Tag: 2021

  • Nick Thomas-Symonds – 2021 Comments on Collapse of Hillsborough Trial

    Nick Thomas-Symonds – 2021 Comments on Collapse of Hillsborough Trial

    The comments made by Nick Thomas-Symonds, the Shadow Home Secretary, on 26 May 2021.

    The collapse of this case is devastating for the families of all those who lost loved ones at Hillsborough, everyone who was there on that tragic day and all those who have spent the last 32 years campaigning for justice for the 96.

    Five years on from the inquest that ruled fans were unlawfully killed, this shameful injustice cannot go on. It’s completely unacceptable that no successful criminal charges have been brought against any individual. The Hillsborough Law must be introduced, without further delay, to ensure proper transparency and accountability. Change is also needed – desperately – to ensure victims of injustices get the support they need.

  • Nick Thomas-Symonds – 2021 Comments on Dominic Cummings

    Nick Thomas-Symonds – 2021 Comments on Dominic Cummings

    The comments made by Nick Thomas-Symonds, the Shadow Home Secretary, on 26 May 2021.

    This admission is absolutely devastating for the Prime Minister and Home Secretary. It lays bare the fact that under this Conservative Government the UK was slow to lockdown borders, slow to border testing and slow to hotel quarantine. The dangerous mess over the ‘Amber List’ shows Dominic Cummings is right to say ‘look at variants…we still don’t have a proper border policy’.

    The Prime Minister and Home Secretary now have very serious questions to answer about the dire failings they have overseen – and must urgently get a grip of the dangerous border chaos they have created.

  • Angela Rayner – 2021 Comments on Dominic Cummings

    Angela Rayner – 2021 Comments on Dominic Cummings

    The comments made by Angela Rayner, the Deputy Leader of the Labour Party, on 26 May 2021.

    The questions raised today go to the heart of the Prime Minister’s direct and personal responsibility for the UK’s shocking death toll.

    Boris Johnson’s casual disregard for the safety of the British people has had fatal consequences. From care homes to borders, repeatedly locking down too late and failing to learn from his mistakes, the Prime Minister’s decisions and failures resulted in tens of thousands of avoidable deaths.

    Families who lost loved ones deserve to know the truth. The public inquiry cannot possibly be delayed any further. No more dither, no more delay. No more blustering his way through. Over 127,000 grieving families deserve answers.

  • Jonathan Reynolds – 2021 Comments on Fabian Report and Universal Credit

    Jonathan Reynolds – 2021 Comments on Fabian Report and Universal Credit

    The comments made by Jonathan Reynolds, the Shadow Secretary of State for Work and Pensions, on 27 May 2021.

    This report confirms that there is strong public support for a social security system in the UK that offers a decent safety net to all. The pandemic has shown Universal Credit to be inadequate, leaving too many people to fall through the gaps.

    These findings will make an important contribution to Labour’s plans for a replacement of Universal Credit which guarantees a proper standard of living and makes work pay.

  • Jonathan Ashworth – 2021 Comments on Government’s Handling of Covid-19

    Jonathan Ashworth – 2021 Comments on Government’s Handling of Covid-19

    The comments made by Jonathan Ashworth, the Shadow Secretary of State for Health and Social Care, on 27 May 2021.

    Isn’t the truth that his failures on testing and PPE contributed to Covid spreading like ‘wildfire’ in care homes?

    It is clear to the country and the families who lost loved ones that we have been let down by this Government, this Prime Minister, and this Health Secretary.

    The truth matters. The least these families and the country now deserve is clear answers from the Health Secretary and Prime Minister today.

  • Nick Thomas-Symonds – 2021 Comments on Indian Variant

    Nick Thomas-Symonds – 2021 Comments on Indian Variant

    The comments made by Nick Thomas-Symonds, the Shadow Home Secretary, on 27 May 2021.

    Three quarters of the cases in the country coming from the variant first discovered in India, confirms the terrible consequence of the Conservatives’ reckless refusal to secure our borders against Covid.

    Labour warned time and time again that refusing to put in place a proper hotel quarantine system would have exactly these consequences. The Prime Minister delayed putting India on the Red List for two weeks, even when cases there were – tragically – rising quickly. Even now, Ministers have created confusion over the ‘Amber List’ for travel. This dangerous incompetence has to stop.

  • Nadhim Zahawi – 2021 Statement on Covid-19

    Nadhim Zahawi – 2021 Statement on Covid-19

    The statement made by Nadhim Zahawi, the Minister for Covid Vaccine Deployment, in the House of Commons on 25 May 2021.

    Our race between the vaccine and the virus continues. As a nation, we have taken some huge strides forward: there are now 908 people in hospital with coronavirus, a fall of 9% in the past week, and the average number of daily deaths is now six, the lowest number since the middle of March. On top of this positive news, our vaccination programme is accelerating at pace. Over 72% of all adults have now been given their first dose, and 43% of all adults have the protection of two doses.

    This weekend, we reached the milestone of 60 million vaccines administered across the United Kingdom, and Public Health England also published new research showing that the effectiveness of vaccination against symptomatic disease from the variant first discovered in India is similar after two doses when compared to the B117 variant dominant in our country. As with other variants, even higher levels of effectiveness are expected against hospitalisation and death. This is encouraging data, and it reinforces once again the importance of our vaccination programme in giving us a path out of this pandemic, as well as showing just how important it is that everyone comes forward for both jabs when the call comes through. It is the progress made by the British people in following the rules, and in taking up the protection offered through our vaccination programme, that means we were able to take step 3 in our road map last week.

    However, we take these steps with vigilance and caution, staying alert to new variants that can jeopardise the advances we have made. We have come down really hard on the variant first identified in India wherever we have found it, surging in testing capacity and vaccines for those who are eligible. Over the past few days, we have extended this rapid approach to even more areas: as well as Bolton and Blackburn with Darwen, which the Prime Minister spoke about at his press conference on the 14th of this month, we are taking rapid action in Bedford, Hounslow, Burnley, Leicester, Kirklees and North Tyneside. As the Prime Minister set out two weeks ago, we are urging people in these areas to take extra caution when meeting anyone outside their household or support bubble, including meeting outside rather than inside where possible; keeping 2 metres apart from people they do not live with; and trying to avoid travelling in and out of the affected areas unless it is essential, for example for work—if a person cannot work from home—or for education.

    As the Prime Minister said, we want the whole country to move out of these restrictions together. We are trusting people to be responsible and to act with caution and common sense, as they have done throughout this pandemic, and to make decisions about how best to protect themselves and their loved ones that are informed by the risks. That is exactly what we should be doing. We are always looking to see how we can communicate more effectively with local authorities, and we will of course take on board the views expressed by the House over the course of this debate. By acting quickly whenever the virus flares up and protecting people through our vaccination programme, we can guard the incredible gains we have all made, and get ourselves on the road to recovery.

    Jonathan Ashworth

    Does the Minister appreciate that cities such as mine, Leicester, or towns and boroughs such as Burnley, Bolton, Batley and Blackburn, have borne the brunt of this crisis over these past 15 months? We have often been in lockdown for longer than elsewhere. At times, we have felt abandoned. We did not have adequate financial support: families did their best, but they struggled. Can the Minister understand how upsetting, how insulting, it is to have new restrictions imposed on us—local lockdowns by stealth, by the back door—without the Secretary of State even having the courtesy to come and tell us?

    Why was the guidance plonked on a website on Friday night and not communicated to everyone? Why were local directors of public health and local authority leaders not consulted? Why were MPs not informed? What does it now mean for our constituents? What does it mean for the family in Leicester who have booked a few days next week by the coast for the school half-term? Do they have to cancel that break? What does it mean for university students in Leicester when they have finished their exams? Do they have to go home—or can they go home? Can prospective students come and look at the campuses?

    What does the guidance mean for the parents in Bolton who are planning to take their children to see grandparents on the other side of Greater Manchester this bank holiday Monday? Should they rearrange their plans? What does it mean for the young couple in Burnley, Blackburn or Batley, who have postponed their wedding for over a year and invited friends and family from across the country to come and celebrate their special day with them? Is the message to them that they have to delay their wedding again?

    Can the Minister answer these questions today? Can he take a message from me, as the Member of Parliament for Leicester South, back to the Secretary of State—“Withdraw this guidance now and convene a meeting this afternoon of the relevant directors of public health to produce a plan involving isolation support and enhanced contact tracing”? As the hon. Gentleman knows from his work as vaccines Minister, a single dose of the vaccine is less effective against this particular variant. Will he produce a plan with local directors of public health to roll out vaccinations to everybody and consider including bringing forward a second dose for a larger cohort of people?

    A year ago, Ministers such as the hon. Gentleman were defending Dominic Cummings on Twitter. Now, Mr Cummings tweets about the lack of competent people in charge. Many of our constituents, looking at this latest lockdown fiasco, will think that Mr Cummings has a point.

    Nadhim Zahawi

    I thank the right hon. Gentleman for, I hope, his equally supportive comments when it comes to supporting his constituents and others around the country—in Bedford, Blackburn, Bolton, Burnley, Kirklees and Leicester, his own patch, as well as Hounslow and north Tyneside.

    I spoke to the M10 metro Mayors this morning, and the one thing I would urge is that we all work together and take the politics out of this. Our constituents deserve that. Essentially, as I said in my opening statement, we are asking people in the affected areas to be cautious and careful. The right hon. Gentleman asked about visiting family: people should meet outside rather than inside, where possible. Meeting indoors is still allowed, in a group of six or as two households, but meeting outdoors is safer. People should meet 2 metres apart from those they do not live with unless they have formed a support bubble; that obviously includes friends and family they do not live with. So yes, people can visit family in half-term if they follow social distancing guidelines. The guidelines include specific sections on meeting friends and family. Avoid travelling in and out of the affected areas, as the Prime Minister said on 14 May, unless it is essential—for work purposes, for example.

    The whole principle is that we need to work together. The right hon. Gentleman has a responsibility, as do I and the metro Mayors, to communicate to our residents and constituents that this is a time to be vigilant and careful. We are putting more surge testing and turbocharging vaccinations in those areas, to make sure that we do the work with local directors of public health. I hope he will agree that we have had that plan in place and seen it operate in Bolton and Blackburn; we will see it operate in his constituency and other parts of the country as well.

    Jeremy Hunt (South West Surrey) (Con)

    I congratulate the Minister on the outstanding roll-out of the vaccine programme, which is a source of enormous pride to all of us, on all sides of the House. As we emerge from lockdown, we all want it to be a permanent change. For most families, the biggest priority is to make sure that schools remain open, even if we find that new variants arrive in the UK in the course of the autumn. We know that children do not tend to get bad symptoms, but they can spread the virus, so is it time to look at vaccinating the over-12s, as they are doing in the United States? Is it time to look at whether we can use some of the US Food and Drug Administration analysis to speed up that decision-making process, so that by the time children come back in the autumn, schools are protected and we can be confident that they will be able to stay open?

    Nadhim Zahawi

    I am grateful for my right hon. Friend’s question. He is absolutely right to focus on the protection of children but also of families and their community. That clinical decision has not been taken in the United Kingdom. He will be aware that, as well as the US regulator, the Canadian regulator has approved the Pfizer-BioNTech vaccine for 12 to 15-year-olds. Operationally, we will be ready, but ultimately the decision has to be a clinical one and our regulator will have to be satisfied that the vaccines are extremely safe. When you are vaccinating children, essentially, you are offering some protection to them—children can be infected with covid and there is some evidence of long covid among children—but on the whole it is to protect their families and to protect against transmission in communities. Vaccines have to be incredibly safe before we administer them to children, but we have the infrastructure in place to be able to do that, as and when the regulatory and clinical decision is made.

    Dr Philippa Whitford (Central Ayrshire) (SNP) [V]

    Can the Minister explain if the new restrictions for areas such as Bolton are only advisory? Will hospitality companies affected still be eligible for financial support? Why was the Public Health England report on variants snuck out at 11 pm on Saturday, during the Eurovision final and minus the promised data on school outbreaks? The B.1.617.2 or April 02 variant appears to be 50% more infectious and is affecting even younger children, so can the Minister explain why on earth the Government have ended the wearing of face coverings in schools? It is good that two doses of the vaccines still provide good protection from the variant, but testing shows that one dose is only 33% effective. The gap between doses has been shortened from 12 to eight weeks, but with less than half of those between 50 and 65 years of age having had their second dose, are there plans to close the gap further?

    Nadhim Zahawi

    I am grateful for the hon. Lady’s question and just remind her that Public Health England makes those decisions for itself: it is not up to the Minister when it releases its data.

