Health and Care Bill

Edward Argar Excerpts

2nd reading
Wednesday 14th July 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

Before winding up this important debate, I would like to put on the record, as I always do and as I know the shadow Minister does, our gratitude to all the staff in the NHS, social care and local government, and other key workers, for everything they have done in recent months. This Bill is evolution, not revolution. It supports improvements already under way in our NHS and it builds on the recommendations of the NHS’s own long-term plan, laying the foundations for our recovery from this pandemic. This Bill is backed by not only the NHS, but so many others working across health and care. A joint statement from the NHS Confederation, NHS Providers and the Local Government Association reads:

“we believe that the direction of travel set by the bill is the right one.”

It notes that working in partnership at a local level is “the only way” we can address the challenges of our time. The chief executive of Age UK has said that ICSs are to be embraced and made as effective and inclusive as they can be, and the King’s Fund is calling for us to press ahead. The list goes on; the NHS wants us to press ahead, and in the words of Lord Stevens, “The overwhelming majority of these proposals are changes the health service have asked for.” So it is vital that we in this House do right by them and by patients at this critical juncture. It is the right time for this Bill. We legislate, Opposition Members obfuscate. I remind the shadow Secretary of State of his 2017 manifesto, which stated:

“We will reinstate the powers of the Secretary of State for Health to have overall responsibility for the NHS.”

With this Bill, we put increased accountability for the Secretary of State at the heart of this, yet now the shadow Secretary of State no longer seems to agree with himself and characterises his own proposals as “meddling”. I know that he is dextrous in his politics and in his policy position, which is probably why he has survived under multiple Leaders of the Opposition, but this is stretching it a bit.

We have sought, in getting to this point, to work on a collaborative basis at every stage, and hon. Members can be reassured that we will continue to adopt that approach in the weeks ahead as we proceed with this Bill, when we hope it goes into Committee. My right hon. Friend the Secretary of State set out in his opening remarks his willingness to listen. In particular, he highlighted that in the case of ICS boundaries no decision has yet been made. As he set out, we are determined to embrace innovative potential wherever we find it. That is quite different from many of the accusations we have heard here today. I know it is tempting for some—even when they know better, and they do—to claim that it is the beginning of the end for public provision. It is not and they know it. They know it is scaremongering rather than reality. They know that there has always been an element of private provision in healthcare services in this country, and they should know that because, as the Nuffield Trust said in 2019:

“The…evidence suggests the increase”

in private provision

“originally began under Labour governments before 2010”.

The shadow Secretary of State should certainly know that because he was a special adviser in the Treasury and in No. 10 at that time.

With regard to the implementation of the Bill, the NHS itself wants, subject to legislation, to move at pace to implement statutory arrangements for ICSs by April 2022. That is why NHS England is beginning preparatory work, including publishing an ICS design framework. Further work, including on integrated care board design and consideration of appointments and staff from CCGs will take place, after Second Reading, of course; this is all subject to the passage of the Bill.

Let me turn to some of the specific points raised by hon. and right hon. Members. The hon. Member for York Central (Rachael Maskell) asked about “Agenda for Change”. I can reassure her that it is not the intention that ICBs depart from “Agenda for Change”. The Bill’s drafting and wording is in line with existing arrangements for other NHS bodies with regard to “Agenda for Change” and translates it into this context. However, I am always happy to discuss that with her further if she wishes. Her suggestion that this was conceived, as she put it, in a bunker is quite simply not the case. Indeed, all the stakeholders, including the NHS, have said that this is one of the most collaborative pieces of legislation development they have seen.

Turning to the workforce, as my hon. Friend the Member for Winchester (Steve Brine) said, we cannot legislate to address workforce challenges but we can and we will look very carefully at the recommendations of the Select Committee and of my right hon. Friend the Member for South West Surrey (Jeremy Hunt).

While we do not always agree on everything, the hon. Member for Twickenham (Munira Wilson) made sensible points, although I would slightly tease her that she argued against the principle of the Secretary of State taking powers in reconfiguration and shortly afterwards her hon. Friend, the hon. Member for Westmorland and Lonsdale (Tim Farron), intervened on him asking him to do exactly that.

[Munira Wilson]

I did point that out.

[Edward Argar]

She did.

In response to the hon. Member for Central Ayrshire (Dr Whitford), I am again grateful for her comments and happy to accept her kind invitation to join her on a visit to Scotland.

The right hon. Member for North Durham (Mr Jones) made a very important point. In doing so, he rightly paid tribute to the work in this space done by my hon. Friend the Member for Sevenoaks (Laura Trott) with her recent private Member’s Bill. As the Secretary of State said, either he, I or the relevant Minister will be happy to meet him to discuss it further. My hon. Friend the Member for Meriden (Saqib Bhatti) was right to talk about the need for local flexibility. That is what we are seeking to do.

The hon. Member for Eltham (Clive Efford) asked more broadly about public spending constraints after 2010. He is brave, perhaps, to mention that. I recall the legacy of the previous Labour Government, which the right hon. Member for Birmingham, Hodge Hill (Liam Byrne) summed up pretty effectively in saying,

“I’m afraid there is no money.”

On social care, which a number of hon. and right hon. Members mentioned, we will take no lessons from Labour. In 13 years, after two Green Papers, a royal commission and apparently making it a priority at the spending review of 2007, the net result was absolutely nothing—inaction throughout. We are committed to bringing forward proposals this year. Labour talks; we will act.

The NHS is the finest health service in the world. We knew that before the pandemic, and the last year and a half have only reinforced that. It is our collective duty to strengthen our health and care system for our times. I was shocked, although probably not surprised, that the Opposition recklessly and opportunistically intend to oppose the Bill—a Bill, as we have heard, that the NHS has asked for—once again putting political point scoring ahead of NHS and patient needs. For our part, we are determined to support our NHS, as this Bill does, to create an NHS that is fit for the future and to renew the gift left by generations before us and pass it on stronger to future generations. We are the party of the NHS and we are determined to give it what it needs, what it has asked for and what it deserves. I encourage hon. Members to reject the Opposition amendment, and I commend the Bill to the House.

[Mr Deputy Speaker (Mr Nigel Evans)]

I apologise to the 30 Members who did not get to speak in this important debate, some of whom are currently in the Chamber.

Question put, That the amendment be made.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 13th July 2021 Commons Chamber

[Tom Randall (Gedling) (Con)]

What steps he is taking to improve the infrastructure of the NHS estate.

[The Minister for Health (Edward Argar)]

In our manifesto, we committed to building 40 new hospitals by 2030 and to upgrading another 20 hospitals. We are delivering on this commitment, and we now have plans to build 48 new hospitals this decade. We are also delivering improvements across the country to hospital maintenance, eradicating mental health dormitories and improving A&E capacity. Finally, the Department has received a £9.4 billion capital settlement for 2021-22, including the first year of a £5.4 billion multi-year commitment until 2024-25 for new hospitals and hospital upgrades, and £4.2 billion for NHS trusts’ operational capital.

[Robbie Moore]

Some 83% of the Airedale hospital in my constituency is built from aerated concrete, with the building containing 50,000 aerated concrete panels in its construction, which is five times more than any other hospital in the UK. This building material is known for its structural deficiencies, so can my hon. Friend assure me that when his Department considers new infrastructure projects, schemes with the highest risk profile, such as the Airedale hospital, will be an absolute priority?

[Edward Argar]

My hon. Friend is a doughty campaigner in this House on behalf of his local hospital at Airedale, going the extra mile, I gather from the Keighley News, by committing to run 100k in 10 weeks to raise funds for, among other things, the Friends of Airedale Hospital—I hope, if he has not finished that yet, it is going well.

To my hon. Friend’s substantive point, he raises an important issue. Airedale has been allocated capital investment in the millions for the 2021-22 financial year from a funding budget that is ring-fenced for RAAC—reinforced autoclaved aerated concrete—plank remediation, but I can reassure him that, as we look to set the criteria for the next eight hospitals, safety considerations are highly likely to be one of the key considerations.

[Philip Dunne [V]]

The Minister will be aware that, in March 2018, Shrewsbury and Telford Hospital NHS Trust was allocated over £300 million to undertake a radical transformation of its acute hospitals at Shrewsbury and Telford. Since then, the trust’s management have been engaged in finalising the strategic business case, but as a consequence of changes to the Green Book and clinical standards the cost will have increased. Will the Minister commit to meet with Shropshire and Telford MPs once the business case is complete to help to ensure that the project can still be delivered?

[Edward Argar]

NHS E&I and the Department of Health and Social Care wrote to the Shrewsbury and Telford Hospital NHS Trust on 19 November last year confirming we remain committed to supporting the scheme. This letter confirmed the allocation remains at £312 million at this time, and of course my right hon. Friend will recall that I committed to approving the request in principle for £6 million of early funding to continue to develop the scheme. It is an important scheme, we want to see it proceed and I am very happy to meet him and fellow Shropshire colleagues.

[Tom Randall (Gedling) (Con)]

In my role as chair of the all-party group for axial spondyloarthritis I have heard from many about the importance of hydrotherapy pools in supporting those living with the condition, but there has been a concern that the reopening of these pools following the pandemic has been jeopardised by space within hospitals being allocated to other functions and a general low level of prioritisation. Does my hon. Friend agree that it is vital that we have robust plans in place to reopen as many hydrotherapy pools as possible, and will he consider meeting me to discuss this matter in further detail?

