Health and Care Bill

Debate between Kevin Hollinrake and Edward Argar

Consideration of Lords amendments
Wednesday 30th March 2022 Commons Chamber

[Kevin Hollinrake (Thirsk and Malton) (Con)]

It is a pleasure to speak after my hon. Friend the Member for Darlington (Peter Gibson). He made some very strong points in his speech with which I absolutely concur. I want to speak to Lords amendment 80, and his constituency—I know it pretty well, having been there and spent a bit of time there prior to the last election—is the kind that will be affected by it. The Government’s decision is to resist that Lords amendment, which I cannot support. In my view, this is a classic policy for levelling down, not levelling up.

The Minister is absolutely right—both Ministers involved in this Bill are good friends of mine, and I do not want to make their lives more difficult in any shape or form—when he says that the policy across the board is a significant improvement on anything we have had before. That is absolutely right. He said that in his speech, and I agree with it, but I do not agree with him when he says that it is fair. I do not believe it is fair, and that must be the basic criterion on which we judge any proposals, not least these.

I think everybody, including the Minister, accepts that it is quite clear that a £900 million transfer is happening here, which was introduced just as the Bill went on to Report stage. That is a direct transfer of £900 million from household wealth to somewhere else. That is what it is: a transfer of assets—household wealth—to healthcare, the Treasury or wherever else it is going, because that is the way that council contributions are used when it comes to the speed at which somebody reaches the cap.

I could live with that, if we were trying to make the system more affordable, as the Minister says—if the burden was going to fall equally on everyone’s shoulders in different parts of the country. It also true to say that most people will not be affected, because only people on very long care journeys tend to be affected badly, but there are quite a few of them: according to the Department’s own figures, about 6,000 a year—10 people per constituency—would be affected in this way, and most of them have dementia. We know that there are 900,000 people with dementia in the UK today; according to the Alzheimer’s Society, there will be 1.6 million by 2040; and 70% of care home residents are dementia sufferers, and they are the sort of people who will suffer because of the changes. They have very long care journeys, and they move out of their house so it becomes one of the assets that we take into account when assessing how much people contribute to the care cap.

The Minister says we are making these changes to make the system sustainable. Well, okay, make it sustainable, but make it fair too. I do not believe that this is fair. I know I am comparing this with a system that never existed—my hon. Friend is right to say that—but one was proposed in which the council contributions would count in calculations of people’s contribution to the care cap. That is the change we have made—the specific measure to make the system more sustainable is that change, and that affects people with limited assets and wealth. We are balancing this on the shoulders of people with fewer assets and less wealth, and on certain areas as well, as people in some of the regions in the north that we represent tend to have fewer assets and less wealth.

Particularly affected are people who have wealth or assets worth between £75,000 and £150,000. The research provided by the Alzheimer’s Society is clear: under the Dilnot proposals, about 50% of people living with dementia benefited fully from the care cap—they reached the care cap. That was true across all the wealth quintiles—it was very fair. This is not. Only 13% of people in the least wealthy quintile will reach the cap, whereas 28% of the most wealthy will. Such huge disparity cannot be right, yet that is the change that we have made. That £900 million has been found from people with less wealth. That cannot be right, nor is it consistent with levelling up. Look at how different regions are affected: only 13% of people in the north-east reach the cap whereas 29% of people in the south-east do so. Previously, in almost every part of the country, about 50% of people did so. The cap was not as generous, but it was very fair across different wealth quintiles and different regions of the country. I cannot see how this is fair.

Instead of each of us having 10 people in our constituency affected, some will have more and those representing wealthy constituencies will have fewer. I and other Members representing the north-east will have more constituents affected by this change and less generously treated because of it. For that reason, and because in my view it levels down, I cannot support the Government and will vote against them this evening on Lords amendment 80.

[Edward Argar]

I am grateful to all colleagues who have spoken this evening. A number of the arguments were made on Report, and rightly, right hon. and hon. Members have reiterated some of those points where they felt it was appropriate. I will address a number of the points raised relatively briefly.

What we are legislating for in this Bill represents an evolution of our health and care system, and improved integration. My hon. Friends the Members for Gosport (Dame Caroline Dinenage) and for Winchester (Steve Brine) both spoke about carers. Young carers are included, which I hope reassures my hon. Friend the Member for Gosport. In respect of the statutory guidance, I hope that it will provide reassurance if I can set out that we will develop that guidance in partnership with Carers UK to ensure its input and so that it captures exactly the things that hon. Members have alluded to. Again, in statutory guidance, we will look at how to ensure that the duty to give people the information that they need is properly and effectively discharged.