    On pubs and hospitality, indoor areas of venues—cafés, restaurants, bars and so on—can reopen. In any premises serving alcohol, customers will still be required to order, to be served and to eat and drink while seated. Venues are obviously prohibited from providing smoking equipment such as shisha pipes. It is just to make sure that we do everything we can to limit the ability of the virus to infect others. Within that, reducing social contact is incredibly important. Some businesses, such as nightclubs, must remain closed and follow the restrictions. It is very much about making sure that we work together to control the B.1.617.2 variant, exercising the common sense that the Prime Minister spoke about. The guidance is there to do that. People on the whole have been following the guidance.

    On transmission and the effectiveness of the two doses—the hon. Lady’s question on accelerating the vaccination programme—the whole idea of us following the Joint Committee on Vaccination and Immunisation guidelines and advice on vaccination is to be able to vaccinate at scale. We have two big weeks ahead of us and we will continue to focus on the second dose. When people get that text message or the call to bring forward their second dose, they should please take that up, because it is incredibly important in controlling the variant.

    Greg Smith (Buckingham) (Con)

    It is tremendous news that the vaccines that are being so successfully rolled out across our United Kingdom are highly effective against the variant first identified in India, but many businesses continue to be delicately balanced on a cliff edge of either a successful summer or bankruptcy. Does my hon. Friend agree that we need a positive message of hope and certainty that all the evidence continues to back up the complete end of all restrictions and social distancing by 21 June?

    Nadhim Zahawi

    It is good news from Public Health England on the B.1.617 variant that two doses of either Pfizer or AstraZeneca-Oxford are as effective on infection and are very likely to be even more effective on serious illness and hospitalisation in real-world circumstances. Ultimately, we are effectively pursuing an evidence-led strategy. The four weeks plus one—the five-week interval—are for us to be able to assess the data and share it with Parliament and the nation. At the moment, I am cautiously optimistic that we are in a good place. We have to remain vigilant and we have to work together. As I said earlier, let us take the politics out of this and make sure that all our constituents are careful, and we will get there together.

    John Spellar (Warley) (Lab)

    I am sure that the Minister will agree that throughout the pandemic our community pharmacies have performed magnificently on the frontline of the health service, but unfortunately there still seems to be institutionalised bias against them in the Department of Health and Social Care, even now. Only a couple of pharmacies in Sandwell have been authorised for the covid vaccine. I urge the Minister to get a grip on his bureaucrats and get vaccines rolling in our Sandwell pharmacies before the bank holiday.

    Nadhim Zahawi

    I know that the right hon. Gentleman is a passionate advocate for community pharmacies; he and I have discussed them in the past. I do not recognise his characterisation of the NHS team, who I absolutely know work every day with community pharmacies. I think that just over 500 community pharmacies and independent pharmacies are now part of the vaccine deployment. In phase 1, they have proved themselves to be excellent at reaching out and giving confidence to their communities and at getting people vaccinated; where primary care has decided not to carry on with phase 2, they have also stepped up to fill the gaps so that we keep going. I will absolutely look at the right hon. Gentleman’s constituency to see whether we can do more.

    Shaun Bailey (West Bromwich West) (Con)

    The record vaccine roll-out has absolutely vindicated the decision of my constituents in Wednesbury, Oldbury and Tipton to believe that this country can succeed in standing on its own two feet. Vaccination is going to form a really big part of our lives. What work is my hon. Friend doing to ensure that, as we continue our vaccination roll-out, we have the localised infrastructure to ensure that our great progress is not hindered?

    Nadhim Zahawi

    I absolutely agree with my hon. Friend. If the virus were designed to test liberal democracies, because the only way we could combat it was to withdraw people’s freedoms with the dreaded non-pharmaceutical interventions, the vaccine has played to the real strengths of the four nations that make up the peoples of these isles. We have had that Dunkirk spirit of coming together as 1,000 flotillas: the 80,000 volunteer vaccinators, the doctors, the nurses, the pharmacists and, of course, our armed forces and local government colleagues, who have stepped up not only to identify communities that we need to protect, but to find sites.

    We are already making plans for the booster jab to be ready by September. I remind the House that the clinical decision has not yet been made, but when it is—whether that is in September, in October, in November or early in the new year—we will be ready to go. We are also planning how it will dovetail with our flu vaccination programme and seeing how we can increase the uptake in flu vaccination, because the worst of all worlds would be to do well against covid and then be hit by a heavy flu season in the autumn.

    Mohammad Yasin (Bedford) (Lab) [V]

    Last evening, I learned that the Government had sneaked Bedford borough into local lockdown without even bothering to warn the public health team. The Minister knows that for almost two weeks I have been calling for surge vaccines in Bedford for all over-16s, yet until last Friday many of my constituents were forced to travel miles to access the Pfizer vaccine. The variant first identified in India has been imported here because of the Government’s lax approach to border control. Why are the people of Bedford paying for the Government’s gross negligence and incompetence once again?

    Nadhim Zahawi

    The hon. Gentleman and I discussed the turbocharging of the vaccination programme in Bedford, which I know he appreciates. The real difficulty is that, if we now begin to vaccinate people who are 18, outside the JCVI’s advice, we are taking vaccine away from others who are eligible and need that protection. So the strategy we are pursuing is to turbocharge. I need to explain that a little. We are effectively putting in more resource, later opening and mobile vaccination centres and we are expanding vaccination centres, so that those who are already eligible and, for whatever reason, have been unable to access the vaccine or have been waiting to see, can get the protection of the first dose. Of course then we get the second dose into all those over the age of 50, because we know that the two doses in those areas, against the B.1.617.2 variant, make a huge difference.

    Jacob Young (Redcar) (Con)

    I congratulate the Minister on the success of the vaccine roll-out and the rate at which the age limit is dropping. At the age of 28, I am regularly checking the NHS website to see when it is my turn. However, those who are a little older than me are trying to get their first jab at the Riverside Stadium in Middlesbrough but struggling to do so, reportedly because only the AstraZeneca jab is being stocked at the vaccine centre there. Will he use his office to try to find out what the problem is and resolve it, so that people are not having to travel unnecessarily to get their first jab?

    Nadhim Zahawi

    I will absolutely look at what the issue is. The good news we have had recently from our regulator, the Medicines and Healthcare products Regulatory Agency, is that the Pfizer-BioNTech vaccine can now be stored for up to a month—it used to be only five days from once it was thawed from minus 70° C—which means it is much more versatile and less challenging than it used to be. So I will absolutely look at that and contact my hon. Friend.

    Munira Wilson (Twickenham) (LD)

    One area of concern for which new restrictions have been published but no advice has been communicated is the London Borough of Hounslow, which shares a boundary with Whitton, Hampton and St Margarets in my constituency. Hundreds, if not thousands, of people go back and forth every day, for school, for work, to get food and other essential supplies and for medical appointments. So, first, could the Minister advise my constituents whether they should be getting on buses and trains that cross the borough boundary and whether they should be going to supermarkets and accessing medical services over the borough boundary? Secondly, will he consider vaccinating, as a priority, people, such as teachers, key workers and airport staff, who have to go to work in Hounslow but live outside the borough?

    Nadhim Zahawi

    I am grateful for the hon. Lady’s question and I discussed this with the Mayor of London this morning. Of course Hounslow is on the list of affected areas and we are turbocharging the vaccination programme, as well as doing the surge testing and the sequencing and isolation. But as I have outlined in response to others, people need to exercise caution and common sense, and travel outside of the area only if it is essential. That is important. The right thing to do is for us to work together to make sure we deliver that message, as I did this morning with the Mayor of London.

    Mr Mark Harper (Forest of Dean) (Con)

    In The Telegraph story this morning about what the rules for self-isolation might be post 21 June, a Government source was quoted as saying, in response to the suggestion that they will not change:

    “There is still a risk of getting the virus and spreading it on,”

    That is of course true—there is a risk—but of course once people have been vaccinated the risk is much lower and, importantly, the vaccines are very effective at stopping serious disease, hospitalisation and death. So may I say to the Minister that post 21 June it is important not only that legal restrictions and social distancing go, but that all the remaining rules are adjusted to reflect the much lower risk that exists once we have vaccinated the population? Otherwise, we are going to have those rules in place forever.

    Nadhim Zahawi

    It is worth waiting for 14 June, when we will be saying more on this, but suffice it to say two things: first, even if someone has had two doses of either vaccine —I have had this experience in my own family—they can still contract covid and should therefore be isolating and quarantining; secondly, we are also looking at ways in which contacts of people who may have contracted covid can be regularly tested instead of isolating.

    Jim Shannon (Strangford) (DUP)

    I thank the Minister for his responses so far and for the magnificent effort. I had my second vaccine yesterday, and just to show how national that was, the person who gave me the injection was a doctor from Lincolnshire. I believe that this very much shows that the United Kingdom of Great Britain and Northern Ireland works better together, and that this is a supreme example of that.

    We understand that things will change depending on the circumstances and that localised lockdowns may be the way to ensure that areas with low numbers are able to allow people to live safely. Can the Minister outline what parameters will establish localised lockdowns and tell us whether the same approach will be taken UK-wide by the devolved regions?

    Nadhim Zahawi

    I am very pleased to hear that my hon. Friend has had his second dose; when people get that text message, they should please come forward and have their second dose. We are looking to ensure that the whole country comes out of this together, hence the advice being very much about exercising caution and self-responsibility. People actually get this; we see in much of the research data that they know the things that can add to the risk and that they should therefore abstain from doing those things while we vaccinate at scale to get to the place where we can all hopefully get our lives back.

    Sir Desmond Swayne (New Forest West) (Con)

    Some of us will be viscerally opposed to the use of covid passports in the domestic economy. When will the Government set out their proposals in some detail?

    Nadhim Zahawi

    We are considering a range of evidence around covid status certification and whether it may have a role in opening up higher-risk settings, so it would be remiss of a Government Minister or a Government not to look at technologies around the world that would allow us to open up not 20% of Wembley stadium but the whole of Wembley stadium for the FA cup final. No final decisions have been made, and we are of course committed to setting out our conclusions on the review ahead of step 4.

    Mr Tanmanjeet Singh Dhesi (Slough) (Lab)

    Some people have been making a lot of money from Government-approved quarantine hotels, but many of my Slough constituents are continuing to suffer during their stays. Their long list of angry complaints includes a lack of water, with people being told to drink from the bathroom tap; poor food standards often not meeting dietary or religious requirements, with people having to fork out for takeaways; poor ventilation with no chance of opening a window; and I have not even started yet on the shambolic state of mixing in hours-long airport queues so that even if somebody does not have coronavirus, they soon will have. Why are the Government failing to get a grip of the situation, despite repeated requests from right hon. and hon. Members of this House?

    Nadhim Zahawi

    I do not recognise the hon. Gentleman’s description of the way the system is working. There were some distressing videos posted online of people in airports, but we work with the airports and require them to ensure that social distancing protocols are followed. Indeed, at Heathrow, we recently looked at people from red list countries arriving at a particular terminal. I will take away his point about particular hotels, and if he lets me have the exact details I can look at what is happening, because it is wrong and distressing if people cannot have fresh drinking water.

    Tom Hunt (Ipswich) (Con)

    In Suffolk and north-east Essex, 97% of the over-80s have now had two jabs, which I think puts it at the top of the league table. I predict that, as a 32-year-old, I am on the cusp of being offered my jab, but I will wait for my contact to confirm that. Huge thanks should also go to BSC Multicultural Services, which has worked incredibly hard with hard-to-reach groups to get the vaccine out, and I also want to give a special mention to community pharmacies, which the right hon. Member for Warley (John Spellar) mentioned. It seems like a long time since the Aqua Pharmacy on Duke Street approached me, but it has gone on to deliver 15,000 doses. I sometimes feel that community pharmacies do not always get the attention they deserve. Can the Minister assure me that in the NHS White Paper community pharmacies will be at the heart of what we are doing to recover from this pandemic?

    Nadhim Zahawi

    I can certainly give my hon. Friend that reassurance. Community pharmacies are an incredibly important part of our deployment infrastructure.

    David Linden (Glasgow East) (SNP)

    Like everybody else, I pay tribute to those who are delivering the vaccine and those who have developed it. I am not quite at the age to have been offered my first dose yet, but I am hoping that it will be soon. When I get that blue envelope through the door, I will go to get my jab. The Minister will be aware that there are a number of people who have a phobia of needles. Is he in a position to update the House on the development of a nasal vaccine?

    Nadhim Zahawi

    I am glad the hon. Member will get his jab when the call comes. We are obviously working with a number of manufacturers, who are looking at different delivery technologies for vaccines in the future. It is still some way off, I am afraid. At the moment, the needle dominates the vaccination deployment technologies, but I know that a number of manufacturers are working on other ways of delivering vaccines, including through pills.

