Oral Answers to Questions

Edward Argar Excerpts

Tuesday 23rd February 2021 Commons Chamber

[Mark Pawsey (Rugby) (Con)]

What steps he is taking to ensure that improvement work on district hospitals is taken forward under the health infrastructure plan.

[The Minister for Health (Edward Argar)]

Alongside our investment in 40 new hospitals, our health infrastructure plan more broadly will deliver a long-term rolling programme of investment in health infrastructure, including our vital district hospitals—I know that my hon. Friend’s constituents are well served by the Hospital of St Cross. Hospitals have benefited from more than £600 million of critical infrastructure risk funding, including for district hospitals, and will shortly receive their capital allocations for the forthcoming financial year.

[Mark Pawsey [V]]

I am grateful to the Minister for his reply. As he says, it is entirely right to be investing in the new hospitals—the 40 new hospitals for our NHS. He referred to our brilliant local district hospital, St Cross. The past year has reminded us of the importance of a well-resourced local health service. How can we ensure that existing district hospitals doing great work, such as St Cross, continue to receive the investment they need?

[Edward Argar]

I am grateful to my hon. Friend for his question. May I join him in paying tribute to his local Hospital of St. Cross and the team who have done an amazing job in very challenging circumstances over the past year? I know that he is a strong champion of it and of his local NHS—I think I can recall him volunteering at the Locke House vaccine centre recently in support of his NHS. Of that critical infrastructure funding to which I referred, £2.2 million was allocated to his trust and local hospital. As I mentioned in my initial answer, we will be making further capital allocations shortly, which will benefit district hospitals, including his own.

[Siobhan Baillie (Stroud) (Con)]

What steps his Department is taking to support people suffering from long covid.

--- Later in debate ---

[Andrew Jones (Harrogate and Knaresborough) (Con)]

What progress his Department has made on improving the health service capital estate.

[The Minister for Health (Edward Argar)]

A total of £600 million has been allocated to tackle almost 1,800 urgent maintenance projects across 178 trusts, all due for completion by March 2012, while £450 million has been invested to upgrade A&E facilities, with funding awarded to over 120 trusts, and improve over 190 urgent treatment sites this winter. In addition, of course, the Prime Minister has confirmed that 40 new hospitals will be built by 2030, with an additional eight further schemes to be identified. Six of these are already under construction. With your permission, Mr Speaker, may I group this question with Question 21?

[Jo Gideon [V]]

NHS staff at Royal Stoke University Hospital in my constituency have been using the old Stoke Royal Infirmary site, which stopped delivering clinical services in 2012, for car parking. However, with the demolition of buildings on the site in readiness for the creation of many new houses, hospital staff really need the University Hospitals of North Midlands NHS Trust’s proposed plans for a multi-storey car park to come to fruition. Will the Minister ensure that the necessary investment is forthcoming for additional staff car parking facilities at Royal Stoke University Hospital to support our wonderful NHS staff and unlock this vital regeneration project for the people of Stoke-on-Trent?

[Edward Argar]

I am very grateful to my hon. Friend, who is a strong champion and a strong voice for Stoke and for her local hospital. The Government are committed to increasing hospital car parking capacity and supporting trusts to invest in their car parks. We will continue working with NHS England, as well as trusts such as her own, to understand the specific requirements. I understand that an emergency funding application by the Royal Stoke in this respect has been received and is currently being considered. However, I am always happy to discuss with her the specifics of the case she raises.

[Andrew Jones]

Harrogate District Hospital, which is an excellent hospital, will be reducing its carbon footprint by a quarter and making energy cost savings thanks to a £40 million Government grant, but the healthcare estate is much more than hospitals: it is also doctors’ surgeries, specialised units and so on. What steps is my hon. Friend taking to ensure that the whole estate, whether large or small, is included in the decarbonisation investment programme?

[Edward Argar]

How could I have failed to remember to group my hon. Friend’s question? I apologise to him. He is right to pay tribute to his local hospital in Harrogate. Zero carbon and environmental sustainability are key design criteria in our 40 hospitals programme, but it is also right, as he says, for that to flow throughout the NHS estate. The NHS’s net zero report provides a detailed plan for decarbonising the whole NHS estate and services. In that context, there is already a range of action under way, including the £50 million NHS energy efficiency fund, which, as a small example, is upgrading lighting across all NHS buildings, big and small, to improve environmental sustainability.

[Karl MᶜCartney (Lincoln) (Con)]

What steps his Department is taking to support the health and social care workforce during the covid-19 outbreak.

Covid-19

Edward Argar Excerpts

Monday 22nd February 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I beg to move,

That this House has considered covid-19.

When I last spoke in this Chamber in a general covid debate, on 12 January, we faced a very grave situation. There was a very real risk of our hospitals being overwhelmed, the number of people tragically dying from covid-19 each day was in four figures, and our vaccine roll-out was just getting off the ground. As I stand here today, we have made huge progress, and while there is no room for complacency, thankfully we now face a very different picture.

That we find ourselves in this changed position is largely down to three factors. The first is our amazing NHS and social care workforce. The pressure they have experienced has been phenomenal. Their response to that pressure has been humbling to all of us: the teamwork, the resilience, the dedication. It has been truly inspiring. They have our admiration and our thanks, and we must always reiterate that, but they must also continue to have our unwavering support in the months ahead as we build back better after this pandemic.



The second factor is, of course, our national lockdown. On 12 January, the average number of cases per day was 44,302; more than 30,000 people were in hospital with covid-19; and, on average, more than 1,000 people were dying of the disease each day. Today, we see an average of just over 11,000 cases each day; just under 20,000 people in hospitals with covid; and a heartening and welcome decline in the number of deaths.

[Steve Brine (Winchester) (Con)]

One of the great differences between the start of this nightmare and where we are now is on personal protective equipment for health and care staff, which was a big issue at the start. There were a lot of stories over the weekend about the procurement of PPE. I know from my time as a Minister in the Department that sometimes government is not elegant, but surely what we did was to make sure that we did not run out of PPE. We should congratulate many of the officials in the Department on making sure that that did not happen, as history records it did not. For my constituents who are concerned about the process that went on, will the Minister reassure me that everything was above where it should be?

[Edward Argar]

My hon. Friend was a distinguished Minister in the Department for some time and rightly highlights the situation that we faced at the height of the first wave of the pandemic. It is testament to the phenomenal efforts to procure PPE of the officials in my Department, in the Paymaster General’s Department and others that we did not run out of PPE in this country. Indeed, credit for that should also go to my right hon. Friend the Secretary of State for Health and Social Care, who ensured that throughout he put the provision of PPE and people first, even when, as we have seen, that may have led to challenges and to process not being entirely adhered to in respect of the timings for the publication of contract details. He and I have the greatest respect not only for the recent judgment, which we will consider carefully, but for the importance of transparency. I believe that my right hon. Friend did the right thing: he did everything he could to ensure that his No. 1 priority was to get that PPE procured and to the frontline to protect those who were protecting all of us and helping to save lives.

As on so many occasions over the past year, in recent weeks the British people have once again made huge sacrifices to comply with the necessary restrictions. It has been incredibly hard for individuals and businesses up and down the country, but in the figures that I have set out, we can see the impact that those sacrifices have made in helping to suppress the spread of this virus.

Despite the progress, over the past week an average of 449 people still lost their lives each day—449 families and friends who have lost loved ones. It is still far, far too many. It reminds us that, even now, as we map a brighter course forward, we must never lose sight of the threat posed by this virus.

[Bambos Charalambous (Enfield, Southgate) (Lab)]

When I asked the Prime Minister a question about his road map a short while ago, he said that he supported a public awareness campaigns for people who cannot wear face coverings but are subject to abuse because people are not aware of their exemption. Does the Minister support such a campaign and will he make the same commitment as the Prime Minister, so that people do not face abuse, and so that people are educated and know that there are reasons why people cannot wear face coverings?

[Edward Argar]

The hon. Gentleman makes a typically measured and sensible point. He is absolutely right: those who are exempt from wearing face coverings for medical reasons should be able to go about their lives without fear of abuse or verbal or other attacks on them for not doing so. I heard what the Prime Minister said and I echo those words. The Paymaster General and I will look carefully at what the hon. Gentleman has just suggested in respect of what we can do as a Government to raise awareness of the fact that there are people who, for entirely legitimate reasons, are not wearing face coverings.

Finally, I turn to the third factor that has changed the situation for the better. That, of course, is our vaccine roll-out, which throughout has been key to the future. As of today, we have provided a first dose to over 17.5 million people. That is almost one in three adults in the United Kingdom. Vaccine take-up has surpassed our expectations. In England, for example, we have now given a first dose to 93% of the over-80s, to 96% of those aged between 70 and 79, and to 94% of eligible care home residents. Those are phenomenal achievements—the result of a huge team effort. In that context, I pay tribute to our NHS, to pharmacists, to the armed forces and, of course, to the army of volunteers who have done their bit to help make this process run as smoothly as it has.

Those are vital achievements because we know that vaccines save lives. The cohorts we are currently working to vaccinate by mid-April represent some 99% of covid deaths, but we will not rest until we can offer that protection to everyone. We urge, and I would urge, everyone who has been offered the vaccine to take up that offer, as I will certainly be doing when I become eligible to receive it. It is safe and it is saving lives.

With an average of 358,341 doses being given each and every day in the UK and more vaccines coming on stream in the spring, I believe that we can confidently begin to look to the future. That is why a few moments ago, at this Dispatch Box, the Prime Minister set out his road map for how we will carefully but irreversibly unlock our country. As he set out, it is based on four tests: first, that the vaccine deployment programme continues successfully; secondly, that evidence shows that vaccines are sufficiently effective in reducing hospitalisations and deaths; thirdly, that infection rates do not pose a risk of a surge in hospitalisations that would put unsustainable pressure on the NHS; and fourthly, that our assessment of the risks is not fundamentally changed by new variants of the virus that cause concern.

Our road map out of lockdown will be taken, as my right hon. Friend set out, in four steps, each step reflecting the reality on the ground, not just our understandable expectations and desires. At every stage, our decisions will be led by data, not dates, with at least five weeks between steps; we will review the data every four weeks and give one week’s notice of any changes. The dates that my right hon. Friend set out today are not target dates; they are, importantly, “no earlier than” dates. We will continue to undertake statutory reviews, including the one taking place today. Yet in doing so, we are ever mindful of those expectations and desires.

[Sir Charles Walker (Broxbourne) (Con)]

I am confused. If we are having this driven by data, why are we worrying about timetables and dates? The Minister mentioned “no earlier than” dates, but why? This is data-driven, not date-driven. There seems to be mixed messaging here.

