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Category: Health

  • Jo Churchill – 2020 Statement on Public Health

    Jo Churchill – 2020 Statement on Public Health

    Below is the text of the statement made by Jo Churchill, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 15 June 2020.

    I beg to move,

    That the Health Protection (Coronavirus, Restrictions) (England) (Amendment) (No. 3) Regulations 2020 (S.I, 2020, No. 558), dated 31 May 2020, a copy of which was laid before the House on 1 June, be approved.

    The amending regulations we are discussing today were made by the Secretary of State on 31 May and were laid before the House on 1 June. I must note that the regulations were amended again, on 12 June, with changes coming into effect between 13 June and today. Hon. Members have previously raised concerns about that sequencing, which I would like to address directly.

    Mr William Wragg (Hazel Grove) (Con)

    I thank my hon. Friend for giving way at this early point. I can inform you, Madam Deputy Speaker, that I do not intend to inflict a speech on the House later and will be withdrawing from our proceedings. May I just ask the Minister briefly why the Government have chosen to use the urgent procedure with regard to the regulations?

    Jo Churchill

    I thank my hon. Friend for that. If he will allow me to go through what I wanted to say, I hope it will be clear why we have used that procedure.

    The rapid and frequent amendments to the regulations have been critical to ensuring that the Government can respond to the threat from the pandemic and its impact. The use of the emergency procedure has enabled us to respond quickly, begin a cautious return to normality and reopen the economy as soon as possible. I recognise that there may be frustrations that we have had to run parliamentary process in parallel during these unprecedented times, but I believe that we have demonstrated the advantages of our flexible constitution. I wish to make it clear that these are extraordinary times and measures, and we are definitely not setting a precedent for how the Government engage with Parliament on other matters and in more usual times. I am very grateful to all hon. Members for their patience and continued support during these difficult times.

    Mr Mark Harper (Forest of Dean) (Con)

    May I just pick the Minister up on the point made by my hon. Friend the Member for Hazel Grove (Mr Wragg)? The thrust of the amendment No. 4 regulations—I accept, if you will give me a little latitude, Madam Deputy Speaker, that they are not the ones that we are debating, but I think the Minister referred to them in her remarks—was announced on Tuesday or Wednesday last week. I do not see what would have prevented a draft of those regulations being laid for debate on Thursday, so that the House could have taken a decision on them before they came into force. Would that not have been better, particularly because they are legally quite complicated in how family support structures are translated into law? That would have been better for our legislative process.

    Jo Churchill

    I thank my right hon. Friend for those remarks. I will certainly take that back and feed it in, because I know that he is not alone in feeling that we could improve the time sequencing slightly, in order ​that we get to a place where these matters are debated fully. I reiterate, however, that these are unprecedented times, and being able to debate complex differences between the timings needs to be thought about.

    Mr Wragg rose—

    Jo Churchill

    If my hon. Friend will forgive me, I am going to make a little progress and then I will of course take another intervention.

    All over the world we are seeing the devastating impact of this disease. It has already radically altered our way of life, and it has, very sadly, taken loved ones away. That is why the Government put in place social distancing measures to slow the spread of the virus and protect our NHS, in order to save lives, and they have been successful. Despite the tragic loss of life, the UK has slowed the spread of coronavirus. Our health system was not overwhelmed and it retained sufficient hospital beds, ventilators and NHS capacity. I am extremely grateful to the public for their continued compliance with these measures, which have been instrumental in us reaching this point.

    Now we must begin to recover and slowly rebuild our way of life. The Government’s objective is to return to our way of life as soon as possible, restarting our economy in a safe and measured way that continues to protect lives and support the NHS. On 11 May, the Prime Minister made a statement to the House outlining the Government’s road map for easing restrictions. We have entered phase 2. This involves gradually replacing the current social distancing restrictions with smarter measures that have the largest effect on controlling the epidemic but the lowest health, economic and social cost.

    Mr Wragg

    I am extremely grateful to my hon. Friend the Minister, to whom I pay full tribute for her incredibly hard work, for indulging me with this intervention. Would it not be possible for the Government to at least lay a written statement on their reasoning as to why some measures have been relaxed and others have not?

    Jo Churchill

    If my hon. Friend will indulge me as I go through my opening speech, I will address that in my concluding remarks. There is transparency in relation to the SAGE minutes, which are readily available and give a clear example of why decisions are being made and the scientific basis for them.

    We are very aware of the burdens that these regulations have placed on society and on individuals. The 1 June amendments play a significant role in reducing the restrictions and lifting some of that strain. It is necessary for the Government to respond quickly to the reduced rate of transmission and to protect individual rights. At all times the regulations in place must be proportionate and necessary. Following on from the small change made to the 13 May amendments, which were debated by a Committee of this House on 10 June, these amendments go a step further. We recognise the toll placed on individuals and families unable to meet loved ones, and have amended the regulations to allow for groups of six to meet outdoors. We hope that these amendments will relieve that burden to some extent.​

    I will now outline the changes made on 1 June, which include allowing increased social contact outdoors, in either public or private space, for groups of up to six people from different households; enabling elite athletes to train and compete in previously closed facilities; opening some non-essential retail while expressly providing for businesses that remain closed; ensuring that venues such as community centres can open for education and childcare services; and ensuring that those required to self-isolate on arrival in the UK can stay in hotels. We have also amended the maximum review period to 28 days. This longer review period ensures that we will be able to fully take into account the impact of any previous amendments before making further changes.

    Sir Charles Walker (Broxbourne) (Con)

    I have looked at the regulations. Am I right in thinking that people are still prevented from staying over at a friend’s house or a partner’s house, or has that been amended as well?

    Jo Churchill

    It is my belief that they can stay over if they are within the guidelines of the social bubble—that is, if they are a single person. There are several distinct areas and I am happy to discuss them with my hon. Friend, or to write to him to clarify them. They are clearly laid out in the regulation of what is or is not applicable.

    The Government continue to work on the process of gently easing restrictions as it is safe to do so, in line with the ambition set out in the road map. Working alongside scientists and experts, we must act swiftly to respond to current infection levels and our assessment of the five tests that have been set out previously. I am sure that we all support the aim to protect and restore livelihoods by only keeping in place restrictions that are proportionate and necessary. We of course remain ready to reimpose restrictions if the need emerges in the future, although we all hope that that will not be the case.

    Mr Harper

    I am grateful to my hon. Friend for giving way. In asking her a question, may I respond to my hon. Friend the Member for Broxbourne (Sir Charles Walker)? The reason for the confusion goes back to the point that I just made. My hon. Friend asked about what has been called the “bubbling” of households, the putting of households together, which was announced at one of the press conferences last week. It has been turned into legislation, which was laid before this House on Friday, but we are not yet debating it. So we are debating one set of amendments, but a new set has already come into force and the reason for the confusion is that we are not yet debating it. I think that rather proves my point that we should really have debated that legislation in advance of it coming into force. I hope that my hon. Friend’s confusion, and he is not a man easily confused, demonstrates the point about why that is important.

    Sir Charles Walker

    I thank my hon. Friend.

    Jo Churchill

    I thank my right hon. Friend the Member for Forest of Dean (Mr Harper) for the clarity with which he put that.

    I have already noted that further amendments were made on 12 June and have now come into force. Those will be debated by this House in due course. I am ​grateful to all parliamentarians for their continued engagement in this process, and for their continued scrutiny, which is rightly and importantly exercised for each set of amendments.

  • Edward Argar – 2020 Statement on Social Distancing

    Edward Argar – 2020 Statement on Social Distancing

    Below is the text of the statement made by Edward Argar, the Minister for Health, in the House of Commons on 15 June 2020.

