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  • Eric Deakins – 1978 Speech on Redditch Casualty Service

    Eric Deakins – 1978 Speech on Redditch Casualty Service

    Below is the text of the speech made by Eric Deakins, the then Under-Secretary of State for Health and Social Security, in the House of Commons on 3 November 1978.

    I begin by congratulating the hon. Member for Bromsgrove and Redditch (Mr. Miller) on getting an Adjournment debate so quickly in the new Session and for giving me the opportunity to speak about the problem generally—it is a difficult one— and to assure the people of Redditch that the difficulties over their casualty service have not gone unnoticed here in London.

    As the hon. Gentleman well knows, through our correspondence, and in his meetings with my right hon. Friend the Minister of State, we have been involved in this issue for some time now. As he ​ said, it is a most difficult one, and I hope in the course of my remarks to clarify some of the problems.

    Our concern has been to ensure that the residents of Redditch are provided with an accident and emergency service appropriate to their needs and—of almost equal importance—that they are fully informed about the different services available. I hope, if there is time, to return to this latter point.

    Hospital treatment for the great majority of casualties from Redditch is provided in one of three ways. The most serious cases are usually treated at Selly Oak hospital in Birmingham—a journey of about 15 to 18 minutes by ambulance.

    Other, less serious, cases are dealt with either at one of the hospitals in Bromsgrove, about seven miles away, or, if the casualty arises between 9 a.m. and 5 p.m. on a Monday to Friday, at the Smallwood hospital in Redditch.
    Smallwood hospital is a general practitioner hospital of some 42 beds, with a casualty department staffed by 24 local general practitioners. They provide medical cover according to a rota which they themselves have drawn up. The general practitioners are not necessarily in attendance at the hospital throughout their period of duty, but they obviously have to be immediately available if required. During the last period of 12 months for which figures are available there were, on average, 170 new patients treated at Smallwood hospital each week. It does appear, however, that the numbers have recently been increasing. Until the end of March 1977 the general practitioners in Redditch provided 24-hour seven days a week cover and were, at that time, treating about 260 new patients a week.

    I think it might be helpful if at this point I briefly describe the general picture with regard to the remuneration of general practitioners who work in general practitioner hospitals. At present, the only approved methods of remuneration are the staff fund—also known as the bed fund—system as provided for by the terms and conditions of service of hospital medical and dental staff, or, where appropriate, sessional payments at the part-time hospital medical officer rate. These practitioners are commonly referred to as clinical assistants. Where the number of patients attending the ​ general practitioner hospital as casualties or the nature of the services being provided—that is, services other than those the general practitioner might have provided in his own surgery—are such that the staff fund alone is not considered to provide adequate remuneration for the work, health authorities may make sessional appointments at the clinical assistant rate to remunerate the work falling outside the scope of the staff fund.

    The clinical assistant rate is, at present, £720 per year for one session per week. Each session is equivalent to three and a half hours’ work at the hospital. There are no nationally agreed rates for “on-call” work for this group and health authorities are expected to agree locally on appropriate assessment of sessions for any on-call work, taking into account the amount of clinical work arising from the on-call commitment, not merely the length of time on-call. The rate of payment into the staff fund and the sessional fees payable to clinical assistants are those recommended by the Doctors’ and Dentists’ Review Body, the independent body set up to advise the Prime Minister of the day on matters of medical and dental remuneration within the NHS.

    Discussions between the general practioners and the Hereford and Worcester area health authority about its future level of remuneration for services at Smallwood hospital began in 1976 when the general practitioners were still providing full casualty cover. I understand that at one stage it was thought that the general practitioners might be eligible for the new hospital practitioner grade. As they were not working as part of a specialist consultant team, however, such a regrading was not possible. At another stage in the negotiations the general practitioners were made an offer that was subsequently withdrawn. I can well understand the general practitioners’ frustration at these events which must clearly have adversely affected their relationship with the area health authority.

    In the end the only agreement that could be reached was for the restricted casualty service now in operation for which the general practitioners as a group are paid 17 clinical assistant sessions a week. This total number is made up of three sessions per day plus an additional ​ two per week to cover bank holidays, sick absences and so on.

    The concern over the introduction of a restricted service and the need for the AHA to establish what kind of service was being provided and what kind was necessary, led the authority to set up a survey of general practitioner casualty provision. As the chairman of the AHA explained in his letter of 27th February 1978 to the hon. Gentleman, the aim of the survey was to establish three things. First, the degree to which the nature and quantity of work carried out by general practitioners at the Smallwood hospital compared with a consultant manned accident and emergency department. One case for paying additional remuneration would be if the general practitioners were dealing with more serious cases than was normal in such a casualty department.

    Secondly, the survey was to find out the degree to which the work undertaken in the department might be considered part of the general practitioners’ normal workload. There is little doubt that a proportion of the patients treated in the casualty department would, elsewhere, be treated in their general practitioners’ surgeries.

    Thirdly, the survey was to provide information to help the AHA to decide whether or not the restricted service provided an acceptable level of casualty cover for the town.

    Unfortunately, both because of the illness of the officer conducting the survey, and because of the complexity and number of patient records being analysed, this review took longer than expected and, indeed, is still incomplete. Apparently the analysis of patients’ records retrospectively has not provided as much information as was expected. It has therefore become necessary to consider embarking on a prospective survey in which, it is hoped specific information will be obtained from patients during the course of their treatment. An interim report from the survey was put before the authority’s meeting on 16th June 1978. On the first of the three questions the report concluded that although the contention that the work was more akin to that of a consultant department could not be conclusively refuted, the evidence thus far available was strongly suggestive to the contrary. The report also dealt at some length with the pattern of treatment ​ for Redditch patients with particular reference to the location of the treatment whilst the Smallwood hospital casualty department was closed.

    I understand that the AHA discussed the report and the whole situation in considerable detail but felt unable to depart from the general principle adopted for its area; namely, that one session per week should be paid for each 600 new attendances annually. The Redditch general practitioners’ current level of remuneration, which had been separately negotiated at 17 sessions a week, exceeds that which would be payable under the general formula; and their request for an ultimate payment of 42 sessions a week for 24-hour cover is well in excess of the level likely to be reached were they to provide such a service.

    The AHA asked the district management team to pursue with the general practitioners the possibility of rearranging the sessions currently worked so as to provide fuller cover at the hospital. This might have involved, for instance, transferring one of the three sessions from the morning period. As the hon. Gentleman is aware, the general practitioners have rejected this approach. The AHA also resolved to delay any final decision on the general level of remuneration payable to general practitioners in cottage hospitals pending the outcome of discussions on the consultants’ contracts.

    The hon. Member may like to know that a joint working group made up of representatives from the health Departments—DHSS, Scottish Home and Health Department and Welsh Office—representatives from NHS management and representatives from the British Medical Association has recently been set up to discuss the work of general practitioners in hospitals with particular reference to the implications for the remuneration general practitioners receive for this work which obviously is directly relevant to this problem. The payment of general practitioners for casualty work in general practitioner hospitals and units is one of the subjects being considered by the working group. The health Departments have made certain proposals on this to the BMA; these include the setting up of a special casualty fund, on the lines of the existing staff fund, to remunerate these casualty services. I cannot say more at ​ this point on progress in the working group or of the shape of any future agreement, but I can assure the hon. Member that we hope that an agreement may be possible in the reasonably near future.

    We must hope that these national discussions lead to a generally accepted basis for this type of remuneration. In the meantime, however, it is for the health authority and the general practitioners locally to agree on an acceptable level of service and of remuneration to the general practitioners for providing it, taking account, obviously, of the needs of the residents of Redditch and of the requirements of the pay policy that extra pay can be justified only by identifiably additional work.

    I ought perhaps also to draw attention to the long-term solution to the problem. As the hon. Gentleman knows, the West Midlands regional health authority is firmly committed to the provision of a major new district general hospital in Redditch. Its first phase is expected to include some 330 beds, together with a full consultant-staffed accident and emergency department. The question of the site for the new hospital has now been finally resolved and it is expected that construction will start in early 1983 with a view to completion of the first phase by 1986.

    A number of points were raised by the deputation which the hon. Gentleman brought to see my right hon. Friend the Minister of State on 20th July. I should like now to deal with these points. I hope that the hon. Member will treat my remarks as a further reply to his recent letter and parliamentary Question.

    Perhaps the most serious point raised was that unless the general practitioner’s remuneration was improved there was a danger that insufficient doctors would be prepared to participate in the scheme and the service might collapse altogether. I hope that the remarks I have made this afternoon about the comparison between the amount paid to Redditch general practitioners and that payable in other hospitals in the area will go some way to avert that danger. I should like to take this opportunity to say that there is no doubt that the local general practitioners are providing an extremely valuable service for their town.

    It was also suggested that the AHA might make its own arrangements for providing an extended casualty service, perhaps by advertising for additional staff. It must be said, however, that this is no more than a theoretical possibility. There would be very great difficulty in attracting suitable applicants for such a post and it is by no means certain that proper consultant supervision could be arranged.

    The deputation raised the possibility of a reduction in the number of new attendances on which the payment was based. I have already said that the AHA felt unable to depart from its general basis of one session for each 600 new attendances.

    Finally, the deputation spoke of the refusal of the Hereford and Worcester family practitioner committee to pay night visit fees for the work formerly undertaken after 11 p.m. by the general practitioners at Smallwood hospital. The statement of fees and allowances payable to general medical practitioners provides that a night’s visit fee will be payable subject to the relevant conditions being met where in the patient’s interest the general practitioner provides specific treatment at a general practitioner hospital, provided that the doctor is not on duty at or on call for the hospital at the time, and that the request for the patient to be seen did not come from the hospital. I think it is clear that those conditions were not satisfied and that the decision of the family practitioner committee not to pay a night visit fee was, therefore, correct.

    At the start of my speech I said that, if there were time, I would return to the question of the information available to the people of Redditch about the health services provided for them. The difficulties over the Smallwood hospital casualty service were discussed at a recent meeting of the West Midlands regional health authority. The authority concluded that the resolution of the dispute did not lie in its hands but felt that the local residents should be kept in touch with the facilities in the area. I understand that the authority’s public relations department is currently having information compiled about the whole range of these services and that, after discussions with the district management team, the family practitioner committee and the ​ local community health council, it is hoped to issue a comprehensive health information sheet within the next few weeks. It is expected that this will be issued by a professional distribution service on a door-to-door basis to every household in Redditch. Such an information sheet would thus have a wider distribution than the existing leaflet on the family practitioner services which is issued by the housing department of the new town development corporation to all its new tenants.

