Category: Health

Daisy Cooper – 2022 Speech on the Supply of Strep A Treatments

The speech made by Daisy Cooper, the Liberal Democrat MP for St. Albans, in the House of Commons on 19 December 2022.

Across the country, parents are worried sick about the sharp rise in strep A infections. Tragically, strep A has caused the death of at least 19 children since September.

Last Thursday, just a few days after insisting there were no shortages, the Government finally admitted that there were indeed serious shortages of three penicillin medicines and issued serious shortage protocols to give pharmacists emergency powers to deal with supply issues. Why on earth did they take so long?

The Government will have seen the data on the number of prescriptions for strep A antibiotics, which started to rise more than a month ago. Health professionals, including Leyla Hannbeck, the chief executive of the Association of Independent Multiple Pharmacies, have been raising the alarm publicly for more than two weeks, and I called for a strep A summit to resolve the supply issues. Because the Government did not come clean sooner about the shortage of antibiotics, parents who are worried about their children have been left to travel to multiple pharmacies, GPs have had to find time to rewrite prescriptions and A&E departments have been overwhelmed by anxious parents and children who cannot access medical help when they need it.

Why have the Government taken so long to act? Did they not look at prescription data, or did they just ignore it? Why did the Secretary of State insist on television that there were no shortages, when GPs, pharmacists, directors of public health and parents all said that there were? After shortages of lateral flow tests, hormone replacement therapy and so on—you name it—why are we in this position again? The Government seem incapable of forward planning, and we are stuck in a shortage groundhog day. Can the Minister update us on the Competition and Markets Authority investigation into the sharp rise in the prices of antibiotics?

Finally, we are in the lead-up to Christmas. Pharmacists have told me that some key contacts in the manufacturing companies are already on leave for the Christmas holiday. Families are making difficult decisions about the safety of their children and extended family. What action will the Government take now to ensure that families across the country can access the antibiotics they might need over the entire Christmas period?

Maria Caulfield

I reassure the hon. Lady that we have not waited to act. We have already issued serious shortage protocols, which are routine mechanisms when there is pressure on supplies. We have the stock of antibiotics in the country—as I outlined in my opening remarks, it is about supply issues. We are seeing five to six times the amount of antibiotics being prescribed at the moment. That is because the UK Health Security Agency has issued guidance to GPs, A&Es and healthcare professionals to lower the threshold of when they would normally give antibiotics. We are seeing significantly increased use of antibiotics. That is in addition to the prophylactic use of antibiotics by directors of public health, if they have had an outbreak locally. That is why we issued the initial SSPs already a couple of weeks ago so that pharmacists had flexibility in how they dispensed that medication. It is why on Friday we issued the new SSPs, which allow amoxicillin, clarithromycin, flucloxacillin, cefalexin, co-amoxiclav and erythromycin to be issued instead, if pharmacists do not have Penicillin V on their shelves. We are being as flexible as possible to give pharmacists that scope.

We are monitoring this issue on a daily basis. May I reassure people that while these are higher than usual incidences for this time of year, overall for this season we are not yet at the 2017, 2018 levels, where we had a significantly higher number of deaths? Strep A occurs not just in—[Interruption.] Hon. Members do not want to listen. I think I have said enough.

December 20, 2022
Maria Caulfield – 2022 Statement on the Supply of Strep A Treatments

The statement made by Maria Caulfield, the Parliamentary Under-Secretary of State at the Department of Health and Social Care, in the House of Commons on 19 December 2022.

I thank the hon. Lady for her question. I know families are concerned about the recent outbreak of strep A in children. Although the vast majority of strep A cases are mild and can easily be treated with antibiotics, a small number of children have gone on to develop serious infections.

The UK Health Security Agency has already declared a national enhanced incident to co-ordinate our public response. Increased demand has led to some temporary supply issues, but I reassure Members on both sides of the House that we have stock of antibiotics and have taken a number of steps to deal with some of the supply issues.

First, we have worked at pace to help to ensure that there are supplies of vital medicines to meet the increased demand. Earlier this month, we convened roundtables with manufacturers of the preferred treatment, penicillin V, and with major UK wholesalers. We continue to work with manufacturers and wholesalers to boost supply to meet demand. The key issue is getting stock to pharmacies across the country. We have brought forward stock to make sure it gets to where it is needed, and we are expediting deliveries. Deliveries to wholesalers and pharmacies continues to be made, with more expected in the coming days and weeks.