[Edward Argar]

I am grateful to my hon. Friend—indeed, my friend—for that point. The reason we are doing this is that we have been clear throughout, and the Prime Minister has been clear throughout, that this should be the last lockdown we experience and that, once we relax these restrictions, they should be irreversibly relaxed. That is why we are doing it in a staged way, one step at a time, and we will continue to monitor the data, which I hope and believe will continue to go in the right direction. But it is because we do not wish to see anything happen that could cause us to pause or reverse that we are taking it step by step.

[Greg Clark (Tunbridge Wells) (Con)]

But if the data surprise us on the upside, would it be possible to look again at those dates and take advantage of that?

[Edward Argar]

I am grateful to my right hon. Friend. What we have sought to do here is to set out a road map that is measured and cautious but provides, as much as we can, that degree of certainty to allow people to plan for the future. We do not want to set out expectations that are unlikely to be met, and therefore this plan is based on those “at the earliest” dates. If I may, I will make a bit of progress, and then, if we have time—I am conscious of the time—he may wish to return to that point.

We know how tough lockdown has been on people—on individuals, on families and on businesses—and naturally we are beginning—

[Andrea Leadsom (South Northamptonshire) (Con)]

rose—

--- Later in debate ---

[Edward Argar]

If I may just finish this point, then I will of course turn to my right hon. Friend. We are beginning with the things that people want to change most, the most important things being to see children return to classrooms, and to be able to begin to see our friends and family again.

[Andrea Leadsom]

Does my hon. Friend see, as he is hearing from our hon. Friends here in the Chamber, that setting out the very earliest dates assumes there is no harm caused by the continued lockdown but, in reality, if we remain locked down when we do not need to, every single day, that is causing harm to people?

[Edward Argar]

My right hon. Friend makes an important point. Often in this Chamber we look at the impact in terms of hospitalisations, infection rates and deaths from covid, but—absolutely rightly—we also look at the impacts more broadly, and she highlights that it is not just deaths or illnesses directly attributable to covid that have an impact on people’s lives, health and wellbeing. However, I come back to the point that the programme and the dates we have set out are reasonable, pragmatic and supported by what we believe reflects the roll-out of the vaccine to the different groups, and they give the public a degree of predictability that has not been there before. I share what I surmise is her view: I would not wish these restrictions to stay in place a day longer than absolutely necessary—I hope I do not misattribute a view to her there. What the Prime Minister set out earlier today achieves that, and does it in a very measured and sensible way that reduces significantly any risk of our seeing things slide backwards.

I am conscious of time. As the Prime Minister has set out before the House, all schools and colleges will return to face-to-face education on 8 March—

[Chris Green (Bolton West) (Con)]

Will my hon. Friend give way?

[Edward Argar]

Very briefly, but this is the last intervention I will take from colleagues, I am afraid.

[Chris Green]

I thank my hon. Friend for giving way. Will he confirm one way or the other whether secondary school children will be compelled to wear masks in the classroom while they are trying to learn?

[Edward Argar]

I am grateful to my hon. Friend, who highlights a point that, along with others, will be concerning parents and pupils. As we set out the plan for unlocking and reopening our schools, which my right hon Friend the Education Secretary will add more detail to, we will look at how we can create an environment that is not only safe but that allows children and young people to learn, socialise and enjoy the benefits of not just education but being back in school. I know that my right hon. Friend will have listened carefully to my hon. Friend’s point.

As I have just alluded to, we know how important being in school is for children—not only for their education but, as I said, for their social development and mental health. That is why it is a crucial first step, and getting children back into classrooms has unquestionably been the Government’s chief priority.

Within that first step, we also want to begin to meet that other great desire—for families to see those they love. From 8 March, every care home resident will be able to nominate a named visitor, who will be able to visit. From 29 March, up to six people, or two households, will be able to meet outdoors. At that point, outdoor sports will also be permitted, as long as they are in groups of up to six.

In respect of households meeting outdoors, I—I dare say along with many others in this House—look forward to that very much. Aside from a family funeral, 2019 was the last time I saw my parents in person, and I suspect that that goes for many people in this Chamber and, indeed, up and down the country. So we do understand just how important this issue is, and I believe that these first steps recognise that vital desire for human contact and for seeing friends and family. Our ambition is to maintain a healthy lifestyle, while also reflecting our continuing need to save lives, but until 29 March, our message continues to be, “Stay at home and stay local.”

As the Prime Minister set out, the road map sets out a broader package of measures for step two, which will be no earlier than 12 April. The rule of six, or two households, will continue to apply outdoors. Non-essential retail and personal care will be permitted to reopen, and domestic overnight stays in England will be allowed for individual households and bubbles in self-contained accommodation. The majority of outdoor settings will reopen, and hospitality, such as pubs and restaurants, will be allowed to resume table service to customers outdoors. At this point, we will also take a decision on whether we can extend the number of visitors to residents in care homes and set out a plan for the next phase of visits.

Step three, no earlier than 17 May, will take us closer to that normal life we yearn for, with the majority of legal restrictions on meeting others outdoors removed, although gatherings will be capped at 30 people. Six people or two households will be able to meet indoors, and indoor hospitality, entertainment and sports will be allowed. Finally, step four, no earlier than 21 June, will see us take key steps to larger scale events.

The Prime Minister set out in more detail the reviews that would underpin the steps and the support being put in place at this time and the support being continued for those who are affected. Conscious of time, I will not recount everything that my right hon. Friend said at this Dispatch Box just a short hour or two ago.

As we look to brighter days ahead, there are still difficult days immediately in front of us. My right hon. Friend the Chancellor of the Exchequer will be setting out how we will continue to support businesses and individuals through this difficult time and how we can build back better in his Budget statement on 3 March. We will do all we can to ensure that British people remain safe: working to keep uptake of the vaccine high, continuing to ramp up testing, including normalising workplace testing as people return to their workplace in increasing numbers, and ensuring that we take proportionate steps at our borders to protect against new variants from abroad and, indeed, to protect the progress we have made as a country.

It is right, even as we move forward, that we tread carefully through the weeks ahead. I understand and can entirely appreciate the points made by hon. and right hon. Friends from their understandable desire to move faster where we can. The Prime Minister understands that, too. I know him well, and no one more than he will want to see restrictions in place a single day longer than is necessary, but we have learned that this virus can move in unpredictable ways.

We owe it to the NHS and social care staff on the frontline, to everyone involved in our incredible vaccine roll-out and, of course, to everyone in this country who has made such tremendous sacrifices over the past year to hold on to and build on the progress we have made. I believe we can do it by once more working together as a country, unified by a shared determination to see this disease beaten and to see our country return to normal. It has been a long and challenging path we have taken together, but as I stand here today, I do so with confidence in this road map—that route back to the future we all wish to see.

[Madam Deputy Speaker (Dame Rosie Winterton)]

Before I call the shadow Minister, I remind hon. and right hon. Members that there will be a three-minute limit on Back-Bench speeches. When that is in effect, there will be a countdown clock visible on the screens of Members participating virtually and on the screens in the Chamber. For those participating physically, the usual clock in the Chamber will operate.

NHS England and NHS Improvement: Annual Assessment 2019-20

Edward Argar Excerpts

Thursday 28th January 2021 Written Statements

[The Minister for Health (Edward Argar)]

Today, I am laying before Parliament my annual assessment of the NHS commissioning board (known as NHS England) for 2019-20.

Covid-19 has presented an unprecedented challenge, the scale of which the NHS has not seen in its 72-year history. I would like to begin by giving my utmost thanks and appreciation to all colleagues throughout the NHS for their dedication and hard work responding to the virus.

My assessment of NHS England and NHS Improvement’s (NHSE/I) performance for 2019-20 reflects the impact these challenges have had on the health service and differentiates between performance before the pandemic took hold and the subsequent impact managing the virus has had on delivery. To this end, I have defined performance pre-covid-19 as the period April 2019 to end January 2020. Evidence from this period has been used to make a reasonable assessment of where performance would have been had covid-19 not happened.

2019-20 was a transitional year for the NHS, that saw NHSE/I embed the first phase of delivery against the NHS long term plan. NHSE/I has worked closely with local health systems to develop robust, system and local-level implementation plans. In 2020-21 these plans will need to be revised to reflect possible new and longer-term demands caused by covid-19 and to account for the Government’s 2019 manifesto commitments. To ensure these plans are workable NHSE/I must ensure disciplined financial management across all organisations. I am therefore pleased to see most NHS providers reporting a year-end position that is equal to or better than their agreed control totals.

To ensure performance targets are appropriate and help improve clinical quality and outcomes, NHSE/I has field tested proposals in urgent and emergency care, routine elective care, cancer and adult and children’s mental health as part of the clinically led review of NHS access standards. The impact of covid-19 has delayed the final evaluation report and I expect NHSE/I to continue to work with wider Government and local NHS organisations to produce evidence-based approaches. An increase in demand for services in 2019-20 pre-pandemic has meant that performance targets on NHS constitutional standards were not on track to be met by the end of the year. Between April 2019 and January 2020, demand for urgent investigation of possible cancer and emergency admissions via A&E increased by 8% and 3.5% respectively, compared to the same period last year, making it harder for the NHS to treat patients within the agreed targets. Key to managing demand in the system is ensuring a steady flow of patients through to the point at which they can be safely discharged. Despite great efforts in both health and social care, the average delayed transfer of care (DTOC) figure of 4,000 or fewer delays remains challenging and the trajectory up until January 2020 was 5128 leaving a cumulative target of 1,182 beds to be delivered.

Another key element of the NHS long term plan was publication in June 2019 of NHSE/I’s interim people plan that was reinforced in August 2020 with the “We are the NHS: People Plan for 2020-21—action for us all”. The publication of the overarching NHS people plan will need to account for new workforce demands and costs due to the pandemic as shortages remain a critical risk to service recovery. It is also critically important that we have rigorous plans in place to deliver the additional 50,000 nurse places that the Government promised to deliver in this Parliament. I am also grateful that NHSE/I has taken the lead in supporting members of our workforce who are most vulnerable and provided an enhanced staff health and wellbeing offer, including targeted support for our BAME colleagues and, where possible, offering opportunities for flexible and remote working.

I am pleased to see NHSE/I support the Government’s health and social care pledges set out in the 2019 manifesto. Great progress has been made on capital in 2019-20, which was underpinned by the health infrastructure plan (HIP), published in September 2019. The Government are committed to building 40 new hospitals, and the NHS has already made significant progress in developing these plans to deliver world-class care in world-class facilities. Similarly, the NHS has pressed ahead with delivering the 20 hospital upgrades announced by the Prime Minister in August 2019. I am assured NHSE/I has committed to work with the Government to improve public confidence in hospital food and commend them for supporting the commitment to abolish hospital parking fees for those patients and families in greatest need.

