the testing in place to move on, and that is very important. The testing has to be accurate and give us the results that we need. It is very important to have professionals who have the knowledge. It is imperative that the workforce are tested often and accurately, when we consider that 80% of UK cases are mild or asymptomatic. We must have an accurate system in place, not simply for NHS staff, but for all those around it. The Minister has spent a second day in the Chamber and we look forward to her response, which I know will be positive.

The NHS has been incredible, but we must not fool ourselves into thinking that the pressure is off, because it is not. On the contrary, the pressure is most assuredly on. We have had almost four months of rescheduled operations and cancer screenings and steroid injection cancellations—all of those needs exist. It has been argued that the pressure is worse.

Covid-19 has devastated cancer services. I referred to that in two interventions on the shadow Minister earlier, so I will not ask those questions again, but as lockdown measures came into effect, urgent referrals plummeted, screening programmes were paused, many surgeries were cancelled, clinical trials were put on hold and existing health inequalities were exacerbated. The epidemic has led to a huge backlog of patients waiting for cancer services.

Cancer Research UK has said that a backlog of some 2.4 million people has developed in the first 10 weeks of lockdown. We need to address that, and I know that the Minister will address that in her response. Steps must be taken to ensure that not only NHS staff but staff in the charitable sector and in cancer care homes are tested accurately, routinely and to a high standard.

In terms of pancreatic cancer, Northern Ireland has one of the worst five-year survival rates in the world and ranks at roughly 32 out of 36 countries with comparable data, according to CONCORD-3. I dread to see—I hope I am wrong—the reality of what covid-19 has done to cancer patients, and we need to work to address that.

Photo of Andrew Griffith Andrew Griffith Conservative, Arundel and South Downs 6:31 pm, 24th June 2020

I will be brief so that as many hon. Members as possible can speak. I congratulate Dr Allin-Khan on securing this debate. It is good to debate this important subject.

I invite the Minister to join me in placing on record my thanks to the leadership team and all the staff at the Western Sussex Hospitals NHS Trust. Sadly, we have had more than 100 deaths in west Sussex, but every one of those people was in the wonderful care and hands of the first acute trust in the country to be rated outstanding by the Care Quality Commission twice in a row.

Collective achievements have individual heroes behind them. We are talking about testing, so I mention in particular the pathology lab at St Richard’s in Chichester. It has been working on swab tests since the start of the crisis, but it has now moved on to doing antibody tests as well. It has done 7,000 already and its capacity is now at 1,000 tests a day, which will be a valuable resource across west Sussex as we move into the next phase of the crisis.

Finally, I extend my thanks and recognition to all the hard-working staff in our care homes, of which we have a great many, for the wonderful job they have done. As we move forward from the acute phase, I am conscious that they will continue to bear that burden, so I thank them.

Photo of Sara Britcliffe Sara Britcliffe Conservative, Hyndburn 6:32 pm, 24th June 2020

We should all be grateful for the dedication that we have seen throughout the pandemic. I do not believe that anybody in this House disagrees with that.

In Hyndburn and Haslingden, frontline staff in the NHS, social care and other key industries, such as food production, manufacturing and transport, went above and beyond to protect my community. The Lancashire & South Cumbria NHS Foundation Trust also went above and beyond, particularly when it saw an increase in those requiring mental health support. It quickly and efficiently launched a mental health urgent response line for anyone of any age in need of professional 24-hour support. It has made great use of video and digital technology to provide services, including appointments, online through the Attend Anywhere initiative. It has also expanded the health and wellbeing support line for those who want to chat or who want emotional support.

In March, I welcomed the UK Government’s announcement of a £5 million grant to fund additional services for people struggling with their mental wellbeing during the coronavirus outbreak. On 22 May, the Government announced that a further £4.2 million would be awarded to mental health charities such as Samaritans, YoungMinds and Bipolar UK to continue to support people experiencing mental health challenges throughout the outbreak. Lancashire’s response to the virus has been nationally recognised as exemplary, and I am very proud to be Lancashire born and bred.

NHS testing has ended the uncertainty about whether essential staff needed to stay at home, and I fully support the Government step to empower that. The East Lancashire Hospitals NHS Trust has tested more than 7,000 staff, with around 13% showing that they have antibodies to covid. This data is important and provides clear evidence of the effectiveness of PPE and the social distancing measures put in place.