[Edward Argar]

I pay tribute to my hon. Friend and the all-party group for their work. He raises an important point: the challenges posed by infection control and the impact of the pandemic on the operation of hospitals. That has had an impact in this space, but I entirely recognise the value and importance of hydrotherapy as a treatment for particular conditions and I will be delighted to meet him.

[Jonathan Ashworth (Leicester South) (Lab/Co-op)]

Of course the number of general and acute beds open across the estate impacts on a trust’s ability to get on top of the elective backlog, which now stands at 5.3 million—a record high—with 336,000 waiting over a year and 7,000 waiting over two years for treatment. On appointment, the Secretary of State promised trusts that they would get everything they need to get through the backlog. So how much will trusts get and when will they get it?

[Edward Argar]

It is an important question. The Secretary of State has made it clear that tackling the elective backlog is one of his key priorities in his new role. The right hon. Gentleman will be aware that the Government have already committed £1 billion to helping to tackle the elective backlog. That, of course, comes on top of the record funding of £33.9 billion to ’23-24 for our NHS, but that commitment remains. We will do whatever is necessary to ensure that our NHS can tackle the elective backlog and get those waiting lists down.

[Jonathan Ashworth]

I am grateful to the Minister for his answer, but if it is a priority of the new Secretary of State why on Friday were trusts told that the threshold for accessing that elective recovery funding was increasing, effectively making it harder for a trust to access funding at just the time when hospital admissions for covid are increasing and we have trusts, such as in Leeds and Birmingham, cancelling cancer surgery? Surely we should be giving trusts more resources now, not restricting access to the elective recovery fund.

[Edward Argar]

In terms of the elective recovery fund, we have worked with the NHS to determine the right thresholds and the right premiums for payment for elective activity over and above what we would be expecting in the circumstances. The NHS is doing an amazing job in difficult circumstances, as the right hon. Gentleman will appreciate, with the impact that infection prevention control restrictions have had on the ability of trusts to see the number of people that they normally would. Trusts are taking huge strides to restore services and the ERF is there to help to ensure that they are funded for that activity level so that they can get provision up and above where it needs to be in order to get the waiting lists down.

[Ian Lavery (Wansbeck) (Lab)]

What steps he plans to take to ensure that the NHS is excluded from future trade deals.

[The Minister for Health (Edward Argar)]

We have been clear that the NHS, the price it pays for medicines and the services it provides are off the table in our trade negotiations. No trade agreement has ever affected our ability to keep public services public, nor forced us to pay for more medicines. My Department works closely with the Department for International Trade to ensure that this is reflected in the negotiations of new trade deals.

[Ian Lavery [V]]

Last week we proudly celebrated the wonderful creation of the NHS—the most cherished of all national institutions—yet grave fears remain about its ultimate privatisation under this Government. If the Government are determined to sign up to the provisions in the trans-Pacific partnership for investor-state dispute settlement, can the Minister at least do one thing today to limit that damage? Will he guarantee that the NHS will be totally exempt from the scope of those ISDS lawsuits and ensure that that exemption is written into the terms of the UK’s accession?

[Edward Argar]

The Government have been clear in our published approach to negotiations, both on the comprehensive and progressive agreement for trans-Pacific partnership and any US trade deal, that protecting the NHS is a fundamental principle of our trade policy. The UK will ensure that the terms we sign up to in any trade negotiation uphold the Government’s manifesto commitment that the NHS, its services and the cost of medicines are not on the table, and that we hold true to our principles underpinning the NHS—of a service available to all at the point of need, free.

--- Later in debate ---

[James Wild (North West Norfolk) (Con)]

What progress his Department has made on selecting the eight new hospital programme schemes invited to bid for funding announced in the spending review 2020.

[The Minister for Health (Edward Argar)]

On 2 October last year, we announced 40 new hospitals to be built by 2030 and committed to an open process to confirm a further eight new schemes. Taken together, those 48 schemes should represent the biggest hospital building programme in a generation. As my hon. Friend would expect, my right hon. Friend the new Secretary of State is taking a close interest in the detail of this process, and I hope to be able to offer a further update on the selection process for the next eight hospitals very soon.

[James Wild]

Spending hundreds of millions of pounds patching up buildings long past their planned lifespan—such as the Queen Elizabeth Hospital in King’s Lynn, which currently has 200 safety props holding up the concrete roof—does not represent value for money. What reassurance can my hon. Friend give to the thousands of my constituents who in recent days have signed a petition for a new hospital to replace the QEH that the Government are looking seriously at the urgent and compelling case for a new fit-for-purpose hospital for staff, patients and visitors?

[Edward Argar]

My hon. Friend’s constituents will know that, in him, they have a doughty champion of their cause and a strong advocate for his hospital. He and I have spoken on many occasions, and I recognise the challenges facing the Queen Elizabeth Hospital, which he has been very clear about. The spending review 2020 included £4.2 billion this financial year for NHS operational capital investment to allow hospitals to maintain and refurbish their infrastructure, including a ring-fenced £110 million allocation for the most serious and immediate risk posed by reinforced autoclaved aerated concrete. My hon. Friend’s hospital has received just over £20 million of that funding to help to mitigate the most urgent RAAC risk, but he will also have heard me say, without prejudging any announcement my right hon. Friend will make about the criteria for the future eight, that safety will be one of the considerations.

--- Later in debate ---

[Jason McCartney (Colne Valley) (Con)]

I have been contacted by a number of my Colne Valley constituents who have had operations and medical procedures cancelled or postponed at short notice. With coronavirus cases still on the rise, what is the strategy to tackle the backlog in operations and medical procedures?

[The Minister for Health (Edward Argar)]

My hon. Friend rightly raises an issue that I know will be a concern for constituents of all Members of this House. The backlog of treatment—the waiting list—is over 5 million. However, we are making rapid progress with that, and so is the NHS. We are looking at a variety of ways to do that—not just providing the funding needed to do it, but through innovation, accelerator hubs and diagnostic hubs, all designed to get the waiting list down and to get people the treatment they need when they need it. I would be very happy to discuss the specifics of my hon. Friend’s local situation with him outside this place.

[Mr Speaker]

Wendy Chamberlain was online, so let us go to Wendy. Welcome, Wendy.

Draft Health Security (EU Exit) Regulations 2021

Edward Argar Excerpts

Tuesday 13th July 2021 General Committees

[The Chair]

Before we begin, I remind Members about social distancing regulations. Spaces available to Members are clearly marked. Mr Speaker has stated that masks should be worn in Committee, when Members are not speaking. Hansard colleagues would be grateful if Members sent any speaking notes to [e-mail].

[The Minister for Health (Edward Argar)]

I beg to move,

That the Committee has considered the draft Health Security (EU Exit) Regulations 2021.

It is a pleasure not only to serve under your chairmanship for the first time, Mrs Murray, but to see you in person again—it has been a long time.

I am sure that hon. Members will agree that sharing information in order to co-ordinate health protection activity between all parts of the UK, as well as internationally, is critical in ensuring that we can effectively prevent and respond to serious cross-border health threats. That has been evident to us all, and of particular importance, during the pandemic. The regulations will ensure that such necessary co-ordination is maintained following our departure from the EU, and will enable us to continue to deliver high levels of human health protection across the whole UK. They modify retained EU law on health security to establish a stand-alone UK-wide regime.

The regulations form part of broader ongoing work to improve our health security capabilities, including through the establishment of the new UK health security agency, which will be fully operational from 1 October 2021. UKHSA will combine key elements of Public Health England, NHS Test and Trace and the Joint Biosecurity Centre. It will provide overarching leadership to strengthen partnership working and the response at local, regional and national levels. UKHSA will be this country’s permanent organisation to build standing capacity to plan for, prevent and respond to threats to health. It will be able to deploy the full weight of our analytic and genomic capability on infectious diseases. It will work collaboratively with partners around the world to lead the UK’s global contribution to health security.

The regulations will support UKHSA, alongside Public Health Wales, Public Health Scotland and the Public Health Agency of Northern Ireland, in quickly identifying and responding to a wide range of health threats. They will ensure that we maintain a robust and consistent UK-wide approach to health security that enables international working and links to international surveillance systems, which is so important.

I will briefly set out a little context. As hon. Members will know, on 24 December 2020, the UK-EU trade and co-operation agreement was announced. These regulations will support the UK in meeting the health security arrangements in that agreement. The TCA provides a strong basis for the UK and the EU to continue to co-operate closely on health security, including: a commitment to inform each other when new public health threats are identified in the UK or the EU; ad hoc UK access to the EU’s database for sharing alerts, known as the early warning and response system; a provision for the UK to attend the EU Health Security Committee; and a commitment to co-operation between the UK and the European Centre for Disease Prevention and Control, including through the inclusion of a memorandum of understanding, which is being negotiated. It is because of these arrangements that the UK was given access to the EWRS for covid-19 from 1 January 2021, ensuring continuity after we left the EU, and we attend the Health Security Committee. Our current access has avoided any disruption in the flow of public health data during the pandemic.

While we were a member state, the UK was required to co-ordinate with the EU, and to share with it certain types of information on health protection, such as early alerts on newly identified threats. As health protection is predominantly a devolved competence in the UK, in order to effectively meet these obligations, the four UK nations had to co-ordinate and share the required information with Public Health England, which is the UK’s focal point for communication with the EU. However, following the end of the transition period, this retained EU law relating to health security no longer operates effectively to set rules for such co-ordination on a UK-wide basis. Therefore, the proposed regulations modify and transfer functions previously carried out by the EU to a new UK health protection committee and to UKHSA, working in co-operation with their counterpart organisations in Wales, Scotland and Northern Ireland. Let me set out the key ways in which the regulations do this.