I am grateful to my hon. Friend the Member for Broxbourne (Sir Charles Walker) and my right hon. Friend the Member for Maidenhead—she is now in the Chamber—for the work that they have done on the Bill to ensure that parity of esteem for mental and physical health is not forgotten and is explicit.

On a point made by the hon. Member for Oldham East and Saddleworth (Debbie Abrahams), I will clarify what I said earlier on the triple aim, which may give her a little reassurance, even if not necessarily sufficient reassurance. We have not created a quadruple aim or a fourth limb, but we have included a reference to health inequalities under the existing triple aim in the other place. It is not forgotten. I hope that gives her a degree of reassurance on that specific point.

Lords amendment 80 was the crux of much of the debate. I fear that many are comparing our proposals with something that was never done. We are significantly improving provision around the sustainability and affordability of social care. The Prime Minister was clear that he would grapple with the issue and resolve it. When the Opposition were in power, they had two Green Papers, one royal commission and one spending review priority on the issue and they utterly failed to address it. We are a Government who have made huge strides in creating a better system.

I listened, as always, with great care to my hon. Friend the Member for Thirsk and Malton (Kevin Hollinrake). I am sorry that he will not be joining me in the Lobby tonight. While I respectfully disagree with him, I know that he has thought long and hard about this matter and has strong and sincerely held views. With that in mind, I regret that we will have to ask the House to disagree with the Lords amendment on care metering.

Lords amendment 11 disagreed to.

Government amendment (a) made in lieu of Lords amendment 11.

Lords amendment 51 disagreed to.

Government amendment (a) made in lieu of Lords amendment 51.

Clause 140

Cap on care costs for charging purposes

Motion made, and Question put, that this House disagrees with Lords amendment 80.—(Edward Argar.)

Health and Care Bill

Debate between Kevin Hollinrake and Edward Argar

Report stage
Monday 22nd November 2021 Commons Chamber

[Kevin Hollinrake (Thirsk and Malton) (Con)]

May I take the Minister back to new clause 49, very briefly? He is right to point out that some measures that he has brought forward are more generous than previously proposed, but there is no doubt that the way that the cap works means that it is less generous for those with more modest assets. Does he not agree? How can that be fair?

[Edward Argar]

I simply take my hon. Friend back to my previous point: when compared to the current system, this is a significant improvement and step forward, particularly when taken in the round with the overall package of measures that see the floors go from £23,250 up to £100,000 and from £14,250 up to £20,000. We have to look at this issue in the round, considering all those aspects rather than purely one element alone.

--- Later in debate ---

[Edward Argar]

I am conscious of time, Madam Deputy Speaker, so I will try to cover some of the main themes that have emerged from today’s debate. I am grateful for the debate we have had today. The vast majority of what is contained in the Bill is exactly what the NHS said that it wanted and needed, and it is the right legislation being brought forward at the right time, to drive forward those priorities highlighted by the NHS in its 2019 consultation. The Bill drives forward integration not only within the local NHS within a region, but also greater integration with a local authority. It provides the foundations on which we can continue to build, as we move forward with greater integration of health and social care services that are designed to work around the individual, rather than in institutional silos.

Despite misleading claims by campaigners—and, indeed, by some Opposition Members—the Bill does not privatise the NHS. The NHS will always be free at the point of delivery. It has been in the hands of the Conservative party longer than it has been in the hands of any other party, and the Conservative party has put in place record investment in terms of resources in our NHS. What we propose in the Bill continues to build on that. Government Amendment 25 on ICBs is clear: ICBs are NHS bodies. They have always been NHS bodies in our proposals, and we have put in place provisions regarding conflicts of interest. Just to make sure, and given the misleading claims about private involvement, new clause 25 puts beyond doubt that ICBs are NHS bodies and must act in the best interests of the NHS. It is an amendment that is much stronger and much more effectively drafted than the alternatives put forward by the Opposition, because we believe in putting this question beyond doubt.

On the ICBs and ICPs, we have sought to be permissive rather than prescriptive, giving those local systems, within a national framework, the flexibility to deliver what they need to deliver for their local areas, which they know best.

I have been happy to accept amendments 102 and 114. I will continue to reflect on the points made by my hon. Friend the Member for Broxbourne (Sir Charles Walker); in the nicest possible way, I suspect that—rightly—he will not go away. The former Secretary of State, my right hon. Friend the Member for South West Surrey (Jeremy Hunt), set out very clearly the case for his amendment 114, which I was happy to accept, and the importance it places on patient safety.

My right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) has done a huge amount of work in this space—I pay tribute to her—and she is right: we will look very carefully in the statutory guidance at how we can emphasise that. I fear that my hon. Friend the Member for Newton Abbot (Anne Marie Morris) was not in her seat when I paid tribute to the work that she had done previously, but I put that on the record too.

