Mount Vernon Cancer Centre
Edward Argar Excerpts(4 years, 8 months ago)
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The Minister for Health (Edward Argar)
I thank the hon. Member for Harrow West (Gareth Thomas) for securing this debate on the future of Mount Vernon cancer centre. I know that the provision and location of radiotherapy services is of great interest to many hon. Members, and I was delighted to meet my hon. Friend the Member for Stevenage (Stephen McPartland) and my right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) earlier this month to discuss aspects of this matter as it relates to their constituencies and their campaigns for a satellite radiotherapy centre, working with Mount Vernon to help serve their constituents.
The hon. Gentleman rightly paid tribute to the work of the staff at Mount Vernon—not just the work that they are and will be doing to help deal with coronavirus, but the work that they do day in, day out, for his constituents and many others. I join him in paying tribute to their work and dedication. He has made a typically courteous but powerful case for investment in that hospital and in the services that serve his constituents. If I may, I will say a little bit about cancer care more broadly before I turn to the specifics of what he has said regarding Mount Vernon.
Improving cancer treatment remains a priority for this Government, and survival rates are at a high. Since 2010, rates of survival from cancer have increased year on year, but we know there is more to do nationally. That is why the NHS long-term plan states how the Government will achieve their ambition of seeing three quarters of all cancers—
Sir Oliver Heald (North East Hertfordshire) (Con)
Will the Minister give way?
Sir Oliver Heald
I am grateful to the Minister for giving way, and apologise to the sponsor of the debate, the hon. Member for Harrow West (Gareth Thomas). Does the Minister agree that both of the preferred options put forward for Mount Vernon include a satellite radiotherapy centre in our area of Hertfordshire? I hope that will form part of the Minister’s thinking, as it seemed to during our recent discussion.
Edward Argar
I am grateful to my right hon. and learned Friend for his intervention. He is right about the importance of satellite radiotherapy centres for his constituents and for large parts of Hertfordshire. He and others have made a powerful case and I have considerable sympathy for it. I find it compelling and I am looking at ways in which we might be able to deliver on that for his constituents and those of other colleagues in the area.
As I was saying, the long-term plan sets out how the Government will achieve their ambition for three quarters of all cancers to be detected at an early stage, and for 55,000 more people to survive cancer for five years in England each year from 2028. That plan includes providing new investment in state-of-the-art technology to transform the process of diagnosis and boost research and innovation. NHS England has committed more than £1.3 billion in funding over the next five years to deliver the long-term plan’s commitments on cancer.
I suspect that the hon. Member for Harrow West will say, “That is great, but what does it mean for Mount Vernon, my constituents and my constituency?” He has set out the background of what has gone on at Mount Vernon cancer centre, and of the review. He will know that the strategic review of that centre’s long-term future was launched by NHS England and NHS Improvement in May 2019. The review began with an independent clinical advisory group visiting the site and speaking with staff and patients. Its report advised that the current service model was not clinically sustainable, as the hon. Gentleman has said, and recommended that leadership of services from a specialist tertiary cancer provider would be key to future service development and sustainability, staff recruitment and retention, and enabling patient access to clinical trials. I am happy to provide him with more details in writing, if that is helpful. Indeed, if I am unable to answer all of his detailed questions in the course of today’s debate, I will write to him with detailed answers as soon as possible.
The hon. Gentleman asked specifically how the review would work, who was leading it, and who would be involved in it. It is being led by a programme board chaired by the NHS regional director of specialised commissioning and health and justice for the east of England. That board includes representatives from Healthwatch Hillingdon, Healthwatch Hertfordshire, London and the East of England Cancer Alliance, as well as local sustainability and transformation partnerships, clinical commissioning groups and a number of acute hospitals. They all sit on that board and are active participants. If it is helpful to the hon. Gentleman, rather than simply giving him the job titles, I can seek to furnish him with some names—those of the senior leadership, at least.
The hon. Gentleman said that the independent clinical advisory group made recommendations for short-term actions, including addressing urgent backlog maintenance of existing clinical facilities and the strengthening of acute oncology services. The current provider, East and North Hertfordshire NHS Trust, supported those recommendations. In January of this year, following evaluation of proposals from interested trusts, University College London Hospitals NHS Foundation Trust was selected as the preferred provider, subject to a period of due diligence. Depending on the outcome of that due diligence, the contract for running the site should transfer in April next year, with UCLH providing additional leadership support for that site over the next 14 months.
The hon. Gentleman mentioned backlog maintenance, which I have touched on. He is right to have done so, because, as he knows, backlog maintenance has increased in recent years. Although the trust received £33 million of central capital in 2019 to tackle critical infrastructure issues across the estate, monitored by NHSE&I, I know that it continues to be of concern. Although I do not wish to prejudge the future capital settlement and the capital spending review, the hon. Gentleman has powerfully made the point that the capital needs of his hospital and his trust should be considered in any future allocations of capital funding.
The hon. Gentleman raised the issue of access to brachytherapy services, which will be wrapped up in the review that is currently under way. Regarding the future location of services, I can assure him and hon. Members that options for the short-term and long-term future of the centre are being actively considered by the clinical advisory group and NHSE&I, with the local area and the hon. Gentleman’s hospital at the forefront of their thinking. When I write to him, I suspect he might wish me to be a little firmer in my reassurances. As far as I am able, subject to that review, I will endeavour to do so.
The hon. Gentleman also talked about staffing issues at the hospital. Existing clinical leads at Mount Vernon have increased their leadership duties at the hospital alongside their clinical responsibilities. Recruitment of a full-time clinical director will take place in conjunction with the new provider, once it is appointed. The hon. Gentleman mentioned the business case for appointing additional staff to the acute oncology service that has been developed and submitted to NHS England. My understanding is that the business case has been approved and recruitment has begun. I will take up with NHS England his request that he have sight of it and—ideally from his perspective, I think—that it be made publicly available. I do not know what the answer will be, but I will certainly ask that question, because it does not seem an unreasonable request.
Regarding whether the three linear accelerators due for replacement this year are going to be replaced, my latest understanding is that although East and North Hertfordshire NHS Trust has not yet agreed its full capital programme for the 2020-21 financial year, it has identified a requirement for capital funding, which the board will consider in that context. As soon as I hear the outcome of those decisions, I will write to the hon. Gentleman, who, as ever, makes his case politely but forcefully. More broadly, as he will be aware, NHS England has invested £130 million in the modernisation of radiotherapy across England, ensuring that older linear accelerators—that is, radiotherapy machines—used by hospitals are upgraded. We have made significant progress. I think the hon. Gentleman’s request acknowledges that, but he is essentially saying, “Yes, I have been given a promise, but please make sure that the delivery follows.” The decision on the trust’s investment priorities rightly sits with the board, and we will wait for that decision, but I will make sure that what the hon. Gentleman has said is communicated to the board. I suspect he will make sure of that as well, but I will ensure that the board is aware of his views.
The hon. Gentleman suggested quarterly updates to track progress against a basket of key indicators or asks in the context of the action plan. I hesitate to give a clear commitment until I have had the opportunity to talk to the trust and NHS England, but what I will say—I hope gives him an indication of my thinking—is that it sounds like an eminently practical and reasonable request to ensure that he, other interested parties and his constituents are kept informed about and engaged with a process that will, of course, be of concern to them but also of interest as well. It sounds reasonable—I am not aware of a factor that makes it unreasonable—and I will certainly press that point, because I think it is a sensible way forward.
In response to my right hon. and learned Friend the Member for North East Hertfordshire, I have touched on satellite radiotherapy centres. Alongside working with the Mount Vernon Cancer Centre, we are proactively looking at providing satellite radiotherapy centres for his constituents in the northern part of Hertfordshire and around Stevenage. It is too early to say exactly how we might do that, but I am determined to work proactively with colleagues to see if we can achieve it.
We are committed to the digitisation of paper records, which the hon. Member for Harrow West mentioned, to enable effective patient care and enhanced patient safety. The digital transformation plan, which will include the digitisation of patient care records, is under way for Mount Vernon’s main acute services and is expected to conclude in May 2020. I understand that the commitment to do that—to support and fund it—remains unchanged. If anything has changed, I will make sure that he is updated as appropriate.