Looking forward, I am pleased to see NHSE/I use evidence from responding to covid-19 to reduce barriers and improve the way services are delivered. The pandemic has also brought to light the burden placed on the NHS by the interoperability of systems and the need for more effective information sharing between care settings and organisations, as well as between professionals and the public, to enhance health outcomes and quality of care. I am therefore eager to see the implementation of the technology standards set out in the “Future of Healthcare” to better integrate information flows.

The NHS remains this country’s most valued public service, an institution that is there for every family, everywhere, at the best of times and at the worst. In light of covid-19, the Government want to continue to ensure that the NHS has the space, certainty and funds to deliver a transformative plan that will ensure patients benefit from a ground-breaking health service into the next decade.

We will continue to work closely with NHSE/I to help them deliver this ambition, address the challenges that lie ahead and provide a sustainable and efficient health service with quality, transparency and safety at its heart.

Copies of my annual assessment and NHSE/I’s annual report will be available from the Vote Office and Printed Paper Office.

[HCWS741]

Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 4) Regulations 2020

Edward Argar Excerpts

Monday 25th January 2021 General Committees

[The Minister for Health (Edward Argar)]

I beg to move,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 4) Regulations 2020 (S.I. 2020, No. 1654).

It is a pleasure, Mr Pritchard, to serve under your chairmanship on one of these Committees—for, I think, the first time. At the outset, I pay tribute once again— as the shadow Minister does each time we have these debates—to the work of our health and social care staff and key workers in this country, who continue, day in, day out, to keep people safe, and to keep this country working. They are clearly, for these reasons, the pride of our nation. I also put on the record my thanks to the population of this country for continuing to follow the lockdown rules. We all know that is incredibly difficult and entails huge sacrifice, but the actions everyone is taking are protecting our NHS, buying time for the roll-out of the vaccine, and saving lives.

While our focus remains on vaccine roll-out and the necessary national lockdown, to keep down infection and hospitalisation levels, it is nonetheless important that we bring forward these regulations, even though they make by and large only minor technical amendments to the “All Tiers” regulations, necessary for legal coherence. Those regulations give effect to the 29 December tiering decisions, which of course have been superseded by the national lockdown restrictions, but it is still right that they be debated in this place. To briefly run through the effects of this statutory instrument, it amends regulation 8(4)(b) of the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020, substituting

“the Tier 2 area and the Tier 3 area”

with

“the Tier 2 area, the Tier 3 area and the Tier 4 area”,

to ensure that the addition of tier 4 is captured. That essentially makes it clear that tier 1 covers every area of England other than those areas in tiers 2, 3 and 4, and therefore that tier 4 restrictions apply only in a tier 4 area. That, of course, is now the whole of England, following the Prime Minister’s announcement of a national lockdown on 4 January. This might seem like nit-picking or a minor clarification, but we feel it is important to remove any scope for misinterpretation from the instrument.

The instrument also makes a further technical amendment to the “All Tiers” regulations, correcting a cross-reference in paragraph 8 of schedule 3A to the “All Tiers” regulations. The larger change in this instrument is the amendment of schedule 4 to the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) Regulations 2020 to move some local authority areas from tiers 2 and 3 to tiers 3 and 4, although those changes have been superseded by the national move to tier 4.

Given the rapid rise in covid cases in several areas at the time these decisions were made, and the likely progression of the new variant, it was agreed on 29 December 2020 to move these local authority areas between the tiers. Decisions on which tier would apply to each area were initially announced on 2 December, and were based on five key indicators: case detection rates in all age groups; case detection rates in the over-60s; the rate at which cases were rising or falling; the positivity rates—the number of positive cases detected as a percentage of tests taken—and, of course, pressure on the NHS in a particular area, including current and projected occupancy.

Before concluding, I put on the record our regret that the regulations could not be debated until now; obviously, the House did not sit until 11 January. Two weeks after the House came back, we have brought them forward. That is swift, but still, I apologise to the House and to my shadow, the hon. Member for Ellesmere Port and Neston, for the fact that we did not have the opportunity to bring them forward for debate in a more timely fashion. None the less, we feel it is important—indeed, it is required—that we bring them forward at this point for the House to scrutinise and challenge them if it wishes.

Furthermore, we may decide to step areas down through the tiers when it is possible to revert to that approach. Therefore, for consistency in the law and confidence in the tiering system, it is right that these technical amendments and tier allocations be considered.

We should remain cautious about the timetable ahead. If our understanding of the virus does not change dramatically, roll-out of the vaccine continues to be successful, deaths start to fall as the vaccine takes effect, the covid situation in our hospitals improves and everyone plays their part by following the rules, we hope—at the right time, when it is safe to do so—to be able to move out of the national restrictions.

I finish by paying tribute once again to our amazing health and social care staff, who are working tirelessly throughout this pandemic. As always, I remind everyone of the importance of following the rules, which are in place for very good reason, and I commend the regulations to the Committee.

--- Later in debate ---

[Edward Argar]

I will endeavour to address the various points raised by the shadow Minister, the hon. Member for Ellesmere Port and Neston. It is a pleasure to serve opposite him in these Committees. He is always measured in his remarks and constructive in the points that he makes. Even when disagree on interpretation, I always welcome his observations and his reasoned challenges.

When the hon. Gentleman mentioned the work that his wife is doing as a local councillor, he kindly did not mention that when paying tribute to our health, social care and key workers, I missed our local authorities. I pay tribute to the officers of those local authorities and to local councillors, who always work very hard but who will be facing an incredibly heavy workload at the moment, serving their communities. In that vein, I pay tribute to them, including the hon. Gentleman’s wife for her work.

The hon. Gentleman is right to highlight the scale of the challenge and the situation that we face, and the number of tragic deaths we have seen. As he rightly said, every one of those is an individual with family and friends, and every one of those deaths is a tragedy. He highlighted that there are 38,000 covid patients hospitalised at the moment, which is well over a third of the beds in our NHS. To demonstrate how rapidly that number has climbed, back in September there were 500 people hospitalised with covid; in October, the number went up to about 2,000; by November, it was 11,000; and, in the past month and a half, we have seen it go up to the current level. The rate of hospitalisation has increased dramatically and he is right to highlight that backdrop to our debate.

The hon. Gentleman mentioned retrospectivity, not in the implementation of the regulations, but in debating them after the for. While that may be in line with what is permitted under parliamentary procedure with statutory instruments of this sort, I take his point that it is better to debate them in a timely fashion, That is what we seek to do, because the House can give its view on them and because the transparent process helps to achieve consent to, and therefore compliance with, the measures. I hope the hon. Gentleman will acknowledge that we have made some significant strides since—well, not since this time last year, but since last spring, now that the House has found a way of speeding up the pace at which we bring statutory instruments before Committees.

The hon. Gentleman asked a specific question about statutory instruments being made on 30 December, a day when the House was sitting. The short answer to his question why they could not be debated that day is because they were only signed and made by the Secretary of State on that day, while the House was sitting, so there was no time to lay them or schedule them for debate. That is why we have brought them forward now, although of course events have slightly superseded them.

On tiering and the effect of tiering, which was the subject of a large part of the hon. Gentleman’s remarks, I have to be very honest. Throughout this pandemic, we have said, “Here is what we are working to achieve, but even now this disease is something that we are still learning more about every day.” The perfectly reasonable and scientifically rational tiering restrictions and regulations in December having to be superseded this month is in large part due to the new variant, with its significantly higher infectiousness. It was not present when the original tiering regulations were put in place. There will always be an element of having to adapt to this disease as the disease itself adapts.

The hon. Gentleman asked what determines whether an area is in a particular tier and how it can move between tiers, and he quite rightly picked up on the five tests, or the five measures, that the Secretary of State has set out. Sadly, he was right to predict that I would say the process is not black and white and is more complex than that. That is because it is the inter-relationship between the factors that matters. For example, the infection rate overall could appear to be plateauing and then coming down, as was the case for a period in my own constituency, while the rate in the over-60s continues to grow. That is a great concern because of the impact of this disease on that age group, and on older people in general,. I fear that it will not be possible to say, “Here is an exact figure for each of these, and if you hit these figures, that moves you from x to y.” A more nuanced and more complex judgment is required

The hon. Gentleman spoke about the importance of data and in particular dashboard data at a localised level, so that people can at least understand the data that is driving these decisions. I hosted a call with colleagues back in December, when we had some of our team in DHSC talk through how we were developing that data dashboard, looking at the data and then subsequently providing ever greater granularity. That work continues and he is absolutely right to highlight it. I suspect that there will always be an appetite for data that we are continuing to chase and trying to keep up with, but we continue to try to put more and more data out. I would argue that, as a country, we have been at the forefront of data transparency and putting information out there. There is always more that we can do, but compared with other countries, on testing rates for example, we were at the forefront of putting data out there, even when that was quite rightly being challenged or questioned by him and by others.

We publish the SAGE papers, but I think what the hon. Gentleman was asking me to pass on to the Secretary of State was a request that those papers are not only published, but published in tandem with recommendations and decisions. I will certainly convey his points to the Secretary of State, as I will to the Transport Secretary. The hon. Gentleman is quite right that those points are above my pay grade in this role, as they relate to borders and travel.

There are three other things that I will touch on very briefly, which I think will cover what the hon. Gentleman asked about: vaccine roll-out, compliance, which he touched on, and bigger-picture elements about when we are likely to see an easing, for want of a better way of putting it, which is the road map argument, including schools as a pathway. I will try to address some of those issues, albeit briefly.

On the vaccine, the hon. Gentleman is absolutely right: we believe, and it has always been part of our strategy, that the vaccine is our way out of this pandemic. It must be delivered quickly and safely, as he said, and I believe that it is being delivered very swiftly and safely across the country, not just by our NHS and our military, but by volunteers who are helping to run the vaccination centres. The huge number of vaccinations that have already taken place is testament to the planning and the work that has been done. As the Secretary of State has always made clear, although we are getting a huge number of people vaccinated, supply is potentially a limiting factor. We will vaccinate as many people as we can get the vaccines for, but there will always be a potential limiting factor there.

On compliance, the hon. Gentleman raised a number of points. The population of this country has been phenomenal in its willingness to comply with incredibly onerous and challenging restrictions. He highlighted support from the Department for Work and Pensions and elsewhere for particular groups, including statutory sick pay and other isolation payments. The Government continue to keep compliance rates and the factors that influence them under review.

The hon. Gentleman’s final question, which is a subject of considerable discussion at the moment, was about the road map for the easing of the national lockdown and how it interacts with the vaccine roll-out. I am afraid that I have to disappoint him slightly. To echo what the Prime Minister said, we all know what we would like to see, and the number of people vaccinated, particularly those in the vulnerable groups, is a key element not just of keeping people safe and being able to ease restrictions, but of decreasing the pressure on the NHS. However, we also know that there is a long lag time between people being infected and then going into hospital and being kept there. Thankfully, with new drugs, we are able to save the lives of people who might have died in the first wave, but they are in hospital longer, so the pressure on NHS capacity will continue for some time.

