Reduction in NHS beds to control innfection

 

Question:
To ask the Secretary of State for Health and Social Care, how much bed capacity has been reduced by to improve infection control in hospitals in England during the covid-19 outbreak. (156227)

Tabled on: 22 February 2021

Answer:
Edward Argar:

The latest data shows that the average daily number of beds open overnight in Quarter 3 2020/21 was 121,524 compared to 128,326 in Quarter 3 2019/20.

Hospitals continue to flex their bed capacity as part of planning to meet the demand from both elective and emergency streams. We are working hard with trusts to maximise the number of open beds while maintaining safe care through the pandemic.

The answer was submitted on 02 Mar 2021 at 12:35.

Cars, batteries and the UK motor industry

The UK government’s decision to announce an end to diesel and petrol car production by the end of this decade is speeding up the need for many decisions about the future of this important industry. Yesterday the Business Secretary had to talk to the Commons about the future of Ellesmere Port, where Vauxhall has been making engines and then assembling cars based on the internal combustion engine for many years. He assured us he wants to help Vauxhall stay there, to make a new all electric vehicle. Clearly under government plans for the industry they cannot carry on making the current types of car for much longer. I hope he succeeds in his “discussions” as he called them.

The battery is an important part of the structure of an electric vehicle, and a substantial part of the cost or added value. Car assemblers are likely to want to be close to battery makers, to take delivery of the whole “skateboard” or  the sub assemblies which will comprise the battery, the wheels,  axles and the electric motor. Electric vehicles are very different to petrol or diesel cars. Designers might soon start to make them look very different too, as they do not need the same engine compartment and fuel tank in the boot  that we have grown used to.

In a wide range of questions from MPs wanting some of the new industry to go to their areas the Secretary of State was offered several good potential sites for battery production, and potential willing workforces. He was reminded of the possible production of lithium for the batteries from the hot springs that can be tapped amongst the granite masses of Cornwall. Because many other countries see the opportunity to gain investment in these new products and technologies, there could be some competitive bidding by governments in terms of support to the companies thinking of taking the risk of putting in large battery and car plants for the new  vehicles. Companies will expect help with site acquisition, training of staff and access to raw materials and power at least.

The Business secretary told us he expected to have one battery factory up and running by 2024, then added that he wanted more. 2024 is not far away. Governments have to accept that because they are leading these changes and want them, they need to work hard to help the industry adjust. The industry’s problem is they need to commit to huge investments in new products and plant before the demand for the electric vehicles has taken off. Meanwhile their cash flow from existing products has been damaged by the new controls to come on diesel and petrol cars. Sorting this out is going to prove costly and is full of competitive hazard for companies and countries.

Speaking for England

Some of you have noticed I have dropped the Speaking for England phrase from this website. I did so after  careful consideration. When I thought through and set out my promises to electors for the late 2019 General Election I decided that the forthcoming Parliament had enough to do to see Brexit through, develop the wins from Brexit, and drive through a levelling up economic agenda. I doubted the Prime Minister’s interest in constitutional reform for England, so thought it better not to arouse expectations. I did in the past promise a referendum on EU membership before it was party policy, and helped bring that about, and promised to speak for England and helped bring about English votes for English issues before that was  party policy.

I was torn over the speaking for England issue, as it is clearly unfinished work. When I helped  persuade David Cameron to take the issue of the unfair devolution settlement seriously I both argued for an English  veto on laws affecting England and a right to initiate England only laws for English MPs. We secured the new procedure that any law affecting  just England requires a majority of English MPs voting to vote for it. I did not secure the other half, the right of a majority of England’s MPs to initiate and pass a law for England  which MPs from other parts of the UK do not approve. William Hague led a successful attempt to block us. England therefore remains way  behind Scotland in our devolved powers, as the Scottish Parliament can initiate and veto legislation for Scotland over a wide range of devolved matters.

Some of you argue England needs its own Parliament, like Scotland, away from  Westminster. I disagree. I do not want to spend more taxpayer money on more politicians and another layer of government. I do want England to have a better voice in government, and control over its own laws. This can be done by having a Cabinet member leading for England and representing England, working closely with the Secretaries of State for Local Government, Transport, Health and Education who are mainly England only Ministers. It can be done by an English Grand Committee of all UK MPs elected for English constituencies forming the English  legislature at Westminster. If I were an English nationalist then of course I would argue for a separate Parliament with as much power as possible. I would prefer the UK to survive as my country, but do want a fairer deal and a better say for England within our devolution settlement.