Secondly, we have issued eight serious shortage protocols to allow pharmacists to supply not only alternative forms of penicillin, but alternative antibiotics. This will make things easier for pharmacists, general practitioners and, of course, patients. We have also added a number of antibiotics to our list of medicines that cannot be exported or hoarded.

Finally, we have updated advice across the board. Further guidance was given to GPs and pharmacists on Friday as part of the new SSPs. My Department has provided advice to colleagues in primary and secondary care on the management of the current supply issues. We have also held a cross-party briefing for MPs, and a “Dear Colleague” letter will go out later today.

I know this is a worrying time for families across the country, but I reassure them and people across the healthcare sector that we are managing the higher-than-normal number of strep A cases this winter and we have a range of medicines available.

December 20, 2022
Will Quince – 2022 Statement on the NHS Workforce

The statement made by Will Quince, the Minister of State at the Department of Health and Social Care, in the House of Commons on 19 December 2022.

The NHS workforce are the key component of the NHS. The NHS is one of the largest single employers in the country and globally. Around 5% of the England workforce are employed by the NHS, so the way in which we value the workforce matters, both in ensuring delivery of health services and as a role model for other employers.

The autumn statement has made up-to £14.1 billion available to Health and Social Care service over the next two years. This funding will help enable us to continue to support the NHS in England. I am therefore pleased to report that there are a record number of people working in the NHS. Latest data for September 2022 show almost 1.4 million full time equivalent staff working across NHS hospital trusts and primary care in England.

Within this workforce there are a record number of over 168,000 full time equivalent doctors across hospitals and general practice. This includes over 131,000 in NHS hospitals and over 37,000 in general practice. There is also a record number of over 333,000 nurses across the NHS, with over 316,000 working in NHS hospital and over 16,000 across primary care.

We have over 32,000 more nurses now than we had in September 2019, putting us well on the way to meeting the Government’s commitment of 50,000 more nurses across hospital and general practice settings by March 2024. Over the last three years, this speed of growth in nursing numbers is faster than we have seen since 2009 when current recording began.

Internationally trained staff are an important component of the 50,000 nurse target. They have been an integral part of the NHS since its inception in 1948 and continue to play a vital role. We hugely value their contribution to providing excellent care. While we are working hard to increase our homegrown supply of health and social care staff, ethical international recruitment remains a key element of achieving our workforce commitments.

I am also pleased to see that other key NHS hospital workforce groups continue to grow, such as the now almost 18,000 professionally qualified ambulance staff, 12% more than in 2019 and over 81,000 allied health professionals, 20% more than 2019. These staff work hand in hand with the over 380,000 clinical support staff who are so vital to the effective delivery of patient care.

We are also growing new professions to support patient care and I am pleased to see over 2,500 physician associates and over 4,600 nursing associates working across hospitals and primary care.

We also have a very healthy pipeline of people training to work in the NHS. There are record numbers of medical students in undergraduate training and graduates from recent expansion in medical school places and schools are starting to enter foundation training. Large numbers of candidates also continue to choose courses in nursing and midwifery in England, and since September 2020 all eligible nursing, midwifery and allied health profession students have received a non-repayable training grant of a minimum of £5,000 per academic year.

For the third consecutive year we have seen over 26,000 acceptances to undergraduate nursing and midwifery programmes. There were 3,700 more acceptances in 2022 than in 2019—a 16% increase. This is alongside substantial expansion of nursing apprenticeships, with over 3,000 people starting in 2021-22 compared to less than 1,000 in 2019-20.

However, in spite of the growth we are seeing, we know health and care staff are facing ongoing challenges. The rising demand for services due to the pandemic, service recovery and an ageing population means that staff continue to work under pressure.

Therefore, alongside expanding the workforce we must therefore work to retain the staff that we have and ensure the NHS is an attractive place to work.

The NHS People Plan and the NHS retention programme are focused on improving the experience of staff working in the NHS, as well as seeking to address the reasons they leave. This means ensuring we support staff health and wellbeing, improve the leadership and workplace culture of NHS organisations, and increase opportunities to work flexibly.

To help with flexible working, we are making changes to NHS pension rules to help retain experienced doctors and nurses, and remove barriers for retired staff who want to return. We have therefore launched a consultation on detailed proposals to enable staff to work more flexibly up to and beyond retirement age, and protect them from unintentionally higher annual allowance pension tax charges driven by inflation.