In Hyndburn, as of 23 June there have been 159 confirmed cases, the second lowest number in Lancashire, and Rossendale was the third lowest with 178. This is a testament to the sacrifice of people staying at home, avoiding all unnecessary contact. The test and trace service has already helped to gather more information about the spread of the virus, and I congratulate those members of the public who have been contacted and have followed the guidance to self-isolate. That is how we stop the transmission of the virus. Alongside industry professionals and committed staff, the test and trace system contacted 87,000 people in its first week, and I know that the Government are continuing to explore all options and utilising technology to improve our understanding of this virus.

My hon. Friend Dr Mullan was absolutely right that this motion’s proposal could put strain on our NHS, and I would like also to hear the evidence from Opposition Members that it is the most effective approach.

Many key services have sought to continue throughout this time, albeit in a reduced or socially distant capacity, and I congratulate the hard-working staff delivering all types of care throughout the NHS. I am truly proud of our NHS and social care workers; the sacrifices they have made to protect the vulnerable during this time are extraordinary, and I want to thank those men and women who are still working tirelessly to protect this country, and particularly those in Hyndburn and Haslingden.

Photo of Rosena Allin-Khan Rosena Allin-Khan Shadow Minister (Mental Health) 6:36 pm, 24th June 2020

Let me start by paying tribute to the staff on our frontline—our NHS and care staff, far too many of whom have paid the ultimate sacrifice while trying to keep us safe and well. I would also like to take this opportunity to pay tribute to my good friend Tracey Crouch; not only is she a friend of mine on the same football team, but she is an outstanding parliamentarian and somebody I am proud to call a friend. I know we all join together in wishing her well and she fights cancer.

I thank my hon. Friend Jonathan Ashworth for his opening speech.

Photo of Rosena Allin-Khan Rosena Allin-Khan Shadow Minister (Mental Health)

You are welcome.

My hon. Friends the Members for Newport West (Ruth Jones) and for Dulwich and West Norwood (Helen Hayes) paid passionate tributes to NHS and care staff, while my hon. Friends the Members for Erith and Thamesmead (Abena Oppong-Asare) and for Bethnal Green and Bow (Rushanara Ali) spoke eloquently about the importance of recognising the sacrifices made by our BAME communities. My hon. Friends the Members for Barnsley East (Stephanie Peacock) and for Warrington North (Charlotte Nichols) spoke movingly about the impact of losing local staff and loved ones; I know that we were all moved. I am also grateful to my hon. Friends the Members for Sheffield, Hallam (Olivia Blake) and for Mitcham and Morden (Siobhain McDonagh) for ensuring that pregnant mothers are not forgotten at this time.

From the very beginning of this pandemic, health and care staff have made immense sacrifices. When we were asked to stay at home, hiding behind closed doors, they went to work and faced this deadly virus head-on. Nothing is more worthy of commendation than the unwavering courage of our health and care staff, fighting this ruthless virus, going to work and facing it to care for us, leaving behind the worries that they had for their own families at home. However, although it is right to pay tribute through our words, it is only through our actions that we can truly honour those who have died.

Our healthcare staff have given everything to fight covid-19, but this Government could not even give them PPE at the height of the crisis. Our frontline staff were sadly unprepared; many went to their death. Ministers must learn from this. Never again can we ask medics and carers to treat patients without protective equipment. Never again can we ask staff to clean the rooms of people who have died from covid-19 without adequate PPE. Our frontline staff have lost patients and colleagues on an unimaginable scale, and the impact will be felt by them for a lifetime.

I cannot tell the House what it is like, as a trained medic used to delivering bad news, to have to break the hearts of people over the telephone, telling them that the worst has happened and their loved one has died, or on rare occasions to have them there in front of you as you deliver the news, fully covered in PPE with only your eyes showing, unable to give them the hug you would previously have been able to give. In those worst of circumstances, you are left shaken to your core because the very thing you have been trained to do is to provide nurturing support. It feels robotic; it feels sterile; it feels inhumane.

As we leave behind the peak of this virus and life slowly starts to resemble some form of normality, it is important to remember that the horrors—the true horrors—of fighting covid-19 on the frontline will never leave the minds of the frontline care and NHS staff. Never will they forget, in their heart of hearts, at their core, what it has been like to face this virus. Our NHS and care staff need mental health support that is tailored to their unique needs, and they need it now. Clapping simply is not good enough. Without action, it is an empty gesture. Only by protecting the mental health of our healthcare workers can we expect them to protect both the physical and the mental health of the nation. Public health fears, social isolation and economic uncertainty are all major risk factors for mental ill health. The coronavirus and the subsequent lockdown have affected us all, and there will undoubtedly be a rise in demand for mental health support in the coming weeks, months and even years.