First, we recognise the importance of early alerting. That has been clearly illustrated by the pandemic. It is imperative that when a threat is identified, information is rapidly shared to enable the quick implementation of control measures that will reduce transmission rates in the general population and protect individuals. To ensure we have a robust early alerting system in the UK, these regulations require the UK’s public health agencies to notify the UK’s focal point—PHE, which will become UKHSA—within 24 hours of any new threats being identified.

For the purpose of these regulations, PHE is designated the UK’s focal point, with that function transferring to UKHSA on 1 October. In this role, UKHSA will be responsible for receiving alert notifications of serious cross-border threats to health from the different parts of the UK, and then working jointly with them to conduct rapid risk assessments and put in place co-ordinated response measures as necessary.

To meet our obligations under the TCA, UKHSA must notify the EU of any threats occurring in the UK that may present a risk to EU member states. In return, the EU will notify the UK of any emerging threat in Europe that may present a risk to us. If the UK and the EU agree that it would be beneficial for the UK to have access to EWRS for any threat, and to sit on that committee, UKHSA will be responsible for uploading and receiving related information to ensure continuity of flow.

Secondly, it is critical that we continue to conduct UK-wide epidemiological surveillance on known communicable diseases. The regulations therefore make provision for the UK’s four public health agencies to conduct surveillance of communicable diseases on a shared list and related special health matters.

Thirdly, the regulations require the UK Government, the devolved Administrations and the UK’s public health agencies to consult each other with a view to co-ordinating their respective monitoring, early warnings and responses to serious cross-border health threats. They must inform each other of any substantial revisions to preparedness and response planning.

Finally, to support the implementation and functioning of these regulations, we are establishing the UK health protection committee. The committee will regularly meet representatives from all parts of the UK, and will provide advice on the list of communicable diseases and related special health matters that are subject to UK-wide surveillance, and on the associated operational procedures. The committee will be accountable to the UK chief medical officers group.

As health security is an area of devolved competence, we have obtained formal consent for these regulations from the devolved Administrations, as the shadow Minister and the Committee would expect. In parallel, we are working together to develop a common framework that will further strengthen UK-wide governance arrangements on the prevention and control of serious cross-border health threats to complement these regulations.

To conclude, I must emphasise that these regulations are critical in ensuring that we continue to take a consistent and collaborative approach to health security in all parts of the UK and, importantly, with our European friends and neighbours. The regulations will help ensure that the UK can meet the obligations on health security that we recently agreed in the TCA, and represent an important step forward in the protection of our citizens and those across Europe.

--- Later in debate ---

[Edward Argar]

I am grateful to the shadow Minister for a well researched and pragmatic response to the regulations; it was typical of the responses that he has given on multiple Delegated Legislation Committees we have been on together. We may not agree on everything, but I agree with him on a huge amount in this case. I suspect that, in this space, we agree on rather more than many might suspect. He is right to highlight that diseases, including the virus in this pandemic, do not respect borders. It is therefore in everyone’s interest to work together—not just internationally, but as he says, with our friends and colleagues in Scotland, Wales and Northern Ireland.

The hon. Gentleman asked a number of questions. He mentioned the explanatory memorandum; he and the Secondary Legislation Scrutiny Committee make a fair point. I suspect that because we all consider regulations almost every week—or feel like we do—the detail under- pinning them is etched on our minds. However, the Committee is right that the explanatory memorandum’s purpose is to make that accessible to members of the public, and Members of the House who may come to these matters afresh. I hope that in my remarks I added a little flesh to the bones of how this will work and what sits behind the regulations.

The hon. Gentleman mentioned the EWRS, the Health Security Committee in Europe and how it will work—that is, how getting access worked this time; he also asked what would happen and what the fallback position was if access were refused. We received confirmation of the TCA over Christmas and new year; at the start of this year, I instructed officials to formally request continued access to EWRS and to the committee. If I recall, that was granted within a matter of hours, if not minutes. At a pragmatic level, therefore, there is genuine recognition and desire from both the EU and the UK to work in a sensible, grown-up way and achieve the results that all our citizens expect.

The hon. Gentleman asked “What if?”, which is fair. The TCA provides a framework for the UK to request access where we think it is in our interest to do so in responding to a serious cross-border threat to health. If the EU rejected that request—on the basis of experience, I would not expect that—the UK would continue to receive the critical information and notifications on public health risks and incidents through our parallel access to alternative international surveillance systems, such as the event management system operated by the World Health Organisation.

That takes me to the hon. Gentleman’s second point, which was about the WHO. We are talking about additionality; the measures in no way replace our commitment to working with the WHO through the Epidemic Intelligence Service, and through our obligation to comply with International Health Regulations 2005, which link closely with the WHO’s work. Our commitment to working collaboratively and openly with the WHO remains and is parallel to what we seek to do with the regulations.

The shadow Minister asked why we are putting UKHSA together, and voiced his concern that it might switch the focus to health security, and away from broader public health considerations. One of the reasons why we are putting it together is that over the past year, we have taken a huge step forward in our diagnostic and testing capability in order to meet the challenges of this pandemic. The measures will bring that test and trace capability into a new organisation, and establish it formally as a proper agency of Government, with the appropriate internal Government arrangements to ensure that it is joined up.

On the hon. Gentleman’s second point, yes, health security is hugely important; that is obviously top of our mind at the moment, given what the country and the world has seen over the past 15 months. As a former council cabinet member for adult social care and health, including public health, I recognise the importance of broader drivers of public health outcomes, and of reducing health inequalities, and UKHSA will absolutely continue to focus on that in parallel with its health security responsibilities.

On the point about debate, the shadow Minister and the Opposition Back Benchers are always welcome to seek a debate on this subject; I say that with relaxed confidence, because I suspect I would not be the Minister answering. Those routes are, of course, open to him on the Front Bench and to Opposition Back Benchers.

The hon. Gentleman talked about the need for internal UK co-operation to match the openness with our EU friends and colleagues. He is absolutely right. That is one of the reasons why I was so keen, as he would expect—we were obliged to, but it was the right thing to do—to engage with the DAs on these regulations to make sure that they work. We are not replacing the public health bodies in Scotland, Wales and Northern Ireland; they will work with PHE, and then UKHSA. They will be full partners in that, because of course we will have to co-operate. They will have an equal say on which diseases go on the list of those we monitor, those we take action against, and those we transmit information on. That is the national list, but that does not prevent a devolved Administration from being able to decide to monitor an additional disease in its territory, so the devolution settlement is respected.

The hon. Gentleman mentioned divergence of tone and timing on occasion during the pandemic. That is a reflection of the fact that going into a set of regulations, it is very easy to move forward as one, but as he said, areas come out of regulations in different ways and at different times, to reflect what is going on in different parts of the country. We have seen that, and we have seen slight tonal differences, but looking at this from within the Department of Health and Social Care, I see that whatever the rhetoric at political level, there has been incredibly effective co-operation beneath the surface, at medical expert and official level, to make sure that the UK continues to do everything that it can to keep citizens safe, wherever they live.

To conclude, as the shadow Minister said, diseases do not respect borders. It is absolutely right that we co-operate internationally and across the United Kingdom. We negotiated a good deal with the EU in respect of the TCA and health security; the regulations give effect to the deal, and will help protect our citizens for many years to come.

Question put and agreed to.

Draft Coronavirus Act 2020 (Early Expiry) Regulations 2021

Edward Argar Excerpts

Wednesday 7th July 2021 General Committees

[The Chair]

We have moved to 1 metre-plus social distancing in general Committees; Members should only sit in places that are clearly marked. Mr Speaker has asked that masks should be worn in Committee, except when speaking and unless Members are exempt. Could Members please send speaking notes to [e-mail]?

[The Minister for Health (Edward Argar)]

I beg to move,

That the Committee has considered the draft Coronavirus Act 2020 (Early Expiry) Regulations 2021.

It is a pleasure to serve with you in the Chair, Mr Robertson.

As we all know from the Prime Minister’s announcement on Monday, the country continues to move towards a “new normal”, and the end is in sight. As such, the removal of some powers contained in the Coronavirus Act 2020, announced earlier this year, is not only in keeping with our direction of travel out of restrictions but also represents and reflects the achievements made by our country’s collective endeavours to track, contain and mitigate the impact of the virus over the past 16 months.

The shadow Minister, the hon. Member for Ellesmere Port and Neston, and I regularly reprise these sessions when we face one another across the Committee Room. Each time I would quite rightly pay tribute to the work not only of the British people but of our health and care workforce, and indeed key workers, particularly our local government workforce and councillors across the country. He would echo that tribute. Just as we in this House have seen the volume of our work increase during this time, our colleagues in local government, irrespective of party, have seen the same. Councillors up and down the country have been doing a fantastic job. It is right that I put on record my gratitude to them, and I know that the shadow Minister will echo that.

The Coronavirus Act 2020 continues to be an important piece of legislation. It has helped to facilitate the coronavirus job retention scheme and the self-employed income support scheme—important examples of how the Government continue to support individuals and businesses. Our justice system continues to be able to operate effectively in challenging times, thanks to sections 53 to 55 of the Act, which allow the use of video technology during court cases. The NHS remains resilient, boosted by the powers in sections 2 and 6, which have helped to permit to date the temporary registration of more than 15,000 nurses, midwives, paramedics and social workers to bolster the workforce available to tackle the pandemic.