Deaths with and from CV 19

 

The UK government has rightly worried about deaths from CV 19. It  has used these concerns along with worries over hospital capacity to treat seriously ill CV 19 patients to drive its anti pandemic lock down policies. The government has repeatedly said it wishes to  be data driven. This requires consistent and accurate data over time to help inform policy decisions

I first took up issues of data adequacy with the government on April 11 th  2020. I reiterated and enlarged my concerns on this site on  April 26th, May 22nd, November 7th and at other times. I asked how the Uk defined a death caused by Covid 19, how it handled deaths with Covid 19 where  it was not the main cause of death, and what use it made of deaths attributed to or with CV 19 when there had been no test on a patient to establish they had the disease. We know from the public daily reporting that the UK has adopted a standard of notifying CV 19 linked to a death if the patient has had CV 19 during the 28 days prior to death whatever other health problems they also experienced.

Others have now taken this up. People have come forward to complain  that their relatives did not think their family member died of CV 19 yet it appeared on the death certificate. Doctors have explained that in some cases mistakes were made, in some cases the death certificate correctly identified other causes of death but needed to cite the presence of CV 19 at some point during  the last 28 days of life. These figures matter, as people make international comparisons without being able to adjust the figures for the differing criteria adopted to define a CV 19 death. If you are going to be data driven you need to understand what your data means, and understand any weaknesses or possible errors in  its compilation.

Using the global published figures the UK comes out as below the countries with most cases per million people, but at the top of the lists of deaths in  relation to case numbers. Assuming the high level of testing adopted in the UK has come up with a  realistic view of the total  number of cases, this leaves us with the need for an explanation of why alongside Belgium we have the relatively high death rate of 2.9% of all identified cases, compared to the USA at 1.79% and figures closer to 2% for many other advanced countries. It looks as if the UK has ascribed more deaths to CV 19 than comparable places . I do not want to  argue that our treatments have been less effective, given the huge efforts contributed by UK medical science and NHS staff to the task.

I suggest the government sets some data specialists onto the task of auditing these figures and adjusting where necessary. It does not seem fair to the NHS to leave the world with the impression we had a higher death rate from this disease given the many queries of death attribution we are now seeing. As many of the people who were recorded as dying of CV 19 were over 80, they belong to the generation that is likely to have other medical conditions that could have been the cause of death.

Scotland’s government

 

It wasn’t meant to be like this. Gordon  Brown and Tony Blair pushed through devolution for Scotland, telling us that would kill off the nascent Scottish independence movement. I wrote at the time:

“Usually , the granting of  more and more powers for separate development and separate government within a once unified state leads inexorably to stronger nationalist movements”  (The Death of Britain? 1999)

I drew attention to the many ways a canny Scottish government could press for more powers and exploit the compromises of the  settlement. It always looked like a political  journey, not a fixed  constitution.  The SNP could blame the UK government for things that went wrong and demand more powers to fix them.

Some defenders of the Union still think Gordon Brown was right, if only the UK Parliament grants a few more powers. They naively think that there is some amount of power for a devolved Parliament that will satisfy nationalists. Surely we have seen enough to know that whatever powers they have they will want more, because they do want their version of independence.

Today I would ben interested in your thoughts on the state of Scotland’s government and Parliament. I myself have no intention of rushing to judgement or intervening in the tense battles between the present and former First Ministers. This is a debate best conducted between those involved and through the voices of the Scottish parliament, now at the very centre of the row. We have  heard Mr Salmond’s serious allegations about the conduct of the senior Ministers and Law Officers, including allegations of misleading the Parliament and obstructing the work of its Committee trying to get to the truth. We now need to hear the government’s defence.

My question during the Growing Back Better Report, 25 February 2021

Sir John Redwood (Wokingham) (Con): I strongly support the green VAT cuts. Did the Committee examine the future of the petrol and diesel car industry, and especially the future of the diesel engine parts, with all the skilled staff and big assets, if the Government move to an early ban on these new vehicles?

Philip Dunne (Ludlow) (Con): I am grateful to my right hon. Friend for his question.