    One of the items which I should imagine will be included is a description of the hospital services available in Bromsgrove. I understand that there is some confusion about the location of the casualty department in that town. The department is, in fact, at the cottage hospital and not at the larger general hospital. I know that the community health council has suggested that a full accident and emergency department should be provided at Bromsgrove general hospital. The AHA has, however, pointed out that when, as would be inevitable, the unit transferred to the new district general hospital planned for Redditch there might be difficulties in reintroducing a general practitioner service in Bromsgrove.

    I should like to conclude by reiterating what I said at the outset. Our concern is to ensure that the residents of Redditch have the type of accident and emergency service they need as quickly as possible. In that connection I am sure that the chairman of the Hereford and Worcester area health authority will not mind my making public a comment in his letter of 27th February 1978 to the hon. Gentleman. In that letter he said that anyone who had direct information concerning patients who had suffered as a result of the restricted service should let either him or the area medical officer know as soon as possible. I understand that no such cases have yet been brought to their attention but the request for information still stands.

  • Hal Miller – 1978 Speech on Redditch Casualty Service

    Hal Miller – 1978 Speech on Redditch Casualty Service

    Below is the text of the speech made by Hal Miller, the then Conservative MP for Bromsgrove and Redditch, in the House of Commons on 3 November 1978.

    On Thursday, 30th May 1895, as reported in the Redditch Indicator, one Thomas Woodward, agricultural labourer, of Red Lion Street, Redditch was admitted as the first patient to the recently opened Smallwood Hospital, Redditch. I assure the Under-Secretary of State for Health and Social Security, for whose presence I am grateful, that I do not intend to set out the whole history of the difficulties besetting the provision of a casualty service in Redditch since that date. But it is significant that the first patient admitted was a casualty patient, there having previously been some argument as to whether a hospital was needed there for that purpose.

    The Minister may be familiar with the argument about whether a new district general hospital was required in my constituency at all, an argument happily concluded. But the hon. Gentleman will not be surprised to learn that even with the construction of the Smallwood hospital there was an argument for about three years over the choice of the site, and there was some delay in the construction. All that my constituents are hoping is that ​ the new hospital will be open well before the centenary of the Smallwood hospital.

    My intention in raising the matter this afternoon is by no means to conduct a witch-hunt of any kind. I pay tribute to the courtesy and attention with which I have been received by the Minister of State on several occasions—regrettably several occasions—on this most difficult matter.

    The truth is that we are confronted with a log jam. My purpose in raising the matter this afternoon is to seek the Minister’s assistance in attempting to break it. I hope that he will understand me when I say that it is also my intention to try to head off the possibility of a witch-hunt being conducted locally, in the press and by other means, against those who are imagined to be responsible for the difficulties affecting the provision of the casualty service. Such a public witch-hunt could only do serious damage to the morale of those who are continuing to provide the greatly reduced service and could well result in the complete withdrawal of the service.

    I hope that the Minister understands that that is a real possibility. I am a member of an action committee which I have been trying to head off from that very course, but I regret that it is one that it may determine to pursue.

    I spoke of a log jam and referred to several visits to the Department. I think that I should proceed to discuss the need for the casualty service before going on to list the various elements in the situation as I see them.

    The new town of Redditch now has a population of about 60,000. According to the statistics handed to me last week by the local employment office, there is a workforce of 33,000, practically all in manufacturing industry. The casualty service does not just provide for the growing new town of Redditch. It also provides for the surrounding areas. That has been recognised in the calculation of the population of the catchment area for the new district general hospital.

    The population of the area currently served by the Redditch casualty service, restricted as it unfortunately is, is about 90,000 and is increasing as the new town moves towards fulfilment in 1981. During the discussions we have had on several ​ occasions with the Department, mention has been made of the need for this service. The Under-Secretary referred to this in his letter to me of 19th August 1977. The area health authority was asked to undertake a survey at that time. A year later an interim survey was produced. We still do not have the results of any final survey, despite the lapse of time since the Under-Secretary was good enough to write to me.

    It can be said that the figure for the number of casualties from Redditch attending the Selly Oak hospital out of normal working hours, which are the only hours during which the Redditch service is provided—this can therefore be taken as a fair indicator of the increase in demand and consequently of the need— have risen from 13 per month in 1976 to 145 per month last year. More up-to-date figures are not available. A further illustration can be obtained by the fact that on a recent Saturday afternoon at the Bromsgrove cottage hospital there were 37 patients from Redditch in attendance.

    There is also a query about the extent of the treatment accorded to these casualties from Redditch at Selly Oak hospital. The question that arises is whether they are given full treatment or some first aid attention and then referred to the Redditch hospital during working hours on Monday for a full and proper examination. I am not qualified to speculate on that but I would point out that it is not unknown for there to be 110 cases awaiting the magic hour of 9 o’clock on Monday morning in Redditch. To the bulk of the 90,000 population the need for this service is totally apparent. People cannot understand why the service cannot be provided on a more satisfactory, that is continuous, basis.

    We must bear in mind that there is in Redditch a history of 24-hour provision of casualty service. Smallwood hospital is equipped not only with radiography but with an operating theatre. The staff at that hospital took a great and justifiable pride in the service they provided for their fellow citizens. It will readily be understood what a serious effect there was upon morale when the hours of operation of the casualty service were reduced to the normal working hours of 9 am to 5 pm, Monday to Friday.

    This reduction in service took place in April 1977. Previous warning had been given—very nearly a year’s warning—that the service would be reduced unless something could be done. Indeed, resignations from the general practitioners providing the service were finally handed in in October 1976, although they continued to provide the full service until April 1977.

    During that period of warning notice, there had been attempts to try to resolve the situation. The suggestion was made that the practitioners providing the service might qualify for the newly-constituted grade the previous year—1975— of hospital practitioner. This was found to be out of order on what appears to the layman to be the technicality that a consultant was not in overall charge. I say that it appears to be a technicality to the layman because consultants do provide a specialist consultant service on a sessional basis at the hospital. It may be that there is some professional objection at the bottom of this situation.

    It is not as if there has been adequate primary care available in the new town of Redditch. We need only to look at the new estate of Church Hill, with a population of 8,000 out of the 16,000 to be achieved in two years time, where there is at the moment a doctor operating from a semi-detached house. It is hoped to provide some portakabins next spring, but heavens knows what happens to people who get ill this winter.

    Adequate primary care is not available in this new town. I have raised this matter before in the House. I did so with the present Foreign Secretary when he was at the Department of Health and Social Security. There has been no provision in new towns for expenditure on health concomitant with the growth of new towns in the same way as has been provided for roads and education. This is a very serious matter.

    I turn now to the possible elements in the log jam. I have hinted that there may be some professional difficulties over the qualifications of these doctors. There may, indeed, be further professional difficulties or disagreements as to the provision of the casualty service and the priority it should be accorded in the expenditure of public funds.

    Whereas, for example, the medical staff committee in Redditch is quite convinced of the need for 24-hour coverage, and has accepted that, as a stage towards that, extension of the hours of the provisions of the casualty service might be a logical next move, expressing its willingness to do so if the necessary arrangements could be made, the district medical team, advising, apparently, the area health authority, did not share that opinion.

    There are administrative elements in the log jam. I will spare the Minister’s blushes about the effects on pay policy on the situation. That was one of the stumbling blocks to an earlier proposal during the period of notice in 1976. But it appears that there may well still be administrative difficulties. The Minister of State at one stage told me that a working party was to be set up with the Department of the Environment to examine new towns and the provision of medical facilities. That would appear to have made no progress. There has been, apparently, some administrative difficulty in the AHA concluding its survey, which has now taken well over a year.

    There may be differences of opinion between the hospital, the district and the area as to how these problems should be tackled, but the public simply cannot understand how it has proved impossible for this log jam to be resolved. With the withdrawal of the service, the increase of population and the advent of the new hospital, I should have thought it would have been perfectly possible to meet their quite legitimate aspirations and to treat this question as the special case which I believe it to be.

  • Fiona Hyslop – 2020 Statement on Covid-19

    Fiona Hyslop – 2020 Statement on Covid-19

    Below is the text of the speech made by Fiona Hyslop, the Cabinet Secretary for Economy, Fair Work and Culture, in the Scottish Parliament on 21 April 2020.

    The Covid-19 public health crisis has led extremely quickly to an economic crisis that is global in nature but also local, impacting on many people and businesses in Scotland. To combat the spread of the virus, many businesses have already closed and we face an enormous challenge in helping other businesses to survive, to provide jobs and to service the economy.

    I thank all businesses and their workers for following the social distancing guidance, the essential sectors and supply chains for continuing to keep the country running and those companies that have repurposed to manufacture supplies for the health sector.

    We estimate that up to 70 per cent of the workforce is still working, with many people delivering health, care and welfare services, and many others working from home, often combining that with childcare and home schooling. By staying home, they are playing their part in tackling the virus. They are helping to protect the health service and to save lives.

    As Covid-19 continues to have a significant impact across the world, there is major uncertainty in financial markets, supply chains and the functioning of the global economy as many countries, including Scotland, have had to reduce economic activity to stop the spread of the virus. The latest surveys for Scotland show a similar pattern to other countries, with falls in business activity in March that are even sharper than during the financial crisis. The chief economist’s “State of the Economy” report, which was published today, projects that Scotland’s gross domestic product will fall by a third during the period of social distancing.

    It is important, however, to put the economic impacts in context. This is no normal downturn and we need to view economic data and projections in that light, recognising that productive and profitable businesses across Scotland have been required to pause activity to support the public health effort.

    We have pursued three main aims for the economic response to date: to keep companies in business and with productive capacity so that they can recover; to keep staff in employment with appropriate income protection and support; and, most important, to provide support to staff so that they can self-isolate and care for loved ones.

    It is in everyone’s interest to help companies through this turbulent period. The United Kingdom Government has the immediate fiscal and macroeconomic powers to respond to the economic crisis and it has made substantial and welcome commitments to support businesses and employees. However, those commitments do not fully meet the needs of Scottish businesses. There are still significant gaps in both the job retention scheme and the support for the self-employed. Last week, along with the Cabinet Secretary for Finance, I wrote to the chancellor, outlining the changes that need to be made. I am also pressing the UK Government to urgently share data on the implementation of support schemes so that we are better able to tailor our support to businesses.