There are a number of hon. Members present. I suspect they are not here to hear my or the hon. Gentleman’s eloquence, but possibly that of other hon. Members and, indeed, my right hon. Friend the Financial Secretary to the Treasury, who will take part in the debate that will start in a few minutes. Given the interest, however, I will see if it is appropriate to put in the Library a copy of my letter to the hon. Gentleman so that it is on the record.
If the hon. Gentleman thinks it would be useful, I am happy to meet him and to visit Mount Vernon with him to meet the staff, to hear the executive team’s thinking on what is going on, and to see it for myself. He raised a number of detailed and precise questions and important points. In the short time I have had, I have sought to reassure him and address a number of them, but I look forward to the opportunity to give him a more detailed answer in writing following the debate, and to visit him.
I reassure hon. Members that cancer, and improving cancer treatment and care, remains a key priority for the Government and the Department. We, along with NHSE&I and other arm’s length bodies, are working hard to ensure that the hon. Gentleman’s constituents and those of all hon. Members are provided with the best care.
Although cancer care and cancer services are the responsibility of the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), given that a large amount of what the hon. Gentleman has talked about relates to performance and to capital and funding, which are in my portfolio, I will endeavour to maintain a personal direct interest in the issue, in partnership with my hon. Friend, to make sure that we both give it the attention it deserves and that he and his constituents have a right to expect.
Question put and agreed to.
NHS Funding Bill
Edward Argar ExcerptsTuesday 4th February 2020
(4 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts Amendment Paper: Legislative Grand Committee (England) Amendments as at 4 February 2020 - (4 Feb 2020)
Alex Cunningham
I am very grateful, Madam Deputy Speaker.
Amendment 2 concerns spending on mental health services and the Secretary of State’s plans to achieve parity of esteem. Mental illness is often not viewed as a risk to human life, but it is exactly that. In 2018, according to the Samaritans, 6,507 deaths in the United Kingdom were registered as suicides—an increase of 10.9% on the previous year. That means that nearly 7,000 people did not believe that there was help, or another way out of what they were going through.
It can be hard for adults to talk about the feelings that come from being mentally unwell. The words are in their vocabulary, and it may be simple enough to string them together into a sentence, but it is incredibly difficult to say them out loud. I can only imagine how hard it must be for children to express how they are feeling when something is not right. Perhaps they do say the words that are in their heads, but they are not taken seriously. It is a scandal that there are suicidal children as young as 12 who are having to wait more than two weeks for a mental health bed. By not viewing mental illness as life-threatening, we are letting generations down.
There is much debate about what causes mental illness and what is the best form of treatment, but it can take several visits to a GP for people to be taken seriously about not being OK—although many GPs, of course, respond immediately. When parents are fighting for their unwell children to be taken seriously and receive the urgent care and treatment they need, it is horrifying for that to be delayed.
At this stage I should pay tribute to my former colleague Paul Williams, who was the Member of Parliament for Stockton South. He is a GP, and as a member of the Health Committee he spoke extensively about health matters, but locally he took on the child and adolescent mental health services. He knew, as I did because we shared the same area, that it was taking well over two years for young people to be seen by CAMHS. As a direct result of his work, that ended, up to a point, because some children who were due to be seen quickly were actually seen when they should have been. However, those long waits still exist in our area. As we heard earlier from the right hon. Member for South West Surrey (Jeremy Hunt), the former Health Secretary, sometimes children are just not taken seriously.
It is right for the Secretary of State to answer to the House on exactly what the Department is doing, because this is a matter of life and death. Not only the House but the country needs assurance and answers. The state of mental health services will only get worse unless we take action to deliver what is required. The additional money is more than welcome, but I see the amendment as the first, necessary step to provide the funds that are so desperately needed. Equally important is the ability to monitor what those funds are being spent on, and how.
There are many other services on which people depend heavily, including some that we may take for granted, such as smoking cessation services. There is widespread concern about existing funding for services to help people stop smoking. Nearly a third of local authorities no longer provide specialist “stop smoking” services. Stopping smoking is not just a matter of nicotine patches or vaping; people need behavioural support as well, particularly pregnant women, children, and people who are already unwell. One ward in my constituency has some of the highest incidences of smoking in families—whole families smoking—but we also have some of the highest incidences of smoking during pregnancy, and that is not good for the unborn child.
We cannot afford to lose the progress that we have made. We have made tremendous progress over the years, but we need local services that are effective and properly funded. The Government also need to return to funding the multi-media approach to smoking cessation services. I was particularly pleased to learn last week that research has shown that the ban on smoking in cars when a child is present has produced a 75% drop in children being exposed to cigarette smoke in a car. I led on that issue during my first few years as an MP, through private Members’ Bills and a ten-minute rule Bill. The Bills were unsuccessful, but I was delighted when the Government adopted my clause a few years later. We still need to be ambitious and bold about helping people to quit smoking, but services need the resources. I hope the Minister will commit to ensuring that such services are provided, whether for mental health or for smoking cessation, and that they are fully funded so that we can continue to make real progress in that area.
Finally, I shall turn to the matter of capital. The Minister has already heard me talk about the needs in my own constituency. In one ward—the same one I referred to earlier: the Town Centre ward in Stockton—men live 14 years less than those in the Prime Minister’s constituency. His constituency is getting a new hospital, but there are no plans yet for us. However, I have good news for the Minister, because the plan for our hospital is still sitting there. I met the chief executive of North Tees and Hartlepool NHS Foundation Trust just two weeks ago, and she told me that they were ready to dust off the plans again and see how we could provide a hospital. At the time we asked for £100 million from the Government as a guarantor in order to make the project work. The numbers do work, and the health inequalities need to be addressed.
We need to be able to attract the best doctors and clinicians that we can to address the problems in our society. The heart problems are higher on average than anywhere else in the country. We have smoking problems, as I have mentioned, with their related lung and respiratory problems. We also have the legacy of our heavy industry on Teesside, where men who have now retired are in extremely ill health but sometimes cannot get the support they need because we do not have the experts locally to provide it.
In my final sentences, I appeal to the Minister to meet me and the trust members so that we can sit down and talk about this project.
Alex Cunningham
I am glad that he is nodding his head. Ten years ago, the Tory-Lib Dem Government cancelled the project, despite the fact that it was a priority for the country and for the national health service, so I hope that we can now have a meeting and actually start to motor on this. I am pleased to see the Minister smiling, and I hope that he can leave me smiling as well.
The Chairman of Ways and Means (Dame Eleanor Laing)
The hon. Gentleman is absolutely right in regard to the procedure. If we finish this part of the procedure before 5.29 pm, there will be a very short time for the next part of the procedure. If this part of the consideration of the Bill goes to 5.29 pm, there will indeed be no time for the Report and consideration stage. That is correct, as is normal in any Bill, but I am grateful to him for pointing it out so clearly.
Edward Argar
In the 15 or so minutes remaining to me, I will endeavour to address all the points that have been raised. First, I thank Members on both sides of the House for their contributions and for the amendments that have been tabled. I particularly thank the shadow Minister for his typically reasonable tone in making his case forcefully. This Committee debate has been a wide-ranging and important one.
I will turn in detail to the amendments shortly, but, in the interests of time, I will swiftly address the requests for meetings or visits. The hon. Member for Stockton North (Alex Cunningham) was right when he said that he saw me nodding. I will be very happy to meet him, my hon. Friend the Member for Stockton South (Matt Vickers) and the chief executive of his hospital trust to discuss the issues that he raised. I will also be very happy to meet the hon. Member for Harrow West (Gareth Thomas) separately to discuss the issues that he raised.
Edward Argar
I will give way very briefly, because the hon. Gentleman is eating into his own time.
Pete Wishart
The Minister is in a very accommodating mood. Does he accept that this Bill has funding implications and consequences for health spending in Scotland?
Edward Argar
As has been very clear throughout the progression of this Bill so far, there are Barnett consequentials, which will be dealt with in the usual and appropriate manner.
I will turn to the detail of the amendments in a moment, but before I do, let me say that my hon. Friend the Member for Telford (Lucy Allan) addressed the debate in Westminster Hall just before the general election. In that, I said that if her constituents wanted a strong voice in this place, they should vote for her. I am very pleased that they did exactly that. Her speech shows exactly why.