It would be wrong to set an arbitrary road map and timetable when, as I say, we are constantly learning more about how this disease behaves and moves in the population. We can set out our ambitions in broad terms, but it would not be right to say, “If we hit x number, that equals x date, which equals x change.” It would be premature to do that. It is right that we are open and transparent with the British people, but we are not at that point yet.

[Justin Madders]

I pay tribute to all those involved in the vaccine roll-out. I had the pleasure of visiting my local centre a couple of weeks ago, and it was very well organised. I was trying to gain some understanding from the Minister about whether the vaccine roll-out will be applied to tier decisions, or whether the national picture will be part of the decision. I do not expect him to say, “This number of people receiving a dose is going to mean x, y or z relaxations,” but will that be considered at national or local level?

[Edward Argar]

I am grateful to the shadow Minister for his clarification. If I am being honest, I think it is probably premature at this point for us to speculate about things at that level of detail, but he makes his point well and it is on the record. I will relay it to the Secretary of State as we look at when the time is right for us to start easing the national regulations and potentially move towards a tiering model again. At that point, those sorts of question are of course pertinent, and I will ensure that the Secretary of State is aware of the hon. Gentleman’s comments.

The hon. Gentleman’s final point was, in the context of vaccines, infection rates and hospital pressure, about the need for information to be as local and granular as we can get it. Vaccinations started in earnest in early to mid-December, and we have ramped up at a huge rate the number of people being vaccinated each day. In parallel with that, we have continued to try to increase the amount and granularity of information that we publish on gov.uk and on the dashboard about vaccinations by region, area and volume. In parallel with actually getting the vaccine in people’s arms, the team continues to look at what more they can do to be as transparent as possible about how that is going, so that people in a local area can understand a bit more about what it means for them.

I hope I have addressed if not all then as many as I can recall of the hon. Gentleman’s questions and points. I commend the regulations to the Committee.

Question put and agreed to.

Resolved,

That the Committee has considered the Health Protection (Coronavirus, Restrictions) (All Tiers) (England) (Amendment) (No. 4) Regulations 2020 (S.I. 2020, No. 1654).

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 12th January 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

Covid, and particularly the new strain of covid, has had a significant impact on NHS bed capacity. As of 10 January, 30,758 beds across the NHS were occupied by covid patients. In just the past day, that has risen to around 32,000, which is over a third of all available beds. The latest bed occupancy data shows that just shy of 80,000 of the NHS’s roughly 90,000 total general and acute beds were occupied.

[Dr Huq [V]]

It is great that the NHS, as I have heard locally, is working hard to stop intensive care beds from running out after a decade of no expansion, now that a major incident has been declared in London. However, can the Minister guarantee that this will not just be a bureaucratic exercise? Will we take a population-based approach, listen to clinicians in apportioning capacity and allow hospitals in high-need mixed ethnicity areas, such as Ealing Hospital, which is currently on a black alert, their fair share, rather than the powerful players—the central London teaching hospitals—always getting all the extra allocation?

[Edward Argar]

I can reassure the hon. Lady that beds and increased capacity, where we put them in place, are allocated on the basis of where they are needed. She is right to highlight the pressure that her local hospital trust, London North West University Healthcare NHS Trust, is under. The team there, as across the NHS, are doing an amazing job, but the critical care bed occupancy rate in her trust was 98.7% on the latest figures I have. That is extremely significant pressure, but I can give her the reassurance that we look to ensure that all areas receive the resources they need.

[Ellie Reeves [V]]

London has declared a state of emergency and the stark reality is that at this rate we will run out of beds for patients in the next couple of weeks. At least two NHS hospitals in the capital have already postponed urgent cancer surgery and figures show that treatment levels are failing to keep pace with demand. Will the Minister therefore commit to fully opening the London Nightingale hospital, secure the use of London’s private hospitals for cancer treatment, and invest in the number of beds in our NHS for the long term?

[Edward Argar]

The hon. Lady is absolutely right to highlight the pressure that the NHS and critical care are under in London and, indeed, more broadly. I pay tribute again to all those who are working in the NHS, including my shadow, who I suspect has been on the frontline in recent days—I pay tribute to her, too. The best way we can thank them is by following the advice to stay at home and to follow the rules. In respect of her specific point, yes, we are involving independent sector capacity, Nightingale capacity and increasing NHS capacity—all those, alongside other measures—to ensure our NHS continues to be able to treat those who need this care at this time.

[Dr Rosena Allin-Khan (Tooting) (Lab)]

Last night, I finished a shift in a busy east London hospital, sharing difficult news with hopeful families. The resilience of staff on the frontline can never be matched, but across the country morale is on a cliff edge. A decade of cuts to beds, services and staff, combined with pay freezes, has left NHS workers undermined and undervalued. Without our incredible staff, a hospital bed is just that —a bed. So does the Health Minister regret how the Government have made frontline workers feel and can he promise to change that?

[Edward Argar]

I reiterate, as I did earlier, my thanks to the hon. Lady and all her colleagues in the NHS for everything they are doing. I reassure her, as I do and as my right hon. Friend the Secretary of State does at every opportunity, just how valued and supported our NHS is. We have put in place just over 1,000 additional critical care bed capacity at this time—the right thing to do. In addition, in respect of supporting staff, we are investing about £15 million—just one example—for mental health hubs and mental health support for staff. I saw, from the hospital that she works in, or has worked in, in her constituency, a number of staff—it was on the BBC recently—setting out just how flat out they are. The best way we can thank them, alongside what we are doing—I make no apologies for reiterating it, Mr Speaker—is by all following the rules to stay at home to help to ease the pressure on those phenomenally hard-working and valued staff in our NHS hospitals.

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

If he will make a statement on his departmental responsibilities.

Covid-19

Edward Argar Excerpts

Tuesday 12th January 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I beg to move,

That this House has considered covid-19.

Thank you, Madam Deputy Speaker, for your courtesy in slightly drawing out your introduction to allow me to take my mask off as I came to the Dispatch Box.

It is less than a year since the coronavirus was first mentioned in a debate in this House, on 22 January 2020. The House has debated this issue, which has affected all aspects of our national life, on many occasions since then. I would say at the outset that, throughout, it is important that we remember that all Members of this House share a common goal. They may have differences of opinion and there may be different perspectives on how best to achieve that goal, but it is important that we are clear that every Member of this House is clear in their determination to see this virus beaten and to see our country recover economically and in every other sense. I pay tribute to all right hon. and hon. Members and to the strength and sincerity of their views on this important topic. Since that first debate, novel SARS-CoV-2, which of course we all now know too well as covid-19, has caused untold disruption to all our lives and our way of life in this country. It is right, at this point, that we remember all those who, sadly, have lost their lives to the disease.

In this first general debate on covid-19 of 2021, it is worth reflecting that despite our painful familiarity with the challenges we face, the situation today is markedly different from many occasions in the past. For a start, and perhaps most importantly, we now see the way out. We have not one but two safe and effective vaccines being injected into people’s arms up and down the country as we speak.

[Sir Charles Walker (Broxbourne) (Con)]

Sorry, Madam Deputy Speaker, just let me take my mask off.

I thank my hon. Friend for his introductory remarks. The vaccine is being rolled out across the country, and in Broxbourne, but a number of my constituents are waiting to be informed by post, as I understand will be the case across the country. There are difficulties with the post at the moment, through nobody’s fault but the virus’s, so could he keep an eye on the postal service to ensure that, if post is not the best way, another way can be found to let people know that their number is coming up in the draw for the vaccine?

[Edward Argar]

It is always a pleasure to hear from my hon. Friend, who is also my friend, in this House, and he raises an extremely important point. I can give him the reassurance that I, other Ministers and particularly the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon (Nadhim Zahawi), who is leading the vaccine deployment effort, will continue to look at ensuring that every means appropriate is utilised to ensure that people in my hon. Friend’s constituency and across the country get notified when their turn is up, so that they have every opportunity to get that life-saving injection.

[Catherine West (Hornsey and Wood Green) (Lab)]

rose—

--- Later in debate ---

[Bob Stewart (Beckenham) (Con)]

rose—

[Edward Argar]

I will give way briefly to the hon. Lady, and then to my hon. and gallant Friend.

[Catherine West]

Does the Minister agree with the suggestion that, given that youth unemployment is shooting up, this might be the time for Royal Mail to take on some extra staff to cover those who are off sick? It is crucial that people know when their appointments are so that they do not miss that golden opportunity to get the jab.

[Edward Argar]

I had the pleasure of working with the hon. Lady in a past life before either of us were Members of this House, and she makes a typically sensible suggestion, which I am sure Royal Mail will have heard. I hope that it will reflect carefully on what she has said.

[Bob Stewart]

The real problem is that people will not know whether they have been called, because the post has not arrived. In my constituency, several instances have come to my notice of people not getting post for over a week. If they are called forward in that week, they are stymied, aren’t they?

[Edward Argar]

I reassure my hon. and gallant Friend that, while there may on occasions be challenges with the post, we are persistent in our determination, and the NHS is persistent in its determination, to ensure that everyone has the opportunity to get this jab. Where someone does not respond, or does not turn up for an appointment, we will keep trying, because it is really important that everyone has the opportunity to have that injection, which could save their life.

[Andrew Griffith (Arundel and South Downs) (Con)]

rose—

[Edward Argar]

I will give way to my hon. Friend, but then I will make some progress.

[Andrew Griffith]

I thank my hon. Friend for giving way; I know he will want to make progress. One group is further away from receiving a vaccine: undergraduates who would otherwise be returning to college today. A significant proportion of their education has been disrupted already. Is there any hope that the Minister can offer to the nation’s undergraduates?

[Edward Argar]

I am grateful to my hon. Friend. I seem to be taking multiple interventions today from people I have known in a past life in different ways and forms, which is always a pleasure. He will be aware that the prioritisation and roll-out of vaccines in that context are guided by the clinical advice of the Joint Committee on Vaccination and Immunisation, which, as he will appreciate, at the current time, and rightly, is clearly focused on what will do the most to save lives. We have seen—I will turn to this in my speech shortly—that age is the single biggest determinant of risk of death, so it is right that we are prioritising those most at risk as we roll out the vaccine. When I come to them later, he will hear about the very ambitious and deliverable plans, which he heard about from the vaccines Minister yesterday, to ramp up the roll-out across our country.

[James Sunderland (Bracknell) (Con)]

rose—

--- Later in debate ---

[Edward Argar]

I did promise my hon. Friend that I would take an intervention from him—then I will make progress.

[James Sunderland]

In 1940, when our small boats set sail for Dunkirk, nobody stopped to check through health and safety paperwork or institutional red tape. Will my hon. Friend the Minister please confirm that the Government will cut through unnecessary bureaucracy as we embark on the vaccine roll-out, and that we will throw the kitchen sink at this with the help of our armed forces?