The Committee is taking an interest in the impact of a transition from the current economy, with its carbon-intensive sectors, to a net zero economy. We are looking at our future programme and some of the impacts of green jobs, which we are in the middle of an inquiry on now, and we will be addressing specifically the point that he makes about the impact on the motor sector.

In the future, we are interested in some of the impacts of moving from an internal combustion engine source of transport to electrified transport and what that might do across different transport sectors. We will be working with the Transport Committee to ensure that we do not duplicate efforts, but that we are able to look into those matters.

My question during Business of the House, 25 February 2021

Sir John Redwood (Wokingham) (Con): As businesses large and small need more orders to power jobs and economic recovery, can we have a debate on Government buying? Can we learn from the great success of buying so many vaccine doses from UK science and facilities, and buy more innovative and competitive goods and services from companies here at home?

The Leader of the House of Commons (Mr Jacob Rees Mogg): My right hon. Friend, as always, raises interesting and important points.

The Government are planning on creating a much simpler and nimbler procurement system, which will open up procurement opportunity to small and medium-sized businesses. However, I hope he will contribute to the Budget debate that is coming up, which will be an opportunity to talk about these matters at greater length.

The rise of the pound

In the first two months after our exit from the single market and customs union, the pound has risen against the dollar, the Euro and the yen. It is up by 3.6% against the dollar and Euro , and by 8.6% against the yen. In the referendum campaign I rightly criticised the silly pessimism of Remain forecasters saying there would be large falls in GDP immediately after a Leave vote, a collapse in house prices and a surge in unemployment. On sterling I merely said that the pound would doubtless continue to fluctuate once we had voted to leave as surely as it had varied widely during our period in the EU. I thought relative interest rates, QE rates, dollar money policy and the other usual issues would have more impact on the pound than Brexit. So it has proved.

Yesterday the pound was at the same level against the dollar and the yen as it recorded before the referendum vote, a time when the establishment and market view was that Remain would win. It would not have been easy to forecast that the pound should now be exactly where it was against the dollar and yen after a Leave vote and after exit given the elapse of time and the many other influences and variables involved. It should worry Remain forecasters that their one remaining gloomy forecast of a big fall in sterling has not proved to be right either. The pound is down by 5.5% against the Euro over the same time period, as the Euro has appreciated against the dollar and yen.

The future of the pound is never easy to forecast given the huge volumes of currency transactions and the differing money policies of the USA, Japan, the Euro area and the UK. We seem to be living through a current period of dollar weakness, probably reflecting the very loose money and fiscal policy being pursued in Washington. The rise this year so far in sterling will help limit inflationary tendencies on all those imports and will make exporting a bit more difficult. What is interesting is that in the first two months of exit sterling has risen against all major currencies including the Euro.

Since I wrote this yesterday there has been a sharp rally in the dollar reminding us of how volatile the main global currencies remain.

Roadmap – Return to full attendance at Education Settings

On the 22 February, the Department for Education announced that all schools, colleges and further education settings should allow full attendance from 8 March. Furthermore, higher education providers are asked to recommence in-person teaching and learning in a phased manner from the 8 March for students on practical or practice-based (including creative arts) courses who need access to specialist equipment and facilities.

Key messages
• Our shared goal now is to support pupils and students returning to face-to-face education, and to reverse the long-term impact of the pandemic on their education.

• The Government will review, by the end of the Easter holidays, the options for timing of the return of remaining students. This review will take account of the latest data and will be a key part of the wider roadmap steps. Students and providers will be given a week’s notice ahead of any further return.

• Although the public health picture is improving, it remains crucial that steps are taken to reduce and mitigate any risks within education and childcare settings. DfE has worked closely with PHE to develop and refresh the system of controls to reduce the risk of transmission in education and childcare settings, based on scientific rationale.

Key Q&A
Infection rates within the community continue to remain high. Why have you asked schools and colleges to return to full attendance?

• We are committed to getting all pupils and students back as soon as it is possible to do so.

• We are clear that the decision is based on the balance of risk: to the NHS of rising admissions, but also to students and pupils of the continued educational, social and psychological harms of missed education.

• In doing so, the Department for Education will be informed by the scientific and medical experts, where data and evidence is considered regularly including by SAGE, the Joint Biosecurity Centre, Public Health England, and the Chief Medical Officers.

Why are you not asking remaining HE students to return?