The reality is that the risk of transmission, of hospitalisation and indeed of death has thankfully been significantly reduced thanks to the unqualified success of the vaccine roll-out, and its role in weakening the link between infections and hospitalisations. That is significant as it underlines the importance of vaccinations because, although we expect cases to climb, as the Secretary of State has set out, vaccines are the reason why, despite the number of infections climbing, it is the right thing to ease restrictions now, and we are able to do so.

The reality is that social restrictions cannot and must not stay in place forever. We have now set out the detail of step 4 and confirmed our commitment to their removal, subject to the assessment and announcement on 12 July. The vaccination programme is the essential constant in our approach to managing the pandemic, and it has always been clear that that would be, and is, our route back to normality.

That is where we are today, but let us briefly go back to where we were in March, when, as part of a raft of tough safeguards built into the 2020 Act, the one-year review sought to assess the powers on an individual basis in order to ensure they continued to be necessary for managing the pandemic. As part of that process, substantial analysis of all temporary provisions was undertaken. As a result of that, 12 provisions were identified for early expiry, and are being brought before the Committee today for agreement. I will briefly detail the provisions.

Sections 8 and 9 facilitated emergency volunteering leave and compensation leave for emergency volunteers. Thanks to the fantastic efforts of the NHS and others those provisions were not needed nor used. Other measures, including NHS Professionals, the bring back staff scheme and continued efforts of bank staff, have been sufficient in addressing the need for trained clinical staff.

Section 15 provided easements to the Care Act 2014, allowing local authorities to prioritise those with the most urgent covid-19 needs by streamlining assessment and charging for care retrospectively. In England, only eight local authorities utilised those powers, and the power has not been used since 29 June 2020. The social care workforce have remained resilient under extreme pressure, and continue to work flat out to deliver excellent care. The expiry of this provision is a clear demonstration of the determination and flexibility of our health and social care system. It is right that given that track record of usage, and lack of usage recently, we expire the provision.

Section 24 allowed for the extended retention of biometric data, allowing it to be held on record for additional time. Sections 25 to 29 required information from businesses and people involved in the food supply chain. Section 71 allowed a single Treasury Minister to sign on behalf of all Treasury Commissioners. Section 79 extended arrangements for business improvement districts, and section 84 allowed for the postponement of General Synod elections. It is right that we move to expire formally all those provisions. We also suspended a further three provisions in the 2020 Act on 21 April. The early expiry of all those provisions is a clear demonstration of the Government’s commitment to act upon parliamentary scrutiny to retain only the powers that are necessary and proportionate, and only for the period of time that that is essential.

In the debate on 25 March, Members raised concerns about accountability in the 2020 Act, and similar concerns were expressed when the Act was passed in 2020. We have put in place a suite of reporting requirements to ensure that the Act is as transparent as possible. The eighth two-monthly status report on the non-devolved provisions is due to be published at the end of this month, and in September we will see publication of the third six-monthly review, and a decision by Her Majesty’s Government on whether to expire the Act or to renew further provisions. I would not wish to prejudge in any way what the review will say, but I would make clear my view and that of the Secretary of State is that we would wish to see provisions in the Act in place for no longer than is absolutely necessary.

The remaining 27 non-devolved provisions in the 2020 Act serve three core purposes. They help to shore up capacity in the health and care system; ensure delivery of essential public services and provide financial and other support to businesses and individuals.

Although, rightly, the threat may feel less pressing, and indeed is so, and life is beginning to look far more normal, we must still ensure that we have the correct support in place to help see us out of the end of the pandemic and set fair on the path to recovery. The Act contains facilitative, enabling provisions that are essential to help bolster our position and further support that recovery. Therefore, at this point, the need for those provisions in the Act remains. However, the next six-monthly review process, concluding in September, will rightly rigorously assess each and every one of the temporary provisions and further expire all those deemed no longer necessary.

As the approach to managing the virus evolves, so too should the legislation governing it. The amendments set out to the 2020 Act signal a step, a large one, in the right direction, a direction that focuses on the positives, on recovery and on reaching the final milestone of the roadmap.

I thank colleagues in the devolved Administrations for their engagement, support and consent in expiring the relevant provisions that apply to them. I commend the regulations to the Committee.

[Justin Madders (Ellesmere Port and Neston) (Lab)]

It is a pleasure to see you in the Chair, Mr Robertson.

I thank the Minister for his introduction, and for his kinds words about local government. I say that because, for the record, my wife is a member of a local authority. I absolutely agree with the Minister that, in his words, the country has shown collective endeavour to do its best to fight the virus. That has been clear whether we are talking about the NHS, social care, local government or any of the other key industries that have contributed to the national effort over the past 15 months. As the Minister said, we all owe them a great deal for the efforts that they have put in.

As the Minister said, the matter was debated in the House in March. From reading the Hansard report, I think it is fair to say that a number of right hon. and hon. Members felt short-changed on account of the truncated nature of the debate, especially given that various other measures were discussed at the same time, and it was not possible to vote on amendments. It feels as though parliamentary procedure is operating in a manner that only gives us the thinnest veneer of accountability.

On a related point, I recognise the pressures on the Department of Health and Social Care, but I am not entirely clear why it has taken so long since March for the regulations to appear in Committee. Although that criticism is not as strong as it would have been were we debating the regulations merely to ratify them after their introduction, there is a pattern of delegated legislation procedures being followed weeks, indeed sometimes months, after the event. That has characterised the Government’s approach throughout the pandemic. We need an explanation of that behaviour. On a related point, I draw the Minister’s attention to the fact that although the legislation.gov.uk website shows the Statutory Instrument, it does not include the date on which it was made or will come into force. I appreciate that that website is outside of the Minister’s control, but we need to be clear about when regulations are made and come into force. I hope that he has a correct copy of the legislation to hand to clarify that for us.

I understand, of course, that the Government have had to move very quickly, and have had to make exceptional decisions throughout the pandemic. Time has moved on, however, and that pace of action has become less and less of an excuse and more and more of a habit. It is almost a default position adopted by the Government. I am sure that that is convenient, but that does not do any good at all to accountability.

The timing of today’s debate is apposite, given that the Government have decided that they no longer need emergency powers. Indeed, the Prime Minister’s announcement on Monday seemed to suggest all but the end of virtually all measures on 19 July. We have been told that the roadmap to unlocking would be driven by data not dates, but the Prime Minister has announced that we will basically no longer need any restrictions before he has seen any of the relevant information. Can the Minister tell us whether Government policy has changed from data not dates to “If not now, when?” to quote the Prime Minister? That is the polar opposite.

Regardless of the methodology used to reach the decision that virtually all measures to prevent the transmission of coronavirus are no longer needed, and regardless of the wisdom of that, which I recognise is outside the ambit of today’s regulations, that decision has a direct bearing on those regulations. As we have heard, the regulations remove a number of the emergency powers granted to Government under the Coronavirus Act 2020, but, as the Minister also correctly pointed out, many more powers still remain. I draw the Committee’s attention to the words of the former Secretary of State, the right hon. Member for West Suffolk (Matt Hancock), who said of the powers in the 2020 Act

“we have always said that we will only retain powers as long as they are necessary. They are exceptional powers.”

Indeed, they are exceptional—they are unprecedented, and that means that they should not remain in force for a moment longer than necessary. The Minister said that there will be a review in September, and we know that those provisions are subject to a two-monthly review, but if the Government’s judgment is that we are so far past the worst of the crisis that we can remove all restrictions on people’s movements and interactions, including measures such as compulsory mask wearing that has been shown to protect the most vulnerable, why do the remaining powers need to stay on the statute book for a day longer than 19 July?

The two-monthly review justifies the continued use of emergency powers under the 2020 Act by claiming

“there is further work to do before returning to a more familiar version of normal life, and the ability to respond flexibly and cautiously still exists.”

Those words jar with the noise coming out of Government. Can the Minister confirm today that all remaining emergency powers will be repealed by 19 July? If not, why not? Clearly, we are no longer in the realms of responding cautiously to the virus, so why do those powers need to remain in force a day beyond 19 July?

Has any consideration been given to retaining some of the remaining powers, rather than all of them? It has been said that, shortly, we may expect 50,000 new cases every day. In that case, the powers relating to statutory sick pay may well be worth retaining. If powers have been enacted under emergency legislation, is there now a case for those powers to be permanently on the statute book? Frankly, I think that is how Parliament would want matters to proceed.

The Minister and I are likely to spend a great deal of time together in the coming months debating the Department’s latest effort to reorganise the NHS via the Health and Care Bill, which was published yesterday. The Minister will no doubt be disappointed that I have not yet read it in its entirety.

[Edward Argar]

There is plenty of time.

[Justin Madders]

Indeed. Would any of the emergency powers contained in the 2020 Act appear in that Bill at a later stage in parliamentary proceedings? I am thinking in particular about the powers in section 14, which I believe the Government have said they found useful. No doubt we can debate the merits of that in some detail at a later stage, but I would be grateful for a response from the Minister today.

The biggest concern raised in the March debate, and which still remains, relates to the powers in section 21 of the 2020 Act to detain potentially infectious persons. That power has been used in a number of prosecutions, and I understand that every one was found to be unlawful by the Crown Prosecution Service. The Joint Committee on Human Rights advised in its report of September last year

“In the absence of any clear evidence to support the retention of these powers”

section 21 powers “ought to be repealed”. It is not at all clear to me why the Government would wish to retain such a draconian, but ineffective, power. That seems at odds with yesterday’s announcement that those who have had both vaccinations will no longer be required to self-isolate. The power to detain under section 21, however, makes no distinction between those who are and are not vaccinated.