    Andy Carter (Warrington South) (Con)

    Seventy per cent of my constituents have now had one vaccine. I am sure the Minister will join me in congratulating and thanking all those people in Warrington who have played such an important part in this incredible vaccination programme. As he will know, vaccines are one part of the solution. Can he give us an update on drugs and research into treatment for those who find themselves in hospital suffering from covid?

    Nadhim Zahawi

    I join my hon. Friend in thanking the local team for going above and beyond, and, as I said earlier, it is all about that spirit of Dunkirk and the coming together of the nation to deliver the vaccination programme. A couple of weeks ago, the Prime Minister announced the therapeutics taskforce, which is moving at pace to identify therapeutics and antivirals to help people who, for whatever reason, cannot be vaccinated and to give us a greater arsenal in our armoury against this pandemic.

    Neale Hanvey (Kirkcaldy and Cowdenbeath) (Alba) [V]

    I get my second vaccine tomorrow, so I would also like to thank all of the NHS staff and other staff who have made this possible in such a quick turnaround. However, all of that cannot conceal the opacity of the UK Government’s position on accusations of cronyism and corruption, but, thanks to the Good Law Project, that is finally being challenged in the High Court this week. I have been attempting to get to the heart of the procurement of unlicensed lateral flow tests and been met with glib obfuscation from the Department. Can the Minister therefore tell me: when was the contract for these devices signed; was it known at the time that these tests were not licensed by the MHRA for asymptomatic testing; which Minister approved this contract; and if the Government really have nothing to hide, why do they just not come clean?

    Nadhim Zahawi

    I just remind the hon. Member that, at this Dispatch Box, the Prime Minister announced a full inquiry that will take place in the spring of 2022, where we can learn all the lessons of the covid pandemic and the Government’s response to it. Suffice to say that all contracting is published in the appropriate way, and civil servants follow the exact rules around contracting.

    Mr Richard Holden (North West Durham) (Con)

    Fifty-seven thousand people in North West Durham have had their first jab and 34,000 the second, so we are doing really well and progressing excellently. I have my first jab this Saturday. I say to my hon. Friend the Member for Ipswich (Tom Hunt) that he is 32, so he can also get his jab now. Anybody else in my constituency or across the country can book now through the app. There are concerns, though, about the vaccine. Can the Minister ensure that all the possible issues and side effects are constantly monitored and published so that people can make informed positive choices to get the vaccine, especially in the younger age groups, to ensure that everyone is protected as much as possible, especially from the new variants?

    Nadhim Zahawi

    I can certainly give my hon. Friend that assurance. We have an independent regulator here in the MHRA and, of course, Public Health England, and we have a yellow card system where adverse incidents are recorded—they can be reported directly by a GP, a clinician or the person themselves. All that data is published and people can access it on their MHRA website, or google it and see it. An incredible part of the success story of the vaccination programme is that sharing of data, which has led to the highest level of vaccine acceptance among adults in the world. The figures suggest that about 90% of all adults say that they will take the vaccine, or are very likely to take the vaccine.

    Janet Daby (Lewisham East) (Lab) [V]

    What steps are the Government taking to ensure that the UK is a leader in the global response to tackling covid-19, especially given the fact that we are not safe until everyone is safe?

    Nadhim Zahawi

    When the Prime Minister set up the vaccines taskforce he gave it two priorities: first, to discover the vaccines that would work, in order to contract for them or to manufacture them in the UK; and secondly, to work out how to help the rest of the world, which is why we were the first country to put £548 million into COVAX and very much establish COVAX, which now has more than 450 million doses, the bulk of which are Oxford-AstraZeneca, which is our gift to the world. Some 98% of the COVAX jabs that have been delivered and have protected people have come from Oxford-AstraZeneca. Pfizer has also been doing the same thing: from day one its chief executive, Albert Bourla, spoke about vaccine equality, and Pfizer is offering vaccines at cost to low and middle-income countries.

    Rachel Hopkins (Luton South) (Lab)

    It is simply unacceptable that my constituents in Luton South found out about the changed advice on travel to Bedford through the back door, via the media last night. They need thorough clarity and formal information to be provided through our local authorities.

    On local authorities, what steps are the Government taking for the prioritisation of turbocharged vaccinations, not just for areas with the new variant but for areas with enduring transmission?

    Nadhim Zahawi

    I think I have dealt with the first part of the hon. Lady’s question, in the sense that the guidance and information was shared with the country on 14 May. We continue to endeavour to improve our communications, in partnership with local government and by addressing local health systems.

    On vaccine turbocharging, the hon. Lady will know that we are looking at mobile vaccination sites, increasing sites’ opening hours and putting in more resource so that we can vaccinate the people who are eligible to be vaccinated—it is important to make that distinction. We will continue to do all that in Bedford to make sure that the people of Bedford are protected and we get the variant under control.

    Theresa Villiers (Chipping Barnet) (Con)

    Over the weekend I was contacted about two instances of people having difficulties getting the access that they wanted to their frail relatives in Barnet Hospital. It was particularly distressing because in both instances the patients had difficulties communicating with and understanding hospital staff. I appreciate that hospitals have a paramount duty to ensure proper infection control, but will the Minister encourage hospitals throughout the country to facilitate visits so that relatives can support the frail elderly while they are in hospital?

    Nadhim Zahawi

    I will certainly take my right hon. Friend’s constituents’ details and look into that. We urge all hospitals to make sure that when the frail elderly need social contact, they are able to get it.

    Mick Whitley (Birkenhead) (Lab) [V]

    No one is safe from covid-19 until we all are, but the UK continues to stubbornly resist calls for a waiver of covid-19 vaccine patents. Given that people in many of the world’s poorest countries cannot expect to be vaccinated until 2023, and given the failure of the COVAX initiative to distribute vaccines at the volume and speed that is needed, will the Government now follow the lead of the Biden Administration and reverse their position on a patent waiver?

    Nadhim Zahawi

    That is a really important question. Let me share with the hon. Member a little about the operational challenges around vaccine manufacture. We will of course look at any text that our US colleagues put forward on the intellectual property issue, but in reality if the exam question is to get more jabs in the arms of those who live in low and middle-income countries, the bottleneck is not the IP but the transfer of technology to manufacturers around the world. What Oxford-AstraZeneca has done incredibly well is to transfer that technology to 20 sites that can manufacture at scale. We have already delivered 450 million doses of the Oxford-AstraZeneca vaccine. The hon. Gentleman might recall that Pfizer did the same thing; it actually paused its manufacturing in Europe and expanded it, to go from 1.2 billion doses a year for 2021 to almost 3 billion doses. If the exam question is to get more jabs in arms, we need that technology transfer. It is not easy, as we saw in Halix in Europe, which had great difficulty operationalising the manufacturing, as did Catalent in the US. That is the real effort that needs to go in—as well, of course, as helping other countries with deployment. It is only one part of the jigsaw to get the vaccine into warehouses in those countries; those countries have to be able to get it out and into people’s arms.

    Robert Largan (High Peak) (Con)

    The experience over the last year has shown that local lockdowns are not effective, because cases simply rocket in the areas immediately outside the local restrictions. With that in mind and to get ahead of the curve, this morning I have been in discussions with Derbyshire County Council and my local director of public health to establish a pop-up vaccination site at Gamesley, where there has been a high number of new cases, so that we can deliver surge vaccination. Will the Minister work with me, my local director of public health and the NHS to ensure that we get the doses we need to get everyone in the High Peak vaccinated as soon as possible?

    Nadhim Zahawi

    My hon. Friend is absolutely right. The important thing is to get those who are eligible vaccinated and for those who need their second dose to get that second dose within the eight-week period. That is the way we control this variant. I will happily work with him on any local initiative that he is working on.

    Stella Creasy (Walthamstow) (Lab/Co-op) [V]

    The evidence is clear: women who are pregnant who get covid are twice as likely to have a premature birth and twice as likely to experience stillbirth. Other countries have recognised this and have ensured that pregnant women of any age are a priority for vaccination, but in this country the conversation about the data has not even happened yet, despite months of asking. There will be thousands of pregnant women in the areas where the variant is on the rise, and across the country, terrified about what might happen if they get covid. What can we do to help them get hold of the vaccine, regardless of age, so that we are protecting the youngest members of our community?

    Nadhim Zahawi

    The hon. Lady will know, because she is on the weekly MPs’ call that I host, that the Joint Committee on Vaccination and Immunisation is looking at this data. In the meantime, because of data provided by the United States of America, we have made the Pfizer-BioNTech and Moderna vaccines available to all pregnant women who are in the eligible cohort. That is happening as we speak. I know that Professor Anthony Harnden, who is the deputy chair of the JCVI, has promised the hon. Lady that the JCVI is looking at the data; when it delivers the advice to us, the system will follow that advice.

    Andrew Jones (Harrogate and Knaresborough) (Con)

    The scale and pace with which we are delivering our vaccine programme is a marvellous achievement and a testament to everybody involved. It is how we are able gradually and safely to come out of the restrictions. Will my hon. Friend confirm that we will always be following the science and the data, so that activities can resume as safely and as soon as possible? I am particularly thinking about indoor gatherings for groups such as community choirs, and other events that bring people together. Such activities are so needed to combat the isolation that has hit so many people during the lockdown.

    Nadhim Zahawi

    My hon. Friend will know that the reason for restrictions on activities such as choirs and singing is the added transmission through aerosols or droplets. The faster that we can move the vaccination programme, the sooner we can end those restrictions. Therefore, my absolute focus—and my commitment to him—is that we continue at pace. We have a big week this week and a big week next week.

    Florence Eshalomi (Vauxhall) (Lab/Co-op)

    I thank the Minister for his weekly updates, which I have found really helpful, and for his work on vaccine hesitancy across the black, Asian and minority ethnic community. I had my vaccine on 14 May at St Thomas’ Hospital—the same hospital that cared really well for our Prime Minister. The Prime Minister thanked those nurses, including Luis, who gave me my vaccine. But we saw that Jenny resigned from the NHS last week, so will the Minister use his will and his power to speak to the Treasury to get our hard-working nurses the pay they deserve?

    Nadhim Zahawi

    I am grateful for the hon. Member’s commitment in ensuring that we get the vaccine message out to harder-to-reach communities and for her work with me on the weekly meetings. We have delivered an increase to nurses. We await the outcome of the deliberations of the panel that will look at nurses’ pay, and then the Treasury will make an announcement in the usual way

    Holly Mumby-Croft (Scunthorpe) (Con)

    I thank my hon. Friend for his assistance in ensuring continuity of supply to the Baths Hall in Scunthorpe and our other vaccination hubs. Over 71% of our adult population in North Lincolnshire have received their first vaccine and almost 50% have had their second vaccine. Will he join me in thanking the fantastic volunteers who I see outside in all weathers at the Baths Hall, welcoming patients to receive their vaccination? We quite simply could not have done it without them.

    Nadhim Zahawi

    I absolutely join my hon. Friend in that, because I see it up and down the country all the time. I spoke earlier about the Dunkirk spirit, with people coming up and saying, “I want to be counted. I want to be part of this.” We demonstrated it to the world a little bit in the 2012 Olympics. This is a whole other scale of operation. Nevertheless, we have delivered on it and will continue to deliver on it, and I stand on the shoulders of the real heroes and heroines of the NHS family, our armed forces and local government.

    Lee Anderson (Ashfield) (Con)

    The vaccine works—it prevents serious illness and helps to prevent transmission—but I read in the papers this morning that even if someone has had two jabs, if they come into contact with someone who is positive after 21 June, they will still have to isolate for 10 days. Could my hon. Friend confirm whether or not that is correct?

    Nadhim Zahawi

    I answered a question on this issue earlier. Obviously if someone contracts covid, they have to isolate and quarantine, but in terms of their contacts, we are looking at regular testing to see whether there is an alternative. I am afraid that my hon. Friend will have to wait a little longer before step four, and we will say more on this on 14 June.

    Vicky Foxcroft (Lewisham, Deptford) (Lab)

    It is a pleasure to be back in the Chamber, but for many like me who are immunocompromised, returning in person to the workplace is concerning, as we do not yet know how effective the vaccines are for us. Will the Minister consider allowing immunocompromised people to have access to antibody testing, thereby giving us some idea of the vaccines’ efficacy and some knowledge of our level of protection from the virus?

