Westminster Hall is an alternative Chamber for MPs to hold debates, named after the adjoining Westminster Hall.
Each debate is chaired by an MP from the Panel of Chairs, rather than the Speaker or Deputy Speaker. A Government Minister will give the final speech, and no votes may be called on the debate topic.
This information is provided by Parallel Parliament and does not comprise part of the offical record
The Minister for Health (Edward Argar)
It is a pleasure to serve under your chairmanship, Ms Bardell; I think that I do so for the first time.
Although I suspect that it is fair to say that the hon. Member for Leeds East (Richard Burgon) and I are not fellow travellers in the same direction on many things politically, I congratulate him on securing this debate on a very important subject. Although his speech was long on opinion and perhaps short on fact, I do not think that anyone could doubt the passion or the sincerity with which he spoke, whether one agrees with everything he says or not. I pay tribute to him in that respect.
I think it is clear to everyone in this Chamber, as I hope it will be to people watching on Parliament TV and those who read the transcript of our debate, the genuine affection and respect that every Member of this House has for our NHS and those who work in it. It is right that I join the shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), and others—I often do so on these occasions, because this cannot be said too often—in paying tribute to those who work in our NHS, including the shadow Minister herself. On the occasions when she and I see each other across the Dispatch Box, I always try to make that point.
A number of key themes have emerged today. The legislation is currently in Committee, and I know that a number of Opposition Members have argued that it should be paused or even scrapped. I have to say that the former chief executive of the NHS, Lord Stevens, said that about 85% of the Bill is exactly what the NHS asked for, wanted and wanted done now—ideally, the NHS wanted it done two years ago, before the pandemic.
In the evidence sessions of our Bill Committee, which continues to meet, we heard NHS Providers, the NHS Confederation and the Local Government Association all saying, “This is the right Bill at the right time.” I should acknowledge that some of those witnesses said there were certain elements that they would question or challenge, but they said it was the right time to pass this legislation. In fact, in a joint statement the NHS Confederation, NHS Providers and the LGA said,
“we believe that the direction of travel set by the bill is the right one.”
At the heart of this legislation is the principle of integration underpinned by evolution. Colleagues across the House who have served with me since 2015 will know that I am not by nature revolutionary, so the legislation is evolutionary in what it seeks to achieve, but it seeks to achieve greater integration. I think it was the hon. Member for Liverpool, Wavertree (Paula Barker) who spoke about accountability needing to be upwards, downwards and sideways. With these proposals we seek to do exactly that: to achieve greater integration at a local level within the NHS and, at the ICP level, to achieve greater integration with local authorities.
Margaret Greenwood
What would the Minister say to the British Medical Association council, which passed a resolution overwhelmingly
“calling for the Health and Care Bill to be rejected, arguing that it is the wrong time to be reorganising the NHS, fails to address chronic workforce shortages or to protect the NHS from further outsourcing and encroachment of large corporate companies in healthcare, and significantly dilutes public accountability”?
Edward Argar
I will turn to those key points in a moment, but first I will address the specifics. The point I made to the Chair of the BMA council in Committee was that, if I recall rightly, every single piece of legislation on the NHS, including the National Health Service Act 1946 that brought it into place, has been opposed by the BMA. I challenged him to tell me which pieces of legislation the BMA had supported, and he said he would write to us. I have yet to get that letter; I am sure, knowing Dr Chaand Nagpaul as I do, that he will write to us, but in the Committee he was unable to say which piece of legislation—including Labour legislation in 1999, 2001, 2003 and 2006—the BMA had supported.
Edward Argar
I will make a little bit of progress, because I want to address the hon. Lady’s allegations about privatisation and workforce. If we have time at the end, I will of course seek to let her come back in.
On allegations or suggestions of furthering privatisation, I know it is tempting for some, even when they know better—and they do—to claim that this is the beginning of the end for public provision. It is not, and Opposition Members know it. There have always been key elements of the NHS that have involved private providers, voluntary sector providers and so on.