The Minister referred to the two-monthly review as being evidence of the Government’s commitment to transparency, but those who studied the latest review in May of section 21 powers raised concerns about the thoroughness of that exercise. The review states:

“Public Health Officers have used these powers a total of 10 times, but have not used them since October 2020…Police have not used these powers to date and they are only to be used after obtaining advice from a Public Health Officer.”

Big Brother Watch, which sends regular briefings to Members on the use of the Government emergency powers, has said that it has documented multiple unlawful use of section 21 by police forces in England to arrest and detain individuals. Members made various references to that in the March debate. It is a little disappointing, and indeed disconcerting, that whoever drew up the two-monthly review did not appear to make any further inquiries about the potential misuse of that power, and indeed its effectiveness.

The two-monthly reviews feel like a bit of a tick-box exercise to me. The Government have serious, unprecedented powers, and despite allegations that those powers are being used unlawfully, the Government review does not appear to be even aware that those powers have been used at all. That is the case before we even get to considering whether those powers are necessary.

The Minister must demonstrate that the Government are not falling into the trap of keeping emergency powers because that is convenient, rather than necessary. The Opposition will not oppose regulations, but I hope that the Minister will address the points I have raised. I hope that he can demonstrate that any emergency powers no longer needed for public health reasons will be revoked as soon as we reach that point.

[Edward Argar]

As ever, I thank the shadow Minister for his typically measured and sensible contribution and pertinent questions. The 2020 Act has formed a central plank of the Government’s approach to coronavirus and has in many ways often been misunderstood. As I said in the March debate, the vast majority of the measures have been undertaken by the Government under the Public Health (Control of Disease Act) 1984, but the 2020 Act none the less plays an important role. Like the shadow Minister, I and the Government have no desire to see the powers in place a day longer than they are absolutely needed. I have highlighted that the reviews will take place and that September is the next six-monthly review. I do not want to prejudge what will emerge, but I put on the record my view that the powers should not be in place a day longer than they can be justified as essential.

In that context, the hon. Gentleman made a number of points, which I will try to address in turn. He talked about whether some powers might be useful in the longer term—I think he referred to section 14 by way of example. I hope to give him the reassurance he seeks: notwithstanding the six-monthly way point or checkpoint in September, the powers in this Act automatically sunset next spring. There was a two-year sunset clause, and the Government are clear that any powers deemed to be useful in the longer term will be subject to the normal legislative process in this place, with hon. Members having the opportunity to scrutinise, challenge and debate in the usual way, if we wish to retain anything in the long term.

In the context of the legislation to which we gave First Reading yesterday, some aspects shade into this space, but do not explicitly replicate what is there. I suspect that the hon. Gentleman and I will spend many happy days in Committee, along with our hon. Friends the Whips sitting next to us on the Bench, so there will be opportunities to discuss and debate how that might be done.

The hon. Gentleman talked about the timing of the draft instrument after the debate on 25 March. My understanding of the timing is that immediately after that debate we went into recess, but that on our return in April, the statutory instrument was laid on 21 April, so relatively swiftly afterwards. The scheduling of debates on such instruments are a matter for the usual channels and the business managers.

My hon. Friends the Whips will have heard what the hon. Member for Ellesmere Port and Neston said, but I know that both Government and Opposition work hard, and have done throughout, to schedule debates in as timely a fashion as possible. We recognise the point he highlighted, that in the early stages the pandemic, that was extremely difficult to achieve, but I know that this House values timely debates on measures that come before it. The usual channels do everything they can to facilitate that for Members of the House.

On legislation.gov.uk, I will check the point the hon. Gentleman made. I cannot give him an answer off the top of my head, but I will endeavour to look into it. If anything is lacking, I will ensure that it is addressed. I suspect that, since the other place debated this on Monday and we are debating it today, with the dates and everything, the powers will be updated following our—I hope—approval. I take that approval slightly as read, given his kind words that he will not be opposing this piece of legislation.

The hon. Gentleman touched on a couple of other areas. Sections 21 and 22 were challenged by hon. Members, not necessarily saying no to them, but wanting to understand the reasons: were they proportionate, were they necessary and how would they operate? Section 21, he is right, has not been used since October 2020. The key aspect of section 21 is that the powers to do with infectious persons are most useful in the early stages of a pandemic, with small numbers.

[Justin Madders]

I think the Minister has misunderstood slightly what I said. The two-monthly review says that the power has not been used since October, but my point is that certain reports have it that it has been used, which raises the question of how thorough the review was.

--- Later in debate ---

[Edward Argar]

If I may, I will come to that. To address why section 21 is useful—I will then address the hon. Gentleman’s specific point—that is so in the early and latter stages of a pandemic, when we have smaller numbers. We might wish to—or can, as we cannot when infection rates are high—prevent new variants and a new spike, so that is when such powers are useful. As I said, on the basis of the information that we have, they have not been used since October 2020, which I think shows they are only used proportionately. However, if he has any information to send me in the context of his comments on the two-monthly review or the coming six-monthly review, I am always happy to receive any correspondence from him.

When section 22 was debated in the Chamber, some hon. Members asked why it was necessary. Given the short nature of that debate, it was not possible to answer every point, so I will address it now, so that it is on the record. The Public Health (Control of Disease) Act 1984 provides considerable powers on things such as the closure of particular businesses or key infrastructure, but it lacks the power to close some elements of critical infrastructure, even in the case of a new variant or a new spike breaking out in a particular location. Section 22 ensured that the power was comprehensive and could be used if necessary. Again, Ministers have no desire to see any of the powers used unless absolutely necessary.

The hon. Gentleman referred to the Prime Minister’s announcement on Monday and the new Secretary of State’s statement to the House. On Monday, the Prime Minister was clear in setting out what step 4 would look like—what he envisaged and how it would work—but he was also clear, as was the Secretary of State in the House, that that was of course subject to the 12 July assessment and decision, as I said. The Prime Minister was very clear in setting out the direction of travel and his intention, and that the data and the dates both looked extremely good at this point. I share his confidence, based on my understanding of where we are today.

I hope that addresses the vast majority of the issues raised by the shadow Minister. If there are any others, he knows that he is always welcome to write to me, and I will endeavour to give him a timely response.

Question put and agreed to.

NHS Integrated Care System Boundaries

Edward Argar Excerpts

Tuesday 29th June 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I congratulate my hon. Friend the Member for Harwich and North Essex (Sir Bernard Jenkin) on securing this timely debate about potential changes to ICS boundaries—and indeed on elevating me to the Privy Council, for which I am grateful. He and I have known each other for a long time and I always listen carefully to what he says. When there was the prospect of extra time, our friendship might have been in doubt had I been in here and unable to see the final result, but we got the result we all wanted just in time, so it is a pleasure to be here today.

The subject is important, not only for my hon. Friend, who works tirelessly for his constituents, but for all hon. Members who have spoken. The provision of healthcare goes to the heart of what many of our constituents care passionately about.

In his remarks, my hon. Friend expressed his concerns about the future of Suffolk and North East Essex ICS as one of the areas included in the NHS England ICS boundary review. I am grateful that he has called the debate, not only to allow fellow parliamentarians to express their views before any decision might be made on the Floor of the House, but to let me listen once again to them. I am equally grateful to my right hon. Friend the Member for Maidenhead (Mrs May). She and I have known each other a very long time and she knows that I have huge respect for her opinions. When she speaks, I always listen carefully.

As has been said, in the recent White Paper, we set out proposals to place integrated care systems in statute. We are working with NHS England and the Local Government Association to deliver and develop those proposals. At the outset, it is important that I highlight a key point. Members alluded in their remarks to the feeling that something here is predetermined. If there is such a feeling, that is a challenge for us to overcome because I want to reassure hon. Members that nothing is predetermined in any of the specific situations that they have outlined.

As has been set out, ICSs aim to strengthen partnerships and joined-up working between the NHS and local authorities. Local authorities therefore have a key role in ICSs. We know that coterminous boundaries can support more joined-up working between the NHS and local government, but I take on board entirely from my time as a local councillor—indeed, as a cabinet member for health and adult social care—the point that my right hon. Friend the Member for Maidenhead made that sometimes natural geographies of place can mean a lot more to our constituents than administrative boundaries to which we as politicians might pay a lot of attention.

For the reasons I have given, earlier this year the former Secretary of State, my right hon. Friend the Member for West Suffolk (Matt Hancock), asked NHS England to conduct a boundary review to understand what the options—I emphasise options—were to achieve alignment in the small number of areas where coterminosity was not already in place. He set out to do that in two stages: NHS England and its regional teams have led on the review at a local level, engaging with local NHS and local authority stakeholders to determine options for alignment, local views and concerns, and to put forward a fair reflection of what they had heard, while in parallel I, as a Minister of the Crown, have held multiple meetings with parliamentary colleagues. I think I have met well over a dozen colleagues in person or virtually—in this day and age—and held almost 10 different meetings.

I thank NHS England for all its engagement and work on the review. As I say, over the past six months its regional teams have worked closely with local NHS and local government stakeholders to consider, with an open mind, the options available for the areas identified in the review.

As right hon. and hon. Members have made clear, it is important to recognise where things are working well irrespective of coterminosity and serving Members’ constituents well. As I say, the review is without prejudgment and I would not wish to pre-empt what may be either recommended or even just set out as options. In that context, keeping the current arrangements would of course be an option to consider. I reassure Members that the Secretary of State and I do have at the forefront of our minds the need primarily to ensure the best health outcomes for local people when any decision is taken. I hope that my hon. Friend the Member for Harwich and North Essex will recognise the sincerity with which I say that.