    To address Scotland’s specific needs, we announced additional funding to fill some gaps in the UK Government’s schemes. There is no doubt that we will be dealing with the uncertainty of the impacts and duration of the virus for some time. I engage regularly with businesses, business organisations and the unions and I have been building consensus in recent weeks in support of our four-step economic plan: response, reset, restart and recover.

    Initially, we have focused the majority of our efforts on the response stage. Our package of business support is now worth more than £2.2 billion: it is delivering almost £900 million-worth of rates relief and we continue to work with local authorities to progress our £1.3 billion business grants scheme. Support for the fishing industry of up to £22.5 million was announced by the Cabinet Secretary for Rural Economy and Tourism, and the Cabinet Secretary for Transport, Infrastructure and Connectivity has agreed further measures of support for the bus industry of £92 million, for ferry operators of £45.7 million and for rail franchisees of £254 million. We continue to work closely with the UK Government and Oil & Gas UK to assess what more can be done to support the oil and gas sector during its immediate and longer-term challenges.

    The Minister for Trade, Investment and Innovation has been working on procuring international and domestic supplies for the health service. On Saturday, 10 million masks arrived at Prestwick airport, and during this week 100,000 litres of sanitiser will arrive at the national health service’s central distribution warehouse. Our enterprise organisations have provided advice and support to over 178,000 companies.

    The additional £100 million that we allocated last week will be a vital lifeline for Scottish individuals and businesses to relieve hardship and protect the newly self-employed, who are ineligible for other support, and viable micro, small and medium-sized enterprises that are in distress and might be ineligible for UK Government sources of funding or not yet in receipt of the funds that they need to survive. The grant funding will be channelled through local authorities and enterprise agencies. The scheme will open for applications by the end of April and recipients will receive funds in early May. The provisional allocation will see £34 million for the newly self-employed, £20 million for creative, tourism and hospitality companies that are not in receipt of business rates relief and £45 million for firms that are vulnerable but vital to Scotland’s local and national economic foundations.

    The recently self-employed, who are excluded from the UK’s scheme but still suffering hardship, will be able to receive £2,000 grants. For creative, tourism and hospitality companies that have up to 50 employees, there will be easy access to £3,000 hardship grants or larger grants of up to £25,000 where it can be demonstrated that that amount is needed. Support and grants for pivotal SME enterprises will depend on the specific need of each enterprise, and will be developed by the relevant enterprise agency with wraparound support.

    I also recognise the challenges that are faced by the cultural sector, which is so reliant on social interaction in theatres, music venues, galleries and festivals. For artists who are facing hardship, I was pleased to announce, yesterday, that an additional £1 million will be given to Creative Scotland’s bridging bursary fund.

    Because of our decisions, thousands more businesses, including some that are in vital sectors of the economy, will benefit from support that is not available elsewhere in the UK. However, there will still be gaps, so we continue to engage with businesses on a regular basis to understand their needs and press the UK Government to deliver for them.

    The reset phase that we are now entering involves preparation to know what a safe restart will look like sector-by-sector across the economy and what needs to be done to help businesses deliver that. Together with industry sector leads and trade unions, we are developing sector-by-sector guidance to give assurance and confidence as closed businesses—at some point—reopen and restart economic activity. However, that will happen only when scientific and health advice supports it. As an example of the work that is being done, the Minister for Local Government, Housing and Planning and the construction leadership forum have formed a cross-industry group to address the wider issues that are needed to get the industry started again following lockdown. During the coming months, our plan for economic restart and recovery will need to be managed in a safe and orderly way.

    Public sector spending on infrastructure accounts for around 50 per cent of all construction activity across Scotland. Therefore, our infrastructure investment will play a vital role in how we reset, restart and recover the economy. So far, only essential construction activity continues in the sectors that are delivering critical national infrastructure—such as primary healthcare, energy, telecommunications, transport and water. Those networks and systems are vital to our ability to keep our country moving and sustain as much economic activity as possible in the current crisis. As we all know, our digital infrastructure has proved to be an essential lifeline for people, businesses and services across Scotland.

    The restart might be phased. A slower but more effective restart will reduce the danger of a second wave of the virus, and will avoid a false restart for the economy, which would require further closures. Recovery will not be quick and the post-crisis world will be very different, with different business practices, markets and behaviours.

    Last week, I announced the establishment of an advisory group on economic recovery. I am sure that members will agree that independent expert advice is more important than ever. The group will be steered by Benny Higgins and will include Professor Sir Anton Muscatelli. The challenge that I have set for the group is to engage, analyse and listen to those who are affected by the crisis, and to bring forward solutions to enable our economy to recover quicker and better.

    Mr Higgins will lead engagement with the business community alongside the enterprise organisations. I am pleased that Lord Smith of Kelvin, who is the chair of Scottish Enterprise, has agreed to be part of the process of gathering the views on the business aspects of the economic response.

    We will go wider, with active engagement with trades unions, local government, third sector and environmental representatives, because how the economy recovers is relevant to everyone.

    I am setting a demanding timetable: proposals to Government are due by the end of June. The proposals will be taken forward alongside a range of other sources of expert policy advice as we implement the Government’s agenda to build a wellbeing economy and ensure a green recovery. The advisory group will also draw on input from the Council of Economic Advisers.

    I can announce further members of the advisory group: Dame Sue Bruce, Professor Anna Vignoles, Professor Dieter Helm, Grahame Smith and Professor John Kay.

    The Scottish Government recognises the significant impact that the response to Covid-19 is having on Scotland’s economy, businesses and people. We are doing everything that we can to mitigate that impact, respond to the crisis and reset as much economic activity as we can. At the same time, we are planning ahead to restart the economy and, in due course, to support economic recovery.

  • Jeane Freeman – 2020 Statement on Covid-19

    Jeane Freeman – 2020 Statement on Covid-19

    Below is the text of the statement made by Jeane Freeman, the Cabinet Secretary for Health and Sport, in the Scottish Parliament on 21 April 2020.

    It is no exaggeration to say that the effort and sacrifice of the people of Scotland in complying with the restrictions that are in place has helped to save thousands of lives. I know that it has not been easy, but I cannot stress enough how much it matters and how much it is appreciated.

    We want to be clear with the public on what the future might look like and the principles that will shape any future decisions on easing any of the restrictions that are currently in place. Later this week, we will set out the principles that will guide us, the evidence that we will use and the framework for our decision making. However, it will not—yet—be a hard and fast plan with dates, because it is simply too early to be able to set out that level of detail.

    Once again, I thank the people of Scotland for complying with the rules and for their patience and continued support. Our aims now, and as we look to shape the steps that we need to take next in order to find different ways to live with this virus, are to minimise the impact of the virus, to continue to protect our national health service and social care services and to protect lives.

    As at 9 o’clock this morning, 8,672 positive cases had been confirmed, which is an increase of 222 on the numbers reported yesterday. A total of 1,866 patients are in hospital with Covid-19, which is an increase of 57 from yesterday. Last night, a total of 166 people were in intensive care with confirmed or suspected Covid-19. That is a decrease of three since yesterday. However, in the past 24 hours, 70 more deaths have been registered of patients who have been confirmed as having Covid-19, which takes the total number of deaths in Scotland, under that measurement, to 985.

    As always, we remember that behind those numbers are human beings—fathers, daughters, mothers, cousins, friends—who all meant so much to those they have left behind. Again, I extend my condolences to all those who have lost loved ones.

    The work that our national health service has undertaken to treble intensive care unit capacity and to increase bed availability has ensured that so far, we have kept the number of cases below our capacity to cope. To ensure that that capacity is in place, we completed the construction of the NHS Louisa Jordan hospital in Glasgow over the weekend. In just over three weeks, we have planned, developed and constructed a hospital that now stands ready for patients. We continue to hope that that temporary facility will not be needed, but its creation gives us greater certainty that our NHS will have the capacity that it needs in all circumstances.

    The effort and support from the army initially and the significant efforts of front-line NHS staff, construction and support staff and SEC staff has been awe inspiring, and I am sure that everyone in the chamber shares my gratitude for their remarkable achievement, the pride with which they have worked and the continued effort that they make to be ready.

    This virus is a particular and serious threat to the most vulnerable in our society. Among those are our oldest citizens and those with underlying conditions. That means that protecting the residents of care homes is vital—just as it is during flu season and when they experience outbreaks of norovirus.

    Guidance on isolation in care homes has been established for some time and requires clear social distancing, active infection prevention and control and an end to communal activity. However, to provide clarity, today I am setting out a series of tailored additional steps that we are taking to support staff and residents.

    I have required NHS directors of public health to take enhanced clinical leadership for care homes. For the first time, NHS directors will report on their initial assessment of how each home is faring in terms of infection control, staffing, training, social distancing and testing and on the actions that they intend to take to rectify—and rectify quickly—any deficits that they identify.

    To supplement that new clinical oversight, we are establishing a national rapid action group, comprised of the key partners with operational responsibility in the area, recognising that care homes are primarily operated by independent providers. The group will receive daily updates and activate any local action that is needed to deal with issues as they emerge, as well as co-ordinate our wider package of support to the sector.

    In addition, we are equipping the Care Inspectorate for an enhanced role of assurance across the country, including greater powers to require reporting.

    Testing for staff and residents is being expanded, including testing of all symptomatic residents of care homes. Covid-19 patients who are discharged from hospital to a care home should have given two negative tests before discharge. I now expect other new admissions to care homes to be tested and isolated for 14 days, in addition to the clear social distancing measures that the guidance sets out.

    I make clear that testing is not an alternative to following the guidance on social distancing, ending communal activities and enhancing infection prevention and control. However, it can and does provide necessary assurance to the families of people who are in or being admitted to care homes, which is important. Of course, it also provides assurance to staff.

    We are working to get students and social care retirees and returners into the system as quickly as possible and we are supporting care homes to recruit additional staff. Employers now have direct access to the Scottish Social Services Council recruitment portal, to enable the quick and effective redeployment of care workers. More than 80 staff have already been matched for work in care homes or care at home under the new portal; more will join them in the coming weeks.

