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Category: Health

  • Sajid Javid – 2022 Comments on the Health and Social Care Levy

    Sajid Javid – 2022 Comments on the Health and Social Care Levy

    The comments made by Sajid Javid, the Secretary of State for Health and Social Care, on 6 April 2022.

    The pandemic put unprecedented pressure on the NHS and is causing the Covid backlogs. This investment will go into tackling those backlogs and will help make sure everyone can get the care and treatment they need.

    We can’t have business as usual, which is why we are rolling out Surgical Hubs and Community Diagnostic Centres up and down the country to deliver millions more scans, checks and operations.

    This vital funding will ensure the NHS is equipped to not only reduce waiting times but also tackle the big challenges we face – from cancer to heart-disease and dementia. We will also reform the adult social care system, invest in the workforce and protect people from catastrophic care costs.

  • Boris Johnson – 2022 Comments on the Health and Social Care Levy

    Boris Johnson – 2022 Comments on the Health and Social Care Levy

    The comments made by Boris Johnson, the Prime Minister, on 6 April 2022.

    We must be there for our NHS in the same way that it is there for us. Covid led to the longest waiting lists we’ve ever seen, so we will deliver millions more scans, checks and operations in the biggest catch-up programme in the NHS’ history.

    We know this won’t be a quick fix, and we know that we can’t fix waiting lists without fixing social care. Our reforms will end the cruel lottery of spiralling and unpredictable care costs once and for all and bring the NHS and social care closer together. The Levy is the necessary, fair and responsible next step, providing our health and care system with the long term funding it needs as we recover from the pandemic.

  • Paul Scully – 2022 Speech on Long Covid

    Paul Scully – 2022 Speech on Long Covid

    The speech made by Paul Scully, the Parliamentary Under-Secretary of State for Business, Energy and Industrial Strategy, in the House of Commons on 31 March 2022.

    I congratulate the hon. Member for Oxford West and Abingdon (Layla Moran) on opening the debate so incredibly well, and I congratulate her, the hon. Member for Oldham East and Saddleworth (Debbie Abrahams) and my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter)—unfortunately he could not be here—on securing this important debate on the impact of long covid in the workplace. I thank the Backbench Business Committee and all those who have taken part in the debate for their thoughtful and insightful comments.

    We heard about the ONS estimate that, in the four-week period ending 31 January 2022, 1.5 million people in the UK reported experiencing ongoing symptoms following covid. Of them, nearly 300,000 reported that their ability to undertake day-to-day activities had been significantly limited. It is therefore clear, as we have heard, that long covid presents a growing challenge for the workplace and more widely. The emergence of a completely new condition such as long covid is a real rarity and, much like our experience of the covid-19 pandemic itself, we must be and are constantly developing our understanding.

    We have put support in place for those suffering from the condition. NHS England has invested £224 million to date to provide care for people with long covid. It has established 90 long covid assessment services across England, which are assessing and diagnosing people experiencing long-term health effects as a result of covid-19 infection, whether they have had a positive test or are likely to have long covid based on their clinical symptoms, regardless of whether they were admitted to hospital during their covid-19 illness. The services offer physical, cognitive and psychological assessment and, where appropriate, refer patients to existing services for treatment and rehabilitation. The hon. Member for Oxford West and Abingdon talked about the $1 billion in the States. Not all of that has been allocated yet, while the UK is already ploughing ahead, and we are quite far ahead of other countries, including the States, in our research in the area. Of course, there is always more that we can do.

    It is clearly essential to get the right healthcare and treatment in place for individuals, for employers and for the wider economy. However, the theme of the debate is the impact of long covid in the workplace. People can suffer from many long-term health and other conditions that may affect their work. We have heard about ME, and we could talk about fibromyalgia, Guillain-Barré, Miller Fisher all those things. Indeed, there are other conditions that are not necessarily post-viral.

    Earlier this month, I gave evidence to the Women and Equalities Committee on the impact of the menopause in the workplace, and in February I responded for the Government to a Westminster Hall debate on supporting people with endometriosis in the workplace. Those are different conditions, but, none the less, they are long lasting and we need to ensure that we can get people the right treatments and adjustments. Indeed, in the case of the hon. Member for Denton and Reddish (Andrew Gwynne), a simple, natural adjustment made his working life so much easier, and for so many of these other conditions there are examples of small things that employers can do to keep people in the workplace. They do not have to be complicated, and they certainly do not have to be expensive.

    We believe that employers should play a significant role in supporting people with long-term health conditions to access and remain in work. That can certainly benefit individuals as well as bringing real bottom-line benefits to employers through, for example, avoiding recruitment costs and not unnecessarily losing experienced and valued members of staff.

    However, it is not sustainable for every condition to get different or special treatment. For employers, that could lead to confusion and complexity; likewise for employees. That is why the Government’s starting position is that, specifically in the workplace and in the overall framework for providing health support to employees, long covid should be treated the same as any other long-term health condition. Let me set out that framework, which, as hon. Members would expect, is a cross-departmental effort.

    The Government’s response to the “Health is everyone’s business” consultation, led by the Department for Work and Pensions, was published in July 2021. It sets out some of the measures that we will take to protect and maintain the progress made to reduce ill health-related job loss and see 1 million more disabled people in work from 2017 through to 2027.

    Debbie Abrahams

    I am listening keenly to the Minister, but the issue is that this is an infectious disease that is contracted partly as a result of exposure, and there is clear evidence that exposure happens in the workplace. It is therefore not the same as existing progressive or fluctuating illnesses; it is very much an infectious disease contracted in the workplace. That is the basis for our recommendations.

    Paul Scully

    I understand the hon. Member’s point. I am trying to set out the framework for managing long-term illness, but clearly, we still have support in the workplace for those with infectious diseases. I cited ME, fibromyalgia, Guillain-Barré syndrome and Miller Fisher syndrome, which are all post-viral infections—an infection beforehand typically leads to those other long-lasting conditions. That is why I am compartmentalising the framework, but none the less, I take the hon. Member’s point about the infections happening in the first place.

    “Health is everyone’s business” did not consult on long covid, or any other specific health condition for that matter; it looked at system-level measures to support employers and employees to manage any health condition or disability in the workplace. The measures that we are taking forward include providing greater clarity on employer and employee rights and responsibilities by developing a national digital information and advice service; working with the Health and Safety Executive to develop a set of clear and simple principles that employers would be expected to apply to support disabled people and those with long-term health conditions in the work environment; and increasing access to occupational health services, particularly for small and medium-sized enterprises, which, as we know, are currently underserved.

    As I said, although those measures are not long covid-specific, they are key steps in our effort to change the workplace culture around health and sickness management. That will benefit those suffering from long covid in the same way as those suffering from other longer-term health issues or disability.

    As the hon. Member for Motherwell and Wishaw (Marion Fellows) said, we are also responsible for flexible working. We know that that policy can be incredibly helpful to those suffering from many long-term health conditions, including long covid, as they seek to manage the symptoms, some of which we have heard about today, such as extreme tiredness, insomnia, depression and anxiety. Although flexible working does not provide the whole answer, it can be an important tool for employers and employees as they have discussions about how better to balance the demands of work and life, particularly for those managing long-term health conditions.

    The consultation on flexible working introduced plans for a future call for evidence on ad hoc flexible working; we want to explore how non-contractual flexibility works in practice. I discussed that with the Flexible Working Taskforce in February. We will ensure that the role of ad hoc flexible working to support those with long covid and other health conditions—such as the menopause and endometriosis, which I have mentioned—is part of its considerations.

    Marion Fellows

    Is the Minister looking at cutting the time before someone can apply for flexible working? At the moment, they have to have been in work for quite a long while before they can do so.

    Paul Scully

    Our manifesto committed to consult on this issue. Within that consultation, we looked at a day one right to request flexible working. That is key, because it will attract people to and keep them in a good workplace. We might as well start as we are set to carry on.