    Nadhim Zahawi

    The hon. Lady asked a similar question last week, and Professor Harnden of the JCVI said that the problem with antibody testing is what it really tells us. I will happily ask the question again on her behalf of the JCVI. Suffice it to say that on 17 May we put out guidance to employers saying that those who are shielding and immunocompromised should be allowed to work from home if they need to.

    Chris Green (Bolton West) (Con)

    Will my hon. Friend confirm that the Government’s position on the coronavirus pandemic is that it is still a question of life and death, that communications are vital in this effort and that compliance follows confidence, which in turn follows competence? Will he confirm when these local lockdown measures were agreed with the leadership at Bolton Council and when the Prime Minister formally agreed to this updated guidance being imposed?

    Nadhim Zahawi

    My hon. Friend will recall that the Prime Minister addressed this issue on 14 May.

    Jonathan Ashworth indicated dissent.

    Nadhim Zahawi

    Yes, he did address this issue in his press conference. I can read the right hon. Member for Leicester South (Jonathan Ashworth) the words from that press conference, because he says from a sedentary position, “He did not.” The Prime Minister said, speaking about Bolton:

    “given the caution that I think we have to exercise with this new variant, the risk of extra transmissibility, I would urge people just to think twice about that. That’s what we’re saying. I think that we want people in those areas to recognise that there is extra risk, an extra disruption, a threat of disruption to progress caused by this new variant and just to exercise their discretion and judgment, in a way I’m sure that they have been throughout this pandemic and will continue to do so, I hope very much.”

    Those were his words, and the guidance was in place.

    Yvette Cooper (Normanton, Pontefract and Castleford) (Lab)

    The Minister has done a good job on the vaccines, but this statement is utterly chaotic and completely confused. What advice is he actually giving to people in the north-west or in West Yorkshire about going to the pub, about weddings and about travel—even about whether, if they are allowed to travel out of Bolton, they are allowed to travel to Portugal, on the green list, for holidays? Is not the reality that he is so uncomfortable about giving any advice because he knows the reason he is putting these people in Bolton, in West Yorkshire and in other places in this position is that the Government failed to put India on the red list earlier? Over 400 people from India came into the country with the Indian variant, and putting India on the red list would have prevented it from spreading to thousands of other people in the community. Will he apologise to people in the areas that are affected with the additional restrictions he is advising because of the Government’s failure?

    Nadhim Zahawi

    I do not agree with the right hon. Lady, as she will not be surprised to hear. I have already talked about how visiting families are impacted and pubs and hospitality are affected, and about the exercise of caution and being careful. She will recall that when India was put on the red list on 23 April, it was a full six days later that this particular variant was identified by the experts—the virologists—as a variant of interest, and a full two weeks later before it became a variant of concern. So her point, actually, is made unfairly.

    Dr James Davies (Vale of Clwyd) (Con)

    When does my hon. Friend anticipate that the NHS smartphone app will be enabled to allow those in Wales to demonstrate their covid vaccination status? Further to that, does he expect that other features of the app, such as the ability to book GP appointments, to order prescriptions and to view notes will also be enabled in Wales?

    Nadhim Zahawi

    We are working closely with the Welsh Government to enable the integration of Welsh citizens’ data with the NHS app, NHS.uk, for the purpose of covid status certification, including undertaking the required scoping and impact assessment that will enable us to set out a detailed timeline for the delivery of that integration.

    Dr Luke Evans (Bosworth) (Con) [V]

    The people of Bosworth are a pragmatic bunch, as are the people of Leicestershire. Leicestershire surrounds Leicester. What advice does the Minister give to those people who are in Leicestershire who send their kids to school in Leicester, who work in Leicester, and who are thinking of having bank holiday time with family in Leicester?

    Nadhim Zahawi

    I thank my hon. Friend—[Interruption.] I hear the right hon. Member for Leicester South saying “Good question.” He is absolutely right. We have to exercise caution and common sense, as I described earlier, around visiting. People absolutely can visit family and friends at half-term if they follow social distancing guidelines. I think people absolutely will exercise that personal responsibility and common sense when they go about their family time or school time.

    Sarah Owen (Luton North) (Lab)

    Last year the Prime Minister gave in to pressure from trade unions and cross-party opposition and announced refunds for health and care workers from overseas for the £624 charge they are paying to use the NHS. Yesterday the Minister for Health, the hon. Member for Charnwood (Edward Argar) could not tell me how many healthcare workers had been refunded, and in Committee earlier, the Care Minister did not know either. Does this Minister know how many, if any, healthcare heroes have had their NHS charges refunded, or was it just another empty promise from this Government?

    Nadhim Zahawi

    I am happy to write to the hon. Lady with the answer to her question. Suffice it to say that this is an important amount of money to those people and I do not think we should be playing politics with it in a sort of “gotcha” moment.

    Esther McVey (Tatton) (Con)

    The Minister will recall that we were told that the first lockdown was required to give time to build capacity in the NHS. Can he therefore tell us how many more hospital beds are available now than in March last year?

    Nadhim Zahawi

    I will write to my right hon. Friend with that detail. Suffice it to say that we now have 908 people with covid, as I said in my statement—the lowest number since lockdown.

    Mrs Emma Lewell-Buck (South Shields) (Lab)

    South Shields and North Tyneside are interconnected. Today, my community and businesses are incredibly anxious. We know that local lockdowns do not work and inevitably lead to national ones. We know that it is likely that there will be other variants of this virus, which may well be with us for ever. Lockdowns break our economy and society, cause mental distress, delay vital cancer treatments, lead to further unemployment and exacerbate inequalities. Can the Minister explain why the Government’s response—instead of fixing test, trace and isolate, for example—is always more restrictions and endless cycles of lockdown?

    Nadhim Zahawi

    I hope the hon. Lady agrees that the vaccination programme has given us a way out of non-pharmaceutical interventions, which were the only thing we had at our disposal to try to slow down the pandemic and the virus. As we transition from pandemic to endemic, we are planning for a booster shot in the autumn to protect the most vulnerable or all people in phase 1—that clinical decision has yet to be made. We are already making plans for next year to deal with covid, as we deal with seasonal flu, through annual vaccination programmes. By next year, this country will be able to manufacture 700 million doses of vaccine, not just for the UK but to help the rest of the world.

    Jason McCartney (Colne Valley) (Con)

    My constituency is in Kirklees. I could ask about how the new travel advice for Kirklees was communicated to my constituents, but instead I want to clarify three things with the Minister. The first is travel advice. It is half-term next week, and families will be visiting and going on short breaks. Should they now cancel those trips? Secondly, hotels, bed and breakfasts, and restaurants are getting cancellations. What support will hospitality get? Finally, my constituents can see the data on where the hotspots are. When will we start using granular data to tackle the outbreaks, rather than lumping whole council areas into these advised restrictions?

    Nadhim Zahawi

    Let me take those questions in reverse. On granular data, we already have the capability in the vaccination programme to see by postcode area where the uptake is at. That is how we can focus our resources to turbocharge the programme, as we have done and will continue to do, including in Kirklees.

    On pubs and hospitality, indoor areas and hospitality venues can continue to serve seated clientele, diners and drinkers, as I described earlier. If people have booked visits to their families, they are absolutely able to have them as long as they follow social distancing guidelines and common sense.

    We need to make sure that we are vigilant, because the B1617.2 variant is concerning, and we have to bring it under control by turbocharging vaccinations, surge testing, isolating and genome sequencing.

    Antony Higginbotham (Burnley) (Con)

    I agree with my hon. Friend the Member for Colne Valley (Jason McCartney): what we need now more than ever before is clear communication from the Government, so that residents of Burnley, Blackburn and Bolton know exactly what is expected of them. Will the Minister confirm that this guidance is guidance and that my constituents can still exercise the freedoms that they reclaimed last Monday? Will he meet me and other colleagues to talk through what more we can do to make sure that communication is clear in the areas where we need it most?

    Nadhim Zahawi

    I am very happy to meet my hon. Friend. On the guidance, as I have made clear on a number of occasions at the Dispatch Box, people have to be careful and vigilant, as they have been already.

    A number of colleagues have asked about the Batley and Spen by-election. We have just demonstrated in the local elections that we can conduct elections safely; we will be able to conduct that by-election safely, too. People just need to be sensible. Let us work together, bring this together and take the politics out of it.

  • Kit Malthouse – 2021 Speech on the Criminal Justice Response to Rape

    Kit Malthouse – 2021 Speech on the Criminal Justice Response to Rape

    The speech made by Kit Malthouse, the Minister for Crime and Policing, in the House of Commons on 25 May 2021.

    I am grateful to the hon. Member for Pontypridd (Alex Davies-Jones) for her continued interest in the Government’s work in this area. Rape and sexual violence are devastating crimes that impact on victims for the rest of their life. When victims take the brave step of reporting the crime, they expose their deep personal trauma in the interests of justice. The criminal justice system needs to support those victims, believe them and ensure that their needs are met at the heart of the criminal investigation.

    The Government have long recognised that the decline in the number of effective trials for rape and serious sexual offences in England and Wales is a cause of significant concern. As a result, we commissioned the end-to-end rape review in March 2019 to look at evidence across the system, from reporting to the police to outcomes in court, in order to understand what is happening in cases of adult rape and serious sexual offences being charged, prosecuted and convicted in England and Wales.

    Our review represents a serious commitment to change by the Government and our partners. At its heart will be a set of actions that will drive system and culture change to ensure that the victims feel supported and able to stay engaged with their case. That, combined with updated and stronger case preparation methods, as well as increased communication between all those involved in the prosecution and new charge mechanisms, should lead to more cases reaching court and, we hope, defendants pleading guilty.

    To ensure that that happens, I have been tasked by the Prime Minister to take personal leadership of the actions from the review, working with colleagues across Government to ensure accountability of operational partners for delivery. I will of course regularly update the House on our progress.

    On the substantive question, I was keen to publish the rape review last year. However, following extensive feedback from the Victims’ Commissioner and the victim sector that we needed to take account of the End Violence Against Women Coalition’s “The Decriminalisation of Rape” report and the pending judicial review judgment, we took the decision to delay publication. We have used the time since that delay to carry out further research and engage with stakeholders in order to formulate an ambitious and wide-reaching action plan, which we will be publishing shortly after recess. When we publish the report, I will present it to Parliament and write to colleagues across the House to outline our approach. I look forward to working with the hon. Member and, indeed, all Members across the House to ensure that this action plan drives the substantial change we need to see.

    Alex Davies-Jones

    The failings of the criminal justice system, particularly in cases involving violence against women and girls, have been well documented in this place, yet victims of rape continue to be a last priority for this Government. Yesterday, The Guardian’s analysis of Home Office figures for rape prosecutions was published, and it makes for truly appalling reading. Fewer than one in 60 rape cases reported to the police last year resulted in a suspect being charged. In 2020, more than 52,000 rapes were reported in England and Wales, yet only 843 resulted in a charge or summons. That figure translates to a shocking rate of just 1.6%.

    Like many others, I initially welcomed the Government’s commitment to an end-to-end rape review of the criminal justice system, yet we are now more than two years down the line and, after a number of delays, that vital review is still nowhere to be seen. The Justice Secretary recently announced that it would be published before the end of the spring, yet the stakeholder reference group that the Minister alluded to has not been consulted on what is in the rape review action plan. Enough is enough.

    The Government have repeatedly acknowledged that they have not been robust enough in their efforts to tackle gender-based violence, but it does not have to be this way. The Labour Government in Wales passed the Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act 2015, which set out 10 national indicators of progress in tackling violence against women and girls by which the Government can be held to account. By contrast, the UK Government cannot even commit to publishing their own review in good time.

    So I ask the Minister: will he now take this opportunity to apologise for this delay to thousands of rape victims, and particularly the 40% who are rapidly losing faith in the justice system and withdrawing from prosecutions? Will he support Labour’s call to introduce a similar indicator to that seen in Wales, to facilitate a transparent approach to tackling violence against women and girls? Lastly, will he once and for all confirm an exact date for when this review will be published?

    Kit Malthouse

    I completely appreciate the hon. Lady’s righteous anger about this situation. As I said in my statement, this is not a matter about which any of us are particularly pleased or proud, and it is a source of regret that the investigation and conviction of rape has been declining for some years. It is a difficult offence to deal with at the best of times, but the significant declines that we have seen in the past few years are absolutely what we wish to address.

    However, against that background, I am sorry that the hon. Lady seeks to politicise what should be a cross-party issue, not a Labour/Conservative issue. There are many Members on the Government Benches for whom this has been a significant issue for some time. As Mayor of London, the Prime Minister himself published the first ever violence against women and girls strategy in this country and, indeed, in any major city around the world. This is an issue that has been close to his heart, and indeed mine, for some time.