    I thank my right hon. Friend for his important urgent question. As part of our work to slow the spread of coronavirus, the Government have put in place social distancing guidance. The guidance specifies that everyone must keep 2 metres away from people outside their household or the support bubbles that have been in place since Saturday. I am grateful for the commitment and the perseverance of the British people in following these guidelines over the past few months; I know it has entailed huge sacrifice.

    We keep all of our public health guidance under constant review to ensure it reflects the latest advice from the Scientific Advisory Group for Emergencies and the latest evidence that we have on the transmission of the virus. The Prime Minister has commissioned a comprehensive review of the 2 metre guidance. It will take advice from a range of experts, including the chief medical officer and the chief scientific adviser, as well as behavioural scientists and economists. It will also receive papers from SAGE, which is conducting a rolling review of the 2 metre guidance already. The review will examine how the current guidance is working, and will look at evidence around transmission in different environments, incidence rates and international comparisons.

    Unless and until there is any change to the guidance, everyone must continue to keep 2 metres apart wherever possible, and must continue to follow our “stay alert” guidance, by washing their hands, for example, and self- isolating and getting tested if they have symptoms. I am aware there is a great deal of interest, understandably, in this matter from both sides of the House. However, I am sure that the House would agree that it would be premature to speculate about that review’s conclusions at this stage. We will, of course, keep the House updated on this work, and we will share any developments at the earliest possible opportunity.

  • Matt Hancock – 2020 Interview with Andrew Marr

    Matt Hancock – 2020 Interview with Andrew Marr

    Below is the text of the interview between Andrew Marr and Matt Hancock, broadcast on 7 June 2020.

    Andrew Marr:

    You’ll have heard Professor Edmunds there saying very, very clearly he understood it was difficult and it wasn’t easy but he wished that we had locked earlier. Do you agree with that?

    Matt Hancock:

    No.

    Andrew Marr:

    No?

    Matt Hancock:

    I think we took the right decisions at the right time and there’s a broad range on SAGE of scientific opinion and we followed – we were guided by the science which means guided by the balance of that opinion, as expressed to ministers through the Chief Medical Officer and the Chief Scientific Adviser. That’s the right way for it to have been done.

    Andrew Marr:

    I’m not saying it was an easy decision but he is absolutely clear that it cost lives not locking earlier.

    Matt Hancock:

    Well, there are others who equally make different scientific arguments and the way that this is done –

    Andrew Marr:

    Is there anyone who thinks it didn’t cost lives?

    Matt Hancock:

    Well yes. If you listen to the balance of opinion on SAGE, a hundred people on SAGE approximately, what we do as ministers is we take the scientific advice, channelled through the Chief Medical Officer on the medical side, the Chief Scientific Adviser on the broader science and then we have to – as Professor Edmund said, we have to make the balanced judgements based on that advice. And that’s the way it works. So you’ll always, in a body of a hundred people you’ll always find differing voices. It’s totally reasonable.

    Andrew Marr:

    And yet absolutely clear you are sure that locking when you did and not earlier did not cost lives?

    Matt Hancock:

    I’m sure, and as I keep looking back on that period, I’m sure that taking into account everything we knew at that moment we made the – my view is – that we made the right decisions at the right time. But the other thing I’d say, Andrew, is that I spend most of my time trying to rid this country, rid all of us of this ghastly virus and really most of my time and energy I devote to looking forwards as well of course of trying to learn lessons from what happened in the past.

    Andrew Marr:

    The reason I’m hanging over that issue about when the country locked up is because right now we’re also wondering is this the right time to unlock? And can I ask you in the same spirit, looking at exactly where the R number is, just hovering around one, whether you’re absolutely sure we’re not going a little fast.

    Matt Hancock:

    Well we’ve got to be very cautious and we’ve got to have a safety first approach. And I thought that on that Professor Edmunds expressed it exactly as I would, which is that with the R below one, the SAGE estimate taking into account all of the models, not just the one that’s been in the news a lot in the last 24 hours, but all ten of them, is that the R is between .7 and .9. That means that the number of new infections continues to fall. It’s around 5,000, 5 and a half thousand a day on the best estimates, but it’s always hard to estimate that.

    Andrew Marr:

    I was going to say this is in a sense art not science because these are old figures you’re getting, there’s a time lag and so forth. To an extent you’re flying blind on all of this and on the Cambridge figures the R number is actually above one in the North West of England.

    Matt Hancock:

    Well, it’s actually science, it’s not art. It is science on which we base these decisions and science is necessarily looking at uncertainty. Now you say it’s flying blind. That’s no longer true. Because the Office for National Statistics Survey and a separate survey by Ipsos, Mori and Imperial are both surveys of actual test results in the community right now, which is different from some of the models that are essentially model predictions.

    Andrew Marr:

    Okay. So we know we’re going ahead into a period where more shops are going to reopen, where places of worship are going to reopen and so on. What would have to happen now for the government to put the brakes on that?

    Matt Hancock:

    Well we don’t want R to go above one. We’ve been absolutely clear about that and the estimate is that R is below one and as Professor Edmunds said, the overall estimate taking into account everything we know is that R is below one in each region. I know that in the North West –

    Andrew Marr:

    What about an increase in the number of infections?

    Matt Hancock:

    Well, if R goes above one then that leads to an increase to the number of infections. That is by definition, that’s the logic of R. So the reason R is important –

    Andrew Marr:

    At that point you stop the unlocking?

    Matt Hancock:

    Well the reason R is important is that if R is below one then the number of infections continues to fall and that’s what we’ve seen over recent weeks.

    Andrew Marr:

    I’m just saying you get direct data in about the number of infections as well and if that goes up do you reverse the unlocking?

    Matt Hancock:

    Well we get survey data about the number of infections. We get direct data about the number of positive test results. What I want is everybody who has the infection to come forward with a test. But addressing the substance of your question, absolutely we are open to, if we need to, to taking local action in the first instance to crack down on a local outbreak, as we’ve already done and we’re prepared to do more, and we’ve always been open to having to reverse some of the measures. But we don’t want to do that and that’s why we’re taking a cautious approach and a safety first approach which means for instance from Monday being able to – Monday next – being able to reopen private prayer. I think is incredibly important for many, many people who have been feeling a lack of that spiritual ability to pray in their place of worship. Again, that’s got to be done very carefully and safely and we’re learning as a society how to be more Covid secure.

    Andrew Marr:

    But we be absolutely clear if there’s an increase in infections the government will re-impose a national lockdown?

    Matt Hancock:

    We’ve always said that. We’ve always said if necessary and you’ve got to look at the overall approach. This isn’t the number moving about from day to day or week to week, this is the overall strategic approach where the strategy has been clear from the start and the number of those new infections has been coming down and down and down and down.

    Andrew Marr:

    There’s been a lot of talk about local lockdowns and like many people I don’t completely understand this. When you say a local lockdown does that means a small area around a care home where there might be a problem? Does it mean a town? Does it mean an entire region or city of Britain? What does it mean?

    Matt Hancock:

    Well preferably the former.

    Andrew Marr:

    So it could be very small, very localised?

    Matt Hancock:

    Absolutely. Take Weston-super-Mare. In Weston-super-Mare the action that we took when we saw a spike in the number of infections was to close the hospital to new admissions. We then put in place testing of asymptomatic people in the community around the hospital and those connected to the hospital and we found that it hadn’t led to community spread because of the action that had been taken.

    Andrew Marr:

    So you just had to close down Weston-super-Mare.

    Matt Hancock:

    Correct.

    Andrew Marr:

    We saw people on the beach so it was just around that area.

    Matt Hancock:

    Correct. Now of course we looked at that and what we might have to do, but we instead simply by stopping the hospital having new people coming in and by very, very significant infection control procedures in the hospital and with the support of the brilliant local Director of Public Health, Leader of the Council, Public Health England at a regional level and of course the NHS we managed to deal with that local outbreak.