Before I conclude, let me turn to a couple of specific points that my hon. Friend mentioned. I wish to clarify that were any changes made to ICS boundaries as a result of the review, they would not impact on the patient’s right to choose or use services outside of their ICS or current patient pathway flows.

On funding, I wish to try to reassure my hon. Friend a little more than perhaps he was reassured in the meeting to which he alluded. Once ICSs are placed on a statutory footing, the allocation of resources to each integrated care board will be determined by NHS England based on the long-standing principles of ensuring equal opportunity of access for equal need and reflecting the considerations that currently inform how moneys flow to areas when following the patient.

[Sir Bernard Jenkin]

Will my hon. Friend allow me to intervene on one point?

[Edward Argar]

Briefly, because I want to give my hon. Friend the reassurance that he seeks before the time runs out.

[Sir Bernard Jenkin]

What my hon. Friend has said does not address how Suffolk would be funded to commission services for Essex patients at an Essex hospital, and it does not address what will happen to the distribution of deficits, which is uneven across the existing ICSs.

[Edward Argar]

I would try to address that point briefly, but I think my hon. Friend would rather have the reassurance that I can give him. Perhaps I can pick up that point separately with him, because I do not want to run out of time.

Finally, and most importantly, I reassure my hon. Friend and other Members that no decisions have yet been made regarding the outcome of the ICS boundary review. As he would expect, the newly appointed Secretary of State will want to consider carefully the background to this issue, the options before him and, indeed, the views of right hon. and hon. Members before any decision is made. I have discussed this matter with the new Secretary of State and wish to extend his clear commitment to meet my hon. Friend, my right hon. Friend the Member for Maidenhead and other Members before he makes any decision and decides how to proceed in this matter.

My hon. Friend knows me well, and my preference is generally for evolution, not revolution. I hope that, him knowing me well and in the light of what I have said today, he will recognise the sincerity of what I say. I also hope it is helpful that I have put on record, once again, that no decisions have been made and that Members will be consulted and have the opportunity to speak to the Secretary of State. I hope that commitment reassures my hon. Friend, at least in the short term, that nothing will happen without him and other Members having their say clearly on the record.

[Madam Deputy Speaker (Dame Eleanor Laing)]

I normally thank the Minister politely at this point in the day, but I really do thank the Minister for what he has just said on this particular occasion.

Indemnity for the Independent Review into Issues Raised at West Suffolk NHS Foundation Trust

Edward Argar Excerpts

Tuesday 22nd June 2021 Written Statements

[The Minister for Health (Edward Argar)]

It is normal practice, when a Government Department proposes to undertake a contingent liability in excess of £300,000 for which there is no specific statutory authority, for the Minister concerned to present a departmental minute to Parliament giving particulars of the liability created and explaining the circumstances; and to refrain from incurring the liability until 14 parliamentary sitting days after the issue of the minute, except in cases of special urgency.

I have today laid a departmental minute proposing the provision by NHS England and NHS Improvement of an indemnity that is necessary in respect of an NHS England and Improvement non-statutory, independent review of whistleblowing at West Suffolk NHS Foundation Trust.

This review follows widely reported events arising from an anonymous letter that was sent in October 2018 to the relative of a patient who had died at the trust. The purpose of the review is:

to consider the appropriateness and impact of the actions taken in response to the issues raised by/connected with the October letter by the trust and other relevant bodies; and

to produce advisory recommendations and learnings.

The indemnity will cover any sums, including any legal or other associated costs, that members of the review team are liable to pay in relation to legal action brought against them by a third party in respect of liabilities arising from any act done, or omission made, honestly and in good faith, when carrying out activities for the purposes of the review. The indemnity will apply to any work carried out from the commencement of the review to its completion in 2021, in accordance with the review terms of reference. The indemnity will cover the contingent liability of any legal action in the run-up to and following the publication of the review report, and for two years after that date. If the liability is called, provision for any payment will be sought through the normal supply procedure.

The Treasury has approved the proposal in principle. If, during the period of 14 parliamentary sitting days beginning on the date on which this minute was laid before Parliament, a member signifies an objection by giving notice of a parliamentary question or by otherwise raising the matter in Parliament, final approval to proceed with incurring the liability will be withheld pending an examination of the objection.

A copy of the attachments can be viewed online at: Written statements - Written questions, answers and statements - UK Parliament

[HCWS110]

Coronavirus

Edward Argar Excerpts

Wednesday 16th June 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

At the outset, I associate myself with the shadow Minister’s remarks in respect of our late colleague, Jo Cox. As we stand at this Dispatch Box, we can see the coat of arms above the Opposition Benches. I pay tribute to her and to all the work that she did while she was in this place, and before.

I would much rather I were not standing here today urging and encouraging colleagues to vote for this motion. I know that colleagues would wish that it were not necessary, but I regret to say that it is. We have made huge progress—progress that has been made possible by our phenomenal vaccine roll-out programme. The tribute for that goes to the scientists who developed the vaccine, those who procured it, the NHS, all the volunteers, the charities, the military, The Sun’s jabs army and everyone who has played their part in helping to deliver this programme. That progress has also been made possible by the incredible efforts of the British people, and by the dedication of everyone who works in our health and care system. I know the shadow Minister will join me in expressing our joint gratitude to them all.

As the Prime Minister set out on Monday, this vaccine remains our route out of the pandemic. With every day that goes by, we are better protected by our vaccines, but the delta variant has made the race between virus and vaccine much tighter. Cases continue to grow rapidly each week in the worst-affected areas. The number of people being admitted to hospital in England has begun to rise, and the number of people in ICUs is also rising, but the vaccine remains our way out.

Data published this week shows that two doses of the jab are just as effective against hospital admission with the delta variant, compared with the alpha variant, and indeed they may even be more effective against the delta variant. That underlines the importance of that second jab and the need for more of us to have the chance to get its life-saving protection.

My right hon. Friend the Member for North Somerset (Dr Fox) put it far more effectively than I dare say I will be able to do. He was absolutely right to highlight the crucial importance, over the next few weeks, of getting those second jabs—particularly the AstraZeneca vaccine—into people’s arms. He is right to highlight that after one jab, the Pfizer vaccine is highly effective, but we need two jabs of the AstraZeneca vaccine to provide that level of protection. It is important, in that context, to remember that the AZ vaccine is the workhorse of our vaccination programme. More than 30 million people have now received their second jab, and in one month’s time that number could stand as high as 40 million. My right hon. Friend the Secretary of State highlighted in his remarks an important factor in getting those second doses into people’s arms. There are still 1.2 million over-50s who have had their first dose—they are not declining the vaccine; they have had the first dose—but who need the second dose to provide that high level of protection. Similarly, there are 4.4 million over-40s who need their second dose. With the delta variant now making up nine in 10 of the cases across the UK, it is vital we bridge the gap and get many more people that life-saving second jab.

This extra time will allow us to get more needles into more arms, getting us the protection that we need and enabling us to see restrictions fall away on 19 July. In that vein, I would remind colleagues of the quote from the Prime Minister on Monday, when he was very clear:

“As things stand, and on the evidence that I can see right now, I am confident that we will not need more than four weeks and that we won’t need to go beyond 19 July.”

[Sarah Owen]

The Minister just said that the Prime Minister has given assurances about another four weeks, but we have had this time and time again. Why should the British people believe the Prime Minister now?

[Edward Argar]

The short answer is that the British people do believe the Prime Minister now.

We face a difficult choice, and my hon. Friend the Member for Bosworth (Dr Evans) set it out extremely clearly. It reflects the underlying debate about risk. I am clear that we must learn to live with this disease, without the sort of restrictions we have seen. We cannot eradicate it. I have to say that, rather than relying on the views of the hon. Member for Leeds East (Richard Burgon), I am inclined to rely on the views of my right hon. Friend the Member for North Somerset, who made that point very clear. Those who advocate zero covid must realise that that is impractical and unachievable, and I consistently do not subscribe to the logic of those who argue for that course.

I am sure the House will agree that, to get to the point where we can learn to live with this disease, an extra few weeks are a price worth paying. I therefore urge the House to support these regulations today. No one can fail to be sympathetic to those who will be affected by this delay, including those couples who want to start their married lives together but have had to change or delay their plans. This weighs on me greatly, as it will on all hon. Members, and in this case I was pleased that we could ease the restrictions on weddings. Equally, I am mindful of those whose livelihoods will be affected by any delay in our road map. I urge the House to support this motion. It provides a short-term delay that significantly strengthens our position for the longer term.

My right hon. Friend the Member for Forest of Dean (Mr Harper) raised a couple of specific points which I will try to answer here; they relate to each other. He mentioned paragraph 7.7 of the explanatory memorandum and his concern that the first review date was on 19 July. I can clarify that the first review date is due by Monday 19 July and will be in advance of that point. That is a legal end point. I would anticipate an announcement coming probably a week before that on the decision and the data. I hope that gives him some reassurance about people having notice of what is coming.