This legislation is a simple Bill of two clauses. The substantive clause—clause 1—puts a double-lock duty on the Secretary of State and Her Majesty’s Treasury to ensure that NHS England will receive, as a minimum, £33.9 billion extra a year by 2024, enshrining in law the NHS England revenue budget rise in line with the Government’s manifesto commitment. The Bill has deliberately been drawn narrowly to focus on that core commitment.
Theo Clarke (Stafford) (Con)
This Bill is about funding, but buildings and services are key to delivering on our national health service priorities, so may I highlight the importance of the A&E at the County Hospital in Stafford and ensuring that we are supporting NHS services in my constituency?
Edward Argar
My hon. Friend is a sound and vocal champion for her constituents in Stafford. I am sure that she will continue to champion their cause, and I am happy to meet her to discuss the specific issue she raised.
I turn to amendment 3, in respect of capital-to-revenue transfers. Clause 1(2) ensures that the funding specified in the Bill can only be used for NHSE revenue spending, meaning that day-to-day spending for the NHS is protected. As we have highlighted in the House previously, the Government have made a range of capital commitments to the NHS, including the commitment to 40 new hospitals. Nevertheless, going to the point in the amendment itself, we have been clear that the transfers from capital revenue should have only been seen as short-term measures that were rightly being phased out, and we are doing so. My right hon. Friend the Member for South West Surrey (Jeremy Hunt), the former Secretary of State, did, however, set out why a degree of flexibility is required, and we would not believe that a blanket ban set in legislation was the right approach.
Edward Argar
I will not, if the hon. Gentleman will forgive me, as I only have 10 minutes or so left.
There are sometimes very good and logical reasons why adjustments between capital and revenue are needed. As the former Secretary of State highlighted, in some cases, for perfectly good reasons a capital pot may not be spent fully within a year and there is an opportunity to achieve patient good from transferring it. While I take his point and believe it is right that we should continue to move away from such transfers, I would not wish to see that rigidly set in legislation.
Amendments 2 and 1, and new clauses 1, 2, 3 and 9, relate to mental health services both for children and adults, and accountability to Parliament and reporting mechanisms. We have rightly seen considerable interest in mental health in this debate, so I will seek to address both those points together. I begin by paying tribute to Paul Farmer of Mind, Sir Simon Wessely, Professor Louis Appleby, the Mental Health Foundation, Rethink Mental Illness, YoungMinds, the Royal College of Psychiatrists, and a host of other individuals and organisations up and down the country, for their fantastic work in making mental health such a feature in our debates and in the public consciousness. It is absolutely right that they have done so.
I pay tribute to the Under-Secretary of State, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), and her predecessor, my hon. Friend the Member for Thurrock (Jackie Doyle-Price), who brought to the role of mental health Minister passion, dedication and a determination to make a difference. I should also reference some former Members of this House: Norman Lamb, who did so much in this area; the former Prime Minister, David Cameron; and of course my right hon. Friends the Members for South West Surrey and for Maidenhead (Mrs May), who ensured that it was front and centre of this Government’s commitment.
I want to be totally clear that the Government are fully committed to transforming mental health services. That is why we enshrined in law our commitment to achieving parity of esteem for mental health in the Health and Social Care Act 2012. As my right hon. Friend the Member for South West Surrey said, that is driving real change on the ground. We have also committed to reforming the Mental Health Act 1983 to provide modernised legislation. I would also highlight that at £12.5 billion in 2018-19, spending on mental health services is at its highest ever level.
We have made huge strides in moving towards parity, but there is still so much more to do. We are ensuring, through the NHS long-term plan, that spending on mental health services will increase by an additional £2.3 billion by 2023-24. This historic level of investment in mental health is ensuring that we can drive forward one of the most ambitious reform programmes in Europe. It will ensure that hundreds of thousands of additional people get access to the services they need in the lifetime of the plan. I flag that up because we can and will always strive to do more, and it is right that we are always pressed by this House to do so. While proposals for a ring fence in mental health spending are understandable, the approach that this Government have already set out, with long-term commitments to funding, is already driving the results we wish to see.
I now turn to new clause 9, tabled by my hon. Friend the Member for Newton Abbot (Anne Marie Morris). If I may, I will also address new clause 2 in this context because there is a degree of overlap. I welcome my hon. Friend’s new clause. Although I hope that, as she indicated, she will not press it to a vote—and I heard what the hon. Member for Twickenham (Munira Wilson) said in respect of hers—the sentiment behind it is a good one, particularly the focus on outcomes and outputs rather than simply inputs and the amount of money going in, and on adopting a holistic approach. I know that my hon. Friend the Member for Newton Abbot recently met the Secretary of State to discuss the matter, and I am happy to meet both her and the hon. Member for Twickenham. While we do not believe it is the right approach to set additional reporting mechanisms in legislation over and above the different reports that NHS England and the Secretary of State already make to Parliament, which offer opportunities for debate, we are happy to consider whether, within the existing reporting mechanisms, there is a way to better convey to the House and the public more widely the progress we are making against those targets.
The NHS long-term plan represents the largest expansion of mental health services in a generation, renewing our commitment to increase investment faster than the overall NHS budget in each of the next five years. Not only will spending on mental health services increase faster than the overall NHS budget as a proportion, but spending on CAMHS will increase at an even faster rate. The hon. Member for Twickenham was right to highlight the importance of CAMHS. In our surgeries, we have all had constituents come to see us who are deeply worried and concerned about the mental health and welfare of their children, be that in relation to eating disorders, which I focused on when I came to this place, or a range of other factors. We are committed to delivering the NHS long-term plan to transform children and young people’s mental health services, with an additional 345,000 children and young people being able to access those services.
While we are deeply sympathetic to the spirit behind the amendments on mental health spending, we do not believe that putting a ring fence into the Bill is the appropriate way forward, given the work already being done, the money already being spent and the outcomes already being delivered. We believe that the reporting requirements are already extensive and varied. They already give the public and Parliament the opportunity to scrutinise the work of the Department and NHS England. We are happy to look at ways in which those reports might be more accessible and include different metrics, but we believe it would be wrong to legislate on them at this point.
As I said on Second Reading, this is a simple Bill. It has two clauses, of which one is substantive. It has a single, simple aim: to enshrine the funding settlement behind the NHS long-term plan in law. It delivers the funding that the NHS said it needed and wanted, and it delivers on this Government’s pledge to do so within three months of the election. In the light of that, while the amendments are clearly well intentioned and we appreciate the spirit behind them, they are unnecessary additions to the Bill, and I urge their proposers not to press them to a vote. I appreciate that Members have indicated their intention to press some amendments to a vote, I urge them, in the short period remaining before Committee ends, to reflect a little longer on whether they might reconsider and not move their amendments to a vote.
Madam Deputy Speaker
The hon. Gentleman’s analysis is not wrong. The knife has fallen. The House voted some days ago to provide three hours, or four hours in total, for consideration of this Bill, and it is indeed the case that because those four hours have passed, there is no time for debate on consideration and Report—that is absolutely correct. There is also no time for debate on Third Reading.
As to whether the Government did not provide sufficient time, or Members of this House took up all the time in the early part of the proceedings, that is not a matter for me to judge; I have merely facilitated it. Members might have decided not to speak for very long at the beginning. If so, the hon. Gentleman and his colleagues would have had the opportunity to discuss the matters that they had tabled. I thank him for his further points.
Does the Minister intend to move a consent motion in the Legislative Grand Committee?
Edward Argar
indicated assent.
The House forthwith resolved itself into the Legislative Grand Committee (England) (Standing Order No. 83M(3)).
[Dame Eleanor Laing in the Chair]
Health and Social Care
Edward Argar Excerpts(4 years, 9 months ago)
Ministerial CorrectionsRead Full debate Read Hansard Text Read Debate Ministerial Extracts
Mr Perkins
I do not know whether the Minister is aware, but we have a winter every year. We have had one for the past 71 years, and yet these are the worst A&E waiting times in history, and they are the culmination of the policies that his party has followed for the past nine years: the cuts in social care, the number of GPs driven out of practices, and this Government’s failure on prevention. All of that has led us to the worst A&E waiting times in history, and the Minister’s answer does not start to look at the failure that he has delivered.