    I should also point out to the hon. Lady that, notwithstanding the fact that there is a document that requires publishing—as I say, that will be published shortly after recess—she should not mistake that for the beginning of the work. Much work has been done thus far, and we are engaged closely with the police, the Crown Prosecution Service and other partners to make sure that the action plan and the work we need to do to get more cases from report into court has begun already. As the hon. Lady will know, the Crown Prosecution Service and the National Police Chiefs’ Council launched their joint action plan in January this year, and I am pleased that that progress is being made as well.

    That is against a background of significant action by the Government over the past decade in various areas of violence against women and girls, which I hope the hon. Lady will appreciate and applaud, ranging from creating the offence of coercive control to outlawing upskirting, stalking, and revenge porn and the threat thereof. We have just passed the landmark Domestic Abuse Act 2021 with great support across both Houses. Alongside that, we have the information and support campaigns the Government have been running, along with the very significant financial support that has gone into support for victims and witnesses of rape and sexual violence.

    The document is important, and it was important to get it right—as I say, we delayed it at the request of the Victims’ Commissioner and the victims sector. Please be under no illusion: we are working extremely hard to try to correct what, as the hon. Lady points out, is an injustice.

    Sir Robert Neill (Bromley and Chislehurst) (Con) [V]

    As somebody who both prosecuted and defended probably dozens of rape cases in the course of my career at the Bar, I can say that the Minister is certainly right to recognise that these are always complex and demanding cases. The difficulty of securing the same level of convictions as there is for other types of serious offence has been around for many years—it is not a recent one.

    It is also right, of course, to have delayed publication until the decision of the Court of Appeal in the judicial review; otherwise, it might have materially altered the review’s conclusions. However, now that all the challenges have been dismissed on all grounds and the judgment has been handed down, on 14 May, will my hon. Friend undertake to ensure that not only is the document published but that there is proper resourcing to support the joint national plan of action between the Crown Prosecution Service and the police? Doing the same is starting to make a difference in relation to the problems experienced in the past with disclosure. Getting the thing working on the ground, surely, is what we must now tackle very urgently.

    Kit Malthouse

    I am grateful to the Chair of the Select Committee. He is quite right that to get this complicated and difficult piece of work correct, it was appropriate for us to delay. I have to confess that I was pretty gung-ho —anxious to get it out before Christmas. But as I say, the intervention of the sector and the judicial review meant that we had to hold off because of the implications.

    My hon. Friend is quite right that the key issue is not so much the document, which is an important statement and political moment, but the operationalisation of what is within it. While we are dealing with a police service of tens of thousands of individuals, a prosecution service with many people involved, and lots of other parties that take a case from report to court, getting them all to both act and think differently—the culture change as well as the operational change—will be an enormous challenge. That is what we are focused on. He will be pleased to know that I have convened a Criminal Justice Board taskforce of key individuals in the organisations involved to try to drive that operational challenge of embedding change.

    Ellie Reeves (Lewisham West and Penge) (Lab)

    Thank you for granting this urgent question, Madam Deputy Speaker.

    The Government are letting down victims of rape and serious sexual violence on every front. Victims are being left waiting years for their day in court, with no support, no communication and no action from the Government. When I have spoken to victims, they tell me that they often feel as though they are on trial and how being left to wait years for their day in court leaves them in a form of purgatory, unable to move on from what has happened to them. Many feel that the justice system is working against them, not for them. That is a complete and utter failing of this Government.

    We have been waiting for over two years for the rape review. The Minister refers to the court judgment, but that was handed down weeks ago—again, the date of publication has been kicked into the long grass, with no action from the Government. In that time, another 100,000 rapes are reported to have taken place.

    Victims cannot wait any longer for action. The Government must urgently publish their review, which must include hard-hitting recommendations and root-and-branch reform to the CPS, Ministry of Justice and Home Office. We need to see how the Government intend to reverse the shocking deterioration of rape prosecutions they have allowed to happen under their watch and how they intend to improve the criminal justice system for victims of rape and sexual violence. What we do not need are slapdash briefings to the press about what is potentially in the review. No more pilots, no more consultations—what we need is action. We need a plan, and Labour has one. We have set out what we would do in our survivors’ support plan and in our Green Paper, “Ending violence against women and girls”. So today, I ask the Minister: will he commit to backing Labour’s survivors’ support plan? Will he introduce indicators across the Crown Prosecution Service, the Ministry of Justice and police to improve victims’ experience of the criminal justice system, as set out in our Green Paper? Will he finally commit to a date for the publication of the review, or will he continue to watch the effective decriminalisation of rape?

    Kit Malthouse

    As I said earlier, we have committed that the review will be published shortly after the recess, but as I said in answer to an earlier question, please do not believe that we are waiting for the production of the plan to start the work. Indeed, much of the work has been done already. The hon. Lady will know, for example, that Project Bluestone in Avon and Somerset police is doing fantastic work at the moment on a new model of operation for this kind of investigation and on joint close working between the police and the Crown Prosecution Service. They have a joint operational improvement board. They have launched their action plan. There was significant support for that and a massive mobilisation across policing to deal with, in particular, the new disclosure guidelines that the Attorney General’s Office has issued in response to the growth in the use of mobile phones in the investigation of crime, particularly in this area.

    I would be more than happy to look at the Labour Green Paper, because I do not think there is any monopoly on good ideas in this area, as I hope that my opposite number will look with an open mind at the plan that we publish and the work we intend to do. We all have a shared desire here to see better outcomes and more justice for victims in court, and we will have to stand shoulder to shoulder if we are going to make that happen.

    Robbie Moore (Keighley) (Con)

    The devastating impact on victims from rape, sexual exploitation, sexual violence and grooming is shattering and long-lasting, and every victim must feel able to come forward with confidence that their complaint will be fully investigated and, where evidence supports, that charges and prosecutions will follow. However, not all victims have confidence in the criminal justice system, so can my hon. Friend outline what steps the Government are taking to support those victims and provide reassurance that any complaint will be taken seriously?

    Kit Malthouse

    My hon. Friend is right that we have to make sure in all we do that victims are at the heart of the criminal justice system, and he will have seen in the recent Queen’s Speech that we have made a commitment to bring in a new victims law. It will put the victims code, which has 12 strong rights for victims in the criminal justice system, into law and ensure that all the operational partners—the police, the CPS and the courts, which are all rightly independent of Government—see the need to take up the challenge of putting victims at the heart of the system.

    Andrew Gwynne (Denton and Reddish) (Lab) [V]

    The statistics are frankly lamentable, and behind each one is a victim. There were 52,210 rapes recorded by police in England and Wales in 2020. Only 843 resulted in a charge or a summons—a rate of 1.6%. For every 10 cases the CPS prosecuted in 2016-17, it now pursues only three. We know what failure looks like: it is this. What should the figures look like to be acceptable to the Minister? How long does he think we should have to wait to get to that point?

    Kit Malthouse

    The hon. Member is quite right. As I have said, the numbers are deeply, deeply regrettable, and he is correct that not enough victims are getting justice in court. There have obviously been significant changes in technology, not least the advent of the mobile phone and the critical part it plays in so many of these investigations. We need to get ourselves in shape, both in terms of capacity and capability, and we need the right framework around inquiry and disclosure for the police and the Crown Prosecution Service. That work is ongoing. We have ambitions, obviously, to raise the number very significantly, but I would not underestimate the operational challenge in embedding this across 43 police forces. The hon. Gentleman will know that creating the structural change alongside the cultural change in two operationally independent organisations, as well as in the court system, will take time and a foundational approach to change, which we are committed to and on which the work has started already.

    Joy Morrissey (Beaconsfield) (Con)

    What is being done to improve the collaboration between the police and the Crown Prosecution Service to ensure that more cases are actually charged?

    Kit Malthouse

    I am grateful to my hon. Friend, who, as usual, puts her finger on the key issue—the relationship between the police and the CPS, in their collaboration to get a case to court, is absolutely critical. I hope she saw that, in January, the National Police Chiefs’ Council and the Crown Prosecution Service launched their joint national action plan, with five themed areas of work that are designed to do exactly that. Those are on support for victims; casework quality and progression; digital capability and disclosure, including looking at mobile phones, as I mentioned earlier; people and expertise—critically, building knowledge and expertise—and engaging properly with stakeholders. I know that Deputy Chief Constable Sarah Crew, with whom I have met many times, and Baljit Ubhey and Sue Hemming from the CPS are leading the charge on this. They form part of the criminal justice support taskforce, which I lead, to try to drive the kind of results that we want to see.

    Liz Saville Roberts (Dwyfor Meirionnydd) (PC) [V]

    Diolch yn fawr, Dirprwy Lefarydd. The shocking drop in rape convictions demonstrates the need for urgent, radical, systemic change. Welsh Women’s Aid has stressed to me the importance of accurate, disaggregated data for Wales in its monitoring of the current duty to prevent crime and protect victims under the Violence against Women, Domestic Abuse and Sexual Violence (Wales) Act 2015. Will the Minister commit to a regular publication of Wales-specific data relating to cases of rape, and will he acknowledge that prosecution support services will work effectively for rape survivors only when justice powers are devolved to Wales, as they are to Scotland and Northern Ireland?

    Kit Malthouse

    Data and transparency is one of the key themes that we have been looking at as part of the rape review. There will be an announcement, when the plan comes, about what we intend to do in terms of reporting. I am afraid that I do not support her call for more devolution. I think that England and Wales are stronger together on this issue, as on so many others.

    Bob Blackman (Harrow East) (Con) [V]

    The vast majority of rape victims know the perpetrator in the first place, and the vast majority are in relationships with them, or historically have been. The key here is ensuring that once a victim of rape reports it to the police, they are dealt with not only sympathetically, but supported all the way along the line to court. This is a structural and cultural change that needs to take place. What effort is my hon. Friend making to ensure that cultural change, as well as structural change, is actually implemented?

    Kit Malthouse

    My hon. Friend is absolutely right that one of the key issues that we have to address is what they call “victim attrition”, which is a slightly depersonalised, desensitised phrase for victims not feeling that they are going to get justice and giving up along the way. I was very pleased that the Government announced a massive increase in the amount of money being given to create the posts of independent sexual violence advisers and domestic abuse advisers, who will help to support victims through the criminal justice system to make sure that they get to court in good shape and able to give the evidence that they wish to give. There will be more about this issue in the review and I hope that, when it comes, he will welcome it.

    Wendy Chamberlain (North East Fife) (LD)

    Despite the reasoning, the long delay in publishing the Government’s review of rape cases is emblematic of the chronic delays throughout the criminal justice system that are denying survivors justice and allowing rapists to walk free. The results of the analysis initiated by my hon. Friend the Member for Bath (Wera Hobhouse) are shocking. As a former sexual offences trained police officer, I think that what these statistics make clear is that police and prosecutors need more resources and training to bring perpetrators to justice, whether that means supporting survivors, handling investigations sensitively, analysing digital evidence or countering damaging stereotypes. The Minister talked in his response about this being part of ongoing work, so what are the Government doing now to deliver?

    Kit Malthouse

    I agree with the hon. Lady about resources and training. The development of expertise, which she obviously had in her career, is a key part of the Crown Prosecution Service and National Police Chiefs’ Council joint national action plan. We see better results from specialist teams, and often those structural issues that allow police officers to stay in post for longer, and develop an expertise in what my hon. Friend will know is a difficult and sensitive area of investigation, are critical. We must also ensure that the CPS is able to develop that specialism, and that will be a critical part of the joint national action plan.

    Stephanie Peacock (Barnsley East) (Lab)

    In South Yorkshire just 24 people were charged, despite nearly 1,600 reports of rape being made in 2019. The Minister says that the Government have taken action, but their recent Police, Crime, Sentencing and Courts Bill does not mention women once. Will he admit that through their lack of action, this Government have effectively decriminalised rape?

    Kit Malthouse

    I am sorry to hear the numbers from South Yorkshire, and I know the hon. Lady will address them with the police and crime commissioner there, who is responsible for the performance of the police. He also chairs the local criminal justice board, which is designed to bring partners together in that area to work on exactly these issues. The Police, Crime, Sentencing and Courts Bill includes provisions that will focus on offences that largely impact women, not least the end of the halfway release for serious sexual offenders, including rapists who, when the Bill goes through, will have to serve two-thirds of their sentence, providing greater protection and justice for their victims.

    Laura Farris (Newbury) (Con) [V]

    Because the majority of rapes take place behind closed doors, where the victim knows the perpetrator, and in circumstances that are incredibly difficult to prove afterwards, it has always been a difficult crime for which to get a conviction. The most striking features of the current rate are the high rate of attrition, and the fact that the CPS has seen fit to update the rape and serious sexual offences guidance all the way through the year on victim behaviour. Does my hon. Friend think there is a case for specialised prosecutors, and a specialist sexual offences court to deal with such crimes?