In closing, I wish to express my sincere thanks to all those who have contributed to today’s debate. I am sorry that so few on the Opposition Benches chose to take part, but I pay tribute to those who did and to those on this side of the House for the sincerity, the strength of feeling and the integrity that they have shown. I hope the House recognises that I have a deep-seated respect for all the views I have heard this afternoon. Hon. Members all want the same thing, which is to save lives and to see us exit these restrictions and return to normality as soon as possible. Difficult as it may be, I urge hon. Members across the House to vote for these measures to give ourselves that short extra time to vaccinate more people—crucially, with that second dose—and take us forward to the stronger, more confident future that we all seek, which I know is just around the corner and which I am confident the Prime Minister will take us to. I commend the motion to the House.

Question put.

New Airedale Hospital

Edward Argar Excerpts

Tuesday 15th June 2021 Westminster Hall

[The Minister for Health (Edward Argar)]

I have known you a very long time, Sir Edward, so it is always a pleasure to serve under your chairmanship in this place.

I congratulate my hon. Friend the Member for Keighley (Robbie Moore) on securing this debate. I know that since his election to this House, he has worked tirelessly for his constituency, not just on healthcare matters but in representing all of his constituents’ needs, particularly, in the context of my role within Government, on the issue of the hospital estate at Airedale.

Quite rightly and justifiably, my hon. Friend thanked the team there and I hope that he will allow me to join him in doing so. I ask him to pass on to them my thanks for everything they have done, not just during the past extraordinary 18 months, when they have been amazing, but year in and year out. They do so not only for his constituents but for those of the Minister of State, Department for Transport, my hon. Friend the Member for Pendle (Andrew Stephenson), my right hon. Friend the Member for Skipton and Ripon (Julian Smith), and of course my hon. Friend the Member for Shipley (Philip Davies). I know that all of them join with him in pressing the case for a rebuild of Airedale General Hospital.

In a sense, my hon. Friend the Member for Keighley is also putting his money where his mouth is, because, if I correctly recall my reading of Keighley News, one of the things that he is doing—he is certainly a braver, or at least fitter, man than I to do it—is running 100 km in, I think, 10 weeks, to raise money for a number of charities, including Friends of Airedale, which he rightly paid tribute to. I wish him all the very best with that.

As my hon. Friend alluded to, I had the pleasure of meeting him and other local MPs back in February to discuss this important matter; indeed, he and I have spoken about it on several occasions. Since his election to the House, he has never missed an opportunity to lobby me, very politely but firmly, and to raise this issue with the Secretary of State and I, on behalf of his constituents.

My hon. Friend set out the history of the hospital site and quite rightly highlighted the vital issue, which is the fact that reinforced autoclaved aerated concrete—the light form of concrete used primarily for roofs from the mid-1950s to the mid-1980s—is the key component part of these buildings. He also quite rightly highlighted the limited durability of RAAC roofs, saying that it has been long recognised but that recent experience suggests the problem may be more serious than previously appreciated.

My hon. Friend also highlighted in his comments that surveying is continuing at Airedale General Hospital to assess fully the extent and condition of the RAAC planks, and I believe that completion of that survey is expected in the coming months. I have asked to be updated when that full survey becomes available. However, I understand that preliminary survey findings have found issues relating to the deflection of rack panels, which I know caused his trust concern.

I fully recognise the need to invest in improving health infrastructure across the country. These safety risks are no different, and my hon. Friend emphasised the urgency of this. At the spending review 2020, courtesy of my right hon. Friend the Chancellor, we provided the NHS with £4.2 billion in 2021 for operational capital investment to allow hospitals to maintain and refurbish their infrastructure, including a £110 million ring-fenced allocation to address the most serious and immediate risks posed by RAAC planks. Within that ring-fenced allocation, as my hon. Friend mentioned, is a significant multimillion-pound allocation earmarked to mitigate RAAC risks at his local hospital. That will go towards re-roofing, as well as decant facilities while work is under way, helping to improve safety for patients and staff. We will continue to review business cases and progress at RAAC-affected trusts, including his, to ensure that we make the full and best use of all those funds over the coming year.

My hon. Friend highlights an important point: at what point does fixing or mitigating something cost more than actually eliminating the risk by having a modern, fit-for-purpose facility going forward? I fully recognise the need to mitigate RAAC risk beyond this year, alongside further investment in mitigation, which I have to confess will be a matter for my right hon Friends the Chief Secretary of the Treasury and Chancellor in the spending review. My hon. Friend would not expect me to pre-empt them, as that can sometimes have unfortunate consequences.

My hon. Friend will know, in that context, that RAAC remediation is not the only area we are investing in at Airedale, because of course on top of that the foundation trust received just shy of £250,000 to upgrade its emergency department from the wider package of £450 million for A&E improvements announced last year by the Prime Minister. Last year, the trust also received a £1.7 million allocation to address backlog maintenance at Airedale General Hospital from the £600-million critical infrastructure risk fund.

Of course, my hon. Friend wants me to speak about the future. He highlighted his strong campaign for investment in a new hospital for his constituents beyond the investment we are making to manage and mitigate the immediate risks. As he will be aware, the Prime Minister and the Health Secretary confirmed that 40 new hospitals will be built by 2030, with funding of £3.7 billion confirmed for the first tranche. I know my hon. Friend was disappointed that Airedale was not in that first tranche, but as is typical of him—ever undaunted—he continued his campaign to persuade the Government with ever-renewed vigour. I can offer him some hope on that, in terms of the prospects for the eight hospitals to which he referred.

An open process will be run to identify those eight further new schemes, delivering on the Government’s manifesto commitment. He asked a couple of specific questions about those, which I will endeavour, in so far as I can, to answer now. The details of this, the criteria and how that process will be run are due to be announced soon, with a generous period for trusts and sustainability and transformation plan and integrated care system partners to respond. To put a little bit more colour on that, I hope that we will be able to make that announcement of the process before the summer recess. I will of course keep him fully aware of progress on that.

My hon. Friend also asked about funding and how it might be allocated. Again, with the caveat that I cannot pre-empt any spending review announcement and the Chancellor’s decision on that, I would not anticipate that all eight of those would be ring-fenced for hospitals such as his. However, I would say, which I think will encourage him, that clearly one of the key criteria and considerations in the allocation of whatever funding is made available will have to be safety considerations and the urgency of any need for a new hospital. That will not be the only factor, but I reassure him that the Secretary of State and I will bear that very much in mind. I also reassure him that any trusts that receive and spend money in the interim to mitigate safety issues will not find that having undertaken that work will in any way count against them in a bid for a new hospital. It will be fairly and openly considered. I am sure the points he has made will be reflected in that.

We continue to work closely with trusts and regions to ensure that the criteria for selection best meets the needs of the NHS both nationally and locally and, of course, achieves value for money for the taxpayer. In that context, those schemes that we will consider will be based on the balance of benefits realised for staff, patients and local communities, condition—going to the safety point—and affordability and value for money.

As part of a national programme, seeking to achieve value for money, we will look for a greater degree of standardisation across those new hospitals, with modern methods of construction and modular builds, where appropriate. I note my hon. Friend’s points and, should we get to that point, I suspect he will want to be engaged in the discussions to ensure we get value for money. Were his hospital to get the go-ahead, it would also deliver what is needed locally. As my hon. Friend touched on in his speech, we are looking for new hospitals to be digitally fit for the future, clean, green and sustainable.

I suspect my hon. Friend will continue, until I, the Secretary of State or the Chancellor relent, to make the firm case for Airedale’s inclusion in our hospital building programme of those next eight. I very much look forward to seeing the bids for the remaining slots when the time comes for them to be submitted. I suspect, though I cannot pre-empt it, that his hospital might be one of those bids that I see put forward by the trusts.

In conclusion, as ever I want to commend my hon. Friend’s work to raise support for Airedale hospital, and personally raise money for the friends of the hospital. On numerous occasions in this House, he has raised the estate issues faced by his hospital. We are taking action in the short term to help mitigate those risks, but he continues to make the case for the long term. His constituents are incredibly lucky to have a Member of Parliament who is so assiduous and determined in carrying out his role in representing them to Government and in this place.

He kindly invited me to sunny Airedale—hopefully sunny, if I go in summer—to visit the hospital and the trust, and I would be delighted to take him up on that. He may face the challenge, given my risk of vertigo, of getting me up on the roof, though I suspect that will not deter him from trying to persuade me to see the issues for myself. I am happy to come and visit him and other right hon. and hon. Friends in the area.

More broadly, I look forward to continuing to work closely with him; my right hon. Friend the Member for Skipton and Ripon; the Minister of State, Department for Transport, my hon. Friend the Member for Pendle; and my hon. Friend the Member for Shipley, in seeking to deliver on the Government’s ambition of levelling up and improving the NHS services available across the country to our constituents.

Question put and agreed to.

Oral Answers to Questions

Edward Argar Excerpts

Tuesday 8th June 2021 Commons Chamber

[Chris Loder (West Dorset) (Con)]

What steps he is taking to support the construction of a new psychiatric intensive care unit in Dorset.

[The Minister for Health (Edward Argar)]

I am grateful to my hon. Friend, not least for providing me with my only opportunity to answer a question on the Order Paper today. I am delighted to confirm that St Ann’s Hospital in Dorset is already part of our plan to build 48 hospitals by 2030—the biggest hospital building programme in a generation. The new build at St Ann’s will provide child and adult mental health services for the people of Dorset, resulting in outdated infrastructure being replaced by facilities for staff and patients that are at the cutting edge of modern technology, innovation and sustainability, driving excellence in this hugely important area of patient care.

[Chris Loder]

I thank the Minister for his hard work in reopening the Yeatman Hospital in Sherborne, which will happen in a couple of weeks for A&E. On top of what he has already offered, which I very much appreciate, will he commit specifically to increase inpatient provision for children and young people in West Dorset with severe mental health difficulties, as we have a number of difficult cases?