Looking to the future, we must ensure that the future workforce is both large enough to meet the challenges it will face and has the right people with the right skills working in the right places to address future demand.

To that end, we have commissioned NHS England to develop a long-term workforce plan for the NHS workforce for the next 15 years. This will look at the mix and number of staff required across all parts of the country and will set out the actions and reforms that will be needed to reduce supply gaps and improve retention. We have committed to independently verifying this report, and publishing it next year.

December 20, 2022
David Ramsbotham – 2021 Speech on the Health and Care Bill (Baron Ramsbotham)

The speech made by David Ramsbotham, Baron Ramsbotham, in the House of Lords on 7 December 2021.

My Lords, when you are number 55 in a 74-strong speakers’ list, you have not got much new to say. As other noble Lords have said, there is much to be welcomed in this Bill—certainly including its intention and stated aims of integration and innovation, particularly for those who require rehabilitation.

However, as always, the devil is in the detail. I must thank Nicola Newson for an outstanding Library briefing. I also join others in congratulating my noble friend Lord Stevens of Birmingham on a superb maiden speech.

Yesterday, the Prime Minister announced in his speech that drug users were to be offered rehabilitation, but I did not hear him refer to the Bill. This is a pity, because I can think of no other form of rehabilitation that is so subject to local conditions and arrangements and therefore so natural to be included in an integrated care system along with speech and language and all the other subjects requiring rehabilitation.

As other noble Lords have pointed out, when the Bill was in the other place there was considerable concentration on workforce issues, which seem to me to be paramount. There are simply not enough doctors, nurses or other healthcare professionals to go round, particularly in the midst of a pandemic, and the future looks very worrying, particularly where replacements are concerned.

It seems to me that we will have our work cut out to try to improve the Bill, bearing in mind the fate of perfectly reasonable amendments tabled in the other place. Yet try we must, because there are too many long-term and national issues at stake.

December 18, 2022
Gordon Brown – 1997 Comments on Increasing NHS Spending

The comments made by Gordon Brown, the then Chancellor of the Exchequer, on 14 October 1997.

This new money for NHS patient care will go to where it is needed most.

The Government’s approach is clear.

We will maintain the control totals we set and therefore achieve the public spending discipline needed for sustainable finances. Savings will be found from within existing resources.

And we will use money saved to fund our priorities, of which NHS patient care is one.

Indeed, we will continue to be relentless in our search for savings, where money can be redirected to priorities.

The new initiatives, including the appointment of best practice teams, will ensure better use of resources. We are satisfied that the money announced today will go to where it is needed most, for patient care during the winter months.

December 18, 2022
Dan Poulter – 2022 Article on Increasing Pay for Nurses

A section of the article written by Dan Poulter, the Conservative MP for Central Suffolk and North Ipswich, with the full article in the Guardian on 16 December 2022.

The government’s decision to squeeze nursing pay will push more nurses to vote with their feet, to leave the NHS and earn more money by either working for temporary NHS staffing agencies or to work for private healthcare providers. This could even result in the perverse situation where reductions in real-terms pay mean that the same nurse could leave their NHS job and return to work for the NHS, perhaps even in the same hospital department, as an agency nurse. The NHS will foot the bill for the agency costs and the increased salary paid to the nurse.

This is poor healthcare economics. Pay needs to be set at a level that helps to recruit and retain the NHS workforce and the time has come for some joined-up thinking from government. Investing in better pay for nurses and other NHS staff would help improve staff retention and reduce the ever-growing temporary staff bill.

December 17, 2022
Margaret Greenwood – 2022 Comments on the Infected Blood Inquiry

The comments made by Margaret Greenwood, the Labour MP for Wirral West, in the House of Commons on 15 December 2022.

Margaret Greenwood (Wirral West) (Lab)

One of my constituents has been deeply affected by this issue. She has endured, in her words,

“a long, upsetting and depressing process.”

The strain on her and her family has been enormous.

The Hepatitis C Trust has warned that people affected by the infected blood scandal are falling through the gaps in the present frameworks for financial assistance and compensation, including those whose medical records have been lost and destroyed, which the Minister touched on—I would like him to expand on that—and people who were born abroad. What assessment have the Government made of the number of people who fit into that category, or when can we expect to receive such an assessment? What will he do to put things right?