    Andrew Marr:

    It worked.

    Matt Hancock:

    It worked. And that is a model of how we can do this elsewhere.

    Andrew Marr:

    So let’s imagine – I won’t name one – but let’s imagine a big city with a lot of people living in it and you see a spike in the R rate, you see a spike in the number of infections in that city. Is it plausible that you then actually try and cut that city off from the rest of the country? Refuse to allow people to travel from wherever it is to someone else in the UK? Do you actually impose that kind of lockdown on part of the UK or is that actually practically impossible?

    Matt Hancock:

    Well, we do have the legal powers to do that but that is not our starting point and the starting point is actually much more localised than that, to try find a much more localised area within a part of a city. And remember the virus spreads by human contact and therefore if you can get this early enough and spot it early enough, then you will get quite a localised area of the outbreak, because human contact tends to be local by its nature. And so actually the focus is to get as early as possible, as local as possible and things like tackling an outbreak in one hospital or in one very small area is what we’re really aiming at here.

    Andrew Marr:

    You mentioned track and trace just now. The system’s been up and running I think for ten days now. How many people have been contacted?

    Matt Hancock:

    Well sadly, I’m not going to tell you that and the reason is because I want to ensure that the statistics authorities are very happy with how we’re collecting and publishing this data before I say anything on the record because we want to get this absolutely right.

    Andrew Marr:

    16,500 people have tested positive in the last period. Is that the kind of numbers that are actually going to be contacted, because if not, if it’s much lower than that, then the system is not working.

    Matt Hancock:

    Oh, thousands are being contacted but I won’t go into more details than thousands unfortunately until the statistics authorities are happy with exactly how these things are measured, but we will be publishing full details and a fully range of statistics once that’s all signed off by the statisticians.

    Andrew Marr:

    The app. You’re wearing your NHS badge, what’s happened to the NHS app? It was supposed to be here three weeks ago and no sign of it.

    Matt Hancock:

    Well we learnt, one of the things we learnt on the pilot on the Isle of Wight which has been very successful and on the Isle of Wight they’ve done a great job of – through the pilot. One of the things we learnt is to get in place the human based system first, that’s what we’re doing and then the technology can add to that.

    Andrew Marr:

    But we were told by you and many others that the app was going to be essential. Are you saying it’s not essential and it’s not going to come in, or what?

    Matt Hancock:

    I’m saying that it will help, it’s an advantage and it will come in but we want to make sure we get this system embedded first with the human contact tracers. After all, the key thing about test and trace isn’t just that you trace the virus, it’s that the people who you find then have to isolate for two weeks and that’s quite a big ask. The evidence is that the overwhelming majority are doing that when the NHS phones them up and asks them to but that’s a very important part of it.

    Andrew Marr:

    So we’ve talked about tracking, let’s talk about testing specifically. How many people were tested yesterday?

    Matt Hancock:

    Well, the latest figures we’ve got is for Friday and it was just over 200,000.

    Andrew Marr:

    200,000 because you were giving us these figures on a daily basis, testing the number of people, and then you stopped.

    Matt Hancock:

    No, sorry. The number of tests were just over 200,000.

    Andrew Marr: Number of people tested I was asking.

    Matt Hancock:

    Well the number of people tested, we will be bringing that data back. The challenge there is that because we’ve introduced different types of testing, making sure that you ensure that you only count one person once amongst the four pillars is a complicated statistical process. So again that’s with the statisticians to sort.

    Andrew Marr:

    In short it’s a bit of a muddle at the moment. Sir David Norgrove, Chair of the UK Statistics Authority as you know said:
    ”The aim seems to be to show the largest possible number of tests at the expense of understanding. It’s not surprising given their inadequacy the data on testing is so widely criticised and often mistrusted. Did that sting?

    Matt Hancock:

    Well, the thing about it is that it’s not true. There are other ways that you could measure testing to give much higher figures and we chose not to. What we chose – advised by my Permanent Secretary – are the most accurate ways to show the testing that the government is doing, which is the number of tests either directly administered or sent out, because that’s the point at which the government is doing its job. So that’s why we measured it in that way and that’s why I’m so cautious about giving further information before we’ve got this all straightened out with the statistical authorities.

    Andrew Marr:

    Has everyone living in or working in a care home now been tested?

    Matt Hancock:

    We have now managed successful to deliver tests to every care home that is eligible both for staff testing and for residents to be tested for every –

    Andrew Marr:

    So anyone in a care home across Britain watching this programme has been tested or they’re deluded?

    Matt Hancock:

    Or the tests have been delivered. So the goal we set is that the tests will be delivered by the 6th of June. That was completed yesterday I’m very glad to say, on time and what that means is that of about three quarters of a million people living in just over 9,000 eligible care homes, the tests have been delivered and –

    Andrew Marr:

    This is the programme, isn’t it, because as David Norgrove said, delivered and tested are two different things. So you can’t actually say they’ve all been tested. Which is what they were promised.

    Matt Hancock:

    No, they were promised that we would get tests to them.

    Andrew Marr:

    Okay.

    Matt Hancock:

    And this is – actually I’m being extremely precise. I have not said that we have tested everybody. What I’ve said is the tests have been delivered. Now the care homes themselves asked us to do it in this way because they say that we were right at the start of this requiring them to send back the tests within a very short space of time. They say actually if you’re running a care home sometimes you may want a couple of days to prepare the residents, to make sure you’re ready. So actually the way that we’re doing it in this way – I’m using my words very precisely – is because the care homes wanted us to do it this way. And I respect that and I think it’s very important to work with the sector.

    Andrew Marr:

    Now, we talked earlier on about community transmission. You told people not to protest yesterday about Black Lives Matter. They did protest. You’ve seen all of that. What’s your reaction? Do you agree, for instance, with Professor Edmunds, who said there is risk with that?

    Matt Hancock:

    Yes, I do. I’ve worked all my political life to tackle discrimination and to support diversity. And the problem is that
    the virus doesn’t discriminate. And there’s a reason that we have laws in place – temporarily – to say that gatherings of over six people should not happen. And that’s because the virus spreads. And the problem therefore is that – I just wish people – I really hope people make the argument, and I will support them in making that argument. I hope that they will make that case stronger. But please don’t gather in groups of more than six, because in groups of more than six that risks spreading the virus and that risks lives. So it is incredibly important – and think of it this way –

    Andrew Marr:

    Sorry, are you saying that because of those protests yesterday and they way those people gathered people will die?

    Matt Hancock:

    The way I’d put it is this: we think that about one in a thousand people has the disease in this country. And so when you
    get groups of thousands gathering, of course the likelihood is some of those people will have the disease, and we know that if you come into contact with people that risks spreading the disease. So Professor Edmunds was absolutely right to say it risks a spread, and the risk of the spread of the disease is that it then risks lives. So I bow to nobody in my support for action to make sure there is true equality of opportunity in this country for everybody, no matter their background.

    Andrew Marr:

    Do you think the police should have been enforcing the law in that case?

    Matt Hancock:

    Well, I think the police did a fantastic job and I’m very proud of the British police for their professionalism, their restraint in the face of the tiny amount of violence – and I would stress it was a very small amount of violence later on in the day. And I think that we can all be proud that the British police are not like the American police in this way, and I think that that’s a very good thing.

    Andrew Marr:

    Thinking about diversity in general, when you look at this government, you look at the Cabinet, there’s a very, very stinging, very interesting piece by Sajid Javid in the Sunday Times this morning about inequality and racism in Britain, but there are still no black faces in the Cabinet are there?

    Matt Hancock:

    Well, hold on, Andrew. The Chancellor of the Exchequer, the Home Secretary, are both from ethnic minority backgrounds.

    Andrew Marr:

    But not black.