    Kit Malthouse

    I had the pleasure of watching a talk that my hon. Friend gave last night to a think-tank about these issues, and she was very thoughtful and interesting on this subject. Across all crime types we see that specialism pays, both in apprehending the perpetrator, but also in getting a conviction. We must ensure that the police and CPS can develop those specialisms. All prosecutions are currently charged by specialist RASSO prosecutors, but a collective expertise must be a key mission for us. Alongside that, we must ensure that victims have specialist support, and expertise is key to that.

    My hon. Friend is right to say that this is a particularly difficult, evidential situation, where often it is one word against another, and other circumstantial evidence may or may not lead to a conviction. I want to concentrate on the key area of recent reporting, and on encouraging people to report as soon as possible. As she will know, there is a short forensic window in such situations—normally 7 to 10 days—and there are sensitive forensic facilities where evidence can be gathered. We know that in such circumstances, the likelihood of conviction is much greater. For historical offenders it is even more difficult, which is why expertise is even more important.

    Yvette Cooper (Normanton, Pontefract and Castleford) (Lab)

    The Government know that rape prosecution and conviction rates have always been too low,

    but they have plummeted over the last four years, dropping by 60% to 70%. Ministers were warned several years ago about the impact of cuts to specialist rape prosecutors and to specialist sexual violence teams in the police. Has the Minister done an assessment of what the reduction in some of those specialist policing teams has been, what the impact has been, and what additional capacity is now needed in those specialist teams, in both the CPS and the police, to turn this awful situation around?

    Kit Malthouse

    I thank the Chair of the Home Affairs Committee for her question, but it would be a mistake to point to one particular issue driving the drop. We know, for example, that the significant fall from 2016-17 was down to difficulties with disclosure that arose from particular cases, and the impact that that has had on both the police and the Crown Prosecution Service.

    I think it is sometimes a mistake to give the impression that somehow a decision was made that this should happen. It was not. There has been a pattern of decline over a number of years. Part of the reason that we instituted the rape review, admittedly 24 months ago, was to try to diagnose exactly what has gone wrong—exactly why these cases are failing to get to court, why so many witnesses are falling out before they get to court, why we are seeing difficulties with disclosure, and what we can do to improve, for example, our operation of digital forensics, in terms of both capacity and capability. All that will be contained in the review. I understand people’s impatience; there is not much longer to wait now.

    David Simmonds (Ruislip, Northwood and Pinner) (Con) [V]

    I commend the Government for the work that has already been put in hand to improve support for rape complainants. Will my hon. Friend give an update on when the new 2017 guidance on achieving best evidence—ABE—will be published and set out how the use of recorded pre-trial evidence and the specialist input of the Criminal Bar Association are informing the Government’s next steps?

    Kit Malthouse

    I am grateful for my hon. Friend’s constructive question. He is right; we do think that the use of section 28, as it is called—giving recorded evidence—will have a role to play. As he will know, we have rolled it out for vulnerable victims across all Crown courts, and we now have a number of pathfinder courts—in Liverpool and, I think, Leeds—where we are using it in cases of intimidated witnesses, not least in cases of rape and sexual violence. As for the guidance that he points towards, that is a police-owned document, and I know that they are collaborating closely with the CPS and the Criminal Bar Association to get it right. We stand ready to help them with publication once their work is finished.

    Charlotte Nichols (Warrington North) (Lab) [V]

    I have heard harrowing testimony from a number of my constituents about their experience of seeking justice after rape and sexual violence. The majority felt that they had been further traumatised by the process and felt like they were the ones on trial, whether because they were required to hand over their digital devices, because they were not able to access pre-trial therapy, or because of the myths and stereotypes that abound.

    Listening to that testimony, I felt vindicated in my own decision not to go to the police—a decision that thousands of women sadly take because they understandably feel like their trauma will only be compounded by the process, with a minuscule likelihood of securing a conviction. Will the Minister therefore please commit to supporting Labour’s call for the establishment of a pre and post-trial survivor support package, including a full legal advocacy scheme for victims and better training for professionals around myths and stereotypes, so that survivors can finally have some confidence in this process?

    Kit Malthouse

    It is obviously a matter of deep regret that anybody feels prevented from coming forward to report a rape, or indeed a sexual assault, to the police. That is one of the issues that we need to address—building confidence among victims that they should and could step forward, recognising at all times that it takes enormous courage to do so. Like the hon. Lady, I have sat with victims of this particularly appalling and intimate crime over the years, so I recognise the devastating impact that it can have. As to the measures that she calls for, I obviously cannot make an announcement today, but I recommend that, when the review is published, she reads it from cover to cover.

    Suzanne Webb (Stourbridge) (Con)

    Being believed is one of the most important things for a rape victim’s confidence. Being able to come forward and report the rape in the first instance is not easy, especially when sexual abuse survivors really fear that if they were to report the crime no one would believe them, when victims know that society can blame them for the aggression or, as is often the case, when the rape victim was known by the perpetrator. I therefore thank my hon. Friend for his assurance today that the voices of victims are at the heart of the review, but will he assure me that rape victims going forward will have confidence in the criminal justice system’s handling of rape complaints?

    Kit Malthouse

    While my primary objective will be to get more cases into court—that, fundamentally, is the problem we are trying to address—my hon. Friend is quite right that, alongside that, it is completely critical that we build confidence among victims in the criminal justice system. We have seen an increase in reported rape over the last few years, and it is quite a significant increase, so more people are confident to come forward. However, given the performance figures so far, that could easily slip away, so making sure they are at the heart of decision making—that they know when they come forward that they can access the support they need, and can get the guidance and indeed the advocacy they need; that they will be received by police officers and prosecutors who are invested properly in and are looking dispassionately at the investigation; and that the natural inquiries required as part of this sort of offence investigation are proportionate and do not invade privacy in a disproportionate way—will be critical to the mission, and I hope that that is what she will find in the report.

    Tonia Antoniazzi (Gower) (Lab)

    The Minister has rightly highlighted the importance of data and transparency in the rape review. With some police forces reporting a rapid rise in sexual offending by women, what steps is he taking to ensure that all police forces accurately record and collect data on the sex of both the victims and the perpetrators in all cases of rape and sexual violence? Does he agree with me that, when it comes to recording crime, sex does matter?

    Kit Malthouse

    I agree with the hon. Lady that demographics of all types matter. Indeed, I forget who it was, but someone said, “If you can’t measure something, you don’t know how to change it”. One of the first questions I have asked in my initial meetings in this job, when officials come in with a particular area of policy to deal with, is: do we actually know what is happening—do we have a clear picture of what is happening out there on the streets and communities we serve? I am more than happy to go back and have a look at the particular issue she has raised to make sure that we are getting the recording right.

    Claire Coutinho (East Surrey) (Con) [V]

    I welcome the Government’s support for independent sexual violence advisers, who we know have a profound effect in helping victims to get through the court process. However, we know that there is an issue in convictions versus acquittals in the court process as well. Could my hon. Friend please assure me that this will be thoroughly investigated in the rape review, but also that we will be looking at how we communicate the changes on a national level, so that people who might not otherwise be engaged in the political stories of the day will learn about these changes and have confidence in the system going forward?

    Kit Malthouse

    My hon. Friend is absolutely right that we need to create a self-reinforcing story of success, where the support we give to victims and the changes in our methodology and indeed practices between the police and the CPS lead to a greater number of cases going into court, and that in turn leads to a greater number of convictions, which should build confidence among victims. I hope that is exactly the kind of spiral of success that the report will produce.

    Paula Barker (Liverpool, Wavertree) (Lab) [V]

    Seven in 10 women say the Government’s efforts to make the UK safer for women are lacking. Does the Minister back Labour’s Bill to end violence against women and girls, and if not, does he believe seven in 10 women are wrong?

    Kit Malthouse

    Obviously, one of the key themes that we wanted to address as a Government is a general sense of safety in the public realm. That is why we are recruiting 20,000 more police officers and working day and night to drive performance on all crime types to create a greater sense of safety and security on our streets for men and women.

    I do not accept necessarily, however, that we need a Bill as the hon. Lady has outlined, not least because we have managed to do a fair amount—a huge amount, actually—on violence against women and girls over the past few years through other means, as I set out earlier. We have new offences of coercive control, upskirting and stalking, and on revenge porn. The rough sex defence has been dealt with, and we have introduced modern slavery offences, when women are often trafficked for sex. We have even campaigned on rape being used as a weapon of war around the world. Alongside that are the report we have made on refuges, the domestic abuse helplines and work that we are doing now on the rape review.

    That huge package points towards the safety of women and girls. While there is much to be proud of in that, there is still a lot more to do, which is why later this year we will publish a violence against women and girls strategy alongside a complementary domestic abuse strategy.

    Rachael Maskell (York Central) (Lab/Co-op)

    The justice system is in meltdown and the victims of all crime are having their justice delayed and subsequently denied, but survivors of rape and sexual violence are also being denied vital psychological therapy and counselling, since to seek such lifesaving support can be deemed to interfere with the validity of their evidence. Will the Minister adopt Labour’s survivors’ support package as a first and immediate step to ensure that survivors may have their evidence pre-recorded and their cross-examination pre-trial, so that they may access the very help that they need?

    Kit Malthouse

    The pandemic has been extremely challenging for the court system over the past year or so, but we all have a duty not to be hyperbolic in our language—it is not in meltdown. Justice is still being dispensed in the courts, and while delay built up naturally during the pandemic, an enormous amount of work has been done to deal with it, with the opening of Nightingale courts and a massive expansion of capacity. We are seeing progress, so I hope that the hon. Lady will focus on the work that needs to be done to recover from the pandemic. We will see more positive outcomes in the months to come.

    Sarah Atherton (Wrexham) (Con)

    The military conviction rate is far lower than that in the civil system. Service personnel and veterans’ representatives are all calling for military rape to be heard in civilian courts. Will my right hon. Friend agree to discuss with his Ministry of Defence counterpart that all victims, regardless of where the assault took place, should receive the justice that they deserve?

    Kit Malthouse

    I share my hon. Friend’s concern about the low figures in military courts as well, and I will of course discuss that with the Secretary of State for Defence or my ministerial counterpart. I know that my hon. Friend is authoring, or leading on, a report on women in the armed forces at the moment. I shall look forward to reading that as well and drawing some conclusions from it for my work.

    Cat Smith (Lancaster and Fleetwood) (Lab)

    Violence against women and girls starts really young. I do not know whether the Minister saw the news today about the research done by Radio 4 and the NASUWT into sexual violence and harassment in schools, but a third of teachers had witnessed peer-on-peer sexual harassment or abuse and one in 10 see this happening on a weekly basis.

    The problem we have with violence against women and girls in this country starts young and it never ends. We have a real problem, so as well as no more delays to the publication of the end-to-end rape review, will the Minister commit to talking seriously to his colleagues in the Department for Education about addressing the need for education on consent for boys and girls in schools and through youth work?

    Kit Malthouse

    The hon. Lady makes an important point which, as I am sure she appreciates, is not within my ministerial ambit to comment on. However, through the work of the Department for Digital, Culture, Media and Sport on the online harms Bill and of the Department for Education, we are all very much aware that young people take their signals and learn their behaviour from the adults around them. We all have a duty to ensure that they grow up as right-thinking members of society.

    Marco Longhi (Dudley North) (Con)

    It is a fact that victims of rape and sexual assault are deterred from reporting these crimes. The combination of very low conviction rates, reporting requirements and a societal view of victim blaming combine to contribute against these feelings of deterrence. What can the Government do to ensure that the voices of victims are right at the heart of the review?

    Kit Malthouse

    I hope that, given his obvious conviction and commitment to this issue, my hon. Friend will volunteer to be on the Committee that considers the victims’ Bill when it enters the House. It will be a critical part of the architecture of ensuring that we build confidence in the system among victims, and I look forward to its passage through the House.

    Stella Creasy (Walthamstow) (Lab/Co-op) [V]

    The Minister says that justice is being dispensed in our courts. Well, in April this year a convicted rapist who named and blamed his victim on Facebook got a paltry £120 fine. We rightly give victims of rape anonymity for life. What message does he think it sends to victims when this important protection is being abused and the penalty for it is less than someone would get for fly-tipping? And if he agrees that it is not acceptable, what is he doing about it?