    Another significant part of the cross-departmental framework is the Government Equalities Office, which is responsible for the Equality Act 2010. That is an important part of the matrix, because it may protect those with long-term health conditions from discrimination. That Act ensures that any person with a condition that meets the definition of a disability is protected, so it should not be stigmatised. The Act describes disability as

    “a physical or mental impairment”

    that

    “has a substantial and long-term adverse effect”

    on a person’s

    “ability to carry out normal day-to-day activities”.

    We heard about that not least from the hon. Member for Denton and Reddish and during the incredibly passionate speech of the hon. Member for City of Chester (Christian Matheson), who cited the example of his family member. By the way, I know how difficult it is for an hon. Member to describe a family member who is suffering from something that we are debating, and I thank him for his personalised experience, which has informed the House and positively contributed so much to the debate.

    As I said, the disability should not be stigmatised, though some may do so. This is simply about the impairment, as we have heard loud and clear. “Long-term” is defined having lasted, or being likely to last for, at least 12 months. “Substantial” is defined as more than minor or trivial, as we have heard strongly in Members’ examples today.

    The Act makes it clear that it is not necessary for the cause of the impairment to be established, nor does the impairment have to be the result of an illness. A disability can therefore arise from a wide range of impairments. That means that any person who falls within that definition will already be protected as having a disability. That can therefore encompass some of the emerging effects of long covid, but every case will be different and should be considered on its merits.

    As well as paying tribute to the hon. Member for City of Chester, I thank the hon. Member for Oxford West and Abingdon and ask her to pass on our regards to Andrew, Nell and Rebecca. We also heard about Julie Wells and her daughter and the caring responsibilities involved. The examples that we have had really add colour and inform the debate.

    The hon. Member for Motherwell and Wishaw talked about statutory sick pay. We have discussed the fact that we need to look at statutory sick pay, but this is not the time to do so, particularly while we are in the middle of the pandemic. However, we also need to look at statutory sick pay in the round. She mentioned people earning under £120 a week, but many in that situation are already in receipt of other benefits. That is what I mean about not just concentrating on one issue; we need to look at the whole person and their whole personal finance.

    In summary, we are supporting people with long-term health conditions, including long covid, by working hard on the general approach to work and health, through our response to the “Health is everyone’s business consultation”, and taking steps to make some of our employment rights work a little harder to support those balancing work with other issues and challenges. All that is underpinned by the protections against discrimination provided by the Equality Act. We must also showcase the good employers, as was mentioned by the hon. Member for City of Chester.

    Layla Moran

    If I understand this correctly, the consultation is happening and guidance will be provided more comprehensively for all longer-term illnesses. The issue particularly with long covid is that it is so new that many employers do not have a clue what it is. Will he consider suggesting a public health information campaign particularly targeted at businesses so that they know that it exists and where they can go for such guidance?

    Paul Scully

    I often talk about ACAS guidance, which, obviously, is available in this area. The hon. Lady mentioned what she saw as shortfalls in that guidance. We will always look at that to make sure that guidance is up to date, especially with an evolving condition such as long covid. I keep citing the example of ME, which, like fibromyalgia, is one of those diseases that is very poorly understood by so many people in the workplace and even, frankly, by health professionals. It will evolve and I am sure that we will able to push that information out to employers.

    I hope that hon. Members would agree that there is a wide-ranging set of actions to address long-term health issues in the workplace, whatever those health conditions are. We want to encourage a better culture around work and health, including for those suffering from long covid. I firmly believe that it is an important principle to have a single, consistent and clear approach to managing health in the workplace. It is unsustainable to have a number of different approaches for different conditions. I close by thanking everyone once again for this helpful and informative debate.

  • Andrew Gwynne – 2022 Speech on Long Covid

    Andrew Gwynne – 2022 Speech on Long Covid

    The speech made by Andrew Gwynne, the Labour MP for Denton and Reddish, in the House of Commons on 31 March 2022.

    I sincerely thank the hon. Member for Oxford West and Abingdon (Layla Moran) for all the work she has done on this issue, and for the way she opened this debate. I also thank the Backbench Business Committee for granting it and the Members who have taken part. I thank in particular my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams), and I sincerely thank my hon. Friend the Member for City of Chester (Christian Matheson) for his kind words. It is nice to know that my experiences have helped somebody else with theirs, and I wish his family member well for the future. I also thank the hon. Member for North East Fife (Wendy Chamberlain), and my hon. Friend the Member for Putney (Fleur Anderson), who is absolutely right to draw parallels with ME both in some of the symptoms and in how that community has been treated over a number of years. I thank my hon. Friend the Member for Strangford (Jim Shannon)—because he is my friend—for his kind words, too.

    As colleagues will know, not least because it has been mentioned in this debate, long covid is an issue very close to my heart. Back in March 2020, I first caught covid. That was 107 weeks and four days ago, and I am still struggling with some of the symptoms of long covid all these weeks and days later. Back then, I felt rough with covid, but to my relief I avoided a lot of the more serious symptoms we were seeing on the news and hearing from friends and colleagues at that time. It was not great, but the fact that I was not hospitalised was a blessing.

    However, when my self-isolation period ended and in theory I should have been fine to return to work, I found that I could not. I found that I was perpetually exhausted, and I could not catch my breath. I would be talking to my wife, and suddenly the words would vanish. I would try to pick them out, but I could not find the right ones. I would forget things and lose track of why I had come into a room. I would sweat as though I had run the London marathon just doing routine day-to-day things such as making a cup of tea. I felt completely terrified. My symptoms were not going anywhere, but instead evolving into something different and seemingly something permanent.

    In May 2020, Elisa Perego coined the term “long covid” to describe these persistent and wide-ranging symptoms, and I felt like a bright light had been shone on what I had been going through. We now know that over 1.5 million people suffer with long covid in the United Kingdom, and that the majority of these—989,000—say it affects their daily activities. It certainly affected mine. I am very fortunate to have a brilliant team across Westminster and in my constituency of Denton and Reddish, and they stepped up on my worst days, when getting out of bed felt like running a marathon. They made sure that my constituents were still well represented, and that I was given sufficient time to rest when needed. Listening to my body was a hard lesson, too.

    However, millions of people in this country are not as fortunate as I was. We have some of the worst sick pay provision in the OECD, and we are in an age of precarious work. In that context, long covid becomes an economic as well as a health emergency. The fact of the matter is that there has been an acute failure on the part of Government to take long covid as seriously as perhaps they should, because it is not just a health issue, but an employment and a DWP issue. The Government could and, I believe, should be doing more to encourage workplaces to better support those suffering from long covid and to enable employers to understand precisely what long covid means for their workforce.

    For December 2021 to January 2022, the most recent period we have access to, it has been shown that, of the 1.5 million people currently suffering from long covid, only 2,869 had attempted to access the post-covid assessment service. Of that tiny number, 34% had been waiting for longer than 15 weeks. Something is going very wrong. Almost 1 million people are reporting long covid symptoms that are adversely affecting their day-to-day lives, yet just a fraction are attempting to access care and only a fraction of those are actually getting it. I would be grateful if, in his response, the Minister set out what conversations he has had with colleagues in the Department of Health and Social Care about these figures, and what action the Government will be taking to ensure that those who have long covid can actually access the care they desperately need.

    This is actually quite crucial because, with the right rehabilitation package, work can become viable again for a proportion of those people. I want to share with the Minister some data I have received from Nuffield Health. Operating a free 12-week programme, it has so far helped over 1,900 people from across the UK to recover from the prolonged effects of covid-19, including breathlessness, anxiety and fatigue, and I am one of the 1,900 who have taken part in that free programme. Its results to date show that for 64% of people the programme improved mental wellbeing, for 39% it improved their functional capacity and for 39% it improved their breathlessness, while 35% saw an improvement in fitness and 30%—not an insubstantial number—were absent from work but felt they could return. This is not a silver bullet for all, because those are still minority figures, but I think that 30% being able to return to work with the right rehabilitation programme is quite encouraging.

    As has been pointed out on numerous occasions, 4% of the UK workforce currently have long covid. That is an extraordinarily high number of people, and it will no doubt be having an impact both on workplace productivity and on wider employment outcomes. The Chartered Institute of Personnel and Development has found that a quarter of UK employers cited long covid as one of the main causes of long-term sickness among their staff, yet those living with long covid have had very little in the way of workplace protection.