    Matt Hancock:

    Well, until the latest reshuffle Kwasi Kwarteng was sitting around the Cabinet table with me. I think that this is one of the most diverse Cabinets in history, and that’s been a record under Boris Johnson and I think – I welcome that. I think that’s a really good thing. And what really matters is tackling inequality of opportunity amongst all sectors of society.

    Andrew Marr:

    So Public Health England produced a report, as you know, on why BAME people are more likely to die of this disease. But there were no recommendations in that report and a lot of MPs, mostly opposition MPs, were really, really concerned about that. Surely it’s not enough to say, ‘here’s the problem,’ you have to have some kind of answer to it.

    Matt Hancock:

    Well, we have been taking action all the way through. We didn’t wait for the report to take action.

    Andrew Marr:

    As Health Secretary what are you doing to better protect BAME people from this disease?

    Matt Hancock:

    In the first instance, the occupations that are more frequently taken by people from black and minority ethnic backgrounds are also some of those that have the biggest risks of infection. So, for instance –

    Andrew Marr:

    Cleaners, nurses, doctors.

    Matt Hancock:

    Absolutely. And – or in fact all staff in hospitals. But the thing is to protect that whole occupation and everybody in it. Also those who are critical on the frontline in public transport, for instance. Bus drivers, taxi drivers. So we’re taking forward the PHE work, we have already – PHE have done the analysis that shows that this is a very significant problem, and Kemi Badenoch, the Minister for Equalities, is taking it forward to ask exactly that question why.

    How much of it is down to occupation, for instance, how much of it is down to co-morbidities, how much of it is down to housing – because we know that housing inequality has an impact.

    Andrew Marr:

    In a very balanced response, she also said that the report had gaps and hasn’t gone far enough. ‘There was more that I was hoping to see from this review.’

    Matt Hancock:

    Well, if it had gone far enough then I wouldn’t have asked her to take the work forward with the prime minister, who obviously cares very deeply about getting this agenda right.

    Andrew Marr:

    The big picture. We’ve had 40,000 deaths and probably a lot more than that in this country, might be 55, might be 60,000. The prime minister said that he took full responsibility and the government have been doing everything they could in tackling coronavirus, ‘and I am very proud of our record.’ Can I put it to you that being very proud of our record, in terms of the number deaths that we have had in this country, is not right?

    Matt Hancock:

    Well, I mourn each one of those deaths. And in a way, you know, 40,000 – the number is less important than the fact that each of these is somebody who has died, with a family who will never be the same again. And we have put unprecedented amounts of action into place, right across the board, to deal with the crisis. And we’re fully accountable for that.

    Andrew Marr:

    You’re working very, very hard, you’re probably putting your life and soul into this but are you really proud?

    Matt Hancock:

    Well, my team, I’m very proud of the work my team have done. Particularly, you know, starting up of test and trace system from scratch and getting the testing system going. Making sure that we flatten the curve. Protecting the NHS, building those Nightingale hospitals, making sure the NHS wasn’t overrun. So there’s enormous amounts of things that I’m very proud of.

    Andrew Marr:

    40,000 or more dead?

    Matt Hancock:

    Well, of course nobody wants to see a pandemic at all.

    Andrew Marr:

    Matt Hancock, thanks very much indeed for talking to us
    today.

  • Jonathan Ashworth – 2020 Comments on Cancer Waiting Times

    Jonathan Ashworth – 2020 Comments on Cancer Waiting Times

    Below is the text of the comments made by Jonathan Ashworth, the Shadow Secretary of State for Health and Social Care, on 11 June 2020.

    These figures should ring alarm bells for ministers – the drop-in urgent referrals suggests that people are either finding it difficult to access services or are being put off seeing a doctor because of the virus.

    Early diagnosis is key to better treatment and saving lives with cancer, so the effects of not being seen early could be devastating. Ministers urgently need to prepare for the backlog of care that is building up as a result of the pandemic.

    We need a new resourced plan for the NHS; a strategy that enables us to move between the competing demands of the Covid-19 pandemic and non-Covid related care in the months and years ahead.

  • Matt Hancock – 2020 Statement on NHS Test and Trace

    Matt Hancock – 2020 Statement on NHS Test and Trace

    Below is the text of the statement made by Matt Hancock, the Secretary of State for Health and Social Care, in the House of Commons on 2 June 2020.

    On 28 May the NHS Test And Trace service was introduced across England. This forms a central part of the Government’s covid-19 recovery strategy to help as many people as possible return to life as close to normal as possible, in a way that is safe and protects our NHS and social care.

    The objective of the NHS Test And Trace service is to push down and keep low the rate of reproduction (R) of covid-19 and reduce the total number of infected people by catching cases before they spread the virus. It brings together testing, contact tracing and outbreak management into an end-to-end service.

    The roll-out of the NHS Test And Trace service has been made possible by the rapid expansion of testing. The largest network of diagnostic testing facilities in British history has been created and now has the capacity to carry out 200,000 tests a day. This includes 50 drive-through sites, more than 100 mobile testing units and three mega laboratories. Everyone in England is now eligible for a test if they have covid-19 symptoms. These symptoms are: a new, continuous cough; or a high temperature; or a loss of, or change in, normal sense of smell or taste.

    The NHS Test And Trace service uses a combination of 25,000 dedicated contact tracing staff, local public health experts and an online service to trace the contacts of anyone who tests positive for covid-19. The NHS covid-19 app, which will further extend the speed and reach of contact tracing, will be rolled out nationally in the coming weeks as part of the NHS Test And Trace service.

    On 22 May we announced £300 million of new funding for local authorities in England to work with NHS Test And Trace to develop local outbreak control plans. These plans will focus on identifying and containing potential outbreaks in places such as workplaces, housing complexes, care homes and schools, ensuring testing ​capacity is deployed effectively and helping vulnerable people who are self-isolating access essential services in their area.

    Anyone who tests positive for coronavirus is contacted by NHS Test and Trace and asked to share information about their recent interactions. This could include household members and people with whom they have been in direct contact or within 2 metres for more than 15 minutes. People identified as having been in close contact with someone who has had a positive test must stay at home for 14 days, even if they do not have symptoms, to stop unknowingly spreading the virus.

    Those who need to self-isolate will be informed about local support networks if they need practical, social or emotional support. They will also have access to the same financial support available to those who have to self-isolate because they or another member of their household have symptoms or have tested positive for covid-19. This includes access to statutory sick pay, subject to normal eligibility conditions.

    The public will have a key role to play in making this service a success. They will need to report covid-19 symptoms, book tests, help to identify recent close contacts, and self-isolate for at least seven days if they have covid-19, and for 14 days after they were in contact with the person who tested positive for covid-19 if they are identified as a close contact by NHS Test and Trace.

    We have put in place a comprehensive media campaign to increase public awareness of the NHS Test and Trace service, what it is, why it is important and what the public need to do. This includes TV, radio, video on demand, posters, digital display and social media.

    We are working closely with the devolved Administrations and public health agencies in Scotland, Wales and Northern Ireland to ensure an aligned approach to testing and tracing across the United Kingdom where possible.

  • Jonathan Ashworth – 2020 Speech on the Covid-19 Response

    Jonathan Ashworth – 2020 Speech on the Covid-19 Response

    Below is the text of the speech made by Jonathan Ashworth, the Labour MP for Leicester South, in the House of Commons on 2 June 2020.

    There have now been 56,308 excess deaths since the beginning of March, 12,500 of which are not related to covid, but we do have one of the worst excess death rates in the world—why does the Secretary of State think that is? What does he believe is the cause of the non-covid excess death rate?