    Kit Malthouse

    As you will know, Madam Deputy Speaker, victims of these kinds of offences do have a right to lifetime anonymity. Although I have to admit that that penalty standing alone does seem derisory, the hon. Lady will know that the particular individual—I think we are talking about the same case—received a very significant sentence for the substantive offence. This is an issue that we will be keeping under review, but for the purposes of the rape review my job is to get more cases into court, and that is what I will be focusing on.

    Felicity Buchan (Kensington) (Con)

    One of the issues in securing convictions is proving lack of consent. As my hon. Friend has said, it is often one person’s word against the other person’s. Would he consider working with the Crown Prosecution Service and the police to establish guidelines as to how to prove consent or lack thereof?

    Kit Malthouse

    My hon. Friend raises a critical issue, which, as she says, is at the heart of so many of these investigations. I know that, as part of their joint action plan, the police and the CPS will be looking at exactly such issues to ensure that there is consistency and, frankly, that they can get the right kind of result in court.

    Dame Diana Johnson (Kingston upon Hull North) (Lab) [V]

    Can the Minister tell the House whether the rape review looks at the shockingly low figures for convictions of men who rape women and girls who have been trafficked for commercial sexual exploitation; and will this be addressed in any action plan, including the need for new legislation to protect women and girls, and to hold men accountable for their actions?

    Kit Malthouse

    As the right hon. Lady will know, thanks to this Government there are now significant penalties under the modern slavery legislation for those who traffic individuals. However, I hope she will forgive me if I do not necessarily reveal what is in the review. I hope that she will see that, whatever the circumstances of that particular offence, once the work starts—the work has started, but once we get going on the work that sits behind the rape review—we will see perpetrators of all kinds of these offences in court, where justice can be dispensed.

    David Johnston (Wantage) (Con)

    Last month, a constituent of mine sent me a very powerful account of how her case has taken nearly three years to reach court. During that time, she has been told not to have therapy; that she could have therapy as long as the notes were shared with the defence; that she should not claim compensation; that she should not speak about it; and, at one point, that she would not be able to watch the trial. Will my hon. Friend assure me that the review will look both at how we can get cases to court more quickly, but at how victims can feel more supported, rather than feeling as my constituent has felt—inadvertently silenced?

    Kit Malthouse

    I am very distressed to hear the experience of my hon. Friend’s constituent; it sounds like a dreadful case. On the therapy issue, the guidelines in place say that pre-trial therapy is absolutely allowed and appropriate, and nobody should be steered away from it. I would be more than happy to meet my hon. Friend to discuss that particular case, because it sounds like one from which we can learn some lessons.

    Ruth Jones (Newport West) (Lab)

    Dame Vera Baird, the Victims’ Commissioner, has stated that the Government’s rape review team

    “took the surprising decision not to seek the views of those who really matter—rape survivors.”

    Will the Minister confirm today that the upcoming end-to-end review did consult survivors of rape and sexual violence? If it did not, how can he assure the House that the review is in fact end-to-end without its speaking to those directly impacted?

    Kit Malthouse

    Of course we consulted survivors, and a number of organisations that represent survivors were represented on the engagement panel as part of the development of the review. Indeed, more than that, the Government appointed Emily Hunt, a high-profile campaigner on this issue and herself a survivor, as an expert adviser.

    Dr Luke Evans (Bosworth) (Con) [V]

    There is a benefit to being last to ask a question: one gets to see the whole debate. Throughout these exchanges there has been one common theme, which is trust. Only this month I have written to the Minister about harassment cases, but at its worst it is rape cases. People need to believe that when they come forward they will be trusted, that the police can be trusted to do their jobs, that they can trust sentences to be punishment and, finally, that we in this House are implementing the right laws. I am not asking the Minister to comment specifically on whether this review will deliver that, but overall does he think that it will bring trust into the system so that more convictions will go forward?

    Kit Malthouse

    My hon. Friend is absolutely right that trust in the police, the prosecution service and the courts is critical to building the confidence and legitimacy on which our law-enforcement system rests. Having been involved in the development of the plan, I hope and believe that it will do two things: first, address that particular issue in what is a complex environment; and secondly, bring justice for individual victims, absent the general confidence that we should all try to instil in the system.

  • Jo Churchill – 2021 Speech on NHS Dentistry

    Jo Churchill – 2021 Speech on NHS Dentistry

    The speech made by Jo Churchill, the Parliamentary Under-Secretary of State for Health and Social Care, in the House of Commons on 25 May 2021.

    First, I congratulate my hon. Friend and Suffolk colleague the Member for Waveney (Peter Aldous) on securing time for this important debate. I also congratulate my hon. Friend the Member for North Norfolk (Duncan Baker), who for the second time today has spoken about the challenges of dentistry that we have.

    As my hon. Friend the Member for Waveney said, this is not a new problem; it was a problem and challenge pre-covid. The pandemic has definitely shone a light, and things have become much more challenging in the world of dental provision during the pandemic. Dentistry has been significantly impacted because of the risks associated with the aerosol-generating procedure that dentists do and, obviously, with the saliva generated when someone is carrying out a procedure on someone else’s mouth. In response, dental practitioners have been required to wear full personal protective equipment to keep them, their teams and their patients safe.

    Public Health England is reviewing the current guidance on infection prevention and control. I mention this because it goes to my hon. Friend’s point on fallow time—the time between the dentist putting their instrument down and cleaning down their room, and then seeing the next patient. These things have been big constraints in trying to have a rapid throughput of patients through the consulting room. Fallow time now is as low as 10 minutes in many cases, although that does depend on material factors such as the ventilation and so on.

    I am talking to NHS England about the use of ventilation and the ability to support dental practices in putting ventilation in, but I gently point out that what sounds easy in a sentence in this place is often challenging. The buildings are not always owned by the dental practices, and in order to put ventilation systems in we have to take the rooms being used to deliver care out. So there is that combination of challenges, but there is new research on ventilation and lighting, and we are constantly looking at these things to see how we can further support the profession.

    An important step forward has been to reduce the amount of time between seeing patients, in order to facilitate more care for more patients, but we have taken the action we have because infection control sits at the heart of what we have to do. I stress that because, with the variant of concern in some of our towns and cities around the country, we have to very mindful that we are looking for progress as to how we proceed with dentistry. I agree with much of what my hon. Friend said about making sure we are looking for opportunities, but we have to be mindful of the fact that we are not yet clear of this pandemic, and that brings enormous constraints.

    The thresholds that have been set for dental practices since the start of the year have been based on data on what is achievable while also complying with infection prevention and control. My hon. Friend alluded to the 45%, which was the level of dental activity placed on practices in the fourth quarter of last year. That figure is now 60%, and 80% through orthodontics. This is the tension that exists in this whole area. Sixty per cent is still 40% lower than what we delivered in pre-covid times—obviously. The challenge is to make sure that we are able to see the backlog, that we drive forward with looking after the most vulnerable and those with the highest degree of need, and that we do not lose ground on what has gone before, while also having to deal with complexities such as retirements and contracts coming back and so on and so forth. However defective the 2006 UDA contract is, it is not just a question of swapping one for the other.

    The current thresholds are monitored on a monthly basis, and the new thresholds have been put in place for six months. Dental practices have been asked to deliver as much care as possible, prioritising urgent care, particularly for vulnerable groups. They are delaying planned care, ensuring that they are dealing on a needs basis with those in the most acute need.

    In addition to these activity thresholds, NHS England has provided a flexible commissioning toolkit. I am very keen for the profession to get real-world examples of what can help deliver the service, based on the successes that have been achieved locally. Some of those successes have been achieved in our own particular area. Flexible commissioning is used to convert units of dental activity, or UDAs as my hon. Friend has referred to them, to activity that focuses on priority areas, such as improving access to urgent care, or targeting high-risk patients, which was exactly what he was asking us to look at in his speech. We are already doing that. It is good practice and regional commissioners can implement it. I am very keen to make sure that that practice is being used as much as it possibly can be. I am having very frequent discussions with NHS England to make sure that we are monitoring the use of these measures.

    As well as flexible commissioning, support is also available to local NHS commissioners to put that capacity where we need it most. In the east of England, NHS England has developed the transformational dental strategy, the aim of which is to prioritise urgent care, prevention and inequalities. Despite our efforts to increase services, we know that patients are still experiencing acute difficulty in finding an NHS dentist—that is also true in my constituency.

    A feature of the debates that we have had today is the availability of private provision in areas where there is no NHS provision. NHS England is charged with commissioning to the need in an area. Making sure that we commission to the need in an area is something that contract change, which I am very keen to see delivered by April 2022, addresses, but it is highly complex. I have met stakeholders in the UK. Some people suggest that the Welsh system is better. Others favour the French system or the one that exists in some of the Scandinavian countries. I have met members of the dental profession from all those places and, actually, no one has a perfect system. We are trying to take what is good about the various systems and ensure that we deliver in localities so that people can have access to care when they need it, with a particular focus on prevention.

    We have a web-based programme in the east called service provider, which provides up-to-date information on dental services that are available. Patients experiencing difficulties are able to contact NHS England’s customer care centre and call 111 for help in accessing emergency dental care. All NHS dental practices in the east of England have been asked to reserve at least one slot per day for urgent dental care to improve capacity and, as my hon. Friend the Member for Waveney said, allow greater access. In addition, we have not stood down the 600 urgent dental centres that we had across the country during the height of the pandemic; we have left those in place, and we have a network of them across both Norfolk and Suffolk.

    However, we know that information on NHS dentists is not always easy to access. Alongside increasing access for patients, it is crucial to support NHS dental practices and mixed practices—and, arguably, private practices—in order that we can start to have a more balanced approach. As my hon. Friends the Member for Waveney and for North Norfolk mentioned, part of the challenge that we have is retention. That is the case particularly in our area, but it is something that I have discussed with Cornish colleagues too; my hon. Friend the Member for St Austell and Newquay (Steve Double) and I have discussed at length how the problem is not unique to the east of England.

    Practices have continued to receive their full contract payments minus agreed deductions, providing that levels of activity are met. An exceptions process has also been put in place for practices that have been disproportionately impacted by the pandemic. It is wrong to say that we want anyone to feel that they are not supported to deliver what they can. We have also made personal protective equipment available free of charge through a dedicated portal; and as of a week ago, we had delivered more than 367 million items free to dentists, orthodontists and their teams.

    If it has done anything, the pandemic has continued to highlight the fact that transformation in dentistry is necessary, particularly if we want to make sure that we drill down on the oral health inequalities that exist across the country. I am meeting the chair of Healthwatch tomorrow, and I am sure that, among other things, we will discuss access to dentistry at some length. We need to develop a sustainable, long-term approach to dentistry that is responsive to the population. It needs to provide high-quality, urgent treatment and then restorative care where clinically necessary, but prevention must sit at its core.

    The majority of oral health failures are preventable. My hon. Friend the Member for Waveney spoke about children. There is nothing more upsetting than a child being in acute pain and having all their teeth removed. That is a broader problem. Through flexible commissioning, we can ensure that we are doing supervised tooth brushing by encouraging local authorities to put that in, but we can also enable parents to do their part and ensure that they can help their children learn good habits right from the early days. Parents can encourage their children to look after their teeth by rubbing their gums before their teeth even appear, making sure that they understand how important it is.

    In addition, any system that we design must improve patient access and oral health, and offer value for money for the taxpayer. It must also be designed in conjunction with, and be attractive to, the profession. NHSE is leading on dental contract reform work. Importantly, it is engaging with stakeholders, including the ADG, which my hon. Friend spoke about. It will be looking at what changes can be made to dental contracts in the short term to offer some improvements and some relief and respite to everyone, while details of the next stage of reform will be agreed by April 2022. Making NHS dental contracts more attractive to the profession will help with vital recruitment and retention, and I know that all my hon. Friends in the Chamber, particularly across rural and coastal areas, will welcome that.

    Health Education England’s Advancing Dental Care programme has also been exploring opportunities for flexible dental training pathways and how we train our dental workforce to improve recruitment and retention. I am also very keen to make sure that we use the broader dental team as efficiently as we can, because dental technicians, dental nurses, hygienists and so on hold many skills that, particularly, could be used for prevention. However, with another hat in my portfolio on, I think of the obesity agenda and making sure that we all look after ourselves a bit better and have healthier lifestyles. Everything that we consume goes in through our mouths. Dentists are wonderfully placed, as are their teams, to help to encourage us to have a healthier lifestyle and to eat a little less sugar.

    We remain committed to prevention and improving oral health, and I am pleased that my hon. Friend the Member for Waveney supports—I think, from his asks—the direction that we are trying to go in by changing the UDAs, concentrating on making sure that we have the skill mix right, focusing on prevention and looking at retention. As he said, however, this is a complex area. I am also having discussions with the GDC—he spoke about recognising dentists who have trained overseas and making sure that once we are assured of standards of education and so on, things are a bit simpler.