The Government must prepare now and put in place a long-term plan to ensure that services can cope with the inevitable surge in demand. Let me be clear: this must include provision for children and young people. Their mental health needs are so often forgotten, and they have suffered immeasurably throughout this period. With child and adolescent mental health services referrals decreasing massively during the crisis, many mental health problems will be picked up only when children return to school. A report by children’s charity Barnardo’s found that 88% of school staff thought that covid-19 would have a negative impact on their pupils’ mental health and wellbeing. We need to ensure that our most vulnerable children do not slip through the cracks. I am sure that, party politics aside and regardless of which Bench we sit on in this place, we all agree on the importance of prioritising the mental health of our children and young people.

To get a handle on the virus early on and come through the crisis completely unscathed might have been impossible, but there is merit in the ambition. From the outset, sadly, the Government seemed to accept that thousands of deaths were inevitable. The lockdown came too late, and it cost us dearly. It cost us friends, it cost us family, it cost us colleagues, it cost us members of our black and minority ethnic community, it cost us NHS and care frontline workers. Our communities have paid the price, and they will suffer immeasurably for a long time to come.

When healthcare systems in other parts of the world began to crumble in the wake of covid-19, when on our television screens on “News at Ten” we could see what was playing out globally, this Government sat idle. At a time when we needed quick, decisive actions, this Government dithered and refused to enter lockdown, failed to get PPE where it was needed and abandoned their community test and trace strategy, letting the virus run rampant through this country. With the benefit of hindsight, that gamble clearly failed, causing countless avoidable deaths.

The last time I stood here and tried to raise that issue with the Government—with the Secretary of State himself—my tone was challenged, but I say this: it was not my tone that was the issue, but the very content of what I had to say. It was the sentiment and the understanding that many frontline workers feel that unnecessarily they had to break people’s hearts in the way I have just described. In the most inhumane of ways, this virus stripped the humanity out of grieving, and there were many avoidable deaths. That is what the Secretary of State took issue with.

With the benefit of hindsight, the gamble clearly failed, causing a countless number of avoidable deaths. Imagine people waving their loved ones off in ambulances, never to see them again—never able to give that last kiss, and never able to say goodbye in person to the person who had brought them the most love and joy in the whole wide world. Our communities will grieve for a lifetime, as will the healthcare workers who had to pass a paltry phone to someone as they took their last breaths, so that their relatives could say words like, “Hang on dad, we love you.” Never again can we find ourselves in this position, when it could have been prevented. Never again can we ever allow our communities to be so failed.

In February, the Government may have been able to feign ignorance of the threat posed by the coronavirus, but today we know all too well its devastating impacts. We have the evidence, we have had the reviews and we have seen it play out in technicolour. I say this: with the very real danger of a second spike and with winter flu season on the horizon, preparations must begin now to ensure that the NHS and the social care sector have everything they need to keep themselves and the public safe in the months and years to come. Will the Government please outline what preparations are being undertaken to plan for those eventualities? We must stockpile PPE now, not later. We needed the track and trace system up and fully operational weeks ago, not in the autumn. We need urgently to learn the lessons and prepare.

We honour those who have died by learning from their sacrifice and ensuring that never again will this country sleepwalk into a crisis. Never again will we accept unnecessary deaths as a consequence of inaction. I believe that there are good people on both sides of this Chamber, and I believe we all are here because we care about our communities. We are all here because in essence, we truly believe and want to believe that we care about our NHS and care staff. So in that light, I sincerely hope that Members from across the House will join us today in supporting the motion.

Photo of Jo Churchill Jo Churchill The Parliamentary Under-Secretary for Health and Social Care 6:48 pm, 24th June 2020

Like all other Members from all parts of the House and from all four nations, I add my thanks to all those in the NHS and across social care, although actually it is broader than that. There are those in primary care, our community health teams, those who have adapted the way they work in addiction services and so on, because all these things have had to change at pace.

When we started to get the news towards the end of January that this was a pandemic, we started to realise that we were dealing with a completely unprecedented time, and all those people stepped forward. We have heard repeatedly this afternoon that more people stepped forward to make this a journey of collaboration and innovation. We have seen changes right across the national health service and the services that we have had to build to make decisive changes.