    In my capacity as shadow Minister for public health, I have been inundated with stories of employees facing an uphill battle to have reasonable adjustments implemented in their workplaces. I have heard from doctors unable to return to work and NHS staff who have been sacked or had contracts terminated because of long covid symptoms. They are the people who carried us through the pandemic—we stood on our doorsteps for them and applauded them. We can do much better than that.

    I turn to the help that I had in returning to work. I pay tribute to Mr Speaker and the staff in the Speaker’s Office, because I am lucky enough to work in an environment where reasonable adjustments were made. When I first returned to the House in person after the summer recess, I found that I could not bob in the Chamber without becoming incredibly fatigued, and that would trigger my brain fog. After almost collapsing during a ministerial statement on Afghanistan—I had been bobbing for almost an hour—I arranged for a meeting with Mr Speaker on the basis that I could not do my job and, if I could not do a simple task like bobbing up and down, I might as well pack up and leave. Mr Speaker and his brilliant staff advised me that instead of rising on each occasion, I could simply hold up my Order Paper. That simple solution made a huge difference to my health and wellbeing. I sincerely thank Mr Speaker, and indeed you, Madam Deputy Speaker, and the staff in the Speaker’s Office for being so understanding.

    However, reasonable adjustments should not just be made for Members of Parliament. The Government need to do much more to empower employees to approach their bosses and have these conversations. The problem is that, with practically zero workplace protections in place for long covid, they become incredibly difficult to have.

    The Opposition recognise the threat that long covid poses both to the health of this nation and to the British workforce. That is why we would end the postcode lottery of long covid care provision, fix the shameful state of sick pay and engage with employers to support those living with long covid. Covid has not gone anywhere, and it is profoundly irresponsible to stick fingers in ears and pretend that 1.5 million people are not still struggling. Free lateral flow testing will end tomorrow and, as a result, covid cases will rise. It will make it much harder to track the level of covid in the UK and, by extension, the number of people who may go on to develop and live with long covid.

    Layla Moran

    I am glad that the hon. Member has brought up that point. He will have heard about the difficulties that people have in accessing benefits and proving that they have long covid. People get long covid from covid, but, if they cannot get a test, how do they know if they have had covid? That makes it so much more difficult for people to prove long covid down the line and access the benefits that they deserve.

    Andrew Gwynne

    The hon. Lady is absolutely right. That is a real concern of mine, not least because I have experienced it. I was in the first wave of covid, having caught it in the weeks when the Government said, “If you develop symptoms, you no longer need to test; just go into self-isolation.” I knew that I had covid, and I know that that led to long covid, but to this day I cannot prove it because there was no routine testing available to show it. That is a real issue.

    I am incredibly worried that getting rid of free testing is a short-term decision that will have major financial and public health implications for the foreseeable future. The Government cannot turn a blind eye to a problem that is having a devastating impact on the people of this country. One of the defining lessons of the pandemic is that we do not have the luxury of dithering and delay when it comes to public health. We urgently need a cross-departmental long covid strategy. I would support that, work on it and gladly give my experience and advice to Ministers to help develop it. We need a long covid strategy, we need proper sick pay, and we need the Government to understand that they have an important role in working with business and industry to ensure that reasonable adjustments and support in the workplace become a thing for all, not just for me.

  • Fleur Anderson – 2022 Speech on Long Covid

    Fleur Anderson – 2022 Speech on Long Covid

    The speech made by Fleur Anderson, the Labour MP for Putney, in the House of Commons on 31 March 2022.

    I am grateful to the hon. Member for Oxford West and Abingdon (Layla Moran) for securing this debate, and I reiterate what has been said by many: we understand that so many people are suffering from long covid, and it must be taken seriously by the Government. We understand the impact it is having not only on those individuals and their daily lives, but the workforce. This economic issue will continue to have a serious impact, and it needs to be addressed. I reiterate the main ask that we have and that the all-party parliamentary group on coronavirus has in its very helpful report on long covid, which is for employer guidelines so that people are not at the whim and the mercy of different employers regarding understanding and support for their continuing in or returning to the workforce.

    I have come to this debate for two groups of people. One is all those suffering from long covid across the country—an estimated 1.5 million people, or 4.4% of the workforce. The other is those constituents who have been suffering from ME, who have learned many lessons from that and think they are relevant to working with those with long covid. They have been underestimated, not believed and not supported. When they have gone to their GP, they have been told the wrong advice—advice that makes their ME worse—and they have not been understood in schools, whether by young people or teachers, or by their employers, and they do not want anyone with long covid to go through the same. I have been disturbed to hear some of the evidence given to the APPG about workforce practices that are not conducive to helping people come back to the workforce and not the best for those individuals and our economy.

    A couple of my constituents have written to me. One said:

    “I have now had long covid for two years…We desperately need more investment in potential treatments. It is clear that the illness impacts the blood, autoimmune system, organs, brain and central nervous system. None of these mechanisms are being treated by the NHS so far. Treatments are being trialled in other countries.”

    There are questions being asked about the trials being conducted in other countries and what more could be done here.

    Another constituent said:

    “I contracted covid-19 at the very end of September. Like many people, I suffered mild symptoms…2 weeks on from my initial infection I was suddenly hit with a wave of long covid symptoms and was truly horrified at what was happening to my brain and body. I felt drained and broken, and…I felt as though a foreign body was inside my head—I could no longer hold even a conversation, yet alone work. For the last 7 months I have been unable to function in any sort of capacity.”

    Finally, my cousin has had long covid for a long time. He sent me a list of his symptoms: fatigue, concentration impairment, memory problems, cognitive loss, internal pain, chills and sweats, sleeplessness, sore throat, dizziness, shaking, anxiety, faintness and muscle aches. All these symptoms and impacts of long covid need to be understood by employers, by teachers and education settings, and by general practitioners and all medical workers, as recommended by the report of the APPG on coronavirus.

    I underline those recommendations and ask specifically for the urgent production of clear employer guidelines, otherwise there will continue to be an employer lottery in the treatment of people with long covid as they return to work. I ask for guidance to education settings, because many students with ME found it difficult to get understanding in order to continue with their education. We cannot have the same happen for those with long covid. And I ask for clear guidance to medical practitioners on children and adults with long covid so that everyone gets the proper care, support and understanding they need so that they have hope and do not add being misunderstood to their long list of symptoms, only increasing their anxiety.

    I welcome this debate, and I hope to hear some good news from the Minister about the key recommendations of this report being taken up to create a good situation for everyone with long covid.

  • Christian Matheson – 2022 Speech on Long Covid

    Christian Matheson – 2022 Speech on Long Covid

    The speech made by Christian Matheson, the Labour MP for the City of Chester, in the House of Commons on 31 March 2022.

    A couple of weeks ago, I attended with constituents the service at St Paul’s Cathedral that was organised by the cathedral, Sir Lloyd Dorfman and others to remember those who have died from coronavirus. Indeed, earlier today in business questions we heard from my hon. Friend the Member for Vauxhall (Florence Eshalomi) about the very striking memorial wall in her constituency along the banks of the Thames by St Thomas’s Hospital.

    I am really grateful to the Backbench Business Committee and the hon. Member for Oxford West and Abingdon (Layla Moran) for enabling us to remind ourselves of all the other victims of covid who are, in a sense, the lucky ones who have survived but who still need our attention. I declare an interest in that a member of my immediate family suffers from long covid. If the House will bear with me, I will not actually identify who it is. For 18 months, that member of my family has not really been able to get out of bed. In terms of work, they were doing well. They are young. Their career was progressing. They were being extremely well rated at work. Almost overnight, that came to a crashing halt.

    At first, when you suffer from covid, as I did at the same time as my family member, you hope and believe that although it is going to be awful and unpleasant, if you get through it, life will carry on. Then long covid starts to emerge and you do not get any better. I got better and my family member did not. It involved all the symptoms that my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams) described—huge tiredness, brain fog and aching limbs. At the time, the best source of advice that was available, and the best source of support, was my hon. Friend the Member for Denton and Reddish (Andrew Gwynne). There was nothing really available. People had not come to terms with the condition and with identifying what its causes were. I pay tribute to and thank him for his work and his support to my family.