    I have spoken to a number of stakeholders in recent days and I thank them for their support. In particular, I am pleased that Scottish Care, which represents the majority of care homes in Scotland, agrees that this strategy and approach is the right one.

    We owe enormous gratitude to workers who are safeguarding our most vulnerable loved ones in care homes and at home.

    To ensure that staff have the personal protective equipment that they need, we are increasing care homes’ access to NHS PPE. Although care homes have their own PPE supply route, as before, we have undertaken to supplement that, recognising the additional demand on care homes at this time.

    More than 16 million items of PPE have been distributed to social care since we launched the triage helpline for the sector on 19 March. This week, we began delivery of a week’s supply of aprons, gloves and fluid-resistant surgical masks direct to every single care home, prioritising those with known outbreaks; delivery of all that will be complete by the end of this week.

    The demand for PPE is a huge global challenge, but we are doing all that we can to ensure continued supply and distribution. On top of the supply of NHS PPE to care homes, we have delivered more than 80 million items to Scottish hospitals and provided eight weeks’ supply to general practitioners and primary care in Scotland.

    Global demand as a result of the pandemic is huge and we continue to run what is now a 24/7 operation to procure the supplies that we need for Scotland. In addition, we are working on a four-nation basis with our colleagues in the rest of the United Kingdom.

    We are continuously updating our guidance in line with the science, as our understanding develops, so that workers have clarity on the type of PPE that they should wear and in which setting or scenario.

    However, I should be clear that the guidance that Public Health England issued last week on actions to undertake in the event of shortages did not apply to Scotland. We continue to have sufficient stocks of PPE. However, we continue to have to work hard, every single day, to ensure that orders arrive on time, that delivery volumes are as ordered, and that we source new suppliers into the market. As always, if staff have concerns, we need to hear about them. They can contact us through the direct dedicated PPE email address, which I will give again: covid-19-health-PPE@gov.scot.

    Work has also been continuing on increasing our NHS testing capacity, and we are on track to meet our target of 3,500 by the end of this month. By that time, every health board will have local testing capacity, and we are working across academia and the independent sector to increase that capacity further. In addition to our own efforts to increase testing, we—again—work on a four-nation basis to increase testing capacity in Scotland as part of the UK effort.

    Increasing our polymerase chain reaction testing capacity and looking forward to other emerging forms of testing—if they are validated—will be essential to plans for the future. Our work on testing now matters now, but we are also building the testing infrastructure that we will need as we move to the next phase. Our capacity to test, trace and isolate will be critical to controlling the virus.

    We are witnessing the most significant transformation of health and social care in a generation. Tripling our intensive care unit capacity, massively scaling up and extending our procurement service, creating a new hospital in three weeks, protecting hundreds of thousands of our most vulnerable, and welcoming thousands of NHS and social care returners, student nurses, midwives, allied health professionals and medics to support our communities and our NHS are just some examples of what has been undertaken.

    All that is testament to the professionalism, dedication and sheer hard work of those who work in, and lead, our NHS and social care. In addition, the people of Scotland have stuck by the rules and stayed at home, maintained social distance, and sacrificed the contact with family and friends that means so much and the pleasures that they otherwise enjoy.

    That transformation and those sacrifices are impressive beyond words. However, alongside that, our NHS remains open. Services from GPs to accident and emergency and urgent care are all open and ready to care for those who need it. I say to everyone: please do not hesitate to come forward if your condition, or that of your child or family member, concerns you. If you have symptoms, seek help by contacting your GP, calling NHS24, or by attending A and E for urgent symptoms. The NHS is ready to cope—and is coping—with Covid-19, and it remains open for all those other important and urgent health issues, in relation to which it cares for people so well. The NHS and our social care services continue to scale up and to work to protect the health of people in Scotland, and we continue to do all that we can to support them.

  • Chris Philp – 2020 Statement on the Right to Rent Scheme

    Chris Philp – 2020 Statement on the Right to Rent Scheme

    Below is the text of the speech made by Chris Philp, the Parliamentary Under-Secretary of State for the Home Department, in the House of Commons on 22 April 1920.

    We welcome the Court of Appeal ruling that the Right to Rent Scheme is lawful and does not breach human rights law.

    The Right to Rent Scheme was launched to ensure only those lawfully in the country can access the private rental sector, and to tackle unscrupulous landlords who exploit vulnerable migrants, sometimes in very poor conditions.​
    In 2016, a requirement was introduced for landlords and lettings agents in England to take reasonable steps to check they are renting only to someone who has a right to do so. This is to help make sure our immigration laws are respected. It is only fair to the many people who come to the UK legally and to British citizens that accommodation is not taken by people who are here illegally.

    Right to Rent checks are straightforward and apply equally to everyone seeking accommodation in the private rental sector, including British citizens, and there are penalties for landlords who fail to complete the checks and who are later found to have rented to someone without a right to be in the UK. We have adapted the checks to make it easier for landlords to carry them out during the coronavirus outbreak. Prospective renters are now able to submit scanned documents, rather than originals, to show they have a right to rent.

    We have always been absolutely clear that discriminatory treatment on the part of anyone carrying out these checks is unlawful. Furthermore, the Right to Rent legislation provides for codes of practice which sets out what landlords are expected to do and how they can avoid unlawful discrimination.

    We are therefore pleased that the Court of Appeal has overturned the High Court’s ruling and found that the scheme has a legitimate policy purpose and is compatible with the European convention on human rights.

    As the Court noted, it is in the public interest that a coherent immigration policy should not only set out the criteria on which leave to remain is granted, but also discourage unlawful entry or the continued presence of those who have no right to enter or be here.

    The Right to Rent Scheme forms an important part of our immigration policy. However, as my right hon. Friend, the Home Secretary said in this House, we are carefully reviewing and reflecting on the recommendations in the Lessons Learned review report, including those relating to the compliant environment. We will bring forward a detailed formal response in the next six months, as Wendy Williams recommended.

    In the meantime, the provisions passed by this House in 2014 remain in force and a full evaluation of the Right to Rent Scheme is under way. The evaluation includes a call to evidence to tenants, landlords and letting agents; a large mystery shopping exercise; and surveys of landlords. Members of the Right to Rent consultative panel provided input into the design of the evaluation.

    The Government are committed to tackling discrimination in all its forms and to having an immigration system which provides control, but which is also fair, humane and fully compliant with the law. The Court of Appeal has found that the Right to Rent Scheme is capable of being operated in a lawful way by landlords in all individual cases. We will continue to work with landlords and lettings agents to ensure that is the case.

  • Maria Eagle – 2020 Speech on Establishing a Public Advocate

    Maria Eagle – 2020 Speech on Establishing a Public Advocate

    Below is the text of the speech made by Maria Eagle, the Labour MP for Garston and Halewood, in the House of Commons on 22 April 2020.

    I beg to move,

    That leave be given to bring in a Bill to establish a public advocate to provide advice to, and act as data controller for, representatives of the deceased after major incidents.

    We have just reached the 31st anniversary of the Hillsborough disaster. It has been a difficult and painful day for the families of the 96 innocent children, women and men who were unlawfully killed on that day. It has been a difficult and painful day for thousands of survivors, many still traumatised, who witnessed what happened at the ground on that day. It has been a difficult and painful day for the people of the city of Liverpool, and much of Merseyside beyond, still united in sorrow.

    The Hillsborough Family Support Group intended to hold their final public memorial service at Anfield—I and many thousands of others had planned to go—after which they had announced their intention to disband and in future to remember their lost loved ones privately in their own way. But the covid-19 pandemic has meant, quite rightly, that the final public memorial service has had to be postponed.

    As the families prepare to end their three decades of large public commemorations of the disaster, many feeling exhausted but vindicated, it is left to us, as lawmakers in this place, to ask ourselves how we can learn the many lessons of Hillsborough. How can it be that it has taken bereaved families so long to get the truth of what happened accepted officially and to get a measure of justice for their loved ones? It was 23 years before the truth was told by the Hillsborough Independent Panel and finally officially accepted. How can it be that bereaved families have had to campaign for over 30 years in the face of official indifference, and sometimes even hostility, to get truth and a measure of justice? What can we do, as lawmakers, to ensure that no other families bereaved in public disasters will ever again have to face what they have endured?

    This Bill is about learning those lessons. I would like to thank Lord Michael Wills for drafting the Bill following work that he and I did in consulting families involved in a number of disasters. It draws on his knowledge and experience of devising the mechanics of how the Hillsborough Independent Panel should work when he was a Minister in the Ministry of Justice in 2009. Without his efforts and expertise in devising its powers to obtain and process documentation, the ability of the Hillsborough Independent Panel to establish the full truth of what happened may well have been compromised, and its findings may not have been accepted officially in the way in which they were. It is a model that can work to stop things going wrong in future disasters if the correct lessons are learned, and the Bill draws upon those lessons. If enacted, it can ensure that what has happened to the Hillsborough families will never happen again to any other families bereaved in a public disaster. Its provisions will change how we handle the aftermath of such events so that we can better enable families of the deceased and injured survivors to be central to what follows.​

    Families usually want two simple things: they want to know what happened to their loved ones, and why; and they want to stop it ever happening again to any other family. This does not seem like much to ask, yet it is striking how frequently bereaved families feel let down by the official processes and legal proceedings that follow disasters. This is not just the experience of the Hillsborough families, but of others I have helped in my time as an MP. The MV Derbyshire families fought for 20 years to get to the truth that it was design flaws, not alleged poor seamanship, that led to the sinking of the bulk carrier that killed their relatives. The Marchioness families, the Lockerbie families and others have all had real misgivings about the outcomes and conduct of inquiries and other legal proceedings. Perhaps such failings are continuing. I have seen reports that the Grenfell families and survivors have similar misgivings about what is happening in the aftermath of that catastrophe. Bereaved families feel alienated and excluded from processes to which they should be central. This is a common experience.

    There are clearly issues about adequate resources for bereaved families to be properly legally represented, but this Bill seeks to prevent things from going wrong at an early stage and then having to right them many years later, and it is separate from those issues about legal aid. It proposes the establishment of an independent, adequately resourced public advocate for those bereaved in public disasters and injured survivors. The public advocate would be located in a Government Department and able to call on its resources, but crucially they would be independent of Government decision, direction or control. The public advocate would be required to act if in that person’s opinion an event had occurred that led to large-scale loss of life and involved serious health and safety issues of failure of regulation, or other events of serious concern.

