I sat through the Health Secretary’s latest statement in disappointed silence. I have heard a few Ministerial statements over the years that have bombed with the Ministers own side as this did, but do not recollect cries of Resign before from the government benches. Sajid Javed needs to ask himself why and start improving the way he does the job.

I guess the impatience with the Secretary of State reflects pent up anger about the way Ministers are constantly telling us the NHS cannot cope despite £64 bn more being spent on health this year than two years ago. Ministers are unable to answer basic questions about plans to recruit more, to increase beds, to improve air filtration in health  settings, to improve infection control, and to   find new treatments.

The PM and the Treasury both want the Health Secretary to get a grip on staffing budgets. They want him to turn the extra  gold for the  NHS into extra  capacity and lower waiting lists. They want the NHS through a combination of vaccines, better treatments and extra capacity to show it can handle a realistic volume  of covid disease going forward.

I did not ask another question as so many of my questions recently have not produced informative answers. My advice to Secretary of State is simple. Go through all the main issues with the CEO of NHS England so you can tell us how the money is being spent, how you will increase capacity, how you will improve  infection control, how you will expand the range of covid treatments, how you will bring down the waiting list anD  then come back to the Commons with a plan to get better results. If the CEO cannot supply you with decent answers you need to consider how this can be brought about.

The public regard you as responsible. The CEO is your chosen person to run the NHS under  your supervision, so make sure you know what is happening and are  able to defend it.

The Chief Executive of the NHS was rarely present at the news  conferences to present the actions being taken to handle the pandemic. That was a pity, as  many of the most important matters were for those running the NHS. One of the main aims of the policy generally was to avoid  placing too much strain on NHS capacity. We needed to know how staff were going to be protected and helped to tackle this big challenge. We needed to know how all the extra money and resource was going to be deployed, how the hospitals would cope and how the virus would gradually be brought under control.

The scientific and medical advisers usually present have a close working relationship with the NHS senior administrators. They did not however see fit to give us presentations about work on finding drugs that could abate symptoms or avert  serious developments in a covid patient. They did not comment  much on why the NHS put in substantial extra  bed capacity for the pandemic, used it little and then closed it all down again before the pandemic was over. They did not comment on the underuse made of the private hospitals whose capacity the NHS bought up for the first year of the disease.

They were reluctant to be tempted to discuss improving infection control. We did not get regular reports on how they were changing and improving air extraction, UV filtration and better air management though they told us  it was an airborne disease.They decided against creating isolation hospitals that just handled covid, living with cross infection dangers in all DG hospitals. They allowed early discharge of elderly patients to care homes in the first weeks of the pandemic which may have increased the wave of infection that visited those homes.

On the whole the news conferences stuck to a routine of presenting figures for cases, hospital admissions  and deaths, and forecasts of grim news to come, followed by announcements and comments on various lockdown policies being followed. They did not do a good job bringing out the need for strong action on treatments, infection control and improving NHS capacity. They told us little about how the senior management of the NHS were using their staff and facilities, how they were managing the  covid workload or how they were ensuring fairness and safety for their medical employees facing the pandemic dangers.

I have had enough of news conferences of the PM or some senior Minister flanked by a scientific and a medical government adviser setting out policy. It is a distortion of our constitution, blurring the roles of both Minister and senior official. The format chosen also gives a very lopsided view of what should be happening in government when making difficult decisions over how to respond to a pandemic.

At the peak of the first wave of the virus I wrote about the questionable  use of some figures and charts and the unreliability of some of the data. The media mainly played the game of accepting everything the “experts” said as true and acting as interpreters of their wisdom to the rest of us. Ministers seemed to add little to the narrative.

It was wrong that the only experts in  the room were of one mind with one purpose, beating the virus. Their advice is rightly bound to be ultra cautious over the virus as that is their sole preoccupation.  Where were the other health experts worried about what might happen to people with other conditions who might lose out on hospital and GP capacity? Would we get more deaths from  other causes? Where were the experts worrying about mental health and the impact on people  that lockdown could bring. Where were the economic experts asking about ways of limiting the damage to jobs, investment and incomes whilst wishing to assist with controlling the disease?

Responding to the virus is a cross government large task. It needs the inputs of many departments and many different areas of expertise. It is the job of Ministers within their departments and acting collectively across government to reconcile conflicting needs and pressures and come up with a  balanced package of measures for the circumstances. The best way of then reporting would be to Parliament with MPs challenging government and putting forward issues and problems they wished to highlight. We should not see the individuals providing  advice on the  scientific, medical, NHS, economic, business and social policy issues, but Ministers should draw on it to support their final decisions. Government would publish relevant data to help us monitor progress. Outside experts would be free to query what the government was doing to inform a better debate.

Tomorrow I will look at some of the important questions that got little air time thanks to this style of presentation.

The relatively new Secretary of State for Health has a major job to do.He has to  ensure the NHS sustains high quality care and a good level of response and service. He needs to supervise how the substantial extra money will be spent and check on how the base budget is used.

Doing good and doing no harm to patients must be the common starting point.  Tackling the unacceptably high waiting lists is a clear priority.

This agenda should include

1 Further improvements in infection control. Controlling viral transmission requires better air extraction and UV filters in air systems. Other hospital infections require high levels of disinfecting and cleaning.

2. Expansion of capacity. Hospitals are short of beds and of some medical staff to man them. This should be a priority in new spend.

3. Reduction of administrative overhead where there are too many layers and bodies over the heads of medical teams

4 Intelligent digitalisation of records with good access for all screened medical staff who need access to a patients condition and diagnoses.

5. Development of more specialist units that become very good and efficient at the more routine operations like joint surgery and cataract removal.