    The employers of my family member were excellent, and still are. They have not been able to continue paying, but as far as they are concerned my family member is still on their books. They value the contribution that my family member has made—again, I am sorry to talk vaguely but I do not want to identify the person—and have said, “When you’re ready to come back, we’re ready to have you.” That is the kind of employment practice that we are looking for.

    To echo my hon. Friend the Member for North Tyneside (Mary Glindon), another member of my family has had to give up their job in order to be the carer. What we are looking for is some kind of hope—something to cling on to and to demonstrate progress. There has been progress. I welcome the Government’s investment of £18 million and the growing recognition of the post-viral chronic fatigue syndrome caused by coronavirus. Whenever there is a new light on this, even in scientific papers that I would not normally understand, we devour them to try to find an explanation, a cause, a hope of a cure or a treatment that will get us and my family member through this. Is it caused by scarring on the lungs? Is it caused by microclots? Is it caused by activating postural orthostatic tachycardia syndrome, which also bears some kind of relation to what is going on? The truth is that it could be any one of those in any number of individuals, but the absolute fatigue is the same.

    I remember my hon. Friend the Member for Denton and Reddish advising me, “If you’re feeling good, don’t do too much—don’t exert yourself.” I passed that advice on. It is also about the mental effect. When you are having a good day, you do not want to exert yourself because then you might be knocked out for the next three days, so that forces you to withdraw into yourself and not want to go out. You cannot even walk down to the shops or to the park because you are so terrified that you might then not make it through the next three days. It is about the hope and desire and almost desperation that when you have a good day and it is followed by another good day and then perhaps another, is this the beginning of the end, or even the end of the beginning? For so many, including my family member, it has not been that.

    I would ask for the same consideration that has been given to my family member to be given to others—for employers to recognise that the Government have recognised this as an issue and the medical establishment has recognised it as an issue. Employers need to treat their employees who have this illness as also being victims of the pandemic, because nobody has chosen to have it. My message to those, including constituents, who still persist in saying that covid-19 is nothing—that it is just like a cold or the flu—would be something along the lines of, “Get stuffed.” There are 140,000 names on the wall outside St Thomas’s, and there are maybe a couple of hundred thousand others who are still suffering today and are desperate to get over this terrible long-term affliction and have some hope of a better life to come. I am most grateful for this debate, and most grateful, again, to my hon. Friend the Member for Denton and Reddish for the support he has given to my family.

  • Layla Moran – 2022 Speech on Long Covid

    Layla Moran – 2022 Speech on Long Covid

    The statement made by Layla Moran, the Liberal Democrat MP for Oxford West and Abingdon, in the House of Commons on 31 March 2022.

    I beg to move,

    That this House has considered the impact of long covid on the UK workforce.

    I thank the Backbench Business Committee for allowing us to hold this updated debate on long covid. I also thank my co-sponsors, some of whom, I am sad to say, are at home ill with covid and very much wanted to be here today. Also the fact that the debate has moved weeks has not helped. For those watching at home, I have been contacted by several Members who are very sorry that they are not able to be here. I also want to put on record my thanks to the many hundreds of people who, over the years, have contacted the all-party group on coronavirus with their personal stories, many of which are very heart warming, but also moving and worrying because it is a debilitating condition. What I say to all of them is: “We hear you, you have not been forgotten and we will continue to fight for you.”

    I want to recognise the actions that the Government have taken so far. I was pleased that, after the first debate we had on the issue in January 2021, the Government made some £18.5 million available for research into long covid, including treatment, and delivered even more funding in the summer, which is incredibly welcome. In that debate, I also welcomed the new dedicated long covid clinics and the publishing of guidance to medical professionals by the National Institute for Health and Care Excellence, the Scottish Intercollegiate Guidelines Network and the Royal College of General Practitioners. However, despite that welcome action, it has felt, over the past eight months, that long covid has totally dropped off the radar and, on this issue, there has been very little debate.

    I thank the Under-Secretary of State for Business, Energy and Industrial Strategy, the hon. Member for Sutton and Cheam (Paul Scully) for coming to the Chamber to answer this debate. I believe that it is the first time that the Department for Business Energy and Industrial Strategy has answered in the Chamber on this. I will focus my remarks on the effect that long covid has had on the workforce because our belief is that this is a looming crisis that we need to think ahead about and that it would be wrong for us just to focus on the medical side— there are broader implications here.

    Although there are many understandable reasons why this matter may have dropped off the radar, including the cost of living crisis and the war in Ukraine, I argue that these things are very much linked. How are we going to have a strong and productive economy if large swathes of our workforce are struggling to do the jobs that they are meant to be doing? How can we help them to recover?

    Over this past year, we have had more information and learned more about long covid, although it is worth saying that there is still no cure. There are treatment plans that can help with symptoms, but the past year has been awful for many, including Andrew, a headteacher whom I spoke about in the debate a year ago, who received multiple written warnings about his inability to do the job in the day. I went back to him and asked how he was. He said:

    “I made the difficult decision to resign from my post as a headteacher, so my limited energies could focus on coming to terms with my illness rather than continuing to face dismissal from a career that I had committed the past 25 years to and one that I dearly love.”

    I also got an email from Nell, one of my constituents, who is a doctor. She said:

    “I adore being a hospital doctor. I love my patients and I trained for years to do this. It’s been nearly two years of struggling with my health after covid, and while I continue to slowly recover, I don’t know if I can do this much longer. I’m so very sorry—I feel that I have let you down writing this.”

    To Nell, I say that I do not believe that she has let anyone down, but I think that, to an extent, the Government have let her down.

    Seema Malhotra (Feltham and Heston) (Lab/Co-op)

    I thank the hon. Member for giving way and for her excellent speech. I also thank the Backbench Business Committee for granting the debate. She has raised a couple of cases that she has heard about. I have been in touch a lot with Sam, a carer in my constituency. At the very beginning when she had long covid, people did not understand the condition and it was not taken seriously, and it has affected her ability to work ever since. Does the hon. Member agree that, as well as dealing with the health side and getting more research on how the condition affects people so differently, it is important to have guidance for employers—she will probably come on to this—on how to deal with this and how to support those who may have long covid through that very difficult period? As we do not know how long the condition lasts, we need a proper long-term strategy for those who are affected and for their families.

    Layla Moran

    The hon. Member hits the nail on the head. People can recover, and very often do, but the way to help them do that is very badly explained to employers right now. Indeed, I will come on to talk in some detail about that.

    Many people were told, especially at the beginning, that long covid was something that they were making up. They were told that it was all in their head. I have a research paper here that shows that scans have been done on people’s chests and the reason they were suffering from breathlessness was that the tissue was fundamentally damaged. This is very much a real disease, which now needs a real response.

    It is not just public sector workers who have dealt with this. I spoke to Rebecca, who gave evidence to the all-party parliamentary group. She was a fitness instructor, Madam Deputy Speaker. You would think that a fitness instructor would be very healthy and would have very good lungs—before the pandemic, anyway. She used to teach 14 high-intensity classes a week and ran her own business. Now long covid means that she is in bed 60% of the time and describes being

    “unable to return to work, and to be the mum, wife or friend I once was”.

    It is utterly heartbreaking. We now need to accept that, if we are going to live with covid, we also have to live with long covid. In the evidence sessions that the APPG took in December and January, we heard how the condition is still severely impacting the lives and livelihoods of people across the country. They described how the condition has left them unable to work, sometimes unable to move, forcing them into long periods of absence from work, dipping into their savings and doing anything to stay afloat—something that is much more difficult now with the cost of living crisis.

    A study released this month by Queen Mary University concluded that becoming infected with covid increases the risk of economic hardship, especially if the individual develops long covid. Those individuals describe a patchwork of uneven availability when it comes to long covid clinics and many are desperate for treatment. We heard from one nurse, for example, who has spent thousands of pounds going to Germany to get treatment that she is not able to access here. Public sector workers gave their lives for us. When we were all allowed to be at home, they went in, and they are the ones, according to Office for National Statistics surveys, who have the highest prevalence of long covid. I believe that we owe them so much more than they have had so far.