Edward Argar
Well, as I pointed out to the hon. Gentleman—he may not have heard this—demand in A&E has significantly increased this winter. He asks about GPs. I am sure he fully supports our clear commitment to 50 million more GP appointments and 6,000 more GPs. I am sure he also welcomes, in his own constituency, the £19 million investment by this Government in 2017 in a new urgent treatment centre, which will serve his constituents and is due to start work this summer.
[Official Report, 28 January 2020, Vol. 670, c. 664.]
Letter of correction from the Minister for Health, the hon. Member for Charnwood (Edward Argar):
An error has been identified in the response I gave to the hon. Member for Chesterfield (Mr Perkins).
The correct response should have been:
Edward Argar
Well, as I pointed out to the hon. Gentleman—he may not have heard this—demand in A&E has significantly increased this winter. He asks about GPs. I am sure he fully supports our clear commitment to 50 million more GP appointments and 6,000 more GPs. I am sure he also welcomes, in his own constituency, the £19 million investment by this Government in 2017 in a new urgent treatment centre, which will serve his constituents and is due to start building works this summer.
Oral Answers to Questions
Edward Argar Excerpts(4 years, 9 months ago)
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Mike Hill (Hartlepool) (Lab)
The Minister for Health (Edward Argar)
My right hon. Friend the Secretary of State has had no discussions with the CCG on the future of services at the University Hospital of Hartlepool.
Edward Argar
I am conscious that both the energetic Mayor Ben Houchen and the hon. Member have campaigned on working to reinstate accident and emergency and maternity services at Hartlepool’s hospital. Although there are currently no plans that I am aware of to change the model of services, and reconfiguration matters are for the CCG, I am happy to meet him and the Mayor to discuss the hospital if that is useful.
Dehenna Davison
Thank you, Mr Speaker. As another north-east MP concerned about local healthcare, I asked the Prime Minister two weeks ago about retention of the stroke service at Bishop Auckland Hospital. Has the Minister made any progress on that point?
Edward Argar
My hon. Friend is already a doughty champion and spokesperson in this House for her constituents on health matters—indeed, she was just that in yesterday’s Second Reading debate on the NHS Funding Bill. I am pleased to inform her that my right hon. Friend the Secretary of State has already met the chief executive of the NHS and the regional NHS director responsible and discussed this matter with them.
The Minister for Health (Edward Argar)
Winter is the most challenging time of year for our NHS, when cold weather and an increase in flu cases place additional pressures on the service. As ever, the NHS staff have done an amazing job this winter, and the NHS has seen a significant increase in demand, with 1 million more patients attending A&E in 2019. The December figures, when compared with those in 2018, show a 6.5% increase on attendance at A&E.
Mr Perkins
I do not know whether the Minister is aware, but we have a winter every year. We have had one for the past 71 years, and yet these are the worst A&E waiting times in history, and they are the culmination of the policies that his party has followed for the past nine years: the cuts in social care, the number of GPs driven out of practices, and this Government’s failure on prevention. All of that has led us to the worst A&E waiting times in history, and the Minister’s answer does not start to look at the failure that he has delivered.
Edward Argar
Well, as I pointed out to the hon. Gentleman—he may not have heard this—demand in A&E has significantly increased this winter. He asks about GPs. I am sure he fully supports our clear commitment to 50 million more GP appointments and 6,000 more GPs. I am sure he also welcomes, in his own constituency, the £19 million investment by this Government in 2017 in a new urgent treatment centre, which will serve his constituents and is due to start work this summer.[Official Report, 29 January 2020, Vol. 670, c. 6MC.]
Imran Hussain
Between winter 2018 and winter 2019, the proportion of A&E attendances in Bradford that were seen within the four-hour target fell by seven percentage points, putting patients at risk and overstretching already pressured staff. In Health questions in October last year, I warned the Minister of these very real dangers, but he refused to meet me even to discuss the matter. Will he now answer the question as to why further funding was not made available to stop staff and patients at Bradford Royal Infirmary being put at risk?
Edward Argar
I remind the hon. Gentleman that Bradford treated more people in A&E this winter than in any previous one, and although he may have omitted to do so, I want to pay tribute to and thank the staff at Bradford for that work. The Conservative party is the party that is investing in our NHS, our A&Es and our staff, and the hon. Gentleman should welcome that.
Justin Madders (Ellesmere Port and Neston) (Lab)
I think it is time that we shook this Government out of their complacency. On their watch, the four-hour A&E waiting target has never been met, and performance is getting worse each month. It is no wonder they are putting so much effort into getting rid of it. We agree with the president of the Royal College of Emergency Medicine, who said:
“Rather than focus on ways around the target, we need to get back to the business of delivering on it.”
Does the Minister agree?
Edward Argar
First, 1.7 million more people are being seen within the four-hour target now than before 2010. I hope that the shadow Minister will acknowledge that that reflects the significant increase in demand due to the number of people going through the system. He talks about the review of standards. That is a clinically-led review, and I am sure he would want to let those clinicians lead it. We will see what it reports and will consider its recommendations when they come back to us. In the meantime, we are getting on with investing in our NHS, and improving services.
Penny Mordaunt (Portsmouth North) (Con)
Daniel Zeichner (Cambridge) (Lab)
The Minister for Health (Edward Argar)
I would not draw that conclusion about my right hon. and hon. Friends. What I would say, though, is that I want all staff to feel that they can speak up and have the confidence that anything they raise will be taken seriously. That is why I requested on 17 January that NHS England and NHS Improvement commission a rapid and independent review into how the West Suffolk NHS Foundation Trust has handled this issue. I will be happy to update Members, including the hon. Gentleman, when that review reports.
Holly Mumby-Croft (Scunthorpe) (Con)
Edward Argar
I appreciate the concerns raised by my hon. Friend about that matter. I understand that the changes, which have been made for patient safety reasons, are temporary, with a review to follow led by the Humber, Coast and Vale cancer alliance. As we monitor the results of the review closely—I will continue to take a close interest in this matter—either I or my right hon. Friend will be happy to take up her invitation for a visit.
Ian Byrne (Liverpool, West Derby) (Lab)
Jack Brereton (Stoke-on-Trent South) (Con)
Edward Argar
I am grateful to my hon. Friend, who, along with my other hon. Friends who represent Stoke, has raised this issue in the past; they are right to highlight it. My hon. Friend is absolutely right that Labour’s PFI deal has left the trust burdened with debt. My Department’s PFI centre of best practice supports trusts in ensuring best value, and I will happily ask it to work with him. Yesterday I also committed to meet him and my other hon. Friends to discuss this matter.
Dr Rosena Allin-Khan (Tooting) (Lab)
Throughout the election there were empty promises from the Conservatives, and one of those promises was to tackle the social care system—but there is still no Green Paper. There are dementia patients who are trapped in hospital due to an inadequate social care system, and yet this Government still do nothing. How many more families have to suffer before this Government act?
Antony Higginbotham (Burnley) (Con)
Edward Argar
My hon. Friend, like his colleagues, has already proved himself to be a doughty champion for his constituency. The urgent care centre at Burnley General Hospital will continue to play an important role in meeting urgent care needs locally, but he is right to highlight the broader importance of Burnley as part of the health ecosystem in his area. I would be delighted to meet him.
Meg Hillier (Hackney South and Shoreditch) (Lab/Co-op)
There are real concerns in east London about the big delays in the breast cancer screening programme, meaning that many women are not getting their first screening until close to their 53rd birthday. Will the Minister meet me and other concerned east London MPs to ensure that we tackle that, to the benefit of our constituents?
NHS Funding Bill
Edward Argar ExcerptsMonday 27th January 2020
(4 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Minister for Health (Edward Argar)
As ever, this has been an excellent and wide-ranging debate, with constructive speeches from both sides of the House. As my right hon. Friend the Secretary of State has said, the NHS is the people’s priority and it is our priority. Today, we take another important step towards delivering on our manifesto commitment: our pledge to the people to enshrine in law the record funding for our NHS.