• We are committed to getting all students back into university as soon as the public health situation allows, taking into account the spread of the virus in communities and the pressures on the NHS. In doing so, the government has been informed by the scientific and medical experts, where data and evidence is considered regularly including by SAGE, the Joint Biosecurity Centre, Public Health England, and the Chief Medical Officers.

• The Government will review, by the end of the Easter holidays, the options for timing of the return of the remaining students. This review will take account of the latest data and will be a key part of the wider roadmap steps. Students and providers will be given a week’s notice ahead of any further return.

• Until then, we ask universities to continue to provide high-quality remote education, enabling students to access the help that they need to continue learning whilst at home.

What about clinically extremely vulnerable pupils, students and staff?

• People in the highest risk category (the clinically extremely vulnerable) are currently advised by the Government to shield and stay at home as much as possible until further notice, except to exercise or to attend health appointments (including your vaccination appointments). These individuals will know who they are as they will have been written to, informing them that they are on the list.

• CEV children and young people are advised not to attend educational settings and wraparound childcare. Education settings should make appropriate arrangements for them to continue their education remotely.

• CEV staff should not attend their workplace. Staff should talk to their employers about how they will be supported, including to work from home. Schools and colleges should continue to pay clinically extremely vulnerable staff on their usual terms.

• CEV advice applies to individuals, not households. Those individuals who live with someone who is CEV, but who are not CEV themselves, can still attend education and wrapround childcare settings and work (if they are unable to work from home).

Can parents send their children to wraparound childcare or out-of-school settings to support them to work?

Until 8 March, wraparound childcare providers and out-of-school settings should only offer face-to-face provision to children of critical workers and vulnerable children and young people, in line with those children eligible to attend school for onsite provision.

• From 8 March, wraparound childcare providers and out-of-school settings will be able to offer provision to all children, in line with those returning to school. However, parents and carers will only be able to access settings for certain essential purposes. Providers will be able to offer provision to vulnerable children and young people as normal, but other children should only be accessing this provision, where it is: o Reasonably necessary to enable their parents or carers to work, seek work, undertake education or training, or attend a medical appointment or address a medical need.

• Being used by electively home educating parents, as part of their arrangements for their child to receive a suitable full-time education.

• Being used for the purposes of obtaining a regulated qualification, meeting the entry requirements for an education institution, or to undertake exams or assessments.

• Schools should be working to resume all their breakfast and after-school clubs for their pupils, where this provision is necessary to support parents to important for providing enriching activities which support children’s education, vulnerable children’s wellbeing, as well as supporting parents to work, attend education and access medical care, and to support pupil’s wider education and training.

• From the start of the school summer term, it is our ambition that all children will be able to access this provision for both indoor and outdoor activities as normal. This will be no earlier than 12 April and will be confirmed as part of Step 2 of the Government’s Roadmap.

Freedom

We have lost a lot of freedoms during the battle against CV 19.  Most have accepted the need to take tough measures to protect those at risk of serious illness and death. Now vaccines supply a way out of the public health imperative it is important we do not come to think some of these controls are acceptable or useful for the future. These were extreme measures which should be temporary.

I never thought I would be living in a country where you needed a reason to leave your house, where you were banned from making trips just for pleasure and where every social contact you wished to make had to be done electronically or under a special dispensation allowed by the regulations.

The government has promised us the way out of lockdown will be data driven. The slow indicative timetable to eventual freedom on June 21 is subject to revision. It is highly likely the data for serious cases admitted to hospital and deaths from CV 19 will continue to fall rapidly as the NHS completes vaccination of most people over 50 and anyone with another worrying  medical condition. The government must understand the data is dynamic, and lagged. It needs to respond to the trend and to the vaccination figures, and get on with relaxing the controls.

I do not think it a good idea to make a vaccination certificate an official document that is used to enforce controls on people’s conduct in the UK. Of course if foreign countries want proof of vaccination for people to travel there that is up to them and the potential traveller. We might wish to require vaccination for people coming to the UK, particularly from countries that still have bad attacks of the pandemic or to require quarantine. A more difficult question which the government as employer does need to resolve is should NHS employees have to have the vaccine in order to work in NHS establishments?  I am happy with the current policy of advising them to but not enforcing it. It would be quite wrong to make the rest of us have the vaccine in order to go to a shop or theatre if the government isn’t even willing to require vaccination as a condition of employment in exposed state employment.