    Unsurprisingly, though, it is not just about public services. We have 1.4 million people across the country experiencing self-reported long covid symptoms. That is 2.4% of the population and that cuts across every single sector, not just the public sector.

    In the hospitality sector, which, as the Minister will know, is already struggling, 2.6% of workers have long covid. If we take the 3 million workforce estimate from UKHospitality, that equates to 70,000 workers unable to do their jobs as they did before. In retail, it is 2.3%, which equates to just under 70,000 workers; for personal service, such as beauticians, it is a bit less at 6,000, but still 2.1%. Those are big numbers in sectors that are already struggling post pandemic and struggling with workers’ visas following Brexit. They do not need this.

    Mary Glindon (North Tyneside) (Lab)

    I congratulate the hon. Lady and her colleagues on securing this important debate. Does she agree that it is not only the people who have had long covid who suffer, but their family members who have to care for them? My constituent Julie Wells has had a working life of nearly 40 years. Her teenage daughter, on a second dose of covid, has been left with totally debilitating symptoms and now needs constant care. Julie hopes at best to get back to part-time work, but she may not. That is a full-time person lost to the workforce because of caring for a family member.

    Layla Moran

    I thank the hon. Lady for her intervention. The caring responsibilities are greatly increased, as is the prevalence in children. I was alerted by my hon. Friend the Member for St Albans (Daisy Cooper) to a case of a parent who is asking for dispensation for her child from taking examinations because she has missed so many days of school. I am talking to the Education Secretary separately about that point, but long covid affects the entire family, not just the workforce.

    Some 1.5 million people have long covid, but 989,000 people say that those long covid symptoms adversely affect their day-to-day activities and 281,000 people report that their ability to undertake their day-to-day activities had been “limited a lot”. That often means they must take part-time instead of full-time work, and sadly it often means they are unable to recover well because they are pushed to try to get back to work.

    The effect on business is now being better documented. The Chartered Institute of Personnel and Development found that a quarter of UK employers cited long covid as one of the main causes of long-term sickness absence among their staff. For small businesses, the effects can be devastating. The Federation of Small Businesses has shared guidance on how to help with statutory sick pay and arranging for temporary staff cover.

    However, I am concerned that the ACAS guidance right now is pretty sparse; I hope the Minister might take that up. The guidance signposts to other websites but does not make it clear that one of the most important things to do with long covid is often to let someone rest. People say “listen to your body” when it comes to medical things; I am afraid that with long covid that is actually the treatment plan.

    If someone is forced or encouraged into work by their employer—often inadvertently, if they do not have proper guidance—it can set them back and cause even more problems down the line. One of our main calls is for employer guidance, but I also urge the Government to look at the ACAS website, for example, and ensure that it is clear to employers how they can help and support their employees to stay at home and rest as long as they need to, so that they come back and we do not unnecessarily lose people from the workforce.

    A legal expert speaking to the APPG described the lack of access to financial support and said,

    “lots of people with Long Covid find themselves starting for the very first time to be involved in the obstacle course which is our benefit system”.

    It is clear that long covid is having a serious impact on the ability of our workforce to do their jobs, and we can only expect that to get worse as the virus spreads through the population again and we get more cases of long covid.

    What can we do? The all-party group has released a report on long covid this week; if the Minister has not seen it, I would be happy to give him a copy. In it, we make 10 recommendations, but I will highlight just a few. First, the Government need urgently to prioritise research treatments for long covid patients. We welcome the money already committed, but we would contrast it with the United States, for example, where $1 billion has been earmarked for this, because the US recognises the effect long covid could have on its economy and sees this as an investment. I urge the UK Government to find similar ambition.

    Secondly, we call for employer guidelines, set out by the Department for Business, Energy and Industrial Strategy in conjunction with the Department of Health and Social Care, to help all businesses to help their employees back into work. Thirdly, we call for the UK Government to launch a compensation scheme for all those frontline workers currently living with long covid, similar to the armed forces compensation scheme.

    The Minister will perhaps be aware that the process for the designation of an occupational disease is ongoing; we are hopeful that that will report back soon, and we are discussing that with the Department for Work and Pensions. That designation could be game-changing, particularly in those public sector areas where prevalence was incredibly high, such as education, the health and social care workforce and public transport, which had some of the highest prevalences of covid, particularly at the beginning.

    The Office for National Statistics survey points to where we need to look. However, I urge the Government not to wait for that designation. Many of those workers, as in my examples, have already left the professions. They are leaving the sector or deciding to take early retirement, and this is a time when our economy needs a boost. It needs those experienced workers. At the moment, we are not paying any attention to that.

    The main reason we secured this debate was to urge the Department for Business, Energy and Industrial Strategy to look ahead and take this seriously. The best thing we can do right now is to help hard-pressed people in the UK in our fight against Putin, against the cost of living crisis and all the rest. If we are to get our economy back on its feet, we must get our workers back at their desks. If those workers have long covid, there is currently very little out there to support them or those businesses that desperately want them back.

  • Edward Argar – 2022 Speech on Ambulance Response Times in Shropshire

    Edward Argar – 2022 Speech on Ambulance Response Times in Shropshire

    The speech made by Edward Argar, the Minister for Health, in the House of Commons on 31 March 2022.

    Just as I had the pleasure of giving the final speech in the final debate before the House went into recess before the last half-term, I have the same privilege today. To that end, I congratulate the hon. Member for North Shropshire (Helen Morgan) on securing this important debate. In the short time in which she has been a Member of this House, she has taken an extremely close interest in the issues of ambulances and healthcare for her constituents more broadly. She has been assiduous in raising them in the House, as she has today, or through other means with Ministers and the Department. I pay tribute to her for that.

    The hon. Lady will be aware, as she has genuinely and openly said, that there are complex causes behind the challenges faced by her constituents, and also by people around the country, with the ambulance service and ambulance response times. Ambulance services have faced extraordinary pressures, which have been particularly exacerbated during the pandemic. I am sure the House will join me in expressing gratitude, as she did, to all the ambulance service staff in the NHS for their outstanding work and dedication during this time. I recognise the very powerful individual cases that the hon. Lady cited, suitably anonymised, to illustrate her arguments and her case.

    As I have mentioned, the pandemic has placed very significant demands on the service. In February this year, the service answered over 760,000 calls to 999—this is nationally, and I will turn to the hon. Lady’s local situation in due course—which is an increase of 13% on February 2020. That places very significant pressures on the ambulance service and the wider NHS, and I will turn to the broader causes shortly. She was absolutely right to highlight that the issue is often not with the ambulance service itself—the number of ambulances or the number of staff—but about handovers and the ability to do turnarounds having safely deposited a patient at an acute setting in a hospital, but I will turn to that in a minute.

    A range of other issues, as well of course as demand, impact on performance, including the need for infection prevention and control measures, which remain in place in hospitals. They may not be as acute or as severe as they were at the height of the pandemic, but they are still there, and that does have an impact. There are the handover delays the hon. Lady spoke about, which are linked to capacity with those infection prevention and control measures, but also to the ability either to treat and discharge or to admit patients to a hospital. In recent months, we have also had high workforce sickness absence rates, often down to covid and covid self-isolation, with staff quite rightly taking the view that when they test positive for covid they should stay at home until they do not.

    In spite of these pressures—and this is in no way to diminish the point the hon. Lady made about the impact on her constituents, but is by way of context—the average response time in the west midlands to category 1 calls, the most serious calls classified as life threatening, was maintained at eight minutes and 11 seconds in February 2022. That was despite of a 40% increase in that category of calls on the previous year and a 16% increase locally in 999 calls overall. At a national level, the category 1 response time has been largely maintained at about nine minutes on average over the last several months—so not quite as good as the performance in the West Midlands—despite a 23.5% increase in those incidents compared with before the pandemic. However, we are clear that there have been significant increases in response times in the other categories, which of course we must improve.