    On making sure that we can expand schemes, subject to funding being secured and consulted on, I want to look at the expansion of fluoridated water. As my hon. Friend said, it is one of the simplest ways that we can improve oral health intervention, and we could significantly improve children’s health across the country. It is unacceptable in this day and age that young children have total dental clearances due to preventable tooth decay. The return on investment on fluoridation is very compelling and there needs to be a renewed focus on the investment in prevention.

    We are committed to increasing dental access both in the short and the long term so that we can ensure equality of access no matter where in the country a patient lives. But this is complex. We are working hard at it. We are working with the profession, but we all need to double down both on prevention and making sure that we are all walking in the same direction to bring accessible oral healthcare to people.

  • Peter Aldous – 2021 Speech on NHS Dentistry

    Peter Aldous – 2021 Speech on NHS Dentistry

    The speech made by Peter Aldous, the Conservative MP for Waveney, on 25 May 2021.

    Thank you, Mr Deputy Speaker.

    There has been an underlying problem with NHS dentistry in the Lowestoft and Waveney area for a long time, with dentists retiring, leading to resources and dental capacity being taken away from the area, notwithstanding the need and demand for NHS dentistry. Many, but not all, of the remaining practices have difficulties in recruiting and retaining dentists. The situation has been exacerbated by a lack of funding, with net Government spending on general dental practice reduced by a third over the past decade. In recent months the situation has reached crisis point, due partly to covid but primarily to the closure due to retirement of two NHS dentist practices in Lowestoft and the closure of the mydentist practice at Leiston in the constituency of my right hon. Friend the Member for Suffolk Coastal (Dr Coffey). The latter was due to the difficulty of recruiting dentists to work in the area.

    This is a national crisis. Official figures in March 2020 showed that 26% of new patients could not get access to an NHS dentist. The situation has worsened during covid, with more than 20 million NHS dental appointments lost nationally since the start of the pandemic. As has been reported today, the British Dental Association’s members survey reveals that almost half the respondents intend to stop working in NHS dentistry in the next 12 months, and two thirds estimate that they will not meet the new 60% activity targets they have been set. This is the worst survey that the BDA has ever carried out, and urgent action is required to stop dentists leaving the NHS in their droves.

    The situation is worse in Waveney. Community Dental Services, an employee-led social enterprise, has recently opened a new dental clinic in the old magistrates court in Lowestoft. That investment is greatly welcomed, although CDS highlights the challenges that it is facing in the area. It is concerned about the lack of access to NHS dental services. Lowestoft and Waveney is an area of high need for dental services, yet there is a serious lack of provision, which has been exacerbated by the backlog caused by covid and, as I have mentioned, by the retirement of well-established local general practitioners. The perceived remote location of the Waveney area and the distance from all the existing centres of dental training make recruitment difficult.

    CDS emphasises the need for a focus on prevention, particularly among children. The treatment of children under general anaesthetic for the removal of teeth that cannot be saved is the highest cause of admittance to hospital for general anaesthetic treatment in England and Wales. CDS advises that the reduction in local authority funding to support targeted or universal prevention—I am not attacking local authorities for this—has had a significant impact on the Waveney population due to reduced oral health improvement services. This limits CDS’s ability to reach out to all the people who need its services.

    The impact on young people needs particular focus. In Suffolk, the proportion of children who saw an NHS dentist fell by half due to the pandemic: 60% in 2019 compared with just 31% in 2020. This translates to 43,000 local children missing out on their dental appointments compared with the year before. CDS, which is a paediatric dental specialist, has a high number of referrals from other practices of children with multiple decayed teeth that require complex treatment, quite often under general anaesthetic. The lack of general dental services locally makes safe discharge difficult, if not impossible, thereby creating further pressure on services. This has a devastating impact on children’s life chances, and could well prevent them from achieving the best start in life.

    Covid has made the situation worse. The interruption of routine dental care and the subsequent reduction in patient appointments has created a backlog of patients. The pandemic has also meant the cancellation of and significant interruption to the dental general anaesthetic list at the James Paget Hospital at Gorleston in the constituency of my right hon. Friend the Member for Great Yarmouth (Brandon Lewis), which causes greater problems. The list will recommence on 1 June, and the backlog of patients needing urgent care is substantial, but this increases the pressure on dental practices, which have responsibilities for their patients’ dental care. It should also be pointed out that there has been no consultant orthodontist at the James Paget since mid-2020, resulting in patients having to travel further for care, and for children this disrupts their education.

    I am receiving approximately 10 emails a week from constituents, many of whom are in agony, looking for an NHS dentist. Some will go private, but for many who are on relatively low wages this option is not open to them and is one they cannot afford. One constituent has been quoted £2,400 for a new front tooth and £2,000 for a bridge repair. Others who are in need of urgent attention, as I have mentioned, go to A&E at the James Paget in Gorleston. There, all that the exasperated consultants can do is to prescribe them antibiotics and painkillers. This is completely unacceptable. Another constituent, who had a new denture fitted in 2019, needed it to be adjusted as it made his mouth sore and had a poor bite. He had no option but to use his old dentures, which were worn down and had a tooth missing. He has only just seen a dentist and is now awaiting the new dentures. These are just a few cases that highlight the agonies that many people are going through.

    Andy Yacoub, the chief executive of Healthwatch Suffolk, summarised the situation well. He said:

    “We are living through a dental disaster, with little to no clear sign of when these problems will ease.”

    He also said:

    “This latest review by Healthwatch England strongly supports our own local view that there is huge inequality in the availability of NHS dental care amongst our population…This includes that some people have waited unreasonable lengths of time to get an NHS dentist appointment, while being told private appointments were available within a week.”

    In Suffolk, he said that we are being

    “inundated by feedback on a daily basis from those struggling to access these services. One individual revealed to us”—

    Healthwatch Suffolk—

    “that they required urgent hospital treatment after overdosing on painkillers to combat their symptoms,”

    while another

    “told us they couldn’t find a dentist to treat a tooth which had reached a point where it was decaying.”

    Duncan Baker (North Norfolk) (Con)

    I confess I have a slight self-interest in this, because my father was the NHS dentist in Fakenham for 34 years. The problems in North Norfolk with dentistry are terrible, with long waiting lists and people not being able to be seen. The Healthwatch report from the past day or so corroborates that. It strikes me that the contracts are some of the root causes of that, as is the disparity between the private and public sectors. What can we do to try to get more people to join this profession? I have one example in North Norfolk where, for more than 10 years, no newly recruited dentist has wanted to come and work at the surgery.

    Peter Aldous

    I thank my hon. Friend for that intervention. The situation is very bad in Waveney. It is also bad in other parts of East Anglia, not least in North Norfolk and in the constituency of my hon. Friend the Member for Peterborough (Paul Bristow). It is particularly bad in East Anglia, and one reason for that is that we are perhaps a little away from the centre of things, and it can be difficult to recruit people to work in the area. My hon. Friend is right that one solution is to reform the existing contract, which dates from 2006, and I will come on to that as I look at some short and long-term solutions that need to be instigated immediately.

    In the short term, I urge my hon. Friend and Suffolk colleague the Minister to take the following actions. First, we must reduce units of dental activity targets. The previous target of 20% was appropriate, but the new 45% target is wholly unrealistic. Many practices will be forced substantially to reduce the number of emergency cases that they provide and to replace them with routine check-ups that are less time-consuming, resulting in an even longer backlog of outstanding emergency and urgent care cases.

    Money that is currently clawed back by the NHS if dentists do not deliver UDAs must be reinvested in the Waveney area. Dentists under-delivering does not indicate low local demand, and any clawback should be reinvested into local dental services, not transferred to other areas. That situation is particularly prevalent in East Anglia. In 2019-20, 9.1% of total contract value was clawed back in the region, compared with 4.8% nationally across England.

    I confess that I do not completely understand the opaque world of UDAs, but I know that the system is short-changing my constituents, many of whom are in agony. For children, there could well be lifelong consequences. Some NHS dentistry practices in the Waveney and Norfolk area want to take on more patients, but they are not able to do so as the UDAs are not available. John Plummer & Associates is a privately owned family dental practice with 10 NHS practices in Norfolk and Waveney. As NHS dental practices in the Lowestoft area have closed in recent years, dentists from those practices have joined John Plummer. Naturally, their patients would like to follow them, but because no more UDAs are now available, the dentists have been unable to treat them, as they will not be able to provide adequate treatment for their regular patients. Those UDAs are then lost to the Waveney area forever. So much more NHS dentistry could be provided in the Waveney area if more NHS dentistry was allowed. John Plummer & Associates would open a walk-in emergency NHS dental service, but it is not able to do so as it is not allowed to do any more NHS work.

    The continuing problem with covid is limiting the number of people that dentists can see each day. That can be eased by installing high-capacity ventilators in dental surgeries. That will reduce the period between appointments, during which the rooms are cleaned, but most practices cannot afford that. I recognise that there is quite a bit of devil in the detail, but the Government can directly increase access to NHS dentistry by providing capital funding for this equipment, as the devolved Administrations in Wales and Northern Ireland plan to do.

    In the long term, root-and-branch reforms need to be instigated immediately. There is a need to get more NHS dentists practising in this area, and the Association of Dental Groups has put forward a six-point plan to achieve this. First, the number of training places should be increased. Earlier this month, Healthwatch Norfolk called for a dental school to be set up: based in Norwich, it would be able to serve the Waveney area and, indeed, the constituency of my hon. Friend the Member for North Norfolk (Duncan Baker). As quickly as possible, the Government must instigate a recruitment drive, increasing the number of UK dentistry training places and introducing incentives for dentists to relocate to areas such as Suffolk and Norfolk.

    Secondly, EU-trained dentists should be recognised. Their role is vital, and there must be continued access to NHS dentistry for EU-trained professionals, thereby preventing further shortfalls from arising. Thirdly, overseas qualifications should be recognised. The General Dental Council’s recognition of dental qualifications should be automatically extended to approved dental schools outside the European economic area, ensuring a smooth process for suitably qualified dentists to work in the UK—notably those from countries such as India. That should also include the doubling of places available under the overseas registration examinations.

    Fourthly, the complex and lengthy process of completing the performers list validation by experience examinations—known as the PLVE—for overseas dentists should be speeded up, simplified and harmonised right across the country, with additional measures introduced to ensure that the process takes no longer than eight weeks.

    Fifthly, whole dentistry teams should be allowed to initiate treatments. Allied dental professionals are, at present, not able to open a course of treatment. This means that they cannot raise a claim for payment of work delivered, with many practices unable to fully utilise therapists as a result; allowing whole dentistry teams to initiate treatments would address this problem.

    The Association of Dental Groups’ sixth and final point is that the Government should create a new strategy to promote NHS workforce retention. They must reform the NHS contract, which is the major driver of dentists leaving NHS dentistry. A new contract, focused on the oral health needs of patients and targeting improved access and preventive care, should replace it.

    With regard to the forthcoming health and social care Bill, with the commissioning of dentists set to move to integrated care systems, it is vital that dentists have a voice and are properly represented on ICSs. There is a worry that the possible pooling of budgets across primary care could lead to further cuts to NHS dentistry, and everything must be done to ensure that this does not happen.

    Fluoridation of water can play a key preventive role in oral health, and it is very important that changes to the framework under which fluoridation schemes are carried out are accompanied by the capital funding that is necessary for those schemes to actually be put in place. I anticipate that we will consider this matter in more detail over the next few weeks when we debate the Bill.

    I now come to the topic of new dental contract arrangements. As mentioned, underlying most of the problems of NHS dentistry is the fact that the current contract, which dates from 2006, is inadequate and now completely unfit for purpose. It must be replaced as quickly as possible. The BDA is looking for this to happen by April 2022 at the latest, and the new contract must break with the units of dental activity, ensure that NHS dentistry is available to all those who need it and prioritise preventive care.

    My hon. Friend and Suffolk colleague the Minister is faced with a major task. From her perspective, it is unfortunate that the music has stopped on her watch. In summary, there are three things we need to be doing. I urge her, in the very near future, to provide practices, such as John Plummer & Associates, that will tackle the enormous the backlog of work with the resources to do so. We must end the cycle of retirements leading to funds being removed from the Waveney area, never to return. Secondly, we must tackle the growing scandal of children having to undergo major dental surgery. That requires much work in the short term in hospitals such as James Paget University Hospital, but in the longer term the introduction of major public awareness preventive initiatives is vital. Thirdly, the dysfunctional 2006 contract should be replaced as soon as possible.