    Crucially, 50% plus one or more of the representatives of the deceased and injured survivors would have to ask the advocate to act in order for them to get involved. This gives the families agency and facilitates collective solidarity among them, and it puts their collective voice at the centre of the aftermath. The public advocate would then be a representative of the interests of the bereaved and survivors collectively and act as an adviser and guide for them. The public advocate would not replace solicitors and barristers acting in legal proceedings for the bereaved and injured, but would fulfil an additional role.

    The public advocate, as a data controller, would establish a panel, like the Hillsborough Independent Panel, in consultation with representatives of the deceased and survivors, to obtain and review all documentation at a much earlier stage than happened with Hillsborough, thus facilitating transparency and disclosure by way of reports to the Lord Chancellor and to Parliament. Such transparency was key to getting to the truth of Hillsborough, but it came 23 years after the event. Getting it done sooner could prevent things from going so wrong for those affected, facilitate openness and establish the truth at an early stage; and the families would be in the driving seat. This would be an important improvement to public policy in reaction to the frequent examples of things going wrong in the aftermath of public disasters. It is a simple and relatively inexpensive measure.​

    In the Queen’s Speech of 2017, the May Government promised to establish such an office, but nothing has been done beyond a consultation in December 2018. The results of that consultation have not yet been published, and I do not know what the current Government’s intention is, because I have only received holding replies to parliamentary questions about this since December 2018.

    The role of the public advocate set out in that consultation document is very different from that envisaged by this Bill. The public advocate envisaged by the Government consultation would not be independent. They would not be a data controller, they would not be able to act at the behest of families but would be directed by the Secretary of State, and they would not have the power to establish and appoint independent panels like the Hillsborough Independent Panel.

    I hope that Ministers will commit to establishing the role as envisaged by this Bill, because unless families have more agency and the public advocate is truly independent, it will not work. To be effective, the public advocate needs independence, the confidence of the families and survivors, and the ability to establish, as a data controller, an independent panel to require the production of documents and to report findings outside of the legal proceedings. These are the essential elements that will prevent the aftermath of future disasters from being made more traumatic for families and survivors, and that will put us on the path to preventing the Hillsborough families’ experience from ever being repeated.

    I feel well placed, after more than 30 years of knowing some of the Hillsborough families, and after 24 years of representing some of them as my constituents in this House, to promote this Bill as close as possible, in parliamentary terms, to the 31st anniversary of the disaster. I am proud that so many Merseyside MPs, who would have wished to have been here today, have agreed to sponsor the Bill and to support it in other ways, because Merseyside MPs understand the extent of the damage and the trauma that has resulted from Hillsborough.

    May I close by saluting the courage and heroic persistence and indefatigability of the families of those unlawfully killed at Hillsborough? I know many of them. They are exceptional people—not least because they would deny that they are exceptional. By the sheer force of their determination to defend the reputations of their lost loved ones, to get truth, justice and accountability for those who were killed, to bring ease and peace to the traumatised survivors, they have won through. And backed by the people of the Liverpool city region, they have shown up the great injustices perpetrated on the innocent by the indifference and hostility of some of our official processes. I believe that this Bill, if enacted, will go a significant way towards preventing what has happened to them from ever happening to any other families in the future—something they fervently wish to see. As they end the big public commemorations on the anniversary of the disaster, it would be a fitting legacy for their efforts if they could help to ensure that what has happened to them never happens again to families who are bereaved in public disasters. This Bill would, I believe, do that. I commend the Bill to the House.

  • Lindsay Hoyle – 2020 Speaker’s Statement on a Virtual Parliament

    Lindsay Hoyle – 2020 Speaker’s Statement on a Virtual Parliament

    Below is the text of the statement made by Lindsay Hoyle, the Speaker of the House of Commons, on 22 April 2020.

    Yesterday, the House agreed to a motion to allow Members to participate virtually in proceedings of the House, for the first time in 700 years of history of the House of Commons. I would like to welcome everyone, both Members joining us remotely from their constituencies up and down the UK, and Members here in the Chamber, to the first hybrid sitting of the House of Commons. I thank hon. Members who are present in the Chamber for continuing to observe the guidance that has been issued about social distancing, in relation not only to each other, but to the staff of the House who are in the Chamber, and indeed myself.

    Before we begin, I want to place on record that parliamentary privilege applies on the same basis to all Members participating, regardless of whether they are contributing virtually or are present in the Chamber. Also, of course, the same rules and courtesies apply to Members participating virtually, as far as is practicable, as they do to the Members participating physically. Members present in the Chamber should not rise in their places to catch my eye but wait to be called, although they should then stand to speak—if they are in the Chamber.

    We will begin with questions to the Secretary of State for Wales. I will call each Question and ask the Secretary of State to respond before calling the Member. I first call the Minister to answer the substantive Question tabled by Marco Longhi, whose birthday it is today.

  • David Ennals – 1978 Statement on the NHS

    David Ennals – 1978 Statement on the NHS

    Below is the text of the statement made by David Ennals, the then Secretary of State for Social Services, in the House of Commons on 2 November 1978.

    I welcome the opportunity of today’s debate on the Gracious Speech to review the state of the National Health Service and to discuss its problems. No public service is held in higher regard than the National Health Service. It has within it men and women of high skill and dedication. None is held in higher esteem than the nurses—and I speak from experience, having had five weeks as a patient in an NHS hospital this summer.

    I believe that much of this respect is due to the basic principles on which the National Health Service is based—namely, a service for everyone, paid for by everyone, free at the point of delivery.

    Today’s debate provides an opportunity for the Government to set out their policies and aims. There is today concern about the state of the NHS. I hope that the Opposition, having chosen this subject, will give the House and the country some straight answers to some straight questions.

    There are three main areas of concern that worry patients, staff and the public generally. First, there is the problem of resources and the priorities for using them. Secondly, there is the bureaucracy in the NHS and the reorganisation carried out by the Conservatives. Thirdly, there are the difficulties over industrial relations ​ and pay, and the alarming effects that industrial action can have in our Health Service.

    I propose to deal with these three areas in turn, starting with resources and priorities. The needs for more cash and more staff in the NHS are plain for all to see. There are increasing demands on the service from growing numbers of elderly people.

    There are new methods of treatment for conditions that would have gone untreated only a few years ago. We have long waiting lists—now sadly longer still. There is a backlog of old, inadequate hospitals and the inheritance of an unfair share-out of health funds and facilities across the country. There are not enough staff, cash or facilities for our geriatric wards or our mental illness hospitals or our hospitals for the mentally handicapped. There is the need to cut still further the number of babies who die at or shortly after birth, and to reduce to a minimum those born handicapped.

    There is also the need for a further improvement in community care, and better primary care, particularly in inner cities. The list could go on. I said at the Labour Party Conference that I had the longest shopping list in the business. I have recognised—I think that we all do—the pressures on the Service, the strain on staff of all kinds, and the suffering of patients who have to wait too long for treatment or face unsatisfactory conditions—let us face it—in some of our hospitals.

    That is why we are planning to spend this year £120 million more in real terms on the NHS than we did last year. The £50 million Budget boost is only now beginning to show results. We have seen the opening of modern new hospitals in, for example, Newcastle, Northampton, Oxford and elsewhere. There has been the recruitment of more staff—especially nurses—and the provision of more resources for the Cinderella services. There is more home dialysis for kidney patients. This is beginning to happen.

    In addition, we have made provision in the Gracious Speech for a scheme of payments for those seriously damaged by vaccination—a problem which has caused great concern in this House over many years. I am proud that it was this Government who responded to that ​ concern. Legislation to cover the scheme of payments will shortly be introduced and will, I hope, have the support of the whole House.

    We are now spending about £8 billion a year on our health and personal social services, an increase from 4·7 per cent. of GNP in 1973 to 5·7 per cent. on the latest available figures. What is more, we are spending this money in accordance with a clear set of priorities, worked out after careful discussion. We are pressing ahead with a steady programme to achieve a fairer share of health funds across the country. That means that while programmes are held back in some regions, particularly in the Thames regions, areas of greatest need in the North, North-West and the East Midlands are seeing very rapid growth. I am sure that that principle is right and should be supported by the House.

    We are giving the Cinderella services for the elderly, the mentally handicapped and the mentally ill a higher priority.

    The House will know that during the recess there have been two important developments in these areas. First, the Government published a White Paper on our review of the Mental Health Act in which we propose new safeguards in the treatment and detention of mental patients and other reforms. Secondly, the National Development Group reported to me on “Helping Mentally Handicapped People in Hospital”, and I have made a statement setting out the Government’s proposals for further improving the quality of care for the mentally handicapped.

    The Cinderella services and geographical redistribution of funds are two of our key priorities. A third is a shift towards prevention. My hon. Friend will have more to say on this subject, especially in relation to perinatal mortality. I hope soon to announce some further initiatives, building on the much improved figures for perinatal mortality of the past few years.

    The Gracious Speech stated:

    “Fresh support will be given to enable the National Health Service to fulfil and extend its services to the public.”

    The Government have a firm commitment to strengthen and develop our National Health Service. We have made it plain that, as the economy improves, it will be possible to devote more resources ​ to the services. We have given practical effect to that commitment twice in the past year, in the November and April measures.

    The House will, of course, have to await announcements at the appropriate time on the Government’s plans for public spending in the period ahead, but there will be an increase in resources available for 1979–80, compared with figures in the last White Paper. It will give us some more room for manoeuvre and will, I am sure, be warmly welcomed in the country, especially by those working in the Service.

    We shall stick to our agreed priorities, and I hope to announce additional resources to help meet the needs of the elderly, to assist mentally-handicapped children, to assist disadvantaged groups, particularly in areas of high mortality, and to make some contribution to the assault on the long waiting lists.

    I have set out the Government’s priorities on resources and the way in which they will spend them. The House and the country will also wish to know where the Conservative Opposition stand. Let us start with the issue of spending on the Health Service. A few months ago, the right hon. Member for Wanstead and Woodford (Mr. Jenkin) was quite clear. He said that a Conservative Government would adopt the projections in last February’s White Paper on public expenditure. His actual words were

    “We have to live within that, and there is no possibility of extra money.”