    Helen Morgan

    I just want to make the point that in Shropshire we are not seeing the same level of service that we see across the west midlands as a whole. I am calling for more granular data because I think some excellent service provided elsewhere in the West Midlands Ambulance Service area is overshadowing some of the specific problems we are seeing in Shropshire. In addition, the number of hospital admissions to the Shrewsbury and Telford Hospital NHS Trust is running roughly at the same level as in prior years, so although the covid pandemic has provided challenges in separating out such patients when they arrive through infection control measures, it is not actually leading to a higher level of admissions.

    Edward Argar

    I am grateful to the hon. Lady, and I will turn to her specific asks in a moment.

    However, I will turn now to the Bill introduced by the hon. Member for St Albans (Daisy Cooper), which I am aware of. I have to be honest and say that we do not consider that the Bill would necessarily be the most appropriate way of achieving what she wants. The challenge with that legislation is that, at a time when we wish trusts to be focused on the delivery of frontline services, it is another administrative process of data collection. I would add that trusts of course operate at trust level, not at an individual station or county level, and trusts may cover a number of counties. So while I am aware of her legislation, it is not something that I believe would achieve the outcomes or be practical in the way she wishes, and she and I regularly have a to and fro across the Dispatch Box about a number of issues when she speaks for her party on health and care matters.

    There is strong support in place to improve performance. At the national level, as the hon. Member for North Shropshire generously recognised, there was £55 million of investment last summer, in advance of the winter, to help increase ambulance staffing capacity to manage pressures. All trusts received a portion of that funding to expand capacity through additional crews on the road and additional clinical support in control rooms as well as extending hospital ambulance liaison officer cover at the most challenged acute trusts.

    On overall staffing, which includes frontline clinical staff and the clinical support staff who work with them, our ambulance service has seen about a 38% increase since 2010—the Liberal Democrats can quite rightly take some credit for that from their five years in government—and, indeed, in the last year we have seen an increase of about 500 frontline staff. So we have increased staff and continue to increase available staff.

    The £55 million was supported by an additional £4.4 million in capital investment—these are still national figures, but I will turn to her specific local circumstances—which helped to keep an additional 154 ambulances on the road during winter over and above normal levels. Call handler numbers, which are equally important, are being boosted with more than 2,400 on target to be in place by the end of March—the end of today. That is about 500 more FTE—full-time equivalent—staff compared with September 2021, with potential for services to increase in capacity further during the coming financial year.

    NHS England and Improvement is also providing targeted support to the hospitals facing the greatest issues with delays in the handover of ambulance patients, helping them to identify short and longer-term interventions to reduce delays and get ambulances swiftly back out on the road. She is right that that is hugely important, and even more so in areas with large rural populations because of the distances involved. Trusts also receive supportive continuous central monitoring and support by NHSEI’s national ambulance co-ordination centre.

    With clinical support in control rooms, the ambulance service is closing just over 11% of 999 calls with clinical advice over the phone, which is an increase of three quarters since before the pandemic. That helps to save valuable ambulance resources to respond to more urgent calls, with that clinical input ensuring that the advice and decisions are right.

    The hon. Lady will be pleased to hear that significant local support is in place to improve response times in her county. The West Midlands Ambulance Service is working with community partners to help avoid conveying patients to hospital where there is no clinical necessity, providing alternate treatment and care at home or in the community and helping to avoid unnecessary trips to hospital, thereby freeing up resources and hopefully providing a more pleasant experience for those patients.

    In raw numbers, the West Midlands Ambulance Service conveyed over 600 fewer patients to hospital in February based on the clinical advice this year compared with two years ago. It has also introduced a clinical validation team of advanced paramedics who work in control rooms and clinically triage lower urgency cases and, where appropriate, signpost patients to other services, as I alluded to. In February, that team reviewed 967 cases in Shropshire, of which 61% of were not sent an ambulance, 14% were treated on the scene and just 25% were conveyed to hospital. That was based on the clinical triage, which I am sure the hon. Lady agrees should be central to any decisions made. That has played a significant part in helping the service to tackle the pressures.

    Other practical solutions include hospital ambulance liaison officers—HALOs—who are paramedics who work with bed managers to smooth out the flow of patients coming to an A&E department. They can provide a constant flow of information about capacity to the strategic command cell at the ambulance service headquarters, escalating any issues and avoiding queueing where possible. There is also joint work to cohort ambulance patients at A&E sites, where a single ambulance crew takes responsibility for three or four patients. That releases crews to respond to outstanding calls in the community more quickly.

    A new same-day emergency centre—SDEC—has been opened at the Royal Shrewsbury to divert patients, as clinically appropriate, away from A&E, improving handover times. In the two and a half years that I have been a health Minister, I have discovered that there are probably almost as many acronyms in health as in the Ministry of Defence. Surgical SDEC capacity at the Royal Shrewsbury has also been expanded and all SDEC units receive ambulances directly for suitable patients.

    The hon. Lady rightly mentioned hospitals, and I am grateful that my hon. Friend the Member for Telford (Lucy Allan) is here and made an intervention. During her seven years in the House, she has been a regular and vocal advocate for her local hospital in Telford. I pay tribute to her, because it was due to her campaigning and tenacity that there is an A&E locally at Telford. That is still seeing patients and helping to alleviate the pressure in Shropshire. She should rightly be proud of that, having successfully campaigned for it.

    Action is being taken locally to improve the patient flow through hospitals by discharging patients more quickly to create bed space. The aim is not only to increase the number of discharges a day, but to bring more discharges forward to earlier in the day, when it is clinically safe to do so, to allow the effective discharge and transition back to care at home or in a care home. Health and care system partners locally are looking to create additional community and social care capacity to support timely discharge, create bed space to take patients from A&E and reduce ambulance handover times.

    At a national level, we have set up a national discharge taskforce. As a Minister, I get almost daily statistics about where we are on delayed discharges across the country. It is a complex picture, with a variety of reasons behind delayed discharges. The hon. Member for North Shropshire is correct that some are about delays in getting into care homes or getting domiciliary care packages or rehabilitation packages at home. Some are also down to delays in the hospital in sign-offs and procedures, and there is more that we continue to do to drive those delays down.

    Construction is also under way on a new modular ward at the Royal Shrewsbury site, with 32 additional beds in service by spring 2022. That is alongside a £9.3 million upgrade of the emergency department at the Royal Shrewsbury, delivering additional cubicles, a new and improved majors department, a new designated emergency zone for children and young people and a new clinical decisions unit. The first phase of that work is complete and all areas will be finished by spring 2022.

    The hon. Lady raised a number of other issues, including the Future Fit model. We have been clear that funding of £312 million was allocated for that project, and that remains allocated. The challenge we face is that, thus far, the trust has not proposed a solution that meets that budget. We continue to work with the trust and to encourage it to do so. I hope that it will so that we can continue to drive that important project forward.

    I will very gently push back on what the hon. Lady said about there being £10 billion of PPE that is not fit for purpose. She will know that that is not correct. In the statement that was made about write-downs, not write-offs, the amount was about £8.7 billion, and it was not all PPE, by any means, that was not fit for purpose. Only a tiny proportion of that was the case. A significant element of that was essentially due to over-ordering at the height of the pandemic to make sure that the frontline had the PPE that it needed. We were buying at the height of the market, and there is currently a glut of PPE, so its value has inevitably declined. Not all of it will be used, because we got more than we needed to make sure that clinicians and others on the frontline were not exposed.

    The hon. Lady touched on local ambulance Make Ready stations and the changes to them. Decisions on reconfigurations and changes to that are made locally by the trust; it consults, but it makes those decisions. The Government do not have any power over those matters. The Health and Care Bill, which we debated yesterday, would give the Secretary of State greater power over such reconfigurations in the way that she asked, but her hon. Friend the Member for St Albans argued against that. I gently say that that is a matter for the local trust and the usual NHS processes on reconfigurations.

    The hon. Lady touched on, I think—forgive me if I am wrong—asking the CQC to look into this issue. It is entirely open for her or others to raise it with the CQC, and the CQC will make a decision or a judgment on whether it believes that it is appropriate or otherwise to look into the matter.