[Edward Argar]

I am incredibly grateful to my—if I recollect correctly—hon. and gallant Friend, who has served in the past with distinction. He is absolutely right to highlight the amazing work of our armed forces, which was highlighted in the Chamber earlier this afternoon. He is also right to highlight the spirit of getting things done. He will have seen that my right hon. Friend the Secretary of State for Health and Social Care has been very clear that, while making no compromises on safety for patients and for those receiving the vaccine, he is working very hard to make sure that any bureaucratic barriers that do not support patient safety are removed to ensure the speedy and effective roll-out of the vaccine. So I am grateful to my hon. Friend for his point.

We have vaccinated more people than the rest of Europe put together—well over 2 million individuals, including more than a quarter of the over-80s in this country. I think that is a record to be proud of, but there is no room for complacency. We continue to work hard to get more injections in more people’s arms.

In that context, I pay tribute not just to the Secretary of State and to the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Stratford-on-Avon, but to Kate Bingham and the Vaccine Taskforce, who have done so much to make sure that this country was at the forefront of being able to purchase and deploy vaccines to help save lives. Yet, just as we accelerate the deployment of the vaccine further and faster, we must also recognise that the new variant of the coronavirus does present us with a renewed challenge.

Our strategy has always been, and continues to be, to suppress the virus to protect the NHS and save lives until a vaccine can make us safe, but with a new variant that is more than twice as transmissible, we must be clear that that task becomes considerably harder. The figures from the Office for National Statistics are stark: more than one in 50 of the UK population has the virus and an even higher proportion than that in places such as London. So, just as the virus has evolved, so must our response. We find ourselves once again in a difficult and challenging national lockdown, taking steps that I do not think anyone could have imagined in January last year—steps that, understandably, are truly testing the patience and forbearance of every person in this country but that are essential to relieve the pressure on our NHS, allow for the vaccine to be effectively deployed and, ultimately, set us free from the need for these restrictions.

Before I turn to those steps in a little more detail and the deployment of our vaccines, I am sure the whole House will, as always, join me in paying tribute to the heroic responses we continue to see from people in every walk of life. The return of the clap for carers initiative last Thursday, under the new guise of clap for heroes, is a reflection of the shift in our collective understanding of just what heroism and service look like and a tribute to everyone who is helping us push through this difficult time.

I know that my constituency neighbour, the hon. Member for Leicester West (Liz Kendall), will join me in paying tribute to and thanking everyone who works in our NHS in this country and all those who support not just the NHS but social care, in care homes, social care settings and domiciliary care—people in a range of roles up and down our country who, day in, day out, selflessly care for those who need it. In a past life, I was a local councillor, and I had the privilege of being the cabinet member for adult social care, health and public health for the council on which I served. I saw at first hand the amazing work that our social care workforce do, and it is right that we recognise that at every opportunity in this Chamber.

It is also important to highlight the great British scientists who are at the forefront of humanity’s fight against this virus, developing not only the Oxford-AstraZeneca vaccine but life-saving treatments for those who become infected with covid, first in the form of dexamethasone and now tocilizumab and sarilumab—I have considerable sympathy with the Prime Minister in his attempts to pronounce those—both of which have been found to reduce the risk of death for critically ill patients by almost a quarter and cut time spent in intensive care by as much as 10 days. Those life-saving drugs are now available through the NHS, and it is an example of the huge debt of gratitude we owe people from all walks of life—not just those on the health and social care frontline, but people who are working under very different but no less considerable pressures for our country. The Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), who is the Minister for prevention, public health and primary care, will no doubt reflect on that when she winds up the debate.

In terms of the context, I must first turn to the pressures in our acute hospital settings. Across the UK, there are more than 32,000 patients in our hospitals with covid. That is over a third of the NHS’s available beds of all types. On 31 December last year, the total reported admission to hospital and diagnosis of covid in English hospitals was 2,536—on one day. That increased by 46% in the week that followed, so on 9 January, we were seeing 3,718 people admitted. The pressures on our acute hospitals and those who work in them are intense. Patients are therefore currently being treated in Nightingale hospitals in Manchester, Exeter, Bristol and Harrogate to cope with these numbers, and NHS England has confirmed that the Nightingale in London is also open for patients.

Last Monday, all four UK chief medical officers recommended that we move the country to covid-19 alert level 5, meaning that in their expert view, there is a material risk of healthcare services being overwhelmed. In this place, we have often talked about the most frightening of possibilities, but frankly, we have never been this close to seeing it happen, although we are all doing everything we can to ensure that the NHS continues to be able to cope during this time. Quite rightly, we have thanked our NHS staff, and people in this country have expressed gratitude and clapped them, but I think it is fair to say—echoing some of the intensive care doctors and nurses I have seen in the media recently—that the best way we can all say thank you to our NHS is to follow the rules and stay home in line with those rules, to ease the pressure on them.

That is why the choice that this House took last Wednesday to vote overwhelmingly for new regulations, placing England into a national lockdown alongside the action taken in each of the devolved nations, was the right choice. The key message is and must be as it was in the spring, as I have just enunciated: you must stay home. We have always said, and I have always been clear, that it is right that schools should be the last thing to close, and we deeply regret that we have had to close them, but as we begin to move out of lockdown, when we can safely do so—and, as the Prime Minister has promised, through the gradual loosening of restrictions when we can—schools will be the first thing to reopen.

Our regulations provide for these new restrictions until 31 March 2021. I hope that they may not be needed for as long as that, but that time allows us to take steady, controlled and evidence-led decisions, including moving places down through tiers on a local basis—again, when it is safe to do so. As you would expect, Mr Deputy Speaker, we will of course keep these restrictions under continuous review, with a statutory requirement to look at them every two weeks and a legal obligation to remove them if they are deemed no longer necessary to limit transmission of the virus.

[Sir Edward Leigh (Gainsborough) (Con)]

On that point, to me, the right strategy to stop the NHS being overwhelmed seems to be to have a flexible tier system, whereby we work out whether local hospitals in each region are about to be overwhelmed; and, if they are, we go into lockdown. Does my hon. Friend understand what I am saying? Is there going to be this flexible approach, rather than this mass lockdown nationally?

[Edward Argar]

I am grateful to my right hon. Friend for his intervention. With the new variant identified before Christmas, we are seeing hospital admission rates and demand for hospital services rising across our country. That is why it was absolutely right that we instituted the measures that we did, which have seen what it is effectively called a national lockdown at this time. The Prime Minister and the Secretary of State for Health have been clear that they hope, and would expect, that as we get the infection under control and ease the pressure on the NHS, when it is safe to do so we will be able to look to returning to that tiering system. Exactly as my right hon. Friend says, one of the five key factors in whether an area went up or down among the tiers was local hospital capacity—and I emphasise the “local” in that context—but, sadly, we are not in that place as we stand here and debate this matter today.

[Mr William Wragg (Hazel Grove) (Con)]

My hon. Friend is being very generous with his time. Could he perhaps say more about what percentage of those vaccinated in the vulnerable categories will count towards such a consideration?

[Edward Argar]

If my hon. Friend will show a little forbearance as I make a little progress, I will come to vaccinations and the vulnerable in a moment. I will seek to address his point then; if I do not, I am sure that he will prompt me.

I think every Member of this House fully appreciates and understands the huge burden that these restrictions now place on people today and every day: on pupils, on parents, on businesses, on individuals and on families. The Secretary of State for Education has set out our plan to support people in education settings, including with the provision of new equipment for remote learning. For businesses such as those in retail, hospitality and leisure that have been forced to close their doors once again, we are providing an additional £4.6 billion of support. There will be not a single Member in this House who has not received correspondence and pleas from their constituents who run businesses, be it in hospitality or the self-employed—a whole range of people. Members on both sides of the House will be working flat out to seek to assist them. I do appreciate the pressures that they are under. Of course, that support comes on top of our unprecedented £280 billion plan for jobs, including the extension of the furlough scheme until April.

Let me turn to vaccines. We know that in the long run the best way to help everyone in this country is to suppress the virus and to vaccinate people against it. The NHS is committed to offering, by 15 February, a vaccination to everyone in the top four priority groups, who currently account for more than four out of every five—roughly 88%—covid fatalities. The groups include older care home residents and staff, everyone over 70, all frontline NHS and care staff, and all those who are clinically extremely vulnerable. In working towards that target, there are already more than 1,000 vaccination centres throughout the country, including more than 200 hospital sites, which will increase to 270, and some 775 GP-led sites. Of course, pharmacies are already working with GPs to deliver the vaccine in many areas of the country. As vaccine supply increases, community pharmacies will continue to play an essential role.

Before my hon. Friend the Member for Hazel Grove (Mr Wragg) prompts me, let me turn briefly to the question he asked. The Prime Minister and ministerial colleagues will take into consideration a number of factors when looking at the right time—the safe time, based on the scientific and clinical advice—to ease the current restrictions and to move to a tiered system. One factor that I know will weigh with them and play a part in that decision will be the extent to which vaccination has significantly reduced the risk of death in those groups most likely to be affected by the virus. It would, though, be premature—indeed, it would go well beyond my pay grade—for me to set out the detail of what precise considerations the Prime Minister will be looking at as we reach that point, hopefully in a few months’ time.

This week has seen the announcement of the opening of seven mass vaccination hubs in places such as sports stadiums and exhibition centres, and yesterday we launched our full vaccine deployment plan, which includes measures that we will take, together with local authorities, to maximise take-up among harder-to-reach communities, and our new national booking service, which will make it easier to book and access appointments. In that context, I should pay tribute to one of the great strengths of this country, which is the willingness of the people of this country to step up, pull together and volunteer to assist in times of great need for this country. We are seeing that happening now. In that context, I also pay tribute to The Sun’s “Jabs Army” campaign, through which The Sun is doing its bit to encourage people to sign up and to volunteer—I believe it has got more than 30,000 people to sign up. All this is a reflection of the innate strength of community in this country: when something needs to be done, the people of this country step up and do their bit.

Another part of the plan is our new vaccinations dashboard, which gives daily updates on our progress in the biggest vaccination effort in British history.

[Mark Tami (Alyn and Deeside) (Lab)]

The Minister has not touched on the covid deniers out there. No doubt we are all getting emails from them, and they are obviously on social media as well. It is important that we get across the message about the safety of the vaccine and the importance of everybody getting a vaccine. It is not just about someone’s personal freedom and what they do; it is about what they can give to somebody else as well.