What is instructive is the extent to which that was accelerated when the Labour party were in power. The shadow Minister talked about the 2012 legislation and any qualified provider, but that was not brought in by the 2012 legislation; it was brought in by the Gordon Brown Government in 2009-10 under the term “any willing provider”. The name was changed, but nothing substantive changed from what the Labour Government had introduced in terms of the ability to compete for contracts.
The other point I would make is that one of the key changes allowing private sector organisations to compete for and run frontline health services came in 2004, under the Labour Government, when the tendering for provision of out-of-hours services by private companies was allowed.
Bell Ribeiro-Addy
So often—not only from Conservative Ministers, but from hon. Members generally—we hear about things that Labour did in the past. I remind the Minister that the Conservatives have been in power since 2010. We are telling him what we think the issues are with the NHS, and we do not want to hear about what Labour or the ghosts of Labour Prime Ministers past did. We want to know what the Conservative Government, who have been in power for 11 years now, are going to do to improve our NHS.
Edward Argar
I appreciate why Opposition Members might not want to hear what Labour Governments did in the past, given the extent to which they massively accelerated the privatisation of our NHS. To address the hon. Lady’s point directly, we do believe that there is a role for private providers, the independent sector, voluntary organisations and others in providing healthcare services in this country.
Workforce is an issue that a number of colleagues have rightly raised. I am afraid I cannot say to the hon. Member for Tooting and others that, among other things, I am taking on responsibility for mental health in my new portfolio. However, following the departure of my hon. Friend the Member for Faversham and Mid Kent (Helen Whately) to the Treasury, as of about three days ago, I will be assuming responsibility for workforce alongside the other responsibilities in my portfolio. I look forward to working with her and the hon. Member for Ellesmere Port and Neston (Justin Madders), who I believe is the shadow Minister, as well as meeting with Opposition Members who take a close interest.
The hon. Member for Rhondda (Chris Bryant) spoke with typical wisdom on that matter and made a number of very powerful points. At the risk of a negative impact on my career prospects—although the reshuffle has just happened, so hopefully I can get away with it now—I agree with a lot of what he said. He highlighted that, were it not for a prompt diagnosis, he would not be here. For what it is worth, I think I speak for everyone in the Chamber—if not on all points, then certainly on this one—when I say we are all extremely pleased that he is still with us. He is a man of great integrity and strong beliefs, and I look forward to working with him. We meet on a number of things. I am happy to meet with him to talk about his suggestions and how they might factor in to how we move forward, in the spirit of bipartisan and constructive discussion.
Edward Argar
With the meeting or the job, or both? A number of hon. Members have raised “Agenda for Change” and pay and conditions. I hope I can reassure them, as I sought to do with the hon. Member for York Central (Rachael Maskell). It is not our intention that integrated care boards depart from “Agenda for Change”. The Bill is drafted in such a way as to seek to replicate what is currently there. On Second Reading, I offered to have a meeting with her. I would be very happy to have that meeting, if she gets in touch.
On funding, this Government have passed legislation increasing NHS funding by £33.9 billion by 2023-24 and put £2 billion into elective recovery. In addition, the Prime Minister announced a massive cash injection into our NHS a couple of weeks ago.
I want to give the hon. Member for Leeds East a little time at the end, so I will just make a couple of quick points. The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) is right: we are always happy to learn from our Scottish friends. In response to the hon. Member for Strangford (Jim Shannon), that is a matter of medicine supply which I discuss regularly with the Northern Ireland Health Minister, and it is absolutely vital that we seek a resolution. I believe that the previous approach by Lord Frost is the right one to find a sustainable way forward.
Dr Cameron
On sharing best practice, I meant to mention that artificial intelligence technology is being used by NHS Greater Glasgow and Clyde and has reduced the heart failure diagnostic waiting times from 12 months to six weeks. I know that Lord Bethell will be visiting to find out more about that. I wanted to highlight it to the Minister today, because I think that technology can support NHS staff workload as we move forward.