    With respect to the PHE’s findings, which I am pleased to see published today, we have always known that there is a social gradient in health. The poorest and most deprived have inequality in access to healthcare and inequality in health outcomes. What the Secretary of State has confirmed today is that covid thrives on inequalities. Yes, indeed, black lives matter, but it is surely a call to action that black, Asian and minority ethnic people are more likely to die from covid and more likely to be admitted to intensive care with covid. He has seen the findings. I note that the Equalities Minister is taking work forward, but what action will be taken to minimise risk for black, Asian and minority ethnic people?

    There are other vulnerable groups who are highly at risk. I am sure the Secretary of State will have seen today the Care Quality Commission report which shows a 134% increase in deaths of people with learning disabilities. Surely it is now time to expand testing to those under 65 in receipt of adult social care.

    On the easing of restrictions, the Secretary of State said that this was a sensitive moment—well, quite, Mr Speaker. Our constituents have concerns and are looking for reassurance, particularly those in the shielding group. They really should not have had to wake up on Sunday morning to find out that they could now leave the house once a day. They need clarity and details. And why were GPs not informed in advance?

    We are still at around 50,000 infections a week, so may I press the Secretary of State a bit further on the easing of restrictions? The biosecurity level remains at 4, but his own Command Paper from 11 May said that changes to lockdown

    “must be warranted by the current alert level”.

    At the Sunday news conference, the Secretary of State for Housing, Communities and Local Government said that all the proposed easing of restrictions had been modelled and showed that the R value remained below 1. That is, of course, reassuring, but will he now publish that modelling so that it can be peer-reviewed?

    The easing of restrictions was based on tests, so may I ask the Secretary of State a couple of questions? First, on NHS capacity, we know that the NHS has not been overwhelmed, but that has been on the back of cancelled planned surgery, delays to vital treatment, and the postponing of cancer screening. Arguably, it has been the biggest rationing exercise in the history of the NHS. Will he now publish the total number of planned operations that have been cancelled and detail them by procedure? As the lockdown is eased, is it his intention to step down some of that surge capacity so that this backlog of clinical need can start to be tackled?

    On managing the virus, one of the tests is on whether we can manage the virus, but, as the Secretary of State has said, that depends on testing and tracing. There is now capacity for more than 200,000 tests, but there is still a lack of clarity about how that figure is arrived at. The UK Statistics Authority has written to him today, saying that his figures are still

    “far from complete and comprehensible”,

    that the testing statistics still fall well short of standards in the code, and that it is not surprising that testing data is mistrusted. That is quite damning, I have to say to him. Will he start publishing again the actual numbers of people tested? Will he stop counting tests mailed to homes as completed? Will he detail what proportion of the 200,000 tests are diagnostic PCR, what proportion are antibody, and what proportion are surveillance? Can he tell us how many care home staff and residents have been tested? When will he start weekly testing of all NHS staff, as that is crucial for getting on top of infections in hospitals? Will he tell us what percentage of the Deloitte-run testing facilities have been sent to GPs?

    On test and trace, which is absolutely vital to safe easing out of the lockdown, the Prime Minister told the House before the recess that it would be “world-beating” and operational by yesterday, but it is not actually fully operational at a local level, is it? Can the Secretary of State confirm that local directors of public health have been told to prepare strategies for tracing with a deadline of the end of June, that they will not actually start receiving local individual data until next week, and that many have still not been told their allocations of the extra £300 million nor what they can spend it on? When will they get those allocations? Despite this, he said yesterday that test and trace is up and running. I am not sure how he can say that it is up and running when local directors of public health are still asking for that information. Will he publish the data and what percentage of infections have been contacted and how many contacts have been followed up? Will that data be published on a daily basis?

    This is a crucial week, given the easing of restrictions, and our constituents want reassurance and clarity, but I am afraid that trust has been undermined by the Dominic Cummings scandal. Our constituents want to do the right thing for their loved ones and their neighbours. Can he give them those reassurances today?

  • Matt Hancock – 2020 Statement on the Covid-19 Response

    Matt Hancock – 2020 Statement on the Covid-19 Response

    Below is the text of the statement made by Matt Hancock, the Secretary of State for Health and Social Care, in the House of Commons on 2 June 2020.

    With permission, I would like to make a statement on coronavirus.

    Thanks to the collective determination and resolve of the nation, we are winning this battle. We have flattened the curve, we have protected the NHS, and together we have come through the peak. Yesterday, I was able to announce that the level of daily deaths is lower than at any time since lockdown began on 23 March. Today’s Office for National Statistics data show that the level of excess mortality is also lower than at any time since the start of lockdown, falling on a downward trend. The ONS reports 12,288 all-cause deaths in England and Wales in the week ending 22 May. That is down from 14,573 in the previous week. That latest figure is still above the average for this time of year and we must not relent in our work to drive it down, but it is now broadly in line with what we might typically see during the winter. We never forget that each of those deaths represents a family that will never be the same again. This House mourns each one.

    We are moving in the right direction, but this crisis is very far from being over and we are now at a particularly sensitive moment in the course of the pandemic. We must proceed carefully and cautiously as we work to restore freedom in this country, taking small steps forward and monitoring the result, being prepared to pause in our progress if that is what public safety requires. So today I would like to update the House on two important aspects of the action we are taking.

    First, NHS Test and Trace is now operational. That means we have updated our public health advice. Since the start of the crisis, we have said to people that you must wash your hands, self-isolate if you have symptoms, and follow the social distancing rules. All those remain incredibly important, but there is a new duty—and it is a duty—that we now ask and expect of people. If you have one of these symptoms—that is: a fever; a new, continuous cough; a change in your sense of taste or smell—you must get a test. We have more than enough capacity to provide a test for anyone who needs one and we have more than enough capacity to trace all your contacts. So, to repeat: if you have symptoms get a test. That is how we locate, isolate and control the virus. By the way, I make no apology for this overcapacity. The fact that we have thousands of NHS contact tracers on standby reflects the fact that transmission of the virus is currently low. If we were in a position where we needed to use all that capacity, it would mean that the virus was running at a higher rate—something that no one wants to see.

    Secondly, I want to update the House on the work we are doing to understand the unequal and disproportionate way that this disease targets people, including those who are from black or minority ethnic backgrounds. This is very timely work. People are understandably angry about injustices, and as Health Secretary, I feel a deep responsibility, because this pandemic has exposed huge disparities in the health of our nation. It is very clear that some people are significantly more vulnerable to covid-19, and that is something I am determined to understand in full and take action to address.

    Today, I can announce that Public Health England has completed work into disparities in the risks and outcomes of covid-19, and we have published its findings. PHE has found the following. First, as we are all aware, age is the biggest risk factor. Among those diagnosed with covid-19, people who are 80 or older are 70 times more likely to die than those under 40. Being male is also a significant risk factor. Working-age men are twice as likely to die as working-age women. Occupation is a risk factor, with professions that involve dealing with the public in an enclosed space, such as taxi driving, at higher risk. Importantly, the data show that people working in hospitals are not more likely to catch or die from covid-19.

    Diagnosis rates are higher in deprived or densely populated urban areas, and we know that our great cities have been hardest hit by this virus. This work underlines that being black or from a minority ethnic background is a major risk factor. That racial disparity holds even after accounting for the effects of age, deprivation, region and sex. The PHE ethnicity analysis did not adjust for factors such as comorbidities and obesity, so there is much more work to do to understand the key drivers of these disparities, the relationships between the different risk factors and what we can do to close the gap.

    I want to thank Public Health England for this work. I am determined that we continue to develop our understanding and shape our response. I am pleased to announce that my right hon. Friend the Equalities Minister will be leading on this work and taking it forward, working with PHE and others to further understand the impacts. We need everyone to play their part by staying alert, following the social distancing rules, isolating and getting a test if you have symptoms. We must not relax our guard but continue to fight this virus together. That is how we will get through this and keep driving the infection down. I commend this statement to the House.