The NHS has a long-term plan to build a sustainable health and social care system that can rise to the challenges of the future. The NHS has told us how much funding it needs to deliver that plan and the Government are providing it. By 2023-24, the NHS will have an additional £33.9 billion to spend each year. I welcome the Opposition’s willingness to support the Bill, as indeed they should; it provides an iron-clad guarantee to deliver the NHS funding. In doing so, we are giving the NHS the certainty it needs to invest now for the long term.
Mr Steve Baker (Wycombe) (Con)
As the Opposition Front Benchers are engaged in a conversation and not listening to my hon. Friend, will he repeat the point he made about the Government giving NHS England the money that it has asked for?
Edward Argar
I have already stated that at the Dispatch Box and my hon. Friend makes the point even more forcefully.
Let me turn to the shadow Secretary of State, the hon. Member for Leicester South (Jonathan Ashworth). Like the shadow Minister, the hon. Member for Ellesmere Port and Neston (Justin Madders), he is a good man and genuinely believes passionately in our NHS, and he campaigned passionately for his party. I have to say, though, that I was a little surprised by his comments suggesting that the Bill caps spending. Had he read the Bill, he would have found that, only four lines in, it states clearly:
“an amount that is at least the amount specified”.
That is a floor, not a cap.
More broadly, I suggest to the Opposition that they may want to be a little cautious when talking about the financial situation that we inherited. Labour’s legacy, as so wonderfully encapsulated in a letter by the former Chief Secretary to the Treasury, the right hon. Member for Birmingham, Hodge Hill (Liam Byrne), is that “there is no money”. It is this Government who have invested in supporting and rebuilding our nation’s finances to give us the strong economy that allows us to invest in our NHS.
Jonathan Ashworth
I am grateful to the Minister for his comments about me. He is a fellow Leicestershire MP and I know that he is passionate about the NHS as well.
If the Bill is not a capped-expenditure Bill, why are the numbers in it in cash terms and not the real-terms percentage increases that the previous Secretary of State, the right hon. Member for South West Surrey (Jeremy Hunt), set out to the House in June 2018?
Edward Argar
Because the cash set out in the Bill is the money that the NHS is going to be getting as a floor.
The shadow Minister rightly raised the issue of mental health. My right hon. Friend the Secretary of State was rightly clear that spending on mental health provision will increase the fastest under the proposals in the Bill, with spending on children’s mental health increasing the fastest of all. I am sure the Opposition will welcome that.
My right hon. Friend the Member for South West Surrey (Jeremy Hunt) rightly highlighted the quantum of spending and how that compares to other countries around Europe and, indeed, in the OECD. I pay tribute to him, because a lot of what we are talking about today is based on the foundations that he built when he did such a fantastic job as Secretary of State.
The hon. Member for Central Ayrshire (Dr Whitford) and my hon. Friend the Member for West Aberdeenshire and Kincardine (Andrew Bowie) rightly alluded to the Bill’s impact on Barnett consequentials and spending in Scotland. As the hon. Lady will know, the Barnett consequentials will apply. My hon. Friend highlighted the fact that not only the NHS in England but the NHS in Scotland faces challenges that we must all step up to meet.
My hon. Friend the Member for Newton Abbot (Anne Marie Morris) highlighted the need for us to focus not just on inputs but on outcomes and what we achieve with the money that we invest. That is exactly what the Secretary of State is determined to do.
The hon. Member for Nottingham South (Lilian Greenwood), a fellow east midlands Member, highlighted the need for capital investment in her local hospitals in Nottingham. I am happy to meet her to discuss that further, if that would be helpful to her.
Let me turn to maiden speeches. My hon. Friend the Member for Darlington (Peter Gibson) made an excellent maiden speech. As Members have said, his predecessor Jenny Chapman was respected and well liked in the House. I suspect that, given his speech, he will achieve exactly the same distinction. He spoke forcefully and powerfully on behalf of his constituents. I am sure that they will find him a doughty local campaigner in their interest.
My hon. Friend the Member for Ashfield (Lee Anderson) paid tribute to his predecessor, Gloria De Piero, who was my shadow when I was a Justice Minister. He was right to pay tribute to her, because she was a fantastic colleague to have in this House. None the less, he achieved a fantastic result. As a fellow east midlands MP, I know his constituency well. It is a fantastic place and his constituents are very lucky to be represented by him. He is a local man standing up for his community. He also spoke movingly of his journey—if I may put it this way—from pit to Parliament, and the power of social mobility, of aspiration and of opportunity. He reminded me of a former colleague of ours and a good friend of mine, Sir Patrick McLoughlin, who made the same journey. He ended up in the Cabinet, so I will be watching my hon. Friend’s inevitable ascent carefully.
The hon. Member for Feltham and Heston (Seema Malhotra) touched on, among other things, Heston health centre. Again, as ever—as in my previous role—I am happy to meet her to discuss that. The hon. Member for Kirkcaldy and Cowdenbeath (Neale Hanvey), in an eloquent but forceful maiden speech, clearly put this House on notice that he will always speak up for his principles and his beliefs, and, while we may on occasion disagree on policy, I doubt we will disagree on his passion and determination to champion his constituents’ interests.
My hon. Friend the Member for Dover (Mrs Elphicke) also focused on achieving outcomes. She touched on the tragic death of Tallulah-Rai Edwards. I extend my condolences to the family, but may I also say that my hon. Friend the Parliamentary Under-Secretary of State for patient safety will be happy to meet her to discuss that in more detail.
It is always a pleasure to meet the hon. Member for Easington (Grahame Morris) and to hear from him. We have met previously, and he and the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Bury St Edmunds (Jo Churchill), are due to meet again to discuss this matter in a few weeks’ time when we will pick it up further.
Let me turn now to my hon. Friend the Member for Birmingham, Northfield (Gary Sambrook). May I pass on my congratulations to his sister on the birth of Freddie and pay tribute to all staff, as he did, working in our amazing NHS for the work that they do. Many hon. Members paid tribute to them, including the hon. Member for Rhondda (Chris Bryant), and my hon. Friend the Member for Banbury (Victoria Prentis)—I have no doubt that I will be hearing from her about the Horton on many occasions in the future. My hon. Friends the Members for North Dorset (Simon Hoare) and for South Dorset (Richard Drax) made powerful pleas for investment in their community hospitals and in their local health infrastructure. I am a regular visitor to the constituency of my hon. Friend the Member for North Dorset, so I look forward to visiting both colleagues in due course.
As well as talking about Crawley Hospital, my hon. Friend the Member for Crawley (Henry Smith) highlighted the need for Gatwick airport to be included in the conversations on the coronavirus, and I know that my right hon. Friend the Secretary of State will have heard what he said, and is already factoring that in.
Before concluding, I will touch very briefly on two other contributions: my hon. Friends the Members for Stoke-on-Trent Central (Jo Gideon) and for Stoke-on-Trent North (Jonathan Gullis)—and indeed my hon. Friend the Member for Stoke-on-Trent South (Jack Brereton), who was not in his place. They have all highlighted the issue of the private finance initiative. I am happy to meet them to discuss it further.
Let me turn now to my hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) and the hon. Member for Mitcham and Morden (Siobhain McDonagh). I have to say that my hon. Friend made a very strong case for the benefits that this investment will bring for all those who are served by his local trust. I encourage the hon. Lady to engage with this process and engage with the benefits that this investment will bring.
Edward Argar
I am afraid that, with one minute to go, I will not give way.
The nation’s health and social care is the people’s priority and it is also our priority. Key to delivering on our long-term plan, and the NHS’s long-term plan, is giving the NHS the investment that it needs. This Bill does exactly that. We are delivering on the people’s priorities and on our pledges to the NHS, and I commend the Bill to the House.
Question put and agreed to.
Bill accordingly read a Second time.