[Edward Argar]

The right hon. Gentleman is absolutely right. I say to those who may doubt or speculate about this disease: it is real and it has, sadly, taken more than 80,000 of our fellow citizens from us. Watch the news coverage that we all see every night of our amazing frontline NHS staff explaining just what they have seen, what they have had to do on their shift, how they have fought valiantly to save people’s lives, often successfully but on occasions sadly not, and what that has meant for them. I reflect on an incredibly dignified elderly gentlemen whom I saw on the news before Christmas—I think his name was Mr Lewis from the Rhondda—who, in the space of a week, had lost his wife and two other members of his family to this cruel disease. I say to those who say that it is not serious and that it is not as dangerous as some people say: watch those news clips and listen to those people who have been bereaved, and to all those people who have been in hospital and thankfully have recovered but have been through hell and back with this disease. The right hon. Gentleman is absolutely right. We all have a part to play in following the rules and beating this disease. I, for one, as soon as I am eligible to have my vaccination—I fear that the grey hair may not get me higher up the list and that I am too young, along with my shadow, and we may have a while to wait—will certainly take up that offer.

[Sir Charles Walker]

The Minister is being so generous in giving way. Long covid will take another form: there will be mental health consequences. May I make one suggestion? We have the two eminent professors flanking the Prime Minister, Professors Whitty and Vallance. At some stage, could we have someone of equal eminence from the mental health field to talk about how we are going to do the mental health piece of the recovery?

[Edward Argar]

My hon. Friend makes a hugely important point. He, of course, has been a huge champion in this House for the cause of mental health. I know that, as we speak, the Minister for Patient Safety, Suicide Prevention and Mental Health, my hon. Friend the hon. Member for Mid Bedfordshire (Ms Dorries), is involved in discussions and meetings about exactly that. There is already support in place, but she is very clear that we need to recognise, in the context of long covid and the impact of this disease, including its indirect impacts, that the future mental health of our nation is hugely important, so my hon. Friend is right to highlight it.

At this Dispatch Box, we have often had occasion to exchange grim statistics: cases, hospitalisations and, sadly, deaths. Of course, behind every one of those numbers is a person—a person with hopes, fears, dreams, families and friends—but I know that the whole House will join me in looking forward to exchanges about perhaps more positive statistics in the weeks to come, of more vaccines given, more people safe and more lives saved.

Before too long I hope we will find ourselves in a situation where we can look at the curve of a graph going up and up not with fear and trepidation about what it means but with tremendous hope, as we look at a graph of vaccines delivered. That prospect is within our grasp, and although we are not yet out of the woods and must not blow it now but must stick to the rules for a little longer until we can be safe, I believe that that prospect should cheer us through the difficult weeks ahead.

[Mr Deputy Speaker (Mr Nigel Evans)]

I pay tribute to the volunteers in Clitheroe whom I saw on Friday helping GPs to roll out the vaccine there.

Some housekeeping notes. To those MPs who are contributing virtually: we will be able to see the clock on the screens in the Chamber, at the bottom of the right-hand side; you should be able to see the clock as well, and please try to finish before three minutes is up. It is a lot cleaner if you do that. To those contributing in the Chamber, the timer will be on the usual monitors in the Chamber, and there is a three-minute limit on all Back-Bench contributions.

Reciprocal Healthcare Arrangements

Edward Argar Excerpts

Thursday 17th December 2020 Written Statements

[The Minister for Health (Edward Argar)]

Today I am notifying the House about arrangements the Government have made to support people who require ongoing, routine healthcare treatment in order to be able to travel to the European economic area or Switzerland after the end of the transition period, should there be no further negotiated outcome with the EU. These arrangements would commence from 1 January 2021.

Current reciprocal healthcare arrangements enable large numbers of UK-insured individuals to access healthcare when they live, study, work or travel in the European economic area or Switzerland, and vice versa when European economic area or Switzerland-insured individuals come to the UK. Although some people are covered under the withdrawal agreement, for everyone else these arrangements will come to an end on 31 December 2020.

Negotiations on future arrangements with the EU are ongoing and include necessary healthcare provisions. If agreed, such provisions would provide effectively the same healthcare cover as the European health insurance card (EHIC). The Government continue to work hard to secure these arrangements.

In the event we have not reached an EU-wide agreement on reciprocal healthcare, the Government will implement a time-limited healthcare scheme that supports UK residents with ongoing, routine treatment needs, who are visiting the European economic area or Switzerland from 1 January 2021. This type of treatment was previously covered under the EHIC scheme.

This Government will introduce the scheme with the intention that it is used by individuals who are certain to require treatment while abroad, such as regular dialysis, oxygen therapy or certain types of chemotherapy. The Government recognise that these ongoing, routine treatment costs can be expensive, and makes travelling abroad extremely challenging for many people.

The scheme will be temporary and will cover travel that takes place between 1 January 2021 to 31 December 2021. People applying for the scheme must be ordinarily resident in England, Wales, Scotland or Northern Ireland and entitled to the treatment on the NHS. Individuals will need to work with their NHS clinician to agree their treatment requirements and confirm they meet the criteria in the scheme.

The NHS Business Services Authority (NHSBSA) will deliver this scheme for the whole of the UK. NHSBSA is an arm’s length body of the Department of Health and Social Care. It provides a range of critical central services to NHS organisations, NHS contractors, patients and the public.

The exception to the new scheme is travel to Ireland as the UK and Irish governments are committed that UK and Irish residents should continue have access to necessary healthcare when visiting the other country.

The Government will assess its options for reciprocal healthcare if we do not achieve an EU-wide arrangement. This includes the possibility of negotiating bilateral arrangements on social security coordination, including reciprocal healthcare, with individual EU member states.

The Department of Health and Social Care will publish further guidance on the scheme, its criteria and application process shortly.

[HCWS670]

Walthamstow Toy Library Eviction: NHS Role

Edward Argar Excerpts

Wednesday 16th December 2020 Westminster Hall

[The Minister for Health (Edward Argar)]

It is always a pleasure to serve under your chairmanship, Mr Hollobone. I will endeavour not to qualify for the Grinch’s green suit in what I am about to say to the hon. Lady. I congratulate her on securing this debate. It is always a pleasure to appear opposite her and she has always been a strong and vocal champion for her constituents in this House.

The hon. Lady has raised a number of points, and I am grateful to her for highlighting in advance the outline and contours of the issue, which means that I have had an opportunity to look into some of it. I will come back to this point later, but I make the offer that I am very happy, as soon as we return after the Christmas recess, to meet her to go into more detail about the issues she has raised and some of the history and chronology of what has happened here, if that is helpful to her.

I know the hon. Lady has been an active supporter of and campaigner for the Walthamstow toy library, which is an important local charity, and she started the campaign to save it from possibly having to move from the current premises, as she has talked about today. As she highlighted, the building is owned by one of the NHS local improvement finance trust companies, CHP, and that is one of the companies that is managed by the Department for Health and Social Care, or owned by the Secretary of State for Health and Social Care. It is now the head tenant for the property, having taken over from the PCT in 2013, when PCTs were abolished. CHP sublet to GPs and other providers of NHS services that received the majority of their income from the local CCG.

I note at the outset that the hon. Lady may wish to challenge some of these points when we meet, as she has done today. As has been related to me, in 2005, the toy library was incentivised to relocate to the new building following the destruction, for want of a better way of putting it, of its old building, by being offered a lease at a peppercorn rent, with a small contribution towards running costs for 10 years, which started on 27 September 2005. It occupies about 9% of the building.

That original lease was between the PCT and the toy library, meaning the PCT bore the cost. In 2013, when the lease was transferred to CHP and the local CCG, they agreed to honour that previous subsidy. My understanding is that during 2015 there were extensive negotiations between CHP, the toy library, the CCG and Waltham Forest children’s services on the expiry of the lease. It was recognised then by the CCG that the toy library would at the very least need time to review the options available to it and to explore securing alternative accommodation, other funding sources to increase its income or, for example, a contract for commissioned services from the council in order to pay its rent. As such, the CCG agreed to subsidise the occupancy for a further three years, beginning on 1 April 2015, at a cost of £50,000 per annum, with contributions also coming from the LIFT company and CHP for the balance of that.

By 2018, my understanding is that no progress had been made in sourcing alternative accommodation, and that the CCG agreed to a further three years of subsidising the rent on similar terms, continuing to contribute £50,000 per annum to costs, with a continued contribution from the LIFT company. The position of the CCG and the LIFT company is that this was always intended to be an interim measure for three years. They state that they sent a clear message to the toy library that, by March 2021, it was expected to pay the full cost of occupancy if it was to remain a tenant. The hon. Lady has put on the record a different interpretation of that, which I am happy to explore with her. If she wants to intervene, I will happily allow it.

[Stella Creasy]

It may be useful to clarify that at no point has the CCG told the toy library that it is to leave the building; indeed, the CCG keeps telling me that it is not evicting the toy library. More importantly, in the chronology that the Minister talks about, if the toy library had been told to find an alternative building, why was it working on commissioning services together with the CCG? I fear that the Minister has been sadly misled by Selina Douglas and the Waltham Forest CCG on this matter.

[Edward Argar]

I was about to make one final point, which is that I understand that a further three-month extension was agreed until 30 June 2021. However, I highlight what the hon. Lady said, not only just now but previously, which clearly suggests that a different complexion has been put on this issue. That is why my meeting her would be useful.

I will put on the record one or two points. It is important to note that the subsidy paid by the CCG is an arrangement that is not offered to any other charitable or voluntary group within the borough. I recognise, as the hon. Lady set out, the value that this charity brings. In my distant past when I was a Westminster city councillor, before I was a Leicestershire MP, I recognised the value that toy libraries and similar charities brought to the local community in London. I put that on the record because we must always remain conscious of fairness. There are specific circumstances, but I just wanted to highlight that point.

The hon. Lady talked about social prescribing, and she is absolutely right. That goes to my experience in seeing the huge value that charity facilities such as this can bring not only to those who are in need, but to others within the community more broadly who access the toy library and come together in that context. Such facilities are hugely important in the communities where they exist. They bring people together and provide mutual support, often to families and individuals who may not have a medical need, or who may not want their needs to be dealt with through medical means, but who find the support they need—help through a difficult time, or just more broadly—through such facilities. I recognise their value.

During the time that the toy library has been in this building, the CHP and the CCG suggest that a substantial debt for service charges and utility bills has accrued, which they assert that the toy library clearly agreed to pay as part of the original lease, separate from the rent. I see from the hon. Lady’s expression that that will feature in our discussion. I appreciate that there are different perspectives on the form that engagement has taken. CHP and the CCG have engaged with the toy library on a number of occasions to explore solutions to the issues that have arisen. Those solutions have included moving to a more sustainable business model, becoming a social enterprise or having the council commission services. They state that the toy library has been supported in those discussions to find alternative premises, with options explored including whether it could be relocated or co-located with other services for children and families.