  • Jim Shannon – 2020 Speech on Organ Donation

    Jim Shannon – 2020 Speech on Organ Donation

    Below is the text of the speech made by Jim Shannon, the DUP MP for Strangford, in the House of Commons on 19 May 2020.

    Thank you, Mr Deputy Speaker, for allowing me to raise a few thoughts. The House may not be aware that my nephew, Peter, had a kidney replacement when he was a child, and that is one of the main reasons I have avidly supported organ donation. My family would have been devastated had that organ not been donated to save Peter’s life. I also absolutely believe that there must be the ability for someone to opt out if they have their own reasons for doing so, whether those are religious or otherwise.

    I commend the hon. Member for Barnsley Central (Dan Jarvis) for what he has done—we look forward to his contribution—and I commend the former Member, Geoffrey Robinson; I was very happy to support and sign his Bill and we will see some of that become law tomorrow. I thank the Minister for her contribution and for bringing this statutory instrument forward—we are really pleased to see it. I also thank the shadow Minister for his contribution, which was very ably put together.

    I will focus on one aspect of this draft legislation for organ donation. Three million people in the UK have chronic kidney disease, including some 1,000 children, and 65,000 people are being treated for kidney failure by dialysis or transplant. In the UK, 6,044 people are on the transplant list, and 4,737 are awaiting kidneys. That was data from the end of 2019, as the transplant programme is currently part-suspended. At least one person a day will die because they have waited too long. Eight out of 10 people waiting are hoping for a kidney. NHS Blood and Transplant estimated that this change in the law has the potential to lead to 700 more transplants each year by 2030—700 lives that can be changed, and 700 lives that can be saved. This may have to be extended by a year because of the pandemic.

    When kidneys fail, three things happen: dialysis, a transplant or death. Dialysis is distressing and demanding, with four to five-hour sessions three days a week and dietary and fluid restrictions. Many of my constituents have had to go through this, as my nephew did for a period of time. People are often unable to continue to work. Families and relationships are strained and depression is common. It has been reported that the levels of pain are equivalent to those of people with terminal cancer. Patients are exhausted, with aching bones, reduced mobility and constant itching. A transplant is transformational in restoring quality and quantity of life, and we recognise the selfless generosity of organ donors, both living and deceased. We commend NHS Blood and Transplant on its achievements; more than 50,000 people are alive with transplants in the UK.

    Kidney transplantation is also economically beneficial. I know that it is not always a good thing to look at the economics and the financial aspect, but a transplant has a cost of £5,000 per annum, compared with a cost of £30,800 per annum for dialysis, so there is a financial factor that we need to bear in mind.

    I am so pleased that this SI means that even during this crisis we are continuing and prioritising the ability to donate kidneys and other organs. I congratulate the Government, the Minister and the Opposition on pushing this issue. There were 28 transplants in Northern Ireland last month, so I pay tribute to the team there. This legislation is tremendous news and I hope that the ​Northern Ireland Assembly will follow the lead of this place on the opt-out issue. The figures for transplants in Northern Ireland were way above and beyond what they normally are, so again this shows the good that can happen as a result of where we are.

    We are pleased to see this legislation, but is clear that there must not be an end to the duty of care. We must also be sure to invest in new technology. There are new machines which, I am told, have shown great promise in preserving or even reconditioning donated organs. That must be investigated by the Department. Will the Minister, in her summing up, give the House some indication of how that will work and an update on those new machines and any other innovations in medicines for the future?

    It is also imperative to ensure that regular monitoring is carried out and that the impact of the new law is reported back to the House. Again I look to the Minister for those assurances, because we will doing this from tomorrow, and the House will need to know how it is progressing and whether we are achieving the figures and stats that we should be achieving. It is also essential that we have education for healthcare staff and the public. Increasing transplantation requires appropriately trained staff working with families, who will still need to allow a donation to take place. This will require comprehensive, consistent and continuous education for members of the public and healthcare staff, and these things need to happen as soon as is practicable. Previously agreed funding for NHS Blood and Transplant’s work should be made available for this work, and I ask the Minister for an update on where we are in relation to that.

    Adequate system capacity is needed to permit transplant procedures, as well as a culture that sees organ donation as the norm. I would love to see that happening. Perhaps after tomorrow we will see some of that taking place. There were already concerns, prior to covid-19, about pressure on theatre space, equipment and staff to cope with an increase in organ availability, including specialist organ donation nurses to support bereaved families. Modelling for the estimated additional transplants has been done, and NHS trusts have been asked to plan accordingly. That will need to be revisited as trusts emerge from the current crisis, and I am sure that the Minister will be all over that. In order for organ donation to be able to continue in the covid-19 age, support and discussion with bereaved families must be facilitated more than ever. We welcome the strengthened role for families in the code of practice, and we thank the Minister for bringing that forward. Technology must be harnessed to aid those vital conversations.

    I concur with the shadow Minister’s comments about BAME communities. Covid-19 has brought the need to address the health inequalities faced by BAME communities into sharp relief. There is too much inequality in transplant deaths. In 2018, 21% of the people who died waiting for a transplant were from black, Asian or minority ethnic groups. People from BAME communities wait six months for an organ despite being more at risk of kidney failure, because fewer organs are available from donors in those communities. There is a higher chance of a successful transplant if the organ comes from an individual from the same ethnic background, and it is important that those groups are the particular focus of awareness campaigns. Will the Minister give us her thoughts on that as well?​

    We welcome the revised codes of practice having a greater focus on faiths and beliefs. We believe that that will support better conversations and give greater assurances to families when a potential donor’s faith or belief is an important part of that decision making. It is important that we have that, and we thank the Government for putting it into the code of practice.

    I was pleased by the outcome of the consultation on the organs—[Inaudible.]—that deemed consent should apply to so-called routine transplants only, and that any rare or novel transplants should be subject to explicit consent. The statutory instrument is therefore limited. What we are talking about are routine transplants for heart, lung, liver, kidney, intestinal organs, small bowel, stomach, abdominal wall, colon, spleen or cornea.

    This SI is important. I absolutely agree with Kidney Care UK when it says that our NHS staff will be exhausted and that resources have been stretched by the pandemic and are likely to be for some time. However, we urge efforts to take forward implementation at the appropriate time to give renewed hope to patients waiting for a life-transforming transplant. We say thank you so much and well done to the Minister, her team and everyone concerned.

  • Alex Norris – 2020 Speech on Organ Donation

    Alex Norris – 2020 Speech on Organ Donation

    Below is the text of the speech made by Alex Norris, the Labour MP for Nottingham North, in the House of Commons on 19 May 2020.

    I have to say that I am used to clearing rooms when I start speaking, but this is quite impressive even by my own standards. Nevertheless, it is a privilege to make my debut at the Dispatch Box as shadow public health Minister on a topic as important as this one. Currently, everything we are addressing is a matter of life and death, but when we are talking about critical transplants, that could never be clearer.

    I thank the Minister for everything she is doing during this crisis, not only on this particular issue but on everything related to protecting us from the coronavirus. She and her ministerial colleagues are working around the clock and have been doing so for weeks; we appreciate that.

    This is my first opportunity to express publicly in this place my thanks to our NHS and social care staff for all the wonderful things that they are doing in my community and communities up and down the country to keep us as safe as possible.

    We clap with you on a Thursday, but we think about you always and we are really grateful for everything you are doing.

    The transplant of organs and human tissue changes and saves lives. It brings hope, it can bring happiness and it is the ultimate altruistic act. The Organ Donation (Deemed Consent) Act 2019 promises a significant breakthrough in the ability to save and change lives. Those who campaigned for it spotted the public mood and understood the British people on this issue. However, a key part of understanding that fundamental desire of the British people to do well by each other is to understand that this change has to hold within reasonable limits. It is therefore right that we are completing the process today and setting out clearly the sort of tissue that goes beyond routine transplantation. That is a critical part of maintaining public confidence in the process.