Edward Argar
The hon. Lady has rightly highlighted the benefits of technology, while my hon. Friend the Member for Bolton West (Chris Green) highlighted the need for us to continue to move with the times and seize those initiatives. I fear that my noble friend Lord Bethell will not be visiting, as he left the Government at the end of last week. However, I have received a very kind invitation from the hon. Member for Central Ayrshire (Dr Whitford) to come and see how the NHS in Scotland is innovating and driving change. I look forward to taking her up on that invitation as soon as I can.
Chris Green
Just as medical devices and drugs innovate change over time, does the Minister agree that the place where the NHS operates and works must also change? Whether those are local surgeries or hospitals, they have to move with the times. In that context, would he also turn his mind to any needs that Bolton Royal Hospital may have in terms of new hospital infrastructure?
Edward Argar
My hon. Friend makes a fair point about the need for us to create the conditions—the physical spaces with the technology—in which the workforce, which is the heart of our NHS, can work. He makes a subtle—or not so subtle—plea for his own local hospital. He will not be surprised that I will not comment on the detail of that.
To finish my response to the hon. Member for Strangford, the Command Paper recognises the challenges posed by the current arrangements in the Northern Ireland protocol around the supply of medicines and other goods, for example. The approach that the hon. Member set out, of removing medicines and medical devices from the orbit of the protocol, is reasonable. I hope that discussions between the European Commission and Lord Frost are productive, and that a consensus can be reached on the way forward.
I have to take issue slightly with the hon. Members who raised the role of Sam Jones, one of the Prime Minister’s advisers. They focused on one particular aspect—that for a brief period she worked for an independent provider. What they did not do, which is extremely unfair to a dedicated public servant, is highlight that she worked for NHS England, running new care models; that she has been an NHS paediatric and general nurse; that she was the chief executive of Epsom and St Helier University Hospitals NHS Trust; that she was the chief executive of West Hertfordshire Hospitals NHS Trust; and that she was the Health Service Journal chief executive of the year for 2014 and was highly commended for her work in driving forward patient safety. I gently say that it ill behoves Members of the House to attack public servants, who cannot answer for themselves in this Chamber, with partial references to their careers rather than recognising that they have contributed a huge amount in the past.
The hon. Member for York Central was absolutely right to highlight health inequalities as one of the greatest challenges—not the only challenge—that we face as a society and as a health system. The measures on integration and change in the Bill will help us tackle those health inequalities. I suspect that on Report and Third Reading she may test and challenge me on those assertions and assumptions, but she is absolutely right to highlight the centrality of health inequalities.
The hon. Member for Liverpool, Wavertree (Paula Barker) spoke about residential care and the link to social care. While I am not the social care Minister, everything that I do in my role as Health Minister must have an eye to social care. I was a cabinet member for adult social care in the dim and distant past, when I had rather more hair, and I also sat on the primary care trust, as it then was, at that time. I recognise the need for those two parts of the system to work together to achieve the best outcomes for our constituents. She makes a valid and important point.
I found what the hon. Member for Wirral West (Margaret Greenwood) said about the US experience of great interest and instructive, but it is utterly divorced from what the Bill and the Government are doing in respect of our NHS. It was an interesting reflection on what is going on in America, but it certainly does not bear any resemblance to what is happening or will happen in this country.
Margaret Greenwood
Does the Minister not recognise that, where we have a postcode lottery and the increased rationing of care—my constituents are very aware of the rationing of care, and a number of Members have spoken about what happens when people cannot get the treatment that they need on the NHS—there is the spectre of an individual, private insurance-based system? Members of his own party have in fact argued for such a system. People need to be mindful of just how dangerous for us all it would be to introduce a private insurance-based system.
Edward Argar
Will the hon. Lady forgive me? I was not questioning the integrity of what she said, but I was suggesting that there was no risk of that system as she described it developing in this country.
I will sum up, because I want to give the hon. Member for Leeds East a little more than two minutes, if I can. We are determined to continue supporting our NHS; this Bill, this legislation, the funding announcements we have made and the reforms we are putting in place do just that. We want to create an NHS that is fit for the future, renewing the gift left to us by previous generations, building on that gift and strengthening our NHS as it evolves to meet the challenges of the future. We remain the party of our NHS; we will give it the support it needs—as we always have done.