Jeremy Quin

First, I absolutely sympathise with the hon. Lady’s constituent. However, I hope that, since 2017, with the statutory inquiry, the report and the payment of interim compensation, they have seen that we have got a direction of travel and that things are moving in the right direction. I know, given the weight of people’s loss, that that has taken too long, but we are working on it.

I recognise that there are issues in regard to hepatitis C and in particular hepatitis B. In relation to hep B, Sir Robert said that Sir Brian needed to take further medical evidence. It is one of the areas where, because of the absolute complexity, we may need to wait for the Langstaff report before we can be specific, but are we aware of the issues? Yes, we are, and I am grateful that the hon. Lady has brought the matter to the House’s attention.

December 17, 2022
Patricia Gibson – 2022 Speech on the Infected Blood Inquiry

The speech made by Patricia Gibson, the SNP MP for North Ayrshire and Arran, in the House of Commons on 15 December 2022.

We in the SNP pay tribute to those affected by the infected blood scandal—one in three infected with HIV were children—and their continued decades-long struggle for justice. Today’s announcement of a swift response to Sir Robert Francis’s final recommendations relating to compensation is indeed welcome, but the Minister will understand the widespread disappointment about his inability to commit today to a date for publishing a response to Sir Robert’s compensation framework report.

The Minister will be aware that there is understandably a significant and remaining lack of trust between those impacted by infected blood, the UK Government and existing support schemes. Recommendation 16 of Sir Robert’s study calls for an arm’s length body to

“administer…compensation…with…independence of judgement and accountable directly to Parliament”.

I hope the Minister will tell us today that he will keep the House updated on the progress of that.

Thousands of families across the UK have experienced great trauma after they have cared for loved ones suffering—or in many cases dying—due to contaminated blood. Does the Minister support the notion of the interim scheme being extended to families and carers who have cared for people with infected blood?

Jeremy Quin

There are two points in particular. On the arm’s length body, a persuasive case is made in recommendation 16. Looking at the principles of that, particularly on independence, we are not yet ready to commit to an ALB, but we definitely want to have a body that will have the trust and respect of those whom we are seeking to support. Work is going on as to how that will best be constituted, but recognition of independence is key behind the principles of the recommendation of an ALB. I look forward to updating the hon. Lady on other issues as the work progresses.

December 17, 2022
Peter Bottomley – 2022 Speech on the Infected Blood Inquiry

The speech made by Sir Peter Bottomley, the Conservative MP for Worthing West, in the House of Commons on 15 December 2022.

I welcome the Minister coming to make an oral statement. We know that both he and the Leader of the House have been deeply involved in this issue over the months and years.

The right hon. Member for Kingston upon Hull North (Dame Diana Johnson) is the most powerful advocate trying to hold Government to account and to get them to come forward. I think she will want to write—and I will happily join her—a whole series of detailed questions to the Minister, some of which he may be able to answer now. For others, he may have to say what conditions need to be met for them to be answered.

One important thing to my mind is allowing those who are not yet registered as possibly entitled to compensation to preregister, so that, when the Government come out with their response to Sir Brain Langstaff’s report, they will be able to take that up fast and make up any missing medical records, which will be a problem for some people who have been infected or affected.

The all-party parliamentary group welcomed the Government accepting the first point of Sir Robert Francis’s report about the moral case. I thank the Government for that. We are also grateful that Sir Robert is going to be invited to help Sue Gray to take forward the work she is doing. We should not underestimate the amount of work.

As and when people get compensation, are they going to be protected from the scams and so-called financial advisers who may not protect their income and use of that money? Can the Minister consider whether he can answer whether inheritance tax will not be applied to someone’s payments if the household is within the inheritance tax limit?

Jeremy Quin

I should have said this in response to the hon. Member for Vauxhall (Florence Eshalomi) but, in response to the Father of the House, I have greatly appreciated spending time with him and the right hon. Member for Kingston upon Hull North (Dame Diana Johnson), who has been a tireless campaigner on this, as has the entire all-party parliamentary group on haemophilia and contaminated blood. I very much appreciated the time they spent with me.

I absolutely recognise the point on preregistration, which is one of the issues at the forefront of our minds as we go through this. The Father of the House recognises that there are particular issues, including in relation to medical records that may have been lost over time, dating back decades. There needs to be a clear system so that people know how to take advantage of the scheme.