6. Provision of more social care back up to allow discharge of frail and elderly from hospital after treatment.

The Department of Health and Social Care has provided the following answer to your written parliamentary question (86525):

Question:
To ask the Secretary of State for Health and Social Care, how much of the funding increase for the NHS announced in the Autumn Budget and Spending Review 2021 will be spent on reducing waiting lists in the NHS in England. (86525)

Tabled on: 03 December 2021

Answer:
Edward Argar (Minister of State):

We have made £2 billion available this year to start to tackle the backlog. Over the next three years, we plan to spend more than £8 billion to support elective recovery and reduce waiting lists in England.

I was glad to see the government yesterday reported cases in hospital and deaths from CV19 have been falling. It seems that Plan A, persuade most people to get the vaccine, is working. So why the need for some new measures?

The Secretary of State told us that though there are only a few hundred Omicron cases in the U.K. they guess there are in practice 10,000 already. If that is so then the lower hospital cases is even more significant. They say Omicron cases are doubling quickly, but most people with it are not seriously ill or have no symptoms.

I disagree that people should have to show vaccination proof to go to an event or a night club. I disagree with people being told to work from home. People now have three options to manage their risk of catching covid. They can take a vaccine which greatly cuts the chances of getting a serious version of it. They can decide to avoid crowded places and observe prudent  distancing in what they do. They can agree homeworking with their employer where that works for both parties. They can decide to take the risk, as we do for most other diseases that we can catch from other people.

It is time to move on from worry about the virus. Trust  people to make their own decisions about how to handle the risk.

The government wants to stop people trafficking and smuggling from France. Its Border Force has been unable to carry out the Home Secretary’s wishes and deter or turn back the small boats. The government is now legislating  to strengthen its powers to  send people back who do not qualify as asylum seekers.

I sponsored Bill Cash’s  amendment to the Bill. We were worried that U.K. courts might refuse to implement  the law, claiming that European Human Rights or the UN  migrant Convention prevented them from doing so. We proposed a simple amendment to clarify that the  U.K. law means what it says notwithstanding any ECHR or UN interpretations.

The government refused to accept the amendment and Opposition parties were against it. The government promised to bring forward proposals to amend the Human Rights laws urgently , implying they agreed with our fears concerning this Bill.

It is a pity they did not just accept the amendment. The danger now is the courts will seek to undermine government borders policy yet again.

John Redwood:

If the legislation is carried in the way the Minister wishes, what impact will it have on the awful, vile trade through small boats? Will it stop it? Is there a danger that the UK courts will overturn the intent?

Tom Pursglove, Parliamentary Under Secretary of State (Ministry of Justice and Home Office):

The measures in the Bill are significant. We have recognised—the Home Secretary has consistently recognised this and I recognise it as the Minister responsible for tackling illegal immigration—that the asylum system in this country is currently broken. The length of time it takes to process claims is unacceptable and we need to improve the situation. The Government’s intention is clearly stated: to improve the way we process claims. We expect individuals who seek to claim asylum in this country to comply with the requirements, but of course safety nets are in place, for good reasons, so that it will be taken appropriately into account if people cannot meet the deadlines. We believe that progressing on the basis of processing claims more quickly and removing those with no right to be here will make quite a significant difference. Importantly, it is also about the work that we do not just with our nearest neighbours in, for example, France and Belgium—that collaboration is important and is delivering results, and we want to secure a returns agreement that will help to build on that—but further upstream in removing those with no right to be here back to source countries.

John Redwood: 

To ask the Secretary of State for Health and Social Care, what recent assessment he has made of the cost of the reorganisation of clinical commissioning groups.

Edward Argar, Minister of State (Department of Health and Social Care):

There has been no specific assessment. NHS England and NHS Improvement are providing guidance and support during the abolition of clinical commissioning groups and the establishment of integrated care boards. NHS England and NHS Improvement are managing changes required to adapt software and processes managed by third-party suppliers and we expect these costs to be absorbed within NHS England’s budgets.

The EU protests against Russia’s seizure of Crimea. The EU says it does not want Russia taking any more of Ukraine. At the same time Germany encourages Russia to put in Nord Stream 2, a second direct pipeline from Russia to Germany to increase German and EU dependence on Russian gas. It also provides a way of diverting gas that might otherwise have flowed through a pipe across Ukraine, with revenues accruing to Ukraine, to a different route and no Ukrainian revenues. For Russia Nord Stream 2 is a double win, weakening  the EU and Ukraine at the same time.

Both Germany and the EU are delaying signature on the regulatory arrangements and the contracts to supply gas via the pipeline. They are trying to place more of it under EU law. That will not of course make much difference should Russia at some date in the future decide to use the leverage it could exert from being a major gas supplier to the EU to demand concessions or changes of policy to its liking. For the legal route to work the other side both has to accept the jurisdiction of the EU court and to willingly submit to the views of the other party in the dispute. Russia would  not necessarily do that in practice whatever the initial documents might say.

The SPD led new German coalition government includes the Greens and is meant to be taking the faster pursuit of net zero seriously. Greens do not usually welcome new sources of fossil fuel delivery. I guess in this case they will be so hard pressed to find ways of implementing their new pledge to try to phase coal out of their electricity generation by 2030  that they will not think they can do without this extra gas as well.

Today President Biden will have a video conference with President Putin. Ukraine will doubtless  be high up the agenda. The USA has told the world of a build up of Russian troops near Ukraine’s eastern border. One of the many things Presidents Biden and Trump agree about is the undesirability of Nord Stream 2. As it gets close to going ahead President Biden will need to find ways to warn Russia off using Ukraine’s greater weakness to his advantage.