[Edward Argar]

My hon. Friend takes a great interest in these matters and, as he will know, the number of places commissioned is a matter for NHS commissioners locally. I reassure him that we can commit, and my hon. Friend the Minister for mental health services is committed, to expanding and transforming community mental health services across England, boosted by an additional £79 million this year, so that children and young people get timely access to the support and treatment they need, without having to be admitted to hospital. That is, of course, alongside the investment to which I have referred for inpatient mental health facilities at St Ann’s.

[Ian Levy (Blyth Valley) (Con)]

What steps his Department is taking to reform mental health treatment.

Kettering General Hospital

Edward Argar Excerpts

Tuesday 8th June 2021 Commons Chamber

[The Minister for Health (Edward Argar)]

I congratulate my hon. Friend the Member for Kettering (Mr Hollobone) on securing this debate about the redevelopment of Kettering General Hospital. I know that it is an incredibly important subject for his constituents and, therefore, for him. He is nothing if not a strong champion for the people of Kettering, as Ministers forget to their cost. He works tirelessly on not only this but many other local matters.

I should also highlight the interest in and passion for this subject of my hon. Friend the Member for Wellingborough (Mr Bone)—who remains a friend, despite him seeking to slightly pre-empt and constrain me today by asking a question of my boss, the Secretary of State, a few hours ago in the Chamber—and my hon. Friend the Member for Corby (Tom Pursglove). As my hon. Friend the Member for Wellingborough rightly said, due to his elevated position as a senior Government Whip, my hon. Friend the Member for Corby is unable to speak in the debate, but I know from the interactions and conversations I have had with him on many occasions just how passionate he is about this hospital project on behalf of his constituents. I can reassure his constituents that, while he may not be speaking in the debate, I have had many lengthy discussions with him, and I suspect that I will be hearing from him many times in the future—although, hopefully, if I can offer some reassurance to my hon. Friend the Member for Kettering, he may be slightly less vociferous in pursuing me on this matter.

I join my hon. Friend the Member for Kettering in paying tribute to the chief executive and the team at Kettering General Hospital for the amazing work they do. They have worked tirelessly throughout this pandemic for his constituents and those of my hon. Friend the Member for Corby, as they do day in, day out, year in, year out for the people who live in that area. It has been a pleasure to take a very close interest in this matter. As my hon. Friend the Member for Kettering knows through his experience in the House, it is sometimes very difficult to say no to him, which can get Ministers into trouble; he is extremely persuasive.

Turning to the substance of the debate, I am delighted that the rebuild of the Kettering General Hospital part of the foundation trust is part of our plans to build 48 new hospitals by 2030—the biggest hospital building programme in a generation. To kick-start the scheme, Kettering General Hospital NHS Foundation Trust has already received £3.7 million of seed funding to develop its plans for the rebuilding of Kettering General Hospital.

Before I turn to the urgent care hub, my hon. Friend the Member for Wellingborough highlighted that plans for that had been mooted, discussed and possibly even agreed before 2015—before my hon. Friend the Member for Corby and I joined this House. The difference, I would suggest, is that on that occasion there was no budget allocated to the trust. For the urgent care hub, there is a budget allocated to it now, following our announcement in 2019, which followed lobbying by my hon. Friend the Member for Kettering. That funding will help transform the provision of urgent and critical care in this area. As he says, £46 million has been allocated for that project.

My hon. Friend asks why it is that, 20 months on since that debate and that visit—I remember them well and I will turn to them in a moment—the money has not been fully drawn down. This is in no way a criticism, but I would say that that is because of the announcement of the new hospital programme and the fact that the trust has, quite rightly, changed what it would like as a result. Therefore, discussions have had to take place about how those two funding streams can be meshed together. I will turn to that in a moment.

As my hon. Friend mentioned, the urgent care hub and the new hospital that are to be built share a set of common enabling works that have been factored into the new hospital development. As he and his trust have requested, we have shown flexibility and agreed to mesh the two projects together if an appropriate way of doing so, including the funding, can be found. As a result, the trust is seeking to incorporate the urgent care hub delivery into the wider redevelopment of the site. That means that the UCH may now be part of the first stage of building the new hospital, but he rightly highlights how approaching this in a more holistic way than a “phase 1 and 2” approach provides opportunities and synergies for achieving better value for money. He has made that point to me and to others.

On the drawdown of funding, the £46 million is available, subject to business case approvals and how those two funding streams can be meshed together in a single project. On drawing down from the new hospital programme fund more broadly, we have a one-year spending settlement from the Treasury. Therefore, if we wish to start drawing down from future years funding and make commitments, that is a matter for the Treasury and a future spending review. My hon. Friend quite rightly highlights, as I expected he would, the need for a synergistic approach between the Department of Health and Social Care and Her Majesty’s Treasury.

All of the new hospitals that will be delivered as part of the programme, including Kettering, are working with the central programme team, with the support of regional, system and local trust leaderships, to design and deliver their hospital in keeping with this approach. The central programme team and the new senior responsible officer, Natalie Forrest, who joined the team and took over its leadership at the beginning of this year, are working closely with the trust on the new build at Kettering and considering all the options currently on the table. I understand that they have had productive meetings, and I look forward to their having further productive meetings.

The programmatic approach will need to be carefully applied to these proposals, as for any other hospital in the new hospital programme, to see how we can best ensure value for money for the taxpayer through standardisation of design and the use of modern methods of construction, without unnecessarily constraining the ambitions of the trust’s plans, in so far as that is possible. The central team, as I have said, will engage with trusts to maximise the application of these approaches to ensure that the scheme has manageable, realistic and, indeed, affordable costs. Funding discussions for these projects are ongoing, and final amounts will be determined through the established business case and Treasury processes.

To stray slightly from the central theme, as my hon. Friend will know—as, indeed, he said in his remarks—Kettering General Hospital NHS Foundation Trust also received £1 million pounds as part of the £450 million investment to help upgrade A&Es and to help the NHS respond to winter pressures and the risks of further outbreaks of coronavirus. That funding was used to support compliance with social distancing and infection prevention and control at Kettering.

On interactions and conversations with the trust, as I have alluded to, the senior responsible officer, Natalie Forrest, met the trust on 2 March for a bilateral roundtable with its senior leadership team to discuss its proposed plans for the build. I understand that those discussions were productive, and they are ongoing. I, too, met the trust in February, with the SRO, to discuss the plans for a new build at Kettering General Hospital. As my hon. Friend mentions, I was fortunate enough to visit the hospital in September 2019 to see for myself, and to be shown by him at his most persuasive, what the case for investment was. As he mentioned, I also had the pleasure of answering a Westminster Hall debate last October on the need for the urgent care hub being funded and built in Kettering, during which I also had the pleasure of confirming the funding, following on from the announcement and promise made by my right hon. Friend the Prime Minister to my hon. Friend. Today’s debate is probably not the right time to discuss this, but I know that all three of my hon. Friends have highlighted the wider opportunities of combining health and social care for vulnerable adults in Northamptonshire.

Our ambitious programme to build 40 new hospitals by 2030 has confirmed funding of £3.7 billion at this point. That is an important and extremely positive start, but we continue to work with Her Majesty’s Treasury on future funding for the whole programme, including for Kettering, and the profiling of the availability of that funding. That is not the reason I am not, at this Dispatch Box, being gently lured by my hon. Friend into a clear commitment today on firm profiling of financial allocations for Kettering at this stage; rather, it is because deciding the funding level for a project of this scale, at this early stage in the process, before full design, exploration or scoping is complete, would not be the most appropriate approach, although I take his point about, for want of a better way of putting it, the need for speed.

Our experience of Government projects and, specifically, the lessons learned from the early work of the Chancellor’s Project Speed taskforce and from the experts in the Government’s Infrastructure and Projects Authority tell us that confirming funding for large, complex projects too early, before all parties are fully agreed on the future approach, can put the project and its overall cost at risk. I am not in any way questioning the ability of my hon. Friend’s local hospital trust to come up with a costed and extremely effective project plan, but it is important, as he would expect, that we are conscious of the need to ensure that we get value for money and the best outcomes for his constituents.

In conclusion, I pay tribute to my hon. Friend, and to my hon. Friends the Members for Wellingborough and for Corby, for the work they are doing to support the redevelopment of Kettering General Hospital. I know that my right hon. Friend the Secretary of State gave the commitment to my hon. Friend the Member for Wellingborough that he would meet him, and I know that he will honour that. I reiterate my commitment that if any point, on perhaps at a more detailed or granular level, my hon. Friend the Member for Kettering wishes to meet me or the SRO again, I am happy to do that. Perhaps as we see progress made in opening up our country again, I might be able to enjoy the pleasure of returning to Kettering to see him and his hospital trust in person. I look forward to continuing to work with him to making sure that this ambitious and innovative approach to building new hospitals is a success.

My hon. Friend is, rightly, incredibly proud of his team in Kettering. He and his colleagues have done a fantastic job of gently inducting me into quite how fantastic the team are and what is needed to get this project going. It was one of the first visits I made when I became a Minister holding this role, so I have a particular affection for that area—I am an east midlands MP, so I know it well. I hope that we will continue to be able to work hand in hand with his trust, the national programme and Her Majesty’s Treasury to move this programme forward at pace. I know it is what he wants, but most importantly I know it is what his constituents would want and expect of us.

Question put and agreed to.