    The Opposition supported the Act during its progress and we support the regulations before us today. We have many people to thank for last year’s Act. I will start by thanking Geoffrey Robinson, the former MP for Coventry North West, for introducing the Bill. His legacy in this place is significant on a number of issues, and this legislation will certainly have long-lasting and far-reaching implications. I also thank my hon. Friend the Member for Barnsley Central (Dan Jarvis) for taking up the baton in 2019 and getting the legislation over the finishing line—he continues to be an excellent champion of the Act, and I think we will hear from him shortly—and, in the other place, the noble Lord Hunt for his stewardship of the legislation.

    Of course, I also pay tribute to Max Johnson and Keira Ball, after whom the Bill was known. Keira tragically died in a road accident, but her heart saved Max’s life at age nine, after an eight-month wait. They are truly inspirational and a huge part of why we are here today, as indeed is everyone who supported the campaign, not least the Daily Mirror and its readers. Each and every supporter has helped to bring us here today to do this important job.​
    It is impossible to talk about anything, especially anything health related, without referencing the coronavirus outbreak and its effect on all aspects of our lives. However, it is particularly pertinent when we talk about transplants, so I will touch on it now before getting into the substance of the regulations. From 1 April to 10 May, 155 transplants took place in the UK from deceased donors. In the previous year, that figure was 404, a drop of more than 60%. There have been no transplants at all from living donors, which usually make up close to a fifth of the total, and current waiting list figures will not accurately reflect the need that may have been created for organ transplant due to the pandemic, which will only cause greater strain in future months.

    I do not say these things to criticise the Government. Kidney transplants are the most common form of transplants, and in answer to a written question, the Minister for Care shared with me the fact that the early data show that both dialysis patients and those who are immunosuppressed through a transplant are more vulnerable to covid-19. The fact that transplants have been taking place at all therefore suggests that decisions are being made on the balance of need and on a case-by-case basis, an approach that I think we would all support. However, we know that, as the Minister said, patients were dying on the transplant waiting list even before the outbreak because the supply of donor organs failed to meet the demand. Fewer transplants quite simply means that the mortality rate will increase.

    What assessment has the Minister made of the impact of covid-19 on the mortality of patients waiting for transplants, and what plans do the Government have to deal with the increasing backlog? I have raised this issue with her colleague, the Minister for primary care and public health, in relation to cancer and have not yet heard clear answers. We need to know what efforts the Government will be making to deal with the bubble challenges that will be coming through the system in future weeks and months. The Minister in the other place talked yesterday about a tremendous effort to restore transplant services. Will this Minister take the opportunity today to outline what the recovery plan is likely to look like and what the timeframes will be?

    At the beginning of the coronavirus crisis we all talked of it as a great leveller and said that the virus would not recognise our differences, but we have seen in the weeks and months since just how much that is not the case. The coronavirus has exposed what many Opposition Members have said for many years. Britain is an unequal country, across regions, across gender and across protected characteristics. These inequalities are terrible for our nation’s health, and tackling them must be a post-covid priority.

    The black, Asian or minority ethnic community suffers particularly when it comes to transplants. In 2018, 21% of those who died waiting for transplants were from a black, Asian or minority ethnic group. There is a higher chance of a successful transplant if the organ comes from an individual of the same ethnic background, but that means that those from black or Asian backgrounds currently wait six to 11 months longer for an organ match. This inequality will not do, and there have to be practical things to change it, starting immediately. The culture change that the Minister talked about is at the heart of that—us all having those conversations with our loved ones—but we know that we have to be doing ​something specifically different to reach those communities experiencing the most unequal outcomes. For that reason, I would like to press the Minister on something her colleague in the other place said yesterday. He said that the Government would be following up with an awareness campaign aimed at BAME audiences. Can the Minister give a firm commitment today that this will take place, tell us when it might happen and critically—I had this conversation frequently during my time in local government—confirm that it will be developed by BAME communities, rather than on their behalf? If it is to be effective, it will have to be different from how it has been in the past.

    A key aim of the 2019 Act, which the regulations will, I hope, supplement today, was to reach an 80% consent rate in England. This will take time but certainly seems possible. In Wales, where the opt-out mechanism was implemented by the Welsh Labour Government in 2015, the consent rate has risen from 58% to 77%. In England, we start from a base line of 67%, so we are better placed, and if we reach the target, we are talking about as many as 700 more transplants a year—700 lives that can be extended, transformed or saved. The Minister has been challenged on the timing of the regulations—I have reflected on that question myself—but that number seems a strong reason to push on. As she says, the recent weeks and months have shown us how precious human life is and that we should not waste moments if we can improve lives.

    Yesterday, the noble Lord Bethell told the other place that the restoration of all transplant services would include training nurses on the new law as soon as possible after they return. I would be keen to know a bit more about that. It was not something we had heard of before, and we would want a sense of the scale of that and the precise timeline the Government are expecting.

    As I said, the Opposition are happy with the regulations as laid, but I seek to make three points. First and foremost, we agree that deemed consent should only apply to routine transplants. This is a matter of ensuring that public policy going forward matches the public’s expectation. I share the Government’s view that this would not reflect rare or novel procedures, including to create advanced therapy medicinal products, taking place without explicit consent. I will reflect on those ATMPs in a couple of seconds.

    Secondly, I welcome the Government’s response to the consultation on the statutory instrument. Following the responses received, they have rightly revised the regulations with additional clarifications on tissues from sexual and reproductive organs, which will not be subject to deemed consent. That is particularly welcome. It is nice—I dare say even novel—to see a Government consultation leading to such concrete changes. It is a good thing and long may it continue.

    Thirdly, the Government indicated in their response to the consultation that they do not expect the list of accepted tissue to need regular updates, and I agree with that in principle. The Minister mentioned how a process might happen if things were to be revised later, but I would like to understand a bit more about what would have to change for her to start such a process.

    On those rare and novel transplants, it is important that public policy matches what people expect from the legislation, but we should be proud that the UK leads the world on such transplants. It is a good sign of the ​health of our country in this regard. They are not currently included under deemed consent, but developing these new technologies and techniques enables us to save more lives. We lead the way in both development and implementation. We have pioneered the OCS—organ care service—heart system, a portable device that can preserve a donor heart in a near-normothermic beating state until it is transplanted, which is currently being used in three heart transplant centres in the NHS and is being introduced in a fourth. We have also shown that abdominal organs can be assessed and their function improved using normothermic regional perfusion technology. As is the aim with this legislation, these developments can save lives, and we should be proud of that, but we should not rest on our laurels, so could the Minister reaffirm the Government’s commitment to continuing the UK as a leader in this regard and to providing the necessary funding to transplant units to ensure they can take advantage?

    I turn now to resources, because what we are agreeing today, though very important, will have resource implications for us to pick up. An increase in the number of transplants will necessitate increased support for families who lose loved-ones. It is a difficult and emotional experience for them, and they will require high-skilled care and support, so what extra support will be available for them as these numbers increase?

    Similarly, we will need specialist nurses for donation, not just for the direct care but for the implementation, providing advice and support to families and playing the vital role of determining what the deceased’s last known decision was, so that no procedures take place without the appropriate consent. As I say, the Minister in the other place yesterday mentioned specialist training. Could the Minister here today expand further on that?

    I welcome the Government’s commitment to ensure that there are enough staff to do this. Will the Minister also commit to providing the additional funding required to ensure that the required increase in specialist nurses continues in line with the increase in transplants, so that they are not having to be begged or borrowed from other parts of the service?