    In the few seconds that I have left, before Mr Deputy Speaker calls me to order, I say that I recognise and do not in any way diminish the significance of the issues that the hon. Lady raised. I hope that I have given her some reassurance that we are working through these issues and that we continue to put the support in place to help her constituents in Shropshire and more broadly.

    Finally, the hon. Lady requested a meeting, and I am conscious that she has raised the issue of correspondence. I have asked for that; I believe that that has happened since Christmas, as the Department works through the backlog. There is still a delay in correspondence, but I have pulled that out and asked for it, and I am happy to meet her and her fellow Shropshire MPs, together with the ambulance trust, to discuss their collective concerns or reflections that they would like to put to me as a Minister.

    I conclude by wishing the hon. Lady a very happy Easter and by thanking her for bringing this to my attention and the attention of the House.

  • Helen Morgan – 2022 Speech on Ambulance Response Times in Shropshire

    Helen Morgan – 2022 Speech on Ambulance Response Times in Shropshire

    The speech made by Helen Morgan, the Liberal Democrat MP for North Shropshire, in the House of Commons on 31 March 2022.

    I thank Mr Speaker for granting today’s Adjournment debate on a topic that is so important to my constituents in North Shropshire and to people across Shropshire and across the country. I start by making it clear that I am not here to criticise the hard-working NHS staff in our ambulance services and emergency departments. Indeed, I thank them for their incredibly hard and dedicated work in difficult and demotivating circumstances, but there is clearly a problem with the provision of emergency care in Shropshire, with complex causes, and I bring it before this House to urge the Government to take some action.

    It was clear throughout my election campaign, and has been clear from my inbox since then, that stories of excessive waits for an ambulance are not a rarity. I have since urged my constituents to contact me and share their experiences. Just since Monday, my office has been met with a tidal wave of correspondence, each story as saddening and frightening as the last. A care home reported a wait of 19 hours for an elderly resident with a broken hip. An elderly diabetic man fell and dislocated his shoulder. He was advised not to drink or eat anything in case surgery was required, and then waited 15 hours for an ambulance to arrive. A disabled man fell in his bathroom and waited for 21 hours for an ambulance. He was fortunately lifted from the floor after eight hours by a helpful neighbour. A man waited with a stranger experiencing heart attack symptoms on the side of the road for hours, only to give up and drive the gentleman to A&E himself.

    A man with a suspected stroke waited nine hours for an ambulance and a further five in the ambulance waiting to be transferred into hospital. A 92-year-old lady fell at 8.30 in the morning, suffering bleeding from the head and a broken leg. She was looked after by her 75-year-old neighbour for almost eight hours until the ambulance arrived, and then waited in the ambulance for transfer into the A&E department until 2.30 the next morning. She had not eaten since 6.30 the evening before her fall. An elderly woman fell down the stairs shortly after lunch. Her emergency carers—she has a red button to press for them—made her comfortable and called an ambulance, but they could not carry on waiting forever. After an 11-hour wait, she was alone with her front door open so that the ambulance crew could access her house. That was 3 o’clock in the morning.

    I could easily spend the next half hour relating heartbreaking stories, and I thank all my constituents who contacted me for taking the time to get in touch and explain the scale of the problem. One story in particular brought the issue home, and some Members may have read about it in the newspapers. It was the story of a young footballer who slipped on AstroTurf while playing football at school. He dislocated his knee and waited so long for an ambulance that by the time one finally arrived he had developed hypothermia. I do not know whether Members can imagine the distress of this young man, and the teaching staff who stayed on in the dark, long after the school day had ended, as his condition deteriorated out in the cold.

    What all these stories have in common is that they could have been much worse. I am sure everyone in the House would agree that nobody should have to suffer waiting an excessive amount of time for an ambulance, yet tragically in North Shropshire it is pretty common. I know this problem is not unique to Shropshire. I am sure that many colleagues have received similar emails describing similar events. In parts of Britain, an excessive wait for an ambulance has become normal.

    The problems surrounding this crisis are complex, and I am not here to propose a simple quick fix. However, there are consistent themes at the core of the issue. It is vital that we recognise them if we are to work out how to move on from here. The first is the problem of handing over patients at the emergency departments in Shrewsbury and Telford. West Midlands Ambulance Service has told me that, on the day the young footballer dislocated his knee, 868 hours were lost waiting to hand over patients, and that nearly 2,600 hours were lost in the month up to 29 March. Handover times in Shropshire are significantly worse than in the rest of the country, and there have been times when every ambulance based in Shropshire is waiting outside a hospital to discharge a patient.

    The hospital trust has declared a critical incident on no less than four separate occasions so far this year, and each of those incidents coincided with an increase in the number of heartbreaking stories coming into my inbox.

    Lucy Allan (Telford) (Con)

    I congratulate the hon. Lady on bringing this incredibly important issue to the House. Such heartbreaking stories are common to all Shropshire MPs. Does she agree that a combination of factors—I am sure she will go on to discuss some of them—including the transfer of patients on to wards, as well as the inaccessibility of general practitioners, is putting additional pressure on A&E?

    Helen Morgan

    I thank the hon. Lady for her intervention, and I entirely agree with her. I will stress some of those points later in my speech.

    The emergency departments of the Shrewsbury and Telford Hospital NHS Trust report that they suffer from a shortage of space and staff, along with the additional challenges of separating covid patients—on Tuesday this week, the trust had more covid patients than at any previous point in the pandemic. The trust also reports delays in discharging patients who are well enough to leave hospital because it is struggling to find care packages or care home spaces.

    A number of care homes in Shropshire are currently closed because of the pandemic. Shropshire shares the national problem of a shortage of care workers and care homes, which is probably exacerbated by our high proportion of elderly patients. The inability to discharge patients who would doubtless be better off at home or in a care home setting reduces the flow of patients through the hospital.

    The impact of all this is that, because ambulances wait so long at hospitals, the vast majority of ambulance journeys across Shropshire begin in Shrewsbury or Telford. It is not possible to reach the most seriously ill patients towards the edge of the county within the target time if the ambulance sets out from one of those two towns. This, combined with the closure of community ambulance stations, means that very few ambulances are free in places such as Oswestry and Market Drayton when people become ill and require one.

    Another factor, as the hon. Member for Telford (Lucy Allan) alluded to, is the volume of patients accessing emergency departments, or being taken to one in an ambulance, because there is no other option locally, particularly in the evening or at the weekend. Shropshire has a worsening shortage of GPs, which is leading to patients attending emergency departments for relatively minor issues because they simply have no alternative. A key reason behind the problem of staff recruitment is the chronic lack of other services in Shropshire, but that is a debate for another day.

    The Government must deliver on their promise to recruit more GPs, and they must ensure that people with non-urgent healthcare needs are provided with adequate resources in the community. I am incredibly proud that my constituents Sian Tasker and Lawrence Chappel in Oswestry and, beyond my constituency, Darren Childs in Ludlow, and other campaigners, are working tirelessly to keep this issue in the public light and are campaigning to keep their community ambulance stations open. It is partly because of their hard work that we are finally discussing this issue in Parliament.

    I am afraid to say that, so far, the Government have refused to listen to the countless warnings by campaigners and those working on the frontline. The Care Quality Commission’s “State of health care and adult social care in England” report last year, gave a stark warning that overstretched ambulance services and emergency departments are putting patients at risk. The numbers speak for themselves. The Association of Ambulance Chief Executives has found that, nationally, 160,000 people a year are coming to harm because of delayed handovers to A&E. Of those, a shocking 12,000 experience severe harm.

    I have repeatedly asked the Secretary of State for Health and Social Care to meet me and the West Midlands Ambulance Service to discuss how we can tackle local issues together. I am deeply disappointed that, so far, he has refused my request. It seems to many people in Shropshire that the Department of Health and Social Care is burying its head in the sand and refusing to acknowledge the seriousness of the issue we face. I take this opportunity to urge the Minister to meet me and my colleagues across the county to discuss the crisis and to hear some first-hand accounts of those left waiting in distress so that we can come to some sort of solution together.