Stepping Hill Hospital
Edward Argar Excerpts(4 years, 9 months ago)
Commons ChamberRead Full debate Read Hansard Text Read Debate Ministerial Extracts
The Minister for Health (Edward Argar)
I thank my hon. Friend the Member for Hazel Grove (Mr Wragg) for securing a debate on this extremely important topic. I know well of his commitment to pursuing the subject of Stepping Hill on behalf of his constituents and ensuring that it continues to be focused on by Ministers and the House more broadly. He is a forceful but always courteous local champion for Hazel Grove, and his constituents are lucky to have him. He ensures that their voice is heard loud and clear in this place. I have recently discussed Stepping Hill with him, as well as with my hon. Friend the Member for Cheadle (Mary Robinson). I pay tribute to her for her work on this issue and to other Members across the House. As has been evidenced by the interventions in the debate, Stepping Hill Hospital is important not only to one or two constituencies but across the region.
My hon. Friend the Member for Hazel Grove is right to highlight how well-regarded Stepping Hill Hospital is by those it serves and its key role in treating some of the victims of the dreadful Manchester Arena attack in 2017. He is also right to raise the challenging performance at Stockport NHS Foundation Trust, of which Stepping Hill Hospital is a part. It is right that I echo his comments in paying tribute to the hard work and dedication of all who work in our NHS and in Stepping Hill, as we should whenever we speak about healthcare in this House. Day in, day out, our amazing NHS workforce deliver world-class care. My hon. Friend highlighted the challenges in the recent A&E performance statistics, but Stepping Hill does perform very well in a number of other areas. For example, in the statistics for some of its cancer treatments it performs well. There is a challenge, which he mentioned, particularly in but not limited to A&E.
Winter is the most challenging time of the year for the NHS, when a number of environmental and external issues, such as cold weather and an increase in flu and other viruses, place additional demands on the service. Of the short-term actions that have been taken and will be taken, and in recognition of recent challenges, oversight and additional input for Stockport and Stepping Hill have been ongoing via NHS England’s national oversight model, which brings national resource and expertise to bear in supporting them. The Trust has also been working with the emergency care intensive support team—commonly known as ECIST—a clinically led national NHS team, to help health and care systems deliver high-quality emergency care. Its intervention has improved the flow of the patient journey through the hospital and achieved a reduction in the number of long length of stay patients.
As my hon. Friend mentioned, the Stockport trust received the largest additional amount in funding given to any trust in the north-west this winter. This has enabled it to open additional beds and to employ additional senior medical staff. Specifically, there is £1.68 million to staff two additional wards; £453,000 to provide consistent medical staffing to additional beds to reduce length of stay; and just over £100,000 to provide additional seven-day acute medical cover, which is also to reduce the length of stay.
I should say that Stepping Hill should be commended for the tremendous achievements it has secured. Its stroke centre in Stockport has been rated the best in England, Wales and Northern Ireland for the third time in five years, and a new service has been launched at Stepping Hill Hospital to provide extra support for mums and dads-to-be who have previously experienced stillbirth, late miscarriage or early neonatal death in previous pregnancies.
At local level, in addition to those broader achievements, additional clinical resources are being sought at Stepping Hill to help discharge patients more safely and more swiftly back into the community. Additionally, GP streaming, a process designed to ensure that less acutely ill patients can be seen more quickly, has moved to a seven-day model to provide enhanced levels of support over the winter period. As part of the wider round of capital work within the Stockport trust, a new frailty unit will be open in Stepping Hill from February, as an important short-term addition to its facilities and capabilities. By moving the existing unit, more space and capacity will be created in the acute medical unit so that more patients can be seen in a timely manner.
While all these interventions are beneficial in the short term, it is crucial that this is matched with investment in the infrastructure of the system for Stepping Hill, as my hon. Friend said, for the longer term. He and other hon. Members, including the hon. Member for Denton and Reddish (Andrew Gwynne), have highlighted some of the broader factors that continue to challenge the trust and hospital, such as the local demographics and the broader economic and societal factors affecting the health of the local population.
As my hon. Friend the Member for Hazel Grove said, the Government, through our new health infrastructure plan, are supporting more than 40 new hospital-building projects across the country, backed by £2.8 billion. We have also provided an extra £1.8 billion, including £850 million for 20 hospital upgrades. From this funding, Stockport NHS Foundation Trust has been awarded £30.6 million to build an emergency care campus at Stepping Hill. I must say that my hon. Friend and my hon. Friend the Member for Cheadle have both played key roles in securing this funding, but it would be right to say that hon. Members from both sides of the House and from the wider region have also played their part in making the case for this investment, and it is right that I pay tribute to all of them as well.
This funding will provide a three-storey, purpose-built campus, including an urgent treatment centre, a GP assessment unit, a planned investigation unit, a new ambulance access road and improved waiting areas. As with any improvements on a scale such as these, I am sure my hon. Friend the Member for Hazel Grove, and indeed all hon. Members, will recognise the importance of getting them right. This is why the development will be subject to a public consultation.
My hon. Friend, and other hon. Members, are right to be ambitious about getting on with this. I am pleased to see my hon. Friend the Member for High Peak (Robert Largan) in his place. He is a welcome addition to the Green Benches, and I know he will be a strong voice for High Peak in the House of Commons. His constituents are lucky to have him. He highlighted timescales, as did my hon. Friend the Member for Hazel Grove, and subject to public consultation and the development of plans, we hope that the business case and appropriate sign-offs and planning will take place this year, with construction beginning next year. I know my hon. Friend will wish us to go further and faster, and I am happy to take up his offer of a meeting. We will work together to see whether we can speed things up, but that is the timescale as it currently stands. More broadly, as well as investing in capital funding, the Government are also investing £33.9 billion more in our NHS, to ensure that its running costs, and day-to-day costs, are fully invested in.
My hon. Friend would not forgive me if I did not touch on his remarks about car parking. He has previously raised concerns about the lack of available parking at Stepping Hill, and the Government have listened. As he said, and as per our manifesto commitment, with the roll-out beginning in April this year, all 206 hospital trusts will move towards providing free car parking for disabled blue badge holders, parents of sick children who are staying overnight, and staff who are working nightshifts. Alongside improving access and cutting costs for those individuals, my hon. Friend is right to highlight the issue of capacity. As he said, we have earmarked a significant pot of capital for that, but we do not yet have a list of hospitals that will receive that funding. We are currently undertaking a data exercise to understand capacity versus demand in hospital trusts, and I know he will make a strong case for his hospital.
Taken together, the initiatives outlined this evening reflect the desire to excel at Stepping Hill, and they bode well for the ambition to turn around performance in other areas. I look forward to visiting, and I am happy to take up my hon. Friend’s kind invitation—I suspect that invitation may also attract Members from other constituencies, if it works with their diaries, and I look forward to working with him to find a date for that visit.
In conclusion, the nation’s health is our biggest asset. The NHS is the people’s priority, and it is our priority. We will continue to work with my hon. Friend and other hon. Members across the House, and with Stepping Hill and Stockport Foundation NHS Trust, to drive the improvements in performance that my hon. Friend’s constituents rightly expect, and that I know all who work at Stepping Hill are determined to deliver.
Question put and agreed to.
Health and Social Care
Edward Argar Excerpts(4 years, 9 months ago)
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The Minister for Health (Edward Argar)
It is a pleasure to wind up a debate on such an important issue as our NHS and social care, and it was marked by the many well-informed contributions from hon. Members on both sides of the House. Those contributions reflect the pride we all feel in our NHS and how important it is to our constituents.
Before moving on to the maiden speeches, I want to highlight the powerful contributions from my right hon. Friend the Member for Old Bexley and Sidcup (James Brokenshire) the former Secretary of the State, my right hon. Friend and for South West Surrey (Jeremy Hunt), and the hon. Member for Kingston upon Hull West and Hessle (Emma Hardy). I can tell the hon. Lady that I believe we already have a date in the diary for February, so I look forward to meeting her and discussing the issues she raised.
Given the short time remaining, I intend to focus on today’s maiden speeches, so I hope the House will forgive me if I do not take interventions on this one occasion. All the maiden speeches we heard today were of an incredibly high quality, and all those who have spoken will play a full role in keeping both Front-Bench teams on their mettle in the months and years ahead.
I will start with my hon. Friend the Member for Bishop Auckland (Dehenna Davison). She spoke deeply movingly about her father and what drives her politics. I congratulate her on already bringing the same passion and determination to ensure that her constituents’ views are heard that she demonstrated in her fantastically successful election campaign. I suspect that we shall all hear a lot more from her in the months ahead.