I gently say that 12 weeks ago, as we went into lockdown, many of those services were very different: the delivery of PPE to just over 200 national health trusts has now ramped up to 58,000 providers; we have developed Clipper and local resilience forums to help us with the distribution of PPE throughout these extremely complex changes; and a large amount of work has been done on vaccines and testing. All these things are a tribute to collaboration and we need to thank the innovation of not only private industry, as my hon. Friend Robert Courts mentioned, but the Army. This truly has been an effort of public service, and as we have come together—as we have done across the House—we have achieved so much more.

How do we carry on achieving more? There was a challenge before we went into the crisis, and the decision to postpone non-urgent elective treatment was the right one, because it allowed us to have the capacity required to help us to manage increased demand in the NHS. Throughout the outbreak, we have ensured that patients who require urgent treatment have been able to access it and, like many Members, we encourage people not to delay in coming forward for treatment as they normally would, should they require it. NHS has a firm “Help Us Help You” message.

We heard of how, as my hon. Friend Selaine Saxby put it—I do not think I can put it better—we achieve much more by working together and focusing on what we do best. How do we drive down waiting times and have routine services return as quickly as possible to their normal provision? We must ensure that that is done in a safe and managed way to maintain capacity but avoid any further surge in covid. As outlined in the guidance already issued to the NHS, the restarting of routine electives should prioritise long waiters first and make full use of all contracted independent-sector hospital and diagnostic capacity.

Cancer was mentioned by severable Members. Urgent cancer care and treatment has continued throughout the pandemic. We know how important it is that referrals, diagnostics and cancer treatment reach pre-pandemic levels as soon as possible. Urgent action should now be taken by hospitals on the two-week-wait referrals, and they should provide two-week-wait out-patient diagnostic appointments at pre-covid-19 levels. That is easy to say but really hard to achieve.

The work done by protected hubs and to ensure that rapid diagnostic centres have been pushed out has been important. During the outbreak, the Secretary of State and I have regularly met the national cancer director, Dame Cally Palmer, to discuss progress not only on how we were dealing with cancer during the crisis, but on restoring cancer services as quickly as possible. We will keep a laser focus on that.

The NHS has continued to deliver over and above. Guidance has been issued and further guidance to restore urgent non-covid services in a safe way while ensuring that surge capacity can be stood up again, should it be needed, is already being planned. Preparations for going forward have already begun: we are learning lessons from where we have been but also driving ourselves to where we need to go. My hon. Friend Dr Spencer said that we should think about what we can learn, how we can reset and how we can make sure that as we go forward we can take the best of what has changed, develop it and weave it in.

Photo of Jo Churchill Jo Churchill The Parliamentary Under-Secretary for Health and Social Care

I am really sorry—I have only a couple of minutes.

Photo of Stephanie Peacock Stephanie Peacock Shadow Minister (Environment, Food and Rural Affairs)

I really appreciate the Minister giving way. I just wondered whether she could respond to the question that I put in my contribution to the debate, which is around the relaxation of guidance on death certificates for those suffering from industrial diseases. I am just asking the Government to revise their guidance so that anyone who has an industrial disease has that recorded on their death certificate.

Photo of Jo Churchill Jo Churchill The Parliamentary Under-Secretary for Health and Social Care

If the hon. Lady will forgive me, I will write to her on that exact point after the end of this debate. If I segway off, I will not make the points that I would like to make.

I was very grateful to my right hon. Friend Jeremy Hunt, who said that the decision by the Secretary of State to put in a stretch target for testing was indeed courageous—something with which many hon. Members, I am sure, would agree. That dramatic expansion of testing has got us to where we are today.

My hon. Friend Paul Bristow spoke of improving care pathways and the joint work between the private sector and the NHS, being ambitious and changing methods of working to meet demand. My hon. Friend Stephen Hammond spoke articulately about the issues, including the stretch target, but also about preparation and how we make sure that our hospitals are ready and fit for the future. My hon. Friend Douglas Ross talked about how challenging it is but pointed out how the four nations have worked together. I join him in supporting the fact that we are stronger together. I have missed out my hon. Friend for—

Photo of Jo Churchill Jo Churchill The Parliamentary Under-Secretary for Health and Social Care

I am sorry. I put Worcestershire, but I knew that it had a bit of the compass before it.

My hon. Friend Harriett Baldwin spoke of innovation. She said that the appointment of Lord Deighton had led to a revolution in the UK manufacturing of PPE to support all our NHS workers as we drive forward. Some 2 billion items have been ordered to be made in this country. She also mentioned innovations by our GPs, pointing to the fact that the number of surgeries delivering video consultations has risen from 3% to 99%. She talked about innovations in medicines and treatment, and about the first effective treatment to save lives. On testing, she said how proud she is of everything that is going on there.