On compensation and scams, I share my hon. Friend’s concern. I am not certain how we will be able to address that. It is obviously an issue that afflicts many of our constituents in many circumstances, but I am sure that it will not be impossible to deliver timely advice alongside the scheme.

In terms of tax, the recommendation is clear that this should be tax free and should be disregarded for benefits. In relation to inheritance tax in particular, there are complexities that need to be examined. Whether we need to have legislation as part of that process is one of the issues that we are working on. If my hon. Friend or other hon. Members have detailed questions, they are more than welcome to write to me and I shall respond.

December 17, 2022
Florence Eshalomi – 2022 Speech on the Infected Blood Inquiry

The speech made by Florence Eshalomi, the Shadow Cabinet Office Minister, in the House of Commons on 15 December 2022.

I thank the Minister for the statement, which is welcome but long overdue. It is very disappointing that the Government did not find time for an oral statement in the House earlier this year when they published Sir Robert’s report. Ministers were dragged kicking and screaming to publish the report when it was leaked. That has been the pattern throughout this long painful process and it seems no different today.

Victims of the contaminated blood scandal will be watching today with great interest. Heartbreakingly, many of those infected have not lived to see today’s exchanges and the prospect of proper justice at the end of the inquiry. My right hon. Friend the Member for Kingston upon Hull North (Dame Diana Johnson) has campaigned tirelessly to raise awareness of this issue, but throughout that time more than 3,000 people have died and statistics from the Terrence Higgins Trust show that, between the start of the inquiry in July 2017 and February 2022, some 419 infected people have died.

I know personally how important this issue is and what it is like to have a loved one rely on a clean blood supply. My late mother suffered from sickle cell anaemia and because of that disease she required regular blood transfusions, which were vital. Without those blood transfusions, her life would have ended a lot earlier. I cannot imagine the pain and trauma experienced by families who were let down by basic failures of standards. The least they deserved was a prompt and thorough response from the Government. While we await the conclusion of the report and inquiry, one person dies every four days. Every day that we delay the compensation is justice denied to those people. The Minister owes it to those victims to provide real answers today.

In a recent Westminster Hall debate, the Minister’s colleague, the Parliamentary Secretary, Cabinet Office, the hon. Member for Brentwood and Ongar (Alex Burghart), gave a frankly insulting response on the subject. He dodged the question and failed to give any certainty about the timeline for payment or the publication of the Government’s response to the report, which they have had for more than eight months. Victims will not accept empty gestures. It seems to families that the plan changes with every announcement.

Can the Minister make a promise to the House today to publish a timetable for the compensation framework for those affected by the infected blood scandal? What plans does he have to work in partnership with the infected blood community to develop the compensation framework for those affected? When will he end the Government’s silence on the other 18 recommendations that have gone ignored? How will the Minister make sure that everyone who wants to respond to the proposals has the opportunity to do so? Rather than sporadic updates without any substance, will the Minister commit to more regular updates on progress and the direction of travel on this heartbreaking issue, ahead of the report next summer?

The contaminated blood scandal had a life-changing impact on tens of thousands of victims who were promised the hope of effective treatment. It can only be right that they see the justice they deserve as soon as possible.

Jeremy Quin

I thank the hon. Lady for her remarks. She spoke movingly of the impact on those infected and affected. I concur that time is of the essence. I appreciate that, for family reasons, she knows how difficult it must be for the people who saw these things happening to their relatives, and how awful that process has been. I also appreciate that it is incredibly important, given all that has happened to this community, that trust is built and retained. I certainly commit that we will update the House regularly.

I cannot commit to a timetable. The reason is that I do not want to say anything in this House that we cannot meet. There is a complex series of steps to be taken and work to be done across Government and with the devolved Administrations. But I assure hon. Members that it is my intention to update the House as we make progress. We must do so in order to ensure that those infected and affected are fully apprised of the progress we are making.

I am grateful to Sir Robert and Sir Brian for how they have incorporated the views of those infected and affected in their work. My impression is that those infected and affected have appreciated the engagement they have had through the work undertaken. I hope that means that Sir Brian’s work is fully reflective of the thoughts of the community. I have said that I wish to meet members of the community. I want to ensure that our work is timely and ready to fully consider and respond to the work that Sir Brian produces during the course of next year.

December 17, 2022