    I have no doubt that all hon. Members present, including those on the Government Benches, want to ensure that people at their most vulnerable are kept safe. I welcome the recently announced additional £55 million of support for ambulance services. I fear, however, that that money may not go far enough or may not be targeted in the areas of greatest need. The hopes of the Shrewsbury and Telford Hospital NHS Trust are pinned on the Future Fit hospital transformation programme, which kicked off in 2013. It is reliant on £312 million of funding, the source of which may be an interest-bearing loan—I will happily correct the record if I am incorrect, but that is my understanding. Unfortunately, more than eight years later, a strategic outline case has still not been signed off. The estimated costs have spiralled by almost 70% and it is likely that they will not be covered by the Government.

    The initial promises of urgent care centres in more rural areas—for example, one was guaranteed for Oswestry—investment in community hospitals and local planned care centres were all quietly dropped in the summer of 2015. Promises of investment in public health and prevention, which is a good idea and would have been welcome in Shropshire, are also apparently no further forward. We are consistently told that there is no more money in the pot for faster, better-resourced ambulance services or urgent care staff, yet the Government wasted more than £10 billion on personal protective equipment that is not up to scratch. It is time that they listened to the warning signs that they have been ignoring and finally step up to provide proper support for ambulance services and accident and emergency departments.

    There are several steps that the Government could take right away to get to the bottom of the causes of the issue. The Secretary of State could commission the Care Quality Commission under powers laid out in section 48 of the Health and Social Care Act 2008 to conduct an investigation into the causes and impacts of ambulance service delays. That is a fairly simple step and the law already allows for him to commission the CQC. Once the Government have a professional assessment of the complexity of the causes of the delays to ambulance service response, they can take the correct steps, targeted at the correct causes of the problems, to make some rapid improvements to the service. As I have outlined, the causes will most likely lie in a number of areas across emergency and social care, but until they are fully understood by the right people, they cannot be resolved.

    The Government could also pass the Ambulance Waiting Times (Local Reporting) Bill of my hon. Friend the Member for St Albans (Daisy Cooper), which would require accessible, localised reports of ambulance response times to be published. Once the data was available, it would enable central and devolved Governments to accurately understand where the delays are and how best to tackle them, because we should be following the data and the facts to provide the right solutions and the right resourcing in the areas that need them most. That Bill is already written, it has had its First Reading and it is ready to go.

    I brought this debate to Parliament to ensure that the Minister and the Secretary of State understand the scale of the problem in Shropshire and, crucially, the urgency in resolving it. How many more elderly citizens will have to wait for 10 hours, with their front door open, for an ambulance? How many more people will have to wait at the roadside with a stranger who they believe might be close to death? How many more young adults will develop hypothermia when they initially have a trivial injury, such as a dislocated knee? How many more cases of serious harm, or even avoidable death, will it take?

    I thank the Minister for being here this evening and responding to my speech. I also thank Mr Speaker for granting this Adjournment debate. I take the opportunity to thank everybody in the Chamber for coming along and to wish them a happy Easter and a restful break.

  • Edward Argar – 2022 Statement on PPE Stock Management

    Edward Argar – 2022 Statement on PPE Stock Management

    The statement made by Edward Argar, the Minister for Health, in the House of Commons on 31 March 2022.

    The Government rightly prioritised saving lives throughout this pandemic. The scale of the challenge we faced should not be underestimated. We have worked tirelessly to source lifesaving PPE, delivering more than 19.1 billion items to protect frontline health and care staff.

    Global demand for PPE reached unparalleled levels at the outset of the pandemic, which resulted in huge disruption across the market for PPE.

    Our fight was against a new infection and at the outset, the data to determine what PPE the health and care sectors needed did not exist. Requirement for supplies was initially forecast on reasonable worst-case scenario modelling, and we now know less PPE was needed in practice.

    However, in a fast-moving world of tough choices too much was preferable to too little given this was about saving lives. We had to plan for the worst. As the orders were being placed during the height of the crisis, when the market was extremely volatile, we had to factor in the likely non-performance of contracts.

    We are now in a position where we have high confidence that we have sufficient stock to cover all future covid-19 related demands, even in the face of new variants of concern such as we have seen with omicron and with cases of the BA.2 lineage rising.

    Not only this, but we now have the capability to produce most of what we need here in the UK across all categories except for gloves.

    Where we have surplus stock, including stock that has turned out not to be suitable for use in the NHS, we have employed a range of measures to reduce it including selling, re-using and donating both in this country and internationally, recycling, and by pursuing return or recovery of costs through the original supplier.

    Where products have failed quality assurance, or if products were ordered that have not arrived, the Department is taking action to determine whether a breach of contract has occurred. The investigations into contracts where we have some degree of dissatisfaction due to our high standards of quality control, or due to clear contractual breach, relate to 176 contracts.

    We are working through the dispute resolution process and we are aiming to recoup significant amounts. The Department has already reduced the supply of PPE by varying and curtailing contracts. As at 18 December, the Department had negotiated the cancellation or variation of contracts to reduce the original supply of PPE by 1.21 billion items that would have cost £572 million.

    Sales

    To date we have achieved the sale of 330 million masks to two private companies, and we have other deals in the pipeline.

    We are also about to launch an online auction to sell PPE, so individuals and companies may bid for our excess stock. Details are available on Gov.UK.

    Repurposing

    There are a number of items that meet all technical requirements and are suitable for use in the NHS, but they are not the preferred option. For example, self-construct visors which take four to six minutes to build were not overly appropriate for clinical settings with high usage.

    However, the items were high quality and have been used in settings which allow for less time-pressured set up, such as by dentists.

    Similarly, flatpack aprons have been able to be distributed for use in social care settings.

    Shelf-life extension

    We are exploring shelf-life extension for items that are in demand.

    The Department has appointed a third-party medical laboratory to provide testing of certain categories of PPE products to see how viable it is to extend their shelf life without the products being compromised where this fits with our overall plans.

    Donations

    We have donated a large number of products domestically to support this country’s road to recovery underpinned by the fantastic success of our vaccination rollout. This includes 207 million masks being supplied to our schools so that pupils could get back to learning in classrooms with their peers and 38 million to transport operators to help get Britain moving once again as we begin to live with the virus. Masks have also been distributed to charities and polling stations.

    Having this stock has also allowed us to provide items across the world to support the global fight against the virus.

    So far, working with the Foreign, Commonwealth and Development Office, we have donated 500,000 items to Lebanon, Nepal and Overseas Territories and are in discussions with other countries and multilateral organisations, working to finalise agreements and logistics with over 30 countries. We have also donated to Ukraine, as part of a wider package of UK Government support.

    Recycling

    After successful trials, we have now recycled 23 million visors into plastic food trays. We are also in the process of recycling 53 thousand pallets of aprons and eye protectors; aprons are being made into bin bags, “Bags for Life” and other high-demand products.

    Disposals

    Our priorities are to sell, donate, repurpose or recycle wherever we can. Nevertheless, there are some PPE products that we cannot reuse or recycle. The majority of PPE items are designed to be single use and disposed of as medical waste and so are often made up of complex chains of polymers. These items cannot be broken down for recycling. As a result, many of the products we hold are not able to be fully recycled and around half are completely non-recyclable.

    We have awarded contracts to two expert waste service providers. These lead waste providers will review the feasibility of recycling each item across our excess and provide detailed options.

    To reduce storage costs, we must accelerate the speed of our programme, particularly for stock that is likely to become out-of-date before it is ever used and is unsuitable for recycling. For every pallet of PPE we sell, repurpose, donate and recycle, taxpayers save on average £2.75 a week for years to come.

    The amount taxpayers will save from taking this decisive action would, for example, be enough to employ around 1,850 nurses for a year.

    We will work with our lead waste providers to examine wider disposal options including through “energy from waste” processes. Environmental concerns will be key, and we will be taking into consideration the Government’s waste hierarchy, prioritising recycling, and then energy from waste for that proportion of stock which we hold that cannot be recycled.

    Our priorities are to keep selling, repurposing and donating the stock that we can but at the same time taking a realistic, pragmatic approach to managing stock and putting in place solutions that make sense economically and environmentally.