    What could be plainer than that? And that was after the Budget injection of £50 million. He was saying that under a Tory Government there would not have been that £50 million boost and there would not be any further increases beyond the figures in the White Paper.

    I hope that the right hon. Gentleman will confirm that that is the dismal prospect facing the NHS if the Tories, by misadventure, were to be returned to power. [Interruption.] If the hon. Member for Reading, South (Dr. Vaughan) doubts that, his right hon. Friend will have an opportunity of dissociating himself from his own quoted statement.

    The subject of resources raises, I believe, two further issues—charges and the Tory plan to shift to an insurance ​ basis of finance. When we last debated the National Health Service in this House, I put a number of questions to the right hon. Member for Wanstead and Woodford. He refused absolutely to answer them. So, having got no way at all with the monkey, I went to the organ-grinder. In order not to confuse the public and the House about who really is the Leader of the Opposition, I should explain that when I use the term “organ-grinder”, I do not mean the organist. I am referring to the right hon. Member for Finchley (Mrs. Thatcher) and not to the right hon. Member for Sidcup (Mr. Heath). In any event, I got no reply. So I shall put the questions again, and give the right hon. Member for Wanstead and Woodford the chance to answer them.

    How much would a Tory Government put on the prescription charge? Will the Tories introduce a new charge for seeing a GP? If so, how much? Will they bring in so-called hotel charges for staying in hospital? If so, how much? Will they bring in a new insurance-based system of finance? If so, will there be different levels of service for different levels of premium, and will there be separate premiums for each member of the family, with extra to pay for the children? When will the Tories publish the Vaughan report on charges? We have had a lot of open government. It is about time we had a little open opposition.

    These are fair questions. I warn the right hon. Member for Wanstead and Woodford that he cannot get away—as he did once before—with saying “We are waiting for the views of the Royal Commission.” He is quite happy to tell us in detail what he wants to do about the organisational structure of the NHS without waiting for the Royal Commission—and that is purely technical matter. This is a matter of deep principle. He does not need the Royal Commission to tell him where his principles lie—or I hope he does not. Let us see what he has to say.

    While he is about it, I hope the right hon. Gentleman will spell out where the Conservative Party stands on the issue of queue-jumping. Where does it stand on common waiting lists for private and NHS patients in NHS hospitals? The Government’s position is plain. While pay beds are being phased out, we believe ​ that those who pay should not be able to jump the queue for treatment. That is why I made proposals in the summer for the implementation of common waiting lists. The hon. Member for Reading, South leapt up and sharply criticised this policy. The issue is all the more important since, as we understand, the Tories want to bring back more pay beds. So I ask the question today: do the Tories support common waiting lists, or are they now openly in favour of queue-jumping? I hope we shall hear an answer to that question from the right hon. Member for Wanstead and Woodford.

    I also hope that, instead of carping criticism, we shall get from the Opposition some recognition of what has been achieved by this Government and those who work in the Health Service. The fact is that, in spite of all the difficulties and the financial restraints, we have more and more staff treating more and more patients. The facts speak for themselves. I am comparing the position in 1977 with that in 1973, the last full year of the Tory Administration. The number of inpatients treated is up by 213,000 to 5,345,000—an all-time record. The number of day-patients is up by 123,000 to 532,000—again a record. The number of medical staff is up by 14 per cent. The number of nurses and midwives is up by 12 per cent.

    In spite of these achievements, waiting lists remain very long, with all the pain and the suffering that means for patients. This is one of the many problems we face in the National Health Service. We have a great deal still to do. But let us take a balanced view and recognise not only the tasks ahead but the real achievements of the many dedicated people who work in the Service.

    I have dealt with the first area of public concern: resources and priorities. I turn now more briefly to the second: the organisation and structure of the National Health Service.

    There is no disguising the very widespread concern over the reorganisation that the Conservatives foisted on the Service four years ago. The public believe—no one doubts it—that there is too much bureaucracy, that the machine is insensitive to the needs of patients and staff and, perhaps especially, that decisions are sometimes taken too far away from the patients themselves.

    I know that the right hon. Gentleman likes to wax eloquent on this last point—he makes speech after speech—but it is a little difficult to take seriously what he and the right hon. Member for Leeds, North-East (Sir K. Joseph) have to say on this matter. Somehow or other they talk as if they had no responsibility for it at all, as if somehow the situation that they are graphically describing is the responsibility of the Labour Government. But they are responsible for it—they and they alone. It was their pet scheme and it was vigorously opposed by Labour when we were in opposition. We knew that they had it wrong. But now they are coming forward with yet another Tory blueprint. The right hon. Gentleman’s party is coming forward with a new blueprint for the reorganisation of the NHS. I ask whether you, Mr. Speaker, would buy a second-hand reorganisation from the men who planted the first one upon us.

    My right hon. Friend the Prime Minister, in his speech to the Labour Party conference, made clear that this Government intend to make decision-making more democratic in a number of spheres of life. In the light of the views of the Royal Commission on the NHS, we are determined to make the Health Service more responsive both to those who use it and to those who work in it. As the Prime Minister made clear, we shall not take major steps on this before we have had a chance to consider the views of the Royal Commission that will be reporting to us early next year.

    This is in stark contrast to right hon. Members on the Opposition side. They are so embarrassed by what they have done that they are falling over themselves to suggest new remedies. I believe that in their haste they seem to be seeking to impose yet another rigid, ill-thought-out pattern upon the Service. Frankenstein may be dissatisfied with his first monster so he is helpfully making another. Let the public be warned.

    Mr. Stanley Newens (Harlow)

    Is it not a fact that one result of the dreadful structure which has been imposed by the present Opposition on the Health Service is not only bureaucracy and administrative waste but the diversion of too many resources from patient care to administration? Ought we not to be seeking some reorganisation which will put more of ​ the money which goes into the Health Service into patient care?

    Mr. Ennals

    That is absolutely right. Until we can carry out the changes that we need—because the burden of bureaucracy must be reduced—we have to see what we can do right now. I advise right hon. Gentlemen that we are first cutting down on management costs which, as my hon. Friend said, result directly from the reorganisation for which they were responsible. In the past two and a half years we have cut out nearly 3,000 administrative posts and at the same time we have seen the number of doctors and nurses increasing. As a result, this year we have been able to release about £13 million for patient care. In a sense, this is a form of organic change. As for districts, we are also looking at the structure at local level to see how we can meet local needs. I have already given approval for four area reorganisations and there are several others in the pipeline. We are making savings on fuel, supplies, drug costs and the rest. My hon. Friend is absolutely right. These are the issues on which we are concentrating.

    That brings me to the third and final area of concern for the Health Service—the problems of industrial relations, pay disputes and industrial action. That is perhaps the most immediate area of concern for the public generally. In fact, the last time this House debated the National Health Service—it was at a time when I was in hospital and could not be here—it was about industrial relations in the Service.

    As patients see only too clearly, the real damage that can be caused by industrial action is the lengthening waiting lists, postponed operations, real problems for staff morale and all the rest. It is in times of internal conflict that the NHS sometimes gives the appearance of having too many warring factions rather than being a united team. The right hon. Member for Wanstead and Woodford will understand what I mean by that. The difficulties are enormous.

    There are no easy answers to problems of pay. Many other disputes can blow up, and they blow up locally. We have all been greatly alarmed by the recent works supervisors’ dispute and by ​ troubles in particular hospitals. There may be more difficulties ahead as we enter the pay bargaining season.

    What judgment can we pass on the use of industrial action in the National Health Service? In 1973 it was the ancillaries who used it, in 1975 it was the doctors, and in 1978 the works supervisors. Some people have attacked industrial action within the NHS as part of a general attack upon the trade unions. That is absolutely unfair.

    I pay tribute to the commitment of the leaders of the Health Service unions to the Service and the interests of patients.

    Can we—as some people suggest—impose a requirement that because they work in the Health Service they should forswear the normal rights of trade unionists? I believe that that would be unrealistic. Most organisations—and I suspect that they include the British Medical Association—would not agree to have their hands tied. Of the three areas of concern being discussed today, I think that this is the one in which Tory hypocrisy is at its worst.

    Mr. Eldon Griffiths (Bury St. Edmunds)

    Before the right hon. Gentleman continues his attacks, may I say that the vast majority of people who work in the Health Service at all levels hate the idea of strikes against patients? They do not like it any more than we do.

    Would the right hon. Gentleman consider at least what was done in the recent police pay settlement, when the police agreed to continue to give up the right to strike but were compensated by an inflation-indexed pay increase and machinery to maintain it? Large numbers of doctors and nurses and other members of the National Health Service have written to me saying that they would like such a deal to be tried out in the Service.

    Mr. Ennals

    I suppose that many people would say that they were prepared to make some sacrifices if they were given 25 per cent. extra pay. I can see that prospect winning a battle across the country.

    I want to come on to the inflationary consequences, because we cannot totally exclude the National Health Service from this Government’s battle against inflation, as the hon. Gentleman seems to think we can. I believe that those who ​ choose to work in the NHS have a very special responsibility to those they serve and to sick people. A hospital is not like a factory complex. Human health and lives are at stake. It cannot be right to put human lives at risk and to cause suffering as an indication of industrial muscle. We must find a better way. We must get our procedures right. We owe it to the Health Service workers and to the patients. Let us look at what we can do in a serious way.

    I believe that there are two distinct problems. First, there is the question of pay and conditions of service, matters dealt with in the Whitley Council machinery. Secondly, there are the disputes that blow up locally—rows about the duty roster, the level of staffing on a ward, where someone parks his bicycle, or a clash of personalities. If they are not tackled, these problems fester and eventually erupt into industrial action, with all that it involves for patients, and all the publicity and effect upon morale.

    That is why earlier this year I brought together round my table the general secretaries of the main Health Service unions, the chairman and secretary of the British Medical Association council, the chairman of the Conference of Medical Royal Colleges and the secretaries of the Royal Colleges of Nursing and of Midwives, together with a representative of the Trades Union Congress and a representative of management. It was the first time that such a meeting had ever taken place in the lifetime of the National Health Service. As a result, I was able to put forward concrete proposals only last week for a new disputes procedure in the National Health Service. This up-to-date procedure is designed to settle disputes quickly at the local level where they arise. The general Whitley Council is now considering these proposals, and I hope that it will embody the essential features in an agreement that can be put into effect as soon as possible throughout the NHS.