The toy library of course has the first option on this space, certainly until the end of that period of extension, but I understand that, in the meantime, a feasibility study has been commissioned by the CCG on prioritising use of the building for health purposes. There are no signed agreements yet, but NHS parties state that they are reserving the right to reconfigure the building for what they deem to be its primary purpose: in their words, to get best value for the local health economy. However, to the hon. Lady’s point, we must always be conscious of the need to look at value not just in financial terms or in purely primary care terms, but in terms of broader health benefits and broader benefits to the community. Value, for want of a better way of putting it, takes many forms, not always with pound signs involved: there are broader, more intangible measures of value. Again, I am very happy to explore that aspect of the issue with her when we meet.

The view and perspective of CHP, the local CCG and the LIFT is that they have sought to engage constructively with the toy library since they first assumed that relationship—in 2013, if my memory of what I just said serves me—but they do need to look to the future. The suggestion of finding an alternative space at a similar peppercorn rent, for example, may be a way forward. However, I again note what the hon. Lady said: this is a purpose-built space for the toy library, and a shared space with others coming in and coming out would not necessarily work with the model for the services that are provided to the people who use it. I hope that as we look to the future, both the toy library and—equally, and hugely importantly—the CCG and CHP will try to engage, genuinely and openly, to explore options around either finance or genuinely viable alternative premises. I also hope that throughout, they will engage directly, and indeed courteously, with the hon. Lady as a representative of her constituents in this House.

The hon. Lady raised two specific points that I am happy to look at and discuss with her: one was about the IRR, and one was about levels of management fees. If she will permit me, I will take those away and look at them, and when we meet we can discuss those points.

This is a challenging situation, and clearly, some compromises may have to be made on both sides to move us forward. I have therefore already asked the CCG, CHP and the LIFT company to engage further with the toy library, openly and constructively, and to report back to me with a jointly agreed update on progress at the end of February. The hon. Lady has raised some significant issues, and I would hope to meet with her well before that stage, because I am keen to hear from her in a way that is not always possible in debates in this House. Although debates may raise the profile of an issue and highlight scrutiny of it, we can sometimes get into more detail in a private conversation. I am very happy to meet her and see whether we can find a constructive way forward that genuinely meets the needs of her community. Thank you, Mr Hollobone.

--- Later in debate ---

[Mr Philip Hollobone (in the Chair)]

Order. I am afraid that the hon. Lady is not allowed a right of reply. Generously, I will allow her to intervene on the Minister, if he agrees that he has not finished his speech, but the intervention has to be brief.

[Edward Argar]

Apologies; when I said “Thank you, Mr Hollobone”, I thought that I had caught your eye and you were about to stand, so I sat down. If I may, I will finish my conclusion, and should the hon. Lady wish to intervene on me, I am happy to take that intervention.

[Stella Creasy]

I thank the Minister for letting me intervene, and for the good Christmas cheer that he is bringing. Can I confirm that a side letter was sent by the CCG to the Walthamstow toy library in, I think, 2018, committing to paying all the costs of it being in the building? As such, the suggestion that charges were outstanding is another misleading statement. When he looks into the issue, could he also clarify who will own the building after 2030, when the original lease runs out? We are fewer than 10 years away, and surely any redevelopment of the building has to take place in that context.

I will very much take the Minister up on his offer of a meeting, because I think a way forward can be found to save the Walthamstow toy library where it is. I hope CHP and Waltham Forest CCG are listening very clearly, and that they will finally start to engage properly with my community. In view of that, I wish everybody a merry Christmas.

[Edward Argar]

I am grateful to the hon. Lady. If she is able and happy to forward me a copy of that letter—she may have to do so in confidence—I am very happy to look at it, because it will be useful for me to see it before we meet. She has raised a number of other questions; forgive me, because I did not pick up on that one when I answered. Again, in so far as I am able to discuss that issue with her, I will do so, and my office will get in touch with hers after this debate to try to get us a meeting in January. I hope that, as I say, we will be able to find a constructive and positive way forward that works for the NHS, for her community and for all parties involved, including the toy library.

Motion lapsed (Standing Order No. 10(6)).

Covid-19: Hospital Parking Charges for NHS Staff

Edward Argar Excerpts

Tuesday 1st December 2020 Westminster Hall

[The Minister for Health (Edward Argar)]

It has always been a pleasure to serve under your chairmanship, Sir Charles, not least on the Procedure Committee, which you chaired when I was first elected to this House.

I congratulate the hon. Member for Coventry South (Zarah Sultana) on securing this important debate. I know that this is an issue that she in particular, with other hon. Members, has taken a very close interest in, and it is a timely debate. Before I turn to the specifics of the issue and the hon. Lady’s points, like her, I would like once again to put on record my gratitude and thanks to our NHS and care workers, including those at her local hospital trust. They, as always, continue to do an amazing job in the face of this incredibly challenging pandemic.

To address one of the hon. Lady’s points, I know she will very much welcome and be encouraged by the fact that the Government have put in place a £33.9 billion increase in investment in the NHS, the biggest increase in investment by any Government of recent years. I know she will welcome that very clear investment by this Government in our NHS. However, as she said, it is important that, in the face of this pandemic, as well as thanking our NHS workers, we have taken practical steps as a country and as a Government to further support them. One of those steps has been funding the provision of free parking for NHS staff at work during the pandemic since the spring, as she set out.

As the hon. Lady will know, parking is determined at trust level. While I appreciate she is critical of trust decisions in this space, and that of course is her right, in acknowledging that, I also express gratitude to the trusts that did, following the Government’s clear statement, provide free parking, and to local councils whose provision of free parking space for NHS staff made that possible. As the Prime Minister stated in the House on 8 July:

“The hospital car parks are free for NHS staff for this pandemic—they are free now—and we are going to get on with our manifesto commitment to make them free for patients who need them as well.”—[Official Report, 8 July 2020; Vol. 678, c. 966.]

That remains the policy of Her Majesty’s Government.

I am conscious that the hon. Lady has previously raised a specific question about her own trust, which she also asked today, and which I will seek to address. NHS trusts have control of their parking policies. We, the Government, have made it very clear that we expect individual trusts to follow the approach that I have just outlined and that the Prime Minister set out. To her specific point, trusts have received and continue to receive additional funding to do so, to ensure that they do not lose income. I hope that her trust and others will recognise that, but if it is helpful to her, I will write to her after the debate with more specific information about her local trust and the specific points she raised about its income and funding and the position it has taken on this.

It is, however, also important to set out the broader context, while not losing sight of the clear expectation that trusts will fulfil that policy position. As I say, as the hon. Lady knows, the decision rests with trusts.

[Zarah Sultana]

What I hear from the conversations I have had at University Hospitals Coventry and Warwickshire is that the money has not continued to come; it has stopped. The Minister makes the point that NHS trusts have decision-making powers around parking, and I want to clarify that point, because I find that it then becomes a decision on whether to fund parking or frontline services, and it should not be a choice between those two. There should be enough funding for frontline services and additional funding for parking, so that trusts do not have to make a decision between those.

[Edward Argar]

I am grateful to the hon. Lady. I will come on to the specific point about funding for this commitment in probably about a page or so’s time in my notes, but I go back to the £33.9 billion increase by 2023-24. The Government have given the NHS the money it said it wanted and needed to fund its services and, in addition, we have funded covid costs over and above that settlement.

Turning to the broader context, which is not just about funding, during the first wave of the pandemic, not only were hospital car parks largely empty of patients and visitors, but high streets are empty and so were council and commercial car parks, which local authorities were able to make available to NHS workers for free. That helped to address the fundamental challenge, which is not primarily funding, but capacity in hospital car parks.

While some trusts have significant capacity in their car parks, a very large number, even before the current situation, saw demand for spaces significantly exceed a limited capacity. By way of a little statistical context, overall, the NHS has around 440,000 spaces on its estate. That is set against over 1.3 million staff, and that is even before visitors or patients are factored into the demand side of the equation.

In recent months, we have seen patient and visitor usage of commercial car parks return. As activity has returned to shops and high streets since the summer, we have seen increased demand for those parking spaces that were available during the height of the first wave. This all means a return to significant demand exceeding a finite supply of available parking spaces. As set out in our manifesto, it is important that the patients and visitors who most need parking can access it, alongside our amazing NHS staff.

I will briefly address the issue of funding that the hon. Lady raised, and the concerns about a potential loss of trust income or trust funding. During the pandemic, we have provided trusts with specific funding for free parking for NHS staff. They continue to receive funding for that, currently as part of the overall system of funding allocation we have put in place. However, as I said, I will look into the hon. Lady’s specific point about her trust and how the allocation of the funding coming through that system is done, to reassure her that her trust continues to be supported through that overall pot.

Alongside the Prime Minister’s clearly stated commitment on NHS staff parking, he referenced our manifesto commitment, the context of which I will touch upon, including what we are doing to increase capacity to address that fundamental, underlying challenge. Some trusts began implementing the manifesto commitment earlier in the year. However, we fully recognise—and did recognise—the need for trusts, given the pandemic, to focus both on implementing the staff parking measures and on their operational response to the pandemic and ensuring they were there for all patients who needed them. We understand that, for reasons that I am sure all reasonable people would understand, many trusts delayed the planned phased roll-out due to take place over the course of this year, reflecting that external context.

The commitment will ensure that, in the course of this Parliament, disabled blue badge holders, frequent outpatient attendees, parents of children staying overnight, as well as night shift NHS staff, will be given free parking at hospitals. This will be the first time that hospital car parking has been completely free in this country for those groups who need it most. It will be mandated by NHS England and NHS Improvement on trusts from 1 January 2021. That mandating process, which takes considerable time, is the only lever by which trusts can be compelled to do this. That is why I say that the decision rests with trusts.

However, we recognise that in the midst of a second wave, flexibility is required. To have both policies operating at the same time will be a challenge for some sites, particularly in urban areas where capacity is limited. As we face this second wave, trusts’ clear focus is on operationally tackling the pandemic and responding to it. I am sure that all reasonable people will recognise the need for roll-out flexibility in the context of the mandating, and given the focus of our NHS on their responsibilities in tackling the pandemic.

On the capacity issues, the Government are committed to increasing hospital car parking capacity. I set out the challenge earlier, but we have set aside over £200 million of capital funding for the financial year to do this. This money is available to trusts to modernise and expand their car parking facilities, and to utilise technology, such as automatic number plate recognition systems, to make parking easier for patients. Trusts will be invited to bid for this funding in the usual way, and we will ensure that they have full details of how they can do that.

The Government have been clear on their commitment on staff parking. We have adhered to that commitment, and continued to provide the funding for it. I will give the hon. Lady more detailed granular information for her trust. We have made significant progress since the announcement of our manifesto commitment. We remain committed to providing free car parking for NHS staff during the pandemic, as the Prime Minister made very clear, and to ensuring that NHS hospital parking is free for those who need it the most, in line with our manifesto commitment that we are clear we will deliver. We must do that while ensuring that the NHS has the necessary resources to deliver the commitment successfully, both in terms of capacity and meeting the revenue funding cost.

