Health and Care Bill

Debate between Baroness May of Maidenhead and Justin Madders

Report stage
Tuesday 23rd November 2021 Commons Chamber

[Justin Madders]

My hon. Friend is right that one of the criticisms we have levelled against the Bill is that it does not address the issues and challenges facing the NHS. I will take no further interventions, because I am conscious that many Members have contributions to make.

I will move swiftly on to our two amendments dealing with inequality and to new clause 64 in the name of my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams). To show that this is an NHS and social care Bill, not just an NHS Bill, local authorities need to be more involved and more emphasis must be placed on wellbeing and better outcomes. We support the NHS triple aim—improving health, quality of care and cost control are, of course, important functions. Nevertheless, we live in a country where significant inequalities remain, and narrowing those gaps should be a national priority.

Research from the IPPR last month highlighted the 10-year gap in life expectancy between a person living in the poorest community and a person in the best off. That gap doubles when we talk about healthy life expectancy. Tackling that disparity must be a priority in the Bill. The Secretary of State for Health and Social Care said in his first speech that said he wanted to tackle the “disease of disparity”, so why is that missing?

Turning to clause 39—one of my favourites—why it remains in the Bill is a mystery given that the previous Secretary of State, the right hon. Member for West Suffolk (Matt Hancock), who requested these powers, is no longer in the role. Perhaps he will give us his insight into that later on. It is the absolute antithesis of the Lansley view that politicians should be distanced from NHS operational issues and makes a mockery of the overall thrust of this Bill, which is about encouraging local decision making. It is no exaggeration to say that, taken literally, clause 39 and its accompanying schedule 6 require the Secretary of State to be told if there are, or even if there might be, proposals to vary service—even moving a clinic from one location to another nearby.

As has been pointed out by wise heads, the power is not one that many Secretaries of State should want to get involved in. A Secretary of State who used it could be accused of favouring certain areas or decisions for political purposes. The well-articulated fear is that it will be used to block necessary but unpopular changes and that expediency will rule. Such decisions should be left to the clinicians or maybe the health economists but not politicians. Labour opposes this new power and would gently say to the Minister, “Be careful what you wish for.”

Finally, the issues around discharge to assess are complex. As we worked our way through in Committee, we heard evidence from many stakeholders, and it is fair to say that views on the matter were polarised. We are led to believe, and have some confirmation, that this development is working well for some acute settings, helping ease the perennial and disruptive issues around delayed transfers of care, but in other places we hear voices calling for much greater caution and for tougher safeguards or even, as amendment 60 requests, to stop it altogether. While we have sympathy with amendment 60, it would only pose more problems for the NHS if it was passed, so we have opted in our amendment 73 just to tighten up on safeguards.

Of course the real solutions are far more complex and would require higher investment both in the NHS and in social care. It should be mandatory that all aspects of ongoing care have been properly discussed and agreed with the patient and carers prior to discharge. An assessment should include carers with special attention if a child carer is involved, and there is a concern that unpaid carers will not be identified and consulted at the point of discharge.

The system for step-down care outside acute hospitals must be adequate, and there must be sufficient high-quality and funded places in care settings of all kinds. We are literally a whole generation away from having that kind of system, even if the funding started to become available today. On a related point, new clause 63 from the hon. Member for St Albans (Daisy Cooper) also deserves support.

I will leave my comments there, as I know many hon. Members want to speak.

[Mrs Theresa May (Maidenhead) (Con)]

I rise to speak in support of amendments 93 to 98, whose purpose is very simple.

The Health and Social Care Act 2012 established parity of esteem between physical and mental health in their treatment in the national health service. The Bill is silent on the issue. I know that Ministers have given assurances, in a variety of ways, that it is not the Government’s intention to move away from that parity of esteem, but if that is the case, the answer is simple: accept the amendments. The Government do not even have to write them; they have been written for them. There would then be absolutely no doubt about the continued commitment to ensuring parity of esteem between physical and mental health.

Mental health was clearly in the long-term plan for the national health service that I was pleased to see introduced. It was there because of the need to accept, as Members across the House do, that for too long mental health has not been given the attention that it deserves. People who were suffering with mental health problems were not getting the services that they need.

It will take time to ensure that we can provide for all, but sadly the issue has been exacerbated by the pandemic. In March 2021, there were 26% more referrals for mental health services than in March 2019, before the pandemic. The Centre for Mental Health reckons that 10 million additional people will need mental health care as a result of the pandemic. I am particularly concerned about the impact on young people; I am sure that Members across the House are seeing young people in their constituencies whose mental health may have been suffering anyway, but has suffered even more as a result of the pandemic.

More people now require mental health services. The Government talk a lot about dealing with the backlog that is a result of the pandemic, but it is only ever spoken about with reference to surgery or operations. The great danger is that in their focus on dealing with that backlog, which we all accept is necessary, the Government will push the issue of mental health services to one side.