My hon. Friend Dr Mullan talked about managers and workloads as normal services return. He, like many hon. Members, brings to the House his experience from the NHS. One thing struck me in particular—that we target messages at the right groups. We know that health inequalities are persistent and stubborn, so we must get the messaging right as we go forward.

My hon. Friend Mrs Drummond spoke about the importance of preparedness, including assisting staff. This afternoon, mental health came up repeatedly and ensuring that helplines are in place to assist all our NHS recover and gain resilience throughout the next phase.

Photo of Jo Churchill Jo Churchill The Parliamentary Under-Secretary for Health and Social Care

I am sorry, I will not give way, as I have only a minute left.

On testing, we are continuing to prioritise our frontline NHS staff with symptoms for testing and testing asymptomatic NHS staff where appropriate, where there is an incident. We are surveying the health and care settings in Public Health England’s SIREN study and monitoring prevalence. Although the CMO has recommended that testing happens fortnightly at the moment, all these issues are currently under review.

At the start of this crisis, we made sure that NHS capacity was always there at the time of need. The goal was clear that, however tough things got, the NHS would never fall short of that founding promise to be there for somebody who needs it. It meant taking difficult decisions and, as we rebuild and refocus on delivering for all those on the waiting list, I want to put on record my thanks to those on the frontline for their heroic efforts.

At the same time, the NHS has been instrumental in carrying out the world’s first successful clinical trial and, in just a few months, it has achieved much. The NHS is also playing a crucial role to help to operate one of the largest and most comprehensive test and trace systems in the world, with capacity for 280,000 tests today. I have gone on the record many times to say that our colleagues in the NHS and across the public services are always there for us. If you are concerned about anything, you should seek help. The NHS will always be there for you. But what we have discovered from the speech by the shadow Secretary of State

Photo of Nick Brown Nick Brown Opposition Chief Whip (Commons)

claimed to move the closure (Standing Order No. 36).

Question put forthwith, That the Question be now put.

Question agreed to.

Question put accordingly (Standing Order No. 31(2)), That the original words stand part of the Question.

Division number 60 Testing of NHS and Social Care Staff

Aye: 197 MPs

No: 335 MPs

Ayes: A-Z by last name

Tellers

Nos: A-Z by last name

Tellers

The House divided: Ayes 198, Noes 344.

Question accordingly negatived.

The list of Members currently certified as eligible for a proxy vote, and of the Members nominated as their proxy, is published at the end of today’s debates.

Question put forthwith (Standing Order No. 31(2)), That the proposed words be there added.

Question agreed to.

Main Question, as amended, put and agreed to.

Resolved,

That this House expresses thanks to the heroic work of frontline NHS staff who have saved lives throughout the Covid-19 pandemic; pays tribute to the at least 312 NHS and Social Care staff who have died of coronavirus in the United Kingdom; recognises the impact that coronavirus will have upon the NHS to deliver routine care including mental health care without additional Government support; notes that NHS waiting lists are projected to reach 10 million by the end of 2020, that cancer referrals fell 60 per cent during the peak of the coronavirus lockdown and that four out of five children have reported their mental health has got worse during the pandemic; further notes that there is a backlog of NHS care that needs to be tackled and that it is vital to prepare NHS services to deliver safe care alongside care for coronavirus, including preparing for winter and ensuring necessary supplies of PPE and medicine; and recognises the unprecedented action the Government has taken in its tireless efforts against Coronavirus to protect the NHS and save lives.

Photo of Steve Reed Steve Reed Shadow Secretary of State for Communities and Local Government

On a point of order, Madam Deputy Speaker. Has the Speaker received notification from the Secretary of State for Communities that he wishes to give a statement on the documents he has recently released regarding the Westferry decision? There appear to be significant discrepancies between what the Secretary of State told the House and what is revealed in the documents, specifically: that he did not immediately notify officials following his dinner with the applicant, Richard Desmond; that rather than closing discussion down with the developer as the Secretary of State implied, he instead initiated contact with him the next day via text; and that the letters confirm that he rushed through the decision deliberately to help the developer avoid a £30 million to £50 million levy payable to Tower Hamlets Council.

Photo of Rosie Winterton Rosie Winterton Deputy Speaker (First Deputy Chairman of Ways and Means)

I thank the hon. Gentleman for that point of order. I have received no notification that the Secretary of State intends to make a statement, but those on the Treasury Bench will have heard his comments. It is obviously up to Ministers to come to the House if they wish to say anything to correct the record through a statement or any other means.