    This is a practical down-to-earth initiative that I hope will cut to a minimum the number of avoidable local disputes. I was impressed by the extent to which the leaders of the professions and the unions came together and hammered out something that they could all support.

    ​The Opposition are always quick to criticise whenever they see the chance, but let us remember that when they had responsibility for these matters, they did absolutely nothing. Now they draw on their great reservoir of imagination and come up with fanciful ideas of a patients’ charter. I hope that the right hon. Member for Wanstead and Woodford will tell us about it. It sounds good. What does it mean? How will it work? I hope that it is more sensible than the right hon. Gentleman’s best known proposal that we should brush our teeth in the dark. At least I can understand that, and perhaps he will enable me to understand his ideas for improving industrial relations in the National Health Service. We are talking about industrial disputes. The Opposition’s attitude to disputes about pay is equally unconstructive. They did nothing to be proud of when they were in office, but they are quick to make capital out of any difficulties that we have.

    Mr. David Crouch (Canterbury) rose—

    Mr. Ennals

    I would have preferred to give way later to the hon. Gentleman. However, as I know he takes a great interest in this matter, I shall give way now.

    Mr. Crouch

    I wish to intervene only on the matter of pay policy. The Secretary of State told us that he had a meeting recently when he called together the representatives of the responsible trade unions operating in the Health Service. Do they appreciate that not only do they operate under the Cabinet’s pay policy so strongly advocated by the Prime Minister, but they also operate under the cash limits that fall on his Department? If they take more than the pay policy limits allow, it will be a matter of robbing Peter to pay Paul. Did he make that clear to them?

    Mr. Ennals

    The conference that produced this initiative on local disputes was dealing specifically with non-Whitley-Council-type disputes. I believe that there may be merit in inviting the same group of people to meet to see whether we can improve methods of dealing with the types of disputes that affect Whitley Council ​ issues. I shall cone to the main issue—the question of the supervisors—in a moment.

    In the case that we have been discussing, the machinery is not the real issue. The real issue is what sort of pay rises various groups of NHS staff are seeking and what they can be given. Here, not only the question of cash limits but the question of pay policy is crucial.

    I must comment briefly on two recent matters of concern—the supervisors’ dispute and the worries expressed about the pay and morale of nurses. I deal first with the dispute.

    I have no doubt that the House will have shared my great anxiety about the effect of the recent dispute on waiting lists and the very real risk to patients. Happily, a settlement has been reached with the help of the good offices of the general secretary of the TUC—and the House will, I know, be grateful to Mr. Len Murray for his most helpful initiative.

    I have no wish to rake over the coals. But there have been suggestions that this dispute could have been settled weeks earlier if Ministers had wished, suggestions that the issue had nothing to do with pay policy, and suggestions that the Government finally accepted a deal that I had said earlier was not on. All these suggestions are false.

    Ministers intervened on a number of occasions in efforts to settle the dispute. It was at my request that ACAS made an attempt to conciliate after talks had broken down. What was really being suggested by some critics of the Government was that we should simply have given the staff concerned all that they were demanding—regardless of pay policy and regardless of cash limits and the consequences for other groups of staff. It was a sure recipe for further disputes and further industrial action in the NHS. Pay up and hang the consequences seemed at one stage to have been the attitude of the hon. Member for Reading, South in a statement that he made. No doubt he or his right hon. Friend the Member for Wanstead and Woodford will tell us the purpose of his intervention at that time, if that was not it. I suppose that is what he wanted.

    Mr. Doug Hoyle (Nelson and Colne)

    Does not my right hon. Friend agree that this dispute was not connected with pay policy but was a hangover from the reorganisation that should have been settled much earlier?

    Mr. Ennals

    No. Let me spell it out. It is most important that the House should understand. Of course it was not a straight issue of whether the pay claim was above 5 per cent. This dispute was not about annual pay settlements. It was about a genuine regrading of staff.

    There were two very important issues of pay policy. First, the Government had to be satisfied that the new salaries offered for the new posts were commensurate with the job descriptions. On this basis, we approved the salary scales that had been offered by the management side several weeks before. The rejection of that management offer was the start of the supervisors’ action. Happily, six weeks later, after the disruption in the Service, they accepted precisely the same salary scales that they had rejected.

    Secondly, we had to be satisfied that any improvements to the supervisors’ productivity allowances were genuinely self-financing. That condition is met in the agreement reached last wek. Bonus payments are clearly subject to the financial viability of the scheme.

    During the negotiations, the staff side was demanding a minimum—I repeat minimum, because it was from 15 per cent. up to 30 per cent.—of 15 per cent. allowances for all supervisors regardless of whether they were involved in productivity schemes and regardless of whether the schemes were saving enough money to cover the costs. I said that that was not on. Productivity deals must be genuinely self-financing. I have stuck to that position. The agreement reached last week is entirely consistent with it. The 15 per cent. allowances provided for will not be an unconditional minimum available to all, regardless of membership of schemes and their viability. All supervisors will now have the opportunity to participate in schemes, but the allowances paid, which we hope may reach 15 per cent. six months after schemes are initiated locally, will depend upon the financial viability of the schemes. That is the crucial point. I am glad that the unions were able to ​ accept it. Until they did, no settlement was possible.

    The other subject that I have to mention is the morale and pay of nurses. I recognise the great pressure that nursing staffs are under, particularly during industrial action by other groups when, in a sense, nurses have to pick up the tabs and carry on seeing that patients are cared for. I think that the House will join me today in expressing the country’s deep feeling of thanks to the nurses and to other staff who did so much to maintain the services during that very difficult and, I believe, tragic period.

    Nurses are under stress for many other reasons. There has been a steady increase in the number of nurses working in the National Health Service. It has doubled in 30 years. There has been an increase in the proportion of trained nurses. But they are under very great pressure. I know that from my own experience in hospital. The number of patients increases, the period that an in-patient stays declines, and inevitably the amount of attention that each patient needs increases. As more patients are elderly, they make heavier demands upon the nurses. The nurses need to master new skills.

    I am very glad that we have managed to include in the legislative programme a Bill to establish a new, unified structure for the regulation, discipline, education and training of nurses, midwives and health visitors. This structure will comprise a United Kingdom central council and four national boards, one for each country of the United Kingdom, with supporting specialist committees which will replace the existing statutory and non-statutory bodies. For heaven’s sake, the nurses have been waiting for a long time for this.

    Mr. Laurie Pavitt (Brent, South)

    Since 1972.

    Mr. Ennals

    We can go back to 1974 at least, when my right hon. Friend the Member for Blackburn (Mrs. Castle) announced the Government’s acceptance of the main recommendations of the Briggs report.

    I am pleased to say that we can now start moving forward. I know that many nurses will welcome this, but that they ​ will also say that their pay has fallen behind. They have asked me to look at their position in the light of the “special case” provisions in the White Paper. The question of nurses’ pay is one that will have to be looked at by the Government in the light of our declared policy on pay as set out in the White Paper.

    I hope that Conservative Members will not seek to make capital out of this matter. With their record on nurses’ pay, they have nothing to be proud of. What did they ever do about it when they had the chance? It was a Labour Government who raised nurses’ pay by 20 per cent. in 1970—I know because I was a Minister in the Department at that time—and it was a Labour Government who gave nurses a further boost of 30 per cent. in 1974 following the Halsbury report. And what happened between 1970 and 1974? Nothing—because we had a Tory Government.

    In the months ahead we face many difficult problems over pay in the National Health Service. I hope that they can be resolved without industrial action. As I have said. I deplore any industrial action in the NHS that puts patients at risk. I hope to explore, with leaders of the profession and the unions, what scope there is for avoiding such action in relation to pay disputes. But to those who say that industrial action in the Health Service must be avoided simply by giving in to whatever demands are made, I give this reply. Of course we must see, within the scope of what is economically possible, that justice is done to the staff. But merely to give in to all demands is the road to anarchy, in the Health Service itself and in the wider pay context.

    I repeat what my right hon. Friend the Prime Minister said yesterday. This Government are not prepared to take that road. Here we see one of the great divides that is opening up in British politics today. The Conservative Party is taking up a series of extreme positions, on the NHS and on the economy. After 30 years of bipartisan approach to the principles behind the NHS, the Tories seem to be showing their true colours. They seem ready to tax the sick with new and heavier charges.

    Dr. Gerard Vaughan (Reading, South)

    Rubbish.

    ​Mr. Ennals

    I am glad. In that case the hon. Gentleman will be able to assure us that it is rubbish and that that part of the Tory programme has been set aside. That will be a great relief for the whole country. I shall see whether we can get some more cries of “Rubbish.” The Tories are committed to a two-tier Health Service. No “Rubbish”? We shall see. The right hon. Member for Leeds, North-East seems to know what it is, because he has been putting forward the idea himself, as have the right hon. Member for Wanstead and Woodford and the hon. Member for Reading, South. They do not know what it means. Perhaps they cannot spell it out; perhaps they do not understand their own proposals. But the moment will come in a minute for the right hon. Gentleman to explain.

    The Tories are committed to massive cuts in public spending which cannot fail to hit the health and personal social services. No doubt the right hon. Gentleman will speak of that. They are also in favour of a free-for-all approach to wages, which would send inflation through the roof. If they restrain pay at all, it will be in the public sector only, so that nurses and other Health Service workers will again have to bear the brunt of rising prices. That is the Tory prescription, not only for the economy of the country but for the National Health Service. The contrast between the positive achievements and the positive programme, of this Government and what the right hon. Gentleman and his hon. Friends have to offer is patently obvious.

  • Jonathan Ashworth – 2020 Speech on the Coronavirus

    Jonathan Ashworth – 2020 Speech on the Coronavirus

    Below is the text of the speech made by Jonathan Ashworth, the Shadow Secretary of State for Health and Social Care, in the House of Commons on 22 April 2020.

    I am grateful to you, Mr Speaker, for making the arrangements for us to be able to participate in these circumstances. I thank the Secretary of State for advance sight of his statement.