My hon. Friend the Member for Watford (Dean Russell) mentioned that he had never really thought he would be here, but having heard him I can see exactly why he is here and why the people of Watford put their trust in him. In response to one of his comments, I say that one’s height—I look at you Madam Deputy Speaker, and I think of the Lord Chancellor and my old friend the former Member for Rutland and Melton—does not directly correlate to the influence that one can have in this place.
The hon. Member for East Dunbartonshire (Amy Callaghan) made an eloquent speech setting out passionately the principles that govern her politics and that she brings to representing her constituents. Her dedication to her constituency and to Scotland was clear in her remarks.
The hon. Member for Vauxhall (Florence Eshalomi) showed that she will be as strong a voice for her constituents as her predecessor. She spoke very movingly about her mother, and I hope she will let me say that I suspect her mother would have been deeply and rightly proud if she could have seen and heard her speech in the House today.
My hon. Friend the Member for Carshalton and Wallington (Elliot Colburn) spoke powerfully on behalf of his constituents. He fought an excellent campaign, and he spoke charmingly and well about his predecessor. He spoke up for his hospital, and I know he will continue to do so, but he was also clear in informing his constituents of why they should ignore the scaremongering they may have heard over many years. In him, they have a strong local champion.
The hon. Member for Twickenham (Munira Wilson) steps into big shoes—indeed, big dancing shoes—and, judging by her speech today, I think she will have no trouble filling them. I hope her contribution today will be the first of many from her on health-related matters.
There may be something about Members for Ealing North, but the hon. Member for Ealing North (James Murray) demonstrated that they all display a good sense of humour in this place, and he is continuing that tradition. He was active as a deputy Mayor of London, and I am sure he will bring that experience, expertise and commitment to his new role. I welcome him to the House.
The hon. Member for Enfield North (Feryal Clark) spoke movingly and powerfully about the diversity of her seat. She spoke about the importance of that diversity, and of how we should all protect, encourage and champion such diversity. I am sure she will be a diligent and determined champion not only for that but for all her constituents.
The hon. Member for Luton North (Sarah Owen) spoke powerfully of the importance of social care and getting it right. Again, she demonstrated a sense of humour in her remarks, which I am sure will mark her future contributions. We look forward to hearing more from her.
Finally, I have known my hon. Friends the Members for Sevenoaks (Laura Trott), for North West Norfolk (James Wild) and for Peterborough (Paul Bristow) as friends over many years, and they have served at the heart of Government and in this place in previous roles. They bring that same dedication and talent to serving their constituents. They spoke incredibly well, demonstrating their experience and passion, and I suspect we will be hearing a lot more from all three of them in this House and in national politics.
The election has broken the deadlock in this House, giving our country a majority Government who are not just getting Brexit done but repaying the trust placed in us by the public to deliver the people’s priorities. The Opposition Front Bench may speak about their commitment to the NHS, but this Government and this Secretary of State for Health and Social Care are actually delivering on our commitments. They are ambitious commitments, but they are the right commitments.
We are delivering the longest and largest cash settlement in the history of the NHS, and we are providing the investment that the NHS itself said it needed. We are delivering the biggest and boldest hospital building programme in a generation. We are delivering new treatments and new technologies to deliver world-class, world-leading and safer care. We are working to find consensus to address the injustices in social care and the inequalities in mental health. For too long, Governments of all shades have not given those issues the priority that this Government will now give them.
It is clear that the Conservative party is the party of the NHS. We have protected and prioritised the NHS for 44 years of its 71-year history when we have been in government. Under this Conservative one nation Government, under this Conservative one nation Prime Minister and with this Queen’s Speech, we will continue to do so. These legislative reforms will strengthen our NHS and put it on a secure and stable footing for the future.
We will ensure a publicly funded NHS, free at the point of use and accessible according to need not ability to pay, and an NHS that is not for sale and never will be; an NHS true to its founding principles but, crucially, an NHS that is ready for the challenges of the future. It is there not only for our generation but for future generations. The NHS belongs to all of us; it is the people’s NHS and this Government are there for it. I commend this Queen’s Speech to the House.
Question put, That the amendment be made.
Ministerial Corrections
Edward Argar Excerpts(4 years, 9 months ago)
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The Minister for Health (Edward Argar)
I would like to inform the House that a written answer I gave on 8 October 2019, to the former hon. Member for Blackpool South contained an error and wish to correct the formal record.
In my reply, I was incorrectly advised and stated that ‘The Chair at Blackpool Teaching Hospitals NHS Foundation Trust and the Chair at East Lancashire Hospitals NHS Trust sought the views of NHS England and NHS Improvement on the possibility of merging services and provision between the two trusts.”
The correct position is that the Chair at Blackpool Teaching Hospitals NHS FT did seek advice from NHS England and NHS Improvement (NHSEI), as to whether they would support a proposal for a joint Chief Executive Officer, working across both organisations. These conversations did not involve discussion around merging services or provision.
Both trusts provided NHSEI with a number of assurances that having a joint Chief Executive working across two organisations would bring actual benefits and improve the care of patient populations in Blackpool and East Lancashire. NHSEI confirmed that they would be happy with those arrangements pending the appropriate approvals from within their own organisations. On 1 May Kevin McGee was appointed as interim Chief Executive of Blackpool Teaching Hospitals NHS Foundation Trust, while remaining as Chief Executive and Accountable Officer of East Lancashire Hospitals NHS Trust. On 4 October 2019 this joint appointment was made permanent.
Powers under Section 56A and 56AA of the NHS Act 2006 enables an NHS Foundation Trust (FT) to merge with another FT or NHS Trust. The trusts are required to make a joint application to NHS Improvement for any merger to go ahead. Where a merger involves an NHS Trust, this must also be supported by the Secretary of State. Any decisions by the two trusts need to reflect the views of local stakeholders, including local Members of Parliament.
[HCWS31]
Departmental Update
Edward Argar Excerpts(4 years, 9 months ago)
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The Minister for Health (Edward Argar)
As set out clearly in our manifesto, the NHS is this Government’s No.1 domestic priority. We are supporting the NHS through our historic funding settlement, which will see the NHS budget increase by £33.9 billion within the next five years. This will soon be enshrined into law.
I recently set out my priorities for the system[1]. This statement highlights the work that has already begun to deliver on these priorities, including our major manifesto commitments of:
50,000 more nurses;
40 new hospitals over the next decade;
ending unfair hospital car parking charges;
and 50 million more GP appointments.
Infrastructure
Work has already begun to deliver our manifesto commitment on free hospital parking for those who need it. This Government recently announced that from April 2020, disabled people, frequent out-patient attenders, parents of sick children staying overnight, and staff working night shifts will be able to access free hospital car parking. This change will benefit thousands of NHS patients and visitors in England and mean that across the country we have a consistent approach whereby those with the greatest need will no longer have to pay for parking. We will also consider car parking capacity across the country, and how improved technology will reduce burdens for hospitals, and take away stress for visitors.
Prevention
Community pharmacies play a crucial role in helping people stay healthy and prevent pressure on hospitals. In October 2019, as part of our ‘pharmacy first approach’, the community pharmacist consultation service was introduced. This means people with minor illnesses or who need medicine urgently have been referred to local pharmacies. More than 100,000 patients have had appointments with expert pharmacists in the last 10 weeks, relieving pressure on GPs and A&E apartments.
People
As we begin 2020, the Year of the Nurse and the Midwife, we are embarking on the biggest nursing recruitment drive in decades, backed by a new universal support package. Nursing students on courses from September 2020 will now benefit from guaranteed, additional support of at least £5,000 a year to help with living costs, some students could be eligible for up to £8,000 per year. It is expected to benefit more than 35,000 students every year. The funding will not have to be repaid by recipients.
The new year’s honours list for 2020 celebrated the incredible work taking place in the health and social care sector all around the UK. This included senior leaders Professor Dame Sally Davies (Chief Medical Officer between 2011 and 2019), Simon Stevens (NHS Chief Executive) and Lyn Romeo (Chief Social Worker).
Technology
We will use frontline technology to improve patients’ experience, provide flexible working for clinicians, and help save lives.