    We support these regulations. This is the next staging point in a really important journey. It will make a difference to hundreds and hundreds of lives—lives of people who are completely unaware that these discussions are even taking place today, not knowing that they will need this. This is the right thing to do and the right time to do it, and we support the regulations.

  • Helen Whately – 2020 Statement on Organ Donation

    Helen Whately – 2020 Statement on Organ Donation

    Below is the text of the statement made by Helen Whately, the Minister for Care, in the House of Commons on 19 May 2020.

    I beg to move,

    That the draft Human Tissue (Permitted Material: Exceptions) (England) Regulations 2020, which were laid before this House on 25 February, be approved.

    Before I explain the draft regulations, I would like to say a few words about why we are changing the law on organ donation. Today more than 5,000 people in England are waiting for a transplant, but, sadly, by the time a suitable organ is found some people will have become too ill to receive one. Tragically, last year alone 777 patients were removed from the transplant list and 400 died waiting for a transplant. There is no option but to take decisive action to address the acute shortage of organs and save the lives of those waiting for a transplant. That is why we passed the Organ Donation (Deemed Consent) Act 2019, which amends the Human Tissue Act 2004 and sets up the new system of consent for organ and tissue donation in England, which is known as “deemed consent” or “opt-out”.

    I wish to thank the hon. Member for Barnsley Central (Dan Jarvis), my hon. Friend the Member for South Basildon and East Thurrock (Stephen Metcalfe), my right hon. Friends the Members for Maidenhead (Mrs May) and for South West Surrey (Jeremy Hunt), a previous Member of this House, Geoffrey Robinson, and Lord Hunt of Kings Heath for their work and support, which has got us to where we are today. They all started this journey for us showing immense leadership, and they continue to show their strong commitment to this cause.

    Subject to approval of these regulations, we aim for deemed consent to become legal on 20 May. While not many transplants are taking place earlier, during the peak of covid-19, NHS Blood and Transplant has already started the recovery process to get transplant units up and running as much as possible. Guidance on how best to restart or extend the transplant service was sent by NHSBT to all transplant units on 26 April. A letter was then sent on 1 May to all trusts with transplant units, asking them to actively review the situation where transplant units have reduced their services.

    To illustrate the progress that is being made to get the transplant system up and running again, on a normal day NHS Blood and Transplant would have received about 55 referrals of a potential donor and would aim for five actual donors, and it would carry out about 70 transplants a week. During the peak of the pandemic, there were days when there were no referrals, many days when there were no donors, and many days when there were no transplants. As of last week, there have been 167 referrals, 11 donors and 38 transplants. Continuing the tremendous effort to restore all transplant services will enable us to reap the benefits of the deemed consent legislation as soon as possible; by “benefits” I mean save the lives of people waiting for transplants.

    I understand that some have disagreed with the timing of going ahead with this law, but we assessed the impact of going ahead with deemed consent very carefully. This horrific pandemic taught us a lot about how precious ​human life is, and we know that the fight against it will continue for some time, while thousands of people will still be waiting for a transplant. I therefore believe very strongly that we have a duty now, more than ever, to push ahead with measures that will reduce human suffering and help people to improve their quality of life. That is exactly what this law does.

    We are of course fully aware that public confidence is important. The deemed consent legislation was first introduced to the House in July 2017, and became law in March 2019, so it has had a long process of parliamentary scrutiny, alongside three public consultations. The Government have been raising awareness of the law and the choices available for over a year, and the 20 May implementation date has been used actively in communications since late February. Putting this legislation on hold would increase the anxiety of thousands of people, who see this law as their only hope to get a new lease of life, and would confuse the communications that have already been in the public domain for some time.

    From the outset, we have been clear that deemed consent would apply only for routine transplants, to increase the number of organs and tissues available and help those that are on a waiting list. Examples of routine transplants are heart, kidneys or lungs. Novel transplants will still require express consent. The organs and tissues specified in the regulations are included because they could be used for non-routine transplants, such as a face transplant. Such transplants are outside the scope of what we want to achieve. Demand for novel transplants is very low, and people would not normally identify organ donation with them.

    During formal scrutiny of the regulations, the Joint Committee on Statutory Instruments cleared the regulations with no comments. Meanwhile, the Secondary Legislation Scrutiny Committee drew the regulations to the attention of the House, and this is testimony to how integral the regulations are for making the new system of consent work, and how important the law change will be when it is introduced.

    Let me now discuss the detail of the regulations. The Organ Donation (Deemed Consent) Act 2019 sets out that deemed consent to transplant activities in England will apply only to permitted material. The Secretary of State has a delegated power to specify in regulations what relevant material—meaning, what organs, tissue and cells—will be excluded from the system of deemed consent. To clarify, the organs, tissues and specific cells that are listed in the draft statutory instrument are organs, tissues and cells that cannot be transplanted without express consent being in place, as that would be a novel transplant.

    Regulation 2(2) sets out the detailed list of organs and tissues that will require express consent in order to be transplanted under all circumstances—such as the brain, spinal cord and face. As a result of our consultation, we expanded the list of reproductive organs and tissues in this regulation, to provide clarity and put it beyond doubt that removing any parts of a reproductive organ will require express consent in all cases. This is to ensure that if and when such transplants are carried out in future in the UK, they will be outside the scope of deemed consent.

    Regulation 2(3) sets out that some relevant material—for example, skin or bone—will require express consent if used for a novel transplant, but not if used for a routine ​transplant. This is to ensure that current practices for tissue donation, under which tissue from a leg, for example, is removed routinely, are not disrupted by deemed consent. So, although a leg transplant would require express consent, if only the skin from a leg is taken, deemed consent may apply; however, if tissue is required from reproductive organs, this will always require express consent. That addresses the feedback from our consultation.

    Regulation 2(4) allows for the trachea to be removed under deemed consent when it is attached to the lungs. This is to allow routine heart and lung transplants, which also require the trachea to be removed with the heart and lungs, to continue under deemed consent. However, the trachea is also listed in regulation 2(2), as trachea transplants by themselves are novel and therefore excluded from deemed consent.

    Regulation 2(5) excludes the removal of certain cells if they are to be used for advanced therapy medicinal products—also known as ATMPs—which are therapies made from tissue cells or genes after manipulation in a laboratory. They are used for treatment of a disease or injury, and often use human tissues and cells as starting materials. For example, an ATMP can treat knee damage by taking cartilage cells from a living patient, growing and modifying them in a lab, and re-injecting them into the patient’s knee.

    ATMPs are an exciting technology, and new therapies are being developed all the time. Current ATMPs are being developed using tissue and cells taken from living donors, but it is also possible to use material from deceased donors to develop novel ATMPs. As such ATMPs are novel, we want to make sure that the donation of such cells cannot happen without express consent being in place. Our consultation raised questions about the public’s understanding of such novel technologies, so we want to ensure that express consent is required.

    Now that I have set out the detail of the regulations, I must highlight that before deciding whether a change to the regulations would be needed in future, the Government would need to consider evidence, public acceptability and clinical need, guided by recommendations from NHSBT’s advisory group research and innovation in transplants. Any changes would need to be approved by Parliament, following the same procedure as we are now, so Parliament would have full oversight. The regulations restrict deemed consent to routine transplants, so they continue current practice, under which express consent needs to be in place for non-routine transplants. There is no additional cost to the health system, so no impact assessment has been prepared.

    In conclusion, I am glad that I am able to present these regulations to the House today. They are an important part of the implementation of the 2019 Act, as they prevent deemed consent from applying to novel transplants. The new system of consent will help to save and improve the lives of many people waiting for a transplant. Donating organs is one of the greatest gifts a person can give. I urge everybody to talk to their families and their loved ones about their wishes. I am proud that all of us present are playing a part in making something positive happen in these very challenging times. I commend the draft regulations to the House.