The amendments stand in the name of my hon. Friend the Member for Broxbourne (Sir Charles Walker), in my name and in the names of Members across the House—there is cross-party concern. I say to the Minister once again: it is very simple. If the Government wish to maintain parity of esteem between physical and mental health and ensure that people with mental health problems are given the services and care that they need, they must put uncertainty to one side, accept the amendments and make it clear that physical and mental health will be treated with parity of esteem in our national health service.

Oral Answers to Questions

Debate between Baroness May of Maidenhead and Justin Madders

Wednesday 10th July 2019 Commons Chamber

[The Prime Minister]

I absolutely agree with my hon. Friend that it is imperative for this House to deliver on the vote of the British people in 2016. I have said that on many occasions, standing at this Dispatch Box and elsewhere. I think it is important that we do that. We could already have done that—I am sorry, but I am going to return to this theme. We could already have done that, had this House supported the deal. It will be up to my successor to find a way through this to get a majority in this Parliament, but I agree that it is important that we do deliver trust in politics by saying to people, “We gave you the choice, you told us your decision, and we will now deliver on it.”

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

Q5. Vauxhall Motors in my constituency has a future if we can avoid crashing out of the EU without a deal, but my constituents are very concerned to hear in recent weeks the Prime Minister’s potential successors talk up the prospects of a no-deal Brexit. Will she tell them both in no uncertain terms that if they pursue that option, they will consign thousands of jobs in my constituency and beyond to history?

[The Prime Minister]

The hon. Gentleman could have voted to save jobs in his constituency—[Interruption.] It is no good Labour MPs trying to deny this. They had the opportunity three times to vote to leave with a deal, and three times they rejected it.

European Council

Debate between Baroness May of Maidenhead and Justin Madders

Thursday 11th April 2019 Commons Chamber

[The Prime Minister]

My hon. Friend is right to identify the uncertainties that businesses face and the actions they have taken in the face of those uncertainties. I hope businesses will see that by reaching out to the Opposition, the Government are genuinely trying to find a way through this, and to do so within a timescale that gives businesses that certainty as soon as possible.

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

Given that the Government’s motion on the EU last Tuesday could attract the support of only about 40% of her party’s MPs, if the Prime Minister were to reach an agreement with the Leader of the Opposition, what guarantees do we have that any deal will be supported by her own party?

[The Prime Minister]

The hon. Gentleman will see that support for the withdrawal agreement has been growing on this side of the House. As he knows, we are looking at whether we can find a point of agreement with the Opposition that will truly command a majority in this House, and enable us to get the necessary legislation through.

European Council

Debate between Baroness May of Maidenhead and Justin Madders

Monday 25th March 2019 Commons Chamber

[The Prime Minister]

The House was very clear after the first meaningful vote that it wanted to see change in a certain area, and the one thing the House positively voted for was to leave with a deal, with some changes to the withdrawal agreement. We negotiated changes to the withdrawal agreement—we negotiated legally binding changes to the withdrawal agreement. The House has not accepted those changes. I continue to talk to colleagues, because I continue to believe that it is better for this country to leave the European Union with a good deal.

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

The Prime Minister has often said that she considers the withdrawal agreement to be in the national interest. If she concluded that the only way she could get support for her deal in this House was to offer her resignation, would she do so in the national interest?

[The Prime Minister]

This is about making sure that we leave the European Union and do it in the way that is best for this country, and that is what the deal is about.

European Council

Debate between Baroness May of Maidenhead and Justin Madders

Monday 17th December 2018 Commons Chamber

[The Prime Minister]

Businesses have been clear that they want to see us leaving with a deal. They have welcomed the deal that we have negotiated and it is therefore in Members’ hands to recognise that when they come to vote.

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

Just so that I am clear, is the Prime Minister saying, beyond a shadow of a doubt, in all circumstances, that when her deal is voted down, she will not bring forward any option other than leaving without a deal?

[The Prime Minister]

I have been clear about the decision that Members will have to take. If the deal is voted down, it is very clear: we have the process set out in legislation that the Government will follow.

Exiting the European Union

Debate between Baroness May of Maidenhead and Justin Madders

Monday 10th December 2018 Commons Chamber

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

Many constituents have contacted me about the withdrawal agreement. I had hoped to speak in the debate later to put forward their views, as well as my own. The Prime Minister said earlier that she wanted to take Members’ concerns back to the EU. How can she do that if she shuts down the debate tonight—or do my constituents’ views not count?

[The Prime Minister]

I set out the position the Government are taking in the statement I gave earlier.

Oral Answers to Questions

Debate between Baroness May of Maidenhead and Justin Madders

Wednesday 12th September 2018 Commons Chamber

[The Prime Minister]

I have always said to this House that I believe a deal that is right for the UK will be a deal that is right for the European Union. I note not only that President Juncker said what my hon. Friend has commented on, but that he went on to say that

“after 29 March 2019, the United Kingdom will never be an ordinary third country for us…I welcome Prime Minister May’s proposal to develop an ambitious new partnership for the future, after Brexit. We agree with the statement made in Chequers that the starting point for such a partnership should be a free trade area between the United Kingdom and the European Union.”