    My thoughts are with all those who have lost their lives to this horrific virus. I pay tribute to the NHS staff who have lost their lives. I hope that, when this is over, we can find an appropriate way to remember the frontline NHS staff who gave their lives for all of us. May we also remember those social care staff who have also lost their lives? Will the Secretary of State tell us the actual number of social care staff who have sadly died? The First Secretary did not have those figures at his fingertips a few moments ago.​

    It looks like we are heading for one the worst death rates in Europe. The Government have been careful to always say that they are following scientific advice. Will the Secretary of State tell us the explanation from the Government’s scientists for why our death rate seems so poor when compared with Germany’s, for example? Will he undertake to publish the Scientific Advisory Group for Emergencies’ minutes, which have not been published? Will he also undertake to publish the evidence on why we are following a seven-day rule for isolation? That appears to contradict the World Health Organisation, which suggests a 14-day rule for isolation.

    As the virus develops, we see that, while it attacks the respiratory system, it also attacks cells throughout the body with ACE2 receptors, leading to cardiovascular and renal failure. In the same way that the Secretary of State can convene SAGE and other committees, will he convene the clinical societies so that we can share understanding of the disease among clinicians regarding how best to treat the disease as research emerges?

    I am sure that the Secretary of State is struck, as I am, by the high proportion of deaths among black, Asian and minority ethnic communities. We see that in the United States, too. He has launched an inquiry. Will he update the House on that and tell us when it will report?

    I am sure the Secretary of State is as horrified as I am by the deaths in care homes and nursing homes. This was always a high-risk sector, which is why we have long called for a social care strategy. Will he undertake to do four things? Will he ensure that all deaths are recorded on a daily basis?

    The CQC suggested today that the death rate in care homes is double what was reported by the ONS yesterday. Can he ensure that testing for staff is delivered in care homes at local NHS sites or by mobile units? It is clearly ludicrous to expect care workers to travel for miles and miles to drive-through testing centres. Can he ensure that PPE supply systems for the NHS are expanded to the social care sector as well? The Secretary of State said in the past that the NHS will get whatever it takes. Will the social care sector now get funding to cover the huge costs that it is facing, which are associated with increased staffing levels and PPE? I join him in praising the leadership of the NHS for what it has done.

    The Secretary of State gave us the critical care figures. How many general and acute beds are currently empty in the NHS? If there are significant numbers of empty beds, could they be used for social care residents, or to start a return to elective surgery? We know that the lockdown is having an impact on people’s wider health. Cancer patients are going without treatment, and we know that elective waiting lists will rise. Can he tell us the latest estimates how high he thinks those lists will rise? There are also bound to be mental health problems associated with the lockdown.

    Many people are understandably angry that front-line staff do not seem to be getting PPE on time, and we do not seem to have taken part in some of the European procurement projects. The Chancellor of the Duchy of Lancaster said that was because we missed an email. The Secretary of State said that we are now part of that project, but that prompts the question of why we were not part of it at the beginning. The senior civil servant at the Foreign Office said it was a political decision. ​Will the Secretary of State tell us exactly what went on? Will he publish the background briefing so that we can see exactly what happened?

    Finally, I agree that testing and contact tracing are vital to coming out of a lockdown. The Secretary of State talked about wanting to upscale contact tracing, but that is very labour-intensive. Can we use the 750,000 volunteers who have signed up to do some of that contact tracing? The app that he mentioned is welcome. When will it be available? Is he proposing that it will be mandatory, or will it be voluntary? If it is voluntary, how will we ensure that it is taken up by the population? Will he comment on reports today that the PCR test, which has been used for some NHS staff, returned false results and that those staff had to be tested again? How many people have been affected by that? What is now in place to ensure that that does not happen again? If the Secretary of State cannot answer all those points today, I hope that he will write to me with the details at a later point.

  • Matt Hancock – 2020 Statement on the Coronavirus

    Matt Hancock – 2020 Statement on the Coronavirus

    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 22 April 2020.

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

    First, may I say how pleased I am that the House is sitting once again? At this important time, it is critical that we have the scrutiny and debate that the House provides. I thank everybody who was involved in setting up the new arrangements, which demonstrate that no virus or threat will thwart our democracy.

    Coronavirus continues to spread throughout the world. The latest figures show that 17,337 people have sadly died here. Our hearts—the hearts of the whole House—go out to their loved ones. I know that across the House we are united in our determination to fight this virus with everything we’ve got; today I want to update the House on each part of our battle plan.

    First, on the resilience of the NHS, I can tell the House that for the first time we now have over 3,000 spare critical care beds in the NHS. That is more than three times more than we had at the start of this crisis. It is thanks to the incredible work of an awful lot of people that we now have this extra spare capacity, even before we include the new Nightingale hospitals. Over the past two weeks, I have been lucky enough to attend, either in person or virtually, the opening of four of these new Nightingales—in London, Manchester, Birmingham and Harrogate—and there are several more to come, all across the UK, including in Belfast, Glasgow, Cardiff, Exeter and Sunderland. These incredible efforts from dedicated staff, supported by our armed forces, mean that our NHS has not at any point been overwhelmed by coronavirus. Some said this would be impossible.

    Today I want to reinforce the message that non-covid NHS services are open for patients: the NHS is there for you if you need advice and treatment. I want to address that message very clearly to those who might be vulnerable to heart attacks or stroke, to parents of young children, to pregnant women and to people with concerns that they may have cancer. I want to emphasise that people with non-coronavirus symptoms must still contact their GP. If you think you need medical help, please contact your GP, either online or by phone, to be assessed. If you need urgent medical advice, use NHS 111 online; if you cannot get online, call 111. And, of course, if something is serious or life-threatening, call 999. If you are told to go to hospital, the place you need to be is in hospital. The NHS is there for you and can provide the very best care if you need it.

    The second part of our battle plan is on supply and working to boost supplies of core equipment. The full weight of the Government is behind this effort. Again, we have brought in the armed forces to help us to meet this demand. This includes ventilators—both purchasing extra stock and increasing the production of new ones. We now have record numbers of ventilators, with 10,700 available for use for patients. This also includes medicines, so that we can make sure everyone has access to the supplies and treatments they need, and of course it ​includes personal protective equipment, too. In normal times, the NHS PPE supply chain supplies 233 hospital trusts. Currently, 58,000 separate health and social care settings are being supplied with PPE, so we are creating a whole new logistics network from scratch, and we have some of the best minds in the country working on this.

    I am grateful to colleagues from the NHS, Public Health England, the Crown Commercial Service, the Cabinet Office, the Ministry of Housing, Communities and Local Government, the Ministry of Defence, the armed forces—again—the devolved Administrations, territorial offices, the Department for Business, Energy and Industrial Strategy, the Treasury, the Foreign Office and the Department for International Trade, because they are all playing their part. Last week, I appointed Lord Deighton, who delivered the Olympics, to a new role in driving forward PPE manufacturing here.

    Since the start of this crisis, we have delivered over 1 billion items of PPE. We are constantly working to improve the delivery system and buying PPE from around the world. We are also working to make more at home, and I would like to thank the UK businesses that have generously come forward with offers to turn their production lines to this national effort. I also thank Members from across the House who have put us in contact with businesses in their constituencies. We are actively engaged with over 1,000 companies who buy from abroad and are working with 159 potential UK manufacturers. We have a rigorous system of verifying the offers that we receive, because not all offers have been credible and it is important to focus on the biggest, most credible offers first. This work is crucial so we can get our NHS and care staff the kit they need so that they can do their job safely and with confidence.

    The third part is to scale up testing. I have set the goal of 100,000 tests a day by the end of this month, and I am delighted to say that the expansion of capacity is ahead of plans, even though demand has thus far been lower than expected. We are therefore ramping up the availability of this testing, expanding who is eligible for testing and making it easier to access the tests. The tests are conducted in NHS hospitals, and through our drive-through centres, mobile units and home deliveries. These tests are then sent to laboratories. We have completed the construction of three Lighthouse Labs in Milton Keynes, Glasgow and Cheshire. Each site took just three weeks to complete and begin testing.

    As we have reached the peak and as we bring the number of new cases down, we will introduce contact tracing at large scale. The introduction of the new NHS app for contact tracing is also in development. As we do this, we are working closely with some of the best digital and technological brains, and renowned experts in clinical safety and digital ethics, so that we can get all this right. The more people who sign up for the new app when it goes live, the better informed our response will be and the better we can therefore protect the NHS.

    Fourthly, we need to make sure that we make the best possible use of science and research to pursue the vaccines and treatments that are essential to defeat the virus once and for all. Here, the UK is at the forefront of the global effort. We have put more money into the global efforts to search for a vaccine than any other country, and yesterday I announced over £40 million of funding for the two most promising UK projects—at Imperial ​and Oxford. The vaccine from the Oxford project will be trialled in people from tomorrow, and I am sure that the whole House agrees that that is a very promising development. I repeat what I said yesterday: in normal times, reaching this stage would take years. The innovative groups of people at both the Jenner Institute in Oxford and the regulator, the Medicines and Healthcare Products Regulatory Agency, deserve our special praise. They are ensuring that the process is safe, yet conducted probably more rapidly than ever before. They deserve the support of the whole House in that work. At the same time, we will invest in manufacturing capability. If either of those vaccines works, we must be able to make them available for the British people as soon as humanly possible.

    The fifth measure that I will talk about in the time available is the one in which everyone can play their part: social distancing. I want to thank everyone across the country for their steadfast commitment in following the rules, including in this House. It is making a difference. We are at the peak. But before we relax or make changes to any social distancing rules, we have set out five tests that need to be met: first, that the NHS can continue to cope; secondly, that the operational challenges have been met; thirdly, that the daily death rate falls sustainably and consistently; fourthly, that the rate of infection is decreasing; and fifthly, and most importantly, that there is no risk of a second peak.

    Finally, we are working to protect the most vulnerable through shielding—this is the sixth part of our battle plan. There has been a huge effort across Government to contact and support those at risk. We have been boosted by the support and help of the heroic NHS volunteer responders, who signed up in droves within two days of our call to action. An unbelievable 750,000 people put themselves forward for this initiative. With those volunteers, and with the support of the Ministry of Housing, Communities and Local Government, the NHS and local councils, which have done amazing work on this, we are shielding the most vulnerable.

    These are unprecedented times for us all. We have all seen the extraordinary impact of coronavirus in our constituencies and across the country. And even though today we are physically separated, the House is at its best when we are united in our purpose and our resolve. I will keep working with Members from right across the House in the fight against this invisible killer. This may be akin to a war, but it is one where the whole of humanity is on the same side. I commend this statement to the House.