Again, I thank the hon. Member for Coventry South for securing the debate and for the tone, by and large, that she adopted. I know she feels passionately about this matter, and it is right that she brings that passion, her knowledge and her constituents’ specific concerns to the House. I hope I have answered her points from the Dispatch Box, but I will of course come back to her about any that I have not been able to provide specific detail on in due course.

Question put and agreed to.

Draft Human Medicines (Amendment etc.) (EU Exit) Regulations 2020 Draft Medical Devices (Amendment Etc.) (EU Exit) Regulations 2020

Edward Argar Excerpts

Thursday 26th November 2020 General Committees

[The Chair]

Good morning. Before we begin, I remind Members to observe social distancing and only sit in places that are clearly marked. Hansard colleagues would be most grateful if all Members sent their speaking notes to [e-mail] after the sitting.

[The Minister for Health (Edward Argar)]

I beg to move,

That the Committee has considered the draft Human Medicines (Amendment etc.) (EU Exit) Regulations 2020.

[The Chair]

With this it will be convenient to consider the draft Medical Devices (Amendment etc.) (EU Exit) Regulations 2020.

[Edward Argar]

It is always a pleasure to serve under your chairmanship, Mr Rosindell.

The statutory instruments concern the regulations for human medicines and medical devices. They form part of a legislative programme to ensure there is a functioning statute book at the end of the transition period to provide certainty for businesses and the public. Most of the changes they make are technical in nature.

It is a pleasure, as ever, to serve in Committee opposite the shadow Minister, the hon. Member for Nottingham North. We have become something of a double act in these Delegated Legislation Committees covering the legislation for the end of the transition period.

I believe that everyone in this Committee Room shares the Government’s intention to protect patient safety and preserve patients’ access to innovative new treatments. That could not be more important than in the context of the covid-19 response. The statutory instruments have been developed to maintain our world-leading standards in the regulation of medicines and medical devices now that we have left the European Union and as the transition period comes to an end.

The statutory instruments broadly achieve three things: they make minor amendments to existing regulations to take account of the implementation period agreed under the withdrawal agreement; they implement our obligations under the Northern Ireland protocol; and they implement specific policy changes to the regulatory regime in Great Britain to ensure that the regulatory framework is up-to-date and functioning correctly at the end of the transition period. The regulations do not prevent the need for future changes, but preserve the solid foundations of the UK regulatory environment to ensure patient safety—something I suspect the shadow Minister will speak about—and to ensure that the UK remains one of the best places in the world for science and innovation.

I will mention briefly the most notable policy changes that the instruments set out in law, for the benefit of Members. The instruments are long and technical, so I am unable to address all elements of them in the time available, but I will endeavour to cover the main points.

The medical devices instrument will allow us to maintain the current standards of regulation. We will ensure that patient safety and health outcomes are not adversely impacted, and we will continue to recognise the CE marking on medical devices and in vitro diagnostic devices, which have demonstrated their conformity with EU regulatory requirements, for a further two and a half years. That approach is both sensible and pragmatic. It provides time for industry to adapt to future regulations and eliminates any delay in access to devices for UK patients, while maintaining continuity.

A policy change that I note for the Committee is the adoption of the new conformity assessment marking for medical devices. The Government have created their own product safety marking, which will be used across goods regulation. The UK conformity assessment—UKCA—mark will be available for industry to use for devices placed on the market in Great Britain from the end of the transition period.

The medical devices instrument, as it applies to Great Britain, removes certain provisions from the previous EU exit instrument, which would have inserted regulations similar to the EU’s medical devices regulation, or MDR, and in vitro diagnostic regulation, or IVDR. That is because the full application of the two EU regulations will now fall outside the transition period.

The independent medicines and medical devices safety review, which delivered its report in July, highlighted the importance of strengthened regulations that do more to protect patients. The regulations, as amended by the medical devices instrument, will be built on using the powers of the Medicines and Medical Devices Bill, which is currently continuing its passage in the other place.

The Bill will provide the opportunity to develop a robust, world-leading regulatory regime for medical devices that prioritises patient safety and innovation. Our plans are in development, and will take into consideration both international standards and global harmonisation in the establishment of our future system. We will of course consult closely with stakeholders within the life sciences and healthcare sectors on that future regime.

I now turn to the human medicines instrument to note a few further changes that will help the UK to maintain its excellent regulatory system for medicines and clinical trials. From 1 January 2021, marketing authorisations granted by the EU will continue to apply in Northern Ireland; however, all medicines to be placed on the market in Great Britain must be authorised through the UK national route.

The human medicines instrument allows the Medicines and Healthcare products Regulatory Agency to have regard to decisions taken by EU member states on products approved via decentralised and mutual recognition procedures when considering whether to authorise those products in Great Britain. That policy is to ensure that the UK can continue to take effective regulatory and safety action on those products.

The instrument will also ensure that novel and innovative medicines continue to come to the UK market after the end of the transition period. That will be achieved by allowing recognition of decisions by the European Medicines Agency to grant UK marketing authorisations for centrally authorised products.

Both the human medicines and the medical devices instruments uphold the Prime Minister’s commitment to unfettered access for Northern Ireland’s businesses to the whole of the UK market. In doing so, they provide for transparency requirements for medicines and medical devices moving from Northern Ireland to Great Britain, which will allow the MHRA to maintain oversight of products on the GB market and thus protect patient safety.

For medicines, the MHRA will still retain regulatory powers, such as carrying out a targeted assessment of a medicinal product where it is deemed necessary for safety reasons. For medical devices, non-UK manufacturers placing devices on the UK market will be required to appoint a UK responsible person. The UK responsible person will be required to register devices with the MHRA in accordance with a transitional timetable set out in the regulations.

To fulfil the requirements of the Northern Ireland protocol, both instruments make relevant changes to ensure that the relevant EU laws will continue to apply in Northern Ireland after the end of the transition period and, additionally, the instruments grant the MHRA powers to continue to regulate medicines and devices in Northern Ireland in order to ensure that there is clear continuity for patients and businesses.

Members will be aware that the MHRA charges fees to cover the costs associated with the regulation of medicines. To reflect the regulatory changes that will take effect after the transition period ends, the instrument reduces some of the fees to ensure that they will still be commensurate with the cost of the work performed by the MHRA.

The devolved Administrations have been kept informed of the drafting of the instrument, and I put on record my gratitude for their continued collaborative approach. In particular, I thank the Minister of Health in Northern Ireland, Robin Swann, who agreed, despite policy for human medicines being a devolved matter, that the human medicines instrument should be signed solely by the Secretary of State for the Department of Health and Social Care.

We have also been working closely with industry through the development of the statutory instruments. In September and since then, we have published a number of guidance documents that go into further detail on those changes on gov.uk. We have held an accompanying series of webinars to engage directly with more than 11,500 industry representatives, providing them with an opportunity for their questions to be asked and answered. My officials continue to meet regularly with the major industry suppliers and key trade associations, including the Association of the British Pharmaceutical Industry, the BioIndustry Association and the Association of British HealthTech Industries.

It is also important to note that the instruments amend pre-existing EU exit legislation made in 2019, taken through on behalf of the Opposition, I think, by the hon. Member for Ellesmere Port and Neston (Justin Madders)—the other half of the Opposition double act on these instruments. A full consultation process was conducted for the pre-existing legislation and, moreover, full impact assessments were conducted for the underlying legislation.

As the nature of the changes in the instruments that we are discussing today are in many instances technical, the impact of the instruments, above and beyond the existing legislation, is not assessed to meet the threshold for further impact assessments; hence they have not been provided for. I commend the draft regulations to the Committee.

--- Later in debate ---

[Edward Argar]

I am grateful to the shadow Minister for his typically reasonable and measured comments. He repeated a number of questions that are familiar to me, but he did not repeat his jokes from previous Committees, which is a relief for hon. Members. I will deal with his points in order.

In respect of a deal or a future relationship agreement, the hon. Gentleman knows me very well and can predict my response. I will, of course, say to him that the negotiations continue, and it would be wrong to prejudge them. However, I know that Her Majesty’s Government continue to negotiate actively and positively with the European Union.

The hon. Gentleman is right in his key point about the importance of patient safety. I reassure him that the Minister for Patient Safety, Mental Health and Suicide Prevention is, as he will know, a passionate advocate for patient safety. She takes it incredibly seriously both in her role as a Minister and given her background in medicine and nursing—it is deeply important to her. As I speak, I suspect she is on the Front Bench with my right hon. Friend the Secretary of State. I will certainly pass on the hon. Gentleman’s request and comments in respect of the Cumberlege review when I see her after the statement.

The hon. Gentleman reflected on a number of other factors. He often asks me in these Committees, quite reasonably, whether we are going to deliver our obligations under the Northern Ireland protocol. I reassure him that this is the penultimate Delegated Legislation Committee—we have one more to go—in fulfilling this Department’s obligations under the protocol by putting through the necessary regulations.

The hon. Gentleman asked for reassurances. I reassure him that I am confident that these statutory instruments and the regime that follows the end of the transition period will not make patients less safe and will not have a negative impact on our life sciences sector and businesses. The whole approach we are adopting in this country is to strengthen patient safety and put it at the heart of what we do, while also supporting our fantastic life sciences sector and its competitiveness and innovation. I reassure him of my confidence that we will continue to deliver on those objectives.

On responsible persons, the hon. Gentleman rightly said it is important that that process and that individual do the job they are there to do, and do it properly. He mentioned the period of two and a half years on top of the transition period. That was reached in discussion with industry about what it needs and with the regulators about how to make the transition to a new regime effective.

Finally, the hon. Gentleman talked at length about the MHRA and asked several questions, so I will spend a few minutes responding to them. He will be aware that the UK has substantial capacity and expertise to regulate and evaluate the quality, safety and efficacy of medicines and medical devices. The MHRA is expert in many areas, including the licensing of medicines, pharmaco- vigilance and clinical trials regulation. That already provides benefits to patients. The MHRA is the lead regulator on more than 3,500 medicines currently on the EU market.

The hon. Gentleman asked about the impact on the MHRA and its workload. I reassure him that it will receive additional funding of just under £13 million by the end of March next year to help it prepare for the end of the transition period and meet its obligations under the regulations. Among other activities, that is being used to fund investments in new and improved IT systems to enable better regulation of medicines and medical devices in Northern Ireland under the protocol. It has also contributed to additional staffing requirements to manage all aspects of the new regime to which he alluded.

The MHRA is taking robust steps to ensure that it is ready to continue to perform, as it always has done, at the highest level, putting patient safety first, and we have given it the resources to do that.

Question put and agreed to.

Draft Medical Devices (Amendment etc.) (EU Exit) Regulations 2020

Resolved,

That the committee has considered the draft Medical Devices (Amendment etc.) (EU Exit) Regulations 2020.—(Edward Argar.)