Let me be very clear: when we leave the European Union, we will be an independent sovereign state—we will have control of our money, our borders and our laws—but I want to say to our closest allies in Europe, “You will also never be an ordinary third party for us.”

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

Q10. There is huge concern over proposals to take decisions on fracking away from local councils. This concern is seemingly shared by a prominent Conservative MP, who has a number of statements on her website, including that“local planning decisions should be returned to locally elected councillors”,and“local councils need the power to stop unsuitable developments”.The Prime Minister will I hope recognise these comments. She made them. Does she still agree with them?

[The Prime Minister]

It has always been the case, across the planning structure that we have here in the United Kingdom, that there are decisions taken at local level, but there are also decisions—sometimes those local decisions are referred—at a national level.

Leaving the EU

Debate between Baroness May of Maidenhead and Justin Madders

Monday 9th July 2018 Commons Chamber

[The Prime Minister]

The opportunity to join the TPP is something that my right hon. Friend the Secretary of State for International Trade has been championing since he came into office. He has been very clear on that particular issue. This morning, the Prime Minister of Australia said that he welcomed the interest that the United Kingdom was showing in the TPP. As we looked at the Chequers agreement, one of the things we looked at was whether it would enable us to join the TPP, and it would.

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

We know that on Friday night the entire Cabinet supported the Prime Minister’s position, but as of today, that is no longer the case for two of her now former colleagues. Can she tell us what further information has come to light in the intervening period to cause her colleagues to change their minds?

[The Prime Minister]

The Chequers agreement remains as it was: the agreement that we took on Friday. I did indicate collective responsibility at that time, and two members of the Cabinet have chosen to stand down.

Oral Answers to Questions

Debate between Baroness May of Maidenhead and Justin Madders

Wednesday 23rd May 2018 Commons Chamber

[The Prime Minister]

I thank my right hon. Friend for raising this issue and for highlighting it with the experience of children like Kaiya and Rajie. I know that she is doing a lot of work to raise awareness of the lack of donors from Asian backgrounds, particularly with her event today in Parliament. We support efforts to raise awareness of the need to recruit more stem cell donors from black, Asian and minority ethnic backgrounds. More than £20 million has been provided to NHS Blood and Transplant and Anthony Nolan for stem cell donations since 2015, and that includes very specific stipulations about the numbers of newly registered donors with units stored in the UK cord blood bank who must be from BAME backgrounds, and specific funding to support the recruitment of donors from BAME backgrounds. Of course more needs to be done. I am happy to voice my support for my right hon. Friend’s event, which I think is continuing to raise awareness of this important issue.

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

Q11. I am sure that the Prime Minister, like millions of other people, was glued to her TV set on Saturday watching an event of national importance—sadly, there was not a fairy-tale ending as Chelsea won the FA cup. That could be the last FA cup final played at Wembley before it is sold to an overseas owner. When the premier league is spending hundreds of millions of pounds every year on wages and transfers, does she agree that there is more than enough money in the game for there to be no need to sell off this iconic national asset?

[The Prime Minister]

That is a decision for the owners of Wembley. It is a private matter; it is not a matter for the Government.

UK/EU Future Economic Partnership

Debate between Baroness May of Maidenhead and Justin Madders

Monday 5th March 2018 Commons Chamber

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

Vauxhall motors in my constituency is fighting for survival, and we desperately need future trading arrangements in the automotive sector to be no less favourable than they are now. Can the Prime Minister give a guarantee on that today?

[The Prime Minister]

I set out very clearly in my speech on Friday why I separated goods trade from other areas of trade with the European Union. I have also set out how we can ensure that we maintain the integrated supply chains that are currently so important to industries such as the automotive industry.

Oral Answers to Questions

Debate between Baroness May of Maidenhead and Justin Madders

Wednesday 14th December 2016 Commons Chamber

[The Prime Minister]

I am sure the thoughts of the whole House are with our hon. Friend the Member for Grantham and Stamford (Nick Boles), and I wish him the very best for his recovery as he goes through this illness. I recognise the strength of feeling he has about the emergency services in his local hospital. I believe that those concerns are shared by our new hon. Friend the Member for Sleaford and North Hykeham (Dr Johnson). I can assure my hon. Friend the Member for Grantham and Stamford that the process that is taking place, which is looking at the development of local services, is about listening to local people, hearing the local voice and, above all, ensuring that the services available to people in their local area are the right services for that area and that they can be delivered safely and securely for local people.

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

Q7. At the last election the Conservative party manifesto said that“we will help local authorities keep council tax low for hardworking taxpayers, and ensure residents can continue to veto high rises”.Band D council tax payers in Ellesmere Port and Neston now face paying an extra £125 a year, with no veto, because of the Government’s failure to tackle the social care crisis. Will the Prime Minister now admit that her party’s pledge on council tax has been abandoned?

[The Prime Minister]

No. Obviously we have put the social care precept in place in recognition of the pressures on social care, but I am very pleased to say that we have seen many examples over the country of good local authorities ensuring that they are keeping council tax down, including the Royal Borough of Windsor and Maidenhead, which cut council tax for six years running.