This Government have announced that it will provide £40 million to reduce NHS staff login times, tackling one of the main technology frustrations facing NHS staff. Currently, many NHS staff have to log in to multiple computer programmes when tending to a patient, with each programme requiring its own login details. Some staff may need to log in to as many as 15 different systems. This outdated technology slows down and frustrates staff and prevents them from giving patients their full attention and the care they deserve. Harnessing the best technology will improve care for patients and improve the burden on our staff.
To further improve the digital capability of NHS trusts, we will set up a new ‘digital aspirant’ programme. This will provide funding over several years to assist with digital transformation projects so that trusts can provide safe, high-quality and efficient care.
Additionally, this Government have announced that a further £4.5 million will be given to local authorities to develop digital adult social care projects to support the most vulnerable in society to live independently for longer and improve information sharing across the NHS and social care.
[1]https://policyexchange.org.uk/pxevents/keynote-speech-by-the-rt-hon-matt-hancock-mp/.
[HCWS30]
Hospital Improvement Plans: VAT Rules
Edward Argar Excerpts(4 years, 10 months ago)
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The Minister for Health (Edward Argar)
Madam Deputy Speaker, it is a pleasure to see you back in the Chair in your new role as Deputy Speaker and Chairman of Ways and Means.
I congratulate the hon. Member for Bristol South (Karin Smyth) on securing this debate. I know this is an important subject for her, as she has raised it on many occasions, but she is right that capital—the buildings our NHS operates out of—is actually an important subject for all of us. While it is a shame that there are not many Members in the Chamber, I hope that quality makes up for a lack of quantity. That is certainly the case with her speech, but it is a pleasure to see the hon. Member for Blaydon (Liz Twist)—who, if I recall correctly, held a debate on this subject almost a year ago—here as well.
The hon. Member for Bristol South was perhaps being unduly modest in her opening remarks about her knowledge of this subject and expertise in this area. While it is always a pleasure to see her speak about it, I always watch with a certain degree of trepidation, because she does know her subject extremely well. My knowledge of VAT and tax rules is rather more limited. Although I spent a period of time as a member of a primary care trust board many years ago, I suspect that my knowledge base will not be as deep as hers. However, I will endeavour to respond to all the points she has made. I recognise that the article she wrote that was published this morning on PoliticsHome highlights a number of these issues as well.
I will start by addressing the capital investment programme that the Government have set out and the impact of VAT on that, and then move on to the hon. Lady’s points about wholly owned subsidiaries and some of her subsequent points. In respect of the VAT position with the new health infrastructure plan hospitals—the new 40 hospitals we will be building—under the tax code VAT will be payable by hospital trusts involved in construction, reflecting that these are new builds and we would expect the appropriate HMRC regulations to be adhered to. However, as the hon. Lady touched on in setting out the background to the VAT rules, VAT chargeable on supplies of goods and services in the UK is collected by HMRC on behalf of the Government, so all moneys received in that way are reinvested in public services.
In addition, the funding provided for the 40 new hospital build projects and other capital schemes includes provision for the VAT charged by the suppliers involved in the developments. There may also be scope for an element of VAT reclaim on aspects of those projects, which will be determined and calculated on a case-by-case basis and in line with VAT regulations and rules. The overall funding allocation for the HIP has been built up by overall cost estimates of the schemes, inclusive of VAT. However, the final amount of VAT payable will be determined once the individual schemes have been fully scoped and costed. Current VAT rules will apply, and VAT recovery will be assessed for each scheme in line with the rules set out in section 41 of the Value Added Tax Act 1994 and the Treasury’s “Contracting Out Direction”. In broad terms, we have made allowance for VAT within the estimated costs of those schemes.
As the hon. Lady noted, it was outlined in the spring statement of 2019 that longer-term plans are currently being considered by Her Majesty’s Treasury to review the section 41 VAT rules, to potentially either allow for full VAT reclaim for NHS bodies on all their purchases of goods and services or remove VAT reclaims entirely from them. The VAT review or policy paper will publish a call for evidence in due course. While I know she would like me to give an exact date, I hope she will forgive me for not making announcements that are possibly more appropriate for Treasury Ministers to make. I will ensure that her request to know that date is conveyed to the Financial Secretary to the Treasury, and I hope that he will be able to respond to her swiftly with further information. In the context of the forthcoming call for evidence, I encourage her and others to contribute. She has a lot of knowledge and expertise in this area, and I suspect that in encouraging her to contribute I am pushing at an open door, because she will certainly do that. I know that the Financial Secretary will be pleased to hear from her.
The hon. Lady focused in both her article and speech on wholly owned subsidiaries, as did the hon. Member for Blaydon in her debate a year ago. While there can be VAT advantages of forming wholly owned subsidiary companies, we are clear that they cannot and should not be set up for the purposes of VAT avoidance, and we wrote to all provider trusts in September 2017 to remind them of their clear tax responsibilities. I may provoke the hon. Member for Bristol South, given her plea earlier, by saying that the origins of this position date back to 2004, subsequently consolidated in the National Health Service Act 2006, but she is right to highlight the changes in the 2012 Act. The position has evolved under Governments of both parties, but she is right to look at the future rather than where we have come from.
We expect all NHS providers to follow the guidance when considering any new arrangements or different ways of going down the wholly owned subsidiary route. There can be advantages in that route, as my predecessor, who is now the Brexit Secretary, set out, for employees in terms of flexibility and choice. There can also be commercial advantages for the NHS bodies setting them up, including things such as enabling providers to employ staff on more flexible and, in some cases, more generous terms and conditions—I emphasise the words “in some”; I see the hon. Member for Blaydon watching me carefully—as well as providing more efficient services in some cases to other trusts, being able to attract staff from the local employment market and giving greater flexibility to the operation of that organisation.
Liz Twist (Blaydon) (Lab)
The Minister said carefully that “some” staff may be advantaged. Does he accept that the vast majority of staff in low-paid jobs—often women—are not benefiting from this and are in fact losing out in pension contributions? When we met Treasury Ministers last year, we were told that it was for the Department of Health and Social Care to decide what its policy is. Will he now commit to redressing that?
Edward Argar
I thought I was going to provoke the hon. Lady to intervene, but it is none the less a pleasure that she has done so. She does highlight disparities, but I would say that it is wrong to suggest—even taking out wholly owned subsidiary companies within the NHS more broadly—that there is an exact commonality of terms and conditions, pension arrangements and so on; there are differences already.
What I will commit to do—I was going to mention this at the end, but I will say it now—is that I am very happy to meet both the hon. Lady and the hon. Member for Bristol South to discuss this more broadly in the context of Department of Health and Social Care responsibilities in the NHS, as well as the point the hon. Lady made about self-employed GPs and independent GPs. I am very happy to have that meeting with them. We may have to revert to the Treasury at some time on technical points, but I am very happy to have that meeting. I am very conscious that, in the two minutes or so I have left, there is a limit to how much I will be able to say, but I am happy to pick up other points in that subsequent meeting.
The hon. Lady is right about buildings. It is right that we are building 40 new hospitals and that we are investing capital in our NHS infrastructure, but she is also right to say that, yes, we shape those buildings, but in talking about place-based approaches, they shape us too and they shape our communities, so it is absolutely right that we get this right. On place-based commissioning, I was a cabinet member on Westminster City Council for many years—in the dim and distant past, when I had more hair and it was not grey—and I sat on the PCT at the same time, and where it works for local circumstances, there are clearly opportunities there as well. However, I do think that autonomy remains important, because while consistency and clarity are vital, so too is enabling local autonomy to address local needs and specific local circumstances, and I think we need to be a little bit careful about that.
I will conclude—with about a minute to go before you stop me, Madam Deputy Speaker—by saying I am sorry that we do not have more time for this debate, because it is an important debate. I am sorry there are not more Members here because it is something that would benefit all Members to be involved in. I look forward to any future such debates. I congratulate the hon. Lady on bringing this forward. She is right to highlight this issue, and I hope she will take an active part in putting forward her views to the Treasury review and call for evidence when that comes forward. As I say, I very much look forward to continuing this discussion—if not on the Floor of the House, in a meeting subsequently—and I hope and believe that we will be debating this at some point across the Floor of the House in the near future.
Question put and agreed to.