On new clause 49, my hon. Friend the Member for Gosport (Caroline Dinenage), a distinguished former Care Minister, made the point extremely well that this is a significant improvement and step forward on where we currently are in respect of tackling the social care challenge.

[Kevin Hollinrake]

Will the Minister give way?

Oral Answers to Questions

Debate between Kevin Hollinrake and Edward Argar

Tuesday 17th November 2020 Commons Chamber

[Edward Argar]

I am delighted that my right hon. Friend the Secretary of State recently gave these plans the green light following independent advice from the IRP, and I am pleased that this will mean my hon. Friend’s constituents and, indeed, many others will benefit from a new state-of-the-art NHS hospital in Sutton. Patients and the public will now be engaged in shaping the detail of the new services; I encourage all local people to participate positively in that process and the council and others to get behind that scheme and that record investment by this Government in his area.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

What recent discussions he has had with the Chancellor of the Exchequer on reducing the economic effect of the covid-19 outbreak.

Covid-19 Restrictions: South Yorkshire

Debate between Kevin Hollinrake and Edward Argar

Wednesday 21st October 2020 Commons Chamber

[Edward Argar]

I hope that the hon. Lady will forgive me; I did not see the evidence to the Select Committees, as I was preparing to come to the House. However, as she will be aware, the SAGE paper that was published recently, in referring to so-called local circuit-breaker lockdowns, did not say it was a one-off and would solve the problem. We are confident that we are taking a proportionate and effective approach on a regional and local basis that will, assuming that compliance is there, continue to drive down infection rates effectively, coupled with an effective economic and financial support package agreed with local leaders.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

Although my thoughts are with the people of South Yorkshire and businesses in South Yorkshire, my primary responsibility is to people in North Yorkshire. Will my hon. Friend help to scotch any rumours that are circulating that North Yorkshire is about to go into tier 2 when its rate of infection is well below the national average? If there is any need to put us in a higher tier, will he look to do that on a district-wide level, where there is significant variation across North Yorkshire, rather than purely at county-wide level?

[Edward Argar]

If I recall correctly, I believe that my right hon. Friend the Secretary of State was able to offer my hon. Friend a reassurance relatively recently in the House in respect of the approach that he was looking to take in that context, and that still stands.

Social Distancing: 2 Metre Rule

Debate between Kevin Hollinrake and Edward Argar

Monday 15th June 2020 Commons Chamber

[Edward Argar]

Before I answer, may I put on the record on behalf of myself and my hon. Friends our very best wishes to the hon. Member for East Dunbartonshire (Amy Callaghan) for a swift and full recovery? I hope that the hon. Member for Central Ayrshire (Dr Whitford) will be able to convey our sentiments to her when they speak. The hon. Member for East Dunbartonshire is a member not just of the SNP family but of the family of this House, and we all wish her well.

The hon. Member for Central Ayrshire is well versed in these issues and is an eminent clinician in her own right. We have made it clear that the 2 metre rule taken in isolation is not the only factor. She is right to highlight the broader context: it is not just about distance, but about duration of contact, how close that contact was, and whether measures were in place to mitigate that, be it screens or other measures. She is absolutely right and, we must always remember that this is not a binary question—it is not just the 2 metre rule, or the distance rule, and nothing else. We must look at it in the round, as the Chancellor and, I believe, the First Minister of Scotland, rightly said. That is exactly what this review will be doing—looking at all those factors in the round, to come up with appropriate scientific and economic advice to the Prime Minister and Ministers so that they can make a balanced decision.

[Kevin Hollinrake (Thirsk and Malton) (Con)]

The Minister is absolutely right that the evidence is changing daily and that we have a menu of options to deal with the transmission of covid. Increasingly, face coverings look effective. Would it not be worth relaxing some measures, such as the 2 metre rule, which make the pubs and restaurants in Thirsk and Malton and every other constituency financially unviable, and tightening up in other areas, such as requiring the compulsory wearing of face coverings in shops, and in pubs and restaurants when moving to and from a table?

[Edward Argar]

My hon. Friend makes a very good point and, as ever, a gentle but clear plug for his constituency encouraging people, when it is safe to do so, to come and enjoy those businesses and that hospitality. He is right to do so, because I—like every other Member of this House, I am sure—have spoken to restauranteurs and those in the hospitality industry and pubs, who are all very clear about the impact that this has on the operation of their business. We are incredibly sensitive to that, but it comes down to making an appropriate judgment on the scientific evidence, balancing economic impact and keeping the disease under control. He is right to allude to other measures within that package or menu of options, which will of course be taken into consideration in the review.